scholarly journals 735Dynamics and Determinants of Birth Spacing in India

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Priyanka Sahu ◽  
C.M. Pandey ◽  
Shambhavi Mishra
Keyword(s):  
Infant Mortality ◽  
Waiting Time ◽  
Birth Interval ◽  
Infant Health ◽  
Family Income ◽  
Cox Regression ◽  
Birth Spacing ◽  
High Fertility ◽  
Contraceptive Devices ◽  
Previous Child

Abstract Background Birth spacing is an important determinant of the high fertility populations and has a strong bearing on maternal and infant health. The birth interval is composed of three major components namely postpartum amenorrhoea (PPA), waiting time to conception and gestation. To manage the high fertility in India, the present study is aimed to investigate the differential pattern of duration of birth interval components with respect to various socio demographic, child mortality, family planning services etc. Methods The data for this analysis was taken from National Family Health Survey 2015-16 (NFHS-4), provides information on population, health and nutrition for India and each State / Union territory. It gathered information from 601,509 households from overall India. Results Cox’ regression explores infant mortality, lactation, use of contraceptive devices, son preference and religion are found significant (P < 0.01) factors on the dynamics of birth interval components After adjustment of the effects of other explanatory variables, duration of breast feeding (P < 0.01), infant mortality (P < 0.01) and family income (P < 0.05) are found to have their significant impacts on the variation of PPA whereas death of previous child in infancy (P < 0.01), sex of previous child (P < 0.05), lactation (P < 0.01), education of mother (P < 0.05), and use of effective contraceptives have are found to be significant factors influencing the duration of waiting time to conception. Conclusions Among the determinants, infant mortality, lactation and religion have significant impacts on both duration variables in the Cox’s stepwise regression models. Key messages To control the growth of population, birth spacing must be maintained.

Birth spacing and infant mortality: evidence for eighteenth and nineteenth century German villages

1991 ◽  
Vol 23 (4) ◽  
pp. 445-459 ◽  
Author(s):  
Anne R. Pebley ◽  
Albert I. Hermalin ◽  
John Knodel
Keyword(s):  
Infant Mortality ◽  
Breast Feeding ◽  
Feeding Behaviour ◽  
Strong Association ◽  
Fertility Control ◽  
Birth Spacing ◽  
Interval Length ◽  
Confounding Factors ◽  
Previous Child ◽  
Previous Birth

SummaryData from an historical population in which fertility control was minimal and modern health services were mostly unavailable are used to show that there appears to have been a strong association between previous birth interval length and infant mortality, especially when the previous child survived. Although only imperfect proxies for breast-feeding practices and other potentially confounding factors are available for this population, the results suggest that the association between previous interval length and infant mortality in this population is not solely, or primarily, a function of differences in breast-feeding behaviour or socioeconomic status. Other factors, e.g. maternal depletion or sibling competition, are more likely to explain the observed association.

Birth spacing and infant and early childhood mortality in a high fertility area of Bangladesh: age-dependent and interactive effects

1995 ◽  
Vol 27 (4) ◽  
pp. 393-404 ◽  
Author(s):  
Nurul Alam
Keyword(s):  
Early Childhood ◽  
Birth Interval ◽  
Neonatal Period ◽  
Birth Spacing ◽  
Childhood Mortality ◽  
High Fertility ◽  
Birth Intervals ◽  
Risk Of Death ◽  
Older Siblings ◽  
Older Sibling

SummaryTo examine the effects of birth spacing on early childhood mortality, 3729 singleton births in 1983–84 were followed for 3 years in rural Bangladesh. Logistic regression analyses were used to assess whether the survival of older siblings modifies the effect of preceding birth intervals and to see if the effects of preceding and succeeding birth intervals are inter-related, controlling for the effects of sex of the child, mother's age and household economic status. With the exception of the neonatal period, birth spacing effects were highly significant. A preceding birth interval of <15 months was associated with a greater mortality risk in the post-neonatal period for children with an older sibling who survived infancy. However, a short preceding birth interval did not adversely affect post-neonatal mortality if the older sibling died in infancy. Neonatal and post-neonatal deaths were higher if older siblings had died in respective age intervals. A pregnancy interval of <12 months after childbirth raised the risk of death at ages 1–2 years considerably if the child was born after a short birth interval (<15 months). The results suggest that the high mortality risks of closely spaced children are due to sibling competition for parental resources.

