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The effect of antimalarial campaigns on child mortality and fertility in sub-Saharan Africa

Author

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  • Joshua Wilde

    (Max Planck Institute for Demographic Research, Rostock, Germany)

  • Bénédicte Apouey
  • Joseph Coleman
  • Gabriel Picone

Abstract

We examine the extent to which recent declines in child mortality and fertility in Sub-Saharan Africa can be attributed to insecticide-treated bed nets (ITNs). Exploiting the rapid increase in ITNs since the mid-2000s, we employ a difference-in-differences estimation strategy to identify the causal effect of ITNs on mortality and fertility. We show that the ITN distribution campaigns reduced all-cause child mortality, but surprisingly increased total fertility rates in the short run in spite of reduced desire for children and increased contraceptive use. We explain this paradox in two ways. First, we show evidence for an unexpected increase in fecundity and sexual activity due to the better health environment after the ITN distribution. Second, we show evidence that the effect on fertility is positive only temporarily – lasting only 1-3 years after the beginning of the ITN distribution programs – and then becomes negative. Taken together, these results suggest the ITN distribution campaigns may have caused fertility to increase unexpectedly and temporarily, or that these increases may just be a tempo effect -- changes in fertility timing which do not lead to increased completed fertility.

Suggested Citation

  • Joshua Wilde & Bénédicte Apouey & Joseph Coleman & Gabriel Picone, 2019. "The effect of antimalarial campaigns on child mortality and fertility in sub-Saharan Africa," MPIDR Working Papers WP-2019-019, Max Planck Institute for Demographic Research, Rostock, Germany.
    • Handle: RePEc:dem:wpaper:wp-2019-019
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    File URL: https://www.demogr.mpg.de/papers/working/wp-2019-019.pdf
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    References listed on IDEAS

    as
    1. Quamrul H. Ashraf & David N. Weil & Joshua Wilde, 2013. "The Effect of Fertility Reduction on Economic Growth," Population and Development Review, The Population Council, Inc., vol. 39(1), pages 97-130, March.
    2. Bénédicte H. Apouey & Gabriel Picone & Joshua Wilde & Joseph Coleman & Robyn Kibler, 2017. "Paludisme et anémie des enfants en Afrique subsaharienne : effet de la distribution de moustiquaires," Revue économique, Presses de Sciences-Po, vol. 68(2), pages 163-197.
    3. Matthias Doepke, 2005. "Child mortality and fertility decline: Does the Barro-Becker model fit the facts?," Journal of Population Economics, Springer;European Society for Population Economics, vol. 18(2), pages 337-366, June.
    4. repec:cup:jdemec:v:81:y:2015:i:01:p:59-66_00 is not listed on IDEAS
    5. Adrienne M. Lucas, 2013. "The Impact of Malaria Eradication on Fertility," Economic Development and Cultural Change, University of Chicago Press, vol. 61(3), pages 607-631.
    6. Venkataramani, Atheendar S., 2012. "Early life exposure to malaria and cognition in adulthood: Evidence from Mexico," Journal of Health Economics, Elsevier, vol. 31(5), pages 767-780.
    7. Vikram Pathania, 2014. "The Impact of Malaria Control on Infant Mortality in Kenya," Economic Development and Cultural Change, University of Chicago Press, vol. 62(3), pages 459-487.
    8. Quamrul H. Ashraf & Ashley Lester & David N. Weil, 2009. "When Does Improving Health Raise GDP?," NBER Chapters, in: NBER Macroeconomics Annual 2008, Volume 23, pages 157-204, National Bureau of Economic Research, Inc.
    9. Quamrul H. Ashraf & David N. Weil & Joshua Wilde, 2011. "The Effect of Interventions to Reduce Fertility on Economic Growth," NBER Working Papers 17377, National Bureau of Economic Research, Inc.
    10. Denis Cogneau & Pauline Rossi, 2019. "Malaria Control and Infant Mortality in Africa," Tinbergen Institute Discussion Papers 19-068/V, Tinbergen Institute.
    11. David Cutler & Winnie Fung & Michael Kremer & Monica Singhal & Tom Vogl, 2010. "Early-Life Malaria Exposure and Adult Outcomes: Evidence from Malaria Eradication in India," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 72-94, April.
    12. Wilde, Joshua & Apouey, Bénédicte H. & Jung, Toni, 2017. "The effect of ambient temperature shocks during conception and early pregnancy on later life outcomes," European Economic Review, Elsevier, vol. 97(C), pages 87-107.
    13. Adrienne M. Lucas, 2010. "Malaria Eradication and Educational Attainment: Evidence from Paraguay and Sri Lanka," American Economic Journal: Applied Economics, American Economic Association, vol. 2(2), pages 46-71, April.
    14. Wilson, Nicholas, 2015. "Child mortality risk and fertility: Evidence from prevention of mother-to-child transmission of HIV," Journal of Development Economics, Elsevier, vol. 116(C), pages 74-88.
    15. repec:bla:popdev:v:43:y:2017:i::p:237-263 is not listed on IDEAS
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    More about this item

    Keywords

    Africa; child mortality; fertility; malaria;

    JEL classification:

    • J1 - Labor and Demographic Economics - - Demographic Economics
    • Z0 - Other Special Topics - - General

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