Birth Interval Research Articles

Determinants of short birth interval among married multiparous women in Chinaksen district, eastern Ethiopia: a case-control study.

The short birth interval is a common public health issue that affects women's and children's health in sub-Saharan Africa. Despite a higher burden of short birth intervals reported in Ethiopia, there is limited evidence to indicate the primary risk factors, particularly in rural eastern Ethiopia. Therefore, this study assessed the determinants of the short birth interval among married multiparous women in Chinaksen district, Eastern Ethiopia. A community-based case-control study was conducted among randomly selected 210 cases and 210 controls from April 01 to June 30, 2019. The total sample size (219 cases and 219 controls) were calculated using Epi-Info software version 7.2. Data were entered using EpiData version 3.1 and analyzed using SPSS version 27, and multivariable logistic regression analyses conducted to identify the determinants of short birth intervals. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was used to report the strength of association and statistical significance declared at p-value < 0.05. The women in the young age group (AOR = 2.33, 95% CI: 1.03, 5.26), missed their antenatal care visits (AOR = 2.23, 95% CI: 1.18, 4.21), failed to utilize postpartum contraceptives (AOR = 5.98, 95% CI: 3.62, 9.89), did not attend postnatal care visit (AOR = 1.86, 95% CI: 1.13, 3.05), nonexclusive breastfed (AOR = 4.05, 95% CI: 2.18, 7.52), short and medium period of breastfeeding (AOR = 4.00, 95% CI: 1.34, 12.10) and (AOR = 3.56, 95% CI: 1.62, 7.82), respectively and female sex of preceding child (AOR = 1.92, 95% CI: 1.18, 3.12) were the important risk factors of short birth interval. Women's age, antenatal care visits, postnatal care attendance, utilization of postpartum contraceptives, exclusive breastfeeding practice, duration of breastfeeding, and sex of the preceding child were the primary predictors of short birth intervals. Improving the utilization of maternal healthcare services in health facilities would be imperative to prevent and reduce short birth intervals, and its negative consequences.

Grandmother effects over the Finnish demographic transition.

Demographic transitions are defining events for human societies, marking shifts from natural mortality and fertility rates to the low rates seen in industrialised populations. These transitions can affect trait evolution through altering the direction and strength of selection when variance in fertility and mortality decline. One key feature of human evolution is the evolution of extended post-reproductive life through indirect fitness benefits from grandmothering. Although studies in pre- and post-transition societies have documented beneficial grandmother presence, it remains unknown whether these associations changed before, during, or after the transition. Here, we use genealogical data from eighteenth- to twientieth-century Finland to show grandmother-associated changes of two measures of evolutionary fitness (grandchild survival and birth rate) over the transition. We find that grandmothers had greater opportunity to help as the transition progressed, but their effect on grandchild survival declined alongside general mortality rates, implying that selection on lifespan from grandmothering declined too. Whilst grandmother presence was still associated with reduced birth intervals and hence more grandchildren born post-transition, the nature of this relationship changed greatly. This suggests that although potential for intergenerational interactions increased over the demographic transition, the (hypothesised) evolutionary importance of these interactions declined, which reduced selection for extended post-reproductive lifespan.

Effects of feeding a negative dietary cation and anion difference diet to twin-bearing Merino ewes in late gestation on parturition outcomes.

