Intergenerational Clustering of Under-Five Mortality: A Cohort Perspective in Low- and Middle-Income Countries

A burgeoning demo graphic lit er a ture doc u ments the exceed ingly high rates at which con tem po rary cohorts of women across the Global South expe ri ence the death of their chil dren-even amid his toric declines in child mor tal ity. Yet, the pat tern ing of mater nal bereave ment remains underinvestigated, as does the extent to which it rep li cates across gen er a tions of the same fam ily. To that end, we ask: Are the sur viv ing daugh ters of bereaved moth ers more likely to even tu ally expe ri ence mater nal bereave ment? How does the inter gen er a tional clus ter ing of mater nal bereave ment vary across countries and cohorts? To answer these ques tions, we make use of Demographic and Health Survey Program data from 50 low and mid dleincome countries, encompassing data on 1.05 mil lion women and their moth ers span ning three decadal birth cohorts. Descriptive results dem on strate that mater nal bereave ment is increas ingly pat terned intergenerationally across cohorts, with most women expe ri enc ing the same fate as their moth ers. Multivariable haz ard mod els fur ther show that, on aver age, women whose mothers were maternally bereaved have significantly increased odds of losing a child them selves. In most countries, the asso ci a tion is sta ble across cohorts; how ever, in select countries, the risk asso ci ated with hav ing a bereaved mother is shrink ing among more recent birth cohorts.