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Hassen TA, Chojenta C, Khan MN, Shifti DM, Harris ML. Short birth interval in the Asia-Pacific region: A systematic review and meta-analysis. J Glob Health 2024; 14:04072. [PMID: 38700432 PMCID: PMC11067827 DOI: 10.7189/jogh.14.04072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
Background Short birth interval is associated with an increased risk of adverse health outcomes for mothers and children. Despite this, there is a lack of comprehensive evidence on short birth interval in the Asia-Pacific region. Thus, this study aimed to synthesise evidence related to the definition, classification, prevalence, and predictors of short birth interval in the Asia-Pacific region. Methods Five databases (MEDLINE, Scopus, Cumulative Index to Nursing and Allied Health Literature, Maternity and Infant Care, and Web of Science) were searched for studies published between September 2000 and May 2023 (the last search was conducted for all databases in May 2023). We included original studies published in English that reported on short birth interval in the Asia-Pacific region. Studies that combined birth interval with birth order, used multi-country data and were published as conference abstracts and commentaries were excluded. Three independent reviewers screened the articles for relevancy, and two reviewers performed the data extraction and quality assessment. The risk of bias was assessed using the Joanna Briggs Institute critical appraisal tool. The findings were both qualitatively and quantitatively synthesised and presented. Results A total of 140 studies met the inclusion criteria for this review. About 58% (n = 82) of the studies defined short birth interval, while 42% (n = 58) did not. Out of 82 studies, nearly half (n = 39) measured a birth-to-birth interval, 37 studies measured a birth-to-pregnancy, four measured a pregnancy-to-pregnancy, and two studies measured a pregnancy loss-to-conception. Approximately 39% (n = 55) and 6% (n = 8) of studies classified short birth intervals as <24 months and <33 months, respectively. Most of the included studies were cross-sectional, and about two-thirds had either medium or high risk of bias. The pooled prevalence of short birth interval was 33.8% (95% confidence interval (CI) = 23.0-44.6, I2 = 99.9%, P < 0.01) among the studies that used the World Health Organization definition. Conclusions This review's findings highlighted significant variations in the definition, measurement, classification, and reported prevalence of short birth interval across the included studies. Future research is needed to harmonise the definition and classification of short birth interval to ensure consistency and comparability across studies and facilitate the development of targeted interventions and policies. Registration PROSPERO CRD42023426975.
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Affiliation(s)
- Tahir Ahmed Hassen
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
| | - Catherine Chojenta
- School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
| | - Md Nuruzzaman Khan
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
| | - Desalegn Markos Shifti
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
- Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Melissa Leigh Harris
- Centre for Women's Health Research, School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Australia
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Okyere J, Dadzie LK, Agbaglo E, Arthur-Holmes F, Aboagye RG, Seidu AA, Ahinkorah BO. Women's Sexual Autonomy and Short Birth Interval in Sub-Saharan Africa: A Multilevel Analysis of Demographic and Health Survey Data. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:413-422. [PMID: 37903958 DOI: 10.1007/s10508-023-02713-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 11/01/2023]
Abstract
Sexual autonomy is an inalienable human right to protect and maintain an informed decision over one's body, sexuality, and sexual experience. With the increased attention to women's empowerment and gender equality all over the world, it is surprising that previous research has overlooked the relationship between women's sexual autonomy and short birth intervals. This study examined the association between women's sexual autonomy and short birth intervals in sub-Saharan Africa (SSA). Data were sourced from the Demographic and Health Surveys of 29 sub-Saharan African countries conducted from 2010 to 2019. A total of 222,940 women were included in this study. Multilevel logistic regression analysis was conducted to examine the association between sexual autonomy and short birth interval. The results were presented as adjusted odds ratios (aOR) and significance level was set at p < .05. The overall proportions of sexual autonomy and short birth interval among women in SSA were 75.1% and 13.3%, respectively. Women who reported having sexual autonomy had lower odds of short birth interval [aOR = 0.94; CI = 0.91, 0.96]. The likelihood of short birth interval among women increased with increasing maternal and partner's age but reduced with increasing level of education and wealth index. Given that short birth intervals could have negative maternal and child health outcomes, public health authorities in sub-Saharan African countries should endeavor to promote health interventions and social programs to empower women with low sexual autonomy.
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Affiliation(s)
- Joshua Okyere
- Department of Population and Health, University of Cape Coast, Private Mail Bag, University Post Office, Cape Coast, Ghana.
| | - Louis Kobina Dadzie
- Department of Population and Health, University of Cape Coast, Private Mail Bag, University Post Office, Cape Coast, Ghana
| | - Ebenezer Agbaglo
- Department of English and Communication, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Francis Arthur-Holmes
- Department of Sociology and Social Policy, Lingnan University, 8 Castle Peak Road, Tuen Mun, Hong Kong
| | - Richard Gyan Aboagye
- Department of Family and Community Health, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Ho, Ghana
| | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Private Mail Bag, University Post Office, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Australia
| | - Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
- REMS Consultancy Services, Sekondi-Takoradi, Western region, Ghana
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Ni W, Gao X, Su X, Cai J, Zhang S, Zheng L, Liu J, Feng Y, Chen S, Ma J, Cao W, Zeng F. Birth spacing and risk of adverse pregnancy and birth outcomes: A systematic review and dose-response meta-analysis. Acta Obstet Gynecol Scand 2023; 102:1618-1633. [PMID: 37675816 PMCID: PMC10619614 DOI: 10.1111/aogs.14648] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 06/20/2023] [Accepted: 06/30/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION The association between extreme birth spacing and adverse outcomes is controversial, and available evidence is fragmented into different classifications of birth spacing. MATERIAL AND METHODS We conducted a systematic review of observational studies to evaluate the association between birth spacing (i.e., interpregnancy interval and interoutcome interval) and adverse outcomes (i.e., pregnancy complications, adverse birth outcomes). Pooled odds ratios (ORs) with 95% confidence intervals (CI) were calculated using a random-effects model, and the dose-response relationships were evaluated using generalized least squares trend estimation. RESULTS A total of 129 studies involving 46 874 843 pregnancies were included. In the general population, compared with an interpregnancy interval of 18-23 months, extreme intervals (<6 months and ≥ 60 months) were associated with an increased risk of adverse outcomes, including preterm birth, small for gestational age, low birthweight, fetal death, birth defects, early neonatal death, and premature rupture of fetal membranes (pooled OR range: 1.08-1.56; p < 0.05). The dose-response analyses further confirmed these J-shaped relationships (pnon-linear < 0.001-0.009). Long interpregnancy interval was only associated with an increased risk of preeclampsia and gestational diabetes (pnon-linear < 0.005 and pnon-linear < 0.001, respectively). Similar associations were observed between interoutcome interval and risk of low birthweight and preterm birth (pnon-linear < 0.001). Moreover, interoutcome interval of ≥60 months was associated with an increased risk of cesarean delivery (pooled OR 1.72, 95% CI 1.04-2.83). For pregnancies following preterm births, an interpregnancy interval of 9 months was not associated with an increased risk of preterm birth, according to dose-response analyses (pnon-linear = 0.008). Based on limited evidence, we did not observe significant associations between interpregnancy interval or interoutcome interval after pregnancy losses and risk of small for gestational age, fetal death, miscarriage, or preeclampsia (pooled OR range: 0.76-1.21; p > 0.05). CONCLUSIONS Extreme birth spacing has extensive adverse effects on maternal and infant health. In the general population, interpregnancy interval of 18-23 months may be associated with potential benefits for both mothers and infants. For women with previous preterm birth, the optimal birth spacing may be 9 months.
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Affiliation(s)
- Wanze Ni
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Xuping Gao
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Xin Su
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Jun Cai
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Shiwen Zhang
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Lu Zheng
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Jiazi Liu
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Yonghui Feng
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Shiyun Chen
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Junrong Ma
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
| | - Wenting Cao
- Department of Medical Statistics & Epidemiology, International School of Public Health and One HealthHainan Medical UniversityHaikouHainanChina
| | - Fangfang Zeng
- Department of Public Health and Preventive Medicine, School of MedicineJinan UniversityGuangzhouGuangdongChina
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Gelagay AA, Worku AG, Bashah DT, Tebeje NB, Gebrie MH, Yeshita HY, Cherkose EA, Ayana BA, Lakew AM, Asmamaw DB, Negash WD, Belachew TB, Fentie EA, Bitew DA. Factors affecting birth interval among mothers in Dabat district, Amhara Regional state, Northwest Ethiopia: A community-based cross-sectional study, 2022. Heliyon 2023; 9:e17046. [PMID: 37484230 PMCID: PMC10361109 DOI: 10.1016/j.heliyon.2023.e17046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 05/11/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Birth interval is the time period from live birth to a successive pregnancy or successive live birth which is the recommended to be at least 2 years or at least 33 months respectively. Both short and long birth intervals are associated with poor health outcomes for both mothers and babies. Therefore, the main objective of this study is to assess the length of birth intervals and its predictors among reproductive-age women in Dabat district.Methods: community-based cross-sectional survey conducted from December 10/2020 to January 10/2021. This study was done on 1262 multi para women. Five days training was given for the data collectors and supervisors. Bivariable and multivariable ordinal logistic regression analysis were done. Those variables which had P-value less than 0.25 in the bi variable analysis were entered to multivariable ordinal logistic regression analysis. An adjusted odds ratio with a 95% confidence interval and P-value less than 0.05 was used to determine significant determinants of birth interval. Result This study revealed that the magnitude of short and long birth interval was 30.59% and 22.82% respectively. Wealth status (poor: AOR = 0.72, CI: 0.53, 0.97), maternal education (Diploma and above: AOR = 2.79, CI: 1.18, 6.56), ANC follow up (having ante natal care: AOR = 2.15, CI: 1.72, 2.69), husband occupation (Employed: AOR = 1.77, CI: 1.03, 3.01) and history of abortion (abortion: AOR = 2.48, CI: 1.08, 5.66) were statistically significant factors. Conclusion Higher percentage of mothers have either short or long birth interval. Birth interval is affected by socio demographic characteristics of mothers and husbands.
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Affiliation(s)
- Abebaw Addis Gelagay
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebaw Gebeyehu Worku
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Debrework Tesgera Bashah
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Nigusie Birhan Tebeje
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mignote Hailu Gebrie
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Hedija Yenus Yeshita
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Endeshaw Adimasu Cherkose
- School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Birhanu Abera Ayana
- Department of Obstetrics and Gynecology, Zewuditu Memorial Hospital, Addis Ababa, Ethiopia
| | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desale Bihonegn Asmamaw
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubshet Debebe Negash
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadele Biresaw Belachew
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Elsa Awoke Fentie
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Desalegn Anmut Bitew
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Kassie SY, Ngusie HS, Demsash AW, Alene TD. Spatial distribution of short birth interval and associated factors among reproductive age women in Ethiopia: spatial and multilevel analysis of 2019 Ethiopian mini demographic and health survey. BMC Pregnancy Childbirth 2023; 23:275. [PMID: 37087447 PMCID: PMC10122344 DOI: 10.1186/s12884-023-05610-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 04/14/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Short Birth Interval negatively affects the health of both mothers and children in developing countries. Studies conducted in Ethiopia on the spatial variation and determinants of individual and community-level factors about short birth intervals were limited. Thus, this study was intended to assess the spatial variation of the short birth interval and its determinants in Ethiopia. METHODS This study is a secondary analysis of the Ethiopian Demographic and Health Survey (mini EDHS 2019). A total of 1784 reproductive-age women were included in the analysis. The global spatial autocorrelation (Global Moran's I) and the Getis-Ord statistics tool were used to detect the presence of clustering and the high/low hotspot areas of SBI respectively. Ordinary kriging was used to interpolate short birth intervals, and spatial scan statistics were employed to identify spatial clusters with high and low SBI. A multilevel multivariable model was used to identify predictors of a short birth interval. RESULTS The prevalence of SBI was 62.89% (95%CI: 59.3, 69.7) in Ethiopia. High clustering of SBI was observed in all parts of Somali, in Afar (zones 1, 3, 4, &5), Oromia (Guje, Bale, & West Harerge), and northern Tigray. The most likely significant primary cluster was observed in the Somali region. Women who lived in the primary cluster were 24% more likely to have a short birth interval than those who lived outside the window. In the multilevel mixed-effect analysis age 25-34 [(AOR = 0.40, 95% CI: 0.35, 0.45)], 35-49 [(AOR = 0.44, 95% CI: 0.38, 0.51)], Muslim religion follower [(AOR = 3.5, 95% CI: 2.7, 4.69)], no formal education [(AOR = 0.5, 95% CI: 0.37, 0.70)], primary education[(AOR = 0.4, 95%CI: 0.28, 0.53)], and secondary education [(AOR = 0.3, 95% CI: 0.24, 0.48)], middle [(AOR: 1.3, 95% CI: 1.2, 1.52)], rich wealth status [(AOR: 1.4, 95% CI: 1.3, 1.68)], female sex children [(AOR: 1.2, 95% CI: 1.09, 1.42)], and two or fewer ideal number of children [(AOR = 0.2, 95% CI: 0.25, 0.32)] were found to be significant predictors of SBI. CONCLUSION Overall, SBI was high and significantly clustered across the region of Ethiopia. Age, religion, education, wealth status, the sex of the indexed child, and the ideal number of children were found to be significantly associated with short birth intervals. Hence, the government should design a health promotion strategy and public health awareness in the identified hotspot areas of SBI and should scale up family planning and the wealth status of reproductive-age women.
