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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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Ahmmed F, Hasan MN, Hossain MF, Khan MTF, Rahman MM, Hussain MP, Hossain MJ. Association between short birth spacing and child malnutrition in Bangladesh: a propensity score matching approach. BMJ Paediatr Open 2024; 8:e002240. [PMID: 38499349 PMCID: PMC10953308 DOI: 10.1136/bmjpo-2023-002240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 03/04/2024] [Indexed: 03/20/2024] Open
Abstract
OBJECTIVES This study aimed to explore the effects of short birth spacing (SBS), which is defined as a period of less than 33 months between two successive births, on multiple concurrent forms of child malnutrition (MCFCM) and at least one form of child malnutrition (ALOFCM) using propensity score matching (PSM). METHODS This study used data extracted from the 2017-18 Bangladesh Demographic and Health Survey. PSM with four different distance functions, including logistic regression, classification and regression tree, single hidden layer neural network and random forest, were performed to evaluate the effects of SBS on MCFCM and ALOFCM. We also explored how the effects were modified in different subsamples, including women's empowerment, education and economic status (women's 3E index)-constructed based on women's decision-making autonomy, education level, and wealth index, and age at marriage, and place of residence. RESULTS The prevalence of SBS was 22.16% among the 4652 complete cases. The matched samples of size 2062 generated by PSM showed higher odds of MCFCM (adjusted OR (AOR)=1.25, 95% CI=1.02 to 1.56, p=0.038) and ALOFCM (AOR=1.20, 95% CI=1.01 to 1.42, p=0.045) for the SBS children compared with their counterparts. In the subsample of women with 3E index≥50% coverage, the SBS children showed higher odds of MCFCM (AOR: 1.43, 95% CI=1.03 to 2.00, p=0.041] and ALOFCM (AOR: 1.33, 95% CI=1.02 to 1.74, p=0.036). Higher odds of MCFCM (AOR=1.27, 95% CI=1.02 to 1.58, p=0.036) and ALOFCM (AOR=1.23, 95% CI=1.02 to 1.51, p=0.032) for SBS children than normal children were also evident for the subsample of mothers married at age≤18 years. CONCLUSION SBS was significantly associated with child malnutrition, and the effect was modified by factors such as women's autonomy and age at marriage.
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Affiliation(s)
- Foyez Ahmmed
- Department of Statistics, Comilla University, Cumilla, Bangladesh
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Md Nahid Hasan
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
- Department of Mathematics, Texas A&M University-Commerce, Commerce, Texas, USA
| | - Md Faruk Hossain
- Institute of Statistical Research and Training, University of Dhaka, Dhaka, Bangladesh
| | - Md Tareq Ferdous Khan
- Department of Mathematics and Statistics, Cleveland State University, Cleveland, OH, USA
| | - Mohammod Mahmudur Rahman
- Department of Biostatistics & Data Science, University of Kansas Medical Center, Kansas City, KS, USA
- Department of Statistics, University of Dhaka, Dhaka, Bangladesh
| | - Md Parvej Hussain
- Department of Economics, University of Chittagong, Chittagong, Bangladesh
| | - Md Jamal Hossain
- Department of Pharmacy, School of Pharmaceutical Sciences, State University of Bangladesh, Dhaka, Bangladesh
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Saraswati CM, Judge MA, Weeda LJZ, Bassat Q, Prata N, Le Souëf PN, Bradshaw CJA. Net benefit of smaller human populations to environmental integrity and individual health and wellbeing. Front Public Health 2024; 12:1339933. [PMID: 38504675 PMCID: PMC10949988 DOI: 10.3389/fpubh.2024.1339933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/13/2024] [Indexed: 03/21/2024] Open
Abstract
Introduction The global human population is still growing such that our collective enterprise is driving environmental catastrophe. Despite a decline in average population growth rate, we are still experiencing the highest annual increase of global human population size in the history of our species-averaging an additional 84 million people per year since 1990. No review to date has accumulated the available evidence describing the associations between increasing population and environmental decline, nor solutions for mitigating the problems arising. Methods We summarize the available evidence of the relationships between human population size and growth and environmental integrity, human prosperity and wellbeing, and climate change. We used PubMed, Google Scholar, and Web of Science to identify all relevant peer-reviewed and gray-literature sources examining the consequences of human population size and growth on the biosphere. We reviewed papers describing and quantifying the risks associated with population growth, especially relating to climate change. Results These risks are global in scale, such as greenhouse-gas emissions, climate disruption, pollution, loss of biodiversity, and spread of disease-all potentially catastrophic for human standards of living, health, and general wellbeing. The trends increasing the risks of global population growth are country development, demographics, maternal education, access to family planning, and child and maternal health. Conclusion Support for nations still going through a demographic transition is required to ensure progress occurs within planetary boundaries and promotes equity and human rights. Ensuring the wellbeing for all under this aim itself will lower population growth and further promote environmental sustainability.
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Affiliation(s)
| | - Melinda A. Judge
- Telethon Kids Institute, Perth, WA, Australia
- School of Mathematics and Statistics, University of Western Australia, Nedlands, WA, Australia
| | - Lewis J. Z. Weeda
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Quique Bassat
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
- Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain
- Paediatrics Department, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues, Barcelona, Spain
- Centro de Investigación Biomédica en Red (CIBER) de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Ndola Prata
- Bixby Center for Population Health and Sustainability, School of Public Health, University of California, Berkeley, Berkeley, CA, United States
| | - Peter N. Le Souëf
- School of Medicine, University of Western Australia, Nedlands, WA, Australia
| | - Corey J. A. Bradshaw
- Global Ecology | Partuyarta Ngadluku Wardli Kuu, College of Science and Engineering, Flinders University, Adelaide, SA, Australia
- Australian Research Council Centre of Excellence for Australian Biodiversity and Heritage, Wollongong, NSW, Australia
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Singh P, Singh KK. Trends, patterns and predictors of high-risk fertility behaviour among Indian women: evidence from National Family Health Survey. BMC Public Health 2024; 24:626. [PMID: 38413929 PMCID: PMC10900591 DOI: 10.1186/s12889-024-18046-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 02/08/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Numerous studies have demonstrated that high-risk fertility behaviour (HRFB), which includes maternal age below 18 or above 34 years, short birth intervals (less than 24 months), and high parity (birth order above 4), is associated with adverse maternal and child health outcomes. There is a substantial research gap in the domain of high-risk fertility behaviour in the Indian context. Therefore, this study is designed to investigate the current trends and patterns in the prevalence of high-risk births among Indian women, with a primary focus on identifying contributing factors associated with this prevalence. METHODS The study utilized data from the nationally representative National Family Health Survey (NFHS), which has been conducted in five rounds since 1992-93. Data from all rounds were used to assess the overall trend. However, data from the most recent round of NFHS, conducted during 2019-21, were employed to evaluate current levels and patterns of HRFB prevalence and to identify socio-economic and demographic predictors of HRFB using binomial and multinomial logistic regression models. RESULTS The prevalence of HRFB has exhibited a consistent decreasing pattern from 1992 to 93 to 2019-21 in India. However, 29.56% of married women continue to experience high-risk births with notably higher rates in several states (e.g., 49.85% in Meghalaya and 46.41% in Bihar). Furthermore, socio-demographic factors like wealth index, educational level, social group, religion, mass media exposure, family size, age at marriage, type and region of residence, and reproductive factors like birth intention, place and type of delivery, ANC visits and current contraceptive use were identified as significant predictors of high-risk births among women in India. CONCLUSION Despite a 20.4 percentage point decline in HRFB prevalence over the past three decades, a significant proportion of women in specific regions and demographic subgroups continue to experience high-risk births. Therefore, the present study recommends interventions aimed at preventing high-risk births among women in India, with particular emphasis on states with high HRFB prevalence and women from socioeconomically disadvantaged backgrounds.
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Affiliation(s)
- Pooja Singh
- Department of Statistics, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India.
| | - Kaushalendra Kumar Singh
- Department of Statistics, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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Vasconcelos A, Sousa S, Bandeira N, Alves M, Papoila AL, Pereira F, Machado MC. Factors associated with perinatal and neonatal deaths in Sao Tome & Principe: a prospective cohort study. Front Pediatr 2024; 12:1335926. [PMID: 38434731 PMCID: PMC10904650 DOI: 10.3389/fped.2024.1335926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
Background Neonatal mortality reduction is a global goal, but its factors are seldom studied in most resource-constrained settings. This is the first study conducted to identify the factors affecting perinatal and neonatal deaths in Sao Tome & Principe (STP), the smallest Central Africa country. Methods Institution-based prospective cohort study conducted at Hospital Dr. Ayres Menezes. Maternal-neonate dyads enrolled were followed up after the 28th day of life (n = 194) for identification of neonatal death-outcome (n = 22) and alive-outcome groups (n = 172). Data were collected from pregnancy cards, hospital records and face-to-face interviews. After the 28th day of birth, a phone call was made to evaluate the newborn's health status. Crude odds ratios and corresponding 95% confidence intervals were obtained. A p value <0.05 was considered statistically significant. Results The mean gestational age of the death-outcome and alive-outcome groups was 36 (SD = 4.8) and 39 (SD = 1.4) weeks, respectively. Death-outcome group (n = 22) included sixteen stillbirths, four early and two late neonatal deaths. High-risk pregnancy score [cOR 2.91, 95% CI: 1.18-7.22], meconium-stained fluid [cOR 4.38, 95% CI: 1.74-10.98], prolonged rupture of membranes [cOR 4.84, 95% CI: 1.47-15.93], transfer from another unit [cOR 6.08, 95% CI:1.95-18.90], and instrumental vaginal delivery [cOR 8.90, 95% CI: 1.68-47.21], were factors significantly associated with deaths. The odds of experiencing death were higher for newborns with infectious risk, IUGR, resuscitation maneuvers, fetal distress at birth, birth asphyxia, and unit care admission. Female newborn [cOR 0.37, 95% CI: 0.14-1.00] and birth weight of more than 2,500 g [cOR 0.017, 95% CI: 0.002-0.162] were found to be protective factors. Conclusion Factors such as having a high-risk pregnancy score, meconium-stained amniotic fluid, prolonged rupture of membranes, being transferred from another unit, and an instrumental-assisted vaginal delivery increased 4- to 9-fold the risk of stillbirth and neonatal deaths. Thus, avoiding delays in prompt intrapartum care is a key strategy to implement in Sao Tome & Principe.
