Prevalence and risk factors of short birth interval in Bangladesh: Evidence from the linked data of population and health facility survey

Abstract

The Sustainable Development Goals 3 targets significant reductions in maternal and under-five deaths by 2030. The prevalence of these deaths is significantly associated with short birth intervals (SBI). Identification of factors associated with SBI is pivotal for intervening with appropriate programmes to reduce occurrence of SBI and associated adverse consequences. This study aimed to determine the factors associated with SBI in Bangladesh. A total of 5,941 women included in the 2017/18 Bangladesh Demographic and Health Survey 2017/18 and 1,524 healthcare facilities included in the 2017 Bangladesh Health Facility were linked and analysed. The sample was selected based on the availability of the birth interval data between the two most recent subsequent live birth. SBI was defined as an interval between consecutive births of 33 months or less, as recommended by the World Health Organization and was the outcome variable. Several individual-, households-, and community-level factors were considered as exposure variables. We used descriptive statistics to summarise respondents’ characteristics and multilevel Poisson regression to assess the association between the outcome variable with exposure variables. Around 26% of live births occurred in short intervals, with a further higher prevalence among younger, uneducated, or rural women. The likelihoods of SBI were lower among women aged 20–34 years (PR, 0.14; 95% CI, 0.11–0.17) and ≥35 years (PR, 0.03; 95% CI, 0.02–0.05) as compared to the women aged 19 years or less. Women from households with the richest wealth quintile experienced lower odds of SBI (PR, 0.61; 95% CI, 0.45–0.85) compared to those from the poorest wealth quintile. The prevalences of SBI were higher among women whose second most recent child died (PR, 5.23; 95% CI, 4.18–6.55), those who were living in Chattogram (PR, 1.52; 95% CI, 1.12–2.07) or Sylhet (PR, 2.83, 95% CI, 2.08–3.86) divisions. Availability of modern contraceptives at the nearest healthcare facilities was 66% protective to the occurrence of SBI (PR, 0.34; 95% CI, 0.22–0.78). Also, the prevalence of SBI increased around 85% (PR, 1.85; 95% CI, 1.33–2.18) for every kilometer increase in the distance of nearby health facilities from women’s homes. Targeted and tailored regional policies and programmes are needed to increase the awareness of SBI and associated adverse health outcomes and availability of modern contraception in the healthcare facilities.

Spatio-temporal pattern of short birth interval and associated factors on women in Ethiopia: Using Ethiopian demographic and health surveys 2000–2016

“…The prevalence of SBI among mothers who lost their index child was higher compared to women whose index child was alive for all EDHS years (2000–2016). This finding was consistent with evidence from studies conducted in Bangladesh ( 20 , 21 ) that found that the experience of a child dying at birth in a woman’s second recent pregnancy was a significant predictor of SBI. The mother’s education level significantly influenced the SBI of women.…”

Rural–urban disparities in birth interval among women of reproductive age in Nigeria

“…Women who have information about short birth intervals through any media channel are expected to have a better understanding of the negative impact of short birth intervals on maternal and children's health. As a result, women who have no exposure to any media are more likely to experience short birth intervals than those who have media exposure 28,29 . Whereas all the zones in the country except North-west were associated with high odds of having a short birth interval at the national level and rural areas, only south-east and south-south were significantly associated with high odds of having short birth interval among urban residents.…”

Association between maternal high-risk fertility behaviour and perinatal mortality in Bangladesh: evidence from the Demographic and Health Survey

“…Improving the uptake of maternal and postnatal healthcare services are also key to the prevention of neonatal and infant mortality. Access to family planning services and use of contraception, including access to contraception at the post-partum period, should also be ensured, particularly among the disadvantaged and unaware population where occurrence of birth in short interval is very higher 16,42 . Existing health problems, including maternal undernutrition and anaemia, are required to be addressed properly.…”