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Affiliation(s)
- Sisay Yitayih Kassie
- Department of Health informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia.
| | - Habtamu Setegn Ngusie
- Department of Health informatics, School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Addisalem Workie Demsash
- Department of Health informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia
| | - Tilahun Dessie Alene
- Department of Pediatrics and Child Health, School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Islam MZ, Rahman MM, Khan MN. Effects of short birth interval on different forms of child mortality in Bangladesh: Application of propensity score matching technique with inverse probability of treatment weighting. PLoS One 2023; 18:e0284776. [PMID: 37083714 PMCID: PMC10121045 DOI: 10.1371/journal.pone.0284776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 04/07/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The prevalence of Short Birth Interval (SBI) is higher in Low- and Middle-Income countries (LMICs), including Bangladesh. Previous studies in LMICs have estimated the effects of SBI on child mortality by comparing two unequal groups of mothers based on their socio-economic status. This approach may lead to overestimation or underestimation of the true effect of birth interval on child mortality, particularly when sample sizes are relatively small. OBJECTIVE We determined the effects of SBI on several forms of child mortality in Bangladesh by comparing two equal groups created by applying the propensity score matching technique. METHODS This study analyzed data from 5,941 mothers and 1,594 health facilities extracted from the 2017/18 Bangladesh Demographic and Health Survey and the 2017 Bangladesh Health Facility Survey. The exposure variable was SBI (defined as the interval between two subsequent births <33 months: yes, no), while the outcome variables were neonatal mortality (defined as mortality within 28 days of birth: yes, no), infant mortality (defined as mortality within 1 year of birth: yes, no), and under-five mortality (defined as mortality within 5 years of birth: yes, no). Multilevel Poisson regression based on inverse probability treatment weights was used to determine the association between exposure and outcome variables. RESULTS The prevalence rates of neonatal, infant, and under-five mortality were 48.8, 30.8, and 23.1 per 1000 live births, respectively. Newborns of SBI mothers were found to have a 63% higher likelihood of neonatal mortality (aPR, 1.63; 95% CI, 1.08-2.46) compared to newborns of non-SBI mothers. Furthermore, the prevalence of infant mortality and under-five mortality was 1.45 times higher (aPR, 1.45; 95% CI, 1.01-2.08) and 2.82 times higher (aPR, 2.82; 95% CI, 2.16-3.70), respectively, among babies born in a short interval of their immediately preceding sibling as compared to babies born in a normal interval of their immediately preceding sibling. CONCLUSIONS Findings of this study indicate that SBI is an important predictor of child mortality. Consequently, around 1 million children born in a short interval every year in Bangladesh are at risk of dying before reaching their fifth birthday. This indicates a challenge for Bangladesh to achieve the SDG 3 target to reduce neonatal and under-five mortality to 12 and 25 deaths per 1000 live births, respectively. Hence, awareness-building programs about the adverse effects of SBI and strengthening existing healthcare facilities are important.
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Affiliation(s)
- Mohammad Zahidul Islam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
- Department of Population Science and Human Resource Development, Rajshahi University, Rajshahi, Bangladesh
| | - Md Mostafizur Rahman
- Department of Population Science and Human Resource Development, Rajshahi University, Rajshahi, Bangladesh
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
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Tesema GA, Wolde M, Tamirat KS, Worku MG, Fente BM, Tsega SS, Tadesse A, Teshale AB. Factors associated with short birth interval among reproductive-age women in East Africa. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231209879. [PMID: 37955253 PMCID: PMC10644753 DOI: 10.1177/17455057231209879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 08/26/2023] [Accepted: 09/28/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND Child and maternal mortality continue as a major public health concern in East African countries. Optimal birth interval is a key strategy to curve the huge burden of maternal, neonatal, infant, and child mortality. To reduce the incidence of adverse pregnancy outcomes, the World Health Organization recommends a minimum of 33 months between two consecutive births. Even though short birth interval is most common in many East African countries, as to our search of literature there is limited study published on factors associated with short birth interval. Therefore, this study investigated factors associated with short birth intervals among women in East Africa. OBJECTIVE To identify factors associated with short birth intervals among reproductive-age women in East Africa based on the most recent demographic and health survey data. DESIGN A community-based cross-sectional study was conducted based on the most recent demographic and health survey data of 12 East African countries. A two-stage stratified cluster sampling technique was employed to recruit the study participants. METHODS AND ANALYSIS A total weighted sample of 105,782 reproductive-age women who had two or more births were included. A multilevel binary logistic regression model was fitted to identify factors associated with short birth interval. Four nested models were fitted and a model with the lowest deviance value (-2log-likelihood ratio) was chosen. In the multivariable multilevel binary logistic regression analysis, the adjusted odds ratio with the 95% confidence interval was reported to declare the statistical significance and strength of association between short birth interval and independent variables. RESULTS The prevalence of short birth interval in East Africa was 16.99% (95% confidence interval: 16.76%, 17.21%). Women aged 25-34 years, who completed their primary education, and did not perceive the distance to the health facility as a major problem had lower odds of short birth interval. On the contrary, women who belonged to the poorest household, made their own decisions with their husbands/partners or by their husbands or parents alone, lived in households headed by men, had unmet family planning needs, and were multiparous had higher odds of having short birth interval. CONCLUSION Nearly one-fifth of births in East Africa had short birth interval. Therefore, it is essential to promote family planning coverage, improve maternal education, and empower women to decrease the incidence of short birth intervals and their effects.
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Affiliation(s)
- Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Maereg Wolde
- Department of Health Education and Behavioral Sciences, Institute of Public Health, University of Gondar, Gondar, Ethiopia
| | - Koku Sisay Tamirat
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bezawit Melak Fente
- Department of General Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aster Tadesse
- Department of Nursing, College of Health Sciences, Debre Markos University, Markos, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Thompson K, Portrait F, Lindeboom M. Is paternal height related to fertility outcomes? Evidence from the Netherlands during the secular growth trend. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101172. [PMID: 35961262 DOI: 10.1016/j.ehb.2022.101172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/21/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
Over the past two centuries, the Dutch experienced a tremendous secular trend in height, and ultimately became the tallest nation in the world. Improving environmental conditions likely played the largest role in explaining these developments. But it is not yet precisely clear what factor set the Dutch head and shoulders above other nations, who were also experiencing improving environmental conditions. Could fertility also have played a role? To understand this, we would first need to know whether height and fertility were related during the secular growth trend. In this study, we investigated whether this was the case. A sample of Dutch men, birth years 1850-1900 (n = 3396), was examined. We tested the extents to which height was associated with having a certain number of children, and with having a certain number of children survive infancy. Multinomial logistic regressions were used. In terms of findings, height's relationship to fertility outcomes was curvilinear: being shorter-than-average (0.75-0.5 standard deviations below the mean height) was associated with a higher probability of being married and having five to seven children, while being moderately tall (0.5 standard deviations above the mean height) was associated with the lowest probability of being unmarried. There was no relationship between paternal height and children surviving infancy in the sample overall, but taller height was associated with a decreased risk of being in a high-mortality family among men born between 1880 and 1900. If paternal fertility played a role in the secular growth trend, we would expect to see very tall men have the most children, and clearly have the most children surviving infancy. Given this study's findings, it is unlikely that this was the case.
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Affiliation(s)
- Kristina Thompson
- Health and Society, Department of Social Sciences, Wageningen, the Netherlands.
| | - France Portrait
- School of Business Economics, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Maarten Lindeboom
- School of Business Economics, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Wegbom AI, Bademosi A, Edet CK, Green KI, Sapira-Ordu L, Fagbamigbe AF. Rural-urban disparities in birth interval among women of reproductive age in Nigeria. Sci Rep 2022; 12:17488. [PMID: 36261492 PMCID: PMC9581961 DOI: 10.1038/s41598-022-22142-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 10/10/2022] [Indexed: 01/12/2023] Open
Abstract
Nigeria like most developing nations still faced with a higher rate of short birth interval (SBI), and its associated consequences, such as adverse maternal and child health outcomes. This study aimed to determine the distribution and factors associated with SBI in rural and urban Nigeria. The data for this study were extracted from the 2018 Nigeria Demographic and Health Survey (2018 NDHS). Statistical analyses were descriptive analysis and binary logistic model. The proportions of SBI in rural and urban Nigeria were 20.7% and 20.3% respectively. Women's age, geopolitical region, education level, and the number of children ever born were significantly associated with SBI in rural and urban Nigeria. Maternal Wealth index and antenatal care visits were only significant in rural while working status was only significant in urban Nigeria after controlling for other factors. Higher odds of SBI for middle class women than poor women (AOR = 1.19, 95% CI = 1.06-1.35), and increase in ANC visits reduces the odds of having SBI: 4-7 visits (AOR = 0.87, 95% CI = 0.77-0.98) and > 7visits (AOR = 0.83, 95% CI = 0.69-0.99). There were slight disparities in the prevalence of short birth intervals in rural and urban areas. Wealth index and ANC visits were only significant in rural Nigeria. Public health awareness campaigns should be strengthened to drive the importance of birth spacing techniques such as the utilization of modern contraceptives and breastfeeding in all the geo-political regions and across all age strata. Women particularly those residing in the rural areas should be encouraged to advance their education to at least a secondary level and enlightened on the importance of ANC.
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Affiliation(s)
- Anthony Ike Wegbom
- grid.412214.00000 0000 9408 7151Department of Community Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Nigeria
| | - Adetomi Bademosi
- grid.412214.00000 0000 9408 7151Department of Community Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Nigeria
| | - Clement Kevin Edet
- grid.412214.00000 0000 9408 7151Department of Community Medicine, College of Medical Sciences, Rivers State University, Port Harcourt, Nigeria
| | - Kinikanwo Innocent Green
- grid.412738.bDepartment of Obstetrics and Gynaecology, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Leesi Sapira-Ordu
- grid.412214.00000 0000 9408 7151Department of Obstetrics and Gynaecology, College of Medical Sciences, Rivers State University, Port Harcourt, Nigeria
| | - Adeniyi Francis Fagbamigbe
- grid.9582.60000 0004 1794 5983Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Asratie MH, Andualem Z. Predictors of early resumption of post-partum sexual intercourse among post-partum period women in Ethiopia: A multilevel analysis based on Ethiopian demographic and health survey 2016. PLoS One 2022; 17:e0271372. [PMID: 36084107 PMCID: PMC9462818 DOI: 10.1371/journal.pone.0271372] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background Early resumption of post-partum sexual intercourse has an adverse outcome on the health of women and indirectly unintended pregnancy might happen and affects both the health of women and the delivered baby. There is limited evidence that shows predictors at the individual and community level from the Ethiopian demographic and health survey. Therefore, the aim of this study was to assess predictors of early resumption of post-partum sexual intercourse among post-partum period women in Ethiopia: a multilevel analysis based on Ethiopian demographic and health survey 2016. Methods This study used an in-depth secondary data analysis of the survey using the 2016 main EDHS. A total weighted sample of 6447 post-partum women who have children aged 0 to 36 months (about 3 years) was included for the analysis. Multilevel binary logistic regression analysis was conducted considering the hierarchical nature of the EDHS data. Intra-class Correlation Coefficient (ICC), and deviance [-2 Log-Likelihood Ratio (LRR)] were used for model comparison and for assessing model fitness. In a multivariable analysis adjusted OR with a 95% CI (Confidence Interval) was reported with a p-value <0.05 was used to declare a significant association between the explanatory and the outcome variables. Results The proportion of early resumption of post-partum sexual intercourse was found to be 60.41% [95% CI 59.19–61.63]. Women with age group of 25–28 (AOR = 0.8; 95% CI 0.67–0.96), 29–32 (AOR = 0.79; 95% CI 0.63–0.98), and 33–49 (AOR = 0.67; 95% CI 0.53–0.85), women with sex of child female (AOR = 0.82; 95% CI 0.73–0.92), women whose child is alive (AOR = 0.52; 95% CI 0.38–0.69), women who delivered by cesarean section(AOR = 0.34; 95% CI 0.23–0.49), women with primary educational level (AOR = 1.27; 95% CI 1.09–1.48), women with secondary educational level (AOR = 1.61; 95% CI 1.19–2.17) and women with higher educational level (AOR = 1.6; 95% CI 1.05–2.45), Para 3–4 women (AOR = 1.45; 95% CI 1.21–1.73) and women with grand multi parity (AOR = 1.61; 95% CI 1.29–2), women with fertility desire wanted latter (AOR = 0.81; 95% CI 0.69–0.94), women with fertility desire wanted no more (AOR = 0.81; 95% CI 0.66–1.01), women who are on family planning use (AOR = 1.2; 95% CI 1.05–1.38) and participant with currently on working (AOR = 0.79; 95% CI 0.69–0.91) were significantly associated with early resumption of post-partum sexual intercourse. Conclusions The magnitude of early resumption of post-partum sexual intercourse was found to be high. Giving emphasis to the age groups of 25–28, 29–32, and 33–49 women, women with the sex of child female, women who delivered by cesarean section, currently working, the child is live, fertility desire wanted later and no more were suggested to reduce early resumption of post-partum sexual intercourse. On the other hand, improved educational attainments of women, women with parity 3–4, and >5, and family planning use were variables to increase early resumption of post-partum sexual intercourse. Therefore, the health care providers and program managers should act on early resumption of post-partum sexual intercourse through health education and promotion considering the significant factors.
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Affiliation(s)
- Melaku Hunie Asratie
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Zewudu Andualem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health sciences, University of Gondar, Gondar, Ethiopia
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Wakeyo MM, Kebira JY, Assefa N, Dheresa M. Short birth interval and its associated factors among multiparous women in Mieso agro-pastoralist district, Eastern Ethiopia: A community-based cross-sectional study. Front Glob Womens Health 2022; 3:801394. [PMID: 36159883 PMCID: PMC9490409 DOI: 10.3389/fgwh.2022.801394] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background Recently, the concern with birth interval has acquired importance in public health and family planning because of its implication for fertility, maternal, and child health. A short birth interval is associated with adverse perinatal, maternal, and infant outcomes. Moreover, too short birth interval lead to high fertility, which in turn contributes to accelerated population growth and undermines development efforts. This study aimed to investigate the prevalence of short birth interval and its associated factors among multiparous women in the Mieso agro-pastoralist district, Oromia region, Eastern Ethiopia. Methods A community-based cross-sectional study was conducted from 1 to 30 March 2020. The multistage sampling technique was used to select 490 multiparous women. Data were collected by face-to-face interviewer-administered structured questionnaires. Bivariate and multivariable logistic regression analyses were executed. Model fitness and multicollinearity were checked. Statistically significant associations of outcome and independent variables were declared at a P-value of < 0.05. Results The prevalence of short birth interval was 56% (95% CI: 51.4–60.5) in the study area. Being married under 18 years (AOR = 3.78, 95% CI: 1.97–7.25), having formal education (AOR = 0.23, 95% CI: 0.11–0.47), having a husband with formal education (AOR = 0.46, 95% CI: 0.22–0.99), having awareness about optimum birth interval (AOR = 0.47, 95% CI: 0.24–0.91), having female index child (AOR = 1.78, 95% CI: 1.07–3.84), death of the index child (AOR = 0.34, 95% CI: 0.12–0.92), breastfeeding of the index child <24 months (AOR = 2.6, 95% CI: 1.53–4.41), use of modern contraceptive (AOR = 2.09, 95% CI: 1.12–3.89), and decision-making by a husband alone when to have a child (AOR = 3.86, 95% CI: 2.06–7.21) were significantly associated with short birth interval at a P-value <0.05. Conclusion The overall prevalence of short birth interval among the study participants was high, as more than half of the women had practiced short birth interval, indicating that the majority of the mother and children in the study area are still at high risk of mortality and morbidity associated with short birth interval. Thus, the current findings suggest that interventions that involve the provision of contraceptives and information on its benefit at points need to be adopted to reach the national and global target of maternal and child mortality reduction attributed to short birth interval.
