Child deaths in the past, their consequences in the present, and mortality conditions in sub-Saharan Africa.

Over the past 50 years, various measures of mortality have been used to develop an understanding of the health of populations. Estimates from these measures have been used to study the determinants of mortality, track mortality transitions, and identify contexts where these transitions are anomalous. Sub-Saharan Africa is one such context where such anomalies persist, and in recent years conventional measures of infant and child mortality have provided the main basis for understanding the changing mortality conditions of children. The perspective provided by these measures is, however, one that focuses on the importance of child deaths as exits from a population. While this perspective is important, new estimation approaches are needed to provide more nuanced perspectives on the dynamics of child mortality in the region. Smith-Greenaway and Trinitapoli’s (1) maternal cumulative prevalence measures of child mortality offer one such approach. Unlike most conventional mortality estimation measures, they provide a dual perspective that highlights the importance of past mortality events in early childhood and their consequences for mothers in the present. With the exception of measures of orphanhood (2) and a small selection of other demographic indicators (3, 4), the repertoire of methods providing this dual perspective is limited. However, Smith-Greenaway and Trinitapoli’s (1) approach adds to this repertoire in important ways. First, it shifts the focus on the conceptualization of child deaths from one that views them as exits from a population to one that sees them as events with long-term consequences. Second, it highlights the need for analyses of child mortality to give more systematic attention to mothers who experience the death of a child during their reproductive years. In sub-Saharan Africa, where many mothers have multiple children who die in early childhood, this nuanced perspective is important for developing a more comprehensive portrait of population health. Because … [↵][1]1Email: kjt11{at}psu.edu. [1]: #xref-corresp-1-1