In Australia, dystocia is responsible for 53% of lamb mortalities, and calcium deficiencies may be a contributing factor. A negative dietary cation-anion difference (DCAD) diet can increase calcium concentrations in sheep. Therefore, this study aimed to investigate the effects of a negative DCAD diet on metabolic state, mineral status, and parturition duration in ewes compared with those fed a positive DCAD diet. At approximately day 130 of gestation (dG), 71 twin-bearing ewes were placed in the following treatment groups; ewes receiving a positive DCAD TMR (total mixed ration; DCAD of total diet = 281.8 mEq/kg DM; n = 35) and twin-bearing ewes receiving a negative DCAD TMR (DCAD of total diet = -89.0 mEq/kg DM; n = 36). Urine and blood were sampled on dG 130, 140, and 145, and blood was also sampled at the onset of parturition and 4h postpartum. Urine was analyzed for pH and blood was analyzed for metabolites, mineral concentration, and acid-base balance. Lambs' liveweight, rectal temperature, blood glucose and lactate, and body morphology were measured. Serum phosphate concentrations at dG 145 were significantly lower for negative DCAD ewes compared with positive DCAD ewes (1.9 ± 0.1 vs. 2.1 ± 0.1 mmol/L, P = 0.047). Ionized calcium (P = 0.09) and serum magnesium (P = 0.09) prepartum were marginally greater in the negative DCAD ewes (1.35 ± 0.06 and 1.06 ± 0.03 mmol/L, respectively) compared with the positive DCAD ewes (1.18 ± 0.08 and 0.98 ± 0.04 mmol/L, respectively). Urine pH was lower in the negative DCAD ewes compared with positive DCAD ewes at both dG 140 (7.38 ± 0.17 vs. and 8.10 ± 0.19. P = 0.01) and dG 145 (and 7.20 ± 0.19 vs. 8.25. P < 0.01). The birth interval between the first the second-born lamb was shorter in the negative DCAD ewes compared with the positive DCAD ewes (P = 0.02), but no differences in lamb survival or lamb viability (P > 0.05) were seen. The negative DCAD diet reduced parturition duration, most likely due to the marginally greater ionized calcium and magnesium concentrations. Despite this improvement, the negative DCAD ewes did not reach urinary acidification, indicating that the marginally significant greater ionized calcium and serum magnesium concentrations were due to the magnesium in the diets and not metabolic acidosis. Further research testing a negative DCAD diet that can achieve the target urine pH is required to determine whether this diet can decrease parturition duration and improve lamb viability.

Effects of Farrowing Induction on Some Farrowing Characteristics in the Pig − A Review

Abstract Several farrowing induction programs have been used to increase the proportion of sow farrowing during the work period and the rate of farrowing supervision, as well as to promote the success of cross-fostering and the practice of all-in all-out in swine production. The present overview aimed to evaluate the effects of farrowing induction on farrowing duration, birth interval, birth weight, dystocia/birth assistance, and stillbirth in pigs. The results showed that via different routes of administration, either natural or synthetic prostaglandins alone or in combination mostly with uterotonic drugs, including oxytocin and carbetocin, have been used for the induction of farrowing. Sometimes other drugs, such as dexamethasone, estradiol, xylazine, ergometrine, and AGN190851, were added. Vulvar and perinatal routes reduced the intramuscular dose of prostaglandins by 50% to 75%, while equal effects remained. A split dose of prostaglandin 6 h apart should be used because it may enhance complete luteolysis. Additionally, if uterotonic drugs are used following prostaglandin injection, they should be injected after the birth of the first piglets at the earliest timepoint to ensure full opening of the cervix. These two practices decrease the farrowing duration, the birth interval, and dystocia. Induction should not be conducted more than 2 days earlier than the expected farrowing date in order to keep the stillbirth rate and birth weight unaltered. This review also revealed that certain factors, such as the rate of farrowing supervision, natural differences in piglets’ birth weights, litter size, gestation length, and treatment with altrenogest before induction, may be confounding factors that possibly alter the effect of induction programs on certain farrowing characteristics.

Geographical variation in hotspots of stunting among under-five children in Ethiopia: A geographically weighted regression and multilevel robust Poisson regression analysis.

Childhood stunting is a global public health concern, associated with both short and long-term consequences, including high child morbidity and mortality, poor development and learning capacity, increased vulnerability for infectious and non-infectious disease. The prevalence of stunting varies significantly throughout Ethiopian regions. Therefore, this study aimed to assess the geographical variation in predictors of stunting among children under the age of five in Ethiopia using 2019 Ethiopian Demographic and Health Survey. The current analysis was based on data from the 2019 mini Ethiopian Demographic and Health Survey (EDHS). A total of 5,490 children under the age of five were included in the weighted sample. Descriptive and inferential analysis was done using STATA 17. For the spatial analysis, ArcGIS 10.7 were used. Spatial regression was used to identify the variables associated with stunting hotspots, and adjusted R2 and Corrected Akaike Information Criteria (AICc) were used to compare the models. As the prevalence of stunting was over 10%, a multilevel robust Poisson regression was conducted. In the bivariable analysis, variables having a p-value < 0.2 were considered for the multivariable analysis. In the multivariable multilevel robust Poisson regression analysis, the adjusted prevalence ratio with the 95% confidence interval is presented to show the statistical significance and strength of the association. The prevalence of stunting was 33.58% (95%CI: 32.34%, 34.84%) with a clustered geographic pattern (Moran's I = 0.40, p<0.001). significant hotspot areas of stunting were identified in the west and south Afar, Tigray, Amhara and east SNNPR regions. In the local model, no maternal education, poverty, child age 6-23 months and male headed household were predictors associated with spatial variation of stunting among under five children in Ethiopia. In the multivariable multilevel robust Poisson regression the prevalence of stunting among children whose mother's age is >40 (APR = 0.74, 95%CI: 0.55, 0.99). Children whose mother had secondary (APR = 0.74, 95%CI: 0.60, 0.91) and higher (APR = 0.61, 95%CI: 0.44, 0.84) educational status, household wealth status (APR = 0.87, 95%CI: 0.76, 0.99), child aged 6-23 months (APR = 1.87, 95%CI: 1.53, 2.28) were all significantly associated with stunting. In Ethiopia, under-five children suffering from stunting have been found to exhibit a spatially clustered pattern. Maternal education, wealth index, birth interval and child age were determining factors of spatial variation of stunting. As a result, a detailed map of stunting hotspots and determinants among children under the age of five aid program planners and decision-makers in designing targeted public health measures.