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Affiliation(s)
- Alexandra Vasconcelos
- Unidade de Clínica Tropical-Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Swasilanne Sousa
- Department of Pediatrics, Hospital Dr. Ayres de Menezes, São Tomé, Sao Tome and Principe
| | - Nelson Bandeira
- Department of Obstetrics & Gynecology, Hospital Dr. Ayres de Menezes, São Tomé, Sao Tome and Principe
| | - Marta Alves
- CEAUL, NOVA Medical School/Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Ana Luísa Papoila
- CEAUL, NOVA Medical School/Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Filomena Pereira
- Unidade de Clínica Tropical-Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Maria Céu Machado
- Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
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Bai YK, Alsaidi M. Sustainable Breastfeeding: A State-of-the Art Review. J Hum Lact 2024; 40:57-68. [PMID: 38153088 DOI: 10.1177/08903344231216094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
BACKGROUND Disparities in breastfeeding rates and exclusivity exist across regions and countries despite multifaceted breastfeeding promotion efforts in recent decades. Markets for artificial milk formula continue to grow as its substitution for breastfeeding is common. A new approach is needed for breastfeeding promotion strategies. RESEARCH AIM This state-of-the-art review aimed to describe the implications of not-breastfeeding on the environment within the context of food system sustainability. METHOD A total of 19 peer-reviewed articles within a 20-year timeframe were included in this review. Authors searched five databases for articles including Science Direct, GreenFILE, Springer Link, ProQuest, and PubMed. RESULTS The demand for artificial milk formula production as a replacement for breastfeeding results in increased greenhouse gas emissions, water pollution, and waste, thereby aggravating problems with freshwater scarcity. A short duration of breastfeeding and limited exclusivity have been associated with close birth spacing and contributing to global population growth. Breastfeeding is a healthy, sustainable diet, and a culturally acceptable first food. It advances health equity and food security. Exclusive breastfeeding for the first 6 months of life can be promoted with emphasis on total carbon footprint reduction, prevention of waterway degradation, and natural birth spacing, thereby sustaining food systems at large. CONCLUSION It is important to reform food, nutrition, and environmental policies to protect exclusive breastfeeding while decarbonizing artificial milk formula production. More research is needed to provide directions for new breastfeeding promotion strategies connecting breastfeeding with environmental stewardship.
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Affiliation(s)
- Yeon Kyung Bai
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA
| | - Manar Alsaidi
- Department of Nutrition and Food Studies, Montclair State University, Montclair, NJ, USA
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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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Hijazi H, Alameddine M, Al Abdi RM, Baniissa W, Sindiani A, Al-Yateem N, Al-Sharman A, Al Marzouqi A, Hossain A. Association between inter-pregnancy interval and risk of adverse birth outcomes in subsequent pregnancy: A retrospective study from Jordan. Birth 2023; 50:946-958. [PMID: 37455440 DOI: 10.1111/birt.12746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Adverse birth outcomes, such as preterm birth and low birth weight (LBW), are leading causes of neonatal morbidity and mortality. In this study, we aimed to estimate the association between inter-pregnancy interval (IPI) and the risks of adverse birth outcomes in a subsequent pregnancy. METHODS We conducted a retrospective analysis involving 630 mothers who delivered a singleton live infant at a leading tertiary hospital in northern Jordan from March to August 2021. Outcome variables were preterm birth (<37 weeks of gestation) and LBW (<2.5 kg). Using multivariable logistic regression, the association between IPI and these two adverse birth outcomes was investigated. RESULTS The rates of preterm birth and LBW were 12.4% and 16.8%, respectively. Compared with an optimal IPI (24-36 months), a short IPI (<24 months) was positively associated with preterm birth (aOR: 4.09; 95% CI: 1.48-6.55) and LBW (aOR: 3.58; 95% CI: 1.57-5.15). Infants conceived after a long IPI (≥ 60 months) had increased odds of preterm birth (aOR: 3.78; 95% CI: 1.12-5.78) and LBW (aOR: 2.65; 95% CI: 1.67-4.03). Preterm delivery was also significantly associated with the mother's age (aOR: 1.10; 95% CI: 1.04-1.17), history of multiple cesarean births (aOR: 2.67; 95% CI: 1.14-4.29), prolonged rupture of membranes (aOR: 2.46; 95% CI: 1.10-5.52), and perinatal death (aOR: 3.42; 95% CI: 1.10-5.49). A mother's history of prior LBW (aOR: 4.39; 95% CI: 1.08-6.80), hypertensive disorders (aOR: 1.95; 95% CI: 1.03-3.89), and multiple cesarean births (aOR: 4.35; 95% CI: 2.10-6.99) was associated with LBW. CONCLUSIONS Both short and long IPIs were related to preterm delivery and LBW. Optimal birth spacing is recommended to improve birth outcomes and must be considered when designing effective family planning programs.
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Affiliation(s)
- Heba Hijazi
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohamad Alameddine
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Rabah M Al Abdi
- Electrical, Computer, and Biomedical Engineering Department, College of Engineering, Abu Dhabi University, Abu Dhabi, United Arab Emirates
- Biomedical Engineering Department, Faculty of Engineering, Jordan University of Science and Technology, Irbid, Jordan
| | - Wegdan Baniissa
- Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Amer Sindiani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Nabeel Al-Yateem
- Nursing Department, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Alham Al-Sharman
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Rehabilitation Sciences Department, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Alounoud Al Marzouqi
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Ahmed Hossain
- Department of Health Services Administration, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Falcão IR, Ribeiro-Silva RDC, Fiaccone RL, Alves FJO, Rocha ADS, Ortelan N, Silva NJ, Rebouças P, Pinto Júnior EP, de Almeida MF, Paixao ES, Pescarini JM, Rodrigues LC, Ichihara MY, Barreto ML. Participation in Conditional Cash Transfer Program During Pregnancy and Birth Weight-Related Outcomes. JAMA Netw Open 2023; 6:e2344691. [PMID: 38015506 PMCID: PMC10685879 DOI: 10.1001/jamanetworkopen.2023.44691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/10/2023] [Indexed: 11/29/2023] Open
Abstract
Importance There is limited evidence of the association of conditional cash transfers, an important strategy to reduce poverty, with prevention of adverse birth-related outcomes. Objective To investigate the association between receiving benefits from the Bolsa Família Program (BFP) and birth weight indicators. Design, Setting, and Participants This cohort study used a linked data resource, the Centro de Integracao de Dados e Conhecimentos Para Saude (CIDACS) birth cohort. All live-born singleton infants born to mothers registered in the cohort between January 2012 and December 2015 were included. Each analysis was conducted for the overall population and separately by level of education, self-reported maternal race, and number of prenatal appointments. Data were analyzed from January 3 to April 24, 2023. Exposure Live births of mothers who had received BFP until delivery (for a minimum of 9 months) were classified as exposed and compared with live births from mothers who did not receive the benefit prior to delivery. Main Outcomes and Measures Low birth weight (LBW), birth weight in grams, and small for gestational age (SGA) were evaluated. Analytical methods used included propensity score estimation, kernel matching, and weighted logistic and linear regressions. Race categories included Parda, which translates from Portuguese as "brown" and is used to denote individuals whose racial background is predominantly Black and those with multiracial or multiethnic ancestry, including European, African, and Indigenous origins. Results A total of 4 277 523 live births (2 085 737 females [48.8%]; 15 207 among Asian [0.4%], 334 225 among Black [7.8%], 29 115 among Indigenous [0.7%], 2 588 363 among Parda [60.5%], and 1 310 613 among White [30.6%] mothers) were assessed. BFP was associated with an increase of 17.76 g (95% CI, 16.52-19.01 g) in birth weight. Beneficiaries had an 11% lower chance of LBW (odds ratio [OR], 0.89; 95% CI, 0.88-0.90). BFP was associated with a greater decrease in odds of LBW among subgroups of mothers who attended fewer than 7 appointments (OR, 0.85; 95% CI, 0.84-0.87), were Indigenous (OR, 0.73; 95% CI, 0.61-0.88), and had 3 or less years of education (OR, 0.76; 95% CI, 0.72-0.81). There was no association between BFP and SGA, except among less educated mothers, who had a reduced risk of SGA (OR, 0.83; 95% CI, 0.79-0.88). Conclusions and Relevance This study found that BFP was associated with increased birth weight and reduced odds of LBW, with a greater decrease in odds of LBW among higher-risk groups. These findings suggest the importance of maintaining financial support for mothers at increased risk of birth weight-related outcomes.
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Affiliation(s)
- Ila R. Falcão
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Rita de Cássia Ribeiro-Silva
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | - Rosemeire L. Fiaccone
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Department of Statistics, Federal University of Bahia, Salvador, Brazil
| | | | - Aline dos Santos Rocha
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- School of Nutrition, Federal University of Bahia, Salvador, Brazil
| | - Naiá Ortelan
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Natanael J. Silva
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Barcelona Institute for Global Health, Hospital Clinic, Barcelona, Spain
| | - Poliana Rebouças
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
| | | | | | - Enny S. Paixao
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Júlia M. Pescarini
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Laura C. Rodrigues
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Maria Yury Ichihara
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Mauricio L. Barreto
- Centre for Data and Knowledge Integration for Health, Oswaldo Cruz Foundation, Salvador, Brazil
- Institute of Collective Health, Federal University of Bahia, Salvador, Bahia, Brazil
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Cueva GAH, Ramírez RGN, Visconti-Lopez FJ, Bendezu-Quispe G, Vargas-Fernández R. Association Between the Autonomy of Peruvian Women and the Choice of the Place of Delivery: Analysis of a National Survey, 2019. Matern Child Health J 2023; 27:1823-1833. [PMID: 37329422 DOI: 10.1007/s10995-023-03740-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVES To determine the association between Peruvian women's autonomy and place of delivery. METHODS An analytical cross-sectional study of secondary data from the Demographic and Family Health Survey 2019 was carried out. The dependent variable was institutionalized childbirth, and the independent variable was women's autonomy. Likewise, the association between women's autonomy and institutionalized childbirth was evaluated using Poisson family generalized linear models with logarithmic link function, and crude (PR) and adjusted prevalence ratios (aPR) with their respective 95% confidence interval (CI) were estimated. RESULTS The analysis included 15,334 women aged 15-49 years. It was found that a high proportion of women had a low level of autonomy (42.6%; 95% CI: 41.5-43.7), while 92.1% (95% CI: 91.3-92.9) had institutionalized childbirth. Moderate (PR: 1.10; 95% CI: 1.08-1.12) and high (PR: 1.13; 95% CI: 1.12-1.15) levels of women's autonomy were found to be associated with institutionalized childbirth, and the same association was found in the adjusted analysis. CONCLUSION Being a woman with a higher level of autonomy was related to a higher prevalence of institutionalized childbirth. Therefore, as decision-making is a multifactorial characteristic, it is necessary to study in depth the determinants of non-institutionalized childbirth in women with less autonomy.
