Determinants of short birth interval among ever married reproductive age women: A community based unmatched case control study at Dessie city administration, Northern Ethiopia

Determinants of short birth interval among married multiparous women in Chinaksen district, eastern Ethiopia: a case-control study

Background

The short birth interval is a common public health issue that affects women's and children's health in sub-Saharan Africa. Despite a higher burden of short birth intervals reported in Ethiopia, there is limited evidence to indicate the primary risk factors, particularly in rural eastern Ethiopia. Therefore, this study assessed the determinants of the short birth interval among married multiparous women in Chinaksen district, Eastern Ethiopia.

Methods

A community-based case-control study was conducted among randomly selected 210 cases and 210 controls from April 01 to June 30, 2019. The total sample size (219 cases and 219 controls) were calculated using Epi-Info software version 7.2. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27, and multivariable logistic regression analyses conducted to identify the determinants of short birth intervals. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the strength of association and statistical significance declared at p-value < 0.05.

Results

The women in the young age group (AOR = 2.33, 95% CI: 1.03, 5.26), missed their antenatal care visits (AOR = 2.23, 95% CI: 1.18, 4.21), failed to utilize postpartum contraceptives (AOR = 5.98, 95% CI: 3.62, 9.89), did not attend postnatal care visit (AOR = 1.86, 95% CI: 1.13, 3.05), nonexclusive breastfed (AOR = 4.05, 95% CI: 2.18, 7.52), short and medium period of breastfeeding (AOR = 4.00, 95% CI: 1.34, 12.10) and (AOR = 3.56, 95% CI: 1.62, 7.82), respectively and female sex of preceding child (AOR = 1.92, 95% CI: 1.18, 3.12) were the important risk factors of short birth interval.

Conclusions

Women's age, antenatal care visits, postnatal care attendance, utilization of postpartum contraceptives, exclusive breastfeeding practice, duration of breastfeeding, and sex of the preceding child were the primary predictors of short birth intervals. Improving the utilization of maternal healthcare services in health facilities would be imperative to prevent and reduce short birth intervals, and its negative consequences.

Acceptance, utilization, and factors associated with immediate postpartum intrauterine contraceptive device among mothers delivered at public health facilities in Hawassa city, Ethiopia: Institution-based study

BACKGROUND

Immediate postpartum intra-uterine contraceptive device (IPPIUCD) placement within 10 min after the expulsion of the placenta following vaginal delivery is a safe and effective method when provided after comprehensive counseling. Studies on its acceptance and utilization are scarce in the study area. This study aims to assess the acceptance and utilization of IPPIUCD.

METHODS

A cross-sectional study was conducted from January 1st up to February 31st, 2020, among 392 mothers who delivered at public health facilities in Hawassa city. EPI-Data version 7.2 was used for data entry and STATA 14 for analysis. Data were collected using an interviewer administered structured questionnaire. A binary logistic regression and a multivariable logistic regression model were used to assess association. Statistical significance was determined at a p-value of less than 0.05 with a 95% confidence interval.

RESULTS

Of the 392 mothers enrolled, 16.3% (95% CI: 12.7-20.0) of them accepted immediate post-partum IUCD. However, only 10% (95%CI: 7.0, 12.9) utilized immediate post-partum IUCD. Counseling about IPPIUCD, Attitude, plan to have another child, and birth intervals were associated with acceptance of immediate PPIUCD while husband support for family planning use, delivery time, and the number of children had a significant association with utilization of immediate PPIUCD.

CONCLUSIONS

The study found a relatively low proportion of acceptors and utilizers of immediate post-partum IUCD in the study area. To improve the acceptance and utilization of immediate PPIUCD among mothers, all stakeholders concerned with family planning need to mitigate and promote the challenges and facilitating factors, respectively.

Short birth interval and its associated factors among multiparous women in Mieso agro-pastoralist district, Eastern Ethiopia: A community-based cross-sectional study

Background

Recently, the concern with birth interval has acquired importance in public health and family planning because of its implication for fertility, maternal, and child health. A short birth interval is associated with adverse perinatal, maternal, and infant outcomes. Moreover, too short birth interval lead to high fertility, which in turn contributes to accelerated population growth and undermines development efforts. This study aimed to investigate the prevalence of short birth interval and its associated factors among multiparous women in the Mieso agro-pastoralist district, Oromia region, Eastern Ethiopia.

Methods

A community-based cross-sectional study was conducted from 1 to 30 March 2020. The multistage sampling technique was used to select 490 multiparous women. Data were collected by face-to-face interviewer-administered structured questionnaires. Bivariate and multivariable logistic regression analyses were executed. Model fitness and multicollinearity were checked. Statistically significant associations of outcome and independent variables were declared at a P-value of < 0.05.

