title: Birth spacing and risk of child mortality at Kalu district South Wollo Zone of Amhara region, Ethiopia.
abstract: BACKGROUND
  Several studies worldwide showed that too short birth interval is correlated with child mortality. Identifying the optimal interval between births at which risk of child mortality is the lowest may benefit developing countries to prioritize family planning services and achieve the millennium development goal (MDG 4).
  
  
  OBJECTIVE
  To assess the influence of birth spacing on neonatal, infant, child and under-five mortality.
  
  
  METHODS
  A house to house census was carried out in 13 kebeles with an approximate population of 80 thousand to identify all child deaths one year preceding the survey at Kalu district. Following the census a matched case control study was carried out on 151 cases and 151 sex and age matched controls. Conditional logistic regression was performed to determine the independent effect of birth spacing under-five mortality.
  
  
  RESULTS
  The neonatal, post neonatal, infant, child and under five mortality rates were found to be 37, 30, 67, 33 and 99 per 1000 live births respectively. Stratified for maternal age, the odds of neonatal death was about 16 times higher (OR=15.60, 95% CI=2.49-70.98) when the interval between births is below 15 months, compared to those who were born with birth intervals 15 or more months. Similarly the odds of post-neonatal and infant deaths were OR= 2.60, (95% CI=0.49-20.32) and OR=6.44, (95% CI=1.96-28.51), respectively. The overall odds of death for under 5 children with birth interval less than 15 months was OR=3.23 (95 % CI=1.28-8.16) compared to those with birth interval 15 or more months after adjusting for maternal age group. Multivariate analysis had showed that under-five mortality was significantly associated with birth spacing.
  
  
  CONCLUSIONS
  The risk of child mortality in the study community was associated with birth spacing, mainly in the neonatal and infant age groups. We recommend that an emphasis should be given to reduce neonatal mortality and it is our strong belief that further longitudinal studies should be carried out on the issue.
authors.affiliation: Department of Community Health, Addis Ababa University, Addis Ababa.
authors.forename: Muluneh
authors.initials: M
authors.lastname: Yigzaw
authors.forename: Fikre
authors.initials: F
authors.lastname: Enquselassie
mesh_terms: D000328:Adult; D001721:Birth Intervals; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D046688:Child Mortality; D002675:Child, Preschool; D003625:Data Collection; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007226:Infant Mortality; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D012959:Socioeconomic Factors; D055815:Young Adult