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Affiliation(s)
| | | | | | - Guido Bendezu-Quispe
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
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Asmamaw DB, Negash WD, Aragaw FM, Belay DG, Asratie MH, Endawkie A, Belachew TB. Spatial distribution, magnitude, and predictors of high fertility status among reproductive age women in Ethiopia: Further analysis of 2016 Ethiopia Demographic and Health Survey. PLoS One 2023; 18:e0290960. [PMID: 37682844 PMCID: PMC10490912 DOI: 10.1371/journal.pone.0290960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 08/18/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUND Women's health and welfare, as well as the survival of their children, are adversely affected by high fertility rates in developing countries. The fertility rate in Ethiopia has been high for a long time, with some pockets still showing poor improvement. Thus, the current study is aimed to assess the spatial distribution and its predictors of high fertility status in Ethiopia. METHODS Secondary data analysis was used using the 2016 Ethiopian Demographic and Health Survey (EDHS). The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of high fertility status. ArcGIS version 10.8 was used to visualize the distribution of high fertility status across the country. Mixed-effect logistic regression analysis was also used to identify the predictors of high fertility. RESULT High fertility among reproductive-age women had spatial variation across the country. In this study, a higher proportion of fertility occurred in Somali region, Southeastern part of Oromia region, and Northeastern part of SNNPR. About 45.33% (confidence interval: (44.32, 46.33) of reproductive-age women had high fertility. Education; no formal (aOR: 13.12, 95% CI: 9.27, 18.58) and primary (aOR: 5.51, 95% CI: 3.88, 7.79), religion; Muslim (aOR: 1.52, 95% CI: 1.28, 1.81) and Protestant (aOR: 1.48, 95% CI: 1.23, 1.78), age at first birth (aOR: 2.94, 95% CI: 2.61, 3.31), age at first sex (aOR: 1.70, 95% CI: 1.49, 1.93), rural resident (aOR: 3.76, 95% CI: 2.85, 4.94) were predictors of high fertility in Ethiopia. CONCLUSION The spatial pattern of high fertility status in Ethiopia is clustered. Hotspot areas of a problem were located in Somali, Central Afar, Northeastern part of SNNPR, and Southeastern part of Oromia region. Therefore, designing a hotspot area-based interventional plan could help to reduce high fertility. Moreover, much is needed to be done among rural residents, reducing early sexual initiations and early age at first birth, and enhancing women's education. All the concerned bodies including the kebele administration, religious leaders, and community leaders should be in a position to ensure the practicability of the legal age of marriage.
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Affiliation(s)
- 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
| | - Fantu Mamo Aragaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Daniel Gashaneh Belay
- Department of Human Anatomy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Melaku Hunie Asratie
- Department of Women’s and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abel Endawkie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, 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
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Mare KU, Sabo KG, Mohammed AA, Leyto SM, Mulaw GF, Tebeje TM, Aychiluhm SB, Ebrahim OA, Wuneh AG, Seifu BL. Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression. Reprod Health 2023; 20:132. [PMID: 37667285 PMCID: PMC10476311 DOI: 10.1186/s12978-023-01678-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 08/28/2023] [Indexed: 09/06/2023] Open
Abstract
BACKGROUND Despite the availability of exempted family planning services, a significant proportion of women in African countries continue to experience inadequately spaced pregnancies. To the authors' knowledge, evidence of suboptimal birth intervals at the SSA level is lacking and previous studies have been limited to specific geographic area. Therefore, this analysis was aimed to estimate the pooled prevalence of suboptimal birth spacing and its predictors among childbearing women in SSA. METHODS Pooled DHS data from 35 SSA countries were used and a weighted sample of 221,098 reproductive-age women was considered in the analysis. The survey across all countries employed a cross-sectional study design and collected data on basic sociodemographic characteristics and different health indicators. Forest plot was used to present the overall and country-level prevalence of suboptimal birth spacing. Multilevel mixed-effects models with robust Poisson regression were fitted to identify the predictors of suboptimal birth spacing. Akaike's and Bayesian information criteria and deviance were used to compare the models. In a multivariable regression model, a p-value less than 0.05 and an adjusted prevalence ratio with the corresponding 95% CI were used to assess the statistical significance of the explanatory variables. RESULTS The pooled prevalence of suboptimal birth spacing among women in SSA was 43.91% (43.71%-44.11%), with South Africa having the lowest prevalence (23.25%) and Chad having the highest (59.28%). It was also found that 14 of the 35 countries had a prevalence above the average for SSA. Rural residence [APR (95% CI) = 1.10 (1.12-1.15)], non-exposure to media [APR (95% CI) = 1.08 (1.07-1.11)], younger maternal age [APR (95% CI) = 2.05 (2.01-2.09)], non-use of contraception [APR (95% CI) = 1.18 (1.16-1.20)], unmet need for family planning [APR (95% CI) = 1.04 (1.03-1.06)], higher birth order [APR (95% CI) = 1.31 (1.28-1.34)], and desire to have at least six children [APR (95% CI) = 1.14 (1.13-1.16)] were the predictors of suboptimal birth spacing practice. CONCLUSION More than four out of ten reproductive-age women in SSA countries gave birth to a subsequent child earlier than the recommended birth spacing, with considerable variations across the countries. Thus, interventions designed at enhancing optimal birth spacing should pay particular attention to young and socioeconomically disadvantaged women and those residing in rural regions. Strengthening community health programs and improving accessibility and availabilities of fertility control methods that ultimately impacts optimal reproductive behaviors is crucial to address contraceptive utilization and unmet need.
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Affiliation(s)
- Kusse Urmale Mare
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia.
| | - Kebede Gemeda Sabo
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Ahmed Adem Mohammed
- Department of Nursing, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Simeon Meskele Leyto
- Department of Anatomy, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Getahun Fentaw Mulaw
- School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tsion Mulat Tebeje
- School of Public Health, College of Health Sciences and Medicine, Dilla University, Dilla, Ethiopia
| | - Setognal Birara Aychiluhm
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Oumer Abdulkadir Ebrahim
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Abel Gebre Wuneh
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
| | - Beminate Lemma Seifu
- Department of Public Health, College of Medicine and Health Sciences, Samara University, Samara, Ethiopia
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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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Arega GG, Mitku AA, Fenta HM. Spatio-temporal pattern of short birth interval and associated factors on women in Ethiopia: Using Ethiopian demographic and health surveys 2000–2016. Front Med (Lausanne) 2023; 10:1131794. [PMID: 37089597 PMCID: PMC10116610 DOI: 10.3389/fmed.2023.1131794] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/15/2023] [Indexed: 04/08/2023] Open
Abstract
BackgroundA short birth interval is a critical factor that contributes to a large number of maternal and infant mortality in low- and middle-income countries. It is the major cause of maternal and child mortality in Ethiopia. This study aimed to explore the spatiotemporal distribution of short birth intervals in Ethiopia using data from four (2000, 2005, 2011, and 2016) consecutive demographic and health surveys.MethodsA total of 34,930 women were included in four consecutive Ethiopian Demographic and Health Surveys (EDHS). Thus, spatial autocorrelation, hotspot analysis, cluster analysis, and spatial interpolation were carried out for each survey separately to show the geographical and temporal pattern of at-risk areas for short birth intervals in Ethiopia. Finally, the highest proportion of short birth interval risk areas in each survey period was mapped. Geospatial analysis was conducted by using ArcGIS V.10.8 and R version 4.2.ResultsThe results of the study indicated that the overall proportion of short birth intervals of women in Ethiopia was highest in 2000 (47.5%), 2005 (46.4%), 2011 (44.7%), and the lowest in 2016 (44.0%). The values for Global Moran’s I (MI = 0.177665 p = 0.0016, MI = 0.2024, p = 0.001, MI = 0.10023, p = 0.002, and MI = 0.764, p = 0.008) showed that the presence of significant short birth interval clustering in Ethiopian administrative zones in 2000, 2005, 2011, and 2016, respectively. The hotspot areas for short birth intervals were consistently observed in the zones in the Somali Region and the zones in the Harari Region for all the EDHS years. In addition, the survival status of the index child, residence, breastfeeding practice, religion, and the spatial variable (Si) were significantly associated with the short birth interval of women in all the EDHS years.ConclusionSpatial distribution of short birth intervals differs across Ethiopian administrative zones. Survival status of the index child being dead, rural residential, and no breastfeeding practice are the risk factors for short birth intervals of women that increase the risk of a short birth interval among women in all the EDHS years. Therefore, the hotspot areas and indicators need interventions to decrease the short birth interval of women.
