Institut
national d'études démographiques
Séminaire "Démodynamiques"
The Effect of Fertility Reduction on Infant and Child Mortality: Evidence from Matlab in Rural Bengladesh
Jeudi 19 décembre 1996 de 14 à 15 h (salle du 3e étage)
(*)Professeur au département de démographie de l'Université
de Montréal
Résumé
The notion that lower fertility leads to improved maternal and child health
is an important rationale for national and international support of family
planning programs in low-income countries. This notion is based, in large
part, on the belief that, as fertility declines, it systematically alters
patterns of birth spacing, parity, and mother's age at childbirth in ways that
are beneficial to mother's and children's health. In 1987, John Bongaarts
published a controversial article ["Does family planning reduce infant
mortality rates?" Population and Development Review 13(2), pps.
323-334] in which he argued that available evidence does not support the
presumption of a strong, positive effect of fertility decline acting through
these mechanisms. In the following years, a great deal of research has focused
on specific causal linkages between birth spacing, mother's age, parity and
children health. Surprisingly, to date there is little evidence showing that
fertility declines have a net positive impact on child survival.
In this study, longitudinal data from the Matlab field station in rural
Bengladesh are used to answer the question: "What is the net effect of
declining total fertility on infant and child mortality rates?". The
International Center for Diarrhoeal Disease Research began the Matlab
Family Planning Health Services Project in late 1977, and its
activities rapidly led to falls in fertility. The quasi-experimental nature of
this project, incorporating both intervention and comparison areas, and the
availability of high-quality time-series data on fertility, mortality and
program interventions, allow us to control potentially confounding factors and
to avoid problems of reverse causality in the analysis. The results show that
fertility reductions has little effect on aggregate neonatal and post-neonatal
mortality, possibly a small effect on toddler (second year) mortality, and a
significant and relatively large effect on the mortality of children aged
between two and four years. Possible explanations for these findings are
discussed, and the argument is made that that the results of this study
probably significantly understate the true beneficial effect of fertility
reductions at the level of individual children and in most other Third Word
settings.
L'exposé sera en français et la discussion sera introduite par
Noël Bonneuil (INED).
Le texte fourni par l'auteur est un article cosigné avec James
Phillips (Population Council, New-York), et publié en 1996 dans
Population Studies, 50(1), pp 51-68.
Animateur de la séance Nicolas Brouard,
brouard@ined.fr
On peut trouver le programme du séminaire sur http://sauvy.ined.fr/seminaires/demodynamiques ou le recevoir sur la liste(listserver) demodyn@sauvy.ined.fr
L'INED est situé au 27 rue du Commandeur à Paris dans le 14e
arrondissement, à 3 minutes du métro Alésia. Tél: 42 18 20 00.
Un texte est généralement disponible une semaine avant l'exposé au
secrétariat, tél 42 18 20 18.
