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. 2025 Mar 25;6(1):325-340.
doi: 10.1089/whr.2024.0179. eCollection 2025.

The Magnitude and Determinants of Suboptimal Child Spacing Practices Among Women of Childbearing Age in Ethiopia: A Systematic Review and Meta-Analysis

Abebaw Alamrew  1 , Mulat Ayele  1 , Eyob Shitie Lake  1 , Getinet Kumie  2 , Haimanot Hailu  3 , Aynalem Yetwale  1 , Tadele Emagneneh  1 , Chalie Mulugeta  1
Affiliations

The Magnitude and Determinants of Suboptimal Child Spacing Practices Among Women of Childbearing Age in Ethiopia: A Systematic Review and Meta-Analysis

Abebaw Alamrew et al. Womens Health Rep (New Rochelle). .

Abstract

Background: Short birth intervals (SBI), also known as suboptimal childbirth intervals, are frequent and have detrimental effects on both mother and child health. There is limited national data except for small-scale studies on the prevalence and contributing factors of SBI practices in Ethiopia. We did this review to find the pooled prevalence of suboptimal birth spacing and its contributing factors among Ethiopian women of reproductive age.

Methodology: This study followed the PRISMA guideline. Articles were found using MEDLINE/PubMed, Scopus, Hinari, Google Scholar, and Web of Science. Subgroup analysis was used to look for heterogeneity evidence. I 2 statistics and funnel plots with the Egger test were used to assess the studies' heterogeneity and publication bias.

Results: In total, 19 studies were included in this meta-analysis with a sample size of 11,674. The pooled prevalence of SBI was 50.29% (95% confidence interval [CI], 43.18, 57.40). Rural residency (adjusted odds ratio [AOR] = 2.13; 95% CI: 1.19, 3.07), age at first marriage less than 18 (AOR = 1.94; 95% CI: 1.34, 2.54), women with no formal educational status (AOR = 3.39; 95% CI: 2.59, 4.19), no contraceptive use (AOR = 4.20; 95% CI: 2.84, 5.56), duration of breastfeeding less than 24 months (AOR = 3.44; 95% CI: 1.64, 5.25), female sex of the index child and survival (death) of the index child (AOR = 2.34; 95% CI: 1.53, 3.15), and (AOR = 2.17; 95% CI: 1.02, 3.31), respectively, were the main determinants of suboptimal child spacing.

Conclusion: The pooled prevalence of suboptimal child spacing practices in Ethiopia was found to be high almost half of the births were suboptimal.

Keywords: Ethiopia; interpregnancy interval; meta-analysis; short birth interval; systematic review; women.

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Figures

FIG. 1.
FIG. 1.
PRISMA flowchart showing the included searches for systematic review and meta-analysis entitled magnitude of suboptimal child spacing practices and its determinants among women of childbearing age in Ethiopia.
FIG. 2.
FIG. 2.
Pooled prevalence of suboptimal birth spacing among reproductive age women in Ethiopia.
FIG. 3.
FIG. 3.
Pooled association between rural residency and suboptimal child spacing among reproductive age group women in Ethiopia.
FIG. 4.
FIG. 4.
Pooled association between age at first marriage less than 18 and suboptimal child spacing among reproductive age group women in Ethiopia.
FIG. 5.
FIG. 5.
Pooled association between women with no formal educational status and suboptimal child spacing among reproductive age group women in Ethiopia.
FIG. 6.
FIG. 6.
Pooled association between no contraceptive use and suboptimal child spacing among reproductive age group women in Ethiopia.
FIG. 7.
FIG. 7.
Pooled association between duration of breastfeeding less than 24 months and suboptimal child spacing among reproductive age group women in Ethiopia.
FIG. 8.
FIG. 8.
Pooled association between female sex of indexed child and suboptimal child spacing among reproductive age group women in Ethiopia.
FIG. 9.
FIG. 9.
Pooled association between survival (death) of the index child and suboptimal child spacing among reproductive age group women in Ethiopia.
FIG. 10.
FIG. 10.
Funnel plot with 95% confidence limits of the pooled prevalence of suboptimal child spacing practice among reproductive age group women in Ethiopia.
FIG. 11.
FIG. 11.
Sensitivity analysis of suboptimal birth spacing among reproductive age group in Ethiopia.
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