Local understandings and current barriers to optimal birth intervals among recently delivered women in Sylhet District, Bangladesh

Nicholas B. Lehnertz, Ashraful Alam, Nabeel Ashraf Ali, Elizabeth G. Henry, Emma K. Williams, Syed Moshfiqur Rahman, Salahuddin Ahmed, Shams El Arifeen, Abdullah H. Baqui, Peter J. Wincha

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Sylhet Division in Bangladesh has the highest proportion of births spaced less than 36 months (46.5%) in Bangladesh. Methods: Formative research was conducted on current fertility-related practices in order to explore how to integrate the promotion of healthy fertility practices into a package of maternal and neonatal care interventions. In-depth interviews, focus group discussions and other qualitative methods were utilized with recently delivered women, their families, community health workers and community leaders in Sylhet Division. Results: Mothers of young children generally understood the benefits of both healthy timing and spacing of pregnancies. However, a variety of factors prevent these desired behaviours from becoming actualized, including the roles of women in the provision of children/grandchildren, local understandings of modern contraceptive methods, perceived side effects, lack of communication regarding healthy fertility practices between partners and extended family members, and limited female autonomy. Conclusions: In order to increase families' ability to achieve optimal birth intervals, we propose the promotion and integration of healthy fertility practices into antenatal and newborn care interventions, focusing on providing biomedically correct and culturally appropriate information on modern contraceptive methods to the entire family, while simultaneously encouraging open spousal and family communication patterns regarding timing and spacing of pregnancy.

Original languageEnglish (US)
Article numberiht031
Pages (from-to)266-272
Number of pages7
JournalInternational health
Issue number4
StatePublished - Dec 2013


  • Bangladesh
  • Birth spacing
  • Family planning

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health


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