The Weather–Child Morbidity Link and the Modifying Effect of Maternal Education and Sanitation: Evidence from Sub-Saharan Africa

ABSTRACT. A database of historic rainfall and temperature standardized anomalies was constructed for sub-Saharan Africa (SSA) over the period 2000 to 2020 and merged with the harmonized versions of 51 rounds of Demographic and Health Surveys for 19 countries in SSA. Multivariable logit models of the determinants of the probability of reported incidence of fever, diarrhea, and coughing among children under 5 years of age were estimated with explanatory variables, including the quintiles of rainfall and temperature anomalies experienced locally, and a variety of observable child, maternal, household, and environmental covariates. The highest marginal effect on the probability of fever was at the top quintile of rainfall anomalies, and the highest marginal effect of anomalous rainfall events on diarrhea was at the bottom quintile of rainfall anomalies. The marginal effects of rainfall on coughing were the highest at the bottom and top quintiles. Anomalously cold and hot conditions were associated with reductions in the incidence of fever, diarrhea, and cough in comparison with the incidence of the same illnesses at normal temperatures. Higher maternal education was associated with a lower probability of fever and diarrhea in the event of unusually wet events and unusually hot temperatures. However, higher maternal education did not have a greater protective effect on the reported incidence of child diarrhea than periods with normal rainfall. Also, improved toilets at home were associated with a significantly lower probability of child fever, diarrhea, and cough, especially during unusually dry and unusually wet weather, as well as during unusually high temperatures.