HIGH-RISK FERTILITY BEHAVIOR RISK RATIOS
Statistics: Ratio of Children in Elevated Fertility Behavior Risk Categories to Children in
Non-Elevated Risk Category
Definition
A. Coverage:
1. Population base: Children born to all women.
2. Time period: Births in the five years preceding the survey.
B. Numerator: Proportion of dead children born in the five years preceding the survey by risk
category.
C. Denominator: Proportion dead of children in non-elevated risk category.
D. Elevated-behavior fertility risk categories:
1. Children born to mothers under age 18 years.
2. Children born to mothers 35 years and older.
3. Children of birth order 4 or higher.
4. Children born less than 24 months since a preceding birth.
E. Unavoidable elevated risk category--First birth order children born to mothers between ages 18
and 34 years.
F. Children not in any elevated risk category
1. Second- and third-birth-order children born to mothers between ages 18 and 34 years
2. The elevated risk categories are also combined into two-way and three-way combinations of
elevated risk.
Calculation
A. To calculate relative risk ratios by categories of elevated risk due to fertility behavior, first the
proportions dead for each category need to be calculated. For each proportion--
1. Numerator: Number of children born in the five years preceding the survey who died at
any age.
2. Denominator: Number of children born in the five years preceding the survey.
3. Proportion dead: Numerator divided by denominator.

B. Then the ratio of the proportions need to be calculated:
1. Risk ratio Numerator: Proportion dead among children in each risk category.
2. Risk ratio denominator: Proportion dead among children not in any elevated risk category
(see definition above).
3. Relative risk ratios: Risk category numerators divided by the non-elevated risk category
denominator.
Handling of Missing Values
None of the information needed to calculate relative risk ratios is allowed to have missing or unknown
data. Note that age at death is not used, only survival status at the time of the survey.
Notes and Considerations
To provide a more robust estimate of the elevated relative risk, proportions dead are used instead of
period mortality rates in the calculation of relative risk, since period mortality rates have higher sampling
errors. In DHS reports, risk ratios are not shown where the proportion dead is based on fewer than 25
births. Risk ratios where the proportion dead is based on 25 to 49 births are placed in parentheses to
indicate large variability due to sampling.
Assumptions
It is assumed that the number of births and death rates do not vary substantially by time period within the
preceding five years.
Changes over Time
Originally, the denominator for the risk ratio included the unavoidable risk category of first-order births to
mothers between 18 and 24 years of age.