Results

The prevalence of short birth interval was 56% (95% CI: 51.4–60.5) in the study area. Being married under 18 years (AOR = 3.78, 95% CI: 1.97–7.25), having formal education (AOR = 0.23, 95% CI: 0.11–0.47), having a husband with formal education (AOR = 0.46, 95% CI: 0.22–0.99), having awareness about optimum birth interval (AOR = 0.47, 95% CI: 0.24–0.91), having female index child (AOR = 1.78, 95% CI: 1.07–3.84), death of the index child (AOR = 0.34, 95% CI: 0.12–0.92), breastfeeding of the index child <24 months (AOR = 2.6, 95% CI: 1.53–4.41), use of modern contraceptive (AOR = 2.09, 95% CI: 1.12–3.89), and decision-making by a husband alone when to have a child (AOR = 3.86, 95% CI: 2.06–7.21) were significantly associated with short birth interval at a P-value <0.05.

Conclusion

The overall prevalence of short birth interval among the study participants was high, as more than half of the women had practiced short birth interval, indicating that the majority of the mother and children in the study area are still at high risk of mortality and morbidity associated with short birth interval. Thus, the current findings suggest that interventions that involve the provision of contraceptives and information on its benefit at points need to be adopted to reach the national and global target of maternal and child mortality reduction attributed to short birth interval.

Time to Resumption of Menses, Spatial Distribution, and Predictors Among Post-partum Period Women in Ethiopia, Evidence From Ethiopian Demographic and Health Survey 2016 Data: Gompertz Inverse Gaussian Shared Frailty Model

Background

The timing of the resumption of post-partum menses is important for a woman who intends to avoid subsequent unintended pregnancy, and it has key implications on maternal, neonatal, and child health outcomes. Despite this, information is scant about the time to resumption of post-partum menses and predictors in Ethiopia. Therefore, this study aimed to determine the time it takes to start menses and spatial distribution among post-partum period women in Ethiopia and identify its predictors.

Methods

A secondary data analysis was conducted based on 2016 Ethiopian Demographic and Health Survey (EDHS). A total weighted sample of 6,489 post-partum women was included in the analysis. STATA 14 was used to weigh, clean, and analyze the data. The shared frailty model was applied since the EDHS data have a hierarchical nature. For checking the proportional hazard assumption, the Schenefold residual test, Log-Log plot, Kaplan–Meier, and predicted survival plot were applied. Akakie Information Criteria (AIC), Cox–Snell residual test, and deviance were used for checking model adequacy and for model comparison. Based on these, the Gompertz inverse Gaussian shared frailty model was the best-fitted model for this data. Variables with a p &lt; 0.2 were considered for the multivariable Gompertz inverse Gaussian shared frailty model. Finally, the adjusted hazard ratio (AHR) with a 95% confidence interval (CI), and a p &lt; 0.05 was reported to identify the significant predictors of time to the resumption of post-partum menses.

Results

The median survival time to post-partum menses resumption was 14.6 months. In this study, 51.90% [95% CI: 50.03, 53.76] of post-partum period women had resumed, and the risk of menses resumption was 1.17 times [AHR: 1.17; 95% CI: 1.03–1.33] higher among urban resident, 1.14 times [AHR: 1.14; 95% CI: 1.0–1.24] in women who had attended formal education, and 1.63 times [AHR: 1.63; 95% CI: 1.4–1.7] higher among women who used hormonal contraceptives. However, the risk of post-partum menses resumption was lower among 7–24 months breastfeeding women by 36% [AHR: 0.64; 95% CI: 0.5–0.76], women with child alive by 26% [AHR: 0.74; 95% CI: 0.6–0.85], and multiparous women by 27% [AHR: 0.73; 95% CI: 0.6–0.80].

Conclusion

Almost half of the participants had resumed post-partum menses, with the median survival timing of menses resumption at 14.5 months. Women residing in urban areas, who attended formal education, and using hormonal contraceptives have a shorter time to resume post-partum menses, whereas a woman with an alive child, breastfeeding practice, and multiple parity has a longer time to resume post-partum menses. Therefore, the healthcare providers and program managers should act on the resumption of post-partum menses through health education and promotion to cultivate the 14 months lag period identified by considering the significant factors.

Knowledge and Attitude Towards Short Birth Interval among Rural Women who Gave Birth in the Last Three Years at Dembecha District, Northwest Ethiopia, 2019

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.