Assessing the Relationship between Short Birth-to-Pregnancy Interval and the Maternal and Perinatal Outcomes among Multiparous Women in Northern Ghana

Introduction: The World Health Organization (WHO) recommends an optimal Birth-to-Pregnancy Interval (BPI) of 24-59 months, or a 33-month interval between two successive births, to reduce the risk of untoward maternal and newborn outcomes. Short Birth to Pregnancy Interval (SBPI) and unmet need for Family Planning (FP) are the major contributors to rapid population growth and increased maternal and newborn mortalities. The purpose of this study was to assess the adverse perinatal and maternal outcomes associated with SBPI among multiparous women in three municipalities of the Upper East Region (UER) of Ghana. Materials and Methods: We employed a cross-sectional design conducted among 904 women aged 15-49 attending Antenatal Care (ANC) clinics in three municipalities in the UER who had at least two successive live births prior to data collection. A multistage cluster sampling technique was employed to recruit respondents for this study. This was conducted in four steps. Out of the 46 health facilities, we randomly selected 25 respondents using the systematic random selection method. Data was collected using a structured questionnaire, incorporated into the electronic data collection tool (Kobo collect), and administered by trained research assistants. Birth interval was categorized according to the WHO’s classification: <24 months as SBPI, 24-≥59 months as Optimal Birth to Pregnancy Interval (OBPI), and >59 months as Long Birth to Pregnancy Interval (LBPI). Results: Of the 904 respondents, the majority (56.2%) had an OBPI, while 36.9% had a SBPI. Factors that influenced SBPI were parity, mode of delivery, and the educational status of woman’s partner. Participants with a higher parity (≥5 children) had 0.67 times the potential of spacing their births (AOR 0.67; 95% CI 0.46-0.98; p = 0.040). Women who experienced a Caesarean Section (CS) delivery were 3.28 times more likely to have LBPI (AOR 3.28; 95% CI 1.02–10.62; p=0.047). Respondents whose partners had secondary education had a 1.87 chance (AOR 2.07; 95% CI 1.09–3.96; p=0.027) of spacing their births. The birth complications reported were retained products of conception (41.9%), pregnancy-induced hypertension (27.9%), postpartum hemorrhage (11.6%), obstructed labor (10.5%), sepsis (38.1%), neonatal jaundice (23.8%), low birth weight (19%), and preterm birth (14.3%). Conclusion: A significant proportion of the participants in this study reported having a short duration between the birth of one child and the conception of the next. This was associated with various adverse maternal and perinatal outcomes, such as birth complications and mortalities. The study emphasizes the need for health professionals to address challenges in contraceptive uptake, especially among multiparous women, and promote optimal birth spacing to improve maternal and perinatal outcomes

Assessing the Relationship between Short Birth-to-Pregnancy Interval and the Maternal and Perinatal Outcomes among Multiparous Women in Northern Ghana

Introduction: The World Health Organization (WHO) recommends an optimal Birth-to-Pregnancy Interval (BPI) of 24-59 months, or a 33-month interval between two successive births to reduce the risk of untoward maternal and newborn outcomes. Short Birth to Pregnancy Interval (SBPI), and unmet need for Family Planning (FP) are the major contributors to rapid population growth and increased maternal and newborn mortalities. The purpose of this study was to assess the adverse perinatal and maternal outcomes associated with SBPI among multiparous women in three municipalities of the Upper East Region (UER) of Ghana.  Materials and Methods:The study employed the Cross-sectional Design conducted among 904 women aged 15-49 years attending Antenatal Care (ANC) clinics in three municipalities in the UER who had at least two successive live births prior to data collection. Data was collected using structured questionnaire, incorporated into the electronic data collection tool, Kobo collect and administered by trained research assistants. Birth interval was categorized according to the WHO’s classification, <24 months as SBPI, 24-≥59 months as Optimal Birth to Pregnancy Interval (OBPI) and >59 months as Long Birth to Pregnancy Interval (LBPI). Results: Of the 904 respondents, the majority (56.2%) had an OBPI, while 36.9% had a SBPI. Factors that influenced SBPI were parity, mode of delivery, and the educational status of women’s partner. Participants with a higher parity (≥5 children) had 0.67 times the potential of spacing their births (AOR 0.67; 95% CI 0.46-0.98; p = 0.040). Women who experienced a Caesarean Section (CS) delivery were 3.28 times more likely to have LBPI (AOR 3.28; 95% CI 1.02-10.62; p=0.047). Respondents whose partners had secondary education had a 1.87 chance (AOR 2.07; 95% CI 1.09-3.96; p=0.027) of spacing their births. The birth complications reported were retained products of conception (41.9%), pregnancy-induced hypertension (27.9%), postpartum hemorrhage (11.6%), obstructed labor (10.5%), sepsis (38.1%), neonatal jaundice (23.8%), low-birth-weight (19%), and preterm birth (14.3%). Conclusion and Global Health Implications: The study recommends health professionals in direct contact with maternal, reproductive, and child health to be proactive in FP counseling, and to support women decision making

