Barriers to Adherence of Optimal Birth Spacing: A Qualitative Study Among Mothers and Their Husbands in Arba Minch Zuria district, Ethiopia

Abstract

Background: Optimal birth spacing plays a critical role in promoting perinatal health. However, in Ethiopia, many women still have shorter birth intervals than they would prefer and studies done to assess knowledge of couples were scarce. The objective of this study therefore was to assess perceived knowledge of couples about the disadvantage of short birth intervals in Arba Minch Zuria district, Ethiopia.Methods: Qualitative study design was conducted from February to April 2014 among women having at least two consecutive live births. Purposive sampling was employed to select information rich participants. Data were collected through focus group discussions using a semi- structured flexible discussion guide. Sixteen FGDs were conducted involving a total of 128 participants. Data were entered in to open code software and analyzed thematically.Result: Perceived disadvantage of short birth spacing, ultimate decision maker about birth intervals and reasons for experiencing short birth spacing were the major themes emerged from the discussion. Perceived knowledge of focus group discussants about the disadvantages of short birth pacing was very high. Ultimate decision maker about birth spacing were couples in the optimal spacers groups. On the other hand, husbands had the right to say the final word among discussants that had short birth intervals. Index child being female, husband & religious influences, fear of side effects of contraceptive, lack of information about the benefit contraceptives, and inaccessibility of reproductive health services were noted as reasons to experience short birth spacing.Conclusion: Perceived knowledge of discussants was similarly high in both short and optimal birth spacers. The main reasons for  experiencing short birth spacing were, husband influence, fear of side effects of  contraceptives, lack of information about the benefits of contraceptives, and geographical inaccessibility of reproductive health care services. For women to achieve optimal birth spacing, they need the support of their significant family members. Hence, behavioral change communications should target all of those who have a direct or indirect influence on birth spacing decisions. Moreover, the district in collaboration with other stallholders needs to work hard to make reproductive health service accessible in all aspects.

Keywords: Perceived advantage, short birth interval, Qualitative study, Ethiopia