The effect of child death on birth spacing in Nigeria

2019 ◽  
Vol 52 (3) ◽  
pp. 330-337
Author(s):  
Jude Ewemade ◽  
Joshua Akinyemi ◽  
Nicole DeWet
Keyword(s):  
Regression Model ◽  
Child Mortality ◽  
Inverse Relationship ◽  
Cox Regression ◽  
Child Death ◽  
Group Analysis ◽  
Birth Spacing ◽  
Childhood Mortality ◽  
High Fertility ◽  
Index Child

AbstractStudies have focused on the effect of short birth spacing on childhood mortality, yet very little attention has been paid to the possibility of an inverse relationship such that child mortality might also positively or negatively affect birth spacing. In Nigeria, where both fertility and child mortality are high, this inverse relationship is a possible reason for the country’s high fertility. The objective of this study was to examine the effect of child death on time to birth of the next child. Data were drawn from the 2013 Nigerian Demographic Health Survey. The study sample comprised 188,986 live births born to women aged 15–49 years within the five years preceding the survey. A multivariate Cox proportional hazard regression model was fitted to the data, and hazard ratios with 95% confidence intervals calculated. More than half of the mothers (68%) already had a next birth by 36 months after the death of the index child. Controlling for other covariates, the Cox regression model showed that the likelihood of next birth was higher when the index child had died compared with when the index child survived (HR: 2.21; CI: 2.03–2.41). Sub-group analysis by geo-political regions in Nigeria showed that in all regions there was a higher likelihood of having a next birth following the death of a preceding child. Death of the index child was found to be a major factor that shortens the length of birth intervals in Nigeria. It is therefore important that the Government of Nigeria intensifies efforts aimed at reducing infant mortality and encouraging adequate birth spacing.

scholarly journals Infant mortality in the Federal District, Brazil: time trend and socioeconomic inequalities

2007 ◽  
Vol 23 (4) ◽  
pp. 767-774 ◽  
Author(s):  
Renata Alves Monteiro ◽  
Bethsáida de Abreu Soares Schmitz
Keyword(s):  
Mortality Rate ◽  
Infant Mortality ◽  
Infant Health ◽  
Family Income ◽  
Federal District ◽  
Infant Mortality Rate ◽  
Neonatal Deaths ◽  
Live Births ◽  
Effective Interventions ◽  
National Capital

This study examined the trend in the infant mortality rate in the Federal District of Brazil (or Greater Metropolitan Brasilia, the national capital) from 1990 to 2000, analyzing the rate according to 5 administrative areas stratified by mean family income, from 1996 to 2000. An ecological time-series study was conducted using the Information Systems on Live Births and Mortality, produced by the Brazilian Ministry of Health. The infant mortality rate (IMR) decreased by 45.2% from 1990 to 2000, from 26.3 per 1000 live births to 14.4, or a mean annual reduction of 5.34% (R² = 0.9397; p < 0.0001). During this period there was a higher proportion of neonatal deaths. However, a higher percentage change occurred in the post-neonatal period (-59.0%, R² = 0.8452, p < 0.0001). Investigation of the IMR in the various areas of the Federal District showed a reduction in differences among the regions with respect to the component rates; however, substantial disparities persisted in relation to the income variable. The results suggest the need for effective interventions in the determinants of neonatal and post-neonatal mortality in order to improve maternal and infant health in all socioeconomic groups in the Federal District.

A Participatory, State–Community–Academic Model to Improve Pregnancy Outcomes in Texas: The Healthy Families Initiative

2020 ◽  
pp. 109019812097715
Author(s):  
Divya A. Patel ◽  
Meliha Salahuddin ◽  
Melissa Valerio ◽  
Nagla Elerian ◽  
Krystin J. Matthews ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Pregnancy Outcomes ◽  
Stakeholder Engagement ◽  
Infant Health ◽  
Secondary Data ◽  
Health Indicators ◽  
Infant Mortality Rate ◽  
State Agency ◽  
Missed Opportunities ◽  
Community Factors

