Divergences in trends in child and adult mortality in sub-Saharan Africa

This paper provides an overview of trends in mortality in children aged under 5 and adults between the ages of 15 and 60 in sub-Saharan Africa, using data on the survival of the children and siblings collected in Demographic and Health Surveys. If conspicuous stalls in the 1990s are disregarded, child mortality levels have generally declined and converged over the last 30-40 years. In contrast, adult mortality in many East and Southern African countries has increased markedly, echoing earlier increases in the incidence of HIV. In recent years, adult mortality levels have begun to decline once again in East Africa, in some instances before the large-scale expansion of antiretroviral therapy programmes. More surprising is the lack of sustained improvements in adult survival in some countries that have not experienced severe HIV epidemics. Because trends in child and adult mortality do not always evolve in tandem, we argue that model-based estimates, inferred by matching indices of child survival onto standard mortality schedules, can be very misleading

Antiretroviral therapy · Child mortality · Child survival · Human immunodeficiency virus (HIV) · Incidence (geometry) · Mortality rate · Population · Sociology · Child Nutrition and Water Access · Demography · Global Maternal and Child Health · Medicine · Poverty, Education, and Child Welfare

• Monitoring adult mortality by type of residence in the absence of death registration

  Open Access•Bruno Lankoandé•International Journal of…•2017

  Incluir item

• Measuring causes of adult mortality in rural northern Malawi over a decade of change

  Open Access•Judith R Glynn, Clara Calvert et al.•Global Health Action•2014

  Incluir item

• The epidemiological transition in Antananarivo, Madagascar

  Open Access•Bruno Masquelier, Dominique Waltisperger et al.•Global Health Action•2014

  Incluir item

• Measuring adult mortality from mobile phone surveys in Burkina Faso, Malawi and the Democratic Republic of the Congo

  Open Access•Kassoum Dianou, Bruno Masquelier et al.•BMJ Global Health•2025

  Incluir item

• UN Population Division's Methodology in Preparing Base Population for Projections

  Patrick Gerland•Asian Population Studies•2014

  Incluir item

• Prime-age adult mortality in sub-Saharan Africa

  Open Access•Henry V Doctor, Ifeyinwa E Udo•Journal of Population Research•2017

  Incluir item

• Collecting mortality data via mobile phone surveys

  Open Access•Michael Chasukwa, Augustine Choko et al.•PLOS Global Public Health•2022

  Incluir item

• Estimation of older adult mortality from imperfect data

  Open Access•Soumaïla Ouedraogo•Demographic Research•2020

  Incluir item

• The Network Survival Method for Estimating Adult Mortality

  Open Access•Dennis M Feehan, Mary Mahy et al.•Demography•2017

  Incluir item

• Biases in Survey Estimates of Neonatal Mortality

  Open Access•Helleringer, Stephane Helleringer et al.•Demography•2020

  Incluir item

• Is the mortality–fertility nexus gendered? A research note on sex differences in the impact of sibling mortality on fertility preferences

  Emily Smith-Greenaway, Ernesto Ponce Puig et al.•Population Studies•2023

  Incluir item

• What have we learned about mortality patterns over the past 25 years

  Open Access•Alyson Van Raalte, Alyson A Van Raalte•Population Studies•2021

  Incluir item

• The shifting rural-urban gap in mortality over the life course in low- and middle-income countries

  Ashira Menashe‐oren, Bruno Masquelier•Population Studies•2022

  Incluir item

• Estimating adult mortality based on maternal orphanhood in populations with HIV/Aids

  Open Access•Bruno Masquelier, Ian M Timaeus•Population Studies•2025

  Incluir item

• Tendances et inégalités de mortalité de 1990 à 2015 dans les pays à revenu faible et intermédiaire

  Open Access•Dominique Tabutin, Bruno Masquelier et al.•Population•2017

  Incluir item

• Taille des fratries et taille des familles dans les données d'enquêtes utilisées pour estimer la mortalité

  Open Access•Bruno Masquelier•Population•2014

  Incluir item

• La démographie de l'Afrique subsaharienne au XXI e siècle

  Open Access•Dominique Tabutin, Bruno Schoumaker et al.•Population•2020

  Incluir item

• The use of mobile phone surveys for rapid mortality monitoring

  Open Access•Dianou Kassoum, Abdramane Soura et al.•Demographic Research•2025

  Incluir item

• Improving old-age mortality estimation with parental survival histories in surveys

