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      Socioeconomic inequality in short birth interval in Ethiopia: a decomposition analysis

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          Abstract

          Background

          Short birth interval, defined as a birth-to-birth interval less than 33 months, is associated with adverse maternal and child outcomes. Evidence regarding the association of maternal socioeconomic status and short birth interval is inconclusive. Factors contributing to the socioeconomic inequality of short birth interval have also not been investigated. The current study assessed socioeconomic inequality in short birth interval and its contributing factors in Ethiopia.

          Methods

          Data from 8448 women collected in the 2016 Ethiopia Demographic and Health survey were included in the study. Socioeconomic inequality in short birth interval was the outcome variable. Erreygers normalized concentration index (ECI) and concentration curves were used to measure and illustrate socioeconomic-related inequality in short birth interval, respectively. Decomposition analysis was performed to identify factors explaining the socioeconomic-related inequality in short birth interval.

          Results

          The Erreygers normalized concentration index for short birth interval was − 0.0478 (SE = 0.0062) and differed significantly from zero ( P < 0.0001); indicating that short birth interval was more concentrated among the poor. Decomposition analysis indicated that wealth quintiles (74.2%), administrative regions (26.4%), and not listening to the radio (5.6%) were the major contributors to the pro-poor socioeconomic inequalities in short birth interval.

          Conclusion

          There was a pro-poor inequality of short birth interval in Ethiopia. Strengthening the implementation of poverty alleviation programs may improve the population’s socioeconomic status and reduce the associated inequality in short birth interval.

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          Most cited references42

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          The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality.

          When the health sector variable whose inequality is being investigated is binary, the minimum and maximum possible values of the concentration index are equal to micro-1 and 1-micro, respectively, where micro is the mean of the variable in question. Thus as the mean increases, the range of the possible values of the concentration index shrinks, tending to zero as the mean tends to one and the concentration index tends to zero. Examples are presented on levels of and inequalities in immunization across 41 developing countries, and on changes in coverage and inequalities in selected countries. Copyright (c) 2004 John Wiley & Sons, Ltd.
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            Correcting the concentration index.

            In recent years attention has been drawn to several shortcomings of the Concentration Index, a frequently used indicator of the socioeconomic inequality of health. Some modifications have been suggested, but these are only partial remedies. This paper proposes a corrected version of the Concentration Index which is superior to the original Concentration Index and its variants, in the sense that it is a rank-dependent indicator which satisfies four key requirements (transfer, level independence, cardinal invariance, and mirror). The paper also shows how the corrected Concentration Index can be decomposed and generalized.
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              Effects of birth spacing on maternal health: a systematic review.

              The objective of the study was to explore the association between birth spacing and risk of adverse maternal outcomes. The study was a systematic review of observational studies that examined the relationship between interpregnancy or birth intervals and adverse maternal outcomes. Twenty-two studies met the inclusion criteria. Overall, long interpregnancy intervals, possibly longer than 5 years, are independently associated with an increased risk of preeclampsia. There is emerging evidence that women with long interpregnancy intervals are at increased risk for labor dystocia and that short intervals are associated with increased risks of uterine rupture in women attempting a vaginal birth after previous cesarean delivery and uteroplacental bleeding disorders (placental abruption and placenta previa). Less clear is the association between short intervals and other adverse outcomes such as maternal death and anemia. Long interpregnancy intervals are independently associated with an increased risk of preeclampsia. Both short and long interpregnancy intervals seem to be related to other adverse maternal outcomes, but more research is needed.
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                Author and article information

                Contributors
                desalegnmarkos@gmail.com , desalegnmarkos.shifti@uon.edu.au
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                6 October 2020
                6 October 2020
                2020
                : 20
                : 1504
                Affiliations
                [1 ]Saint Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
                [2 ]GRID grid.266842.c, ISNI 0000 0000 8831 109X, Priority Research Centre for Generational Health and Ageing, , School of Medicine and Public Health, University of Newcastle, ; Newcastle, NSW Australia
                [3 ]GRID grid.266842.c, ISNI 0000 0000 8831 109X, Centre for Clinical Epidemiology and Biostatistics, , School of Medicine and Public Health, University of Newcastle, ; Newcastle, NSW Australia
                Author information
                http://orcid.org/0000-0001-6638-6194
                Article
                9537
                10.1186/s12889-020-09537-0
                7542382
                33023567
                f9a8b5d8-0435-44d9-98ea-529f6c79fb24
                © The Author(s) 2020

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 26 June 2020
                : 13 September 2020
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2020

                Public health
                socioeconomic inequality,concentration index,concentration curve,decomposition analysis,short birth interval,ethiopia

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