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Global burden of maternal bereavement: indicators of the cumulative prevalence of child loss
  1. Emily Smith-Greenaway1,
  2. Diego Alburez-Gutierrez2,
  3. Jenny Trinitapoli3,
  4. Emilio Zagheni2
  1. 1Sociology & Spatial Sciences, University of Southern California, Los Angeles, California, USA
  2. 2Max Planck Institute for Demographic Research, Rostock, Germany
  3. 3Sociology, University of Chicago, Chicago, Illinois, USA
  1. Correspondence to Dr Emily Smith-Greenaway; smithgre{at}usc.edu

Abstract

Background We provide country-level estimates of the cumulative prevalence of mothers bereaved by a child’s death in 170 countries and territories.

Methods We generate indicators of the cumulative prevalence of mothers who have had an infant, under-five-year-old or any-age child ever die by using publicly available survey data in 89 countries and an indirect approach that combines formal kinship models and life-table methods in an additional 81 countries. We label these measures the maternal cumulative prevalence of infant mortality (mIM), under-five mortality (mU5M) and offspring mortality (mOM) and generate prevalence estimates for 20–44-year-old and 45–49-year-old mothers.

Results In several Asian and European countries, the mIM and mU5M are below 10 per 1000 mothers yet exceed 200 per 1000 mothers in several Middle Eastern and African countries. Global inequality in mothers’ experience of child loss is enormous: mothers in high-mortality-burden African countries are more than 100 times more likely to have had a child die than mothers in low-mortality-burden Asian and European countries. In more than 20 African countries, the mOM exceeds 500 per 1000 mothers, meaning that it is typical for a surviving 45–49-year-old mother to be bereaved.

Discussion The study reveals enormous global disparities in mothers’ experience of child loss and identifies a need for more research on the downstream mental and physical health risks associated with parental bereavement.

  • maternal health
  • child health
  • cross-sectional survey

Data availability statement

All data used in this study are publicly available. DHS data are available at https://dhsprogram.com/. MICS data are available at https://mics.unicef.org/. NSFG data are available at https://www.cdc.gov/nchs/nsfg/index.htm. Replication files are posted at Harvard Dataverse, https://doi.org/10.7910/DVN/UVBVZ7 (27).

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjgh-2020-004837

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    Data availability statement

    All data used in this study are publicly available. DHS data are available at https://dhsprogram.com/. MICS data are available at https://mics.unicef.org/. NSFG data are available at https://www.cdc.gov/nchs/nsfg/index.htm. Replication files are posted at Harvard Dataverse, https://doi.org/10.7910/DVN/UVBVZ7 (27).

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    Footnotes

    • Handling editor Sanni Yaya

    • Twitter @smithgreenaway, @d_alburez, @JTrinitapoli, @ezagheni

    • Contributors ES-G produced the empirical results using survey data and DA-G conducted the indirect demographic analysis. ES-G drafted the initial manuscript. All four authors contributed to revising and editing the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Map disclaimer The depiction of boundaries on this map does not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. This map is provided without any warranty of any kind, either express or implied.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.