BIRTH SPACING AND CHILD HEALTH IN CORE NORTHERN NIGERIA

Abstract

Short birth interval is known to adversely affect infant and childhood mortality, and also can impede childhood nutrition repletion in low-income settings like Nigeria. The effects of the length of time between pregnancies on subsequent childhood morbidity and childhood mortality require careful assessment. Short birth spacing has been shown to be related to poor child health. The Northern region in Nigeria is characterized with the highest; childhood mortality, high fertility and undernourished children. Unfortunately, immunization is lowest in the core North among all regions in Nigeria. This study was designed to access birth spacing pattern and relationship between birth spacing and child health in core north Nigeria. The Nigeria Demographic and Health Survey (NDHS) 2013 data was utilized in this study. Data were extracted from the complete child dataset and with focus on 17,353 women resident in core north Nigeria. The key independent variable is the length of the preceding birth interval measured as the number of months between the most recent birth and the immediately preceding birth to the mother. The birth spacing pattern was assessed among the women who have had at least a child. The dataset was weighted and analyzed using descriptive statistics and Chi-square. Further analyses were carried out using binary logistic regression, cox regression and brass model. The level of significance was set at 5%. The mean age of the women was 28.79±7.29 and median birth interval was 31.0 months. Prevalence of short birth interval (less than 24 months) was highest among the Muslim women. The percentage of women who left about 36-59 months interval before the birth of index child was highest among the women with higher education. About 24.4% of the women in core north left between 36-59 months interval before their last birth. The prevalence of complete childhood immunization was 20.4% and it was highest among those who left 36-59 months interval before their most recent birth. About 40% of the children in the core north were stunted and underweight and the prevalence were highest among the children who had preceding birth interval of less than 24 month (42.4% and 31.4% respectively). The percentage of women who had lost at least a child was highest among respondents who left less 24 months interval before their most recent birth (16.1 %). The likelihood of stunting and underweight were. 0.20 (CI=0.73-0.89; P<0.001) and 0.13 (CI=0.79-0.96; P<0.001) times lesser among children who had preceding birth interval of 36-59 months than those who had less than 24 months. Short birth spacing was common among women in NE and NW Nigeria and the level of childhood mortality was high. In addition, the immunization coverage was low. The identified predictors of birth spacing were; contraceptive use, education, duration of breast-feeding, wealth index residence and age of mothers. Government should intensify more efforts in programmes and frameworks aim at reducing childhood mortality and improving immunization coverage in core North Nigeria. Poor nutritional status of the children in the core north region needs urgent attention.