Multi-Level Mixed-Effects Analysis of Stunting Among 6 to 59 Months Children in Ethiopia: Evidenced from Analysis of Health and Demographic Survey, 2000 to 2019

Background. Stunting remains a major public health issue in developing countries like Ethiopia. It is termed as a chronic malnutrition which leads to morbidity and mortality among children. This study aimed to assess the prevalence and factors associated with stunting among 6 to 59 months children in Ethiopia. Methods. A total weighted sample of 34 930 children aged 6 to 59 months was included in this study. A Multilevel Mixed-Effect logistic regression was carried out. The Median Odds Ratio (MOR) and the Intra class Correlation Coefficient (ICC) were calculated. An adjusted odds ratio along with a 95% confidence interval was reported and statistical significance was declared at a P-value ≤ .05. Results. The weighted prevalence of stunting in Ethiopia was 48.3% (95% CI: 47.8%, 48.8%). Being male, increased in age, having multiple births (twin), having less than 2 years birth interval, history of diarrhea, anemia, lack of maternal and paternal formal education, having poor and middle-wealth status, and living in rural areas were significantly associated with stunting. Conclusions. The prevalence of stunting is high in Ethiopia. The risk factors mentioned above increase the likely hood of stunting among children. Therefore, we recommend that responsible bodies place a greater emphasis and priority on promoting parental education, awareness on the impact of the birth interval on child nutrition, the prevention of childhood diarrhea and anemia, improving household economic status, and reducing rural-urban disparities.

"Twenty-five years of Progress of Neonatal Deaths in Bangladesh: An Analysis of the Bangladesh Demographic and Health Surveys 1993-2018"

Bangladesh has experienced a reduction in neonatal mortality by degrees from 52 deaths per 1,000 live births in 1994 to 30 deaths per 1,000 live births in 2018. While the country is expecting to attain the sustainable development goals target 3.2 related to neonatal deaths by 2030; the slower reduction of neonatal mortality might appear as a key challenge. This study aims to analyze the trend of neonatal mortality for the last 25 years and identify the underlying determinants of such unexpected deaths. To analyze the trend of neonatal mortality Bangladesh Demographic and Health Survey (BDHS) for the survey years of 1993-2018 data has been used. Both bivariate and multilevel regression analyses have been used focusing on the main objective of the study. The study demonstrates that the risk of neonatal death reduces with the mother’s age and birth interval. Additionally, sex of the child and birth order were significantly associated with neonatal deaths for all survey years (p &lt; 0.001). According to this study, newborn mortalities are more common in rural areas than in urban areas. Despite a downward trend that was shown from 1993 to 2018, it can be concluded that the neonatal death reduction rate is substantially slower. If the current rate of progress continues, it is unlikely that Bangladesh will meet the SDG target by 2030. Strong initiatives are needed to minimize newborn mortalities, to meet the Sustainable Development Goals (SDG) objective of 12 per 1000 live births.

Effectiveness of an Interactive Mobile Health Intervention (IMHI) to enhance the adoption of modern contraceptive methods during the early postpartum period among women in Northeast Ethiopia: A cluster Randomized Controlled Trial (RCT).

