Adverse Effects of Next Birth, Gender, and Family Composition on Child Survival in Rural Bangladesh

This study examines mortality risks among children aged 1-4 years in Bangladesh. Data were obtained from the 1982 Matlab Census and Demographic Surveillance System on 12266 singleton births that occurred in Matlab between January 1981 and December 1982. Findings indicate that the proportion of 4-year-olds at birth-to-conception intervals (BCI) at ages 13-24 months was 0.228. Mortality rates varied by the sex of the child area and length of the BCI. The risk of dying during the ages of 1-5 years was over 50% higher for girls than for boys and over 55% higher for children who did not have access to the Maternal-Child Health/Family Planning (MCH/FP) program. The lowest mortality risk was among girls aged 1-3 years whose mothers had not conceived. The highest mortality risk was among girls aged 1-3 years whose mothers conceived at age 1 2 or 3 years. Mortality risk was 3.35 times higher at age 1 2.62 times higher at age 2 and 1.79 times higher at age 3. Girls experienced excess mortality in almost every age-BCI group. The analysis examines the effect of socioeconomic status and access to MCH-FP on child survival as well as the effects of childs age and sex the composition of older siblings and the BCI. Risks were lower among children who were born in the MCH-FP area and had mothers with some schooling and among children whose families had at least one durable good or received remittances and had more housing space. If the BCI was 1-2 years over 30% were expected to die before the age of 5. The MCH-FP program contributed to a 30% reduction in child mortality. Risks were very high for girls with at least one older sister and moderately high for boys with at least two older brothers. Second-born children had moderately high risks if the first-born child was a boy. Girls were at risk at all ages regardless of family composition but competition occurred mostly at earlier ages.