ArticleBMC pregnancy and childbirth2021
Impact of high-risk fertility behaviours on underfive mortality in Asia and Africa: evidence from Demographic and Health Surveys.
Article in BMC pregnancy and childbirth, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Barriers and facilitators to accessing and utilising sexual and reproductive health services during the COVID-19 pandemic in Africa: a systematic review and meta-analysis.BMC health services research · 2024Pooled it
- Patriarchal norms and reproductive vulnerability: association between son preference and high-risk fertility behaviour in India.Tropical medicine and health · 2026Article
- Multilevel analysis of women's empowerment and maternal high-risk fertility behavior in Sub-Saharan Africa, 2011-2022.BMC pregnancy and childbirth · 2026Article
- High-risk fertility behavior among reproductive age women in extremely high and very high maternal mortality sub-Saharan African countries.Reproduction & fertility · 2026Article
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- Comparisons of cox semi-parametric and parametric shared frailty models: application for under-five children survival in sub-Saharan Africa.BMC public health · 2025Article
- Geospatial inequalities in women's malnutrition in Pakistan.BMC women's health · 2025Article
- Factors influencing high-risk fertility practices among women of childbearing age in Tanzania: using DHS 2022.BMC public health · 2025Article
- Individual, household, and community-level factors associated with high-risk fertility behaviour among Nigerian women: secondary analysis of the 2018 demographic and health survey data.Reproductive health · 2025Article
- Identifying determinants of under-5 mortality in Bangladesh: A machine learning approach with BDHS 2022 data.PloS one · 2025Article
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- The effect of maternal high-risk fertility behavior on child nutritional status in Sub-Saharan Africa: a propensity score-matched analysis.Frontiers in public health · 2025Article
- Air pollution and under-5 child mortality: linking satellite and IPUMS-DHS data across 41 countries in South Asia and Sub-Saharan Africa.BMC public health · 2024Article
- Association between high-risk fertility behaviors and neonatal mortality in Ethiopia: A multilevel mixed-effects logit models from 2019 Ethiopian mini demographic and health survey.Public health in practice (Oxford, England) · 2024Article
- Maternal High-Risk Fertility Behavior and Its Associated Factors in Hadiya Zone, Southern Ethiopia: A Facility-Based Cross-Sectional Study.Ethiopian journal of health sciences · 2024Article
- Association between sexual violence and multiple high-risk fertility behaviours among women of reproductive age in sub-Saharan Africa.BMC public health · 2024Article
- High-risk fertility behaviors and associated factors among married reproductive-age women in sub-Saharan Africa: A multilevel mixed-effect analysis of nationally representative data from 35 countries.PLOS global public health · 2024Article
- Article
- Multilevel bivariate analysis of the association between high-risk fertility behaviors of birth and stunting with associated risk factors in Ethiopia.Frontiers in nutrition · 2024Article
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5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundMaternal age < 18 or > 34 years, short inter-pregnancy birth interval, and higher birth order are considered to be high-risk fertility behaviours (HRFB). Underfive mortality being disproportionately concentrated in Asia and Africa, this study analyses the association between HRFB and underfive mortality in selected Asian and African countries.
methodsThis study used Integrated Public Microdata Series-Demographic and Health Surveys (IPUMS-DHS) data from 32 countries in sub-Saharan Africa, Middle East, North Africa and South Asia from 1986 to 2017 (N = 1,467,728). Previous evidence hints at four markers of HRFB: women's age at birth of index child < 18 or > 34 years, preceding birth interval < 24 months and child's birth order > 3. Using logistic regression, we analysed change in the odds of underfive mortality as a result of i) exposure to HRFB individually, ii) exposure to any single HRFB risk factor, iii) exposure to multiple HRFB risk factors, and iv) exposure to specific combinations of HRFB risk factors.
resultsMother's age at birth of index child < 18 years and preceding birth interval (PBI) < 24 months were significant risk factors of underfive mortality, while a child's birth order > 3 was a protective factor. Presence of any single HRFB was associated with 7% higher risk of underfive mortality (OR 1.07; 95% CI 1.04-1.09). Presence of multiple HRFBs was associated with 39% higher risk of underfive mortality (OR 1.39; 95% CI 1.36-1.43). Some specific combinations of HRFB such as maternal age < 18 years and preceding birth interval < 24 month significantly increased the odds of underfive mortality (OR 2.07; 95% CI 1.88-2.28).
conclusionMaternal age < 18 years and short preceding birth interval significantly increase the risk of underfive mortality. This highlights the need for an effective legislation to curb child marriages and increased public investment in reproductive healthcare with a focus on higher contraceptive use for optimal birth spacing.
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