Women in the early postpartum period face substantial unmet needs in contraception to encourage birth intervals and reduce unintended pregnancies. The widespread ownership of mobile devices offers an opportunity to employ mobile health strategies for enhancing communication between healthcare providers and clients. However, little is known about the effectiveness of mobile health interventions to improve early adoption of contraceptive methods after childbirth in Ehiopia. This study aimed to evaluate the effectiveness of a mobile health intervention in enhancing the uptake of modern contraceptive methods in the early postpartum period in Dessie and Kombolcha cities, northeast Ethiopia. The research was conducted in Dessie and Kombolcha cities zones located in the Amhara region of Northeast Ethiopia from 15th January to 15th June, 2023. Pregnant women with a confirmed gestation of 30 weeks were enrolled and followed up to the 45-day postpartum period. The study employed a cluster randomized control trial involving 764 participants (381 controls and 383 in the intervention group). The intervention group received a new mobile health intervention in addition to the existing healthcare practices, while the control group solely adhered to the current healthcare practices. Data were collected using the Open Data Kit (ODK) and exported to STATA 17 for analysis. The marginal model Generalized Estimating Equations (GEE) through the application of an exchangeable working correlation was applied. The effect of the intervention on the outcome was measured using the odds ratio with a 95% confidence interval at a p-value less than 0.05 significant level. The study found that 78.7% of participants in the control group and 77.3% in the intervention group had sexual practice after childbirth. The proportion of early postpartum contraceptive uptake in the intervention group (51.6%) was significantly higher than in the control group (38%). The odds of adopting modern contraceptive methods during the early postpartum period were 1.6 times higher among mothers who received the mHealth intervention compared to those in the control group (AOR: 1.6, 95% CI: 1.249-2.123). The study identified significant predictors for the uptake of contraceptive methods during the early postpartum period, including having a live newborn (AOR: 3.7, 95% CI: 1.034-13.353), parity (AOR: 1.7, 95% CI: 1.069-2.695), and previous experience with contraceptive initiation (AOR: 0.5, 95% CI: 0.358-0.912). This study findings demonstrated that the potential effectiveness of mobile health interventions in promoting timely contraceptive adoption during early postpartum period. The mobile health intervention, combined with factors such as timing of previous contraceptive initiation, newborn status, and maternal parity, significantly enhances the likelihood of early contraceptive adoption. These nuanced insights provide a strong foundation for developing targeted health interventions and policies aimed at improving early postpartum contraception. The trial was registered on December 23, 2022, in the Protocol Registration and Results System (PRS) Clinical Trial Registry, www.ClinicalTrials.gov, ID: ClinicalTrials.gov ID: NCT05666037.

Determinants of the First Birth Interval Among Women in India.

The first-birth interval after a marriage indicates the reproduction behavior of women and influences the population's birth rates and size. The present study assesses predictors of the interval between marriage and first childbirth in India. The study employed the Cox proportional hazard model and Kaplan Meier Survival plot based on the data collected from 79,787 ever-married women in the 15-49 age group from the National Family Health Survey 2019-2021. The median age of marriage to the first birth interval was 23 months in India. The older marriage cohort had longer birth intervals than the younger. The hazard ratios (HR) showed that the risk of first birth after marriage was much higher among women with higher education (HR= 2.05, 95% confidence interval (CI) = 1.98-2.11) than women without education. Women in urban areas (HR=1.22, 95% CI = 1.20-1.25) had a higher risk of first birth after marriage earlier than women from rural areas. Women from North-east (HR=1.14, 95% CI=1.10-1.18) and South (HR=1.15, 95% CI=1.12-1.19) had a higher risk of having their first birth earlier after marriage than women in the North region. The women who married within 18-24 years of age had a 69 percent higher likelihood of first birth interval than those women who were married below the age of 18. The risk of first birth after marriage increased as women delayed marriage up to age 25 years and more (HR=3.18, 95% CI=3.02-3.35) than others. The timing of first birth was associated with the age at the first marital union, women's educational attainment, place of residence, region, economic status, exposure to mass media, contraception use, and history of pregnancy termination.

