The Effects of Maternal Mortality on Infant and Child Survival in Rural Tanzania: A Cohort Study

Jocelyn E. Finlay, Corrina Moucheraud, Simo Goshev, Francis Levira, Sigilbert Mrema, David Canning, Honorati Masanja, Alicia Ely Yamin

Research output: Contribution to journalArticlepeer-review


Objectives: The full impact of a maternal death includes consequences faced by orphaned children. This analysis adds evidence to a literature on the magnitude of the association between a woman’s death during or shortly after childbirth, and survival outcomes for her children. Methods: The Ifakara and Rufiji Health and Demographic Surveillance Sites in rural Tanzania conduct longitudinal, frequent data collection of key demographic events at the household level. Using a subset of the data from these sites (1996–2012), this survival analysis compared outcomes for children who experienced a maternal death (42 and 365 days definitions) during or near birth to those children whose mothers survived. Results: There were 111 maternal deaths (or 229 late maternal deaths) during the study period, and 46.28 % of the index children also subsequently died (40.73 % of children in the late maternal death group) before their tenth birthday—a much higher prevalence of child mortality than in the population of children whose mothers survived (7.88 %, p value <0.001). Children orphaned by early maternal deaths had a 51.54 % chance of surviving to their first birthday, compared to a 94.42 % probability for children of surviving mothers. A significant, but lesser, child survival effect was also found for paternal deaths in this study period. Conclusions: The death of a mother compromises the survival of index children. Reducing maternal mortality through improved health care—especially provision of high-quality skilled birth attendance, emergency obstetric services and neonatal care—will also help save children’s lives.

Original languageEnglish (US)
Pages (from-to)2393-2402
Number of pages10
JournalMaternal and Child Health Journal
Issue number11
StatePublished - Nov 1 2015


  • Cohort study
  • Infant mortality
  • Maternal mortality
  • Orphanhood
  • Survival analysis
  • Tanzania

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health


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