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Can Family Planning Accelerate Mortality Reduction? Evidence on Birth Spacing and Child Survival from Rural Tanzania, 2000-2015

Colin Baynes, University of Washington
Almamy Kante, Johns Hopkins Bloomberg School of Public Health
Jitihada Baraka, Ifakara Health Institute (IHI)
Amon Exavery, Ifakara Health Institute (IHI)
James F. Phillips, Heilbrunn Department of Population and Family Health, Columbia University, New York, NY 10032, USA

This study investigates the birth spacing-child survival relationship using longitudinal data on 25,762 children born in three rural regions of coastal and inland Tanzania between 2000 and 2015. The data were compiled through the routine procedures of the Ifakara and Rufiji Demographic Surveillance Systems. Results demonstrate significant and very distinctive effects of the subsequent and previous birth intervals. The former influenced the risk of death among children aged 1 to 5 years, whereas the previous birth interval demonstrated its effect among neonates and among children aged 12 to 23 months. Regarding the subsequent birth interval (SBI), our analysis, which adjusted for multiple confounders, reported that relative to SBI less than 18 months, SBI 18-23 and 34-35 months were associated with a 1-5-year-old mortality risk that were 0.31 and 0.24 times lower, respectively. Duration of the previous birth interval (PBI) was significantly associated with neonatal mortality risk. Compared to index births with PBI <18-months, PBI 24-35 months were associated with a neonatal mortality risk that was 0.47 times lower. Compared to the same referent group, PBI of 18-23, 24-35 and 36 + months were significantly associated with 12–23-month-old mortality risks that were 0.31, 0.44 and 0.40 times lower, respectively.

Keywords: Family planning and contraception, Fertility and childbirth, Event history analysis, Longitudinal studies

See extended abstract.

  Presented in Session P9.