Short birth spacing and its association with maternal educational status, contraceptive use, and duration of breastfeeding in Ethiopia. A systematic review and meta-analysis.

Mastewal Arefaynie,Bezawit Adane,Bereket Kefale,Yitayish Damtie,Mohammad Rifat Haider,Melaku Yalew

doi:10.1371/journal.pone.0246348

Abstract

Closely spaced birth increases the risk of adverse maternal and child health outcomes. In Ethiopia, the prevalence of short birth spacing was highly variable across studies. Besides, contraceptive use, educational status, and duration of breastfeeding were frequently mentioned factors affecting short birth spacing. Therefore, this meta-analysis aimed to estimate the pooled prevalence of short birth spacing and its association with contraceptive use, educational status, and duration of breastfeeding among reproductive-age women in Ethiopia. International databases: Google Scholar, PubMed, CINAHL, Cochrane library, HINARI, and Global Health were searched systematically to identify articles reporting the prevalence of short birth spacing and its association with contraceptive use, educational status, and duration of breastfeeding among reproductive-age women in Ethiopia. The data were analyzed by STATA/SE version-14 statistical software. The random-effect model was used to estimate the pooled prevalence of short birth spacing and the log odds ratio was used to determine the association. Moreover, egger's test and I-squared statistics were used to assess publication bias and heterogeneity respectively. After reviewing 511 research articles, a total of nine articles with 5,682 study participants were included in this meta-analysis. The pooled prevalence of short birth spacing in Ethiopia was 46.9% [95% CI: (34.7, 59.1)]. Significant heterogeneity was observed between studies (I2 = 98.4, p <0.001). Not using contraceptives [OR = 3.87, 95% CI: (2.29, 6.53)] and duration of breastfeeding < 24 months [OR = 16.9, 95%CI: (2.69, 106.47)] had a significant association with short birth spacing. Although a minimum inter-pregnancy interval of two years was recommended by the World Health Organization (WHO), significant numbers of women still practiced short birth spacing in Ethiopia. Duration of breastfeeding and non-use of contraceptives were factors significantly associated with short birth spacing. So, efforts should be made to improve breastfeeding practice and contraceptive utilization among women in Ethiopia.

Highlights

Maternal mortality remains the major public health challenge to the global population
The pooled prevalence of short birth spacing in Ethiopia was 46.9% [95% CI: (34.7, 59.1)]
A minimum inter-pregnancy interval of two years was recommended by the World Health Organization (WHO), significant numbers of women still practiced short birth spacing in Ethiopia

Summary

Introduction

Maternal mortality remains the major public health challenge to the global population. Reports indicated that an estimated 303,000 maternal deaths occurred worldwide and among this, 99% of deaths were from developing countries [1]. The recent national health survey data showed that an estimated 412 maternal deaths per 100,000 live births occurred in Ethiopia [4]. Like many other developing countries, short birth spacing is the problem of Ethiopian in which 41.5% of women practiced short birth spacing [14]. Contraceptive use, educational status, and duration of breastfeeding were frequently mentioned factors affecting short birth spacing This meta-analysis aimed to estimate the pooled prevalence of short birth spacing and its association with contraceptive use, educational status, and duration of breastfeeding among reproductive-age women in Ethiopia

Methods

Results

Conclusion