Why Many Women in Arba Minch District Have Short Inter Birth Intervals? Implication to Health Care Workers and District Health Managers in Ethiopia

摘要

Background : One of the key strategies to reduce fertility and promote the health status of mothers and their children is adhering to optimal birth spacing. However, women still have shorter birth intervals and studies addressing its determinants were scarce. The objective of this Study, therefore, was to assess determinants of birth interval among women who had at least two consecutive live births. Methods : Case control study was conducted from February to April 2014. Cases were women with short birth intervals (<3years); whereas, controls were women having history of optimal birth intervals (3 to 5 years). A pre-tested and structured questionnaire was used. Multivariable analysis was performed to determine independent predictors. For the qualitative study, data were collected through focus group discussions (FGDs) with mothers and their husbands. Result: Having no formal education (AOR=2.36, 95%CL: [1.23-4.52]), duration of breast feeding for less than 24 months(AOR: 66.03, 95%CI;[34.60-126]), preceding child being female(AOR: 5.73, 95%CI; [3.18-10.310]), modern contraceptive use (AOR: 2.79, 95%CI: [1.58-4.940]) and poor wealth index (AOR: 4.89, 95%CI; [1.81-13.25]) of respondents were independent predictors of short birth interval. In the qualitative study, lack of information about optimal birth spacing, inaccessibility of health care service, reliance on clean lactation, family & religious influence, previous child being female were indicated as reasons of short birth interval. Conclusion: In equalities in education, duration of breast feeding, sex of the preceding child, contraceptive method use and wealth index were markers of the unequal distribution of inter birth intervals. Thus, to optimize birth spacing, strategies of providing information, education and communication targeting predictor variables should be improved. Key words: Determinants, short inter birth interval, between two live births, Case control study