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Tesema GA, Teshale AB, Yeshaw Y, Angaw DA, Molla AL. Assessing the effects of duration of birth interval on adverse pregnancy outcomes in sub-Saharan Africa: a propensity score-matched analysis. BMJ Open 2023; 13:e062149. [PMID: 37015793 PMCID: PMC10083766 DOI: 10.1136/bmjopen-2022-062149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/06/2023] Open
Abstract
OBJECTIVES Unlike high-income countries, sub-Saharan African countries have the highest burden of adverse pregnancy outcomes such as abortion, stillbirth, low birth weight and preterm births. The WHO set optimal birth spacing as a key strategy to improve pregnancy outcomes. Estimating the impact of short and long birth intervals on adverse pregnancy outcomes based on an observational study like the Demographic and Health Survey (DHS) is prone to selection bias. Therefore, we used the propensity score-matched (PSM) analysis to estimate the actual impact of short and long birth intervals on adverse pregnancy outcomes. DESIGN A community-based cross-sectional study was conducted based on the DHS data. SETTING We used the recent DHS data of 36 sub-Saharan African countries. PARTICIPANTS A total of 302 580 pregnant women for stillbirth and abortion, 153 431 for birth weight and 115 556 births for preterm births were considered. PRIMARY OUTCOME MEASURES To estimate the impact of duration of birth interval (short/long) on adverse pregnancy outcomes, we used PSM analysis with logit model using psmatch2 ate STATA command to find average treatment effect on the population (ATE), treated and untreated. The quality of matching was assessed statistically and graphically. Sensitivity analysis was conducted to test the robustness of the PSM estimates using the Mantel-Haenszel test statistic. RESULTS The prevalence of short and long birth intervals in sub-Saharan Africa was 46.85% and 13.61%, respectively. The prevalence rates of abortion, stillbirth, low birth weight, macrosomia, and preterm births were 6.11%, 0.84%, 9.63%, 9.04%, and 4.87%, respectively. In the PSM analysis, the differences in ATE of short birth intervals on abortion, stillbirth, low birth weight, and preterm births were 0.5%, 0.1%, 0.2%, and 0.4%, respectively, and -2.6% for macrosomia. The difference in ATE among the treated group was 1%, 1%, and 1.1% increased risk of abortion, low birth weight, and preterm births, respectively, while there was no difference in risk of stillbirth between the treated and control groups. The ATEs of long birth intervals on abortion, stillbirth, low birth weight, macrosomia and preterm births were 1.3%, 0.4%, 1.0%, 3.4%, and 0.2%, respectively. The ATE on the treated group had 0.9%, 0.4%, 2.4%, 2.8%, and 0.2% increased risk of abortion, stillbirth, low birth weight, macrosomia, and preterm births, respectively. The estimates were insensitive to hidden bias and had a good quality of matching. CONCLUSION Short and long birth intervals had a significant positive impact on stillbirth, abortion, low birth weight, macrosomia and preterm births after matching treated and control groups by observed variables. These findings highlighted maternal and newborn healthcare programmes and policies to empower reproductive-aged women to exercise optimal birth spacing to reduce the incidence of stillbirth, abortion, low birth weight, macrosomia and preterm births.
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Affiliation(s)
- Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Medical Physiology, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Dessie Abebaw Angaw
- Department of Epidemiology and Biostatistics, College of Medicine and Health Sciences, Institute of Public Health, Gondar University, Gondar, Ethiopia
| | - Ayenew Lakew Molla
- Department of Epidemiology and Biostatistics, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Islam MZ, Rahman M, Khan N. Exploring the association between child nutritional disorders and short birth interval: Evidence from 2017/18 Bangladesh demographic and Health Survey data. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023. [DOI: 10.1016/j.cegh.2023.101256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
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Yosef T, Debela D, Shifera N. Determinants of short birth interval among child-bearing age women in the Gedeb Hasasa district of the West Arsi zone, Ethiopia. Front Med (Lausanne) 2023; 10:1025111. [PMID: 36760403 PMCID: PMC9902654 DOI: 10.3389/fmed.2023.1025111] [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: 09/24/2022] [Accepted: 01/04/2023] [Indexed: 01/25/2023] Open
Abstract
Background Short birth intervals have been linked to higher rates of fetal loss, prenatal mortality, and poorer child survival. Therefore, for countries like Ethiopia that have a population policy intended at reducing fertility, understanding the level and factors influencing birth spacing is crucial in order to apply appropriate intervention. This study aimed to assess the prevalence and determinants of the short birth interval among child-bearing age women in the Gedeb Hasasa district of the West Arsi zone, Ethiopia. Methods A community-based cross-sectional study was conducted from 20 July to 20 August 2018. A multistage sampling method was used. Face-to-face interviews were conducted to gather data. The collected data were entered into Epi Data version 3.1 and later exported to SPSS version 21 for analysis. Logistic regression was used to identify factors associated with the short birth interval. The level of significance was declared at a p-value of <0.05. Results A total of 714 women participated, with a 98% response rate. The median birth interval length was 32 months. The prevalence of the short birth interval was 50.4%. After adjusting for confounding variables, being a rural resident [AOR = 2.50, 95% CI (1.52, 4.09)], having an illiterate husband [AOR = 4.14, 95% CI (2.15, 8.45)], breastfeeding duration for 7-12 months [AOR = 3.16, 95% CI (1.95, 5.13)] and 13-23 months [AOR = 2.45, 95% CI (1.52, 3.95)], sex of the prior child [AOR = 0.63, 95% CI (0.45, 0.88)], and previous child alive [AOR = 0.20, 95% CI (0.14, 0.96)] were the determinants of short birth interval. Conclusion and recommendation One in every two women practiced short birth intervals. The median birth interval duration was 32 months, which is below the minimum standard recommended by the WHO duration for the birth interval, which is 33 months. Short birth intervals were determined independently by residence, husband education, breastfeeding time, previous child's sex, and previous child's survival. Therefore, increasing women's awareness of the ideal birth interval should be done through community health professionals and health developmental armies.
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Affiliation(s)
- Tewodros Yosef
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
| | - Degfachew Debela
- Public Health Department, Ethiopian Public Health Institute, Harare Regional Health Bureau, Harar, Ethiopia
| | - Nigusie Shifera
- School of Public Health, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan Teferi, Ethiopia
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Woldeamanuel BT, Gessese GT, Demie TG, Handebo S, Biratu TD. Women's education, contraception use, and high-risk fertility behavior: A cross-sectional analysis of the demographic and health survey in Ethiopia. Front Glob Womens Health 2023; 4:1071461. [PMID: 36937044 PMCID: PMC10014881 DOI: 10.3389/fgwh.2023.1071461] [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: 10/16/2022] [Accepted: 02/10/2023] [Indexed: 03/05/2023] Open
Abstract
Background High-risk fertility behavior (HRFB) among women is the main factor in a wide range of detrimental effects on both the mother's and the child's health, which has an impact on both the mother's and the child's survival. Early childbearing is associated with a higher number of live births and may result in poorer maternal, baby, and child health outcomes. Infant and child mortality are also linked to short birth intervals and higher birth order. Thus, this study aims to examine the link between women's education, contraception use, and high-risk fertility behavior in Ethiopia. Methods Data was drawn from the 2019 Ethiopian Interim Demographic and Health Survey. The analysis covered a total of 5,846 women. The effect of predictor variables on HRFB was quantified using multivariable logistic regression analysis. At a 95% CI of the odds ratio excluding one, a significant association between the HRFB and predictor variables was observed. Results About 72.8% (95% CI 71.6%-73.9%) of women experience high-risk fertility behaviors. Of these, 32% experience single high-risk fertility behavior, and 40.8% experience multiple high-risk fertility behaviors. Of those who experience high-risk fertility behaviors, 58.7% have birth orders of more than three, 22.4% have short birth intervals (less than 24 months); 35.1% are old (over 34 years old); and 1.6% are young (less than 18 years old). Women with no education (AOR = 4.31; 95% CI: 2.09, 8.89) and primary education only (2.71; AOR = 2.71; 95% CI: 1.63, 4.50) are more likely to engage in high-risk fertility behaviors than women with a higher level of education. Every additional year of schooling reduces the odds of high-risk fertility behavior by 6% (AOR = 0.94; 95% CI: 0.89, 0.98). The use of modern contraception (AOR = 0.74; 95% CI: 0.622, 0.879) and knowledge of modern contraception methods (AOR = 0.80; 95% CI: 0.66, 0.96) reduce the risk of HRFB. Conclusions Primary education and a lack of education significantly raise the risk of HRFB. However, in Ethiopia, the risk of experiencing HRFB is reduced through modern contraceptive methods, awareness of modern contraceptive methods, and years of education. All initiatives to decrease maternal and newborn mortalities by reducing the risk of HRFB should educate women and encourage them to use modern contraception.
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Otchere SA, Omunyidde S, Rosales A, Ochieng JA, Chebon L, Agordoh SW, Allison A. Faith Leaders Improve Healthy Timing and Spacing of Pregnancy: Results of Operations Research on the Channels of Hope Methodology in Kenya and Ghana. Ann Glob Health 2023; 89:19. [PMID: 36937332 PMCID: PMC10022531 DOI: 10.5334/aogh.3944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 01/15/2023] [Indexed: 03/18/2023] Open
Abstract
Background Family planning averts unintended pregnancies, unsafe abortions, and maternal deaths, while improving child health and socio-economic progress, but an estimated 218 million women and girls in low- and middle-income countries, especially in sub-Saharan Africa, have an unmet need for modern family planning. Faith leaders can impact the demand and uptake of family planning. However, there is limited understanding of the mechanisms for effective family planning advocacy by faith leaders. Channels of Hope (CoH) is World Vision's process that engages faith leaders and faith communities to address health issues. Objectives To determine the impact of CoH on promoting healthy timing and spacing of pregnancies and family planning (HTSP/FP) by mothers of children under two years old in select parts of Kenya and Ghana. To also determine faith leaders' attitudes, perceptions, and potential roles in influencing HTSP/FP after exposure to CoH. Methods A mixed methods operations research comprising quantitative (quasi-experimental design with surveys of 4,372 mothers of children under two years old) and qualitative arms (in-depth interviews of 17 faith leaders and their seven spouses) was implemented. Findings Taking both countries together, male sterilization, female condom, and LAM were the only FP methods that did not show increases from baseline to endline. Methods with the highest knowledge increases between intervention areas and control areas were implants, injectables and pills, with 18.4, 12.1 and 11.2 percentage point increases, respectively. The faith leaders in both countries reported that their views on healthy timing and spacing of pregnancies changed due to the Channels of Hope workshops. Conclusion The HTSP/FP model has potential for positive health and social transformation that is built on the trust of faith leaders. Ghana and Kenya provide great examples of possible scenarios in order to help prepare implementers to scale the learnings of this operations research across sub-Saharan Africa.
