Effects of birth spacing on infant and child mortality: Expanded evidence from demographic and health surveys 2000-2006

Findings from a study on the effects of birth spacing on infant and child mortality will be summarized. The study pools birth history data from all 52 DHS surveys conducted in the first six years of the new millennium, with a resulting data set of 1,123,454 births. The effects of the birth to pregnancy interval are studied for infant and child mortality broken down into early neonatal, neonatal, post-neonatal, infant, child (1 to 4 years), and under age five years periods. Confounding relationships are statistically removed by including control variables for birth-specific, mother-specific and household characteristics. Birth weight, size at birth and nutritional status at the time of the survey (stunting, wasting and underweight) are studied using means and logistic regressions. Controls used in addition to the above were breastfeeding status and types of other child feeding. Bivariate results indicate that 36 to 47 months between a birth and the next conception is the interval with the lowest risk of neonatal, infant, and under-five mortality. Multivariate results confirm and clarify the findings. The findings show that the effect of waiting at least 36 months to conceive after a birth would avoid 25% of under-five deaths. Furthermore, it is clear that the longer the interval, the more chronic and overall under-nutrition decline substantially. Children conceived after an interval of 12 to 17 months are 25 percent more likely to be stunted and 25 percent more likely to be underweight than children conceived after an interval of 36 to 47 months.