Determinants of Birth Interval Dynamics范文 [英语论文]

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The birth interval is a major determinant of levels of fertility in high fertility populations. A house-to-house survey of 1225 women in Manipur, a tiny state in North Eastern India was carried out to investigate birth interval patterns and its determinants. Using survival analysis, among the nine explanatory variables of interest, only three factors – infant mortality, Lactation and use of contraceptive devices have highly significant effect.

Introduction

 Natural fertility depends on the duration of effective reproductive span and length of birth interval.(1) Analysis of those factors influencing the span and those affecting the length of birth interval has proven useful, since in many cases they appear to vary quite substantially across populations.(2) In recent years, policy makers and planners have focused a great deal of attention on the birth interval and its determinants. The reasons are that not only does the number of births women may have during her reproductive span depend on the spacing between the births but also there is a significant link between birth spacing and maternal and child health.(3) Thus, the spacing of births through a deliberately prolonged interval between births and a delay in child bearing following marriage could be logical alternative strategies for fertility control

Different studies have examined this issue and identified different risk factors contributing to the length of birth intervals. Age at marriage of mothers and parity are negatively associated with the length of birth interval.(4-7) The positive association between the duration of breast feeding and length of birth interval is well documented from the experience of many countries. (8-10) Sex of the index child can be regarded as a regarded as a determinant of birth interval.(9,11) They show that average birth interval is significantly shorter for women with a preceding birth of a female child. The death of previous child is associated with the short duration of birth interval.(12-14) The place of residence is also found to have an important impact on the length birth interval.(9) In terms of behaviours, empirical evidence over many years and many settings indicates that lactational amenorrhea arising from breastfeeding lengthens birth interval.(13,15) Moreover, in many settings couples who practice postpartum abstinence have additional benefits if the duration of abstinence exceeds that of postpartum amenorrhea. The present study is initiated empirically to investigate the effects of some demographic and socio-economic factors which are expected to cause variation in the length of birth interval by utilizing the survival model.

Materials and Methods

A cross sectional study was conducted in four valley districts of Manipur namely Bishnupur, Thoubal, Imphal West and Imphal East during the period from 1 January 2017 to 30 June 2017. Manipur is a tiny state of North East India inhabited mainly by the Mongoloid race. A house-to-house survey was carried out on all households in the selected village and eligible women having at least one live birth were interviewed. The sample consists of 1225 eligible women. An eligible woman is hereby defined if both spouses are alive and normally living together during her child bearing period. The pre-tested and semi-structural type of interview schedule is utilized as the tool for collecting the required information from the eligible women. Cluster sampling is adopted as sampling technique. The clusters of randomly selected villages in rural area and wards in urban area are completely enumerated. Altogether 45 villages in rural areas and 35 wards in urban areas are randomly selected. 5 villages and 7 wards, 9 villages and 10 wards, 11 villages and 12 wards, and 20 villages and 6 wards are respectively selected from Bishnupur, Thoubal, Imphal West, Imphal East districts. Out of 1225 eligible women, 180, 316, 387 and 342 eligible women are picked up from Bishnupur, Thoubal, Imphal West, Imphal East districts respectively. A total of 1013 households are surveyed.()

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