scholarly journals A comparative analysis of the influence of contraceptive use and fertility desire on the duration of second birth interval in four sub-Saharan African countries

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rotimi Felix Afolabi ◽  
Adeniyi Francis Fagbamigbe ◽  
Martin Enock Palamuleni
Keyword(s):  
South Africa ◽  
Health Outcomes ◽  
Birth Interval ◽  
Contraceptive Use ◽  
Demographic And Health Surveys ◽  
Additional Child ◽  
Fertility Desire ◽  
Dr Congo ◽  
Birth Intervals ◽  
Sub Saharan

Abstract Background Fertility decline characterised by inter-birth intervals remains rather slow or stall in many countries of sub-Saharan African (SSA). Non-adherence to optimal inter-birth intervals often occasioned by low prevalence of contraceptive use and high fertility desires often lead to poor maternal and child health outcomes. Additionally, information on the influence of contraception and fertility desire on interval between first and second births (SBI) is rarely available. This study therefore aimed to examine the influence of fertility desire and contraception on SBI among women in four SSA countries. Methods We analysed cross-sectional data on women aged 15–49 years who participated in the recent Demographic and Health Surveys in DR Congo, Ethiopia, Nigeria and South Africa. Semi-parametric Cox proportional hazards regression was employed for the analysis at 5% significance level. Results The median time to second birth was 34 months in DR Congo; 35 months, Nigeria; 42 months, Ethiopia; and 71 months, South Africa. About 70% of the women desired additional child(ren) and two-thirds have never used contraceptive in both Nigeria and DR Congo. The hazard of second birth was significantly lower among women who desired additional child(ren) compared to desired for no more child in DR Congo (aHR = 0.93; CI: 0.89–0.97), Ethiopia (aHR = 0.64; CI: 0.61–0.67) and South Africa (aHR = 0.51; CI: 0.47–0.55). Women who had never used contraceptive were 12%, 20% and 24% more likely to lengthen SBI than those who were current users in DR Congo, Nigeria and South Africa respectively. DR Congo and Nigerian women were about two times more likely to shorten SBI compared with their South African counterparts. Other significant determinants of SBI include ethnicity, rural residential, age and marital status at first birth, wealth and employment status. Conclusion Findings showed differentials in the linkage between second birth interval and the desired fertility and contraception by country, demonstrating the importance of context. The contribution of these factors to second birth interval requires country context-specific attention if further decline in fertility and poor health outcomes associated with sub-optimal inter-birth interval is to be attained in SSA.

Changes in demand for children between 2003 and 2013 in Nigeria: Evidence from survey data

2018 ◽  
Vol 15 (1) ◽  
pp. 16-29
Author(s):  
Stella Babalola ◽  
Joshua O. Akinyemi ◽  
Clifford O. Odimegwu
Keyword(s):  
Health Surveys ◽  
Contraceptive Use ◽  
Religious Affiliation ◽  
Large Family ◽  
Fertility Rate ◽  
Demographic And Health Surveys ◽  
High Fertility ◽  
Fertility Desire ◽  
The North ◽  
Demand For Children

Abstract Nigeria has one of the highest fertility rates in Africa. Data from 2013 Demographic and Health Surveys indicate a virtual stagnation of fertility rate since 2003. Low contraceptive use and pronatalist attitudes are among the factors contributing to the high fertility rate in Nigeria. In this manuscript, we pooled data from three most recent waves of Demographic and Health Surveys to examine trends in demand for children over time and identify the factors associated with change in demand for children. The data show that demand for children has declined since 2003 although not monotonically so. Variables that were positively associated with increased likelihood of desiring no additional children were residence in the South-West (as opposed to residence in the North-Central), exposure to family planning (FP) messages on the mass media, number of children ever born, educational level, and urban residence. In contrast, uncertainty about fertility desire was more widespread in 2008 compared to 2013 although less widespread in 2003 than in 2013. The likelihood of being undecided about fertility desire was positively associated with discrepancies in family size desires between husband and wife, parity and Islamic religious affiliation. Programs should aim to increase access to effective contraceptive methods and promote demand for contraceptives as a way of fostering a sustainable reduction in demand for children. Furthermore, strategies that address uncertainty by fostering women’s understanding of the social and health implications of large family sizes are relevant.

