scholarly journals Impact of high-risk fertility behaviours on underfive mortality in Asia and Africa: evidence from Demographic and Health Surveys

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rafi Amir-ud-Din ◽  
Lubna Naz ◽  
Aneela 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 ◽  
Underfive Mortality ◽  
Age At Birth

Abstract Background Maternal age < 18 or > 34 years, short inter-pregnancy birth interval, and higher birth order are considered to be high-risk fertility behaviours (HRFB). Underfive mortality being disproportionately concentrated in Asia and Africa, this study analyses the association between HRFB and underfive 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 birth of index child < 18 or > 34 years, preceding birth interval < 24 months and child’s birth order > 3. Using logistic regression, we analysed change in the odds of underfive 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 birth of index child < 18 years and preceding birth interval (PBI) < 24 months were significant risk factors of underfive mortality, while a child’s birth order > 3 was a protective factor. Presence of any single HRFB was associated with 7% higher risk of underfive mortality (OR 1.07; 95% CI 1.04–1.09). Presence of multiple HRFBs was associated with 39% higher risk of underfive mortality (OR 1.39; 95% CI 1.36–1.43). Some specific combinations of HRFB such as maternal age < 18 years and preceding birth interval < 24 month significantly increased the odds of underfive mortality (OR 2.07; 95% CI 1.88–2.28). Conclusion Maternal age < 18 years and short preceding birth interval significantly increase the risk of underfive mortality. This highlights the need for an effective legislation to curb child marriages and increased public investment in reproductive healthcare with a focus on higher contraceptive use for optimal birth spacing.

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

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: 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.

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

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.

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

2020 ◽  
Author(s):  
Rafi Amir-ud-Din ◽  
Lubna Naz ◽  
Anila Rubi ◽  
Muhammad Usman ◽  
Umesh Ghimire
Keyword(s):  
High Risk ◽  
Birth Order ◽  
Child Mortality ◽  
South Asian ◽  
Birth Interval ◽  
Health Surveys ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Under Five ◽  
Increased Risk

Abstract Background High-risk fertility behaviors (HRFBs) are common in African and South Asian countries and can potentially affect child survival. This study examines the high-risk fertility behaviors concerning child mortality across the countries. Method Data from a series of Demographic and Health Surveys from the year 1987 to 2016 from 24 South Asian and African countries (N=1,224,832) were included in this study. Four HRFB parameters - women’s age <18 or >=34 years at childbirth, birth spacing <24 months, and child order of birth >3, were categorized into three exposure levels: i) exposure to any HRFBs category (exposure to any of four parameters); ii) exposure to single and multiple HRFB category (a combination of two or more parameters); and iii) the specific type of HRFB category (either single or multiple HRFB categories). Bivariate descriptive analysis and a multivariate logistic regression model were used to examine the association between under-five child mortality and various measures of HRFBs. Results Our pooled data analysis reported that HRFBs was associated with an increased risk of under-five child mortality in Asian and African countries. Children of women exposed to HRFBs were at increased risk of under-five mortality by 77% (Adjusted Odds Ratio (AOR) = 1.771, 95% confidence interval (CI): 1.722 - 1.821). Children born within 24 months’ birth interval were four times more likely to die (AOR = 4.995, 95% CI: 4.842-5.152) than their counterparts. However, a single high-risk category was not associated with under-five mortality, and birth order was found to be a protective factor against under-five mortality. Age of women (<18 or >=34 years) was found to be a risk factor of Under-five child mortality in 16 countries. The association between under-five mortality risk and birth interval of less than 24 months was highly significant in all countries. Conclusion Women’s age at childbirth, birth interval, and birth order were significantly associated with under-five mortality. Quality care for women and newborns need to be ensured through investment in the healthcare system, and by promoting health services with more focus given to the valuable populations through sexual and reproductive health education programs and empowering women.

scholarly journals HIV EPIDEMIC HETEROGENEITY IN ZIMBABWE: EVIDENCE FROM SUCCESSIVE DEMOGRAPHIC AND HEALTH SURVEYS

2018 ◽  
Vol 50 (6) ◽  
pp. 840-852
Author(s):  
Zainab Oseni ◽  
Farah Seedat ◽  
Ngianga-Bakwin Kandala
Keyword(s):  
Risk Factors ◽  
Regional Variation ◽  
Health Surveys ◽  
Mixed Model ◽  
Policy Design ◽  
Regional Level ◽  
Demographic And Health Surveys ◽  
Hiv Epidemic ◽  
Regression Framework ◽  
The World

