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Determinants of Short Birth Interval among Married Women of Child Bearing Age in Becho Woreda, South West Showa Zone, Oromia region, Ethiopia

Abdurehman Kalu Tololu, Jemal Edris

A longer interval between consecutive births has a greater advantage in reducing abortions, complication related to unsafe abortion and unwanted pregnancies and also improves children's development by improving the nutritional status of the preceding child [1]. Studies show that when the length of time between two births in a family is less than two years, the newborn, on average, is twice as likely to die in infancy as might a child born after a long birth-interval and babies born after a three-to-four year interval has the best chances of survival [2]. Ethiopia is the second most populous country in Africa with a total fertility rate of 4.6 (2.3 for Urban and 5.2 for rural) for which a high proportion of reproductive age women (58%) were illiterate in Africa [3]. With this very low literacy rate, the contraceptive prevalence of Ethiopia is about only 35% however; currently, there is improvement in total fertility rate (TFR) reduced from 5.8 in 2000 to 4.6 in 2016. World Health Organization technical consultation on birth spacing recommended inter birth interval of at least 33 months before a women deliver the next child [4]. The hypothetical causal mechanisms which explains the association between short inter-birth intervals and adverse outcomes were: maternal nutritional depletion, foliate depletion, cervical insufficiency, vertical transmission of infections, suboptimal lactation related to breastfeeding–pregnancy overlap, sibling competition, transmission of infectious diseases among siblings, incomplete healing of uterine scar from previous cesarean delivery, and abnormal remodeling of endometrial blood vessels [5]. According to data from Ethiopian Demographic and Health Survey of 2016, children born less than two years after the preceding birth were 2.5 times more likely to die within the first year of life and within the first five years of life compared to children born three years after the preceding birth [6]. In general, previously conducted studies in different parts of developing and developed countries have proved that short birth intervals have an impact on maternal and child health. However, few studies conducted to assess factors contributing to a short birth interval in Ethiopia have some limitations. For instance, almost all the previous studies measured the duration of birth interval. This could not identify the contributing factors of short birth interval [7]. In addition, this specific study area also lacks information on determinants of birth interval, which is not addressed well for further intervention. In addition, understanding the practice of birth interval and its determinants is helpful to design evidence-based strategies for interventions in this study area. Understanding factors which influence women inter birth interval is critical for countries like Ethiopia with a population policy aiming at reducing fertility.