Variations In Child Mortality Research Articles

The importance of extremes: The social implications of intra-household variation in child mortality

The extreme variation in child-rearing among women of the same polygynous household raises questions about the factors involved in child mortality and the social processes that magnify that variation. The extremes may not seem significant statistically and indeed are not widely reported, yet it is precisely the extremes of experience that generate the theories that alter action most. The spectacle of one wife having 90% of her children alive while her co-wife has 90% dead exerts enormous influence not only on people's beliefs but also on their practical responses in the face of the spectre of serial child death. A high divorce rate, wide inequalities among women and marriage strategies that favour large, rich households are some of the consequences; beliefs in repeatedly returning children and changelings focus blame on the children, while a premium is put on very early diagnosis and often drastic remedial action. Extreme suffering, though seldom spoken aloud, generates its own logic, its own corpus of relevant data.

Empirical findings on the association between education and child health status: Discussion

The 3 papers presented in this section attempt to explain variations in child mortality. They use regression models in which a large number of independent variables appear in a reduced form obtained from an underlying structural system. These papers, which are essentially multivariate analyses of infant mortality using micro or household data, manifest 2 general problems. The 1st problem is that education is 1 of the independent variables to these analyses and is of special interest to this conference. However, education is closely associated with other possibly strong determinants of infant mortality and, in general, data are unavailable on these other determinants. Education in these regression analyses tends to represent the pure effects of education and also the effect of the other socioeconomic variables with which it happens to be either statistically or causally related. The 2nd general area of concern is that none of the papers is able to shed much light on the precise mechanisms by which education might affect health condition and mortality. The 3 papers recognize these 2 problems and are unable to do much about them. The papers do, however, come up with several interesting findings. Simmons and Bernstein report as their main finding that postneonatal mortality is determined to an important extent by preferences within the family for additional male or female children. These preferences or attitudes lead to either to neglect or to extra care of new children, and hence have an important effect on mortality patterns. The education variable, relating to the education of the mother and father, is of somewhat less importance. Chowdhury reports that education is relatively unimportant as a determinant of mortality. He suggests that there may nonetheless be some indirect influence of education or health. The main finding of Rosenzweig and Schultz is that health care programs offered by the public sector, like free clinics and public hospitals, tend to be redistributive. The programs result in the greater reductions in mortality among the less educated segments of the population. Whether their education variable represents itself or income, the finding that the health programs are redistributive or egalitarian stands up either way.