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Affiliation(s)
| | | | - Alfonso Rosales
- Formerly of World Vision, 300 “I” Street NE, Washington, DC 20002, US
- Epidemiology at Universidad Evangelica, El Salvador
- Columnist, El Mundo newspaper, El Salvador
| | - Jacob Ajwang Ochieng
- Formerly of World Vision Kenya, Karen Road, Off Ngong Rd. M/S, Nairobi, 254 Kenya
| | - Lilian Chebon
- World Vision Kenya, Karen Road, Off Ngong Rd. M/S, Nairobi, 254 Kenya
| | | | - Adrienne Allison
- Formerly of World Vision US, 300 “I” Street NE, Washington, DC, US
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Olorunsaiye CZ, Huber LRB, Ouedraogo SP. Interbirth Intervals of Immigrant and Refugee Women in the United States: A Cross-Sectional Study. Int J MCH AIDS 2023; 12:e621. [PMID: 37124334 PMCID: PMC10141878 DOI: 10.21106/ijma.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2023] Open
Abstract
Background and Objective Despite guidelines recommending an interval of at least 18-24 months between a live birth and the conception of the next pregnancy, nearly one-third of pregnancies in the United States are conceived within 18 months of a previous live birth. The purpose of this study was to examine the associations between multiple immigration-related variables and interbirth intervals among reproductive-aged immigrant and refugee women living in the United States. Methods This was a cross-sectional, quantitative study on the sexual and reproductive health (SRH) of reproductive-aged immigrant and refugee women in the United States. The data were collected via an online survey administered by Lucid LLC. We included data on women who had complete information on nativity and birth history in the descriptive analysis (n = 653). The exposure variables were immigration pathway, length of time since immigration, and country/region of birth. The outcome variable was interbirth interval (≤18, 19-35, or ≥36 months). We used multivariable ordinal logistic regression, adjusted for confounders, to determine the factors associated with having a longer interbirth interval among women with second- or higher-order births (n = 245). Results Approximately 37.4% of study participants had a short interbirth interval. Women who immigrated to the United States for educational (aOR = 4.57; 95% CI, 1.57-9.58) or employment opportunities (aOR = 2.27; 95% CI, 1.07-5.31) had higher odds of reporting a longer interbirth interval (19-35 or ≥36 months) than women born in the United States. Women born in an African country had 0.79 times the odds (aOR = 0.79; 95% CI, 0.02-0.98) of being in a higher category of interbirth interval. Conclusion and Global Health Implications Although all birthing women should be counseled on optimal birth spacing through the use of postpartum contraception, immigrant and refugee women would benefit from further research and policy and program interventions to help them in achieving optimal birth spacing. SRH research in African immigrant and refugee communities is especially important for identifying ameliorable factors for improving birth spacing.
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Affiliation(s)
- Comfort Z. Olorunsaiye
- Department of Public Health, Arcadia University, 450 S Easton Road, Glenside, PA 19038, USA
- Corresponding author
| | - Larissa R. Brunner Huber
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Blvd, Charlotte, NC 28223, USA
| | - Samira P. Ouedraogo
- Department of Public Health, Arcadia University, 450 S Easton Road, Glenside, PA 19038, USA
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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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Maria A, Mukherjee R, Upadhyay S, Pratima K, Bandyopadhyay T, Gupta R, Dubey B, Sharma A, Mall PK, Sahoo M, Pathak KK, Pawar P, Mohapatra A. Barriers and enablers of breastfeeding in mother-newborn dyads in institutional settings during the COVID-19 pandemic: A qualitative study across seven government hospitals of Delhi, India. Front Nutr 2022; 9:1052340. [PMID: 36570141 PMCID: PMC9773092 DOI: 10.3389/fnut.2022.1052340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 11/10/2022] [Indexed: 12/14/2022] Open
Abstract
Introduction The COVID-19 pandemic disrupted newborn care and breastfeeding practices across most healthcare facilities. We undertook this study to explore the barriers and enablers for newborn care and breastfeeding practices in hospitals in Delhi, India for recently delivered mother (RDM)-newborn dyads during the first wave of the COVID-19 pandemic (2020) and inductively design a "pathway of impaction" for informing mitigatory initiatives during the current and future pandemics, at least in the initial months. Materials and methods We used an exploratory descriptive design (qualitative research method) and collected information from seven leading public health facilities in Delhi, India. We conducted separate interviews with the head and senior faculty from the Departments of Pediatrics/Neonatology (n = 12) and Obstetrics (n = 7), resident doctors (n = 14), nurses (labor room/maternity ward; n = 13), and RDMs (n = 45) across three profiles: (a) COVID-19-negative RDM with healthy newborn (n = 18), (b) COVID-19-positive RDM with healthy newborn (n = 19), and (c) COVID-19 positive RDM with sick newborn needing intensive care (n = 8) along with their care-giving family members (n = 39). We analyzed the data using grounded theory as the method and phenomenology as the philosophy of our research. Results Anxiety among clients and providers, evolving evidence and advisories, separation of the COVID-positive RDM from her newborn at birth, providers' tendency to minimize contact duration and frequency with COVID-positive mothers, compromised counseling on breastfeeding, logistic difficulties in expression and transportation of COVID-positive mother's milk to her baby in the nursery, COVID restrictions, staff shortage and unavailable family support in wards and nursery, and inadequate infrastructure were identified as major barriers. Keeping the RDM-newborn together, harmonization of standard operating procedures between professional associations and within and between departments, strategic mobilization of resources, optimization of human resources, strengthening client-provider interaction, risk triaging, leveraging technology, and leadership-in-crisis-situations were notable enablers. Conclusion The separation of the RDM and newborn led to a cascade of disruptions to newborn care and breastfeeding practices in the study institutions. Separating the newborn from the mother should be avoided during public health emergencies unless there is robust evidence favoring the same; routine institutional practices should be family centered.
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Affiliation(s)
- Arti Maria
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India,*Correspondence: Arti Maria
| | - Ritika Mukherjee
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Swati Upadhyay
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Kumari Pratima
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Tapas Bandyopadhyay
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Rachita Gupta
- WHO Country Office for India, Nutrition, R.K. Khanna Stadium, Safdarjung Enclave, New Delhi, India
| | - Bhawna Dubey
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Abhinav Sharma
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Pranaya Kumar Mall
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Manaswinee Sahoo
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Keshav Kumar Pathak
- Department of Neonatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Priyanka Pawar
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India
| | - Archisman Mohapatra
- Generating Research Insights for Development (GRID) Council, Executive Office, Noida, Uttar Pradesh, India,Archisman Mohapatra
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Mishra GD, Baneshi MR, Dobson AJ, Tooth LR. Maternal factors associated with interbirth intervals in Australia: Results from a population-based longitudinal study. Birth 2022; 49:728-740. [PMID: 35355322 PMCID: PMC9790452 DOI: 10.1111/birt.12638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 01/30/2022] [Accepted: 03/16/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE Short and long intervals between successive births are associated with adverse birth outcomes, especially in low-income and middle-income countries, yet the birth intervals in high-income countries remain relatively understudied. The aim was to examine maternal factors associated with birth intervals in Australia. METHODS The sample comprised 6130 participants in the Australian Longitudinal Study on Women's Health who were born in 1973-1978, had two or more births, and responded to regular surveys between 1996 and 2018. Interbirth interval (IBI) was defined as the time between successive live births. Maternal factors were examined using accelerated failure time models. RESULTS For women with only two births (n = 3802), the median time to the second birth was 34.0 months (IQR 23.1, 46.2) with shorter IBI associated with higher socioeconomic status (eg, university education (31.9 months), less income stress (31.1)), and longer IBI associated with age over 35 (39.7), fair/poor health (43.0), untreated fertility problems (45.5), miscarriage (39.4), or abortion (41.0). For women with three or more births (n = 2328), the median times to the second and third births were 31.2 months (19.9, 42.1) and 36.5 months (25.3, 50.1), respectively; some factors were consistent between the first IBI and second IBI (eg, university education and being married were associated with shorter IBI), whereas income stress was associated with longer first IBI but not with second IBI. CONCLUSIONS Understanding maternal factors associated with birth intervals in a high-income country like Australia may enable more nuanced tailoring of guidelines for prepregnancy care.
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Affiliation(s)
- Gita D. Mishra
- School of Public HealthThe University of QueenslandHerstonQueenslandAustralia
| | - Mohammad Reza Baneshi
- School of Public HealthThe University of QueenslandHerstonQueenslandAustralia
- Department of Biostatistics and Epidemiology, School of HealthKerman University of Medical SciencesKermanIran
| | - Annette J. Dobson
- School of Public HealthThe University of QueenslandHerstonQueenslandAustralia
| | - Leigh R. Tooth
- School of Public HealthThe University of QueenslandHerstonQueenslandAustralia
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Tesfaw LM, Workie DL, Dessie ZG. Discrepancies of recurrent birth intervals using longitudinal data analysis in Ethiopia: interim EDHS 2019. BMJ Open 2022; 12:e066739. [PMID: 36379657 PMCID: PMC9668039 DOI: 10.1136/bmjopen-2022-066739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to determine whether the birth interval changes differently over time among women in Ethiopia and whether the change depends on women, children and household characteristics measured at the last visit. METHODS Longitudinal study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey consisting of a total of 3630 mothers. Generalised estimating equation and generalised linear mixed model were employed to estimate the effect of the determinants given the correlation between birth intervals within a mother is under consideration. RESULTS The majority of women were Muslims (48.1%) and come from rural areas (82.2%). About 77.2% of women at first birth were below 20 years old. A significant correlation (p value <0.0001) between the first and second birth intervals of mothers was observed. The estimated birth interval of women from the poorest household was 0.877 (e-0.1317) times the estimated birth intervals of women from the richest household. This indicates richest households were likely to have higher birth intervals as compared with the poorest households (95% CI e-0.1754=0.839 to e-0.088=0.916). CONCLUSION The birth intervals of over one-fifth of mothers were 1 year, less than the birth interval recommended by the WHO standard. It was also perceived that successive birth intervals are correlated. Mothers who have delivered female children had lower birth intervals than mothers who have delivered male children. As compared with the birth intervals of mothers from a household with higher economic status, the birth intervals of mothers from a household with lower economic status had lower birth intervals. In this study, significant effects of religion, contraceptive use, region, mothers' current age, education level and mothers' current marital status on birth intervals were also noted.
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Affiliation(s)
| | | | - Zelalem G Dessie
- Department of Statistics, Bahir Dar University, Bahir Dar, Ethiopia
- School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa
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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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Câmara SMA, McGurk MD, Gigante D, Lima MDA, Shalaby AK, Sentell T, Pirkle CM, Domingues MR. Intersections between adolescent fertility and obesity-pathways and research gaps focusing on Latin American populations. Ann N Y Acad Sci 2022; 1516:18-27. [PMID: 35781886 PMCID: PMC9588536 DOI: 10.1111/nyas.14854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Latin America has notably elevated rates of adolescent fertility and obesity in women. Although numerous studies document associations between adolescent fertility and obesity across the life course, the pathways explaining their association are insufficiently theorized, especially regarding the factors in Latin America that may underpin both. Additionally, much of the existing research is from high-income countries, where fertility and obesity are trending down. In this paper, we review the various complex pathways linking adolescent fertility and obesity, highlighting research gaps and priorities, with a particular focus on Latin American populations. We carefully consider pregnancy's distinct impact on growth trajectories during the critical period of adolescence, as well as the cumulative effect that adolescent fertility may have over the life course. We also articulate a pathway through obesity as it may contribute to early puberty and thus, to adolescent fertility. If obesity is a cause of adolescent fertility, not a result of it, or if it is a mediator of early-life exposures to adulthood obesity, these are critical distinctions for policy aiming to prevent both obesity and early fertility. Research to better understand these pathways is essential for prevention efforts against obesity and undesired adolescent fertility in Latin America.
