Modeling successive birth interval of women in Ethiopia: application of parametric shared frailty and accelerated failure time model

Mustefa, Nuru Muhammed; Belay, Denekew Bitew

doi:10.1186/s12905-021-01190-y

Cited by 7 publications

(8 citation statements)

References 17 publications

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“…The region where mothers are living has also a substantial effect on recurrent birth in which the risk of recurrent birth in Afar and Oromia was lower by 34.3% and 26.4% respectively than the risk of recurrent birth of mothers in the Tigray region. These findings were supported by a study in [21] that revealed that there is a considerable birth difference across regions. A study reported in overall sub-Saharan Africa [22], Muslim mothers had a higher likelihood of recurrent birth as compared to non-Muslim mothers.…”

Section: Discussionsupporting

confidence: 60%

“…The estimated risk of recurrent birth of mothers from the rural area was lower than 11.5% of the estimated risk of recurrent birth of mothers from the urban area and it is supported by [23], the significant recurrent birth not only between urban and rural areas but also between zones. In contrast, a study finding in [21] reported that as compared to single mothers, the mothers whose marital status was divorced, widowed/ separated, and married had a longer birth interval, and the effect of mothers' current marital status on recurrent birth events was null.…”

Section: Discussionmentioning

confidence: 84%

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Exploring and modeling recurrent birth events in Ethiopia: EMDHS 2019

Tesfaw

Muluneh

2022

BMC Pregnancy Childbirth

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Background Globally, the estimated recurrent childbirth of one forth of women happens every two years or fewer. Next to Nigeria, Ethiopia is the second populist country in Africa and the first populist country in sub-Saharan Africa which consists of over 114 million population. There are prevalent short successive birth intervals problems in underdeveloped nations such as Ethiopia that contributes to adverse effects on mother and child health. However, studies that explore recurrent birth events and associated factors are very limited. Thus, this study aimed to explore and model the recurrent birth event by considering its subsequent within a mother and identifying its important determinants. As a result, the research findings of this study will be one of the preliminary research papers on the recurrent birth events that take into account the subsequent event and enable to be input for the policymakers, health institutions, and future researchers. Methods A total of 4676 mothers with their 16833 corresponding children were involved in this study. The data was obtained from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). In this study, extended cox regression models such as Andersen-Gill (AG), Prentice, Williams, and Peterson total time (PWP-TT) model, PWP-gap time (PWP-GT) model, and Frailty model were employed. These all models are used to consider recurrent events within mothers and determine the potential determinants. AG, PWP-TT, and PWP-GT estimate the effect of covariates by considering the correlation between event times for a person can be explained by past events given the covariates, kth event since the entry time, kth event since the time from the previous event, respectively. Results Among mothers who have first and ninth recurrent birth events, 75.5% and 80.1% of them respectively were rural residents while 57.6% and 70.6% of them respectively were a place of delivery in the health sector. The highest prevalence of first recurrent births (44.3%) was obtained from Muslim mothers. Mothers' education level (HR: 1.210; 95%CI: 1.010, 1.460), mothers' age at first birth (HR: 0.713; 95% CI: 0.614, 0.828), household wealth index (HR: 0.776; 95% CI: 0.625, 0.965), child mortality (HR: 0.673; 95%CI: 0.514, 0.881), household size (HR: 1.914; 95%CI:1.539,2.381) and sex of child (HR:0.836; 95%CI = 0.755,0.926) were important determinants of recurrent birth event. This indicates mothers’ education level and household size were positively associated with recurrent birth events. Whereas mothers’ age at first birth, household wealth index, child mortality, and sex of the child was negatively associated with recurrent birth events. Conclusion The WHO recommends a minimum of 33 months between two consecutive births, which is longer than the Ethiopian recurrent birth intervals observed in this study. The highest recurrent birth occurred during the age of fewer than twenty years old of mothers at first birth as compared to mothers whose age was older at first birth. Mothers, children, and household characteristics had significant effects on recurrent birth events. We authors would like to recommend communities, governmental and non-governmental stakeholders consider the associated factors of frequent recurrence of birth noticed in this study. Besides, we would also like to recommend women start birth while they got mature in age to reduce frequent recurrent birth and its corresponding adverse effects.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 84%

Exploring and modeling recurrent birth events in Ethiopia: EMDHS 2019

Tesfaw

Muluneh

2022

BMC Pregnancy Childbirth

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“…This consistency might be because of that in this study adequate number of observations are incorporated. Like the study findings20 21 in the wealth index, contraceptive use had a significant effect on birth intervals. In this study, it was perceived that as compared with the birth intervals of mothers from a household with higher economic status, the birth intervals of mothers from a household with lower economic status had lower birth intervals.…”

