Gap between preferred and actual birth intervals in Sub-Saharan Africa : implications for fertility and child health

The results show a clear pattern. Women prefer much longer birth intervals than they actually have in Comoros, Ghana, Kenya, Rwanda, and Zimbabwe, compared with women in the other 15 countries studied. As a consequence, the potential effects of spacing preferences on the level of fertility, as well as on the prevalence of short birth intervals (less than 24 months) and child malnutrition, are greatest in the same five countries. An explanation based on the observed sharp decline in fertility recently experienced by these five "forerunners" is offered for this pattern. The covariates of preferred birth interval lengths are also examined. In general, women who know, approve of, discuss, and use family planning prefer longer intervals than do their counterparts. The educational attainment of husbands matters more than that of female respondents in determining spacing preferences. For nine countries that have conducted more than one survey, an average increase of 6 months in the length of preferred intervals is documented. Similarly, data from 12 countries that conducted a survey in the mid- or late 1990s show an increase in the actual lengths of birth intervals; the magnitude of the increase is higher in the most recent period studied (when intervals starting in the 1980s are compared with intervals starting in the 1990s). The policy and program relevance of these results is discussed. (Author abstract)