  Open Access•Bruno Masquelier, Ashira Menashe‐oren et al.•Demographic Research•2024

  Incluir item

• Excess mortality associated with HIV

  Open Access•Shannon Farley, Shannon M Farley et al.•Demographic Research•2024

  Incluir item

• The dynamic role of household structure on under-5 mortality in southern and eastern sub-Saharan Africa

  Open Access•Ashira Menashe‐oren, Ashira Menashe-Oren et al.•Demographic Research•2023

  Incluir item

• Estimating mortality from external causes using data from retrospective surveys

  Open Access•Gilles Pison, Bruno Masquelier et al.•Demographic Research•2018

  Incluir item

• Generalized Additive Models

  Simon N Wood•Generalized Additive Models•2006

  Incluir item

• Demography of Tropical Africa

  William Brass•Demography of Tropical Africa•1968

  Incluir item

• Generalized Additive Models

  Trevor Hastie, Robert Tibshirani•Statistical Science•1986

  Incluir item

• Population-Level HIV Declines and Behavioral Risk Avoidance in Uganda

  Open Access•Rand Stoneburner, Rand L Stoneburner et al.•Science•2004

  Incluir item

• Thin Plate Regression Splines

  Open Access•Simon N Wood•Journal of the Royal Statistical…•2003

  Incluir item

• Age-specific and sex-specific mortality in 187 countries, 1970–2010

  Open Access•Haidong Wang, Laura Dwyer-Lindgren et al.•The Lancet•2012

  Incluir item

• Violence and injuries in South Africa

  Open Access•Mohamed Seedat, Ashley Van Niekerk et al.•The Lancet•2009

  Incluir item

• Maternal mortality for 181 countries, 1980–2008

  Open Access•Margaret C Hogan, Kyle J Foreman et al.•The Lancet•2010

  Incluir item

• Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality

  Open Access•R Lozano, Haidong Wang et al.•The Lancet•2011

  Incluir item

• Neonatal, postneonatal, childhood, and under-5 mortality for 187 countries, 1970–2010

  Open Access•Julie Knoll Rajaratnam, Jake R Marcus et al.•The Lancet•2010

  Incluir item

• Countdown to 2015 decade report (2000–10)

  Open Access•Zulfiqar A Bhutta, Mickey Chopra et al.•The Lancet•2010

  Incluir item

• The burden of non-communicable diseases in South Africa

  Open Access•Bongani M Mayosi, Alan J Flisher et al.•The Lancet•2009

  Incluir item

• Non-communicable diseases in sub-Saharan Africa

  Shona Dalal, Juan J Beunza et al.•International Journal of…•2011

  Incluir item

• A New Method for Deriving Global Estimates of Maternal Mortality

  John R Wilmoth, Nobuko Mizoguchi et al.•Statistics Politics and Policy•2012

  Incluir item

• Adult mortality in sub-Saharan Africa

  Open Access•Ian M Timaeus, Momodou Jasseh•Demography•2004

  Incluir item

• Marital strategies for regulating exposure to HIV

  Open Access•Georges Reniers•Demography•2008

  Incluir item

• Reporting Errors in Siblings’ Survival Histories and Their Impact on Adult Mortality Estimates

  Open Access•Helleringer, Stephane Helleringer et al.•Demography•2014

  Incluir item

• Is there evidence for behaviour change in response to Aids in rural Zimbabwe

  Open Access•Sarah Gregson, Tom Zhuwau et al.•Social Science & Medicine•1998

  Incluir item

• A flexible two-dimensional mortality model for use in indirect estimation

  John R Wilmoth, John Wilmoth et al.•Population Studies•2012

  Incluir item

• Models for the estimation of the probability of dying between birth and exact ages of early childhood

  Jeremiah M Sullivan•Population Studies•1972

  Incluir item

• The Level and Age Pattern of Mortality in Bandafassi (Eastern Senegal)

  Gilles Pison, A Langaney•Population Studies•1985

  Incluir item

• The Impact of HIV/Aids on Adult Mortality in Zimbabwe

  Open Access•Griffith Feeney•Population and Development Review•2001

  Incluir item

• INDEPTH Model Life Tables for Sub-Saharan Africa

  Open Access•Géraldine Duthé, Indepth Network•Population•2005

  Incluir item

• Adult mortality in a rural area of Senegal

  Open Access•Géraldine Duthé, Gilles Pison•Demographic Research•2008

  Incluir item