Determinants of birth spacing intervals among women in Imvepi refugee settlement - Arua District

Abstract

Introduction: Poorly spaced pregnancies have been documented to result in poor maternal and child health outcomes due to associated risks. WHO recommends 33 months inter birth interval to improve maternal and child health by 32% and 10%, respectively. The government and implementing partners have carried out sensitization campaigns and increased funding for health care, however, women in Imvepi still have not fully embraced optimal birth spacing. Therefore this study aimed at assessing the prevalence and determinants of birth spacing intervals to guide on policy formulation and implementation. Objective: To assess prevalence of birth spacing intervals and its determinants among women in Imvepi refugee settlement, Arua district. Methods: This was a cross-sectional study employing both qualitative and quantitative methods. 537 women aged 18 to 49 years were recruited for quantitative and 9 key informant interviews held for qualitative data. The outcome variable was birth spacing intervals while the independent variables were; age, education, religion, number of children, family planning use, food distribution policies among others. Multistage sampling and purposive sampling techniques were employed. Quantitative data was analyzed using STATA version 14, binary regression analysis was conducted and results presented using measures of central tendency, dispersion and associations. Qualitative data was analyzed using Atlas ti version 6 and results presented under different themes that is; challenges with policies, Human resources, essential medicines and supplies among others. Results: 537 women aged 18-49 years in Imvepi refugee settlement were studied, the prevalence of optimal birth spacing was 26% while that of sub optimal birth spacing was 74%. Age (p-value = 0.000), number of children (p-value = 0.000), education (p-value = 0.044), occupation (pvalue = 0.054), gender of previous child (p-value = 0.006), pressure from relatives (p-value = 0.019) were statistically significant for sub-optimal birth spacing intervals . Partner mandates, lack of funds, low levels of awareness, food distribution policies among others were barriers hindering optimal birth spacing. Conclusion and recommendation: This study established that 26% of all women studied practiced optimal birth spacing while 74% practiced sub optimal birth spacing intervals, as women produced, the need to space their children optimally reduced, as it was seen with proceeding children, their spacing intervals kept being skewed to sub-optimal birth spacing intervals. Therefore, sensitization campaigns should be carried out to enhance maternal and child health outcomes in Imvepi refugee settlement.