Ethnicity and Child Mortality in sub-Saharan Africa

Analysis of recent survey data reveals large differentials in child mortality among ethnic groups in countries throughout sub-Saharan Africa. These disparities correspond with the prominence of specific ethnic groups in the national political economy. In many countries where heads of state since independence have come from one or two ethnic groups—as in Côte d’Ivoire, Kenya, and Niger—these groups have experienced levels of early child mortality at least one-third lower than those of other groups. In other countries where there have been several transitions in state control, as in Ghana and Uganda, descendants of precolonial kingdoms such as Ashanti and Buganda have experienced much lower mortality than others. In most countries, the lower mortality of potent ethnic groups—who typically represent small proportions of national populations—is strongly related to economic privilege. Persistent inequalities among African ethnic groups deserve strong consideration in planning economic development and child health strategies. This material may not be reproduced without written permission from the authors. Journalistic accounts of wars in Rwanda, Somalia, and several other countries of sub-Saharan Africa in the 1990s have raised concerns that ethnic cleavages and overlapping affiliations of religion and race may undermine prospects for economic and political development in much of Africa (Kaplan 1994). The threat of elevated child mortality from internecine violence has been cited, in particular, based on the young age structure of African populations, the dependency of children on adults, and the invariably high proportion of child combatants in recent disputes (UNICEF 1996). Paradoxically, there has been no systematic examination of ethnic inequality in child survival chances across countries in the region, including the majority of African countries that have experienced relative peace over the past decade or more. Nor has there been significant advancement of a theoretical model by which one might test the political, economic, and cultural mechanisms through which ethnic affiliation affects child mortality across highly diverse African settings. These shortcomings are conspicuous insofar as early cross-national analysis of ethnicity and mortality, using data from the 1960s and 1970s, concluded that “ethnicity...exerts a strong influence on mortality in countries where ethnic groups appear to be sharply differentiated” (Mensch, Lentzner, and Preston 1985:86). Neglect of mother’s ethnicity, in particular, as an influence on child survival is remarkable in light of the countless studies that have emphasized the central importance of maternal characteristics and behavior for child health in Africa. This paper uses survey data from 12 countries to examine whether ethnic inequality in child mortality is indeed pervasive throughout sub-Saharan Africa. The focus is on child mortality since the early 1980s. To understand how ethnicity affects child mortality, we introduce below a conceptual framework and test its central hypotheses. While some African offspring are the product of interethnic marriages, the analysis centers on the ethnic 4 affiliation of the mother, given women’s typically heavy responsibility, whether imposed or appropriated, for childrearing. Of special interest to this study is the relationship between child survival and the dominance of certain ethnic groups in the national political economy. Specifically, given that national political authority in many stable African countries has been assumed by one or two minority ethnic groups for most of the independence era, while other more volatile countries have been guided indirectly by groups with historical economic advantages, we investigate whether such dominance has conferred child survival advantages to members of these groups, and if so, how.