Length Of Preceding Birth Interval Research Articles

Statistical Modelling and Evaluation of Determinants of Child Mortality in Nyanza, Kenya

One of the Millennium Development Goals is the reduction of infant and child mortality by two-thirds of 1990 mortality levels by 2015. Generally, significant progress has been made in reducing mortality in children under five years of age. The global under-five mortality rate declined by 59 per cent, from 93 deaths per 1,000 live births in 1990 to 38 in 2019. In Kenya, the infant mortality rate in 2021 is 32.913 deaths per 1000 live births, a 3.36 per cent decline from 2020. In 2020 it was 34.056 deaths per 1,000 live births, a drop of 3.24 per cent from the year 2019. In Kenya, Nyanza Province has the highest infant mortality rate (133 deaths per 1,000 live births) and the lowest in Central Province (44 deaths per 1,000 live births). Despite this advancement, the world still needs to achieve that Millennium Development Goal, target number four, of reducing child mortality. This study aims at identifying vital risk factors affecting child mortality in Kenya. The paper's main objective is to determine the effect of socioeconomic and demographic variables on child mortality in the presence of dependencies in clusters. We then did a logistic regression and tested the proportionality of the significant covariates. Then, performed a Stratified Cox regression model and, finally, a shared frailty model in survival analysis based on data from the Kenya Demographic and Health Survey (KDHS 2014), which was collected using questionnaires. Child mortality from the KDHS 2014 data was analyzed in an ageing period: mortality from the age of 12 months to the age of 60 months, referred to as "child mortality". The study reveals that clusters (households), maternal age at birth, preceding birth interval length and the number of births in the last five years significantly impacted child mortality.

A comprehensive analysis on child mortality and its determinants in Bangladesh using frailty models

BackgroundBangladesh has experienced a significant reduction of child mortality over the past decades which helped achieve the Millennium Development Goal 4 (MDG 4) target. But the mortality among under-5 aged children is still relatively high and it needs a substantial effort to achieve the Sustainable Development Goal (SDG) target and decelerate the current rate of under-5 mortality. At this stage, it is hence important to explore the trend and determinants of under-5 mortality in order to reduce the vulnerability of child’s survival. The aim of this study is to explore the trends and identify the factors associated with mortality in children aged less than 5 years in Bangladesh.MethodsData from three repeatedly cross-sectional Bangladesh Demographic and Health Surveys (BDHSs) for the year 2007, 2011 and 2014 were used. A stratified two-stage sampling method was used to collect information on child and maternal health in these surveys. Cox’s proportional hazards models with community and mother level random effects (or frailty models) were fitted to identify the associated factors with under-five mortality.ResultsOur study reveals that urban-rural disparity in child mortality has decreased over the time. The frailty models revealed that the combined effect of birth order and preceding birth interval length, sex of the child, maternal age at birth, mother’s working status, parental education were the important determinants associated with risk of child mortality. The risk of mortality also varied across divisions with Sylhet division being the most vulnerable one. Moreover, significant and sizable frailty effects were found which indicates that the estimations of the unmeasured and unobserved mother and community level factors on the risk of death were substantively important.ConclusionOur study suggests that community-based educational programs and public health interventions focused on birth spacing may turn out to be the most effective. Moreover, unobserved community and familial effects need to be considered along with significant programmable determinants while planning for the child survival program.

A systematic review and meta-analysis of the effect of short birth interval on infant mortality in Ethiopia.

IntroductionEven though Ethiopia has been celebrating the achievements of MDG 4, still one in every 17 Ethiopian children dies before their first birthday. This is the biggest of the African regional average. Short birth interval is inconsistently reported as a risk factor by limited and independent studies in Ethiopia. Therefore, the purpose of this meta-analysis was to determine the pooled effect size of the preceding birth interval length on infant mortality.MethodsStudies were accessed through the electronic web-based search mechanism from PUBMED, Advanced Google Scholar, WHO databases and journals: PLOS ONE, and BMC, using independent and combinations of key terms. Comprehensive meta-analysis version 2 was used to analyze the data. An I2 test was used to assess heterogeneity. Funnel plot and statistical significance by Egger’s test of the intercept was used to check publication bias. The final estimate was determined in the form of odds ratio by applying Duval and Tweedie’s trim and fill analysis in the Random-effects model.Results872 studies were identified on the reviewed topic. During screening, forty-five studies were found to be relevant for data abstraction. However, only five studies fulfilled the inclusion criteria and were included in the analysis. In all of the studies included in the analysis, the preceding birth interval had a significant association with under-one mortality. The final pooled estimate in the form of the odds ratio for infant mortality with a preceding birth interval of less than 24 months was found to be 2.03 (95% CI: 1.52, 2.70, random effect (five studies, n=43,909), I2=70%, P<0.05).ConclusionIn Ethiopia, promoting the length of birth interval to at least two years lowered under-one mortality by 50% (95% CI: 35%, 63%).