Pattern and determinant factors of birth intervals among Iranian women: a semi-parametric multilevel survival model

2019 ◽  
Vol 52 (4) ◽  
pp. 534-546
Author(s):  
Maryam Seyedtabib ◽  
Abbas Moghimbeigi ◽  
Mahmood Mahmoudi ◽  
Reza Majdzadeh ◽  
Hossein Mahjub
Keyword(s):  
Mass Media ◽  
Birth Interval ◽  
Family Income ◽  
Contraceptive Use ◽  
Frailty Model ◽  
Population Heterogeneity ◽  
Iranian Women ◽  
Birth Intervals ◽  
Effective Role ◽  
Using Data

AbstractThe interval between successive pregnancies (birth interval) is one of the main indexes used to evaluate the health of a mother and her child. This study evaluated birth intervals in Iran using data from the Iranian Multiple Indicators Demographic and Health Survey (IrMIDHS) conducted in 2010–2011. A total of 20,093 married Iranian women aged 15–54 years from the whole country constituted the study sample. Based on the nature of sampling and the unobserved population heterogeneity for birth intervals in each city and province, a multilevel survival frailty model was applied. Data were analysed for women’s first three birth intervals. The median first and second birth intervals were 30.3 and 39.7 months respectively. Higher education, Caesarean delivery, contraceptive use and exposure to public mass media were found to decrease the hazard rate ratio (HRR) of giving birth. Meanwhile, higher monthly income increased the hazard of giving birth. The results suggest that public mass media can play an effective role in encouraging women to have the recommended birth interval. Furthermore, increasing family income could encourage Iranian couples to decrease the time to their next birth.

scholarly journals Dietary Diversity and Undernutrition in Children Aged 6–23 Months in Sub-Saharan Africa

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3431
Author(s):  
Richard Gyan Aboagye ◽  
Abdul-Aziz Seidu ◽  
Bright Opoku Ahinkorah ◽  
Francis Arthur-Holmes ◽  
Abdul Cadri ◽  
...  
Keyword(s):  
South Africa ◽  
Health Status ◽  
Dietary Diversity ◽  
Statistical Significance ◽  
Feeding Practices ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Odds Ratios ◽  
Sub Saharan ◽  
Minimum Dietary Diversity

Dietary diversity plays a major role in the health status of children. However, evidence on its crucial role on children’s health status remains inconclusive in sub-Saharan Africa (SSA). In this study, we examined the association between dietary diversity and undernutrition among children aged 6–23 months in SSA. We pooled data from the most recent Demographic and Health Surveys of 32 countries in SSA from 2010 to 2020. A sample of 48,968 mother-child pairs of children within the ages of 6–23 months and mothers aged 15–49 years were included in this study. Multilevel logistic regression analysis was carried out to examine the association between dietary diversity and stunting, wasting, and underweight. The results were presented as crude odds ratios (cOR) and adjusted odds ratios (aOR) with their 95% confidence intervals. Statistical significance was set at p < 0.05. The overall prevalence of minimum dietary diversity was 25.1%, with South Africa recording the highest prevalence (43.9%) and Burkina Faso recording the lowest prevalence (5.6%). The highest prevalence of stunting was recorded by Burundi (51.8%) while the lowest prevalence was found in Ghana (13.6%), with an overall regional prevalence of 28.6%. For wasting, prevalence from all countries was found to be 9.4%. South Africa recorded the lowest prevalence of wasting (2.1%) while Niger recorded the highest prevalence (27.3%). Lastly, the prevalence of underweight ranged from 5.3% in South Africa to 41.8% in Niger, with an all-country prevalence of 16.4%. Children who had adequate minimum dietary diversity had 12% less likelihood of being stunted (aOR = 0.88, 95% CI = 0.83, 0.94), compared to those who had inadequate minimum dietary diversity. Having an adequate minimum dietary diversity significantly lowered the risk of underweight among children by 17% (aOR = 0.83, 95% CI = 0.77, 0.91). Having an adequate minimum dietary diversity was associated with 13% reduced odds of wasting among children (aOR = 0.87, 95% CI = 0.78, 0.97), compared to those who had inadequate minimum dietary diversity. This study highlights the significant association between minimum dietary diversity and stunting, wasting, and underweight among 6–23 month-old children in SSA. There is an urgent need for additional nutrition-specific interventions and strengthening of existing interventions aimed at improving infant and young child feeding practices, including complementary feeding practices among children aged 6–23 months in the 32 countries in SSA. Such interventions should focus more on countries where the prevalence of adequate minimum dietary diversity was low and undernutrition was high.

