Individual and community level determinants of short birth interval in Ethiopia: A multilevel analysis


Autoři: Desalegn Markos Shifti aff001;  Catherine Chojenta aff002;  Elizabeth G. Holliday aff003;  Deborah Loxton aff002
Působiště autorů: Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia aff001;  Priority Research Centre for Generational Health and Ageing, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia aff002;  Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia aff003
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227798

Souhrn

Background

The World Health Organization recommends a minimum of 33 months between two consecutive live births to reduce the risk of adverse maternal and child health outcomes. However, determinants of short birth interval have not been well understood in Ethiopia.

Objective

The aim of this study was to assess individual- and community-level determinants of short birth interval among women in Ethiopia.

Methods

A detailed analysis of the 2016 Ethiopian Demographic and Health Survey data was performed. A total of 8,448 women were included in the analysis. A two-level multilevel logistic regression analysis was used to identify associated individual- and community-level factors and estimate between-community variance.

Results

At the individual-level, women aged between 20 and 24 years at first marriage (AOR = 1.37; 95% CI: 1.18–1.60), women aged between 25 and 29 years at first marriage (AOR = 1.65; 95% CI: 1.20–2.25), having a husband who attended higher education (AOR = 1.32; 95% CI: 1.01–1.73), being unemployed (AOR = 1.16; 95% CI: 1.03–1.31), having an unemployed husband (AOR = 1.23; 95% CI: 1.04–1.45), being in the poorest wealth quintile (AOR = 1.82; 95% CI: 1.39–2.39), being in the poorer wealth quintile (AOR = 1.58; 95% CI: 1.21–2.06), being in the middle wealth quintile (AOR = 1.61; 95% CI: 1.24–2.10), being in the richer wealth quintile (AOR = 1.54; 95% CI: 1.19–2.00), increased total number of children born before the index child (AOR = 1.07; 95% CI: 1.03–1.10) and death of the preceding child (AOR = 1.97; 95% CI: 1.59–2.45) were associated with increased odds of short birth interval. At the community-level, living in a pastoralist region (AOR = 2.01; 95% CI: 1.68–2.39), being a city dweller (AOR = 1.75; 95% CI: 1.38–2.22), high community-level female illiteracy (AOR = 1.23; 95% CI: 1.05–1.45) and increased distance to health facilities (AOR = 1.32; 95% CI: 1.11–1.56) were associated with higher odds of experiencing short birth interval. Random effects showed significant variation in short birth interval between communities.

Conclusion

Determinants of short birth interval are varied and complex. Multifaceted intervention approaches supported by policy initiatives are required to prevent short birth interval.

Klíčová slova:

Behavioral and social aspects of health – Birth – Educational attainment – Ethiopia – Child health – Literacy – Regression analysis – Socioeconomic aspects of health


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