Levels and Correlates of Non-Adherence to the WHO’s Recommended Inter-Birth Interval Lengths among Childbearing-Aged Multiparous Women in Rufiji,Tanzania

Amon Exavery, Ifakara Health Institute (IHI)
Sigilbet Mrema, Ifakara Health Institute (IHI)
Amri Shamte, Ifakara Health Institute (IHI)
Kristin Bietsch, Princeton University
Dominic Mosha, Ifakara Health Institute (IHI)
Honorati Masanja, Ifakara Health Research and Development Centre

Poorly spaced pregnancies have been documented worldwide to result into unpleasant maternal and child health outcomes. The WHO recommends an interval length of at least 33 months between two live births to reduce the risk of adverse maternal and child health outcomes. We analyzed longitudinal data from Rufiji HDSS collected from 1999-2010 to investigate levels of birth spacing interval lengths and factors affecting non-adherence to the recommendation. 15,373 inter-birth intervals were recorded from 8,979 women aged 15-49 years. Median inter-birth interval length was 33.4 months. Of these, 48.8% were below the WHO’s recommended length of ≥33 months between two live births. Non-adherence correlates were parity, multiple births, maternal age, maternal education, marital status and place of delivery. Generally, one in every two inter-birth intervals in Rufiji district is poorly spaced. Community and health facility-based optimum birth spacing education is urgently required for better health outcomes of our mothers and children.