understanding the rationale & benefits of healthy timing and spacing of pregnancy
TRANSCRIPT
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
1/19
HEALTHY PREGNANCY SPACING AND TIMING :Understanding the Rationale and the Benefits
Presented at
Family Planning Budget Training Workshop
June 22 24, 2011
Kabir M. AbdullahiNURHI Kaduna, State Team Leader
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
2/19
Objectives
At the end of the presentation participantswould have:
Increased knowledge on the evidence in support of
longer birth spacing interval
Identified key benefits of longer birth intervals and
the risks associated with shorter birth intervals
Identified key messages for birth spacing
promotion
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
3/19
What we Mean by Birth Spacing
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
4/19
Kaduna State Relevant Statistics
Issues 2011 Projected Population: 7.15m Neonatal Mortality Ratio: 55 p. 1000
Under 5 Mortality Ratio: 269 p. 1000
Maternal Mortality Rate: 800 p. 100,000 live birth
Fertility Rate: 7.3 Contraceptive Prevalence (modern method): 9.6%
Unmet Need for Family Planning: 12%
Desire to Use: 18%
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
5/19
Findings and Implication for MCH
Policy is silent on pregnancy spacing/timing role in
mortality reduction No budget line for family planning
Families unaware of risk of annual childbearing/shortspacing of births and pregnancy
Mortality reduction strategies (free MCH) do not includepregnancy spacing//childbirth spacing
Dearth of skilled personnel trained on Birth Spacing
Training/counseling materials for birth spacingunavailable
Desire for large family size
Conspiracy of silence on the benefits of FP/childbirthspacing by religious leaders
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
6/19
Findings and Implication for MCH
Studies show EVIDENCE of longer birth intervals
effects on health
For Children
Lower risk of:
Child death Infant death
Neonatal death Fetal death Stunting and underweight Small for gestational age Low birth weight Preterm birth
For Mother
Lower risk of:
Maternal death Puerperal endometritis Premature rupture membranes Anemia
Third trimester bleeding
Conde-Agudelo A., Effect of Birth Spacing on Maternal and Perinatal Health: A Systematic Review and Meta-Analysis. Rutstein, S. Johnson & Conde-
Agudelo A. Systematic Literature Review and Meta-Analysis of the Relationship between Interpregnancyor Interbirth Intervals and Infant and ChildMortality. Reports submitted to CATALYST Consortium, October 2004, Conde-Agudelo, A. and Belizan, J.M. Maternal morbidity and mortalityassociated with interval: Cross sectional study. British Journal (Clinical Research Ed.) 321 (7271): 1255-1259. Nov. 18, 2000.
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
7/19
Birth Intervals Effects on Newborn and
Child Health
24 months birth intervals, or longer, areassociated with lowest risk of stunting andunderweight among under-five children
LBW is an indirect cause of 60-80% ofneonatal deaths
Risk of death among under-five children is
lower if the preceding birth interval was lonerthan 24 months
Source: United States Agency for International Development (USAID), Bureau for Global Health, Office of Population and
Reproductive Health, Washington, D.C. 20523-3600. December 2002. (WWW.USAID.GOV)
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
8/19
Neonatal Mortality RISK declines withincreasing birth-to-birth interval length up
48 59 months
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
9/19
Birth Spacing SavesChildrens Lives
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
10/19
Birth Spacing Saves Mothers Lives
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
11/19
How Much Death Would beAverted?
In Nigeria thousands deaths could be avertedannually if births occurred after longerintervals
In Nigeria, if no births occurred before 36
months of a preceding birth: Infant Mortality Rate would drop by 28%
Under Five Mortality Rate would drop by 23%
Deaths to children under five years of age would fallby165,000 annually
Fertility Rate would drop by 8%
Source: Shea Rutstein, PhD, Measure/DHS+,Macro International, Inc.
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
12/19
Consequences of Shorter BirthInterval !!!
When births are too close, families cannot take care ofseveral small children, they are weaned too soon, andthey are thus at greater risk of dying;
When children are weaned too soon, their growth
suffers, they are more likely to suffer from diarrhealdisease, and skins infections, and they are thus greaterrisk of dying
When women have too close pregnancies, they have
greater risk of pregnancy related and deliverycomplications
Spacing births more than 24 months can reduce the riskof morbidity and mortality for mothers and children.
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
13/19
Overall Benefits of Birth Spacing
Healthy timing and spacing of pregnancy isassociated with multiple health and other benefitsto mother, neonates and children
It is associated with reduced health risks to mother
and child
It is a preventive strategy against adversematernal and infant/child health outcomes.
It is a key strategy for preventing maternal, infantand child morbidity and mortality.
It is complementary to all care and treatmentstrategies for mother and children
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
14/19
WHO Recommendation for Spacing
After a live birth, the recommended interval beforeattempting the next pregnancy is at least 24months in order to reduce the risk of adversematernal, perinatal and infant outcomes,
After a miscarriage or induced abortion, the
recommended minimum interval to next pregnancyshould be at least six months in order to reducerisks of adverse maternal andperinatal outcomes
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
15/19
Key Messages:Healthy Spacing of Pregnancy
After a live birth:
Couples should use an effective family planning (FP)method of their choice continuously for at least two yearsafter a live birth but not more than five years before trying tobecome pregnant again.
After a miscarriage or abortion:
Couples should use an effective FP method of their choicecontinuously for at least six months after a miscarriage or
abortion before trying to become pregnant again.
For adolescents:
Adolescents need to use an effective FP method of theirchoice continuously until they are 18 years old before trying
to become pregnant. Source: ESD Pocket guide, version 2006
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
16/19
Suggested Strategies to helpCouples Space Birth
Increase access to good-quality contraceptiveservices and full range of methods,
Encourage community campaigns that speakabout needs of younger couples and cultural
norms and tradition beliefs,
Use prenatal and post natal periods as crucialtimes for information and counseling about birthspacing,
Discuss with mothers the benefits of maintaining 2- 3 years for the next child,
Support initiative that strengthen the womendecision- making power in the household.
Source: Population Reports, Volume XXX, Number 3, Summer 2002 (11)
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
17/19
How Do we Integrate?
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
18/19
-
8/3/2019 Understanding the Rationale & Benefits of Healthy Timing and Spacing of Pregnancy
19/19