The Crucial Role of Siblings on Child Survival: Evidence from 29 Health and Demographic Surveillance Systems in Sub-Saharan Africa

Philippe Bocquier, Universite catholique de Louvain (UCL)
Carren Ginsburg, University of the Witwatersrand, Johannesburg
Ashira Menashe Oren, Université Catholique de Louvain
Yacouba Y. C. Compaoré, Université Catholique de Louvain (UCLouvain)
Mark Collinson, University of the Witwatersrand

Understanding the mechanisms that drive child mortality in sub-Saharan Africa is important for healthcare policies. Maternal factors including birth intervals have been identified as key proximate determinants of child mortality but most research looks at older siblings, and a pre-birth interval (pregnancy with a younger sibling) has been neglected. In addition, the absence of a sibling, due to migration or death, can be detrimental. We use pooled longitudinal data from 29 Health and Demographic Surveillance Systems sites, covering 560,000 children and 40,650 deaths, to disentangle the effects of siblings – their absence by migration or death, and when they are present, the birth intervals – on child mortality in sub-Saharan Africa. Our results indicate that younger sibling effects are more pronounced than older sibling effects. The period before pregnancy with the younger sibling is most favourable for child survival. The pregnancy effect is strongest when the birth interval is shorter.