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Item A comparative analysis of the infuence of contraceptive use and fertility desire on the duration of second birth interval in four sub-Saharan African countries(BioMed Central, 2021) Afolabi, R. F.; Fagbamigbe, A. F.; Palamuleni, M. E.Background: Fertility decline characterised by inter-birth intervals remains rather slow or stall in many countries of sub-Saharan African (SSA). Non-adherence to optimal inter-birth intervals often occasioned by low prevalence of contraceptive use and high fertility desires often lead to poor maternal and child health outcomes. Additionally, information on the influence of contraception and fertility desire on interval between first and second births (SBI) is rarely available. This study therefore aimed to examine the influence of fertility desire and contraception on SBI among women in four SSA countries. Methods: We analysed cross-sectional data on women aged 15–49 years who participated in the recent Demo graphic and Health Surveys in DR Congo, Ethiopia, Nigeria and South Africa. Semi-parametric Cox proportional hazards regression was employed for the analysis at 5% significance level. Results: The median time to second birth was 34 months in DR Congo; 35 months, Nigeria; 42 months, Ethiopia; and 71 months, South Africa. About 70% of the women desired additional child(ren) and two-thirds have never used contraceptive in both Nigeria and DR Congo. The hazard of second birth was significantly lower among women who desired additional child(ren) compared to desired for no more child in DR Congo (aHR=0.93; CI: 0.89–0.97), Ethiopia (aHR=0.64; CI: 0.61–0.67) and South Africa (aHR=0.51; CI: 0.47–0.55). Women who had never used contraceptive were 12%, 20% and 24% more likely to lengthen SBI than those who were current users in DR Congo, Nigeria and South Africa respectively. DR Congo and Nigerian women were about two times more likely to shorten SBI compared with their South African counterparts. Other significant determinants of SBI include ethnicity, rural residential, age and marital status at first birth, wealth and employment status. Conclusion: Findings showed differentials in the linkage between second birth interval and the desired fertility and contraception by country, demonstrating the importance of context. The contribution of these factors to second birth interval requires country context-specific attention if further decline in fertility and poor health outcomes associated with sub-optimal inter-birth interval is to be attained in SSA.Item Survival analysis of time interval between first and second childbirth among women in Nigeria(College of Medicine, University of Ibadan, 2020) Fagbamigbe, A. F.; Ojo, A. E.; Onyeike, N. O.; Okafor, I. P.; Atilola, S. O.; Olabuyi, R. A.; Afolabi, R. F.Background: Birth spacing, especially between first and second births, could impact on fertility, and on maternal and child health. While the interval between marriage and first-birth has been widely studied, information on intervals between first and second births (SBI) and its determinants is scarce. We investigated the timing of second childbirth and its determinants among women in Nigeria. Methods: Using the 2013 Nigeria Demographic and Health Survey, we analysed data on 27451 women of reproductive age who had reported at least one childbirth as of the survey date. We used Kaplan-Meier survival analysis and Cox proportional-hazard regression with 95% confidence interval (CI) computed. Results: The median SBI among women in Nigeria was 34 months (CI: 33.7–34.3). The hazard of second-birth was higher among women from rural (HR=1.161; CI: 1.13-1.19) compared to those from the urban areas. While women living in other regions had tendencies to shorten SBI compared with the North Central, those from South West were 9% (aHR=0.91; CI: 0.86–0.96) less likely to delay it. For every one year age-at-first birth delayed among women, the hazard of second-birth increased by 1.9%. Wealth status, contraceptive use, being employed, higher education among women and spouses, and first-child survival are protective of SBI. Conclusions: Contraceptive use, being employed, living in an urban area, belonging to higher wealth quintile and higher educational attainment could lead to longer second birth interval which could lead to a healthier child, safer motherhood, and reduced fertility. Women should be encouraged to delay SBI as a fertility-control-strategy