Global burden of maternal bereavement: indicators of the cumulative prevalence of child loss

Smith-Greenaway, Emily; Alburez-Gutierrez, Diego; Trinitapoli, Jenny; Zagheni, Emilio

BACKGROUND: We provide country-level estimates of the cumulative prevalence of mothers bereaved by a child’s death in 170 countries and territories. METHODS: We generate indicators of the cumulative prevalence of mothers who have had an infant, under-five-year-old or any-age child ever die by using publicly available survey data in 89 countries and an indirect approach that combines formal kinship models and life-table methods in an additional 81 countries. We label these measures the maternal cumulative prevalence of infant mortality (mIM), under-five mortality (mU5M) and offspring mortality (mOM) and generate prevalence estimates for 20–44-year-old and 45–49-year-old mothers. RESULTS: In several Asian and European countries, the mIM and mU5M are below 10 per 1000 mothers yet exceed 200 per 1000 mothers in several Middle Eastern and African countries. Global inequality in mothers’ experience of child loss is enormous: mothers in high-mortality-burden African countries are more than 100 times more likely to have had a child die than mothers in low-mortality-burden Asian and European countries. In more than 20 African countries, the mOM exceeds 500 per 1000 mothers, meaning that it is typical for a surviving 45–49-year-old mother to be bereaved. DISCUSSION: The study reveals enormous global disparities in mothers’ experience of child loss and identifies a need for more research on the downstream mental and physical health risks associated with parental bereavement.