SummaryZimbabwe has one of the worst HIV epidemics in the world. This study investigated data from two successive Zimbabwe Demographic and Health Surveys (ZDHS) conducted in 2005–06 and 2010–11. A random representative sample of 30,000 men aged 15–59 and women aged 15–49 was selected from the two surveys. The HIV prevalence was mapped with a flexible, coherent regression framework using a geo-additive semi-parametric mixed model. HIV indicator prevalence maps were constructed at the regional level, and at the administrative level relevant for policy design, planning and decision-making. Substantial regional variation was found, not only in the burden of HIV, but also in its risk factors. The results suggest that responses/policies should vary at the regional level to ensure that the often diverse needs of populations across a country are met and incorporated into planning the HIV response. The use of geographically referenced data in two successive ZDHS provides crucial new insights into the spatial characteristics of the HIV epidemic in Zimbabwe. In particular, it highlights the HIV heterogeneity across Zimbabwe, with substantial regional variation, not only in the burden of HIV, but also in its risk factors.

Maternal factors and infant and child mortality in Bangladesh

1988 ◽  
Vol 20 (1) ◽  
pp. 89-98 ◽  
Author(s):  
Abul Kashem Majumder
Keyword(s):  
Multivariate Analysis ◽  
Birth Interval ◽  
Maternal Age ◽  
Fertility Survey ◽  
Single Factor ◽  
Maternal Factors ◽  
Mortality Risks ◽  
Infant And Child Mortality ◽  
Using Data ◽  
Age At Birth

SummaryMultivariate analysis of the effects of maternal age at birth, birth order and the preceding birth interval on mortality risks in early childhood, using data from the Bangladesh Fertility Survey, 1975–76, confirms that the length of the preceding birth interval is the most influential single factor. But the lower mortality risks among infants and children of educated mothers are due neither to the age at which childbearing was initiated nor to the spacing between births.

scholarly journals Maternal determinants affecting perinatal mortality: a multivariate statistical approach

2017 ◽  
Vol 6 (3) ◽  
pp. 1052
Author(s):  
Manish Agrawal ◽  
Kriti Bhatnagar
Keyword(s):  
Risk Factors ◽  
High Risk ◽  
Child Health ◽  
Pregnant Women ◽  
Perinatal Outcome ◽  
Maternal Age ◽  
Maternal Risk Factors ◽  
Maternal Risk ◽  
Grass Root ◽  
Antenatal Visits

Background: India has made considerable progress over the last two decades in the area of maternal and child health, through innovative and comprehensive health packages that covers the spectrum of Reproductive Child Health (RCH). Awareness of the special vulnerability of the cohort of mothers with ‘high risk factor’ has led to the popular recognition of ‘risk approach’, involving the optimal use of existing MCH services, providing essential obstetrical care for all with early detection of complications and emergency services for those who need it, thus reducing the need for intensive care along with reduction in perinantal mortality. The objective was to assess the prevalence of various maternal risk factors in pregnant women in hospital admissions and their correlation with perinatal mortality.Methods: The present study was carried out on 2050 consecutive deliveries from 1st April 2015 to 31st March 2016 at Department of Obstetrics and Gynecology and Department of Pediatrics, Muzaffarnagar Medical College, Muzaffarnagar Uttar Pradesh, India. All the pregnant women were interviewed and examined in detail at the onset of labor regarding various biosocio-economic characteristics, history of past and present medical and obstetrical complications.Results: The PNMR (93.66/1000 birth) observed in present study was still at a higher level and comparable to that in other studies done by various authors in past in this region. A significantly higher PNMR was observed with increase in maternal age and parity (3 times higher PNMR at >35 years and 2 ½ times higher PNMR at parity >5). Similarly, medical illnesses (3 times higher PNMR) and obstetrical complications (1.5 times higher PNMR) during present pregnancy were showing significant effect on perinatal outcome. In a multivariate analysis, residence (rural /urban), place and number of antenatal visits, gestational age and type of delivery remained as most significant maternal risk factors (p<0.005) after multiple logistic regression of other factors viz. maternal age, height, weight, parity, education, socio-economic status and antepartum anemia.Conclusions: It is heartening to observe that highest risk is associated with simple and easily identifiable factors like, unbooked cases, <3 antenatal visits, severe anemia, age >35 years, parity >5, weight <40 kg, height < 140cm , poor dietary calories, medical and obstetrical complications. These can identified from history only by grass root workers like traditional birth attendants and even elderly female family members. These risk determinants, labeled as simple but ‘high’ high risk are associated with poor perinatal outcome. If these factors are timely identified at community level and appropriately referred by grass root workers, it will significantly reduce perinatal mortality and improve neonatal survival.

Sign in / Sign up

Export Citation Format

Share Document