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Background <p>The World Health Organization (WHO) recommends a minimum of 24 months from birth to conception and 33 months from birth to birth interval to reduce the incidence of adverse maternal and child health outcomes. Birth intervals can significantly affect the health of both women and children, impacting them in both the short and long term. Regional-level aggregated data analysis is essential for programs and policy. Therefore, this study aimed to determine the duration of the birth interval and identify the predictors in East Africa.</p> Methods <p>This cross-sectional study analyzed data from the Demographic and Health Survey, encompassing a weighted sample of 86,619 women of reproductive age. We employed a Weibull gamma shared frailty model to identify predictors of birth intervals. They utilized the theta value and Akaike Information Criteria (AIC) for model selection. Adjusted hazard ratios (AHR) with 95% confidence intervals (CI) were reported to show the strength and the association.</p> Results <p>In East Africa, the median interbirth interval was reported to be 34 months (95%CI: 28, 36). Rural residents (AHR = 1.21 (95% CI: 1.18, 1.24), Muslim religion (AHR = 0.9 (95% CI: 0.88, 0.93), Protestant religion (AHR = 1.03 (95% CI: 1.01, 1.05), other religion (AHR = 1.12(1.1–1.2), women in the age group of 20–29(AHR = 0.54 (CI: 0.50, 0.60), age groups of 30–39(AHR = 0.33 (95% CI: 0.31, 0.36), age group 40–49(AHR = 0.23 (95% CI: 0.21, 0.25), Being in the rich (AHR = 0.83 (95% CI: 0.81, 0.85), women attending secondary education (AHR = 0.87 (95% CI: 0.85, 0.90), attending tertiary education (AHR = 0.82 (95% CI: 0.77, 0.86), having a female household (AHR = 0.87 (95% CI: 0.85, 0.90), women who had their own work (AHR = 1.08 (95% CI: 1.04, 1.10), having a living child (AHR = 0.83 (95% CI: 0.80, 0.87), longer distances to health facilities (AHR = 1.03 (95% CI: 1.01, 1.04), women who used contraceptives (AHR = 0.87 (95% CI: 0.85, 0.88) were found the significant predictors of duration of birth interval.</p> Conclusion <p>The median duration of birth intervals in East Africa is comparable the WHO’s recommendations. Implementing tailored and multifaceted interventions that address the identified predictors could enhance birth intervals. Policymakers and program designers should take these predictors into account when developing strategies.</p>

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Predictors of birth interval among childbearing-age women in East Africa: Weibull gamma shared frailty model

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月6日

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  • Melsew Setegn Alie,
  • Gossa Fetene Abebe,
  • Yilkal Negesse,
  • Desalegn Girma,
  • Amanuel Adugna

摘要

Background

The World Health Organization (WHO) recommends a minimum of 24 months from birth to conception and 33 months from birth to birth interval to reduce the incidence of adverse maternal and child health outcomes. Birth intervals can significantly affect the health of both women and children, impacting them in both the short and long term. Regional-level aggregated data analysis is essential for programs and policy. Therefore, this study aimed to determine the duration of the birth interval and identify the predictors in East Africa.

Methods

This cross-sectional study analyzed data from the Demographic and Health Survey, encompassing a weighted sample of 86,619 women of reproductive age. We employed a Weibull gamma shared frailty model to identify predictors of birth intervals. They utilized the theta value and Akaike Information Criteria (AIC) for model selection. Adjusted hazard ratios (AHR) with 95% confidence intervals (CI) were reported to show the strength and the association.

Results

In East Africa, the median interbirth interval was reported to be 34 months (95%CI: 28, 36). Rural residents (AHR = 1.21 (95% CI: 1.18, 1.24), Muslim religion (AHR = 0.9 (95% CI: 0.88, 0.93), Protestant religion (AHR = 1.03 (95% CI: 1.01, 1.05), other religion (AHR = 1.12(1.1–1.2), women in the age group of 20–29(AHR = 0.54 (CI: 0.50, 0.60), age groups of 30–39(AHR = 0.33 (95% CI: 0.31, 0.36), age group 40–49(AHR = 0.23 (95% CI: 0.21, 0.25), Being in the rich (AHR = 0.83 (95% CI: 0.81, 0.85), women attending secondary education (AHR = 0.87 (95% CI: 0.85, 0.90), attending tertiary education (AHR = 0.82 (95% CI: 0.77, 0.86), having a female household (AHR = 0.87 (95% CI: 0.85, 0.90), women who had their own work (AHR = 1.08 (95% CI: 1.04, 1.10), having a living child (AHR = 0.83 (95% CI: 0.80, 0.87), longer distances to health facilities (AHR = 1.03 (95% CI: 1.01, 1.04), women who used contraceptives (AHR = 0.87 (95% CI: 0.85, 0.88) were found the significant predictors of duration of birth interval.

Conclusion

The median duration of birth intervals in East Africa is comparable the WHO’s recommendations. Implementing tailored and multifaceted interventions that address the identified predictors could enhance birth intervals. Policymakers and program designers should take these predictors into account when developing strategies.