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Affiliation(s)
- Saionara M. A. Câmara
- Postgraduate program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Meghan D. McGurk
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Denise Gigante
- Postgraduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Mateus D. A. Lima
- Postgraduate Program in Rehabilitation Sciences, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, RN, Brazil
| | - Alena K. Shalaby
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Tetine Sentell
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, HI, USA
| | - Catherine M. Pirkle
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, HI, USA
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Tesfaw LM, Muluneh EK. Exploring and modeling recurrent birth events in Ethiopia: EMDHS 2019. BMC Pregnancy Childbirth 2022; 22:617. [PMID: 35931977 PMCID: PMC9354376 DOI: 10.1186/s12884-022-04948-w] [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: 11/30/2021] [Accepted: 07/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Globally, the estimated recurrent childbirth of one forth of women happens every two years or fewer. Next to Nigeria, Ethiopia is the second populist country in Africa and the first populist country in sub-Saharan Africa which consists of over 114 million population. There are prevalent short successive birth intervals problems in underdeveloped nations such as Ethiopia that contributes to adverse effects on mother and child health. However, studies that explore recurrent birth events and associated factors are very limited. Thus, this study aimed to explore and model the recurrent birth event by considering its subsequent within a mother and identifying its important determinants. As a result, the research findings of this study will be one of the preliminary research papers on the recurrent birth events that take into account the subsequent event and enable to be input for the policymakers, health institutions, and future researchers. Methods A total of 4676 mothers with their 16833 corresponding children were involved in this study. The data was obtained from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). In this study, extended cox regression models such as Andersen-Gill (AG), Prentice, Williams, and Peterson total time (PWP-TT) model, PWP-gap time (PWP-GT) model, and Frailty model were employed. These all models are used to consider recurrent events within mothers and determine the potential determinants. AG, PWP-TT, and PWP-GT estimate the effect of covariates by considering the correlation between event times for a person can be explained by past events given the covariates, kth event since the entry time, kth event since the time from the previous event, respectively. Results Among mothers who have first and ninth recurrent birth events, 75.5% and 80.1% of them respectively were rural residents while 57.6% and 70.6% of them respectively were a place of delivery in the health sector. The highest prevalence of first recurrent births (44.3%) was obtained from Muslim mothers. Mothers' education level (HR: 1.210; 95%CI: 1.010, 1.460), mothers' age at first birth (HR: 0.713; 95% CI: 0.614, 0.828), household wealth index (HR: 0.776; 95% CI: 0.625, 0.965), child mortality (HR: 0.673; 95%CI: 0.514, 0.881), household size (HR: 1.914; 95%CI:1.539,2.381) and sex of child (HR:0.836; 95%CI = 0.755,0.926) were important determinants of recurrent birth event. This indicates mothers’ education level and household size were positively associated with recurrent birth events. Whereas mothers’ age at first birth, household wealth index, child mortality, and sex of the child was negatively associated with recurrent birth events. Conclusion The WHO recommends a minimum of 33 months between two consecutive births, which is longer than the Ethiopian recurrent birth intervals observed in this study. The highest recurrent birth occurred during the age of fewer than twenty years old of mothers at first birth as compared to mothers whose age was older at first birth. Mothers, children, and household characteristics had significant effects on recurrent birth events. We authors would like to recommend communities, governmental and non-governmental stakeholders consider the associated factors of frequent recurrence of birth noticed in this study. Besides, we would also like to recommend women start birth while they got mature in age to reduce frequent recurrent birth and its corresponding adverse effects.
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Rocha ADS, Falcão IR, Teixeira CSS, Alves FJO, Ferreira AJF, Silva NDJ, Almeida MFD, Ribeiro-Silva RDC. Determinants of preterm birth: proposal for a hierarchical theoretical model. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022278.03232022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Preterm birth (PB) is a syndrome resulting from a complex relationship between multiple factors which do not have fully understood relationships and causality. This article discusses a hierarchical theoretical model of PB determinants, considering maternal characteristics such as sociodemographic, psychosocial, nutritional, behavioral and biological aspects, traditionally associated with increased risk of PB. The variables were distributed in six dimensions within three hierarchical levels (distal, intermediate and proximal). In this model, the socioeconomic determinants of the mother, family, household and neighborhood play indirect effects on PB through variables at the intermediate level, which in turn affect biological risk factors at the proximal level that have a direct effect on PB. The study presents a hierarchical theoretical model of the factors involved in the PB determination chain and their interrelationships. Understanding these interrelationships is an important step in trying to break the causal chain that makes some women vulnerable to preterm birth.
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Affiliation(s)
| | - Ila Rocha Falcão
- Universidade Federal da Bahia, Brazil; Fundação Oswaldo Cruz, Brazil
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Rocha ADS, Falcão IR, Teixeira CSS, Alves FJO, Ferreira AJF, Silva NDJ, Almeida MFD, Ribeiro-Silva RDC. Determinants of preterm birth: proposal for a hierarchical theoretical model. CIENCIA & SAUDE COLETIVA 2022; 27:3139-3152. [PMID: 35894325 DOI: 10.1590/1413-81232022278.03232022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 05/05/2022] [Indexed: 11/22/2022] Open
Abstract
Preterm birth (PB) is a syndrome resulting from a complex relationship between multiple factors which do not have fully understood relationships and causality. This article discusses a hierarchical theoretical model of PB determinants, considering maternal characteristics such as sociodemographic, psychosocial, nutritional, behavioral and biological aspects, traditionally associated with increased risk of PB. The variables were distributed in six dimensions within three hierarchical levels (distal, intermediate and proximal). In this model, the socioeconomic determinants of the mother, family, household and neighborhood play indirect effects on PB through variables at the intermediate level, which in turn affect biological risk factors at the proximal level that have a direct effect on PB. The study presents a hierarchical theoretical model of the factors involved in the PB determination chain and their interrelationships. Understanding these interrelationships is an important step in trying to break the causal chain that makes some women vulnerable to preterm birth.
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Affiliation(s)
- Aline Dos Santos Rocha
- Escola de Nutrição, Universidade Federal da Bahia, Salvador. Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. R. Mundo 121, ed. Tecnocentro, sl. 315, Trobogy. 41745-715 Salvador BA Brasil.
| | - Ila Rocha Falcão
- Escola de Nutrição, Universidade Federal da Bahia, Salvador. Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. R. Mundo 121, ed. Tecnocentro, sl. 315, Trobogy. 41745-715 Salvador BA Brasil.
| | - Camila Silveira Silva Teixeira
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | - Flávia Jôse Oliveira Alves
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | - Andrêa Jacqueline Fortes Ferreira
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. Instituto de Saúde Coletiva, Universidade Federal da Bahia. Salvador BA Brasil
| | - Natanael de Jesus Silva
- Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. Instituto de Saúde Global de Barcelona, Hospital Clínic. Barcelona Espanha
| | | | - Rita de Cássia Ribeiro-Silva
- Escola de Nutrição, Universidade Federal da Bahia, Salvador. Centro de Integração de Dados e Conhecimentos para Saúde (Cidacs), Fundação Oswaldo Cruz. R. Mundo 121, ed. Tecnocentro, sl. 315, Trobogy. 41745-715 Salvador BA Brasil.
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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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Sheppard WEA, McCarrick D, Wilkie RM, Baraas RC, Coats RO. A Systematic Review of the Effects of Second-Eye Cataract Surgery on Motor Function. FRONTIERS IN AGING 2022; 3:866823. [PMID: 35821847 PMCID: PMC9261376 DOI: 10.3389/fragi.2022.866823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022]
Abstract
Cataract removal surgery is one of the most commonly performed surgical procedure in developed countries. The financial and staff resource cost that first-eye cataract surgery incurs, leads to restricted access to second-eye cataract surgery (SES) in some areas, including the United Kingdom. These restrictions have been imposed despite a lack of knowledge about the impact of not performing SES on visuo-motor function. To this end, a systematic literature review was carried out, with the aim of synthesising our present understanding of the effects of SES on motor function. Key terms were searched across four databases, PsycINFO, Medline, Web of Science, and CINAHL. Of the screened studies (K = 499) 13 met the eligibility criteria. The homogeneity between participants, study-design and outcome measures across these studies was not sufficient for meta-analyses and a narrative synthesis was carried out. The evidence from objective sources indicates a positive effect of SES on both mobility and fall rates, however, when considering self-report measures, the reduction in falls associated with SES becomes negligible. The evidence for any positive effect of SES on driving is also mixed, whereby SES was associated with improvements in simulated driving performance but was not associated with changes in driving behaviours measured through in vehicle monitoring. Self-report measures of driving performance also returned inconsistent results. Whilst SES appears to be associated with a general trend towards improved motor function, more evidence is needed to reach any firm conclusions and to best advise policy regarding access to SES in an ageing population. Systematic Review Registration:https://osf.io/7hne6/, identifier INPLASY2020100042.
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Wondemagegn AT, Mulu A. Effects of Nutritional Status on Neurodevelopment of Children Aged Under Five Years in East Gojjam, Northwest Ethiopia, 2021: A Community-Based Study. Int J Gen Med 2022; 15:5533-5545. [PMID: 35707740 PMCID: PMC9189147 DOI: 10.2147/ijgm.s369408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/27/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Amsalu Taye Wondemagegn
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
- Correspondence: Amsalu Taye Wondemagegn, Department of Biomedical Sciences, School of Medicine, Debre Markos University, P.O. Box: 269, Debre Markos, Amhara Regional State, Ethiopia, Tel +251 921815441, Email
| | - Abay Mulu
- Department of Anatomy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Ahmed GS, Saleh L, Alareed HR, El-Shabrawy EM, Elbahrawe RS. Effects of sociodemographic background on fertility motivation patterns in the Beni-Suef governorate, Upper Egypt. J Taibah Univ Med Sci 2022; 17:853-860. [PMID: 36050960 PMCID: PMC9391587 DOI: 10.1016/j.jtumed.2022.04.006] [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: 01/14/2022] [Revised: 03/07/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022] Open
Abstract
Objectives Subjects and methods Results Conclusion
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Affiliation(s)
- Gehad S. Ahmed
- Corresponding address: Department of Public Health and Community Medicine, Faculty of Medicine, Beni-Suef University, Beni-Suef Governorate, Mohammed Hasan Street, Egypt.
