High Risk Births, Unmet Need In Family Planning, and Their Correlates in Ethiopia
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Date
1998-06
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Addis Ababa University
Abstract
Early marriage and childbearing are considered to be the norms in many developing
countries-resulting higher total fertility rates. The prevalence of matemal, infant and
child mortality is partially attributed to higher fertility rates. Maternal demographic
factors: age, parity (birth order), and birth interval help to determine health risks
associated with pregnancy and childbirth. Assessing the magnitude of high risk
fertility behavior and the incidence of high risk births is crucial for health and family
planning policy makers and service providers. Reproductive health/family planning
services can delay or prevent pregnancy and will reduce health risks for the mother
and child. Thus, the identification of non- users of reproductive health/family planning
services on the basis of health risk criteria will help policy makers and service
providers to design appropriate intervention strategies including IEC and service
delivery.
This study has attempted to see health risks (both to the mother and child) related to
age, parity and birth interval; and the use of family planning to alleviate the problem
in Eth iopia. The 1990 National Family and Fertility Survey (carried out by CSA) data
has been used for this purpose. All women interviewed (8757 women) and births that
had occurred five years preceding the survey were treated. However, the result of
this study does not represent areas which were not covered in the survey (Tigrai, the
nomadic areas, North and South Gondar, North and South Wello). The Univariate,
bivariate and the logistic regression model have been used in the analysis.The results of the study revealed that the largest proportion of women of reproductive
ages in Ethiopia fall into: too young « 18), too old (> 34) and too many (four or more
children) categories. Moreover, like many other sub-Saharan African countries old
maternal age and high parity; and high parity and short birth interval appeared to be
the most important multiple risk factors in Ethiopia. These women under the above
mentioned risk categories will run a risk when they intend to give birth. Children born
within short birth interval were at an increased mortality risk than those born after an
interval of 24 months. Twin births and first order births also experience an elevated
mortality risk. The use of family planning is believed to reduce mortality risk of
children. However, the unmet high risk birth need for family planning to avoid high
risk pregnancies was found to be higher. Women's education and rural residence
were identified as the main explanatory variables for unmet reproductive health/family
planning need to avoid high risk births. The study concludes that provision of
reproductive health/family planning methods irrespective of sex and residential areas;
raising the existing legal age at first marriage; and closing the gap in education
between boys and girls could help to reduce the risk of dying both to the mothers and
their children.
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Keywords
Unmet Need In Family Planning