Birth Spacing and Risk of Child Mortality at Kalu District South Wollo Zone of Amhara Region, North East Ethiopia
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Date
2009-06
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Addis Abeba University
Abstract
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.
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Keywords
Birth Spacing, Child Mortality