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Affiliation(s)
| | - Jemal Yusuf Kebira
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- *Correspondence: Jemal Yusuf Kebira
| | - Nega Assefa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Merga Dheresa
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Islam MZ, Billah A, Islam MM, Rahman M, Khan N. Negative effects of short birth interval on child mortality in low- and middle-income countries: A systematic review and meta-analysis. J Glob Health 2022; 12:04070. [PMID: 36057919 PMCID: PMC9441110 DOI: 10.7189/jogh.12.04070] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Methods Eight databases, PubMed, CINAHL, Web of Science, Embase, PsycINFO, Cochrane Library, Popline, and Maternity and Infant Care, were searched, covering the period of January 2000 to January 2022. Studies that had examined the association between SBI and any form of child mortality were included. The findings of the included studies were summarized through fixed-effects or random-effects meta-analysis and the model was selected based on the heterogeneity index. Results A total of 51 studies were included. Of them, 19 were conducted in Ethiopia, 10 in Nigeria and 7 in Bangladesh. Significant higher likelihoods of stillbirth (odds ratio (OR) = 2.11; 95% confidence interval (CI) = 1.32-3.38), early neonatal mortality (OR = 1.58; 95% CI = 1.04-2.41), perinatal mortality (OR = 1.71; 95% CI = 1.32-2.21), neonatal mortality (OR = 1.85; 95% CI = 1.68-2.04), post-neonatal mortality (OR = 3.01; 95% CI = 1.43-6.33), infant mortality (OR = 1.92; 95% CI = 1.77-2.07), child mortality (OR = 1.67; 95% CI = 1.27-2.19) and under-five mortality (OR = 1.95; 95% CI = 1.56-2.44) were found among babies born in short birth intervals than those who born in normal intervals. Conclusions SBI significantly increases the risk of child mortality in LMICs. Programmes to reduce pregnancies in short intervals need to be expanded and strengthened. Reproductive health interventions aimed at reducing child mortality should include proper counselling on family planning, distribution of appropriate contraceptives and increased awareness of the adverse effects of SBI on maternal and child health.
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Affiliation(s)
- Mohammad Zahidul Islam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh.,Department of Population Science and Human Resource Development, University of Rajshahi, Bangladesh
| | - Arif Billah
- Department of Social Work and Counselling, Faculty of Business, Economics and Social Development, Universiti Malaysia Terengganu, Malaysia
| | - M Mofizul Islam
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Mostafizur Rahman
- Department of Population Science and Human Resource Development, University of Rajshahi, Bangladesh
| | - Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Mymensingh, Bangladesh
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Short birth interval and associated factors among women who gave birth in the last three years in Dembecha district, Northwest Ethiopia. PLoS One 2022; 17:e0272612. [PMID: 35998184 PMCID: PMC9398008 DOI: 10.1371/journal.pone.0272612] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 07/22/2022] [Indexed: 11/19/2022] Open
Abstract
Background Maternal and child mortality remains a major public health problem in Ethiopia. Improving short birth interval practice is a main strategy to reduce neonatal mortality, maternal mortality, adverse pregnancy outcomes, high fertility rate, and enhance economic development efforts. However, there has been limited study done regarding short birth intervals in the study area. Therefore, this study aimed to assess short birth intervals and associated factors among women who gave birth in the last three years in Dembecha district, Northwest Ethiopia, 2019. Method A community-based cross-sectional study was conducted among 880 reproductive-age multipara mothers using a stratified cluster sampling technique. The data were collected by face-to-face interviews through pretested and semi-structured questionnaires. Bivariable and multivariable logistic regression model was fitted. Variables with a p-value ≤0.05 were considered statistically significant factors. Adjusted odds ratio with a 95% confidence interval was used to report the association between predictors and the outcome variable. Results The prevalence of short birth interval was found to be 43.4% (95% CI: 40.2, 46.9). Husband education (able to read and write) [AOR:2.81,(95% CI:1.04,7.85)], wealth index (lowest quartile) [AOR:3.75,(95% CI:2.35,5.97), residence (urban) [AOR:3.20,(95% CI:1.62,6.33)],age at first marriage (15–17 years old) [AOR: 1.65,(95% CI:1.15, 2.26),and non-use of contraceptive [AOR: 8.78, (95% CI: 6.18, 12.47) were statistically significant variables. Conclusion The study revealed that the prevalence of short birth intervals among multipara women is found to be high. Husband education, wealth index, urban residence, age at first marriage, and non-use of contraceptives were variables significantly associated with short birth intervals. Hence, to overcome the problem the focus should be on increasing family planning utilization, avoiding early marriage, strengthening paternal education, and improving family income.
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Duration of inter-pregnancy interval and its predictors among pregnant women in urban South Ethiopia: Cox gamma shared frailty modeling. PLoS One 2022; 17:e0271967. [PMID: 35913995 PMCID: PMC9342774 DOI: 10.1371/journal.pone.0271967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Short inter-pregnancy interval is a public health concern because it results in adverse perinatal outcomes such as postpartum hemorrhage, anemia, premature birth, low birth weight, and perinatal deaths. Although it is critical to understand the factors that contribute to short inter-pregnancy interval to reduce the risk of these negative outcomes, adequate evidence about the factors in the urban context is lacking. Therefore, we aimed to assess the duration of the inter-pregnancy interval and its predictors among pregnant women in urban South Ethiopia.
Methods
A community-based retrospective follow-up study was conducted among 2171 pregnant women in five geographically diverse urban settings in South Ethiopia. For the analysis, a Cox gamma shared frailty (random-effect) model was used. Adjusted hazard ratio (AHR) with a 95% CI was used to assess significant predictors. The median hazard ratio (MHR) used to report clustering effect.
Results
The median duration of the inter-pregnancy interval was 22 months, 95% CI (21, 23), with an inter-quartile range of 14 months. Maternal age ≥30 years [AHR = 0.75, 95% CI: 0.58, 0.97], having no formal education [AHR = 0.60, 95% CI: 0.46, 0.78], contraceptive non-use [AHR = 2.27, 95% CI: 1.94, 2.66], breastfeeding for <24 months [AHR = 4.92, 95% CI: 3.95, 6.12], death of recent child [AHR = 2.90, 95% CI: 1.41, 5.97], plan pregnancy within 24 months [AHR = 1.72, 95% CI: 1.26, 2.35], lack of discussion with husband [AHR = 1.33, 95% CI: 1.10, 1.60] and lack of husband encouragement about pregnancy spacing [AHR = 1.25, 95% CI: 1.05, 1.48] were predictors of short inter-pregnancy interval. Adjusting for predictors, the median increase in the hazard of short inter-pregnancy interval in a cluster with higher short inter-pregnancy interval is 30% [MHR = 1.30, 95% CI: 1.11, 1.43] than lower cluster.
Conclusions
In the study settings, the duration of the inter-pregnancy interval was shorter than the World Health Organization recommendation. There is a need to improve contraceptive use and breastfeeding duration to maximize the inter-pregnancy interval. Men’s involvement in reproductive health services and advocacy for women’s reproductive decision-making autonomy are fundamental. The contextual disparities in the inter-pregnancy interval suggests further study and interventions.
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Black KI, Middleton P, LibSt G, Huda TM, Srinivasan S. Interconception Health: Improving Equitable Access to Pregnancy Planning. Semin Reprod Med 2022; 40:184-192. [PMID: 35901810 DOI: 10.1055/s-0042-1744517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Challenges remain with the implementation of preconception care, as many women do not plan their pregnancies and clinicians do not initiate preconception consultations. However, the interconception period may present a more opportune time to address health issues that impact on pregnancy outcomes and may influence future conceptions. It is also an important time to focus on pregnancy complications that may influence a person's health trajectory. This review discusses the evidence pointing to a need for greater attention on interconception health and focuses on five areas of care that may be particularly important in affecting equitable access to good care before a subsequent pregnancy: interpregnancy intervals, contraception, weight, nutrition, and gestational diabetes follow-up. Several programs internationally have developed models of care for interconception health and this review presents one such model developed in the United States that explicitly seeks to reach vulnerable populations of women who may otherwise not receive preconception care.
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Affiliation(s)
- Kirsten I Black
- Faculty of Medicine and Health, Central Clinical School, The University of Sydney, Sydney, New South Wales, Australia
| | | | - GradDip LibSt
- Pregnancy and Perinatal Care, SAHMRI Women and Kids, Women's and Children's Hospital, North Adelaide, SA, Australia
| | - Tanvir M Huda
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Sukanya Srinivasan
- UPMC McKeesport Family Medicine Residency, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Byamukama O, Migisha R, Kalyebara PK, Tibaijuka L, Lugobe HM, Ngonzi J, Ahabwe OM, Garcia KRM, Mugyenyi GR, Boatin AA, Muhumuza J, Ssalongo WGM, Kayondo M, Kanyesigye H. Short interbirth interval and associated factors among women with antecedent cesarean deliveries at a tertiary hospital, Southwestern Uganda. BMC Pregnancy Childbirth 2022; 22:268. [PMID: 35354443 PMCID: PMC8969244 DOI: 10.1186/s12884-022-04611-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Women with previous cesarean deliveries, have a heightened risk of poor maternal and perinatal outcomes, associated with short interbirth intervals. We determined the prevalence of short interbirth interval, and associated factors, among women with antecedent cesarean deliveries who delivered at Mbarara Regional Referral Hospital (MRRH), in southwestern Uganda. METHODS We conducted a cross-sectional study on the postnatal ward of MRRH from November 2020 to February 2021. We enrolled women who had antecedent cesarean deliveries through consecutive sampling. We obtained participants' socio-demographic and obstetric characteristics through interviewer-administered structured questionnaires. We defined short interbirth interval as an interval between two successive births of < 33 months. Modified Poisson regression was used to identify factors associated with short interbirth intervals. RESULTS Of 440 participants enrolled, most had used postpartum family planning (PPFP) prior to the current pregnancy (67.5%), and most of the pregnancies (57.2%) were planned. The mean age of the participants was 27.6 ± 5.0 years. Of the 440 women, 147 had a short interbirth interval, for a prevalence of 33% (95%CI: 29-38%). In multivariable analysis, non-use of PPFP (adjusted prevalence ratio [aPR] = 2.24; 95%CI: 1.57-3.20, P < 0.001), delivery of a still birth at an antecedent delivery (aPR = 3.95; 95%CI: 1.43-10.9, P = 0.008), unplanned pregnancy (aPR = 3.59; 95%CI: 2.35-5.49, P < 0.001), and young maternal age (aPR = 0.25 for < 20 years vs 20-34 years; 95%CI: 0.10-0.64, P = 0.004), were the factors significantly associated with short interbirth interval. CONCLUSION One out of every three womenwith antecedent caesarean delivery had a short interbirth interval. Short interbirth intervals were more common among women with history of still births, those who did not use postpartum family planning methods, and those whose pregnancies were unplanned, compared to their counterparts. Young mothers (< 20 years) were less likely to have short interbirth intervals compared to those who were 20 years or older. Efforts should be made to strengthen and scale up child-spacing programs targeting women with previous cesarean deliveries, given the high frequency of short interbirth intervals in this study population.
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Affiliation(s)
- Onesmus Byamukama
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
| | - Richard Migisha
- Department of Physiology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Paul Kato Kalyebara
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Leevan Tibaijuka
- Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Henry Mark Lugobe
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Joseph Ngonzi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Onesmus Magezi Ahabwe
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Kenia Raquel Martinez Garcia
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Godfrey R Mugyenyi
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Adeline Adwoa Boatin
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, USA
| | - Joy Muhumuza
- Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Wasswa G M Ssalongo
- Department of Obstetrics and Gynecology, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Musa Kayondo
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
| | - Hamson Kanyesigye
- Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, P.O. Box 1410, Mbarara, Uganda
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Alhassan A, Anyinzaam-Adolipore J, Abdulai K. Short birth interval in Ghana: Maternal socioeconomic predictors and child survival. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/145914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Mihretie GN, Getie SA, Shiferaw S, Ayele AD, Liyeh TM, Kassa BG, Asferie WN. Interbirth interval practices among reproductive age women in rural and Urban kebeles in Farta Woreda: Case-control study. PLoS One 2022; 17:e0256193. [PMID: 35085250 PMCID: PMC8794163 DOI: 10.1371/journal.pone.0256193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 08/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Closely spaced births have been reported all over the world especially in developing countries, and they have been correlated with poor maternal and infant health. Enhancing optimal birth interval is one of the key strategies to promote the health status of mothers and their children. However, factors affecting short birth intervals have not been identified in the study area and region. This study was aimed to assess determinants of short birth interval practice among reproductive women in Farta woreda, Ethiopia, 2019. METHODS Community based unmatched case-control study design was conducted from February to March 2019. The sample size of 303 (101 case and 202 controls) was included by using multistage sampling and then study participants were selected by simple random sampling technique. The data was collected by structured and pre-tested face-to-face interviewer-administered questionnaires from the selected respondents. The collected data were entered with Epi-Data version 4.2 and analyzed by using SPSS version 23 software. Bivariate and multivariate analyses were used to examine the association. Odds ratios, 95% CI, and P-value <0.05 were used to determine the statistical association. RESULTS Women who had no formal education (AOR = 2.15, 95% CI (1.19, 3.88), had not a history of antenatal care follow up (AOR = 2.66, 95% CI (1.55, 4.56)), did not use modern contraceptives before getting the latest pregnancy (AOR = 3.48, 95% CI (1.74, 6.95)) and duration of breastfeeding less than 24 months (AOR = 3.59, 95% CI (2.06, 6.24)) were significantly associated with short birth interval. CONCLUSIONS AND RECOMMENDATION Maternal education, duration of breastfeeding, contraceptive utilization, and antenatal follow-up were identified as the predictor variables of short birth interval practice. Therefore, providing health information for reproductive-age women about the benefit of contraceptive utilization, breastfeeding practice and antenatal care follow up to minimize problems resulting from the short birth intervals.