Background While the Texas infant mortality rate (IMR) is below the Healthy People 2020 objective (5.7 per 1,000 live births), stark differences in IMR are seen across Texas communities. Health indicators for the state suggest important missed opportunities for improving maternal and infant outcomes. The Healthy Families initiative was a collaboration between a Texas state agency, community partners, and academic institutions to understand how evidence-based interventions could be identified, adapted, and implemented to address community priorities and reduce disparities in pregnancy outcomes. Method The Healthy Families initiative included two Texas counties, one with low utilization of prenatal care and one with persistent disparities in infant mortality. The model served to (1) identify community factors influencing IMR and maternal morbidity through stakeholder engagement and secondary data, (2) build community capacity to link pregnant women with existing and newly developed services, and (3) develop partnerships within the community and clinics to improve access to and sustainability of services. Results A community-based participatory approach focused on stakeholder engagement was used to identify, design, and adapt strategies to address community-identified priorities. Conclusions The Healthy Families initiative is a unique state–community–academic partnership aimed at improving pregnancy outcomes in vulnerable communities, with a focus on promotion of capacity building, maintenance, and sustainability of maternal and infant health programs.

scholarly journals Determinants of short birth interval among women in South Gondar, Ethiopia: community-based unmatched case-control study

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Gedefaye Nibret Mihretie ◽  
Fentahun Yenealem Beyene ◽  
Bekalu Getnet Kassa ◽  
Alemu Degu Ayele ◽  
Tewachew Muche Liyeh ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Birth Interval ◽  
Case Control Study ◽  
Birth Spacing ◽  
Case Control ◽  
Community Based ◽  
Short Birth Interval ◽  
South Gondar ◽  
Control Study

Abstract Background The effect of short birth interval on socio-economic, negative maternal and child health outcomes remains common in developing countries. This study aimed to assess determinants of short birth interval among reproductive age women, who gave birth in health institution for last six-month in South Gondar, Ethiopia 2019. Methods Community-based unmatched case control study design was conducted from February 1 to March 30, 2019. Sample size of 150 was included by simple random sampling technique. The data was collected by semi-structured and pre-tested face to face interviewer-administered questionnaire from selected respondent. The collected data was entered with Epi-Data version 3.1 and analyzed by using SPSS version 23 software. Bivariate and multivariable analyses were used to examine the association. Odds ratio, 95% CI and P-value < 0.05 were used to determine the statistical association. Result The mean age of the respondents was 32.42 (SD ± 5.14) and 35.12 (SD ± 5.86) for cases and controls, respectively. Mothers not used contraceptives (AOR = 6.29, 95% CI (1.95, 20.24)), participants who had ≤2 alive children (AOR = 5.57, 95% CI (1.47, 21.13)), mothers who breast fed less than 24 months (AOR = 3.42, 95% CI (1.38, 8.46)), husband decision on contraceptives utilization (AOR = 2.69,95% CI (1.05,6.88)) and mothers who did not have history of antenatal care follow up (AOR = 3.52, 95% CI (1.27, 9.75)) were associated with short birth interval. Conclusion The optimum birth spacing plays a vital role in decreasing fertility and the morbidity and mortality of mothers and children. Thus, providing health information on the benefit of breast feeding, follow-up of antenatal care during pregnancy, use of contraceptives after delivery and encouraging mothers to make decisions about their own health and use of contraceptives to optimize birth spacing for rural communities.

scholarly journals Gaps in the Continuum of HIV Care: Long Pretreatment Waiting Time between HIV Diagnosis and Antiretroviral Therapy Initiation Leads to Poor Treatment Adherence and Outcomes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Shu Su ◽  
Shifu Li ◽  
Shunxiang Li ◽  
Liangmin Gao ◽  
Ying Cai ◽  
...  
Keyword(s):  
Treatment Adherence ◽  
Waiting Time ◽  
Cox Regression ◽  
Treatment Guidelines ◽  
Current Treatment ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Hiv Diagnosis ◽  
Treatment Data ◽  
Poor Treatment

