Patterns of birth intervals and infant/child mortality in Kenya: evidence from KDHS 1998

Abstract

The main objective of this study was to examine the patterns of birth intervals and infant and child mortality by birth parities in Kenya, alongside which, other variables both socio-economic and demographic were considered. To achieve this objective, several hypotheses were tested, by applying life table technique to estimate the levels and to determine the nature of the patterns. The data used in the study was obtained from the Kenya Demographic and Health Survey (KDHS) of 1998. A conceptual framework developed from Mosley and Chen framework of infant and child mortality guided the analysis. The dependent variable for this study was considered to be infant and childhood death while the main dependent variable was the preceding birth interval length. Other socio-economic and demographic variables were used in studying the differentials in the patterns. The results of the study revealed that the pattern of birth spacing and infant and child mortality varies across various population subgroups as' defined by socio-economic and demographic status of the mother. Region of residence was found to be associated with the fertility situation as depicted by the'birth interval measures with Nairobi and Central showing the least prevalence especially of short intervals below 24 months. However when mortality measures were introduced the 5th and 6th parities were the only exception whereby the expected pattern of association between short birth intervals and high infant and child mortality was not observed. Similarly mortality was not observed to increase with achievement of higher parity especially beyond the 5th parity in the low mortality regime. The patterns by mothers' education level differential showed that all parity births conform to the expectations. Mothers with incomplete primary education show high shorter birth intervals and also high incidence of infant and child mortality rate. Mortality is also observed to increase with achievement of higher parities for both the women with incomplete primary education and ones with at least secondary education. Although by place of residence urban women showed relatively lower prevalence of short spaced births the expected pattern was not observed especially in the 2nd, 4th and 7th parities. In the 2nd and 4th parities, despite women of rural residence showing relatively shorter birth intervals, corresponding infant and child mortality was lower. On the other hand in the s" and ih parities, although women of urban residence showed a high prevalence of short intervals, infant and child mortality was much lower than for women of rural residence. Subsequently, the study to health planners and managers responsible for programs to reduce infant and child mortality recommends the following measures among others. The encouragement of mothers on the need to space births by at least 24 months and ensure enhanced health care for higher parity births i.e. 4 and above because they relatively experience higher mortality. Also reduction of disparities with regard to socio-economic development such as improving educational attainment of mothers to above secondary level and availability of social facilities are recommended. Finally this study recommends the need to study the determinants involving birth intervals while controlling other variables to isolate the effects of birth spacing on infant and child mortality.