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Effects of birth spacing on adverse childhood health outcomes: evidence from 34 countries in Sub-Saharan Africa

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Yaya, Sanni, Uthman, Olalekan A., Ekholuenetale, Michael, Bishwajit, Ghose and Adjiwanou, Vissého (2019) Effects of birth spacing on adverse childhood health outcomes: evidence from 34 countries in Sub-Saharan Africa. The Journal of Maternal-Fetal & Neonatal Medicine, 10 . pp. 1-8. doi:10.1080/14767058.2019.1576623 ISSN 1476-4954.

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Official URL: https://doi.org/10.1080/14767058.2019.1576623

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Abstract

Background

Interpregnancy intervals (IPI) are independently associated with maternal, perinatal, infant and child outcomes. Birth spacing is a recommended tool to reduce adverse health outcomes especially among children. This study aims to determine the prevalence of adverse child health outcomes in sub-Saharan Africa (SSA) countries and to examine the association between the length of preceding birth interval child health outcomes.

Methods

Secondary data from Demographic and Health Survey (DHS) in 34 SSA countries with 299 065 births was used in this study. The outcome variables were infant mortality, low birth weight, stunting, underweight, wasting, overweight and anemia. Percentage was used in univariate analysis. Cox proportional hazard regression was used to examine association between the adjusted model of preceding birth interval and infant mortality. Multinomial and binary logistic regression models were used to examine the association between under-five children adverse health outcomes and interpregnancy birth interval.

Results

Infant mortality was lowest in Gambia (3.4%) and highest in Sierra Leone (9.3%). Comoros (16.8%) accounted for the highest percentage of low birth weight (<2.5 kg). Child stunting was as high as 54.6% in Burundi. IPIs of <24 months, 24–36 months, 37–59 months and ≤60 months accounted for 19.3, 37.8, 29.5 and 13.4% respectively. Median IPI was 34 months. Results from Cox proportional hazard regression showed that children with preceding birth interval <24 months had 57% higher risk of infant mortality, compared to children with IPI of 24–36 months (Hazard ratio (HR) = 1.57; 95%CI: 1.45, 1.69). However, there were 19% and 10% reduction in the risk of infant mortality at IPIs of 37–59 months and ≥60 months, compared to 24–36 months IPI (37–59 months: HR = 0.81; 95%CI: 0.75, 0.87; ≥60 months: HR = 0.90; 95%CI: 0.81, 0.99).

Conclusion

The findings of this study suggest the need for urgent intervention to promote the recommended interpregnancy interval of 24–36 months to reduce adverse child health outcomes. These data also bring into limelight the importance of exclusive breastfeeding to enhance proper nutritional approach and to prolong lactational amenorrhea. Health care system stakeholders would find this study interesting as a base for policy formulation and implementation

Item Type: Journal Article
Subjects: R Medicine > RJ Pediatrics
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
SWORD Depositor: Library Publications Router
Library of Congress Subject Headings (LCSH): Birth intervals -- Africa, Children -- Health and hygiene -- Africa
Journal or Publication Title: The Journal of Maternal-Fetal & Neonatal Medicine
Publisher: Informa UK Limited
ISSN: 1476-4954
Official Date: 29 January 2019
Dates:
DateEvent
10 February 2019Updated
29 January 2019Available
28 January 2019Accepted
Volume: 10
Page Range: pp. 1-8
DOI: 10.1080/14767058.2019.1576623
Status: Peer Reviewed
Publication Status: Published
Reuse Statement (publisher, data, author rights): “This is an Accepted Manuscript of an article published by Taylor & Francis in The Journal of Maternal-Fetal & Neonatal Medicine on 29/01/2019, available online: http://www.tandfonline.com/10.1080/14767058.2019.1576623
Access rights to Published version: Restricted or Subscription Access
Date of first compliant deposit: 5 March 2019
Date of first compliant Open Access: 5 March 2019
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDUnited States. Agency for International Developmenthttp://viaf.org/viaf/125410167

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