Decision support tools for site-specific fertilizer recommendations and agricultural planning in selected countries in sub-Sahara Africa

Peer Revie

Modelling varietal differences in response to phosphorus in West African sorghum

International audienceIn West Africa’s highly weathered soils, plant-available soil-P levels determine sorghum performance and yield to a far greater extent than projected variability in climate. Despite local landrace varieties having excellent adaptation to the environment and a relatively stable yield, sorghum grain yield remains quite low, averaging less than 1 t ha−1. Low P availability in West African soils has significant effects on crop development and growth with potential grain yield losses of more than 50%. Use of mechanistic models, which integrate physiological processes, could assist with understanding the differences in P-uptake among varieties and guide effective P management. Yet only few crop models include a soil-plant P model for simulating crop yield response to P management. A generic soil-plant P module was developed for crop models in the Cropping System Model (CSM) of the Decision Support System for Agrotechnology Transfer (DSSAT) but the module was adapted and tested only on two crops, groundnut and maize. The aim of the study was to adapt the soil-plant P module for sorghum and perform initial testing on highly weathered soils in West Africa. Data used in adapting and testing the soil-plant P model for sorghum consisted of in-season P concentrations and dry weights of stems, leaves and grain from four sorghum varieties covering a range of maturities and photoperiod sensitivities and grown in high-P and P-deficient soils at ICRISAT-Mali. Results showed that the coupled CERES-Sorghum − P module reasonably reproduced the vegetative and grain yield reductions experienced in the field experiments with an average RMSE of 1561 and 909 kg ha−1 under high P conditions and 1168 and 466 kg ha−1 under low P conditions, respectively. The simulations are in most cases within the observation error. We also confirmed that contrasting variety types differ in their P-uptake dynamics relative to above-ground growth change over time, and hence respond differently to available P

Predicting maize phenology: intercomparison of functions for developmental response to temperature

Accurate prediction of phenological development in maize (Zea mays L.) is fundamental to determining crop adaptation and yield potential. A number of thermal functions are used in crop models, but their relative precision in predicting maize development has not been quantified. The objectives of this study were (i) to evaluate the precision of eight thermal functions, (ii) to assess the effects of source data on the ability to differentiate among thermal functions, and (iii) to attribute the precision of thermal functions to their response across various temperature ranges. Data sets used in this study represent >1000 distinct maize hybrids, >50 geographic locations, and multiple planting dates and years. Thermal functions and calendar days were evaluated and grouped based on their temperature response and derivation as empirical linear, empirical nonlinear, and process-based functions. Precision in predicting phase durations from planting to anthesis or silking and from silking to physiological maturity was evaluated. Large data sets enabled increased differentiation of thermal functions, even when smaller data sets contained orthogonal, multi-location and -year data. At the highest level of differentiation, precision of thermal functions was in the order calendar days < empirical linear < process based < empirical nonlinear. Precision was associated with relatively low temperature sensitivity across the 10 to 26 degrees C range. In contrast to other thermal functions, process-based functions were derived using supra-optimal temperatures, and consequently, they may better represent the developmental response of maize to supra-optimal temperatures. Supra-optimal temperatures could be more prevalent under future climate-change scenarios, but data sets in this study contained few data in that range