The Impact of Birth Intervals on Under-Five Mortality in Ghana: Evidence from the 2022 Ghana Demographic and Health Survey

Abstract

Under-five mortality remains a significant public health issue, influencing a country's broader child mortality rates. This study examines the relationship between birth intervals and neonatal mortality in Ghana, using data from the 2022 Ghana Demographic and Health Survey (GDHS). Specifically, the study investigates how the length of time between successive births impacts under-five mortality and explores how socio-demographic factors modify this relationship. The study employed a cross-sectional design, analyzing data from women of reproductive age (15 49 years) who gave birth in the five years prior to the survey. After adjusting for potential confounders, including socioeconomic status and healthcare-related factors, the study used logistic regression models to evaluate the association between birth intervals and neonatal mortality. The findings indicate that 25.3% of under-five mortality occurred within the first 28 days of life. Infants born after short birth intervals (<24 months) were 25% more likely to die within the neonatal period compared to those born after intervals of 24–59 months (Adjusted Odds Ratio = 1.25, 95% CI: 1.11 to 1.35, p < 0.001). The study also revealed that longer birth intervals (≥60 months) were associated with a slightly lower risk of under-five mortality, although this effect was less pronounced compared to shorter birth intervals. These results underscore the protective effect of longer birth intervals in reducing under-five mortality rates in Ghana. The findings suggest that enhancing maternal health education and expanding access to family planning services, particularly in rural areas, are critical for improving neonatal survival rates. The study calls for policies promoting healthy birth spacing as a key strategy for reducing neonatal mortality and improving child and maternal health outcomes in Ghana.