Birth Spacing and Risk of Child Mortality at Kalu District South Wollo Zone of Amhara Region, North East Ethiopia

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Addis Abeba University


Background: Family planning services are usually evaluated in terms of their impact on fertility. Less attention has been given to the way in which changes in family planning related behavior may affect childhood mortality. Identifying the optimal interval between births at which risk of child mortality is the lowest may benefit developing countries to prioritize family planning services and achieve MDG 4. Objective: To Asses the child mortality rate and determine whether birth spacing is associated with increased risk of childhood mortality at a rural district. Methods: A house to house census carried out in 13 kebeles with an approximate population of 80 thousand to identify all child deaths one year preceding to the survey and to determine the child mortality rate at kalu district. Sex and age group matched case control study was carried out after the census to assess the association between birth spacing & child mortality. A conditional logistic regression was performed to point out the independent effect birth spacing has on children under 5 years mortality. Result: The neonatal, post neonatal, infant, child and under five mortality rates were found to be 37, 30, 67, 33 and 99/1000 live births respectively. Age group stratified analysis showed a significant decline in the trend of neonatal (X for trend = 4.62, P = 0.03) and infant (X 2 2 for trend = 13.23, P = 0.0003), post neonatal (X for trend = 17.06, P = 0.0001) mortality as the interval between births increases from less than 15 months to 48 or more months. Multivariate analysis showed that the odds of under five years mortality was 6.45 (95% CI = 1.53, 27.15), 3.20 (95% CI = 1.07, 9.57), 3.21 (95% CI = 1.18, 8.77) and 2.61 (95% CI = 0.97, 7.01) when the interval between births is less than 15, 15-23, 24-35 and 36-47 months respectively compared to birth intervals 48 or more months. Conclusion: Risk of childhood mortality was significantly associated with birth spacing. Recommendation: Mothers at the study district should space births for at least 36 months in order to reduce the risk of childhood mortality.



Birth Spacing, Child Mortality