Accounting for Reversals in Child Mortality in Africa: The Role of Economic Trends, Policy and Demographic Transitions

Gervais Beninguisse, Institut de Formation et de Recherche Demographiques (IFORD)
Pierre Nsoa Mbondo, Institut de Formation et de Recherche Demographiques (IFORD)
Patrice Tchanang Toula, Institut de Formation et de Recherche Demographiques (IFORD)

During the 1990s, many African countries experienced a visible resurgence in child mortality at the same time as they were undergoing a period of demographic transition, economic decline and/or structural adjustment. This confluence of events raised key theoretical and practical questions about demographic dividends and about the prospects for these African countries to achieve their Millennium Goals in health. Our paper examines the drivers of these recent trends in under-5 mortality, focusing on the contributions of demographic and economic trends, as well as national policy. The analyses combine national socioeconomic statistics with data from DHS surveys from nine African countries representing contrasted economic and demographic regimes. The methodological approach combines decomposition analysis with multi-level regression. The paper thus provides an opportunity to test theories about the impacts of demographic transitions and the contexts under which these impacts are more likely to be beneficial.