Effects of short birth interval on neonatal, infant and under-five child mortality in Ethiopia: A nationally representative observational study using inverse probability of treatment weighting

Objective: To assess the effect of short birth interval (SBI) on neonatal, infant, and under-five mortality in Ethiopia. Design: A nationally representative cross-sectional survey. Setting: This study used data from the Ethiopia Demographic and Health Survey 2016. Participants: A total of 8448 women who had at least two live births during the 5 years preceding the survey were included in the analysis. Outcome measures: Neonatal mortality (death of the child within 28 days of birth), infant mortality (death between birth and 11 months) and under-five mortality (death between birth and 59 months) were the outcome variables. Methods: Weighted logistic regression analysis based on inverse probability of treatment weights was used to estimate exposure effects adjusted for potential confounders. Results: The adjusted ORs (AORs) of neonatal mortality were about 85% higher among women with SBI (AOR=1.85, 95% CI=1.19 to 2.89) than those without. The odds of infant mortality were twofold higher (AOR=2.16, 95% CI=1.49 to 3.11) among women with SBI. The odds of under-five child mortality were also about two times (AOR=2.26, 95% CI=1.60 to 3.17) higher among women with SBI. Conclusion: SBI has a significant effect on neonatal, infant and under-five mortality in Ethiopia. Interventions targeting SBI are warranted to reduce neonatal, infant and under-five mortality.