Danger Signs and 4T Risk Factors of Pregnant Women

The number of cases of maternal death in 2020 was 122, an increase of 25 cases compared to 2019, which was 97 cases of maternal death. The highest number of maternal death cases was in West Lombok district with 43 cases. The maternal mortality rate in NTB Province has increased from 93.92 per 100,000 live births to 119.05 per 100,000 live births. When compared with the performance achievements in the RPJMN, the NTB province is still below the national target. The 4T factors (too old, too young, too closely spaced between pregnancies and too many children) can increase cases of complications in the mother. Birth interval between one child and another child of less than 2 years can increase the risk of maternal death. Delivery at intervals of less than 24 months (too often) is a high-risk group for postpartum hemorrhage. This research aimed to determine the risk factors experienced by pregnant women so that prevention can be taken to prevent maternal death during childbirth. The research method used a quantitative analytical observational with a Focus Group Discussion (FGD) approach. The research results showed that pregnant women did not understand the danger signs and risk factors for 4T, so that pregnant women are able to take preventive measures. Apart from that, this research also provides anticipatory solutions so that pregnant women and their husbands can avoid further complications related to the risks of 4T. This research concludes that the understanding of pregnant women and their husbands regarding the danger signs and risks of 4T has increased so that they are able to know the mother's condition during pregnancy and are able to plan and have a healthy pregnancy.

Farrowing Induction in Swine with Prostaglandin: Effect on Farrowing Traits and Piglet Performance

The variation of gestation length in sows leads to difficulties performing farrowing supervision in commercial farms. The present study determined the efficacy of prostaglandin F2alpha (PGF2α) administration on induction of farrowing in pig. The sows (n=50) were randomly divided into two groups. In group-1, sows (n=25) were injected with placebo intramuscularly (one mL sterile water) on 113th day of gestation at 8.00 am in the morning. In group-2 (n=25), cloprostenol sodium (250 mcg) was injected intramuscularly on 113th day of gestation at 8.00 am in the morning. The parameters recorded during the experiment were gestation length, farrowing duration, total number of piglets born per litter (NTB), number of piglets born alive per litter (NBA), number of stillborn per litter, mummified foetuses per litter, birth interval (min), number of piglets alive at day 3 of lactation and piglet mortality (%) till day 3 of lactation. Gestation length was significantly (p&lt;0.05) shorter in Group-2 compared to Group-1. Similarly, the interval from PGF2α administration to onset of farrowing was significantly (p&lt;0.05) shorter as compared to natural farrowed sows. Farrowing duration did not differ significantly (p&gt;0.05) between two groups. There was no effect of PGF2α administration on NTB, NBA, stillbirths, mummified fetuses. The numbers of alive piglets at day 3 of lactation were also similar between two groups (p&gt;0.05). The PGF2α administration also resulted in increased proportion of sows that farrowed on day 114 of gestation. In conclusion, PGF2α administration on day 113 of gestation could be an option for controlled farrowing in sow without any adverse effects.

Characteristics of stunting in children in the Kintamani III Community Health Center area, Bangli District

Background: Stunting is a chronic physical growth disorder in children characterized by a decrease in growth rate and is influenced by nutritional imbalances over a long period with a WHO MGRS z-score value of less than -2 SD. This condition has a fairly high incidence rate in Indonesia, especially in Bangli, Bali, which is caused by various factors. This research was conducted to determine the characteristics of stunting in children in the Kintamani III Community Health Center area, Bangli district. Methods: We conducted a descriptive cross-sectional study from February to December 2022. The parameters assessed in this study are family income, maternal education, additional food, birth weight, history of infection, exclusive breastfeeding, high genetic potential, environmental sanitation, mother age, gender, and birth spacing. Data were analyzed with SPSS version 25.0 for Windows. Results: There were 70 children with stunting were involved in this research. The research subjects were mostly female (55.7%), the highest birth weight distribution was in the range of 2500-4000 grams (90%), there was no history of infection (88.6%), exclusive breastfeeding was given for 6 months or more ( 92.9%), birth interval more than or equal to 2 years (77.1%), additional food given 3 times a day (80%) which is higher in stunting population compare to severely stunting, average genetic potential height 159.36 + 8.03, mother's age 20-35 years (81.4%), maternal high school education (32.4%), family income above minimum wage (UMK) (87.1%). Conclusion: This research shows that patients with severe stunting tend to have a lower frequency of additional food.