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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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Breastfeeding practices among Syrian refugees in Turkey. Int Breastfeed J 2022; 17:10. [PMID: 35164812 PMCID: PMC8842938 DOI: 10.1186/s13006-022-00450-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 01/15/2022] [Indexed: 12/01/2022] Open
Abstract
Background We evaluated (a) opinion of Syrian and Turkish healthcare workers (HCWs), and perceptions and attitudes of Syrian refugee mothers, pregnant women, fathers and grandmothers on age-appropriate breastfeeding, (b) the effect of cultural characteristics, migration and pandemics on Syrian’s infant nutrition, and (c) the suggestions of HCWs and Syrian family members to improve breastfeeding practices in the Syrian refugee society in a qualitative study. Methods The qualitative study consisting of structured focus group discussions (FGDs) was held in four provinces in Turkey where Syrian refugees live intensely in September and October 2020. Seven different types of online FGDs were held with Turkish HCWs working in maternity hospitals, Syrian HCWs working in Refugee Health Centers (RHCs), Syrian pregnant women, mothers, fathers, and grandmothers. In total, we carried out 46 FGDs with 335 individuals. Thematic analysis of the transcripts in a deductive-inductive fashion was carried out with MAXQDA 11. Results Most Syrian HCWs did not get any training on breastfeeding counseling. The short duration of breastfeeding in Syrian refugees was seen to be related to the cultural characteristics, and migration. Some cultural characteristics can be summarized as “believing that breastfeeding harms mother’s health”, “adolescent marriages”, “wanting to have as many children as possible”, “giving anise to infants and not breastfeeding at night”, “prelacteal feeding”, “believing that milk is not enough”, “over controlling mother–child interaction by grandmothers, which limits the interaction”, “short pregnancy intervals”, and “not using modern family planning techniques”. We found out that migration increased the tendency for adolescent pregnancies, deepened the poverty, and decreased family social support. We did not observe any change in breastfeeding practices during pandemics. Conclusions Breastfeeding counseling programs should be designed in consideration of cultural characteristics of Syrian HCWs and family members. Continuing health education programs for family members with socially appropriate interventions to prevent adolescent marriages are important.
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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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Dhamrait G, Fletcher T, Foo D, Taylor CL, Pereira G. The effects of birth spacing on early childhood development in high-income nations: A systematic review. Front Pediatr 2022; 10:851700. [PMID: 36507145 PMCID: PMC9732574 DOI: 10.3389/fped.2022.851700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 10/12/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This study aimed to systematically review the literature on the associations between birth spacing and developmental outcomes in early childhood (3-10 years of age). Studies examining the associations between interpregnancy intervals and child development outcomes during and beyond the perinatal period have not been systematically reviewed. METHODS We searched Ovid/MEDLINE, Global Health, PsycINFO, EMBASE, CINAHL Plus, Educational Source, Research Starters, ERIC, Scopus, PubMed, Social Science Research Network database, and ProQuest's Social Sciences Databases for relevant articles published between 1 January 1989 and 25 June 2021. Studies published in English, conducted in populations residing in high-income countries with any measure of birth spacing, and child development outcomes among children aged <10 years were included. Two authors independently assessed the eligibility of studies and extracted data on the study design, setting and population, birth spacing, outcomes, and results. RESULTS The search yielded 1,556 records, of which seven studies met the inclusion criteria. Five of these seven studies used birth intervals as the exposure measure. Definitions of exposure differed between the studies. Three studies reported an association between short birth spacing and poorer child development outcomes, and two studies reported an association between long birth spacing and poorer child development outcomes. CONCLUSION Currently, limited evidence suggests that the adverse effects of sub-optimal birth spacing are observable beyond infancy.
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Affiliation(s)
- Gursimran Dhamrait
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Tess Fletcher
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,School of Psychology, Curtin University, Perth, WA, Australia
| | - Damien Foo
- Curtin School of Population Health, Curtin University, Perth, WA, Australia.,Wesfarmers Centre of Vaccines and Infectious Diseases, Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Catherine L Taylor
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
| | - Gavin Pereira
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia.,Centre for Fertility and Health (CeFH), Norwegian Institute of Public Health, Oslo, Norway.,enAble Institute, Curtin University, Perth, WA, Australia
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Aklil MB, Temesgan WZ, Anteneh KT, Debele TZ. Knowledge and Attitude Towards Short Birth Interval among Rural Women who Gave Birth in the Last Three Years at Dembecha District, Northwest Ethiopia, 2019. SAGE Open Nurs 2022; 8:23779608221107997. [PMID: 35800116 PMCID: PMC9253980 DOI: 10.1177/23779608221107997] [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: 12/28/2021] [Revised: 05/04/2022] [Accepted: 05/20/2022] [Indexed: 11/22/2022] Open
Abstract
Background A woman can have fewer children when intervals between consecutive births are
optimal. This has great importance for the well-being of women, pregnancy
outcomes, and the long-term health of children under the age of five. We can
save 2millon of the 11 million deaths of children under the age of five per
year by avoiding short birth intervals. It is affected by the knowledge and
attitude of women, particularly rural women, who had a high fertility rate.
To our deep review, this is the first study done in Ethiopia. Hence, this
study aimed to assess knowledge and attitude towards short birth intervals
and associated factors among rural women who gave birth in the last three
years at Dembecha district, northwest Ethiopia. Method A community-based cross-sectional study was conducted from September 20 to
October 20, 2019. A cluster sampling technique was employed to select the
study participants and data were collected using a pre-tested,
semi-structured, interviewer-administered questionnaire. Bivariable and
multivariable logistic regression model was fitted to identify factors
associated with knowledge and attitude towards short birth interval. The
level of significant association was declared using the adjusted odds ratio
(AOR) with 95% confidence interval (CI) and a p-value of <0.05. Result From the total study participants, 66.4% (95% CI: 63.0–70.0) had good
knowledge and 45.9% (95% CI: 42.3–49.8) had a positive attitude towards
short birth intervals. In multivariable logistic regression: marital status,
antenatal care follow-up, maternal occupation, and wealth status were
significantly associated with knowledge. In addition, antenatal care
follow-up and maternal occupation were significantly associated with
attitude. Conclusion Majority of the participants had poor knowledge and a positive attitude
towards short birth intervals. Hence, interventions should be done to
optimize women's knowledge and attitude towards short birth intervals by
enhancing antenatal care utilization.
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Affiliation(s)
- Mastewal Belayneh Aklil
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Wubedle Zelalem Temesgan
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kiber Temesgen Anteneh
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tibeb Zena Debele
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, 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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Differences in postpartum contraceptive choices and patterns following low- and high-risk pregnancy. Contraception 2021; 107:52-57. [PMID: 34748749 DOI: 10.1016/j.contraception.2021.10.012] [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: 08/24/2021] [Revised: 10/25/2021] [Accepted: 10/27/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess the impact of a high-risk pregnancy on postpartum contraceptive planning and use. METHODS We conducted a retrospective cohort study of women who gave birth in a teaching hospital in 2020. We classified women into 2 groups based on their risk status according to the Society for Maternal-Fetal Medicine. The World Health Organization (WHO) tiers of contraceptive efficacy were used to categorize contraceptive planning and administration. The primary outcome was the utilization rate of Tier 1contraceptive methods at their postpartum visit in women with prior high-risk pregnancy. Univariate and multivariate analyses were carried out to determine the relationships between risk status, characteristics, contraceptive preference, and actual utilization. RESULTS This study included 788 low-risk and 482 high-risk postpartum women. High risk women indicated greater interest in (43.5% low-risk vs 52.2% high-risk, p < 0.01) and usage rates of (45.7% low-risk vs 54.3% high-risk, p = 0.01) Tier 1 contraception. The most commonly chosen contraceptive methods among low- and high-risk women were progestin-only pills (30.6%) and tubal ligation (36.4%), respectively. Uptake rates of immediate postpartum contraceptive implants did not differ between low (9.3%) and high-risk (11%) women (p = 0.32). Few patients adopted intrauterine devices (1.1%). CONCLUSION High-risk status was associated with intention to use and uptake of effective contraceptive methods, which persisted through the postpartum period. IMPLICATIONS To assist women in achieving the recommended interpregnancy intervals, counseling tailored to their individual risks and needs should be provided. Reasons for low intrauterine devices uptake should be explored. Postnatal care should include immediate postpartum long-acting reversible contraception (LARC) services.
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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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Naz S, Acharya Y. The Effect of Reframing the Goals of Family Planning Programs from Limiting Fertility to Birth Spacing: Evidence from Pakistan. Stud Fam Plann 2021; 52:125-142. [PMID: 34014560 PMCID: PMC8362150 DOI: 10.1111/sifp.12155] [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] [Indexed: 11/28/2022]
Abstract
Contraceptive prevalence in Pakistan has plateaued near 34 percent for over a decade, suggesting that fertility levels are likely to stay high unless effective interventions are designed. We evaluate the Family Advancement for Life and Health 2007–2012 (FALAH), a family planning project implemented in 31 districts of Pakistan. Deviating from previous programs, FALAH emphasized birth spacing—as opposed to limiting family size—as the primary purpose of contraceptive use. We use Pakistan Demographic and Health Survey to evaluate FALAH's impact on continuous and binary measures of birth intervals. To estimate the causal effects of the project, we compare the outcomes for multiple children born to the same mother before and after the project. We find that FALAH increased interbirth intervals by 2.4 months on average and reduced the proportion of short birth intervals by approximately 7.1 percentage points. This finding suggests that birth spacing as a goal of contraceptive use may resonate better with Pakistani couples than limiting family size. The project's effects were more pronounced for women with high education, in rural areas, and in the middle of the wealth distribution.
