Department of Health informatics, College of Health Sciences, Mettu University, P.O.Box:318, Mettu, Ethiopia.
Department of Health informatics, School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia.
BMC Pregnancy Childbirth. 2023 Apr 22;23(1):275. doi: 10.1186/s12884-023-05610-9.
Short Birth Interval negatively affects the health of both mothers and children in developing countries. Studies conducted in Ethiopia on the spatial variation and determinants of individual and community-level factors about short birth intervals were limited. Thus, this study was intended to assess the spatial variation of the short birth interval and its determinants in Ethiopia.
This study is a secondary analysis of the Ethiopian Demographic and Health Survey (mini EDHS 2019). A total of 1784 reproductive-age women were included in the analysis. The global spatial autocorrelation (Global Moran's I) and the Getis-Ord statistics tool were used to detect the presence of clustering and the high/low hotspot areas of SBI respectively. Ordinary kriging was used to interpolate short birth intervals, and spatial scan statistics were employed to identify spatial clusters with high and low SBI. A multilevel multivariable model was used to identify predictors of a short birth interval.
The prevalence of SBI was 62.89% (95%CI: 59.3, 69.7) in Ethiopia. High clustering of SBI was observed in all parts of Somali, in Afar (zones 1, 3, 4, &5), Oromia (Guje, Bale, & West Harerge), and northern Tigray. The most likely significant primary cluster was observed in the Somali region. Women who lived in the primary cluster were 24% more likely to have a short birth interval than those who lived outside the window. In the multilevel mixed-effect analysis age 25-34 [(AOR = 0.40, 95% CI: 0.35, 0.45)], 35-49 [(AOR = 0.44, 95% CI: 0.38, 0.51)], Muslim religion follower [(AOR = 3.5, 95% CI: 2.7, 4.69)], no formal education [(AOR = 0.5, 95% CI: 0.37, 0.70)], primary education[(AOR = 0.4, 95%CI: 0.28, 0.53)], and secondary education [(AOR = 0.3, 95% CI: 0.24, 0.48)], middle [(AOR: 1.3, 95% CI: 1.2, 1.52)], rich wealth status [(AOR: 1.4, 95% CI: 1.3, 1.68)], female sex children [(AOR: 1.2, 95% CI: 1.09, 1.42)], and two or fewer ideal number of children [(AOR = 0.2, 95% CI: 0.25, 0.32)] were found to be significant predictors of SBI.
Overall, SBI was high and significantly clustered across the region of Ethiopia. Age, religion, education, wealth status, the sex of the indexed child, and the ideal number of children were found to be significantly associated with short birth intervals. Hence, the government should design a health promotion strategy and public health awareness in the identified hotspot areas of SBI and should scale up family planning and the wealth status of reproductive-age women.
短生育间隔会对发展中国家的母婴健康产生负面影响。在埃塞俄比亚，关于短生育间隔的个体和社区层面因素的空间变异及其决定因素的研究有限。因此，本研究旨在评估埃塞俄比亚短生育间隔的空间变异及其决定因素。
本研究是对埃塞俄比亚人口与健康调查（迷你 EDHS 2019）的二次分析。共纳入 1784 名育龄妇女进行分析。采用全局空间自相关（全局 Moran's I）和 Getis-Ord 统计工具分别检测 SBI 的聚类和高/低热点区域的存在。采用普通克里金插值法对短生育间隔进行插值，采用空间扫描统计识别高 SBI 和低 SBI 的空间聚类。采用多水平多变量模型识别短生育间隔的预测因素。
埃塞俄比亚 SBI 的患病率为 62.89%（95%CI：59.3，69.7）。在索马里、奥罗米亚（居朱、巴莱和西哈勒尔）和提格雷北部的所有地区，以及阿法尔（1、3、4 和 5 区）都观察到 SBI 的高度聚类。最有可能显著的原发性聚类发生在索马里地区。与居住在窗口外的妇女相比，居住在原发性聚类中的妇女发生短生育间隔的可能性高 24%。在多水平混合效应分析中，年龄 25-34 岁[比值比（AOR）=0.40，95%置信区间（CI）：0.35，0.45]、35-49 岁（AOR=0.44，95%CI：0.38，0.51）、穆斯林宗教信徒（AOR=3.5，95%CI：2.7，4.69）、没有正规教育（AOR=0.5，95%CI：0.37，0.70）、小学教育（AOR=0.4，95%CI：0.28，0.53）、中学教育（AOR=0.3，95%CI：0.24，0.48）、中等（AOR：1.3，95%CI：1.2，1.52）、富裕的财富状况（AOR：1.4，95%CI：1.3，1.68）、女性别儿童（AOR：1.2，95%CI：1.09，1.42）和两个或更少理想子女数（AOR=0.2，95%CI：0.25，0.32）被发现是 SBI 的显著预测因素。
总体而言，SBI 在埃塞俄比亚整个地区都很高且呈显著聚集性。年龄、宗教、教育、财富状况、索引儿童的性别以及理想子女数与短生育间隔显著相关。因此，政府应在 SBI 的确定热点地区制定健康促进策略和公共卫生意识，并应扩大计划生育和育龄妇女的财富状况。