Short Birth Intervals Less than 2 Years Double Under-One Mortality in Ethiopia: Evidence from a Meta- Analysis

Introduction: Even though Ethiopia has been celebrating the achievements of MDG 4, still one in every 17 Ethiopian children dies before their first birthday. This is the biggest of the African regional average. Short birth interval has been inconsistently reported as a risk factor by limited and independent studies in Ethiopia. Therefore, the purpose of this meta-analysis was to determine the pooled effect of the preceding birth interval length on under- one mortality. Methods: Studies were accessed through the electronic web-based search mechanism from PUBMED, Advanced Google Scholar, WHO databases and journals: PLoS one, BMC using independent and combination of key terms. Comprehensive meta-analysis version 2 was used to analyze the data. An I2 test was used to assess heterogeneity. Publication bias was checked by using a funnel plot and the statistical significance by Egger’s test of the intercept. The final effect size was determined in the form of odds ratio by applying Duval and Tweedie's trim and fill analysis in the Random-effects model. Results: 872 studies were identified on the reviewed topic. During screening, forty five studies were found to be relevant for data abstraction. However, only five studies fulfilled the inclusion criteria and included in the analysis. In all of the studies included in the analysis, the preceding birth interval had a significant association with under-one mortality. The final pooled effect size in the form of the odds ratio for under one mortality with a preceding birth interval of less than 24 months was found to be 2.03(95%CI: 1.52, 2.70,random effect(five studies, n=43,909), I2=70%, P<0.05). Conclusion: In Ethiopia, promoting the length of birth interval to at least two years was associated with the reduction of under one mortality by 50% (95%CI: 35%, 63%). Endorsement of family planning services at postpartum period by improving access and quality is highly recommended.

Infant Mortality and its Determinates in Uttar Pradesh, India

The effects of socio-economic and demographic variables play significant role in infant mortality in less developed states in India. The deleterious effect on infant survival of reduced birth spacing is exacerbated in states such as Uttar Pradesh where economic development is limited. The determinants of infant mortality in developing countries can be classified under two major headings: socioeconomic and demographic. Socio-economic determinants include mother education, place of residence, mother caste and religion; demographic variables include sex and birth order of the child, maternal age at birth, birth interval [1]. For infant mortality, traditional societies, the demographic factors have more impact than the socioeconomic factors. From the NFHS-III, aggregate deaths reported at ages 0-12 are used to estimate infant mortality. The differentials by socioeconomic and demographic variables are examined and then their importance is assessed using binomial logistic regression. Data analysis shows that preceding birth interval length, birth order are the most important factors associated with differential infant mortality risks; sex of the index child and mothers education and their place of residence are also significant. With the aim of updating the earlier findings, the present paper examines whether there have been any changes in the factors explaining differentials in infant mortality in Uttar Pradesh.

Birth intervals, breastfeeding and determinants of childhood mortality in Malawi

Childhood mortality in Malawi is analyzed by employing proportional hazards models. The analysis uses highly reliable data collected from the 1992 Demographic and Health Survey (DHS) of Malawi. The results show that the substantial birth interval and maternal age effects are largely limited to the infant period. The influence of social and economic variables on the mortality risk and on the relationship between biodemographic variables and mortality risk is much enhanced with increasing age of the child. It has also been found that consideration of breastfeeding status of the child does not significantly alter interpretation of effects of preceding birth interval length on mortality risk, but does partially diminish the succeeding birth interval effect. The results are discussed and then summarized in the context of policy implications for Malawi. The paper addresses a very important issue in Malawi and it adds valuable insights to the base of knowledge in childhood mortality in sub-Sahara Africa.

Infant and child mortality determinants in Bangladesh: are they changing?

From the data of the 1989 Bangladesh Fertility Survey, aggregate deaths reported at ages 0-12 and 13-60 months are used to estimate infant and child mortality. Multivariate analysis shows that preceding birth interval length, followed by survival status of the immediately preceding child, are the most important factors associated with differential infant and child mortality risks; sex of the index child and mother's and father's education are also significant. Demographic factors are influential during infancy as well as childhood, but social factors, particularly mother's and father's education, now emerge as significant predictors of infant mortality risks. This indicates a change in the role of socioeconomic factors, since the earlier Bangladesh Fertility Survey in 1975.

Child survival and its effect on mortality of siblings in Bangladesh

This study of the relationship between mortality risks of siblings born to the same mother shows that, in Bangladesh, the death of the immediately preceding sibling in its infancy has a negative influence on the survival chance of the child in question in its infancy; however, death of the preceding sibling appears to have a positive influence on the index child's survival at ages 1-5 years. Similar results are found for the survival status of the two preceding siblings. Preceding birth interval length and survival status and sex of the immediately preceding sibling are also significant predictors of child mortality between ages 1 and 5 years. Possible explanations may be that the index child faces stronger competition from its immediately preceding brother than from its immediately preceding sister, or that the index child is likely to be looked after more by its preceding sister than by its preceding brother.