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Affiliation(s)
- Gedefaye Nibret Mihretie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Simegnew Asmer Getie
- Department of Midwifery, College of Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia
| | - Shumye Shiferaw
- Department of Midwifery, College of Health Sciences, Bahir Dar University, Bahir Dar City, Ethiopia
| | - Alemu Degu Ayele
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Tewachew Muche Liyeh
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Bekalu Getnet Kassa
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Worku Necho Asferie
- Department of Neonatal Nursing and Child Health, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
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Tuz-Zahura F, Sen KK, Nilima S, Bari W. Can women's 3E index impede short birth interval? evidence from Bangladesh Demographic and Health Survey, 2017-18. PLoS One 2022; 17:e0263003. [PMID: 35081128 PMCID: PMC8791508 DOI: 10.1371/journal.pone.0263003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 01/10/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Women's empowerment, education, and economic status are jointly introduced as women's 3E. A number of studies found the significant association of these three variables with maternal health outcomes, but no studies, to the best of knowledge, have been found to justify the joint influence of women's 3E on the birth interval. As several studies have revealed that the short birth interval increases the risk of adverse maternal, perinatal, and infant outcomes and it is also responsible for increasing the country's population size, more research is needed on the birth interval. Therefore, the present study aimed to investigate the influence of women's 3E on the short birth interval after controlling the other selected covariates. METHODS Data from the Bangladesh Demographic and Health Survey (BDHS), 2017-18 have been used to serve the purpose of the study. To measure the birth interval, at least two live births for non-pregnant mothers and at least one live birth for currently pregnant mothers born in the 5 years before the survey were included in the study. The Chi-Square test was applied to know the unadjusted association of the selected covariates including women's 3E with the short birth interval. In order to find out the adjusted association of women's 3E with the short birth interval, sequential binary logistic regression models have been used. RESULTS The study found that about 23% of births in Bangladesh were born in a short birth interval. The likelihood of subsequent births of women decreases with an increase in the score of women's 3E before or after controlling the characteristics of women, child, and households. The results of the final model show that mothers with the coverage of 50% - 75%, 75% - 100%, and full coverage (100%) in 3E have a 23%, 41%, and 42% lower odds of having short birth interval compared to mothers with coverage of below 50% in 3E, respectively. CONCLUSION AND RECOMMENDATION Bangladesh still lags behind in meeting the minimum requirements for inter-birth intervals set by the World Health Organization. The study has shown that the 3E in women can contribute in prolonging the duration of subsequent births in Bangladesh. Policy-making interventions are needed to raise awareness among uneducated, under-empowered and economically poor reproductive women through family planning and fertility control programs so that the country can achieve the desired fertility rate.
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Affiliation(s)
| | | | - Shahnaz Nilima
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
| | - Wasimul Bari
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
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Roble AK, Osman MO, Ibrahim AM, Wedajo GT, Abdi Usman S. Determinants of short birth interval among ever married reproductive age women living in Jigjiga, Eastern Ethiopia 2020 (unmatched case-control study). SAGE Open Med 2022; 9:20503121211067870. [PMID: 34992784 PMCID: PMC8725026 DOI: 10.1177/20503121211067870] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: A short birth interval is a universal public health problem resulting in adverse maternal, neonatal, and child outcomes. Therefore, the aim of this study was to identify determinants of short birth interval among ever married reproductive age mothers who live in Jigjiga city administration, Eastern Ethiopia, 2020. Methods: A community-based unmatched case–control study was used among 194 cases and 194 controls in Jigjiga city administration from September to December 2020. Cases were women with short birth interval (less than 3 years) and controls were women with optimum birth interval (3–5 years). Simple random sampling technique was employed to select cases and controls. Data were entered into Epi data version 4.2 and analysis with SPSS version 22. Binary logistic regression with 95% confidence interval at p < 0.05 is used to declare significantly associated predictors of short birth interval. Result: This study reported that women who have not attended formal education (adjusted odds ratio = 5.28, 95% confidence interval: (2.25–12.36)), attended primary education (adjusted odds ratio = 2.79, 95% confidence interval: (1.46–5.34)), women who married to a polygamous husband (adjusted odds ratio = 3.69, 95% confidence interval: (1.80–7.58)), having a history of neonatal death (adjusted odds ratio = 2.15, 95% confidence interval: (1.07–4.32)), preceding child being female (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)), and never used contraceptive methods (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)) were identified as determinants of the short birth interval. Conclusion: Short birth intervals were associated with educational level of the women, sex of the baby, husband marriage types, history of neonatal death, and contraceptive utilization. Strategy should be engaged to enhance women education, contraceptive uses, and to decrease neonatal death.
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Affiliation(s)
- Abdurahman Kedir Roble
- Department of Midwifery, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Mohamed Omar Osman
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Ahmed Mohamed Ibrahim
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Girma Tadesse Wedajo
- Department of Public Health, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
| | - Seid Abdi Usman
- Department of Nursing, College of Medicine and Health Science, Jigjiga University, Jigjiga, Ethiopia
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Islam MZ, Islam MM, Rahman MM, Khan MN. Prevalence and risk factors of short birth interval in Bangladesh: Evidence from the linked data of population and health facility survey. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000288. [PMID: 36962161 PMCID: PMC10021594 DOI: 10.1371/journal.pgph.0000288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 03/02/2022] [Indexed: 11/19/2022]
Abstract
The Sustainable Development Goals 3 targets significant reductions in maternal and under-five deaths by 2030. The prevalence of these deaths is significantly associated with short birth intervals (SBI). Identification of factors associated with SBI is pivotal for intervening with appropriate programmes to reduce occurrence of SBI and associated adverse consequences. This study aimed to determine the factors associated with SBI in Bangladesh. A total of 5,941 women included in the 2017/18 Bangladesh Demographic and Health Survey 2017/18 and 1,524 healthcare facilities included in the 2017 Bangladesh Health Facility were linked and analysed. The sample was selected based on the availability of the birth interval data between the two most recent subsequent live birth. SBI was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization and was the outcome variable. Several individual-, households-, and community-level factors were considered as exposure variables. We used descriptive statistics to summarise respondents' characteristics and multilevel Poisson regression to assess the association between the outcome variable with exposure variables. Around 26% of live births occurred in short intervals, with a further higher prevalence among younger, uneducated, or rural women. The likelihoods of SBI were lower among women aged 20-34 years (PR, 0.14; 95% CI, 0.11-0.17) and ≥35 years (PR, 0.03; 95% CI, 0.02-0.05) as compared to the women aged 19 years or less. Women from households with the richest wealth quintile experienced lower odds of SBI (PR, 0.61; 95% CI, 0.45-0.85) compared to those from the poorest wealth quintile. The prevalences of SBI were higher among women whose second most recent child died (PR, 5.23; 95% CI, 4.18-6.55), those who were living in Chattogram (PR, 1.52; 95% CI, 1.12-2.07) or Sylhet (PR, 2.83, 95% CI, 2.08-3.86) divisions. Availability of modern contraceptives at the nearest healthcare facilities was 66% protective to the occurrence of SBI (PR, 0.34; 95% CI, 0.22-0.78). Also, the prevalence of SBI increased around 85% (PR, 1.85; 95% CI, 1.33-2.18) for every kilometer increase in the distance of nearby health facilities from women's homes. Targeted and tailored regional policies and programmes are needed to increase the awareness of SBI and associated adverse health outcomes and availability of modern contraception in the healthcare facilities.
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Affiliation(s)
- Mohammad Zahidul Islam
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
- Department of Population Science and Human Resource Development, Rajshahi University, Rajshahi, Bangladesh
| | - M Mofizul Islam
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - Md Mostafizur Rahman
- Department of Population Science and Human Resource Development, Rajshahi University, Rajshahi, Bangladesh
| | - Md Nuruzzaman Khan
- Department of Population Science, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh, Bangladesh
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Kikula AI, Pembe AB, Sunguya B. Short inter-pregnancy interval: why is it still high among women in Dar es Salaam? Pan Afr Med J 2021; 40:17. [PMID: 34733385 PMCID: PMC8531956 DOI: 10.11604/pamj.2021.40.17.29770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/16/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction in Tanzania, for the past decade, there has been a rising trend of women with short inter-pregnancy interval (IPI) (16% to 19%). Short IPI is associated with poor maternal and neonatal outcomes. We aimed to determine the factors associated with short IPI among women attending antenatal clinic (ANC) at Mnazi Mmoja Hospital, Dar es Salaam, Tanzania. Methods a cross-sectional study was conducted in September 2018 at Mnazi Mmoja hospital among women receiving ante-natal care. A total of 530 women were included in the analysis. Analysis was conducted through SPSS version 24 computer program using descriptive analyses to determine the IPI and characteristics thereof, and logistic regression analysis to examine factors associated with IPI among pregnant women. Associations with a p-value < 0.05 were considered statistically significant. Results twenty-two percent of the women attending ANC in Mnazi Mmoja hospital had short IPI. Short IPI was associated with young (<25years) age (AOR=2.67, 95% CI=1.23-5.79); non-use of a contraceptive method (AOR=2.05, 95%CI=1.22-3.45); breastfeeding for less than 6 months (AOR=3.45, 95% CI=1.17-10.13) and having an antecedent dead child at the time of index conception (AOR=3.38, 95% CI=1.15-9.93). Conclusion about 1 in every 5 women attending ANC in Dar es Salaam had a short IPI. Addressing short IPI will complement the government´s efforts to improve maternal indicators in Tanzania and areas with similar contexts. Such efforts should emphasize in adherence to recommended infant feeding practices, women at a younger reproductive age group, those with a history of pregnancy loss, and strengthening contraception use among women of reproductive age.
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Affiliation(s)
- Amani Idris Kikula
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Andrea Barnabas Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Bruno Sunguya
- School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Fekene DB, Bulto GA, Woldeyes BS, Dina GD, Negash KM. Determinants of adverse birth outcome in the west shewa zone, Oromia, regional state, Ethiopia: Unmatched case-control study. JOURNAL OF MOTHER AND CHILD 2021; 25:9-18. [PMID: 34643348 PMCID: PMC8603841 DOI: 10.34763/jmotherandchild.20212501.d-21-00003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/17/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Adverse birth outcome (ABO) can lead to higher rates of poor health and infection for newborns, as well as long-term neurological and health problems. Hence, the aim is to identify determinants of ABOs among mothers who gave birth in hospitals in West Shewa zone, Ethiopia. METHODS A hospital-based, unmatched, case-control study was conducted from March 5to July 29, 2020, among 591mothers (171 cases and 420 controls) who had given birth in hospitals found in West Shewa zone. The questionnaire was collected using census and survey processing system (CS-Pro) version7.1.The data were entered into Epi-data version 3.1 and analyzed by SPSS software version 23. Descriptive statistics, bivariate analysis, and multivariate logistic regression analysis were performed. Finally, P-value < 0.05 was used to declare and include variables with statistically significant in predicting the outcome variable. RESULT On multivariate analysis, urban residence(AOR=0.65, 95%, CI=0.43-0.98),lack of family support during child bearing(AOR =5.24, 95% CI=3.16-8.71),pregnancy type(AOR = 4.02, 95% CI: 2.47-6.52,),short inter-pregnancy interval (AOR = 1.43,95% CI= 1.23-4.48),less than four antenatal care (ANC) visits (AOR =1.80,95%CI: 1.17- 2.78),and having current obstetric complication (AOR=2.07, 95% CI =1.18-3.61) were significantly associated with adverse birth outcomes. CONCLUSIONS Residence, lack of family support during childbearing, pregnancy type, short inter-pregnancy interval, having current obstetric complications, and number of ANC visits were identified as determinants of adverse birth outcome. Therefore, improving family support, increasing inter-pregnancy interval through family planning counselling and provision, and having the recommended ANC follow-up were recommended.
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Affiliation(s)
- Daniel Belema Fekene
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia, E-mail:
| | - Gizachew Abdissa Bulto
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Benyam Seifu Woldeyes
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Gurmesa Daba Dina
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Kassa Mamo Negash
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
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Ahinkorah BO, Obisesan MT, Seidu AA, Ajayi AI. Unequal access and use of contraceptives among parenting adolescent girls in sub-Saharan Africa: a cross-sectional analysis of demographic and health surveys. BMJ Open 2021; 11:e051583. [PMID: 34551951 PMCID: PMC8461275 DOI: 10.1136/bmjopen-2021-051583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE We examined the divergent patterns, prevalence and correlates of contraceptive use among parenting adolescents in sub-Saharan Africa using the Demographic and Health Survey datasets of 17 countries. DESIGN We included a weighted sample of 9488 parenting adolescent girls in our analysis. Current contraceptive use was defined as the use of any methods to delay or avoid getting pregnant at the survey time. We reported the prevalence of any contraceptive use for all countries and used multilevel binary logistic regression analysis to examine the individual and contextual factors associated with contraceptive use. OUTCOME MEASURES Contraceptive use. RESULTS We found an overall contraceptive prevalence of 27.12% (CI 27.23% to 28.03%) among parenting adolescent girls in sub-Saharan Africa, ranging from 70.0% (CI 61.76% to 77.16%) in South Africa to only 5.10% (CI 3.04% to 8.45%) in Chad. The prevalence of contraceptive use was lowest in West andCentral Africa, with most countries having less than 20% prevalence. Increasing age (adjusted OR (aOR)=1.46, 95% CI 1.28 to 1.65), being married (aOR=1.63, 95% CI 1.43 to 1.87), having a secondary or higher level of education (aOR=2.72, 95% CI 2.25 to 2.3.27), and media exposure (aOR=1.21, 95% CI 1.08 to 1.36), were associated with higher odds of contraceptive use in the pooled data but preference for a higher number of children (more than five children) (aOR=0.61, 95% CI 0.52 to 0.72) was related to lower likelihood of use. Significant heterogeneity was observed in the country-level disaggregated results. CONCLUSION African countries differ widely when it comes to contraceptive use among parenting adolescent girls, with only three countries having a relatively high prevalence of use. The governments of countries in sub-Saharan Africa, particularly those in West and Central Africa, should invest in expanding access to contraceptives for adolescent mothers to prevent repeat pregnancy and improve the overall well-being of parenting adolescent girls.
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Affiliation(s)
- Bright Opoku Ahinkorah
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | | | - Abdul-Aziz Seidu
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
- Department of Estate Management, Takoradi Technical Unversity, Takoradi, Ghana
| | - Anthony Idowu Ajayi
- Population Dynamics and Sexual and Reproductive Health, African Population and Health Research Center, Nairobi, Kenya
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Mushy SE, Shishido E, Leshabari S, Horiuchi S. Postpartum Green Star family planning decision aid for pregnant adolescents in Tanzania: a qualitative feasibility study. Reprod Health 2021; 18:170. [PMID: 34372864 PMCID: PMC8351107 DOI: 10.1186/s12978-021-01216-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/26/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The use of a decision aid in clinical settings has been beneficial. It informs and educates patients about the available treatment options that can help them reduce decision-making conflicts related to feeling uninformed compared with routine care. There is a scarcity of published data about using a decision aid during family planning counseling with postpartum women focusing on long-acting reversible contraception in Tanzania. Therefore, we developed a "postpartum Green Star family planning decision aid" and assessed its feasibility. The study outcomes were practicality, usefulness, and acceptability perceived by pregnant adolescents and nurses/midwives. METHODS We used an exploratory qualitative in-depth interview involving six nurses/midwives with three or more years of experience in family planning services and 12 pregnant adolescents aged 15-19 years. Purposive sampling was used to select the participants, and selection relied on the saturation principle of data collection. We used a semi-structured interview guide translated into the Kiswahili language. Data were transcribed and analyzed following inductive content analysis. RESULTS The amount of information presented was just right, with the time of reading the data ranging from 20 min to 1 h. The study participants perceived the flow of information to be good, with small significant changes suggested. Kiswahili language was used and reported to be appropriate and well elaborated. However, a few words were told to be rephrased to reduce ambiguity. The nurses/midwives said that the decision aid included most of the vital information the participants wanted to know during their family planning counseling. Pregnant adolescents stated that the decision aid improved their knowledge and provided new details on the long-acting reversible contraception methods (intrauterine copper devices and implants) offered immediately after childbirth. The participants stated that the decision aid addressed long-acting reversible contraception methods' benefits and side effects and dispelled myths and misconceptions. The study participants considered the decision aid helpful in complementing the family planning counseling offered and improving pregnant adolescents' knowledge. CONCLUSION The postpartum Green Star family planning decision aid was practical, useful, and acceptable in enhancing the objectivity of counseling about long-acting reversible contraception methods. It improved the knowledge of pregnant adolescents in Tanzania about the available contraception methods (i.e., the use of intrauterine copper devices and implants), which can be immediately used postpartum. Further research is needed to assess the effects of the decision aid on long-acting reversible contraception postpartum uptake among pregnant adolescents in Tanzania.
