Preceding Birth Intervals and Child Survival: Searching for Pathways of Influence

Abstract

The importance of the length of preceding birth intervals for the survival chances of young children has been established, but the debate concerning the causal biomedical or behavioral mechanisms continues. This article uses data from 17 Demographic and Health Surveys to investigate the effect of birth intervals on child mortality: Anthropometry of children, recent morbidity of children, and use of health services are examined in addition to child survival data for children born in the five years before the survey. Various methodological approaches are used to investigate the relative importance of the postulated mechanisms linking birth intervals and child survival. Short preceding birth intervals are associated with increased mortality risks in the neonatal period and at 1-6 months of age, and, to a much lesser extent, at 7-23 months of age. The effects of short birth intervals on nutritional status are rather moderate, and there is a weak relationship with lower attendance at prenatal care services. No consistent relationship exists between the length of birth intervals and other health status or health-service utilization variables. The results indicate that prenatal mechanisms are more important than postnatal factors, such as sibling competition, in explaining the causal nature of the birth interval effect.

The correlates of infant and childhood mortality

“…This might in turn contribute to a better understanding of demographic correlates of epidemiological transition. Although these alternative measures are far from being free from all distortions, they show surprisingly constant patterns across populations and time.The effect of the birth rank and birth interval has been analyzed in many historical and tradition populations, producing quite consistent results (Boerma and Bicego 1992;Cohen 1975;Knodel and Hermalin 1984;Miller et al 1992;Modin 2002;Palloni and Millman 1986;Pebley, Hermalin, and Knodel 1991;Retel-Laurentin and Benoit 1976).The results of the current study show quite similar results. Children born in large Tymicki: Correlates of infant and childhood mortality: A theoretical overview and new evidence 588…”

“…Many studies have found that the length of the birth interval is positively correlated to the survival of the index child (Boerma and Bicego 1992;Knodel and Hermalin 1984;Palloni and Millman 1986;Retel-Laurentin and Benoit 1976). This is mostly related to the duration of breastfeeding.…”

Heterogeneous Effects of Birth Spacing on Neonatal Mortality Risks in Bangladesh

“…A consistent negative relationship between birth interval length and infant mortality risks has been identified in a wide variety of contexts (Cleland and Sathar 1984; Hobcraft, McDonald, and Rutstein 1985; Palloni and Millman 1986; Millman and Cooksey 1987; Pebley, Hermalin, and Knodel 1991; Boerma and Bicego 1992; Curtis, Diamond, and McDonald 1993; Rutstein 2005; Kozuki and Walker 2013; Mahande and Obure 2016; Molitoris 2017). The ubiquity of this relationship has led the World Health Organization to recommend that mothers in developing countries space their births at least three years apart (WHO 2007), and this recommendation has been implemented in community‐based family planning programs (Ahmed et al.…”

Investigating the Important Correlates of Maternal Education and Childhood Malaria Infections

“…The causal pathway through which maternal education impacts child health in developing countries has been described in multiple ways. 5,15,31 A multicountry analysis looking at the effect of maternal education on child survival rates by age-specific segments concluded that child survival rates by mother's education levels *Address correspondence to Joseph D. Njau, 1600 Clifton Road 16NE, Atlanta, GA 30333. E-mail: jnjau@cdc.gov were substantially higher among those children ages 1-5 years than those children in the neonatal and post-neonatal periods.…”

“…Studies have shown that birth order, maternal age at birth, and birth interval length were important factors contributing to improved child health. 2,31,38 Education enhances the tendency for women to delay childbearing and avoid high-risk childbearing when younger. 39 Educated mothers also tend to avoid early marriages, which accord them time to grow and mature as they prepare to deal with marriage and childbearing challenges.…”