TY - JOUR T1 - Global burden of maternal bereavement: indicators of the cumulative prevalence of child loss JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2020-004837 VL - 6 IS - 4 SP - e004837 AU - Emily Smith-Greenaway AU - Diego Alburez-Gutierrez AU - Jenny Trinitapoli AU - Emilio Zagheni Y1 - 2021/04/01 UR - http://gh.bmj.com/content/6/4/e004837.abstract N2 - 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.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). ER -