Birth intervals and reversible contraception in Sub-Saharan Africa

Kandala Ngianga-Bakwin, Kings College London
R. William Stones, University of Southampton

The interval between births is associated with child survival in the developing world. Short birth intervals contribute to mortality risk extending beyond the first year of life and the effect is apparent even after taking into account other potential determinants. We analysed data from successive Demographic and Health Surveys (DHS) undertaken in nine sub-Saharan African countries. We used a logistic regression of pooled data from countries where use of reversible contraception is substantial to calculate crude odds ratio of having a short birth interval during 1991-3 and 1999-2001. We then added residence, education, mother’s age, household income and breastfeeding practice to the model. Our results show that use of modern reversible contraception in the region is low, and where use has increased substantially this has not been accompanied by any impact on short birth intervals. Progress towards attainment of the Millennium Development Goals for child mortality is well behind target.