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The effect of child death on birth spacing in Nigeria.

Authors
  • Ewemade, Jude1
  • Akinyemi, Joshua1, 2
  • DeWet, Nicole1
  • 1 Demography and Population Studies Programme, Schools of Social Sciences and Public Health, University of the Witwatersrand, Johannesburg, South Africa. , (South Africa)
  • 2 Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria. , (Niger)
Type
Published Article
Journal
Journal of Biosocial Science
Publisher
Cambridge University Press
Publication Date
May 01, 2020
Volume
52
Issue
3
Pages
330–337
Identifiers
DOI: 10.1017/S0021932019000464
PMID: 31293229
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Studies have focused on the effect of short birth spacing on childhood mortality, yet very little attention has been paid to the possibility of an inverse relationship such that child mortality might also positively or negatively affect birth spacing. In Nigeria, where both fertility and child mortality are high, this inverse relationship is a possible reason for the country's high fertility. The objective of this study was to examine the effect of child death on time to birth of the next child. Data were drawn from the 2013 Nigerian Demographic Health Survey. The study sample comprised 188,986 live births born to women aged 15-49 years within the five years preceding the survey. A multivariate Cox proportional hazard regression model was fitted to the data, and hazard ratios with 95% confidence intervals calculated. More than half of the mothers (68%) already had a next birth by 36 months after the death of the index child. Controlling for other covariates, the Cox regression model showed that the likelihood of next birth was higher when the index child had died compared with when the index child survived (HR: 2.21; CI: 2.03-2.41). Sub-group analysis by geo-political regions in Nigeria showed that in all regions there was a higher likelihood of having a next birth following the death of a preceding child. Death of the index child was found to be a major factor that shortens the length of birth intervals in Nigeria. It is therefore important that the Government of Nigeria intensifies efforts aimed at reducing infant mortality and encouraging adequate birth spacing.

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