Predictors of mortality among under-five children in rural Ethiopia: a cross sectional study

BackgroundUnder-five child mortality (UFCM) is one of the major significant and sensitive indicators of the health status of the public. Although the world has seen a remarkable and substantial decrease in UFCM since 1990, its progression rate still remains alarmingly high in Sub-Saharan African (SSA) countries, particularly in Ethiopia. Therefore, this study aimed to assess associations between mortality and under-five children in rural Ethiopia.MethodsThis study used a secondary data analysis of the 2019 Ethiopia Mini Demographic and Health Survey (EMDHS) report. A total of 4,425 under-five children were included in the final analysis. The Kaplan-Meier (K-M) and Cox proportional hazard (PH) model analyses were utilized to estimate survival time and investigate the major predictors of mortality in under-five children, respectively. An adjusted hazard ratio (AHR) along with a 95% confidence interval (CI) was employed to measure the association size and direction of the association (STATA 12).ResultsThe study showed that 6.2% (95% CI: 5.43, 6.86) of children died beforehand celebrating their fifth birthday in rural Ethiopia. The multivariable Cox PH regression model analysis revealed associations of large spacing preceding birth interval (16–26 months) (AHR = 0.61; 95% CI: (0.402–0.920)), 27–38 months (AHR = 0.72; 95% CI: (0.496–1.03)), and ≥ 39 months, multiple births (AHR = 3.9; 95% CI: (2.77–5.62)), being breastfeeding (AHR = 0.13; 95% CI: (0.099–0.162)), and unvaccinated child (AHR = 11.6; 95% CI: (1.62–83.1)) were significant associations of under-five children mortality.ConclusionsIn this study, the UFCM rate was present, with 6.2% in the rural areas of Ethiopia. The birth type, preceding birth interval, vaccination of the child, and breastfeeding are identified as significant associations with under-five child mortality in rural Ethiopia. Therefore, public health interventions should be given attention to multiple births, unvaccinated, and non-breastfeeding children, as well as mothers’ better encouragement to have a large spacing preceding the birth interval. Moreover, investigators should conduct continuous research on UFCM, which is imperative to provide current information and inform interventions in a timely manner.

Determinants of high-risk fertility behavior among women of reproductive age in Kenya: a multilevel analysis based on 2022 Kenyan demographic and health survey

BackgroundWomen’s high-risk fertility behavior (HRFB), which is characterized by narrow birth intervals, high birth order, and younger maternal age at birth, have been scientifically reported to have detrimental effects on the mother and child’s health. To date, there has been limited research into the underlying factors contributing to high-risk fertility behavior in Kenya. Thus, the aim of this study is to identify the factors associated with high-risk fertility behavior among women of reproductive age in Kenya.MethodThe 2022 Kenyan Demography and Health Survey data was used for the current study. This study included 15,483 women of reproductive age. To account for the clustering effects of DHS data and the binary nature of the outcome variable, a multilevel binary logistic regression model was applied. An adjusted odds ratio with a 95% confidence interval was reported to declare the statistical significance. In addition, the model that had the lowest deviance was the one that best fit the data.ResultsThe overall prevalence of HRFB among Kenyan women were 70.86% (95%CI = 69.96, 71.40). Women with primary, secondary, and higher educational levels, Protestant and Muslim religion followers, women whose husbands/partners had secondary and higher educational levels, a high household wealth index, ever had a terminated pregnancy, and rural residence, all of these factors were found to be strongly associated with high-risk fertility behavior.ConclusionAs per the findings of our study, in Kenya a significant proportion of women has experienced HRFB. This is a matter of concern as it poses a significant challenge to the healthcare system. The high prevalence of HRFB indicates that there is an urgent need to take appropriate measures in order to mitigate its impact. The situation calls for a comprehensive and coordinated approach involving all stakeholders to address this issue effectively. It would benefit policymakers to create programs that consider factors like education, wealth, and residence that make women more susceptible to HRFB. Targeting women living in high HRFB-prevalence areas could help address the root causes of the issue. This approach can alleviate negative impacts and ensure effective and sustainable solutions.

Community Groups Co-Design Evidence-Based Docudramas to Communicate About Child Spacing in Bauchi State, Nigeria: A Qualitative Descriptive Study.

