- Title
- Short birth interval in Ethiopia: spatial variations, determinants, and its impact on child undernutrition and mortality
- Creator
- Shifti, Desalegn Markos
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2022
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Birth interval is defined as the duration of time elapsing between two live births to the same mother, with an inter-birth interval of less than 33 months considered to be a short birth interval. Birth interval is viewed as an important and modifiable risk factor for adverse birth, child, and maternal health outcomes, such as preterm birth, low birth weight, labor dystocia, and preeclampsia. Although short birth interval is common in most low and middle income countries, its geographic variations, and determinants, including socioeconomic inequalities, have not been well understood in Ethiopia. In addition, evidence regarding the impact of short birth interval on child undernutrition and mortality has been inconclusive. Therefore, the purpose of this thesis was to investigate the spatial variations, determinants, socioeconomic inequalities, and child health outcomes of short birth interval in Ethiopia. Data from a nationally representative survey, the 2016 Ethiopia Demographic Health Survey (EDHS), was used in this thesis. The 2016 EDHS was the 4th nationally representative cross-sectional survey aimed to provide estimates at the national level, urban and rural areas, and for each of the 9 regions and 2 administrative cities. The survey employed two-stage stratified cluster sampling and collected data from all women aged 15-49 years and all men aged 15-59 years in the selected households. Spatial analyses, multilevel modeling, and concentration index analysis were performed to identify the geographic variations, determinants, and the socioeconomic inequality of short birth interval. Generalized structural equation modeling and inverse probability of treatment weights were applied to identify the impact of short birth interval on child undernutrition and mortality, respectively. Significant geographic variation in short birth interval rates were identified in Ethiopia. Individual level factors, such as maternal age at first marriage, husbands’ education and occupation, and the number of children, were associated with increased odds of short birth interval. Community level factors that predicted the odds of short birth interval were female illiteracy, distance to health facilities, region, and place of residence (urban/rural). There was a pro-poor inequality of short birth interval in Ethiopia. The effects of short birth interval included stunting and underweight, and neonatal, infant, and under-five mortality. Short birth interval varies by geographic area, is determined by multiple factors, and is disproportionately concentrated among the poor in Ethiopia. Short birth interval has a significant effect on child undernutrition and mortality. Targeted and multifaceted intervention approaches supported by policy initiatives are required to prevent short birth interval. Child undernutrition and mortality prevention program development should consider the prevention of short birth interval as one of their intervention components.
- Subject
- short birth interval; spatial analyses; infant mortality; under-five mortality; inverse probability of treatment weights; propensity scores; Ethiopia; thesis by publication; determinants; multilevel mixed effect logistic regression; socioeconomic inequality; concentration index analysis; decomposition analysis; undernutrition; Generalized Structural Equation Modeling (GSEM); neonatal mortality
- Identifier
- http://hdl.handle.net/1959.13/1507439
- Identifier
- uon:56021
- Rights
- Copyright 2022 Desalegn Markos Shifti
- Language
- eng
- Full Text
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 9 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 312 KB | Adobe Acrobat PDF | View Details Download |