Examining infant and child death clustering among families in the cross-sectional and nationally representative Bangladesh Demographic and Health Survey 2017–2018
Objectives We aim to examine the phenomenon of infant and child death clustering while considering the unobserved heterogeneity (frailty) at the family level.Design, setting, and participants We analysed Bangladesh Demographic and Health Survey 2017–2018 data, including the birth history information...
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e053782.full |
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| author | Shobhit Srivastava Ronak Paul Rashmi Rashmi |
| author_facet | Shobhit Srivastava Ronak Paul Rashmi Rashmi |
| author_sort | Shobhit Srivastava |
| collection | DOAJ |
| description | Objectives We aim to examine the phenomenon of infant and child death clustering while considering the unobserved heterogeneity (frailty) at the family level.Design, setting, and participants We analysed Bangladesh Demographic and Health Survey 2017–2018 data, including the birth history information for 47 828 children born to 18 134 women. We used Gompertz shared frailty model to control the correlation between event times at the mother level and capture the unobserved risks in infant and child deaths.Outcome measures We estimated two sets of survival regression models where the failure event is the survival status of the index child during the infancy period, that is, from birth to 11 months, and childhood period, that is, between 12 and 59 months, respectively. All children who died during infancy and childhood were coded as ‘yes’; otherwise, they were coded as ‘no’.Results About 2% of mothers experienced two or more infant deaths, and cumulatively these mothers account for 20% of all infant deaths in the sample. Children whose previous sibling was not alive at the time of their conception had 1.86 times (95% CI 1.59 to 2.17) more risk of dying as an infant. However, we did not find a statistically significant effect of death scarring on the risk of child mortality among siblings. Statistically significant frailty effect with a variance of 0.33 (95% CI CI 0.17 to 0.65) and 0.54 (95% CI 0.14 to 2.03)] in infancy and childhood, respectively, indicates the clustering of survival risks within families due to unobserved family-level characteristics shared by the siblings.Conclusion This study suggests that preceding birth interval, mother’s age at first birth and mother’s education are the most critical factors which can help in reducing scaring effect on infant mortality. Additionally, women from poor socioeconomic strata should be focused on as still an infant, and child mortality is concentrated among poor households. |
| format | Article |
| id | doaj-art-08212f41da30449eb61de07841dc9472 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-08212f41da30449eb61de07841dc94722025-01-24T07:15:21ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-053782Examining infant and child death clustering among families in the cross-sectional and nationally representative Bangladesh Demographic and Health Survey 2017–2018Shobhit Srivastava0Ronak Paul1Rashmi Rashmi2Department of Survey Research & Data Analytics, International Institute for Population Sciences, Mumbai, IndiaInternational Institute for Population Sciences, Mumbai, Maharashtra, IndiaDepartment of Population & Development, International Institute for Population Sciences, Mumbai, IndiaObjectives We aim to examine the phenomenon of infant and child death clustering while considering the unobserved heterogeneity (frailty) at the family level.Design, setting, and participants We analysed Bangladesh Demographic and Health Survey 2017–2018 data, including the birth history information for 47 828 children born to 18 134 women. We used Gompertz shared frailty model to control the correlation between event times at the mother level and capture the unobserved risks in infant and child deaths.Outcome measures We estimated two sets of survival regression models where the failure event is the survival status of the index child during the infancy period, that is, from birth to 11 months, and childhood period, that is, between 12 and 59 months, respectively. All children who died during infancy and childhood were coded as ‘yes’; otherwise, they were coded as ‘no’.Results About 2% of mothers experienced two or more infant deaths, and cumulatively these mothers account for 20% of all infant deaths in the sample. Children whose previous sibling was not alive at the time of their conception had 1.86 times (95% CI 1.59 to 2.17) more risk of dying as an infant. However, we did not find a statistically significant effect of death scarring on the risk of child mortality among siblings. Statistically significant frailty effect with a variance of 0.33 (95% CI CI 0.17 to 0.65) and 0.54 (95% CI 0.14 to 2.03)] in infancy and childhood, respectively, indicates the clustering of survival risks within families due to unobserved family-level characteristics shared by the siblings.Conclusion This study suggests that preceding birth interval, mother’s age at first birth and mother’s education are the most critical factors which can help in reducing scaring effect on infant mortality. Additionally, women from poor socioeconomic strata should be focused on as still an infant, and child mortality is concentrated among poor households.https://bmjopen.bmj.com/content/12/6/e053782.full |
| spellingShingle | Shobhit Srivastava Ronak Paul Rashmi Rashmi Examining infant and child death clustering among families in the cross-sectional and nationally representative Bangladesh Demographic and Health Survey 2017–2018 BMJ Open |
| title | Examining infant and child death clustering among families in the cross-sectional and nationally representative Bangladesh Demographic and Health Survey 2017–2018 |
| title_full | Examining infant and child death clustering among families in the cross-sectional and nationally representative Bangladesh Demographic and Health Survey 2017–2018 |
| title_fullStr | Examining infant and child death clustering among families in the cross-sectional and nationally representative Bangladesh Demographic and Health Survey 2017–2018 |
| title_full_unstemmed | Examining infant and child death clustering among families in the cross-sectional and nationally representative Bangladesh Demographic and Health Survey 2017–2018 |
| title_short | Examining infant and child death clustering among families in the cross-sectional and nationally representative Bangladesh Demographic and Health Survey 2017–2018 |
| title_sort | examining infant and child death clustering among families in the cross sectional and nationally representative bangladesh demographic and health survey 2017 2018 |
| url | https://bmjopen.bmj.com/content/12/6/e053782.full |
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