Background. Studies examining the associations between short birth spa
cing and child mortality have often concentrated on the strength of th
e associations whilst the public health importance of short spacing in
specific communities has received less attention. This study re-exami
nes the association between short birth intervals and child mortality
in rural Senegal and discusses the potential direct effects of efforts
to delay births on child mortality in this community. Methods. The st
udy uses longitudinal data in a cohort of 4852 children born between 1
983 and 1989. The associations between birth spacing and child mortali
ty are examined using logistic and Cox proportional hazards regression
models. Results. The probability of dying before age five is 224 per
1000 livebirths. The median interval between births is 33 months and o
nly 12% of the birth intervals are less than 24 months in length. The
odds of dying in the neonatal and post-neonatal period is 2.27 and 2.1
2 times higher respectively for children born after preceding birth in
tervals of one year or less compared to children born after longer int
ervals. Children born within two years of a subsequent birth are at 4.
09 times higher risk of dying in the second year of life than children
whose mother gave birth more than 2 years after the index birth. Conc
lusions. In this community where prolonged breastfeeding causes women
to space their births at long intervals, short birth intervals are a c
onsequence rather than a cause of child mortality and the potential di
rect effects of birth spacing efforts on child mortality are limited.
To reduce the high levels of child mortality, efforts will have to be
made to ensure effective preventive and curative health services, and
to maintain the traditional pattern of breastfeeding.