A multilevel analysis of short birth interval and its determinants among reproductive age women in developing regions of Ethiopia

Aychiluhm, Setognal Birara; Tadesse, Abay Woday; Mare, Kusse Urmale; Abdu, Mohammed; Ketema, Abdusemed

doi:10.1371/journal.pone.0237602

Cited by 34 publications

(53 citation statements)

References 33 publications

(79 reference statements)

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“…Our finding is not similar with previous studies in Ethiopia [16,21,22] and other countries like sub-Saharan Africa [37], India [38] on which contraceptive use is not significantly associated with birth interval. The reason for this difference might arise because of study population, sample size, methodology, sociodemographic, health service access for family planning, and awareness of women's on contraceptive use.…”

Section: Discussioncontrasting

confidence: 99%

“…(Table 1). From thirteen studies, Ten of them were showed a statistically significant association between contraceptive use and short of birth interval [17][18][19][20][23][24][25][26][27][28] while, three studies did not showed a statistically significant association between contraceptive use and short of birth interval [16,21,22].…”

Section: Study Characteristicsmentioning

confidence: 99%

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Usage of Contraceptive and Birth Interval in Ethiopia: Systematic Review and Meta-analysis

Assefa¹,

Tegegne²,

Tegegne³

et al. 2021

JFMHC

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Background: Children born soon after previous birth are at high risk for health problems and died at a younger age, especially if the interval between the births is less than two years. The purpose of this review is to summarize the evidence whether contraceptive use is associated with birth interval among women in Ethiopia. Methods: Studies for this meta-analysis were accessed through main databases searches (PUBMED and Advanced Google Scholar) that were published from 2010 onwards. Three blinded reviewers evaluated the abstracts as well as the full texts and performed the data extraction. To assess external and internal validity, a risk-of-bias tool was used. Pooled effect size of birth interval was estimated from the reported proportion of eligible studies using RevMan V. 5.3 software. Results: Thirteen studies were found to be eligible and included in the meta-analysis. A total of 16311 women were involved. Of which, 6112 (37.5%) women had contraceptive users and 5873 (36%) of women had experienced short birth interval. The final pooled effect size after trim and fill analysis in random effect model was found to be -0.67 (95%CI: -0.74, -0.59). This indicated that presence of a significant association between contraceptive use and the length of birth interval. Conclusions: This meta-analysis found that, in Ethiopia, promoting contraceptive use was associated with decreasing short birth interval by 33%. Thus, the existing efforts of optimizing birth interval should be enhanced through modern contraceptive use.

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Section: Discussioncontrasting

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Usage of Contraceptive and Birth Interval in Ethiopia: Systematic Review and Meta-analysis

Assefa¹,

Tegegne²,

Tegegne³

et al. 2021

JFMHC

View full text Add to dashboard Cite

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“…Previous studies conducted in Ethiopia to investigate the risk factors of neonatal mortality were institutionalbased [14,15] and considering only individual-level factors [11][12][13]. However, neonatal mortality can be affected by community-level factors, such as the source of drinking water [16,17], types of toilet facilities [18,19], and cluster (enumeration area) [20,21]. Moreover, the uses of a single-level logistic regression analysis approach to analyze data with a hierarchical structure (i.e., neonates nested within communities) violate the regression's independence assumptions [22].…”

Section: Introductionmentioning

confidence: 99%

Risk factor of neonatal mortality in Ethiopia: multilevel analysis of 2016 Demographic and Health Survey

2021

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Background In sub-Saharan African countries, neonatal mortality rates remain unacceptably high. Ethiopia is one of the countries in Sub-Saharan Africa with the highest death rates of newborn children. Therefore, this study aimed to identify the risk factors associated with neonatal mortality in Ethiopia at the individual and community level. Methods The 2016 Ethiopian Demographic and Health Survey data was accessed and used for the analysis. A total of 2449 newborn children were included in the analysis. The multilevel logistic regression model was used to identify the significant factor of neonatal mortality. Adjusted odds ratio with a 95% confidence interval and p-value < 0.05 in the multilevel model was reported. Results A total of 2449 newborn children were included in this study. Multiple birth type (AOR = 3.18; 95% CI 2.78, 3.63), birth order of ≥ 5 (AOR = 2.15; 95% CI 1.75, 2.64), pre-term birth (AOR = 5.97; 95% CI 4.96, 7.20), no antenatal care (ANC) visit during pregnancy (AOR = 2.33; 95% CI 2.09, 2.61), not received TT injection during pregnancy (AOR = 2.28; 95% CI 1.92, 2.71), delivered at home (AOR = 1.99; 95% CI 1.48, 2.69), less than 24 months of preceding birth interval (AOR = 1.51; 95% CI 1.35,1.68), smaller birth size (AOR = 1.58; 95% CI 1.46, 1.71), never breastfeeding (AOR = 2.43; 95% CI 2.17, 2.72), poor wealth index (AOR = 1.29; 95% CI 1.17,1.41), non-educated mothers (AOR = 1.58; 95% CI 1.46, 1.71), non-educated fathers (AOR = 1.32; 95% CI 1.12, 1.54), rural residence (AOR = 2.71; 95% CI 2.23, 3.29), unprotected water source (AOR = 1.35; 95% CI 1.16, 1.58), and have no latrine facility (AOR = 1.78; 95% CI 1.50, 2.12) were associated with a higher risk of neonatal mortality. Neonates living in Amhara, Oromia, Somali, Harari, and Dire Dawa had a higher risk of neonatal mortality compared to Tigray. Moreover, the random effects result showed that about 85.57% of the variation in neonatal mortality was explained by individual- and community-level factors. Conclusions The findings suggest that attention be paid to education-based programs for mothers that would highlight the benefits of delivery care services, such as ANC visits, TT injections, and facility births. Meanwhile, public health initiatives should focus on expanding access to quality sanitation facilities, especially for latrines and drinking water that could improve neonatal health at the community-level as a whole.

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“…Studies on birth interval showed that household wealth status [ 15 ], residence [ 15 ], husband education [ 16 ], maternal education [ 17 , 18 ], contraceptive use [ 19 , 20 ], media exposure [ 21 ], women health care decision making autonomy [ 22 ], religion [ 23 , 24 ], maternal occupation [ 15 ], breastfeeding duration [ 23 ], parity [ 24 ], and maternal age [ 25 ] were significant predictors of birth interval.…”

Section: Introductionmentioning

confidence: 99%

Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling

2021

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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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A multilevel analysis of short birth interval and its determinants among reproductive age women in developing regions of Ethiopia

Cited by 34 publications

References 33 publications

Usage of Contraceptive and Birth Interval in Ethiopia: Systematic Review and Meta-analysis

Usage of Contraceptive and Birth Interval in Ethiopia: Systematic Review and Meta-analysis

Risk factor of neonatal mortality in Ethiopia: multilevel analysis of 2016 Demographic and Health Survey

Duration of birth interval and its predictors among reproductive-age women in Ethiopia: Gompertz gamma shared frailty modeling

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