USING COUPLES’ DISCORDANT REPORTS TO ESTIMATE FEMALE COVERT USE OF MODERN CONTRACEPTION IN SUB-SAHARAN AFRICA

2017 ◽  
Vol 50 (3) ◽  
pp. 326-346 ◽  
Author(s):  
Natalie C. Gasca ◽  
Stan Becker
Keyword(s):  
Contraceptive Use ◽  
Modern Method ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Modern Contraceptive ◽  
African Countries ◽  
Couple Communication ◽  
Significant Difference ◽  
Contraceptive Prevalence ◽  
Sub Saharan

SummarySubstantial numbers of married women use contraceptives without their partner’s knowledge in sub-Saharan Africa, but studies of female covert use across time are rare. This study investigates the levels, trends and correlates of covert use in nine countries and determines which contraceptive methods are more frequently used covertly by women. Data from monogamous couples in Demographic and Health Surveys were used from nine sub-Saharan African countries that had experienced an increase of 10 percentage points in current modern contraceptive use between an earlier (1991–2004) and later (2007–2011) survey. Covert use was indirectly estimated as the percentage of women who reported a female modern method whose husband did not report a modern method. The percentage of women using covertly increased in eight of the countries studied (significantly in three of them), yet when comparing across countries cross-sectionally, covert use was lower where contraceptive prevalence was higher. In general, women with more years of schooling and those with larger spousal schooling gaps had lower odds of covert use. There was no significant difference between covert and open injectable use, though more than half of both groups used this method in the later surveys. Encouraging couple communication about contraception, where the woman feels it is safe to do so, could be an important strategy to minimize covert use. Further research is needed to better identify the contraceptive prevalence and social context in which covert use declines within a country.

DISAGREEMENT IN SPOUSAL REPORTS OF CURRENT CONTRACEPTIVE USE IN SUB-SAHARAN AFRICA

2005 ◽  
Vol 38 (6) ◽  
pp. 779-796 ◽  
Author(s):  
STAN BECKER ◽  
MIAN B. HOSSAIN ◽  
ELIZABETH THOMSON
Keyword(s):  
Health Surveys ◽  
Contraceptive Use ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
Sex Partners ◽  
Recent Period ◽  
Survey Question ◽  
Contraceptive Prevalence ◽  
Sub Saharan ◽  
Using Data

Contraceptive prevalence is a key variable estimated from Demographic and Health Surveys. But the prevalence estimated from reports of husbands differs widely from that estimated for wives. In this research, using data from six Demographic and Health Surveys of sub-Saharan Africa, reports from spouses in monogamous couples with no other reported sex partners in the recent period are examined. Agreement ranged from 47% to 82%, but among couples in which one or both reported use, the ‘both’ category represented less than half in all nations except Zimbabwe. Husbands generally had higher reports of condoms, periodic abstinence and pills but fewer reports of the IUD, injections and female sterilization. Either discussion of family planning with the spouse and/or higher socioeconomic status was associated with agreement in most of the surveys. Ambiguities in the survey question regarding current use need to be reduced, perhaps with an added probe question for non-permanent methods.

Association between type of contraceptive use and haemoglobin status among women of reproductive age in 24 sub-Saharan Africa countries

2018 ◽  
Vol 45 (1) ◽  
pp. 54-60 ◽  
Author(s):  
Samson Gebremedhin ◽  
Anteneh Asefa
Keyword(s):  
Contraceptive Use ◽  
Secondary Data ◽  
Reproductive Age ◽  
Sub Saharan Africa ◽  
Hormonal Contraceptives ◽  
Demographic And Health Surveys ◽  
Barrier Methods ◽  
Oral Contraceptive Pills ◽  
Nationally Representative ◽  
Sub Saharan

