Community Factors Influencing Birth Spacing among Married Women in Uganda and Zimbabwe

Abstract

Short birth spacing continues to be a problem in Uganda and Zimbabwe, resulting in negative infant, child, and maternal health outcomes. This study investigates community-level influences on birth spacing outcomes among women aged 15-49 in Uganda and Zimbabwe, using Demographic and Health Surveys conducted in 2011 (Uganda) and 2010-2011 (Zimbabwe). Women living in communities with higher mean maternal age, mean age at marriage, and mean parity were significantly more likely to have longer birth spacing. Women living in communities with higher levels of contraceptive use and low levels of unmet contraceptive need were more likely to have short birth spacing. The significance of community-level demographic and fertility norms, gender norms, economic prosperity, and family planning behaviors demonstrate the broad influence of community variables on birth spacing outcomes. This analysis highlights the importance of moving beyond individual and household-level interventions in order to harness the power of contextual influences on birth spacing.

Keywords: birth spacing, community, gender, social epidemiology