Article Text

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}


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 MICS data are available at NSFG data are available at Replication files are posted at Harvard Dataverse, (27).

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:

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Data availability statement

All data used in this study are publicly available. DHS data are available at MICS data are available at NSFG data are available at Replication files are posted at Harvard Dataverse, (27).

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  • 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.

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  • Competing interests None declared.

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

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