Birth spacing among Ethiopian women between 2000 and 2016: trends and predictors

Introduction
The objective of the present study is to explore the trends and predictors of birth spacing in Ethiopia with a focus on the unmet need for family planning.

Material and methods
We analysed open-access data from 4 rounds of the Ethiopia Demographic and Health Survey (2000, 2005, 2011, 2016), which collected information on various sociodemographic factors, including preceding the birth interval. The primary explanatory variable was an unmet need for family planning, defined as the current unmet need for birth spacing and limiting. Preceding birth interval was the outcome variable and was classified as short (< 33 months) and optimal ( 33 months) according to the established guidelines. The sample population for this study was 33,212 women aged 15–49 years. Data were analysed using descriptive and multivariable analyses.

Results
Between 2000 and 2016 there was a marginal decrease in the prevalence of optimal birth spacing (from 77% to 75.4%). Women in lower age groups, especially teenage mothers, are more likely to experience short preceding birth intervals. Having an unmet need for contraception showed a positive association with short birth intervals in the 2000 (OR = 1.201, 95% CI: 1.042–1.384) and 2016 surveys (OR = 1.180, 95% CI: 1.022–1.363). In 2016, women who delivered at a health facility were significantly less likely to have short birth intervals (OR = 0.777, 95% CI: 0.657–0.921).

Conclusions
Our analysis of 4 nationally representative surveys indicates that the prevalence of short birth interval has remained virtually unchanged since 2000, emphasising the need for urgent intervention. The potential areas of intervention may include preventing teenage motherhood, improving women’s socioeconomic status, addressing the unmet need for family planning, and promoting the use of health facility delivery.