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Community-level effects on infant and child mortality in Zambia, with special attention to HIV prevalence

Laurie DeRose, University of Maryland
Veena Kulkarni, University of Maryland

We estimate the effect of HIV prevalence and other community characteristics on childhood mortality in Zambia. Community HIV rates significantly elevate risk of child death but not infant death, indicating that own or parental infection matters more than indirect mechanisms like a high dependency ratio. Other community characteristics also affect infant mortality and child mortality in distinct ways. The proportion of women in the community completing primary school significantly augments infant survival, an effect that is in addition to the positive individual-level effect of the child’s own mother being educated. Full immunisation also improves infant survival chances, but beyond infancy material resources appear more crucial. Attainable health interventions could reduce childhood mortality even more than reducing the national-level HIV prevalence rate one to two percentage points. While profound improvement in childhood survivorship is unrealistic in the context of a generalised HIV epidemic like Zambia’s, significant progress is nonetheless possible.

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Presented in Session 115: Infant and child health