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Affiliation(s)
- Stella E. Mushy
- Community Health Nursing Department, School of Nursing, Muhimbili University of Health and Allied Sciences, P.O. Box 65004, Dar es Salaam, Tanzania
| | - Eri Shishido
- Department of Midwifery, Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-Cho, Chuo, Tokyo 104-0044 Japan
| | - Sebalda Leshabari
- Community Health Nursing Department, School of Nursing, Muhimbili University of Health and Allied Sciences, P.O. Box 65004, Dar es Salaam, Tanzania
| | - Shigeko Horiuchi
- Department of Midwifery, Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-Cho, Chuo, Tokyo 104-0044 Japan
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Mamo H, Dagnaw A, Sharew NT, Brhane K, Kotiso KS. Prevalence of short interpregnancy interval and its associated factors among pregnant women in Debre Berhan town, Ethiopia. PLoS One 2021; 16:e0255613. [PMID: 34339456 PMCID: PMC8328324 DOI: 10.1371/journal.pone.0255613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/19/2021] [Indexed: 11/19/2022] Open
Abstract
Background Short inter-pregnancy interval is an interval of <24 months between the dates of birth of the preceding child and the conception date of the current pregnancy. Despite its direct effects on the perinatal and maternal outcomes, there is a paucity of evidence on its prevalence and determinant factors, particularly in Ethiopia. Therefore, this study assessed the prevalence and associated factors of short inter-pregnancy interval among pregnant women in Debre Berhan town, Northern Ethiopia. Methods A community based cross-sectional study was conducted among a randomly selected 496 pregnant women in Debre Berhan town from February 9 to March 9, 2020. The data were collected by using an interviewer-administered questionnaire and analyzed using STATA (14.2) statistical software. To identify the predictors of short inter-pregnancy interval, multivariable binary logistic regression was fitted and findings are presented using adjusted odds ratio (AOR) with 95% confidence interval (CI). Result The overall prevalence of short inter-pregnancy interval (<24 months) among pregnant women was 205 (40.9%). Being over 30 years of age at first birth (AOR = 3.50; 95% CI: 2.12–6.01), non-use of modern contraceptive (AOR = 2.51; 95% CI: 1.23–3.71), duration of breastfeeding for less than 12 months (AOR = 2.62; 95% CI: 1.32–5.23), parity above four (AOR = 0.31; 95% CI: 0.05–0.81), and unintended pregnancy (AOR = 5.42; 95% CI: 3.34–9.22) were independently associated factors with short inter-pregnancy interval. Conclusion Despite the public health interventions being tried in the country, the prevalence of short inter-pregnancy interval in this study is high. Therefore, it implies that increasing contraceptive use and encouraging optimal breastfeeding might help in the efforts made to avert the problem.
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Affiliation(s)
- Hana Mamo
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hosaena, Ethiopia
| | - Abinet Dagnaw
- Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nigussie Tadesse Sharew
- Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
| | - Kalayu Brhane
- Department of Public Health, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Kehabtimer Shiferaw Kotiso
- School of Medicine, College of Health Sciences and Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- * E-mail:
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Getaneh T, Asres A, Hiyaru T, Lake S. Adverse perinatal outcomes and its associated factors among adult and advanced maternal age pregnancy in Northwest Ethiopia. Sci Rep 2021; 11:14072. [PMID: 34234283 PMCID: PMC8263553 DOI: 10.1038/s41598-021-93613-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 06/25/2021] [Indexed: 02/06/2023] Open
Abstract
Even though reduction of neonatal mortality is needed to achieve Sustainable Development Goals 2030, advanced maternal age is still an independent and a substantial risk factor for different adverse perinatal outcomes, in turn causes neonatal morbidity and mortality. In Ethiopia, research has validated that advanced maternal age is a significant factor in adverse perinatal outcomes, but researches which addressed or estimated its adverse perinatal outcomes are limited, reported inconsistent result and specifically no study was done in the study area. Therefore, this study was aimed to compare adverse perinatal outcomes and its associated factors among women with adult and advanced maternal age pregnancy in Northwest Ethiopia. Comparative cross-sectional study was conducted in Awi Zone, public hospitals, Northwest Ethiopia. Systematic random sampling was employed to select 348 adult and 176 advanced aged pregnant women. Structured questionnaire were used to collect the data. The collected data were analyzed using Statistical Package for the Social Sciences version 25. Binary and multivariate logistic regressions were fitted to assess the association between adverse perinatal outcomes and explanatory variables. P-value less than 0.05 was used to declare statistical significance. Significant percentage of advanced aged women (29.1%) had adverse perinatal outcomes compared to (14.5%) adult aged women. Similarly, proportion low birth weight, preterm birth and low Apgar score were significantly higher among advanced maternal age. The odds of composite adverse perinatal outcomes were higher among advanced maternal age women when compared to adult aged women (AOR 2.01, 95% CI 1.06, 3.79). No formal education (AOR 2.75, 95% CI 1.27, 5.95), short birth interval (AOR 2.25, 95% CI 1.07, 4.73) and complications during pregnancy (AOR 2.12, 95% CI 1.10, 4.10) were also factors significantly associated with adverse perinatal outcomes. Being advanced maternal age is at higher risk for adverse perinatal outcomes compared to adult aged women. Maternal illiteracy, short birth interval and complications during pregnancy were also significantly associated with adverse perinatal outcomes. Access of equal education, provision of family planning and perinatal care (including early detection and management of complication) is recommended.
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Affiliation(s)
- Temesgen Getaneh
- Department of Midwifery, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Azezu Asres
- Department of Midwifery, College of Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Toyiba Hiyaru
- Department of Midwifery, College of Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Selamawit Lake
- Department of Midwifery, College of Health Science, Bahir Dar University, Bahir Dar, Ethiopia
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Das T, Roy TB. While inadequate birth interval becomes detrimental to health & nutritional outcome in infant and under-five year children; a systematic review through BLR and CPH model. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Beyond knowledge acquisition: factors influencing family planning utilization among women in conservative communities in Rural Burundi. Reprod Health 2021; 18:94. [PMID: 33985538 PMCID: PMC8120830 DOI: 10.1186/s12978-021-01150-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/05/2021] [Indexed: 12/01/2022] Open
Abstract
Background With a fertility rate of 5.4 children per woman, Burundi ranked as seventh country with the highest fertility rate in the world. Family planning is an effective way of achieving desirable family size, appropriate birth spacing and significant reduction in unintended pregnancies. Furthermore, family planning has been linked to improvements in maternal health outcomes. Yet, in spite of the overwhelming evidence on the benefits of family planning and despite high knowledge and free services, utilisation is low especially in rural communities with conservative people. Employing a mixed methods approach, this study first quantifies contraceptive prevalence and second, explores the contextual multilevel factors associated with low family planning utilisation among community members. Methods An explanatory sequential mixed study was conducted. Five hundred and thirty women in union were interviewed using structured and pre-tested questionnaire. Next, 11 focus group discussions were held with community members composed of married men and women, administrative and religious leaders (n = 132). The study was conducted in eighteen collines of two health districts of Vyanda and Rumonge in Bururi and Rumonge provinces in Burundi. Quantitative data was analysed with SPSS and qualitative data was coded and deductive thematic methods were applied to find themes and codes. Results The overall contraceptive prevalence was 22.6%. From logistic modelling analysis, it was found that women aged 25 to 29 (aOR 5.04 (95% CI 2.09–10.27 p = 0.038), those that have completed secondary school and having four or less children were significantly associated with use of family planning (aOR 1.72 (95%1.35–2.01) p = 0.002). Among factors why family planning was unused included experience with side effects and costs associated with its management in the health system. Religious conceptualisation and ancestral negative beliefs of family planning had also shaped how people perceived it. Furthermore, at the household level, gender imbalances between spouses had resulted in break in communication, also serving as a factor for non-use of family planning. Conclusion Given that use of family planning is rooted in negative beliefs emanating mainly from religious and cultural practices, engaging local religious leaders and community actors may trigger positive behaviours change needed to increase its use. In the Burundian context, community members agree that large family sizes are difficult to maintain, yet use of family planning remains consistently low. This study explored the factors behind this low utilisation of family planning in two health districts located in the South of Burundi. The findings suggest that fear of side effects is the main reason for family planning non-utilization or discontinuation. The culture and religious beliefs in Rural Burundi also espouse large family sizes and among men, this is conceived as a sign of wealth, power, and respect. Lack of spousal communication and unequal gender relations in household also impedes women from contributing decisions on family planning. The onus on making decisions on contraceptive use lies on men, whom usually, have limited understanding of family planning methods. In improving coverage of family planning in these communities, capacity of the health system to provide quality, timely and people-driven family planning services should be strengthened. At the community level, the use of community health workers to deliver family planning services to the doorstep of community members could significantly increase uptake. Finally, men and religious leaders’ involvement in promoting family planning use can contribute to reducing the impact of cultural and religious barriers to uptake.
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Nausheen S, Bhura M, Hackett K, Hussain I, Shaikh Z, Rizvi A, Ansari U, Canning D, Shah I, Soofi S. Determinants of short birth intervals among married women: a cross-sectional study in Karachi, Pakistan. BMJ Open 2021; 11:e043786. [PMID: 33903142 PMCID: PMC8076934 DOI: 10.1136/bmjopen-2020-043786] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Birth spacing is a critical pathway to improving reproductive health. WHO recommends a minimum of 33-month interval between two consecutive births to reduce maternal, perinatal, infant morbidity and mortality. Our study evaluated factors associated with short birth intervals (SBIs) of less than 33 months between two consecutive births, in Karachi, Pakistan. METHODS We used data from a cross-sectional study among married women of reproductive age (MWRA) who had at least one live birth in the 6 years preceding the survey (N=2394). Information regarding their sociodemographic characteristics, reproductive history, fertility preferences, family planning history and a 6-year reproductive calendar were collected. To identify factors associated with SBIs, we fitted simple and multiple Cox proportional hazards models and computed HRs with their 95% CIs. RESULTS The median birth interval was 25 months (IQR: 14-39 months), with 22.9% (833) of births occurring within 33 months of the index birth. Women's increasing age (25-30 years (aHR 0.63 (0.53 to 0.75), 30+ years (aHR 0.29, 95% CI 0.22 to 0.39) compared with 20-24 years; secondary education (aHR 0.75, 95% CI 0.63 to 0.88), intermediate education (aHR 0.62, 95% CI 0.48 to 0.80), higher education (aHR 0.69, 95% CI 0.51 to 0.92) compared with no education, and a male child of the index birth (aHR 0.81, 95% CI 0.70 to 0.94) reduced the likelihood of SBIs. Women's younger age <20 years (aHR 1.24, 95% CI 1.05 to 1.24) compared with 20-24 years, and those who did not use contraception within 9 months of the index birth had a higher likelihood for SBIs for succeeding birth compared with those who used contraception (aHR 2.23, 95% CI 1.93 to 2.58). CONCLUSION Study shows that birth intervals in the study population are lower than the national average. To optimise birth intervals, programmes should target child spacing strategies and counsel MWRA on the benefits of optimal birth spacing, family planning services and contraceptive utilisation.
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Affiliation(s)
- Sidrah Nausheen
- Obstetrics & Genecology, Aga Khan University, Karachi, Pakistan
| | - Maria Bhura
- Center of Excellence in Women & Child Health, Aga Khan University, Karachi, Pakistan
| | - Kristy Hackett
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Imtiaz Hussain
- Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Zainab Shaikh
- Center of Excellence & Child Health, Aga Khan University, Karachi, Pakistan
| | - Arjumand Rizvi
- Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Uzair Ansari
- Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - David Canning
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Iqbal Shah
- Global Health and Population, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Sajid Soofi
- Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
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Mihretie GN, Yenealem Beyene F, Getnet Kassa B, Degu Ayele A, Muche Liyeh T, Minuye Birihane B. Determinants of short birth interval among women in South Gondar, Ethiopia: community-based unmatched case-control study. Arch Public Health 2021; 79:47. [PMID: 33836836 PMCID: PMC8034130 DOI: 10.1186/s13690-021-00567-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/22/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The effect of short birth interval on socio-economic, negative maternal and child health outcomes remains common in developing countries. This study aimed to assess determinants of short birth interval among reproductive age women, who gave birth in health institution for last six-month in South Gondar, Ethiopia 2019. METHODS Community-based unmatched case control study design was conducted from February 1 to March 30, 2019. Sample size of 150 was included by simple random sampling technique. The data was collected by semi-structured and pre-tested face to face interviewer-administered questionnaire from selected respondent. The collected data was entered with Epi-Data version 3.1 and analyzed by using SPSS version 23 software. Bivariate and multivariable analyses were used to examine the association. Odds ratio, 95% CI and P-value < 0.05 were used to determine the statistical association. RESULT The mean age of the respondents was 32.42 (SD ± 5.14) and 35.12 (SD ± 5.86) for cases and controls, respectively. Mothers not used contraceptives (AOR = 6.29, 95% CI (1.95, 20.24)), participants who had ≤2 alive children (AOR = 5.57, 95% CI (1.47, 21.13)), mothers who breast fed less than 24 months (AOR = 3.42, 95% CI (1.38, 8.46)), husband decision on contraceptives utilization (AOR = 2.69,95% CI (1.05,6.88)) and mothers who did not have history of antenatal care follow up (AOR = 3.52, 95% CI (1.27, 9.75)) were associated with short birth interval. CONCLUSION The optimum birth spacing plays a vital role in decreasing fertility and the morbidity and mortality of mothers and children. Thus, providing health information on the benefit of breast feeding, follow-up of antenatal care during pregnancy, use of contraceptives after delivery and encouraging mothers to make decisions about their own health and use of contraceptives to optimize birth spacing for rural communities.
