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  • Marwân-al-Qays Bousmah (a1)


The effects of childhood mortality and morbidity on the fertility decision-making process are analyzed using longitudinal micro data from a Senegalese rural community, for the period 1984–2011. I attempt to identify the effect of individual child mortality, and also that of community child mortality and morbidity, on subsequent fertility choices. The results provide consistent support for both the child-replacement hypothesis and the precautionary demand for children. I find that community child mortality and morbidity attributable to malaria, which capture changes in the epidemiological context, exert a joint influence on fertility behaviors. Community-level malaria incidence among children has a positive effect on subsequent fertility choices, and this positive effect is stronger the more the disease is fatal to children who are infected. This study highlights the role of morbidity, acting through the relative risk of dying from the disease, on the slow fertility transition in sub-Saharan Africa.


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Address correspondence to: Marwân-al-Qays Bousmah, Aix-Marseille School of Economics, 2 rue de la Charité, 13002 Marseille, France; e-mail:


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I am indebted to three anonymous referees and to the editor for their valuable comments and suggestions, which greatly helped improve the paper. I am also grateful to Mohammad Abu-Zaineh, Raouf Boucekkine, Valérie Delaunay, Anne Lovell, Aline Munier, Daria Onori, Luis Sagaon Teyssier, Bruno Ventelou, and Maame Esi Woode for their help in various stages of this work. I am solely responsible for any remaining errors. This work has been carried out thanks to the support of the A*MIDEX project (no. ANR-11-IDEX-0001-02) funded by the “Investissements d’Avenir” French Government program, managed by the French National Research Agency (ANR).



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