While inadequate birth interval becomes detrimental to health & nutritional outcome in infant and under-five year children; a systematic review through BLR and CPH model

Abstract Background: Smaller or older maternal age, smaller inter-pregnancy birth interval, and higher birth order of the child are considered to be high-risk fertility behaviour (HRFB). Under-five mortality being disproportionately concentrated in Asia and Africa, this study analyses the association between HRFB and under-five mortality in selected Asian and African countries. Methods: This study used Integrated Public Microdata Series-Demographic and Health Surveys (IPUMS-DHS) data from 32 countries in Sub-Saharan Africa, Middle East, North Africa, and South Asia from 1986 to 2017 (N=1,467,728). Previous evidence hints at four markers of HRFB: women's age at the birth of index child <18 years or >34 years, smaller preceding birth interval (PBI) <24 months, and child's birth order >3. Using logistic regression, we analysed the change in the odds of under-five mortality as a result of i) exposure to HRFB individually, ii) exposure to any single HRFB risk factor, iii) exposure to multiple HRFB risk factors, and iv) exposure to specific combinations of HRFB risk factors. Results: Mother's age at the birth of index child <18 years and preceding birth interval (PBI) <24 months were significant risk factors of under-five mortality, while a child's birth order >3 was a protective factor against under-five mortality. Presence of any single HRFB was associated with 1.067 times higher risk of under-five mortality (OR = 1.067; 95% CI: 1.042 - 1.090; P < 0.001). Presence of multiple HRFBs was associated with 1.392 times higher risk of under-five mortality (OR = 1.392; 95% CI: 1.355 - 1.431; P < 0.001). Some specific combinations of risky fertility behaviour such as younger maternal age (<18 years) and smaller preceding birth interval (PBI <24) significantly increased the odds of under-five mortality.Conclusion: Younger maternal age and small preceding birth interval significantly increase the risk of under-five mortality. This highlights the need for effective legislation to curb child marriages and increased public investment in reproductive healthcare with a focus on higher contraceptive use for an optimal interpregnancy interval.

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Impact of High-Risk Fertility Behaviour on Under-five Mortality in Asia and Africa: Evidence from Demographic and Health Surveys

10.21203/rs.3.rs-29205/v3 ◽

2020 ◽

Author(s):

Rafi Amir-ud-Din ◽

Lubna Naz ◽

Anila Rubi ◽

Muhammad Usman ◽

Umesh Ghimire

Keyword(s):

Risk Factors ◽

High Risk ◽

Birth Order ◽

Birth Interval ◽

Health Surveys ◽

Maternal Age ◽

Demographic And Health Surveys ◽

Index Child ◽

Under Five ◽

Fertility Behaviour

Abstract Background: Younger or older maternal age, short inter-pregnancy birth interval, and higher birth order of the child are considered to be high-risk fertility behaviour (HRFB). Under-five mortality being disproportionately concentrated in Asia and Africa, this study analyses the association between HRFB and under-five mortality in selected Asian and African countries.Methods: This study used Integrated Public Microdata Series-Demographic and Health Surveys (IPUMS-DHS) data from 32 countries in Sub-Saharan Africa, Middle East, North Africa, and South Asia from 1986 to 2017 (N=1,467,728). Previous evidence hints at four markers of HRFB: women’s age at the birth of index child <18 years or >34 years, short preceding birth interval (PBI) <24 months, and child’s birth order >3. Using logistic regression, we analysed the change in the odds of under-five mortality as a result of i) exposure to HRFB individually, ii) exposure to any single HRFB risk factor, iii) exposure to multiple HRFB risk factors, and iv) exposure to specific combinations of HRFB risk factors. Results: Mother’s age at the birth of index child <18 years and preceding birth interval (PBI) <24 months were significant risk factors of under-five mortality, while a child’s birth order >3 was a protective factor against under-five mortality. Presence of any single HRFB was associated with 1.067 times higher risk of under-five mortality (OR = 1.067; 95% CI: 1.042 - 1.090; P < 0.001). Presence of multiple HRFBs was associated with 1.392 times higher risk of under-five mortality (OR = 1.392; 95% CI: 1.355 - 1.431; P < 0.001). Some specific combinations of risky fertility behaviour such as younger maternal age (<18 years) and short preceding birth interval (PBI <24) significantly increased the odds of under-five mortality.Conclusion: Younger maternal age and short preceding birth interval significantly increase the risk of under-five mortality. This highlights the need for effective legislation to curb child marriages and increased public investment in reproductive healthcare with a focus on higher contraceptive use for an optimal interpregnancy interval.

