Differentials of post-partum amenorrhea: a survival analysis.

Post-partum amenorrhea is an important event for females' reproductive life and their health. It is the time period between the end of pregnancy and the resumption of menstruation after delivery, and it is considered to be the temporary infecundable period of women's reproductive life-span. The main aim of this article is to examine the differentials of post-partum amenorrhea by using current status reporting data according to the characteristics of the mother and her child. The data are utilized from a sample survey of Palpa and Rupandehi districts of western rural Nepal. A life-table based technique of survival analysis has been used. Important summary measures have been computed in order to see the differentials of duration of post-partum amenorrhea. The study revealed that parity of mothers, age of mothers, breast-feeding practices and survival status of the child were found to be the main differentials of the duration of post-partum amenorrhea. Amenorrhea period was found shorter for lower parity and younger mothers. Amenorrheic period was found to be increased with increased birth-interval and duration of breast-feeding practices. A strong positive association was found between the duration of post-partum amenorrhea and breast-feeding. The study also revealed that an inverse association was found between the duration of post-partum amenorrhea and socio-economic status of mothers. The survival status of the child showed a strong effect for the timing of amenorrhea. This study investigated the important differentials of amenorrhea by using current status reporting data according to the characteristics of mother and her child. The estimated values of mean, median and trimean duration of amenorrhea were compared. For instance, trimean of amenorrheic period was found to be 9.6 months while median was 8.4 months and mean was 10.4 months. This finding indicates that the trimean provided the most consistent and best estimates of the duration of amenorrhea than other averages. The trimean is the best measure if the data contain censored and open-ended class interval. Parity, age of mothers, survival status of child, breast-feeding practices and socio-economic status of mothers were found to be the main influencing factors for the timing of amenorrhea among rural Nepalese mothers. Although the coverage of the present study is limited to small areas as well as to a small sample size, it is expected that the findings may help in designing appropriate policies and programs for improving mothers' and children's health as well as for reducing the existing fertility level of a country.

Breastfeeding in Nepal: patterns and determinants.

The aim of this study was to investigate the determinants of breast-feeding according to the characteristics of mother and her child. Cox proportional hazard model technique has been employed to investigate the determinants of breast-feeding. The data were utilized from a sample survey of Palpa and Rupandehi districts of rural Nepal. The study revealed that the current age of mothers, their education and socio-economic status were found to be the main determinants of breast-feeding. The current age of mother showed statistically significant relation with the duration of breast-feeding. Younger mothers are most likely to terminate breast-feeding early as compared to older counter-parts. The decreased risk of terminating breast-feeding was found with increased duration of post-partum amenorrhea, and a strong positive association was found to be statistically significant. The increased relative risk of terminating breast-feeding was found with increased the level of education of mothers, which indicates that the education is inversely related to the duration of breast-feeding. For instance, three times higher risk of terminating breast-feeding was found for educated mothers as compared to illiterate mothers. Socio-economic status of the household exhibits a statistically significant effect on the duration of breast-feeding. It is believed that this finding may help planners and policy-makers for designing proper policy and program for improving mothers and their children's health and for reducing fertility of a country.

Retrospective reporting of the duration of post-partum amenorrhea: a survival analysis.

INTRODUCTION: Duration of post-partum amenorrhoea (PPA) is the period from the end of pregnancy to begin of menstruation. It is a temporary infecundable period. The attainment of first menstruation after delivery is treated as the termination of PPA. OBJECTIVES: The main aim of this paper is to investigate the differentials of the duration of PPA according to the characteristics of mothers and their child. METHODS: The data are taken from a sample survey of Palpa and Rupandehi districts. A total of 1019 ever-married mothers were interviewed. 481 mothers were provided information on the duration of PPA to their last but one born child (retrospective status reporting). Survival analysis technique has been used. RESULTS: It was found that the distribution of PPA showed a heaping at the multiple of three months. Mean duration of PPA was found to be ten months and it was higher among mothers of higher parity, older mothers and higher age at birth of child. Younger mothers have lower duration than that of the older. Mean duration was increased with the increased parity of mothers. A strong positive association was observed between the duration of PPA and breastfeeding (BF). The increased duration of PPA was found with the increased birth interval. The survival status of child was found a strong consequence on amenorrheaic period. Inverse association was found with education as well as high socioeconomic status of the family. A significant association was found with residential as well as caste/ethnic groups. CONCLUSION: Mean duration of PPA was found to be 10.6 months. Amenorrheaic period was found higher among mothers of higher parity, older ages, and higher age at birth of the child. A positive relationship was found with BF whereas inverse association was found with the level of education. Duration of PPA was decreased with the increased level of socio-economic status.