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.