Background.Criteria for antiretroviral treatment (ART) were adjusted to enable early HIV treatment for people living HIV/AIDS (PLHIV) in China in recent years. This study aims to determine how pretreatment waiting time after HIV confirmation affects subsequent adherence and outcomes over the course of treatment.Methods.A retrospective observational cohort study was conducted using treatment data from PLHIV in Yuxi, China, between January 2004 and December 2015.Results.Of 1,663 participants, 348 were delayed testers and mostly initiated treatment within 28 days. In comparison, 1,315 were nondelayed testers and the median pretreatment waiting time was 599 days, but it significantly declined over the study period. Pretreatment CD4 T-cell count drop (every 100 cells/mm3) contributed slowly in CD4 recovery after treatment initiation (8% less,P<0.01) and increased the risk of poor treatment adherence by 15% (ARR = 1.15, 1.08–1.25). Every 100 days of extensive pretreatment waiting time increased rates of loss to follow-up by 20% (ARR = 1.20, 1.07–1.29) and mortality rate by 11% (ARR = 1.11, 1.06–1.21), based on multivariable Cox regression.Conclusion.Long pretreatment waiting time in PLHIV can lead to higher risk of poor treatment adherence and HIV-related mortality. Current treatment guidelines should be updated to provide ART promptly.

scholarly journals Survival Analysis and Determinants of The First Birth Interval in Indonesia

CAUCHY ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. 55
Author(s):  
Alfensi Faruk ◽  
Endro Setyo Cahyono ◽  
Ning Eliyati
Keyword(s):  
Survival Analysis ◽  
Educational Level ◽  
Birth Interval ◽  
Cox Regression ◽  
Wealth Index ◽  
First Birth ◽  
Factors Affecting ◽  
Kaplan Meier ◽  
Censored Observations ◽  
Socioeconomic And Demographic Factors

<p class="Abstract">The first birth interval is one of the indicators of women’s fertility rate. Because in most cases the first birth interval contains censored observations, the only appropriate statistical method to handle such data is survival analysis. The main objective of this study is to analyze several socioeconomic and demographic factors that affect the first birth interval in Indonesia using the univariate and multivariate survival analysis, that is Kaplan-Meier method and Cox regression model, respectively. The sample is obtained from 2012 Indonesian Demographic and Health Survey (IDHS) and consists of 28242 ever married women aged 15-49 at the time of interview. The results show that age at the first birth, women's educational level, husband’s educational level, contraceptive knowledge, wealth index, and employment status are the significant factors affecting the first birth interval in Indonesia.</p>

scholarly journals Smoke-free legislation and neonatal and infant mortality in Brazil: longitudinal quasi-experimental study

2019 ◽  
pp. tobaccocontrol-2019-054923 ◽  
Author(s):  
Thomas Hone ◽  
Andre Salem Szklo ◽  
Filippos T Filippidis ◽  
Anthony A Laverty ◽  
Isabela Sattamini ◽  
...  
Keyword(s):  
Experimental Study ◽  
Mortality Rate ◽  
Infant Mortality ◽  
Neonatal Mortality ◽  
Fixed Effects ◽  
Infant Health ◽  
Infant Mortality Rate ◽  
Infant Deaths ◽  
Quasi Experimental ◽  
Fixed Effects Regression

ObjectiveTo examine the associations of partial and comprehensive smoke-free legislation with neonatal and infant mortality in Brazil using a quasi-experimental study design.DesignMonthly longitudinal (panel) ecological study from January 2000 to December 2016.SettingAll Brazilian municipalities (n=5565).ParticipantsInfant populations.InterventionSmoke-free legislation in effect in each municipality and month. Legislation was encoded as basic (allowing smoking areas), partial (segregated smoking rooms) or comprehensive (no smoking in public buildings). Associations were quantified by immediate step and longer term slope/trend changes in outcomes.Statistical analysesMunicipal-level linear fixed-effects regression models.Main outcomes measuresInfant and neonatal mortality.ResultsImplementation of partial smoke-free legislation was associated with a −3.3 % (95% CI −6.2% to −0.4%) step reduction in the municipal infant mortality rate, but no step change in neonatal mortality. Comprehensive smoke-free legislation implementation was associated with −5.2 % (95% CI −8.3% to −2.1%) and −3.4 % (95% CI −6.7% to −0.1%) step reductions in infant and neonatal mortality, respectively, and a −0.36 (95% CI −0.66 to−0.06) annual decline in the infant mortality rate. We estimated that had all smoke-free legislation introduced since 2004 been comprehensive, an additional 10 091 infant deaths (95% CI 1196 to 21 761) could have been averted.ConclusionsStrengthening smoke-free legislation in Brazil is associated with improvements in infant health outcomes—particularly under comprehensive legislation. Governments should accelerate implementation of comprehensive smoke-free legislation to protect infant health and achieve the United Nation’s Sustainable Development Goal three.

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