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Affiliation(s)
- Gedefaye Nibret Mihretie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Fentahun Yenealem Beyene
- Department of Midwifery, College of Health Sciences, Bahir Dar University, Bahir Dar Town, Ethiopia
| | - Bekalu Getnet Kassa
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Alemu Degu Ayele
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Tewachew Muche Liyeh
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
| | - Binyam Minuye Birihane
- Department of Pediatric Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor Town, Ethiopia
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Tesema GA, Worku MG, Teshale AB. Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling. PLoS One 2021; 16:e0247091. [PMID: 33606724 PMCID: PMC7894930 DOI: 10.1371/journal.pone.0247091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/02/2021] [Indexed: 11/17/2022] Open
Abstract
Background The World Health Organization recommended a minimum of 33 months between consecutive live births to reduce the incidence of adverse pregnancy outcomes. Poorly spaced pregnancies are associated with poor maternal and child health outcomes such as low birth weight, stillbirth, uterine rupture, neonatal mortality, maternal mortality, child malnutrition, and maternal hemorrhage. However, there was limited evidence on the duration of birth interval and its predictors among reproductive-age women in Ethiopia. Therefore, this study aimed to investigate the duration of birth interval and its predictors among reproductive-age women in Ethiopia. Methods A secondary data analysis was conducted based on the 2016 Ethiopian Demographic and Health Survey data. A total weighted sample of 11022 reproductive-age women who gave birth within five years preceding the survey was included for analysis. To identify the predictors, the Gompertz gamma shared frailty model was fitted. The theta value, Akakie Information Criteria (AIC), Bayesian Information Criteria (BIC), and deviance was used for model selection. Variables with a p-value of less than 0.2 in the bi-variable analysis were considered for the multivariable analysis. In the multivariable Gompertz gamma shared frailty analysis, the Adjusted Hazard Ratio (AHR) with a 95% Confidence Interval (CI) was reported to show the strength and statistical significance of the association. Results The median inter-birth interval in Ethiopia was 38 months (95% CI: 37.58, 38.42). Being living in Addis Ababa (AHR = 0.15, 95% CI: 0.03, 0.70), being rural resident (AHR = 1.13, 95% CI: 1.01, 1.23), being Muslim religious follower (AHR = 6.53, 95% CI: 2.35, 18.18), having three birth (AHR = 0.51, 95% CI: 0.10, 0.83), having four birth (AHR = 0.30, 95% CI: 0.09, 0.74), five and above births (AHR = 0.10, 95% CI: 0.02, 0.41), and using contraceptive (AHR = 2.35, 95% CI: 1.16, 4.77) were found significant predictors of duration of birth interval. Conclusion The length of the inter-birth interval was consistent with the World Health Organization recommendation. Therefore, health care interventions that enhance modern contraceptive utilization among women in rural areas and Muslim religious followers would be helpful to optimize birth interval.
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Affiliation(s)
- Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department Human Anatomy, School of Medicine, of the College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Damtie Y, Kefale B, Yalew M, Arefaynie M, Adane B. Short birth spacing and its association with maternal educational status, contraceptive use, and duration of breastfeeding in Ethiopia. A systematic review and meta-analysis. PLoS One 2021; 16:e0246348. [PMID: 33534830 PMCID: PMC7857626 DOI: 10.1371/journal.pone.0246348] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 01/15/2021] [Indexed: 11/18/2022] Open
Abstract
Background Closely spaced birth increases the risk of adverse maternal and child health outcomes. In Ethiopia, the prevalence of short birth spacing was highly variable across studies. Besides, contraceptive use, educational status, and duration of breastfeeding were frequently mentioned factors affecting short birth spacing. Therefore, this meta-analysis aimed to estimate the pooled prevalence of short birth spacing and its association with contraceptive use, educational status, and duration of breastfeeding among reproductive-age women in Ethiopia. Methods International databases: Google Scholar, PubMed, CINAHL, Cochrane library, HINARI, and Global Health were searched systematically to identify articles reporting the prevalence of short birth spacing and its association with contraceptive use, educational status, and duration of breastfeeding among reproductive-age women in Ethiopia. The data were analyzed by STATA/SE version-14 statistical software. The random-effect model was used to estimate the pooled prevalence of short birth spacing and the log odds ratio was used to determine the association. Moreover, egger’s test and I-squared statistics were used to assess publication bias and heterogeneity respectively. Results After reviewing 511 research articles, a total of nine articles with 5,682 study participants were included in this meta-analysis. The pooled prevalence of short birth spacing in Ethiopia was 46.9% [95% CI: (34.7, 59.1)]. Significant heterogeneity was observed between studies (I2 = 98.4, p <0.001). Not using contraceptives [OR = 3.87, 95% CI: (2.29, 6.53)] and duration of breastfeeding < 24 months [OR = 16.9, 95%CI: (2.69, 106.47)] had a significant association with short birth spacing. Conclusions Although a minimum inter-pregnancy interval of two years was recommended by the World Health Organization (WHO), significant numbers of women still practiced short birth spacing in Ethiopia. Duration of breastfeeding and non-use of contraceptives were factors significantly associated with short birth spacing. So, efforts should be made to improve breastfeeding practice and contraceptive utilization among women in Ethiopia.
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Affiliation(s)
- Yitayish Damtie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- * E-mail:
| | - Bereket Kefale
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Melaku Yalew
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Mastewal Arefaynie
- Department of Reproductive and Family Health, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Bezawit Adane
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Addisu D, Biru S, Mekie M, Minuye B, Bezie M, Alebachew W, Demis S, Dagnew E, Melkie A. Predictors of adverse pregnancy outcome at Hospitals in South Gondar Zone, North-central Ethiopia: A multicenter facility-based unmatched case-control study. Heliyon 2021; 7:e06323. [PMID: 33665464 PMCID: PMC7907473 DOI: 10.1016/j.heliyon.2021.e06323] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/27/2021] [Accepted: 02/16/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Adverse pregnancy outcomes are the most significant public health problem which leads to serious short and long-term health consequences to the mother and the newborn baby. Adverse pregnancy outcomes, especially prematurity and low birth weights are the major cause of neonatal morbidity and mortality in Ethiopia, particularly in the study area. Therefore, this study was aimed to determine predictors of adverse pregnancy outcome among mothers who gave birth at Hospitals in South Gondar zone, North-central Ethiopia. METHODS Hospital-based unmatched case-control study was conducted. A total of 441 study participants with 147 cases and 294 controls were included. The study participants were selected by multi-stage sampling technique. A combination of chart review and interview were used. Data entry and analysis were done by using Epi data version 3.1 and SPSS version 23 respectively. Descriptive & analytical statistics were computed. In the binary logistic regression, both bivariable and multivariable analysis was computed. Statistical significance was considered at P < 0.05 and the strength of association were assessed by using the adjusted odds ratio with their 95%confidence interval. RESULT A total of 147 cases and 294 controls were included. The mean age (±SD) of study participants was 26.8 ± 5.5 years. History of adverse birth outcome (AOR = 6.39, 95%CI = 2.55, 15.99), did not receive dietary counseling during pregnancy (AOR = 5.17, 95%CI = 2.09, 12.84), pregnancy induced hypertension (AOR = 3.74, 95%CI = 1.20, 11.62), history of hyperemesis gravidarum in the recent pregnancy (AOR = 4.01, 95%CI = 1.58, 10.21) and inter-pregnancy interval less than 24 months (AOR = 2.02, 95%CI = 1.04, 3.91) were significantly associated with adverse pregnancy outcome. CONCLUSION This study showed that history of adverse pregnancy outcome, pregnancy induced hypertension, did not receive dietary counseling, history of hyperemesis gravidarum, and inter-pregnancy interval less than 24 months were significantly associated with adverse pregnancy outcome. This study implies the need to improve dietary counseling for pregnant mothers during antenatal care visits. Beside to this, counseling on birth spacing should be given to improve inter-pregnancy intervals.
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Affiliation(s)
- Dagne Addisu
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Shimeles Biru
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Maru Mekie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Binyam Minuye
- Department of Pediatrics, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Minale Bezie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Alebachew
- Department of Pediatrics, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Solomon Demis
- Department of Pediatrics, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Enyew Dagnew
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Abenezer Melkie
- Department of Midwifery, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Shimels Hailemeskel H, Assebe T, Alemayehu T, Belay DM, Teshome F, Baye A, Bayih WA. Determinants of short birth interval among ever married reproductive age women: A community based unmatched case control study at Dessie city administration, Northern Ethiopia. PLoS One 2020; 15:e0243046. [PMID: 33275603 PMCID: PMC7717527 DOI: 10.1371/journal.pone.0243046] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 11/13/2020] [Indexed: 11/23/2022] Open
Abstract
Background Short birth interval is a universal public health problem resulting in adverse fetal, neonatal, child and maternal outcomes. In Ethiopia, more than 50% of the overall inter birth spacing is short. However, prior scientific evidence on its determinants is limited and even then findings are inconsistent. Methods A community -based unmatched case-control study was employed on 218 cases and 436 controls. Cases were ever married reproductive age women whose last delivery has been in the past five years with birth interval of less than 3 years between the latest two successive live births whereas those women with birth interval of 3–5 years were taken as controls. A multistage sampling technique was employed on 30% of the kebeles in Dessie city administration. A pre-tested interviewer based questionnaire was used to collect data by 16 trained diploma nurses and 8 health extension workers supervised by 4 BSc nurses. The collected data were cleaned, coded and double entered into Epi-data version 4.2 and exported to SPSS version 22. Binary logistic regression model was considered and those variables with P<0.25 in the bivariable analysis were entered in to final model after which statistical significance was declared at P< 0.05 using adjusted odds ratio at 95% CI. Result In this study, contraceptive use (AOR = 11.2, 95% CI: 5.95–21.15), optimal breast feeding for at least 2 years (AOR = 0.098, 95% CI:0.047–0.208), age at first birth <25 years (AOR = 0.36, 95% CI: 0.282–0.761), having male preceding child (AOR = 0.46, 95% CI: 0.166–0.793) and knowing the duration of optimum birth interval correctly (AOR = 0.45, 95% CI: 0.245–0.811) were significant determinants of short birth interval. Conclusion Contraceptive use, duration of breast feeding, age at first birth, preceding child sex and correct understanding of the duration of birth interval were significant determinants of short birth interval. Fortunately, all these significant factors are likely modifiable. Thus, the existing efforts of optimizing birth interval should be enhanced through proper designation and implementation of different strategies on safe breastfeeding practice, modern contraceptive use and maternal awareness about the health merits of optimum birth interval.
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Affiliation(s)
| | - Tesfaye Assebe
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tadesse Alemayehu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Demeke Mesfin Belay
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Fentaw Teshome
- Department of Health Service Management, Debre Tabor University, Debre Tabor, Ethiopia
| | - Alemwork Baye
- Department of Environmental Health, Wollo University, Dessie, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Spatial pattern of perinatal mortality and its determinants in Ethiopia: Data from Ethiopian Demographic and Health Survey 2016. PLoS One 2020; 15:e0242499. [PMID: 33227021 PMCID: PMC7682862 DOI: 10.1371/journal.pone.0242499] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 11/03/2020] [Indexed: 12/17/2022] Open
Abstract
Background The perinatal mortality rate in Ethiopia is among the highest in Sub Saharan Africa. The aim of this study was to identify the spatial patterns and determinants of perinatal mortality in the country using a national representative 2016 Ethiopia Demographic and Health Survey (EDHS) data. Methods The analysis was completed utilizing data from 2016 Ethiopian Demographic and Health Survey. This data captured the information of 5 years preceding the survey period. A total of 7230 women who at delivered at seven or more months gestational age nested within 622 enumeration areas (EAs) were used. Statistical analysis was performed by using STATA version 14.1, by considering the hierarchical nature of the data. Multilevel logistic regression models were fitted to identify community and individual-level factors associated with perinatal mortality. ArcGIS version 10.1 was used for spatial analysis. Moran’s, I statistics fitted to identify global autocorrelation and local autocorrelation was identified using SatSCan version 9.6. Results The spatial distribution of perinatal mortality in Ethiopia revealed a clustering pattern. The global Moran’s I value was 0.047 with p-value <0.001. Perinatal mortality was positively associated with the maternal age, being from rural residence, history of terminating a pregnancy, and place of delivery, while negatively associated with partners’ educational level, higher wealth index, longer birth interval, female being head of household and the number of antenatal care (ANC) follow up. Conclusions In Ethiopia, the perinatal mortality is high and had spatial variations across the country. Strengthening partner’s education, family planning for longer birth interval, ANC, and delivery services are essential to reduce perinatal mortality and achieve sustainable development goals in Ethiopia. Disparities in perinatal mortality rates should be addressed alongside efforts to address inequities in maternal and neonatal healthcare services all over the country.
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Akinyemi JO, Afolabi RF, Awolude OA. Semi-parametric model for timing of first childbirth after HIV diagnosis among women of childbearing age in Ibadan, Nigeria. PLoS One 2020; 15:e0240247. [PMID: 33027315 PMCID: PMC7540879 DOI: 10.1371/journal.pone.0240247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/22/2020] [Indexed: 11/26/2022] Open
Abstract
Background HIV diagnosis is a watershed in women’s childbearing experience. It is usually accompanied by the fear of death and stigmatisation. Women diagnosed of HIV are often sceptical about pregnancy. Meanwhile, availability of antiretroviral treatments has impacted positively on childbearing experience among women living with HIV. We therefore investigated the timing of first childbirth after HIV diagnosis and its determinants among women in Ibadan, Nigeria. Methods We extracted and analysed data from a 2015 cross-sectional study on childbearing progression among 933 women living with HIV and receiving care at University College Hospital, Ibadan, Nigeria. Extended Cox proportional hazards regression, a semi-parametric event history model was used at 5% significance level. Results The women’s mean age was 38.1 (± SD = 6.1) years and the median time to first birth after HIV diagnosis (FBI_HIV) was 8 years. The likelihood of first birth after HIV diagnosis was lower among women who desired more children (HR = 0.63, CI: 0.51–0.78). Women whose partners had primary and secondary education respectively were about 2.3 times more likely to shorten FBI_HIV compared to those whose partners had no formal education. Knowledge of partner’s HIV-positive status (HR = 1.42, CI: 1.04,1.93) increased the likelihood of having a first birth after HIV diagnosis. Older age, longer duration on ART and a higher number of children at diagnosis were associated with a declined hazard of first birth after HIV diagnosis. Conclusions The median time to first childbirth after HIV diagnosis was long. Partner’s HIV-positive status and higher educational attainment were associated with early childbearing after HIV diagnosis.
