Poorer children at risk from death when mother dies

In poorer countries, young children are more likely to die in the months before their mother’s death, when she is seriously ill, and also in the period after her death, according to a study by international researchers published in this week’s PLOS Medicine.

These findings are important as they highlight the urgent need for proactive and coordinated community-based interventions to support families, especially vulnerable children, when a mother becomes seriously ill, not just in the period following her death.

Research was carried out in a large socio-economically disadvantaged area in northeast South Africa near the border with Mozambique. The team, led by Samuel Clark, Alan Stein and Kathleen Kahn from Washington, Oxford, and Witwatersrand Universities, reached these conclusions by studying 15 years of information (1994-2008) during which 1,244 children died (3% of the total population studied). Data came from a health and socio-demographic surveillance system run by the MRC / Wits Rural Health and Transitions Unit, a founding member of the INDEPTH Network (http://www.indepth-network.org).

The researchers found that the period in which children are more likely to die began 6 – 11 months before their mother’s death, and importantly, there were three distinct periods with a much higher chance (odds) of death: the period 1 – 2 months before their mother’s death (7-fold increase in odds of dying), the month of her death (12-fold increase in odds of dying) and the period 1 – 2 months following her death (7-fold increase in odds of dying).

Furthermore, during the five-month period around the time of their mother’s death, children (both boys and girls) aged 0 – 6 months were about nine times more likely to die than children aged 24 – 59 months. And, children were about 1.5 times more likely to die if their mother died of an AIDS-related cause rather than some other cause of death.

The authors say: “Young children’s survival is put at substantial risk when their mothers become very ill. In particular, a period of very high risk for the child occurs in the two months prior to a mother’s death and extends for two months after. ”

They continue: “This effect is considerably greater when a mother has HIV and AIDS but the pattern is maintained for non-HIV-related causes.”

The authors add: “Proactive and coordinated community-based interventions are urgently needed to support families when a mother becomes seriously ill, as well as following her death.”