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Factors Contributing Towards Malnutrition Among Under Five Indigenous Children: A Systematic Review

Indian Journal of Science and Technology ◽

10.17485/ijst/2019/v12i7/141509 ◽

2019 ◽

Vol 12 (7) ◽

pp. 1-12

Author(s):

Liyanatul Najwa Zakaria ◽

Halimatus Sakdiah Minhat ◽

Nor Afiah Mohd Zulkefli ◽

Anisah Baharom ◽

Norliza Ahmad ◽

...

Keyword(s):

Systematic Review ◽

Under Five ◽

Indigenous Children

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Epidemiology of COVID-19 infection in young children under five years: A systematic review and meta-analysis

Vaccine ◽

10.1016/j.vaccine.2020.11.078 ◽

2020 ◽

Author(s):

Mejbah Uddin Bhuiyan ◽

Eunice Stiboy ◽

Md. Zakiul Hassan ◽

Mei Chan ◽

Md. Saiful Islam ◽

...

Keyword(s):

Systematic Review ◽

Young Children ◽

Meta Analysis ◽

Children Under Five ◽

Under Five

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Under-five anemia and its associated factors with dietary diversity, food security, stunted, and deworming in Ethiopia: systematic review and meta-analysis

Systematic Reviews ◽

10.1186/s13643-020-01289-7 ◽

2020 ◽

Vol 9 (1) ◽

Cited By ~ 3

Author(s):

Amare Belachew ◽

Tilahun Tewabe

Keyword(s):

Systematic Review ◽

Food Security ◽

Associated Factors ◽

Dietary Diversity ◽

Meta Analysis ◽

Under Five

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Association between birth interval and wasting in children under 5 years of age in Ethiopia: a systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2020-037976 ◽

2020 ◽

Vol 10 (11) ◽

pp. e037976

Author(s):

Mesfin Wudu Kassaw ◽

Ayele Mamo Abebe ◽

Biruk Beletew Abate ◽

Ayelign Mengesha Kassie ◽

Murat Açık

Keyword(s):

Systematic Review ◽

Birth Interval ◽

Meta Analysis ◽

Geographical Area ◽

Public Health Problem ◽

Joint Estimation ◽

Hard Copy ◽

P Value ◽

Pooled Prevalence ◽

Debre Berhan

IntroductionAccording to the UNICEF, WHO and World Bank joint estimation, 1 in every 13 children suffered from wasting globally. The highest burden of undernutrition recorded in Asia and Africa. Wasting remains a considerable public health problem in Ethiopia despite the introduction of exhaustive nutritional programmes. As reported in the literature, the prevalence of wasting in Ethiopia has remained high over the last four decades. In Ethiopia, more than one-third of child deaths are associated with malnutrition. The current nutritional interventions implemented in Ethiopia need to be evidence based. For this purpose, systematic review is preferable as it can present a more reliable and precise estimate than individual studies. The aim of this review is to assess the pooled prevalence of wasting and its association with birth interval in Ethiopia.MethodologyStudies published after 20 January 2012 will be retrieved from databases, mainly PubMed/Medline, Scopus, Embase, CINAHL and HINARI. The articles retrieved from databases will be selected after reading the title, abstract and full text. Three reviewers will independently assess the quality of each study using both the Joanna Briggs Institute and Ottawa Scale critical appraisal checklists. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be used to maintain scientific strength. Funnel plots, Egger’s test and Begg’s test will be used to deal with publication bias, and I2, forest plots and Cochrane’s Q square statistics will be used for heterogeneity. Potential causes of heterogeneity will be explored through sensitivity and subgroup analyses. Because heterogeneity among studies is inevitable, given the wide geographical area and variety of study designs, the Der-Simonian and Laird random-effects model will be used. The presence of a statistical association between birth interval and wasting will be declared if the p value is <0.05 with the 95% CI.Ethics and disseminationEthical issues will not be applicable to this review and meta-analysis. This review and meta-analysis will report the pooled prevalence of wasting and its association with birth interval in Ethiopia. Effort will be made to publish the findings in a peer-reviewed journal such as the Ethiopian Journal of Health and Development, and the findings will be presented at national conferences. A hard copy will also be sent to Woldia University and Debre Berhan University.

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