In Bauchi State, northern Nigeria, communities recognise short birth interval (kunika in the Hausa language) as harmful, but family planning is a sensitive topic. This paper describes the development of a culturally safe way to communicate about kunika in a conservative Muslim setting. The objective was to co-design culturally safe communication material, based on local knowledge about short birth interval, to share with women and men in households.Six community co-design groups of women and six of men (total 96 participants) reviewed summaries of their previously created maps of perceived local causes of kunika, categorised as frequent sex, family dynamics and non-use of contraception. They advised how these causes could be discussed effectively and acceptably with women and their husbands in households and suggested storylines for three short video docudramas about the prevention of kunika. The research team created the docudramas with a local producer and fieldworkers piloted their use in households.The design groups advised that communication materials should focus on child spacing rather than on limitation of family size. Even sensitive issues could be covered. People would not change their sexual behaviour but could be advised to use contraceptives to prevent kunika. The groups approved the final videos and six focus groups of visited women and men reported they were acceptable and helpful. Community co-design of communication about kunika was feasible and led to videos about a sensitive topic that were acceptable to ordinary men and women in communities in Bauchi.

Knowledge and Practices of Breastfeeding among Mothers in Mechinagar

Although breastfeeding is a universal practice, it varies across social, economic, cultural, and educational variables in society. In this context, this paper explores knowledge and practices of breastfeeding among the mothers (N=132) in two culturally different groups, namely hill-origin and Tarai-origin, who live in Mechinagar, a village of the eastern Tarai of Nepal. This study was carried out based on mixed methods in which data were collected through Individual Survey (IS), Key Informant Interview (KII), and Focus Group Discussion (FGD). The findings of the study show that the knowledge of and behavior of breastfeeding among mothers are influenced and shaped by socio-demographic, cultural, and health-related factors, such as – caste and ethnic backgrounds, occupation, age, the birth interval between children, education, social belief, cultural values, etc. Consequently, the mother is not a homogeneous group, but rather a more diverse group that demands the concept of social heterogeneity for a better understanding of breastfeeding knowledge and behaviors in a diverse society. It will help to develop appropriate maternal educational programs to improve breastfeeding practices in society.

Association between adequacy of antenatal care and neonatal outcomes in Rwanda: a cross-sectional study design using the Rwanda demographic and health surveys

BackgroundMaternal and neonatal health services are life-saving interventions for neonatal health outcomes. As Rwanda endeavors to accomplish sustainable development goals, adequate ANC is essential to lessen of neonatal mortality. The utilization of ANC continues to be inadequate and high neonatal mortality rate persevere in Rwanda. Understanding the direct and indirect factors that affect newborn health outcomes is necessary for well-targeted interventions. However, few studies had been conducted in Rwanda to evaluate the importance of ANC in improving neonatal health. This study therefore assessed the association between ANC and neonatal outcomes.MethodsThe Demographic and Health Surveys (DHS) are household surveys that are cross-sectional, nationally representative, and used to collect data on population, health, and nutrition. Data from the 2010,2015 and 2020 Rwanda Demographic and Health Surveys (RDHS) were used. The study involved 17,747 women between the ages of 15 and 49 who had a single live birth and at least one ANC visit in five years prior to each survey. Bivariate and multivariable logistic regression, a survey adjusted for clusters at multiple level, and the estimation of adjusted odds ratios (aOR) and 95% confidence intervals were used to evaluate the relationship between the outcome and independent variables.ResultsOut of 17,747 women ;7638(42.91%) of the mothers had adequate ANC visits and low birth weight (LBW) was found among 833(4.63%) neonates. The birth of a LBW baby (aOR:4.64;95%CI:3.19,6.74) was directly related to increased odds of neonatal death. Mothers aged 20–34 years (aOR:0.40; 95%CI:0.20,0.81), a preceding birth interval of 24months or greater (aOR:0.41:95%CI:0.28,0.60), baby being female (aOR:0.72; 95%CI:0.54,0.96), having adequate ANC visits (aOR:0.64;95% CI:0.46,0.89) and the birth order of the newborn being ranked second or third (aOR:0.60; 95%CI:0.38,0.95) were negatively associated with neonatal death.ConclusionHealth education programs targeting teen and primigravida mothers should be encouraged. Among the newborn survival interventions, addressing short birth intervals and the effective management of LBW cases should be explored. The findings confirm the fundamental importance of adequate ANC in the neonatal survival.

