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Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression
BACKGROUND: Despite the availability of exempted family planning services, a significant proportion of women in African countries continue to experience inadequately spaced pregnancies. To the authors’ knowledge, evidence of suboptimal birth intervals at the SSA level is lacking and previous studies...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476311/ https://www.ncbi.nlm.nih.gov/pubmed/37667285 http://dx.doi.org/10.1186/s12978-023-01678-w |
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author | Mare, Kusse Urmale Sabo, Kebede Gemeda Mohammed, Ahmed Adem Leyto, Simeon Meskele Mulaw, Getahun Fentaw Tebeje, Tsion Mulat Aychiluhm, Setognal Birara Ebrahim, Oumer Abdulkadir Wuneh, Abel Gebre Seifu, Beminate Lemma |
author_facet | Mare, Kusse Urmale Sabo, Kebede Gemeda Mohammed, Ahmed Adem Leyto, Simeon Meskele Mulaw, Getahun Fentaw Tebeje, Tsion Mulat Aychiluhm, Setognal Birara Ebrahim, Oumer Abdulkadir Wuneh, Abel Gebre Seifu, Beminate Lemma |
author_sort | Mare, Kusse Urmale |
collection | PubMed |
description | BACKGROUND: Despite the availability of exempted family planning services, a significant proportion of women in African countries continue to experience inadequately spaced pregnancies. To the authors’ knowledge, evidence of suboptimal birth intervals at the SSA level is lacking and previous studies have been limited to specific geographic area. Therefore, this analysis was aimed to estimate the pooled prevalence of suboptimal birth spacing and its predictors among childbearing women in SSA. METHODS: Pooled DHS data from 35 SSA countries were used and a weighted sample of 221,098 reproductive-age women was considered in the analysis. The survey across all countries employed a cross-sectional study design and collected data on basic sociodemographic characteristics and different health indicators. Forest plot was used to present the overall and country-level prevalence of suboptimal birth spacing. Multilevel mixed-effects models with robust Poisson regression were fitted to identify the predictors of suboptimal birth spacing. Akaike’s and Bayesian information criteria and deviance were used to compare the models. In a multivariable regression model, a p-value less than 0.05 and an adjusted prevalence ratio with the corresponding 95% CI were used to assess the statistical significance of the explanatory variables. RESULTS: The pooled prevalence of suboptimal birth spacing among women in SSA was 43.91% (43.71%-44.11%), with South Africa having the lowest prevalence (23.25%) and Chad having the highest (59.28%). It was also found that 14 of the 35 countries had a prevalence above the average for SSA. Rural residence [APR (95% CI) = 1.10 (1.12–1.15)], non-exposure to media [APR (95% CI) = 1.08 (1.07–1.11)], younger maternal age [APR (95% CI) = 2.05 (2.01–2.09)], non-use of contraception [APR (95% CI) = 1.18 (1.16–1.20)], unmet need for family planning [APR (95% CI) = 1.04 (1.03–1.06)], higher birth order [APR (95% CI) = 1.31 (1.28–1.34)], and desire to have at least six children [APR (95% CI) = 1.14 (1.13–1.16)] were the predictors of suboptimal birth spacing practice. CONCLUSION: More than four out of ten reproductive-age women in SSA countries gave birth to a subsequent child earlier than the recommended birth spacing, with considerable variations across the countries. Thus, interventions designed at enhancing optimal birth spacing should pay particular attention to young and socioeconomically disadvantaged women and those residing in rural regions. Strengthening community health programs and improving accessibility and availabilities of fertility control methods that ultimately impacts optimal reproductive behaviors is crucial to address contraceptive utilization and unmet need. |
format | Online Article Text |
id | pubmed-10476311 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-104763112023-09-05 Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression Mare, Kusse Urmale Sabo, Kebede Gemeda Mohammed, Ahmed Adem Leyto, Simeon Meskele Mulaw, Getahun Fentaw Tebeje, Tsion Mulat Aychiluhm, Setognal Birara Ebrahim, Oumer Abdulkadir Wuneh, Abel Gebre Seifu, Beminate Lemma Reprod Health Research BACKGROUND: Despite the availability of exempted family planning services, a significant proportion of women in African countries continue to experience inadequately spaced pregnancies. To the authors’ knowledge, evidence of suboptimal birth intervals at the SSA level is lacking and previous studies have been limited to specific geographic area. Therefore, this analysis was aimed to estimate the pooled prevalence of suboptimal birth spacing and its predictors among childbearing women in SSA. METHODS: Pooled DHS data from 35 SSA countries were used and a weighted sample of 221,098 reproductive-age women was considered in the analysis. The survey across all countries employed a cross-sectional study design and collected data on basic sociodemographic characteristics and different health indicators. Forest plot was used to present the overall and country-level prevalence of suboptimal birth spacing. Multilevel mixed-effects models with robust Poisson regression were fitted to identify the predictors of suboptimal birth spacing. Akaike’s and Bayesian information criteria and deviance were used to compare the models. In a multivariable regression model, a p-value less than 0.05 and an adjusted prevalence ratio with the corresponding 95% CI were used to assess the statistical significance of the explanatory variables. RESULTS: The pooled prevalence of suboptimal birth spacing among women in SSA was 43.91% (43.71%-44.11%), with South Africa having the lowest prevalence (23.25%) and Chad having the highest (59.28%). It was also found that 14 of the 35 countries had a prevalence above the average for SSA. Rural residence [APR (95% CI) = 1.10 (1.12–1.15)], non-exposure to media [APR (95% CI) = 1.08 (1.07–1.11)], younger maternal age [APR (95% CI) = 2.05 (2.01–2.09)], non-use of contraception [APR (95% CI) = 1.18 (1.16–1.20)], unmet need for family planning [APR (95% CI) = 1.04 (1.03–1.06)], higher birth order [APR (95% CI) = 1.31 (1.28–1.34)], and desire to have at least six children [APR (95% CI) = 1.14 (1.13–1.16)] were the predictors of suboptimal birth spacing practice. CONCLUSION: More than four out of ten reproductive-age women in SSA countries gave birth to a subsequent child earlier than the recommended birth spacing, with considerable variations across the countries. Thus, interventions designed at enhancing optimal birth spacing should pay particular attention to young and socioeconomically disadvantaged women and those residing in rural regions. Strengthening community health programs and improving accessibility and availabilities of fertility control methods that ultimately impacts optimal reproductive behaviors is crucial to address contraceptive utilization and unmet need. BioMed Central 2023-09-04 /pmc/articles/PMC10476311/ /pubmed/37667285 http://dx.doi.org/10.1186/s12978-023-01678-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Mare, Kusse Urmale Sabo, Kebede Gemeda Mohammed, Ahmed Adem Leyto, Simeon Meskele Mulaw, Getahun Fentaw Tebeje, Tsion Mulat Aychiluhm, Setognal Birara Ebrahim, Oumer Abdulkadir Wuneh, Abel Gebre Seifu, Beminate Lemma Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression |
title | Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression |
title_full | Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression |
title_fullStr | Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression |
title_full_unstemmed | Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression |
title_short | Suboptimal birth spacing practice and its predictors among reproductive-age women in Sub-Saharan African countries: a multilevel mixed-effects modeling with robust Poisson regression |
title_sort | suboptimal birth spacing practice and its predictors among reproductive-age women in sub-saharan african countries: a multilevel mixed-effects modeling with robust poisson regression |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10476311/ https://www.ncbi.nlm.nih.gov/pubmed/37667285 http://dx.doi.org/10.1186/s12978-023-01678-w |
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