Barriers to Adherence of Optimal Birth Spacing: A Qualitative Study among Mothers and their Husbands in Arba Minch Zuria District, Ethiopia

Abstract

Background: Optimal birth spacing plays a critical role in promoting perinatal health. However, in Ethiopia, many women still have shorter birth intervals than they would prefer and studies done to assess knowledge of couples were scarce. The objective of this study therefore was to assess perceived knowledge of couples about the disadvantage of short birth intervals in Arba Minch Zuria district, Ethiopia.Methods: Qualitative study design was conducted from February to April 2014 among women having at least two consecutive live births. Purposive sampling was employed to select information rich participants. Data were collected through focus group discussions using a semi-structured flexible discussion guide. Sixteen FGDs were conducted involving a total of 128 participants. Data were entered in to open code software and analyzed thematically.Result: Perceived disadvantage of short birth spacing, ultimate decision maker about birth intervals and reasons for experiencing short birth spacing were the major themes emerged from the discussion. Perceived knowledge of focus group discussants about the disadvantages of short birth pacing was very high. Ultimate decision maker about birth spacing were couples in the optimal spacers groups. On the other hand, husbands had the right to say the final word among discussants that had short birth intervals. Index child being female, husband & religious influences, fear of side effects of contraceptive, lack of information about the benefit contraceptives, and inaccessibility of reproductive health services were noted as reasons to experience short birth spacing.Conclusion: Perceived knowledge of discussants was similarly high in both short and optimal birth spacers. The main reasons for experiencing short birth spacing were, husband influence, fear of side effects of contraceptives, lack of information about the benefits of contraceptives, and geographical inaccessibility of reproductive health care services. For women to achieve optimal birth spacing, they need the support of their significant family members. Hence, behavioral change communications should target all of those who have a direct or indirect influence on birth spacing decisions. Moreover, the district in collaboration with other stallholders needs to work hard to make reproductive health service accessible in all aspects.

Modern contraceptive utilization and associated factors among married pastoralist women in Bale eco-region, Bale Zone, South East Ethiopia

“…And this finding coincides with the findings reported by various other researchers from different community contexts who frequently reported discussion among couple was decisive to women’s contraceptive use [16, 17, 19, 24, 25]. And this could be due to either both women and men need encouragement from partners to apply their knowledge to their own situation or women and men who were reluctant to apply their understanding may need support from someone who had a close relationship with them.…”

“…This could be due to the reality that factors which influence modern contraceptive utilization by pastoralist women are multifaceted and challenging, which results in a continued higher fertility rate and unwanted pregnancy particularly in pastoralist communities which intern affects the health of mothers and children [5, 10]. Though several studies reported that the use of contraceptive service is determined by socio-demographic, socio-cultural, socio-economic, and the source of family planning information and service [6, 10, 12–17], evidences on the predictors of modern contraceptive method utilization are scarce and not well known in the context of pastoralist women in the study area. Therefore the current study was conducted with the intent to assess modern contraceptive method utilization and its determinants among married women in pastoralist communities of the Bale Eco-region (BER); so that the study findings will contribute to the development of context-specific strategies and family planning programs in pastoralist communities.…”

<p>Determinants of Sub-Optimal Birth Spacing in Gedeo Zone, South Ethiopia: A Case–Control Study</p>

“…22 Geographical inaccessibility of reproductive health care services was also reported as one of the major barriers to adherence to optimal birth spacing in a qualitative study conducted in Arbaminch district. 32 A similar finding was also reported in studies conducted in India. 25,33 Having information on birth spacing and contraception was found to be a statistically significant determinant of suboptimal birth spacing.…”

“…Lack of information about the benefit of contraceptives and fear of side effects of contraceptives was reported as one of the reasons to practice short inter-birth intervals in Arba Minch Zuria district. 32 Higher fertility was also reported among women who did not know their fertility period. 28…”

Associated factors of pregnancy spacing among women of reproductive age Group in South of Iran: cross-sectional study

“…In a study conducted in India, there was a relation between son child preference and smaller pregnancy spacing [ 16 ]. There was another similar result that showed women with boy child in their first delivery, tended to have longer interval up to their next pregnancy [ 20 ]. Longer duration of breast feeding is found to have a significant relation with longer pregnancy spacing.…”