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Affiliation(s)
- Joshua Odunayo Akinyemi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Demography and Population Studies, Schools of Public Health and Social Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Rotimi Felix Afolabi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Population and Health Research Entity, Faculty of Humanities, North-West University, Vanderbijlpark, South Africa
- * E-mail:
| | - Olutosin Alaba Awolude
- Department of Obstetrics and Gynaecology, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Shifti DM, Chojenta C, Holliday EG, Loxton D. Socioeconomic inequality in short birth interval in Ethiopia: a decomposition analysis. BMC Public Health 2020; 20:1504. [PMID: 33023567 PMCID: PMC7542382 DOI: 10.1186/s12889-020-09537-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 09/13/2020] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Short birth interval, defined as a birth-to-birth interval less than 33 months, is associated with adverse maternal and child outcomes. Evidence regarding the association of maternal socioeconomic status and short birth interval is inconclusive. Factors contributing to the socioeconomic inequality of short birth interval have also not been investigated. The current study assessed socioeconomic inequality in short birth interval and its contributing factors in Ethiopia. METHODS Data from 8448 women collected in the 2016 Ethiopia Demographic and Health survey were included in the study. Socioeconomic inequality in short birth interval was the outcome variable. Erreygers normalized concentration index (ECI) and concentration curves were used to measure and illustrate socioeconomic-related inequality in short birth interval, respectively. Decomposition analysis was performed to identify factors explaining the socioeconomic-related inequality in short birth interval. RESULTS The Erreygers normalized concentration index for short birth interval was - 0.0478 (SE = 0.0062) and differed significantly from zero (P < 0.0001); indicating that short birth interval was more concentrated among the poor. Decomposition analysis indicated that wealth quintiles (74.2%), administrative regions (26.4%), and not listening to the radio (5.6%) were the major contributors to the pro-poor socioeconomic inequalities in short birth interval. CONCLUSION There was a pro-poor inequality of short birth interval in Ethiopia. Strengthening the implementation of poverty alleviation programs may improve the population's socioeconomic status and reduce the associated inequality in short birth interval.
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Affiliation(s)
- Desalegn Markos Shifti
- Saint Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
| | - Catherine Chojenta
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Elizabeth G Holliday
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
| | - Deborah Loxton
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
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Aychiluhm SB, Tadesse AW, Mare KU, Abdu M, Ketema A. A multilevel analysis of short birth interval and its determinants among reproductive age women in developing regions of Ethiopia. PLoS One 2020; 15:e0237602. [PMID: 32845940 PMCID: PMC7449410 DOI: 10.1371/journal.pone.0237602] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/29/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Short Birth Interval negatively affects the health of both mothers and children in developing nations, like, Ethiopia. However, studies conducted to date in Ethiopia upon short birth interval were inconclusive and they did not show the extent and determinants of short birth interval in developing (Afar, Somali, Gambella, and Benishangul-Gumuz) regions of the country. Thus, this study was intended to assess the short birth interval and its determinants in the four developing regions of the country. METHODS Data were retrieved from the Demographic and Health Survey program official database website (http://dhsprogram.com). A sample of 2683 women of childbearing age group (15-49) who had at least two alive consecutive children in the four developing regions of Ethiopia was included in this study. A multilevel multivariable logistic regression model was fitted to identify the independent predictors of short birth interval and Akaike's Information Criterion (AIC) was used during the model selection procedure. RESULTS In this study, the prevalence of short birth interval was 46% [95% CI; 43.7%, 47.9%]. The multilevel multivariable logistic regression model showed women living in rural area [AOR = 1.52, CI: 1.12, 2.05], women attended secondary education and above level [AOR = 0.27, CI: 0.05, 0.54], have no media exposure [AOR = 1.35, CI: 1.18, 1.56], female sex of the index child [AOR = 1.13, CI:1.07,1.20], breastfeeding duration [AOR = 0.79, CI: 0.77, 0.82], having six and more ideal number of children [AOR = 1.14, CI: 1.09, 1.20] and having preferred waiting time to birth two years and above [AOR = 0.86, CI: 0.78, 0.95] were the predictors of short birth interval. CONCLUSIONS The prevalence of short birth intervals in the developing regions of Ethiopia is still high. Therefore, the government of Ethiopia should work on the access of family planning and education in rural parts of the developing regions where more than 90% of the population in these regions is pastoral.
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Affiliation(s)
- Setognal Birara Aychiluhm
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
- * E-mail:
| | - Abay Woday Tadesse
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Mohammed Abdu
- Department of Midwifery, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Abdusemed Ketema
- Department of Midwifery, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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Muluneh AA, Kassa ZY, Siyoum M, Gebretsadik A, Woldeyes Y, Tenaw Z. <p>Determinants of Sub-Optimal Birth Spacing in Gedeo Zone, South Ethiopia: A Case–Control Study</p>. Int J Womens Health 2020; 12:549-556. [PMID: 32801932 PMCID: PMC7399454 DOI: 10.2147/ijwh.s252516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/09/2020] [Indexed: 11/23/2022] Open
Abstract
Background Birth spacing is key in ensuring the health of mothers and their children as well as determining population growth. Most of the mothers in developing nations including Ethiopia have been practicing short inter-birth intervals. There is a paucity of studies concerned with suboptimal birth spacing among women in reproductive age in the study area. Purpose This study aims to identify the determinants of sub-optimal birth spacing among reproductive-age women in Gedeo zone, South Ethiopia. Materials and Methods A community-based unmatched case–control study was undertaken among 814 reproductive-age women in Gedeo zone, South Ethiopia from October 1 to November 30, 2018. Cases were women practiced suboptimal/short birth intervals (<33 months), whereas controls were women practiced inter-birth intervals of 33 months and more. A structured interviewer-administered questionnaire was used. A stratified, two-stage cluster sampling technique was used. EpiData version 3.1 and SPSS version 22 were used for data entry and analysis, respectively. Bivariate and multivariable logistic regression analyses were computed. P-value <0.05 was considered as statistically significant. All ethical procedures were considered. Results Women’s educational status, AOR (95% CI) =0.6 (0.43, 0.96), age at first marriage, AOR (95% CI) = 0.9 (0.85, 0.99), distance from the nearest health facility, AOR (95% CI) = 1.4 (1.04, 1.94), wealth index, AOR (95% CI) = 4.1 (2.66, 6.19), and postnatal care utilization after the previous birth, AOR (95% CI) = 0.4 (0.25, 0.53) were statistically significant with suboptimal birth spacing. Conclusion Women’s educational status age at first marriage, distance from the nearest health facility, wealth index and postnatal care utilization after the previous birth were the determinants of suboptimal birth spacing.
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Affiliation(s)
- Abebaw Abeje Muluneh
- Department of Midwifery, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
- Correspondence: Abebaw Abeje Muluneh Department of Midwifery, Hawassa University College of Medicine and Health Sciences, HawassaTel +251 921 194 571 Email
| | - Zemenu Yohannes Kassa
- Department of Midwifery, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Melese Siyoum
- Department of Midwifery, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Achamyelesh Gebretsadik
- School of Public Health, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Yewlsew Woldeyes
- Department of Midwifery, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Zelalem Tenaw
- Department of Midwifery, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
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Shifti DM, Chojenta C, Holliday EG, Loxton D. Application of geographically weighted regression analysis to assess predictors of short birth interval hot spots in Ethiopia. PLoS One 2020; 15:e0233790. [PMID: 32470020 PMCID: PMC7259714 DOI: 10.1371/journal.pone.0233790] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 05/12/2020] [Indexed: 11/18/2022] Open
Abstract
Background Birth interval duration is an important and modifiable risk factor for adverse child and maternal health outcomes. Understanding the spatial distribution of short birth interval, an inter-birth interval of less than 33 months, and its predictors are vital to prioritize and facilitate targeted interventions. However, the spatial variation of short birth interval and its underlying factors have not been investigated in Ethiopia. Objective This study aimed to assess the predictors of short birth interval hot spots in Ethiopia. Methods The study used data from the 2016 Ethiopia Demographic and Health Survey and included 8,448 women in the analysis. The spatial variation of short birth interval was first examined using hot spot analysis (Local Getis-Ord Gi* statistic). Ordinary least squares regression was used to identify factors explaining the geographic variation of short birth interval. Geographically weighted regression was used to explore the spatial variability of relationships between short birth interval and selected predictors. Results Statistically significant hot spots of short birth interval were found in Somali Region, Oromia Region, Southern Nations, Nationalities, and Peoples’ Region and some parts of Afar Region. Women with no education or with primary education, having a husband with higher education (above secondary education), and coming from a household with a poorer wealth quintile or middle wealth quintile were predictors of the spatial variation of short birth interval. The predictive strength of these factors varied across the study area. The geographically weighted regression model explained about 64% of the variation in short birth interval occurrence. Conclusion Residing in a geographic area where a high proportion of women had either no education or only primary education, had a husband with higher education, or were from a household in the poorer or middle wealth quintile increased the risk of experiencing short birth interval. Our detailed maps of short birth interval hot spots and its predictors will assist decision makers in implementing precision public health.
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Affiliation(s)
- Desalegn Markos Shifti
- Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- School of Medicine and Public Health, Priority Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
- * E-mail: ,
| | - Catherine Chojenta
- School of Medicine and Public Health, Priority Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
| | - Elizabeth G. Holliday
- School of Medicine and Public Health, Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, New South Wales, Australia
| | - Deborah Loxton
- School of Medicine and Public Health, Priority Research Centre for Generational Health and Ageing, University of Newcastle, Newcastle, New South Wales, Australia
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Pimentel J, Ansari U, Omer K, Gidado Y, Baba MC, Andersson N, Cockcroft A. Factors associated with short birth interval in low- and middle-income countries: a systematic review. BMC Pregnancy Childbirth 2020; 20:156. [PMID: 32164598 PMCID: PMC7069040 DOI: 10.1186/s12884-020-2852-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 02/28/2020] [Indexed: 11/08/2022] Open
Abstract
Background There is ample evidence of associations between short birth interval and adverse maternal and child health outcomes, including infant and maternal mortality. Short birth interval is more common among women in low- and middle-income countries. Identifying actionable aspects of short birth interval is necessary to address the problem. To our knowledge, this is the first systematic review to systematize evidence on risk factors for short birth interval in low- and middle-income countries. Methods A systematic mixed studies review searched PubMed, Embase, LILACS, and Popline databases for empirical studies on the topic. We included documents in English, Spanish, French, Italian, and Portuguese, without date restriction. Two independent reviewers screened the articles and extracted the data. We used the Mixed Methods Appraisal Tool to conduct a quality appraisal of the included studies. To accommodate variable definition of factors and outcomes, we present only a narrative synthesis of the findings. Results Forty-three of an initial 2802 documents met inclusion criteria, 30 of them observational studies and 14 published after 2010. Twenty-one studies came from Africa, 18 from Asia, and four from Latin America. Thirty-two reported quantitative studies (16 studies reported odds ratio or relative risk, 16 studies reported hazard ratio), 10 qualitative studies, and one a mixed-methods study. Studies most commonly explored education and age of the mother, previous pregnancy outcome, breastfeeding, contraception, socioeconomic level, parity, and sex of the preceding child. For most factors, studies reported both positive and negative associations with short birth interval. Shorter breastfeeding and female sex of the previous child were the only factors consistently associated with short birth interval. The quantitative and qualitative studies reported largely non-overlapping results. Conclusions Promotion of breastfeeding could help to reduce short birth interval and has many other benefits. Addressing the preference for a male child is complex and a longer-term challenge. Future quantitative research could examine associations between birth interval and factors reported in qualitative studies, use longitudinal and experimental designs, ensure consistency in outcome and exposure definitions, and include Latin American countries. Trial registration Prospectively registered on PROSPERO (International Prospective Register for Systematic Reviews) under registration number CRD42018117654.
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Affiliation(s)
- Juan Pimentel
- CIET/PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges 3rd Floor, Suite 300, Montreal, Quebec, H3S 1Z1, Canada. .,Facultad de Medicina, Universidad de La Sabana, Campus Universitario puente del común, Chía, Colombia, CP, 250001. .,Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Carrera 24 # 63 C 69, Bogotá, Colombia.
| | - Umaira Ansari
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Calle Pino s/n Colonia El Roble, 39640, Acapulco, Guerrero, Mexico
| | - Khalid Omer
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Calle Pino s/n Colonia El Roble, 39640, Acapulco, Guerrero, Mexico
| | - Yagana Gidado
- Federation of Muslim Women Association of Nigeria (FOMWAN), Bauchi, Nigeria
| | - Muhd Chadi Baba
- Federation of Muslim Women Association of Nigeria (FOMWAN), Bauchi, Nigeria
| | - Neil Andersson
- CIET/PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges 3rd Floor, Suite 300, Montreal, Quebec, H3S 1Z1, Canada.,Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Calle Pino s/n Colonia El Roble, 39640, Acapulco, Guerrero, Mexico
| | - Anne Cockcroft
- CIET/PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges 3rd Floor, Suite 300, Montreal, Quebec, H3S 1Z1, Canada.,Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Calle Pino s/n Colonia El Roble, 39640, Acapulco, Guerrero, Mexico
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Sanga LA, Mtuy T, Philemon RN, Mahande MJ. Inter-pregnancy interval and associated adverse maternal outcomes among women who delivered at Kilimanjaro Christian Medical Centre in Tanzania, 2000-2015. PLoS One 2020; 15:e0228330. [PMID: 32027674 PMCID: PMC7004302 DOI: 10.1371/journal.pone.0228330] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 01/13/2020] [Indexed: 11/18/2022] Open
Abstract
Inter-pregnancy interval is an important determinant of both maternal and child health. Suboptimal inter-pregnancy interval has been associated with adverse maternal outcomes -including postpartum hemorrhage and hypertensive disorders, direct causes of maternal mortality. Both overall maternal mortality and the contribution of postpartum hemorrhage on maternal mortality have increased in Tanzania. If we are to achieve sustainable development goal (SDG) number 3.1 to reduce the global maternal mortality ration to less than 70 per 100,000 live births by 2030, it is highly important that such contributors are dealt with. This study aimed to determine the distribution and trends of inter-pregnancy interval and to deduce its association with adverse maternal outcomes among women who delivered at Kilimanjaro Christian Medical Centre (2000-2015).A retrospective cohort study was designed using Kilimanjaro Christian Medical Centre medical birth registry data for women who delivered from 2000 to 2015. Women with at least two births recorded in the registry were included. A total of 7,995 births from 6,612 mothers were analyzed. Anemia during pregnancy, post-partum hemorrhage and pre-eclampsia were adverse maternal outcomes of interest. Data analysis was performed using multivariable logistic regression models allowing for robust standard errors. Crude and adjusted odds ratio with their respective 95% confidence intervals were estimated. More than half (51.7%) of non-first births were born within sub-optimal IPI. The median IPI was 34 months (IQR: 33.5 months). The median IPI increased from 11 months in 2002 to 35 months in 2006 and plateaued until 2014, but it rose to 41.6 months in 2015. Median IPI was shorter in young women <20 years and in birth order seven and above (16 vs. 27 months, respectively). Short IPI was associated with lower risk of pre-eclampsia [aOR: 0.71, 95%CI: 0.52, 0.97] while long IPI was associated with lower risk of post-partum hemorrhage [aOR: 0.70, 95%CI: 0.52, 0.94]. This study found an association between long and short IPI with adverse maternal outcomes. Even though these results should be interpreted with caution based on the fact that the data was sampled from a referral hospital and hence there could be overrepresentation of women with maternal complications, our findings still warrant the importance of supporting modern family planning methods as a measure to improve IPI and thereby improve maternal outcomes as well.
