Short birth spacing and child mortality in Mozambique

Sandra D. Goncalves, University of Cape Town

A short preceding birth interval is associated with increased child mortality risk. High socio-economic status and access to health care mitigate the high mortality risk. The legacy of colonialism and two almost successive wars in Mozambique resulted in widespread poverty, low literacy and low contraceptive use and an inadequate health care system. A piecewise log rate model is applied to examine child mortality risk associated with short preceding birth intervals in Mozambique using the 1997 and 2003 DHS data. Effects of a short preceding birth interval are strongest during the first month, suggesting pre-natal mechanisms of maternal depletion as the dominant pathway. An optimal birth spacing period of three and a half years was estimated to reduce the high risk of neonatal mortality, thus advocating an extra “waiting period” of 6 months under the optimal spacing banner of “Three to five saves lives” for couples in Mozambique.