High risk fertility behaviour and health facility delivery in West Africa

BackgroundEvidence suggests that women who give birth in a health facility have lower odds of experiencing pregnancy complications and significantly reduced risk of death from pregnancy-related causes compared to women who deliver at home. Establishing the association between high-risk fertility behaviour (HRFB) and health facility delivery is imperative to inform intervention to help reduce maternal mortality. This study examined the association between HRFB and health facility delivery in West Africa.MethodsData for the study were extracted from the most recent Demographic and Health Surveys of twelve countries in West Africa conducted from 2010 to 2020. A total of 69,479 women of reproductive age (15–49 years) were included in the study. Place of delivery was the outcome variable in this study. Three parameters were used as indicators of HRFB based on previous studies. These were age at first birth, short birth interval, and high parity. Multivariable binary logistic regression analysis was performed to examine the association between HRFB and place of delivery and the results were presented using crude odds ratio (cOR) and adjusted odds ratio (aOR), with their respective 95% confidence interval (CI).ResultsMore than half (67.64%) of the women delivered in a health facility. Women who had their first birth after 34 years (aOR = 0.52; 95% CI = 0.46–0.59), those with short birth interval (aOR = 0.91; 95% CI = 0.87–0.96), and those with high parity (aOR = 0.58; 95% CI = 0.55–0.60) were less likely to deliver in a health compared to those whose age at first delivery was 18-34 years, those without short birth interval, and those with no history of high parity, respectively. The odds of health facility delivery was higher among women whose first birth occurred at an age less than 18 years compared to those whose age at first birth was 18-34 years (aOR = 1.17; 95% CI = 1.07–1.28).ConclusionHRFB significantly predicts women's likelihood of delivering in a health facility in West Africa. Older age at first birth, shorter birth interval, and high parity lowered women’s likelihood of delivering in a health facility. To promote health facility delivery among women in West Africa, it is imperative for policies and interventions on health facility delivery to target at risk sub-populations (i.e., multiparous women, those with shorter birth intervals and women whose first birth occurs at older maternal age). Contraceptive use and awareness creation on the importance of birth spacing should be encouraged among women of reproductive age in West Africa.

The Impact of Childhood Mortality on Fertility in Rural Tanzania: Evidence From the Ifakara and Rufiji Health and Demographic Surveillance Systems

This manuscript examines the relationship between child mortality and subsequent fertility using longitudinal data on births and childhood deaths occurring among 15,291 Tanzanian mothers between 2000 and 2015. Generalized hazard regression analyses assess the effect of child loss on the hazard of conception, adjusting for child-level, mother-level, and contextual covariates. Results show that time to conception is most reduced if an index child dies during the subsequent birth interval, representing the combined effect of biological and volitional replacement. Deaths occurring during prior birth intervals were associated with accelerated time to conception during future intervals, consistent with hypothesized insurance effects of anticipating future child loss, but this effect is smaller than replacement effects. The analysis reveals that residence in areas of relatively high child mortality is associated with hastened parity progression, again consistent with the insurance hypothesis. Investigation of high-order interactions suggests that insurance effects tend to be greater in low-mortality communities, replacement effects tend to be stronger in high-mortality community contexts, and wealthier families tend to exhibit a weaker insurance response but a stronger replacement response to childhood mortality relative to poorer families.

“A STUDY OF MATERNAL FACTORS INFLUENCING VERY LOW BIRTH WEIGHT BABIES”

Background: In developed countries, because of improvement in health care facilities and increased funds spent for health ,the problem of VLBW has been reduced. But in developing countries like India, where lacunae in health care facilities and funds, the survival and long term complications of very low birth weight babies still remain the challenge. 1.To study Objectives: the inuence various maternal factors like age, parity, occupation, obstetric history etc on the outcome of birth weight babies. Materials And Methods: Study design: Study area: Prospective case control study Government general hospital, siddhartha medical college, vijayawada, Krishna district, Andhra pradesh. January 2019 to July 2019. All newborn babies with birth w Study period: Study population: eight &lt;1500 gms irrespective of gestational age Study consisted of 100 newborns (50 cases and 50 control Sample size: Sample method: s). Simple random sampling method. All newborns less than 1500 gms irrespective of gestational age, examined and det Study tools and data collection: ailed antenatal, natal history was obtained and recorded. The incidence of very low birth Results: weight newborn was found to be 2.08%, and the most common cause is preterm delivery. There is NO relation found between family structure, mother occupation, antenatal visits and incidence of very low birth weight. As the literacy rate of mothers increases, the weight of the baby increases. Birth weight of babies has Conclusion: signicant association with maternal factors like parity, birth interval and previous bad obstetric history. Literacy rate of mothers had a positive correlation.