Section: Discussionsupporting

confidence: 72%

Discrepancies of recurrent birth intervals using longitudinal data analysis in Ethiopia: interim EDHS 2019

2022

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ObjectiveThis study aimed to determine whether the birth interval changes differently over time among women in Ethiopia and whether the change depends on women, children and household characteristics measured at the last visit.MethodsLongitudinal study design was implemented based on the data obtained from the 2019 Ethiopia Mini Demographic and Health Survey consisting of a total of 3630 mothers. Generalised estimating equation and generalised linear mixed model were employed to estimate the effect of the determinants given the correlation between birth intervals within a mother is under consideration.ResultsThe majority of women were Muslims (48.1%) and come from rural areas (82.2%). About 77.2% of women at first birth were below 20 years old. A significant correlation (p value<0.0001) between the first and second birth intervals of mothers was observed. The estimated birth interval of women from the poorest household was 0.877 (e−0.1317) times the estimated birth intervals of women from the richest household. This indicates richest households were likely to have higher birth intervals as compared with the poorest households (95% CI e−0.1754=0.839 to e−0.088=0.916).ConclusionThe birth intervals of over one-fifth of mothers were 1 year, less than the birth interval recommended by the WHO standard. It was also perceived that successive birth intervals are correlated. Mothers who have delivered female children had lower birth intervals than mothers who have delivered male children. As compared with the birth intervals of mothers from a household with higher economic status, the birth intervals of mothers from a household with lower economic status had lower birth intervals. In this study, significant effects of religion, contraceptive use, region, mothers’ current age, education level and mothers’ current marital status on birth intervals were also noted.

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“…Ultimately, formulating an effective family planning strategy requires an understanding of reproductive patterns and behaviors to ensure optimum birth spacing. 22 …”

Section: Introductionmentioning

confidence: 99%

“…Ultimately, formulating an effective family planning strategy requires an understanding of reproductive patterns and behaviors to ensure optimum birth spacing. 22 In Ethiopia, increasing the birth interval to at least 2 years reduced infant mortality by half. 23 Over the last 20 years, there has been no substantial change in the median birth interval, whereas the average birth interval has grown slightly but steadily.…”

Section: Introductionmentioning

confidence: 99%

Determinants of short birth interval among ever married reproductive age women living in Jigjiga, Eastern Ethiopia 2020 (unmatched case–control study)

et al. 2021

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Objectives: A short birth interval is a universal public health problem resulting in adverse maternal, neonatal, and child outcomes. Therefore, the aim of this study was to identify determinants of short birth interval among ever married reproductive age mothers who live in Jigjiga city administration, Eastern Ethiopia, 2020. Methods: A community-based unmatched case–control study was used among 194 cases and 194 controls in Jigjiga city administration from September to December 2020. Cases were women with short birth interval (less than 3 years) and controls were women with optimum birth interval (3–5 years). Simple random sampling technique was employed to select cases and controls. Data were entered into Epi data version 4.2 and analysis with SPSS version 22. Binary logistic regression with 95% confidence interval at p < 0.05 is used to declare significantly associated predictors of short birth interval. Result: This study reported that women who have not attended formal education (adjusted odds ratio = 5.28, 95% confidence interval: (2.25–12.36)), attended primary education (adjusted odds ratio = 2.79, 95% confidence interval: (1.46–5.34)), women who married to a polygamous husband (adjusted odds ratio = 3.69, 95% confidence interval: (1.80–7.58)), having a history of neonatal death (adjusted odds ratio = 2.15, 95% confidence interval: (1.07–4.32)), preceding child being female (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)), and never used contraceptive methods (adjusted odds ratio = 3.69, 95% confidence interval: (2.02–6.72)) were identified as determinants of the short birth interval. Conclusion: Short birth intervals were associated with educational level of the women, sex of the baby, husband marriage types, history of neonatal death, and contraceptive utilization. Strategy should be engaged to enhance women education, contraceptive uses, and to decrease neonatal death.

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Modeling successive birth interval of women in Ethiopia: application of parametric shared frailty and accelerated failure time model

Cited by 7 publications

References 17 publications

Exploring and modeling recurrent birth events in Ethiopia: EMDHS 2019

Exploring and modeling recurrent birth events in Ethiopia: EMDHS 2019

Discrepancies of recurrent birth intervals using longitudinal data analysis in Ethiopia: interim EDHS 2019

Determinants of short birth interval among ever married reproductive age women living in Jigjiga, Eastern Ethiopia 2020 (unmatched case–control study)

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