Birth Seasonality in Sub-Saharan Africa: Its Determinants and Implications for Child Health

Abstract

Seasonality is a characteristic and important feature of the birth rate, but hitherto largely undocumented for sub-Saharan Africa. The research we present in Chapter 2 helps close the gap by providing contemporary documentation of the seasonal patterns of births in 31 sub-Saharan African countries, and 21 ecological zones. In the remainder of the dissertation, we analyze the determinants of birth seasonality and its implications for child health, by using data from the Demographic and Health Surveys (DHS), Demographic Surveillance Sites, and weather station data, in conjunction with an interdisciplinary set of methods. Specifically in Chapter 3, we make a valuable contribution to the existing literature on determinants of birth seasonality by using multivariate analysis to look at the independent contributions of both social and ecological factors. In Chapter 4, we analyze the relationship between birth month and child growth (stunting) and survival. We also test whether the relationship is due to socio-demographic differences in fertility patterns. In Chapter 5, we analyze the impact of seasonal fluctuations in births on the dynamics of acute, immunizing childhood diseases, such as measles. We pay particular attention to the effects of interactions with seasonality in the contact rates.

There are many policy implications resulting from this dissertation research. Knowledge of birth seasonality patterns can help improve the provision of obstetrical services. Understanding the determinants of birth seasonality can help prevent unwanted births and influence the timing of births. Policies that help women can help women conceive and give birth during optimal months for child survival and therefore can also help sub-Saharan African countries achieve the Millennium Development Goal 4 of reducing under-five mortality. Finally, our findings also help to elucidate how infectious disease dynamics may change as birth amplitude or peak month changes.