Short birth interval and its predictors among reproductive age women in high fertility countries in sub-Saharan Africa: a multilevel analysis of recent Demographic and Health Surveys

Abstract

Background In developing countries, short birth interval is one of the major public health issues. It is one of the leading cause’s adverse birth outcomes in the worldwide. Despite the fact that ending maternal and perinatal morbidity and mortality is one of the Sustainable Development Goals (SDG), the burden of the problem continues to be a huge concern in developing countries, including high fertility countries. Thus, this study aimed to determine the short birth interval and its predictors in ten high fertile sub-Saharan African countries. Methods Data for this study was obtained from the most recent Demographic and Health Surveys (DHS). A total of weighted sample of 303,979 women of childbearing age group (15– 49) who had at least two alive consecutive children was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the associated factors of short birth interval. As a final step, the Adjusted Odds Ratio (AOR) was used with a confidence interval of 95% in determining statistical significance. Results Overall prevalence of short birth interval in high fertile sub Saharan Africa was 58.74% (52.32%, 65.17%).The factors significantly associated with the short birth interval were women's educational status; primary education (AOR = 0.88; 95% CI: 0.86,0 .91), secondary and higher (AOR = 0.10; 95% CI: 0.09, 0.11), working (AOR = 0.91; 95% CI: 0.88, 0 .93), classified as rich wealth index level (AOR = 0.90; 95% CI: 0.88, 0.93),having six and above ideal number of children (AOR = 2.25; 95% CI: 2.22, 2.30), preferred waiting time two years and above to give birth (AOR = 0.83; 95% CI: 0.76, 0.89), contraceptive non users (AOR = 3.01; 95% CI: 2.93, 3.07), community level education (AOR = 1.97; 95% CI: 1.54, 2.08), rural residency (AOR = 2.17; 95% CI: 2.13, 2.22), and country Chad (AOR = 1.37; 95% CI: 1.22, 1.54). Conclusion The prevalence of short birth interval in the top ten high fertile sub Saharan African countries is still optimally high. Therefore, the government of each country should work on the access to family planning and education in rural parts of the countries.

Short Birth Interval and Associated Factors among Women of Reproductive Age in Arba Minch, in Gamo Zone SNNPR Ethiopia: Evidences from Health and Demographic Surveillance Sites

“…The ndings this study were found to be in line with the study conducted in Northwest Ethiopia (12). However, it was lower than the study conducted in Uganda(52.4%), Tanzania (48.4%), rural India (50%), Sub-Saharan Africa (58.7%), and other places of Ethiopia (62.9%) (2,(13)(14)(15)(16)). On the other hand, this nding is higher than studies conducted in Northern Ethiopia(23.3%,) and Bangladesh (26% ) respectively (4,17).…”

Prevalence and factors associated with short birth interval in Kaya Municipality, North Central Burkina Faso: a multilevel Poisson regression modeling with a robust variance of a community survey

“…African countries with high fertility [23]. Another study in 35 sub-Saharan African countries found a pooled prevalence of 43.91%, with South Africa having the lowest prevalence (23.25%) and Chad having the highest (59.28%).…”

“…This high prevalence is common in many African countries. It has also been noted in the literature, ranging from 16.99% to 58.74%: analyses carried out on Demographic and Health Survey (DHS) databases showed that the pooled prevalence was 16.99% for 12 East African countries in a study published in 2023 [10], and 58.74% as a pooled prevalence in 10 African countries with high fertility [23]. Another study in 35 sub-Saharan African countries found a pooled prevalence of 43.91%, with South Africa having the lowest prevalence (23.25%) and Chad having the highest (59.28%).…”

“…According to the literature, there are several factors associated with short birth interval: the duration of breastfeeding of the previous child, the number of antenatal care (ANC) visits for the index pregnancy, woman's level of education, woman's occupation, contraceptive practice, woman's age at marriage, the woman's age at first pregnancy, partner's religion, partner's level of education, partner's occupation, the parity of the index child, the survival of the previous birth, the place of residence and the well-being index, etc. [8][9][10][11]. Most studies have considered only the woman's most recent birth interval and therefore excluded her previous birth intervals.…”

Determinants of Suboptimal Birth Spacing among Reproductive-Age Women in Adama District, Ethiopia: A Community-Based Unmatched Case-Control Study

“…In Africa, including Ethiopia, many women still experience untimely and closely spaced pregnancies, despite the availability of family planning services. This situation exposes them to a higher risk of health issues and even death during pregnancy and childbirth (14,16,17). Efforts by the government and other stakeholders have not fully addressed this concern, as suboptimal or short birth intervals continue to occur (18)(19)(20).…”