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Affiliation(s)
- Saman Naz
- Saman Naz, Yubraj Acharya, Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, USA
| | - Yubraj Acharya
- Saman Naz, Yubraj Acharya, Department of Health Policy and Administration, College of Health and Human Development, Pennsylvania State University, USA
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Belaid L, Atim P, Ochola E, Omara B, Atim E, Ogwang M, Bayo P, Oola J, Okello IW, Sarmiento I, Rojas-Rozo L, Zinszer K, Zarowsky C, Andersson N. Community views on short birth interval in Northern Uganda: a participatory grounded theory. Reprod Health 2021; 18:88. [PMID: 33910570 PMCID: PMC8080315 DOI: 10.1186/s12978-021-01144-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
Background Short birth interval is associated with adverse perinatal, maternal, and infant outcomes, although evidence on actionable factors underlying short birth interval remains limited. We explored women and community views on short birth intervals to inform potential solutions to promote a culturally safe child spacing in Northern Uganda.
Methods Gendered fuzzy cognitive mapping sessions (n = 21), focus group discussions (n = 12), and an administered survey questionnaire (n = 255) generated evidence on short birth intervals. Deliberative dialogues with women, their communities, and service providers suggested locally relevant actions promote culturally safe child spacing.
Results Women, men, and youth have clear understandings of the benefits of adequate child spacing. This knowledge is difficult to translate into practice as women are disempowered to exercise child spacing. Women who use contraceptives without their husbands’ consent risk losing financial and social assets and are likely to be subject to intra-partner violence. Women were not comfortable with available contraceptive methods and reported experiencing well-recognized side effects. They reported anxiety about the impact of contraception on the health of their future children. This fear was fed by rumors in their communities about the effects of contraceptives on congenital diseases. The women and their communities suggested a home-based sensitization program focused on improving marital relationships (spousal communication, mutual understanding, male support, intra-partner violence) and knowledge and side-effects management of contraceptives.
Conclusions The economic context, gender power dynamics, inequality, gender bias in land tenure and ownership regulations, and the limited contraceptive supply reduce women’s capacity to practice child spacing.
Supplementary Information The online version contains supplementary material available at 10.1186/s12978-021-01144-5. The evidence on what increases birth spacing remains limited. This study explored community views on influences on short birth interval to promote a culturally safe child spacing in Northern Uganda. A participatory research process began by collating perspectives of causes of short birth intervals through fuzzy cognitive mapping. Focus group discussions clarified concepts emerging from the fuzzy cognitive mapping exercise. Fieldworkers administered a household survey to quantify reproductive health outcomes. In deliberative dialogue sessions involving women and their communities, shared and discussed these results and suggested potential actions to promote culturally safe child spacing. Women, men, and youth showed clear understandings of the benefits of adequate child spacing. This knowledge is difficult to translate into practice, however, as women feel they are unable to exercise child spacing. Women who use contraceptives without their husbands’ consent risk losing financial and social resources and are likely to face intra-partner violence. Women were not comfortable with contraceptive methods and reported experiencing side effects. The deliberative dialogues suggested a home-based sensitization program focused on improving marital relationships (spousal communication, mutual understanding, male support, intra-partner violence) and knowledge and side-effects management of contraceptives.
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Affiliation(s)
- Loubna Belaid
- CIET (Community Information Epidemiological Technologies), Department of Family Medicine (PRAM), McGill University, 5858 Chemin de la Côte des Neiges, Montreal, QC, H3S 1Z1, Canada.
| | - Pamela Atim
- Department of Public Health, Gulu University, Laroo Division, Gulu Municipality 166, Gulu, Uganda
| | | | - Bruno Omara
- Gulu University, Gulu Municipality 166, Gulu, Uganda
| | | | - Martin Ogwang
- St Mary's Lacor Hospital, Gulu/P.O. Box, 180, Gulu, Uganda
| | - Pontius Bayo
- St Mary's Lacor Hospital, Gulu/P.O. Box, 180, Gulu, Uganda
| | | | | | - Ivan Sarmiento
- CIET (Community Information Epidemiological Technologies), Department of Family Medicine (PRAM), McGill University, 5858 Chemin de la Côte des Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Laura Rojas-Rozo
- Department of Family Medicine, McGill University, 5858 Chemin de la Côte des Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Kate Zinszer
- University of Montreal, 7101 Av du Parc, Montreal, QC, H3N 1X9, Canada
| | | | - Neil Andersson
- CIET (Community Information Epidemiological Technologies), Department of Family Medicine (PRAM), McGill University, 5858 Chemin de la Côte des Neiges, Montreal, QC, H3S 1Z1, Canada.,Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Mexico
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Sarmiento I, Ansari U, Omer K, Gidado Y, Baba MC, Gamawa AI, Andersson N, Cockcroft A. Causes of short birth interval (kunika) in Bauchi State, Nigeria: systematizing local knowledge with fuzzy cognitive mapping. Reprod Health 2021; 18:74. [PMID: 33823874 PMCID: PMC8022364 DOI: 10.1186/s12978-021-01066-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 01/01/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Short birth intervals, defined by the World Health Organization as less than 33 months, may damage the health and wellbeing of children, mothers, and their families. People in northern Nigeria recognise many adverse effects of short birth interval (kunika in the Hausa language) but it remains common. We used fuzzy cognitive mapping to systematize local knowledge of causes of kunika to inform the co-design of culturally safe strategies to address it. METHODS Male and female groups in twelve communities built 48 maps of causes and protective factors for kunika, and government officers from the Local Government Area (LGA) and State made four maps. Each map showed causes of kunika or no-kunika, with arrows showing relationships with the outcome and between causes. Participants assigned weights for the perceived strength of relationships between 5 (strongest) and 1 (weakest). We combined maps for each group: men, women, and government officers. Fuzzy transitive closure calculated the maximum influence of each factor on the outcome, taking account of all relationships in the map. To condense the maps, we grouped individual factors into broader categories and calculated the cumulative net influence of each category. We made further summarised maps and presented these to the community mapping groups to review. RESULTS The community maps identified frequent sex, not using modern or traditional contraception, and family dynamics (such as competition between wives) as the most influential causes of kunika. Women identified forced sex and men highlighted lack of awareness about contraception and fear of side effects as important causes of kunika. Lack of male involvement featured in women's maps of causes and in the maps from LGA and State levels. Maps of protective factors largely mirrored those of the causes. Community groups readily appreciated and approved the summary maps resulting from the analysis. CONCLUSIONS The maps showed how kunika results from a complex network of interacting factors, with culture-specific dynamics. Simply promoting contraception alone is unlikely to be enough to reduce kunika. Outputs from transitive closure analysis can be made accessible to ordinary stakeholders, allowing their meaningful participation in interpretation and use of the findings. For people in Bauchi State, northern Nigeria, kunika describes a short interval between successive births, understood as becoming pregnant again before the previous child is weaned. They recognise it is bad for children, mothers and households. We worked with 12 communities in Bauchi to map their knowledge of the causes and protective factors for kunika. Separate groups of men and women built 48 maps, and government officers at local and state level built four maps. Each group drew two maps showing causes of kunika or of no-kunika with arrows showing the links between causes and the outcome. Participants marked the strength of each link with a number (between 5 for the strongest and 1 for the weakest). We combined maps for women, men and government officers. We grouped similar causes together into broader categories. We calculated the overall influence of each category on kunika or no-kunika and produced summary maps to communicate findings. The maps identified the strongest causes of kunika as frequent sex, not using modern or traditional contraception, and family dynamics. Women indicated forced sex as an important cause, but men focused on lack of awareness about contraception and fear of side effects. The maps of protective factors mirrored those of the causes. The groups who created the maps approved the summary maps. The maps showed the complex causes of kunika in Bauchi. Promoting contraception is unlikely to be enough on its own to reduce kunika. The summary maps will help local stakeholders to co-design culturally safe ways of reducing kunika.
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Affiliation(s)
- Ivan Sarmiento
- CIET-PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, 3rd floor, Montreal, QC, H3S 1Z1, Canada.
| | - Umaira Ansari
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Mexico
| | - Khalid Omer
- Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Mexico
| | - Yagana Gidado
- Federation of Muslim Women Association of Nigeria (FOMWAN), Bauchi State, Nigeria
| | - Muhammad Chadi Baba
- Federation of Muslim Women Association of Nigeria (FOMWAN), Bauchi State, Nigeria
| | | | - Neil Andersson
- CIET-PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, 3rd floor, Montreal, QC, H3S 1Z1, Canada.,Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Mexico
| | - Anne Cockcroft
- CIET-PRAM, Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, 3rd floor, Montreal, QC, H3S 1Z1, Canada.,Centro de Investigación de Enfermedades Tropicales (CIET), Universidad Autónoma de Guerrero, Acapulco, Mexico
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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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Chloroquine and its derivatives in the management of COVID-19: A scoping review. ACTA ACUST UNITED AC 2020; 40:80-95. [PMID: 33152192 PMCID: PMC7676841 DOI: 10.7705/biomedica.5478] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Indexed: 12/27/2022]
Abstract
Introducción. Recientemente, investigadores chinos y franceses reportaron la eficacia de la cloroquina y la hidroxicloroquina para inhibir la replicación in vitro del virus SARS-CoV-2. La diseminación oportuna de la información científica es clave en tiempos de pandemia. Es urgente contar con una revisión sistemática sobre el efecto y la seguridad de estos medicamentos en la COVID-19. Objetivo. Describir el estado actual de la literatura científica publicada hasta el 25 de marzo de 2020 sobre el uso de la cloroquina o sus derivados en el manejo de pacientes con COVID-19. Materiales y métodos. Se hizo una revisión sistemática exploratoria en PubMed, Embase, Lilacs y 15 bases de datos de la Plataforma de Registros Internacionales de Ensayos Clínicos de la Organización Mundial de la Salud (OMS). Se incluyeron publicaciones empíricas y teóricas en inglés, español, italiano, francés o portugués, y se hizo una síntesis narrativa de los resultados. Resultados. Se incluyeron 19 documentos y 24 registros de ensayos clínicos (n=43) de 18.059 pacientes. El 66 % (16/24) de los ensayos están registrados en China. Nueve ensayos evalúan la cloroquina exclusivamente y ocho, la hidroxicloroquina. Los documentos son comentarios (n=9), estudios in vitro (n=3), revisiones narrativas (n=2), guías de práctica clínica (n=2), así como una revisión sistemática, un consenso de expertos y un ensayo controlado. Conclusiones. Un ensayo clínico pequeño (n=26), no aleatorizado y defectuoso, respalda el uso de la hidroxicloroquina en pacientes con COVID-19. Se requiere de manera urgente tener acceso a los resultados de otros ensayos clínicos para determinar la efectividad y la seguridad de la cloroquina y sus derivados en pacientes con COVID-19.
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