Usage of Contraceptive and Birth Interval in Ethiopia: Systematic Review and Meta-analysis

Background: Children born soon after previous birth are at high risk for health problems and died at a younger age, especially if the interval between the births is less than two years. The purpose of this review is to summarize the evidence whether contraceptive use is associated with birth interval among women in Ethiopia. Methods: Studies for this meta-analysis were accessed through main databases searches (PUBMED and Advanced Google Scholar) that were published from 2010 onwards. Three blinded reviewers evaluated the abstracts as well as the full texts and performed the data extraction. To assess external and internal validity, a risk-of-bias tool was used. Pooled effect size of birth interval was estimated from the reported proportion of eligible studies using RevMan V. 5.3 software. Results: Thirteen studies were found to be eligible and included in the meta–analysis. A total of 16311 women were involved. Of which, 6112 (37.5%) women had contraceptive users and 5873 (36%) of women had experienced short birth interval. The final pooled effect size after trim and fill analysis in random effect model was found to be -0.67 (95%CI: -0.74, -0.59). This indicated that presence of a significant association between contraceptive use and the length of birth interval. Conclusions: This meta-analysis found that, in Ethiopia, promoting contraceptive use was associated with decreasing short birth interval by 33%. Thus, the existing efforts of optimizing birth interval should be enhanced through modern contraceptive use.