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

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  • Desalegn Markos Shifti
  • Catherine Chojenta
  • Elizabeth G. Holliday
  • Deborah Loxton

Abstract

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.

Suggested Citation

  • Desalegn Markos Shifti & Catherine Chojenta & Elizabeth G. Holliday & Deborah Loxton, 2020. "Individual and community level determinants of short birth interval in Ethiopia: A multilevel analysis," PLOS ONE, Public Library of Science, vol. 15(1), pages 1-17, January.
    • Handle: RePEc:plo:pone00:0227798
    DOI: 10.1371/journal.pone.0227798
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    References listed on IDEAS

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    1. Julie DaVanzo & Abdur Razzaque & Mizanur Rahman & Lauren Hale & Kapil Ahmed & Mehrab Ali Khan & Golam Mustafa & Kaniz Gausia, 2004. "The Effects of Birth Spacing on Infant and Child Mortality, Pregnancy Outcomes, and Maternal Morbidity and Mortality in Matlab, Bangladesh," Working Papers WR-198, RAND Corporation.
    2. Julie DaVanzo & Abdur Razzaque & Mizanur Rahman & Lauren Hale & Kapil Ahmed & Mehrab Ali Khan & Golam Mustafa & Kaniz Gausia, 2004. "The Effects of Birth Spacing on Infant and Child Mortality, Pregnancy Outcomes, and Maternal Morbidity and Mortality in Matlab, Bangladesh," Working Papers 198, RAND Corporation.
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