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Affiliation(s)
- Leah Anku Sanga
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
- * E-mail:
| | - Tara Mtuy
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
- Department of Global Health & Development, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Rune Nathaniel Philemon
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
- Department of Community Health, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
| | - Michael Johnson Mahande
- Department of Epidemiology & Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Kilimanjaro, Tanzania
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Sociodemographic factors associated with birth interval: a study among rural women in Chandina, Comilla, Bangladesh. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-019-01018-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Shifti DM, Chojenta C, G. Holliday E, Loxton D. Individual and community level determinants of short birth interval in Ethiopia: A multilevel analysis. PLoS One 2020; 15:e0227798. [PMID: 31935262 PMCID: PMC6959604 DOI: 10.1371/journal.pone.0227798] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/31/2019] [Indexed: 11/25/2022] Open
Abstract
Background The World Health Organization recommends a minimum of 33 months between two consecutive live births to reduce the risk of adverse maternal and child health outcomes. However, determinants of short birth interval have not been well understood in Ethiopia. Objective The aim of this study was to assess individual- and community-level determinants of short birth interval among women in Ethiopia. Methods A detailed analysis of the 2016 Ethiopian Demographic and Health Survey data was performed. A total of 8,448 women were included in the analysis. A two-level multilevel logistic regression analysis was used to identify associated individual- and community-level factors and estimate between-community variance. Results At the individual-level, women aged between 20 and 24 years at first marriage (AOR = 1.37; 95% CI: 1.18–1.60), women aged between 25 and 29 years at first marriage (AOR = 1.65; 95% CI: 1.20–2.25), having a husband who attended higher education (AOR = 1.32; 95% CI: 1.01–1.73), being unemployed (AOR = 1.16; 95% CI: 1.03–1.31), having an unemployed husband (AOR = 1.23; 95% CI: 1.04–1.45), being in the poorest wealth quintile (AOR = 1.82; 95% CI: 1.39–2.39), being in the poorer wealth quintile (AOR = 1.58; 95% CI: 1.21–2.06), being in the middle wealth quintile (AOR = 1.61; 95% CI: 1.24–2.10), being in the richer wealth quintile (AOR = 1.54; 95% CI: 1.19–2.00), increased total number of children born before the index child (AOR = 1.07; 95% CI: 1.03–1.10) and death of the preceding child (AOR = 1.97; 95% CI: 1.59–2.45) were associated with increased odds of short birth interval. At the community-level, living in a pastoralist region (AOR = 2.01; 95% CI: 1.68–2.39), being a city dweller (AOR = 1.75; 95% CI: 1.38–2.22), high community-level female illiteracy (AOR = 1.23; 95% CI: 1.05–1.45) and increased distance to health facilities (AOR = 1.32; 95% CI: 1.11–1.56) were associated with higher odds of experiencing short birth interval. Random effects showed significant variation in short birth interval between communities. Conclusion Determinants of short birth interval are varied and complex. Multifaceted intervention approaches supported by policy initiatives are required to prevent short birth interval.
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Affiliation(s)
- Desalegn Markos Shifti
- Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
- * E-mail: ,
| | - Catherine Chojenta
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Elizabeth G. Holliday
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Deborah Loxton
- Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
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Hailemichael HT, Debelew GT, Alema HB, Weldu MG, Misgina KH. Determinants of adverse birth outcome in Tigrai region, North Ethiopia: Hospital-based case-control study. BMC Pediatr 2020; 20:10. [PMID: 31914947 PMCID: PMC6947822 DOI: 10.1186/s12887-019-1835-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 11/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adverse birth outcome which attributes to most perinatal deaths is an important indicator of child health and survival. Hence, this study aims to identify determinants of adverse birth outcome among mothers who gave birth in public hospitals of Tigrai region, North Ethiopia. METHODS Hospital based case-control study was conducted in Tigrai region, Ethiopia between December 2015 and January 2016 among 405 (135 cases and 270 controls) consecutively selected mothers who gave birth in four randomly selected public Hospitals. Mothers with adverse birth outcome (preterm birth; < 37 gestational weeks at birth, low birth weight; < 2.5 kg at birth, or still birth) were the cases while mothers without adverse birth outcome (live birth, birth weight ≥ 2.5 kg and of ≥37 gestational weeks at birth) were the controls. Data were collected by interview and reviewing medical records using structured questionnaire. The collected data were entered into database using EPI info version 3.5.1 then exported to SPSS version 21 for analysis. Finally, multivariate logistic regression was used to identify determinants of adverse birth outcomes at P value < 0.05. RESULT The mean age of cases and controls was 27.3 (SD = 6.6) and 26.14 (SD = 4.9) years, respectively. In a multivariate analysis; less than four antenatal care visits [AOR = 4.35, 95% CI: 1.15-13.50], not receiving dietary counseling [AOR = 11.24, 95% CI: 3.92-36.60], not using family planning methods [AOR = 4.06, 95% CI:1.35-17.34], less than 24 months inter pregnancy interval [AOR = 5.21, 95% CI: 1.89-13.86], and less than 11 g/dl hemoglobin level [AOR = 4.86, 95% CI: 1.83-14.01] were significantly associated with adverse birth outcomes. CONCLUSION AND RECOMMENDATION The number of antenatal care visits, ever use of family planning methods, not receiving dietary counseling during antenatal care follow up visits, short inter-pregnancy interval, and low hemoglobin level were identified as independent determinants of adverse birth outcome. A concerted effort should be taken improve family planning use, and antenatal care follow-up with special emphasis to maternal nutrition to prevent adverse birth outcomes.
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Affiliation(s)
| | | | | | - Meresa Gebremedhin Weldu
- Department of Public Health, College of Health Science, Aksum University, P.O.Box: 298, Axum, Ethiopia
| | - Kebede Haile Misgina
- Department of Public Health, College of Health Science, Aksum University, P.O.Box: 298, Axum, Ethiopia
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Divakar H, Bhardwaj A, Purandare CN, Sequeira T, Sanghvi P. Critical Factors Influencing the Acceptability of Post-placental Insertion of Intrauterine Contraceptive Device: A Study in Six Public/Private Institutes in India. J Obstet Gynaecol India 2019; 69:344-349. [PMID: 31391742 DOI: 10.1007/s13224-019-01221-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 03/09/2019] [Indexed: 10/26/2022] Open
Abstract
Objective To determine critical factors and barriers to postpartum intrauterine contraceptive device (PPIUCD) use in India in order to guide programs aimed at reducing maternal and child mortality. Methods All pregnant women were enrolled for contraception counseling during their visit to the antenatal outpatient clinic. Women who opted for PPIUCDs were enrolled in the study and offered PPIUCD insertion, irrespective of mode of delivery. Those who withdrew consent when in labor or soon after delivery, experienced severe bleeding, or exhibited unstable vital signs were excluded, as were febrile women and those diagnosed with chorioamnionitis. Results A total of 66,508 women were enrolled in the study. 86.1% indicated they discussed family planning options with their partners/husbands before making a decision. 178 respondents (0.3%) could not mention one advantage of PPIUCDs, while 23.1% could not mention one disadvantage. 13.9% of the women withdrew consent. Family member objections (43.44%), husband/partner objection (27.94%), and deciding on another method (15.59%) were the main reasons for consent withdrawal. Conclusions Awareness of PPIUCDs is not a limiting factor in women's consent to PPIUCD insertion. As a woman's decision to use a PPIUCD is significantly influenced by family members and her partner/husband, awareness initiatives that target these populations should be considered.
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Affiliation(s)
- Hema Divakar
- Federation of Obstetric and Gynaecological Societies of India, Mumbai, 400013 India
- Divakar's Speciality Hospital, 220, 2nd Phase, JP Nagar, Bengaluru, 560078 India
| | - Ajey Bhardwaj
- Avni Health Foundation, 2nd Floor, Amarsons Bhavan, 68 Misquitta St, Vile Parle East, Mumbai, 400057 India
| | | | - Thelma Sequeira
- Avni Health Foundation, 2nd Floor, Amarsons Bhavan, 68 Misquitta St, Vile Parle East, Mumbai, 400057 India
| | - Pooja Sanghvi
- Avni Health Foundation, 2nd Floor, Amarsons Bhavan, 68 Misquitta St, Vile Parle East, Mumbai, 400057 India
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Gebrehiwot SW, Abera G, Tesfay K, Tilahun W. Short birth interval and associated factors among women of child bearing age in northern Ethiopia, 2016. BMC WOMENS HEALTH 2019; 19:85. [PMID: 31266479 PMCID: PMC6604155 DOI: 10.1186/s12905-019-0776-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 06/02/2019] [Indexed: 11/10/2022]
Abstract
Background Short birth interval is known to have a negative effect on perinatal, neonatal and child health outcomes. In Ethiopia, 29% of births are short birth intervals at less than 24 months. Even though optimum birth spacing is considered as an essential factor for the health of women and their children, to the best of the authors’ knowledge studies conducted on short birth interval are insufficient to inform policy makers. Therefore, the aim of this study was to assess short birth interval and associated factors among women of child bearing age in Tigray, Ethiopia. Methods A community based cross-sectional study was conducted in Tselemti district among women of child bearing age from January 28 to February 28, 2016. Systematic sampling technique was used to select participants. Data were collected through face to face interviews and analyzed using SPSS version 20.0. Odds ratio along with 95% CI was computed to ascertain association between the outcome and predictor variables. A p-value of < 0.05 was considered as cut off point to assess significance of associations in the multivariable analysis. Results The overall prevalence of short birth interval among women of child bearing age was 187 (23.3%). Sub-optimum breastfeeding (AOR = 7.01; 95% CI: 3.64, 13.46), non-use of contraceptive (AOR = 2.44; 95% CI: 1.55, 3.82), being Muslim (AOR = 2.02; 95% CI: 1.20, 3.40) and not having desire to had the last child (AOR = 3.63; 95% CI: 2.23, 5.91) were factors associated with short birth interval. Conclusion Even though currently coverage of family planning use has increased, this study showed that short birth interval is still a concern for Ethiopian women due to factors such as: religion, suboptimum breastfeeding, unwanted pregnancy and non-use of contraceptives. Improving the accessibility and coverage of contraceptive use and involvement of religious leaders in family planning programs are essential strategies to be considered. Electronic supplementary material The online version of this article (10.1186/s12905-019-0776-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Gedamu Abera
- School of Nursing, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Kidist Tesfay
- School of Nursing, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
| | - Weyzer Tilahun
- School of Nursing, College of Health Science, Mekelle University, Mekelle, Tigray, Ethiopia
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Nisha MK, Alam A, Islam MT, Huda T, Raynes-Greenow C. Risk of adverse pregnancy outcomes associated with short and long birth intervals in Bangladesh: evidence from six Bangladesh Demographic and Health Surveys, 1996-2014. BMJ Open 2019; 9:e024392. [PMID: 30798311 PMCID: PMC6398728 DOI: 10.1136/bmjopen-2018-024392] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE To examine the effect of short (<36 months) and long (≥60 months) birth intervals on adverse pregnancy outcomes in Bangladesh. DESIGN, SETTING AND PARTICIPANTS We analysed data from six Bangladesh Demographic and Health Surveys (1996-1997, 1999-2000, 2004, 2007, 2011 and 2014). We included all singleton non-first live births, most recently born to mothers within 5 years preceding each survey (n=21 382). We defined birth interval according to previous research which suggests that a birth interval between 36 and 59 months is the most ideal interval. Bivariate and multivariable analyses were conducted to obtain the crude and adjusted ORs (aOR) respectively to assess the odds of first-day neonatal death, early neonatal death and small birth size for both short (<36 months) and long (≥60 months) spacing between births. MAIN OUTCOME MEASURES First-day neonatal death, early neonatal death and small birth size. RESULTS In the multivariable analysis, compared with births spaced 36-59 months, infants with a birth interval of <36 months had increased odds of first-day neonatal death (aOR: 2.11, 95% CI: 1.17 to 3.78) and early neonatal death (aOR: 1.58, 95% CI: 1.13 to 2.22). Compared with births spaced 36-59 months, infants with a birth interval of ≥60 months had increased odds of first-day neonatal death (aOR: 2.02, 95% CI: 1.10 to 3.73) and small birth size (aOR: 1.17, 95% CI: 1.02 to 1.34). When there was a history of any previous pregnancy loss, there was an increase in the odds of first-day and early neonatal death for both short and long birth intervals, although it was not significant. CONCLUSIONS Birth intervals shorter than 36 months and longer than 59 months are associated with increased odds of adverse pregnancy outcomes. Care-providers, programme managers and policymakers could focus on promoting an optimal birth interval between 36 and 59 months in postpartum family planning.
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Affiliation(s)
- Monjura Khatun Nisha
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ashraful Alam
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Tanvir Huda
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Camille Raynes-Greenow
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
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Ejigu AG, Yismaw AE, Limenih MA. The effect of sex of last child on short birth interval practice: the case of northern Ethiopian pregnant women. BMC Res Notes 2019; 12:75. [PMID: 30717796 PMCID: PMC6360797 DOI: 10.1186/s13104-019-4110-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/31/2019] [Indexed: 01/29/2023] Open
Abstract
Objective Improving short birth interval practice is a key strategy to reduce maternal mortality, neonatal mortality, adverse pregnancy outcomes, high fertility rate and undermining economic development efforts. However, there were limited evidences on short birth interval practice and its determinant factors in Ethiopia. This study aimed to determine the prevalence of short birth interval practice and associated factors among pregnant women. Institutional based cross-sectional study was conducted among 418 pregnant mothers using stratified sampling technique. Multivariable logistic regression analysis was performed at the level of significance of P-value < 0.05. Result Short birth interval practice was found to be 40.9%. Child death (AOR = 3.60, 95% CI 1.35, 9.59), female child (AOR = 2.03, 95% CI 1.12, 3.67), younger maternal age (AOR = 4.23, 95% CI 1.14, 12.66), contraceptive non-use (AOR = 8.15, 95% CI 4.17, 15.94), increase duration of breastfeeding (AOR = 4.72, 95 CI% 1.10, 20.60) and home delivery (AOR = 4.75, 95 CI% 2.30, 9.79) were found to be significantly associated with short birth interval practice. The prevalence of short birth interval practice is high. Multi disciplinary approach through improving maternal and child health care are recommended to prevent short birth interval practice.
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Affiliation(s)
- Amare Genetu Ejigu
- Department of Midwifery, College of Health Science, Mizantepi University, Mizantepi, Ethiopia
| | - Ayenew Engida Yismaw
- Department of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Miteku Andualem Limenih
- Department of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
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