Hajia Aishetu Tairu
Forty-three year old Alice Atule, a resident of Pobaga community, in the Bolgatanga Municipality of the Upper East Region by luck or share coincidence has been able to space the birth of her three children.
Alice who for the past seven years has been on a modern form of contraceptive- the injectables- to limit the number of births said she has benefited from the two to three-year birth spacing of her children.
“I had time for all my children especially when they were young because I spaced their birth,” Alice said. “I made sure I breast fed them and also gave them good food,” she added.
Alice noted that there are very few occasion when there is a bumper harvest in the community leaving families with more children being the most affected.
“This place is difficult so if you give birth plenty your children will suffer of hunger and I did not want my children to suffer.”
The right nutrition during the first 1,000 days of a child’s life has a profound impact on his or her ability to properly develop, learn and reach their full potential.
This is because proper nutrition during pregnancy and in the first years of a child’s life provides the essential building blocks for brain development, healthy growth and a strong immune system.
In fact, a growing body of scientific evidence shows that the foundations of a person’s lifelong health are largely set during this 1,000 day window.
This is why it is critical that women and children get the right nutrition during this time. But issues of poverty, inadequate healthcare access, poor young infant feeding practices due to poor birth spacing brings about inadequate nutrition for children particularly those in the three northern regions of Ghana.
Malnutrition in Ghana
Poor nutrition is a major issue in Ghana, where two in five children are stunted (suffering from chronic malnutrition).
The United Nations Children’s Fund (UNICEF) Ghana Report shows that although levels of malnutrition in Ghana have dropped, 23% of children are still stunted and 57% are anaemic.
It also states that nutrition is particularly poor in the three northern regions of Ghana, where more than 80% of children suffer from anaemia.
“Only 35 % of households are using iodized salt, leading to iodine deficiency – the most common cause of brain damage in the world with less than half of all children aged 0–6 months in Ghana are exclusively breastfed,” the report stated.
Malnutrition/Birth Spacing
Child bearing patterns, such as maternal age, birth order, and the interval between births have an important influence upon the probability that a child will survive infancy and early childhood although health experts have paid little attention to the link between the two phenomena.
Recent world fertility surveys of comparative data from developing countries has reconfirm the significance these relationships, particularly birth spacing or child spacing, have as key factors contributing to child nutrition and survival.
Indeed the name of the serious nutritional disease “Kwashiorkor” originates from Ghana, where it means the sickness of a suckling child when the next one is conceived.
Dr. Patrick Kumah Aboagye, Director of the Family Health Division, Ghana Health Service (GHS) said one factor that is often ignored when it comes to strategies to reduce under nutrition is the time interval between births.
He indicated that a quick succession of pregnancies can have a deleterious effect on the health status of the mother, and consequently affect the health conditions of the baby during child development in the womb.
“Birth or child spacing has a particular significance for child nutrition and survival,” he said. “Studies show that when the length of time between two births in a family is less than two years, the new-born, on average, is twice as likely to die in infancy as might a child born after a longer birth-interval.”
According to the UNICEF Study, birth spacing plays an important role in nutritional status among children under 5 years of age, with shorter birth intervals increasing the risk of both stunting and underweight.
Data from numerous WHO collaborative studies also indicate that in most communities babies had the best chance to survive infancy when they were born after a three-to-four year interval.
It is interesting to note that these phenomena appear to hold true for families irrespective of the wealth or poverty of the family, level of maternal education, rural or urban habitat.
Social Mobilization
Hajia Aishetu Tairu, the Regional President of the Federation of Muslim Women in Upper East Region, has been mobilizing women to support each other economically and socially and one of the things they do when they meet is to talk about birth spacing.
“We took this decision because we realize our members were having too many children within a short period of time so we bought in nurses to talk to them about family planning,” she said. “When the men marry their women it takes them at least three years and they have two children so when they see that the child is about two years and pregnancy is not coming they normally ask but we make them understand it is right to properly space the children.”
Hajia Aishetu said since the programme started a few years ago the group has seen significant changes in the spacing of births by group members. “Now our babies are healthy and they grow stronger,” she said.
Thus, when organizations like UNICEF is supporting the GHS to scale up community level support to address severe acute malnutrition by scaling up the Community Management of Acute Malnutrition (CMAM) programme in the three Northern Regions issue of birth spacing should not be left out.
From Jamila Akweley Okertchiri, Pobaga, Bolgatanga