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The birth interval, defined as the length of time between two
successive live births, indicates the pace of childbearing. It is
an important indicator of fertility. Short birth intervals may
adversely affect a mother's health and her children's survival.
Babies born less than two years after the previous child are at
least twice as likely to die in the first year of life as those
born after an interval of at least two years. Even if these
infants survive the first year, they are 1.5 times more likely to
die before age 5 than children whose births were spaced at least 2
years apart (Bohler 1994, Alam 1995, Shane 1997), (Pandey et
al.,1998; Govindaswamy et al., 1993). Data from the World
Fertility Survey provide a strong evidence about increased
mortality risks of children with short birth intervals (Hobcraft
et.al, 1985).
Adverse effect of less than optimum birth spacing is also
evident in Andhra Pradesh (Figure 1). The infant mortality rate is
more than three times as high for children with a previous birth
interval of less than 24 months as for children with a previous
interval of 48 months or more (NFHS-2). Figure 1 shows the infant
mortality rates according to previous birth interval.
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| Figure 1: Infant
mortality by previous birth interval in AP |
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Source: NFHS-2 (Andhra
Pradesh) p-121, tbl-6.4 |
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Closely spaced pregnancies increase the chances of
women having low birth weight babies, and increase risk of
transmission of infectious diseases (National Research Council
1989). Rowe and Plomin (1981) argue that within-family influences
like birth order and spacing of children, influences on
intelligence and make siblings different from one another. Zajonc
and Markus (1979) also proposed that children's scores on IQ
should be higher in families with wider spacing among siblings.
But several studies by different psychologists show that birth
order and spacing, show relationships with IQ, but they are not
very powerful (Berk, 1989).
According to estimates from the NFHS-2, in 1998-99, the median
birth interval in India range for about 27 months in Nagaland to
about 38 months in Kerala. The median birth interval in AP was 31
months (Figure 2). In Andhra Pradesh, 13% of births occur within
18 months of a previous birth and 27% occur within 24 months.
About 38% of births occur after an interval of 3 years or more
(Table 1). Birth intervals are four months shorter among urban
women than among rural women.(NFHS-2). |
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Figure 2: Birth intervals by state
1998-99
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Source: NFHS-2 India
p-103, tbl no: 4.12 |
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SRS also provides information on birth intervals.
The data from SRS on birth intervals is available from the year
1990 onwards (Figure 3). Current live births with a birth interval
of 10-12 months were about 3.15% of total births in the early
1990s. This proportion reduced to about 0.9% towards second half
of 1990s (1994-98). Percentage of live births with a birth
interval 12-18 months stayed almost constant and 10%. Proportion
of live births after a birth interval of 24-30 months increased
towards the second half of 1990s. For about 15% in early 1990s to
about 25% in the late 1990s. During the late 1990s the proportion
of live births after 36 months increased , while those after 18-24
months decreased. Thus the birth intervals in AP appear to be
improving. Proportion of live births before the critical 2 year
birth interval has reduced from 22% from 1990-93 to about 14%
between 1994-98.
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| Table 1:
Distribution of births according to months since previous
birth in AP |
| Months
since previous birth |
Urban |
Rural |
Combined |
Urban |
Rural |
Combined |
| 1993 |
1999 |
| <12 |
3.2 |
1.3 |
1.8 |
4.4 |
1.8 |
2.4 |
| 12-17 |
9.7 |
7.4 |
8 |
14.3 |
8.7 |
10.1 |
| 18-23 |
15.7 |
12 |
12.9 |
15.6 |
14.6 |
14.8 |
| 24-35 |
28.9 |
35.3 |
33.7 |
35.2 |
34.9 |
35 |
| 36-47 |
19.9 |
21.6 |
21.2 |
15.9 |
20.2 |
19.1 |
| 48> |
22.6 |
22.4 |
22.5 |
14.6 |
19.7 |
18.5 |
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Source: NFHS 1&2
(Andhra Pradesh) NFHS-1 p-69, tbl no: 5.9 NFHS-2 p-68, tbl
No:4.8 |
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SRS also provides information on birth intervals.
The data from SRS on birth intervals is available from the year
1990 onwards (Figure 3). Current live births with a birth interval
of 10-12 months were about 3.15% of total births in the early
1990s. This proportion reduced to about 0.9% towards second half
of 1990s (1994-98). Percentage of live births with a birth
interval 12-18 months stayed almost constant and 10%. Proportion
of live births after a birth interval of 24-30 months increased
towards the second half of 1990s. For about 15% in early 1990s to
about 25% in the late 1990s. During the late 1990s the proportion
of live births after 36 months increased , while those after 18-24
months decreased. Thus the birth intervals in AP appear to be
improving. Proportion of live births before the critical 2 year
birth interval has reduced from 22% from 1990-93 to about 14%
between 1994-98.
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| Figure 3:
Percentage distribution of current live births by birth
intervals in Andhra Pradesh from the years 1990 to 98 |
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Source: SRS 90 to 98. |
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| Table 2:
Median months since previous birth according to background
characteristics in Andhra Pradesh. 1998-99 |
| Background
characteristics |
Median months since
previous birth |
Background
characteristics |
Median months since
previous birth |
| Sex
of previous birth |
Survival
of previous birth |
| Male |
31.7
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Living |
31.7
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| Female |
30.4
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Dead |
24.7
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| Education
of the mother |
Standard
of living index |
| Illiterate |
33
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Low |
31.9
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| < middle school |
28.2
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Medium |
31.7
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| Middle school
complete |
31.5
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High |
25.9
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| High school and
above |
26.7
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Source: NFHS-2 (AP)
p-68, tbl no: 4.8 |
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Various factors may for example, NFHS-2 found that
the median birth interval is slightly shorter if the previous
child was a girl than it was a boy (Table 2). Birth intervals are
much shorter if the previous child died (25 months) than if the
previous child survived (32 months). There is also a tendency for
birth intervals to decrease with education. Mothers with at least
a high school education have a median birth interval that is six
months shorter than the interval for illiterate mothers.
Similarly, mothers living in households with a high standard of
living have a median birth interval that is six months shorter
than the interval for mothers who live in households with a low
standard of living. Thus socioeconomic development and spread of
education may contribute to reduction in fertility and tend to
reduce birth intervals. However, these same factors may improve
access to contraceptives, with its resultant effect on birth
spacing. Probably the median birth interval may not change much.
From reproductive health point of view, the median birth interval
of more than 24 months would be acceptable provided the
distribution is such that births less than 24 months after the
previous birth are brought down to near zero levels. Hence it will
be desirable to look at the distribution of birth intervals.
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Updated by
Samatha Reddy
Dated: 18/08/2003 |
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