BackgroundLittle is known whether contraceptive methods differentially modify women’s risk of anaemia or not. We compared the haemoglobin status of women currently using different fertility regulation methods in sub-Saharan Africa (SSA) where anaemia is a major concern.MethodsWe conducted the study based on the secondary data of 24 nationally representative demographic and health surveys carried out recently in SSA. The data of 105 532 women were included in the analysis. In the original surveys, respondents were selected using multistage sampling techniques and haemoglobin was determined using the HemoCue analyser. The association between method of contraception and anaemia status was determined via a mixed-effects logistic regression model adjusted for potential confounders. The outputs are presented using adjusted odds ratio (AOR) with 95% CI.ResultsThe mean (±SD deviation) haemoglobin was 12.3 (±1.7) g/dl and 36.7% of the women had anaemia. Current use of modern contraceptives, as compared with non-use, was associated with a 25% reduction (AOR=0.75 (95% CI: 0.73 to 0.78)) in the odds of anaemia. Comparison among individual modern methods showed, as compared with current barrier methods users, use of injectables (AOR=0.62 (95% CI: 0.57 to 0.67)), oral contraceptive pills (OCP) (AOR=0.62 (95% CI: 0.57 to 0.66)) and implants (AOR=0.63 (95% CI: 0.58 to 0.70)) were significantly associated with reduced odds of anaemia. With reference to women with less than 12 months of use, the odds were significantly reduced by about a quarter among women with more than 12 months of OCP or injectables use.ConclusionThe use of hormonal contraceptives is associated with lower odds of anaemia.

ESTIMATION OF BIRTHS AVERTED DUE TO BREAST-FEEDING AND INCREASES IN LEVELS OF CONTRACEPTION NEEDED TO SUBSTITUTE FOR BREAST-FEEDING

2003 ◽  
Vol 35 (4) ◽  
pp. 559-574 ◽  
Author(s):  
STAN BECKER ◽  
SHEA RUTSTEIN ◽  
MIRIAM H. LABBOK
Keyword(s):  
Burkina Faso ◽  
Breast Feeding ◽  
Contraceptive Use ◽  
The Other ◽  
Interval Length ◽  
Birth Intervals ◽  
Feeding Duration ◽  
Sub Saharan ◽  
Dhs Surveys ◽  
Very High

After contraceptive use, breast-feeding duration is the major determinant of the birth interval length. Three methods of estimating births averted by breast-feeding, and the increase in contraceptive use needed to substitute for breast-feeding, are presented. Method 1 simply utilizes Bongaarts’ Ci, and the other two are based on mean birth intervals with and without breast-feeding. Estimates for each method are derived for six countries with DHS surveys from the mid-1990s: Burkina Faso, Uganda, India, Indonesia, Brazil and Peru. The estimated percentage of additional births that would occur if there were no breast-feeding ranged from 1–4% in Brazil to about 50% in Burkina Faso and Uganda, reflecting very low breast-feeding in Brazil and very high levels in the sub-Saharan African nations. Strengths and limitations of the three methods are considered.

scholarly journals The Crucial Role of Mothers and Siblings in Child Survival: Evidence From 29 Health and Demographic Surveillance Systems in Sub-Saharan Africa

Demography ◽  
2021 ◽  
Vol 58 (5) ◽  
pp. 1687-1713
Author(s):  
Philippe Bocquier ◽  
Carren Ginsburg ◽  
Ashira Menashe-Oren ◽  
Yacouba Compaoré ◽  
Mark Collinson
Keyword(s):  
Child Mortality ◽  
Birth Interval ◽  
Child Survival ◽  
Sub Saharan Africa ◽  
Surveillance Systems ◽  
Birth Intervals ◽  
Sub Saharan ◽  
Demographic Surveillance Systems ◽  
Older Sibling

Abstract A considerable body of research has studied the effects of siblings on child mortality through birth intervals. This research has commonly focused on older siblings. We argue that birth intervals with younger siblings may have equal or stronger effects on child mortality, even during a mother's pregnancy. Moreover, we contend that birth interval effects need to be considered only when siblings are coresident. Using longitudinal data from 29 Health and Demographic Surveillance Systems across sub-Saharan Africa, covering more than 560,000 children, we examine the proximate role of siblings and mothers in child mortality. We find that a birth interval of 24 months or more is advantageous for both older and younger siblings. The effect of a younger sibling on child mortality is more pronounced than that of an older sibling and adds to the effect of an older sibling. Moreover, child mortality is particularly low during a mother's subsequent pregnancy, contrasting the shock resulting from a younger sibling's birth. Further, we find that a mother's or sibling's absence from the household results in a higher risk of mortality, and the death of either reduces child survival up to six months before the death.

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