Socioeconomic inequality in short birth interval in Ethiopia: a decomposition analysis

Desalegn Markos Shifti,Catherine Chojenta,Deborah Loxton,Elizabeth G. Holliday

doi:10.1186/s12889-020-09537-0

Abstract

BackgroundShort birth interval, defined as a birth-to-birth interval less than 33 months, is associated with adverse maternal and child outcomes. Evidence regarding the association of maternal socioeconomic status and short birth interval is inconclusive. Factors contributing to the socioeconomic inequality of short birth interval have also not been investigated. The current study assessed socioeconomic inequality in short birth interval and its contributing factors in Ethiopia.MethodsData from 8448 women collected in the 2016 Ethiopia Demographic and Health survey were included in the study. Socioeconomic inequality in short birth interval was the outcome variable. Erreygers normalized concentration index (ECI) and concentration curves were used to measure and illustrate socioeconomic-related inequality in short birth interval, respectively. Decomposition analysis was performed to identify factors explaining the socioeconomic-related inequality in short birth interval.ResultsThe Erreygers normalized concentration index for short birth interval was − 0.0478 (SE = 0.0062) and differed significantly from zero (P < 0.0001); indicating that short birth interval was more concentrated among the poor. Decomposition analysis indicated that wealth quintiles (74.2%), administrative regions (26.4%), and not listening to the radio (5.6%) were the major contributors to the pro-poor socioeconomic inequalities in short birth interval.ConclusionThere was a pro-poor inequality of short birth interval in Ethiopia. Strengthening the implementation of poverty alleviation programs may improve the population’s socioeconomic status and reduce the associated inequality in short birth interval.

Highlights

Health inequality is defined as a systematic difference in health across individuals or according to socially relevant groupings such as between more and less advantaged groups [1,2,3]
Unlike the aforementioned previous studies [30,31,32,33] performed in Ethiopia, the current study aims to answer the following research questions: “what type of socioeconomic inequality in short birth interval is observed in Ethiopia, and what are the factors contributing to any observed socioeconomic inequality?”
There was a pro-poor inequality of short birth interval in Ethiopia

Summary

Introduction

Health inequality is defined as a systematic difference in health across individuals or according to socially relevant groupings such as between more and less advantaged groups [1,2,3]. Socioeconomic inequalities in health and health-related outcomes are common in developing countries [5,6,7], where the poor are disproportionately affected. As a result, addressing health inequality has become a top priority intervention area for international organizations such as the World Health Organization (WHO) [8, 9], the United Nations Development Programme [10], and the World Bank [11]. One of the Sustainable Development Goals (SDGs) set by the United Nations (i.e., Goal 10) aims to reduce inequality within and among countries [12, 13]. Evidence regarding the association of maternal socioeconomic status and short birth interval is inconclusive. Factors contributing to the socioeconomic inequality of short birth interval have not been investigated. The current study assessed socioeconomic inequality in short birth interval and its contributing factors in Ethiopia

Objectives

Methods

Results

Discussion

Conclusion