The Impacts of Maternal Mortality and Cause of Death on Children's Risk of Dying in Rural South Africa: Evidence from a Population-Based Surveillance Study (1992-2013)

Brian Houle, Australian National University
Kathleen Kahn, University of the Witwatersrand
Stephen Tollman, University of the Witwatersrand
Alicia Ely Yemin, Harvard University

Maternal mortality, HIV/AIDS, and child survival are closely linked. We used data for children younger than 10 years from the Agincourt health and socio-demographic surveillance system (1992-2013). We used discrete time event history analysis to estimate children's risk of dying who experienced a maternal death compared to children whose mother survived. Children who experienced an early maternal death were at 15 times the risk of dying (95% CI 8.3-27.9) compared to children whose mother survived. Children under 1 month whose mother died an early (p=0.002) maternal death were at increased risk of dying compared to older children. Children whose mothers died of an AIDS/TB-related early maternal death were at 29 times the risk of dying compared to children with surviving mothers (95% CI 11.7-73.1). This study contributes evidence on the impact of a mother's death on child survival in a poor, rural setting with high HIV prevalence.