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The paper contributes to scholarship on institutions in new democracies, chiefly authority, the conditions for infant and under-five survival, and the political determinants of health. In doing so, it demonstrates the value of drilling down to the local level to probe the political determinants of population health. Infertility, a common experience among women and men worldwide, remains on the margins of public health and medicine in low-resource settings. Previous studies identified associations between individual experiences of infertility and negative ou