Burden of maternal high-risk fertility behaviour on under-five children's health status in Hadiya zone, Southern Ethiopia: a facility-based cross-sectional study.

Background: Maternal high-risk fertility behaviours (HRFBs) are common in African countries and can potentially affect child survival. Evidence of the burden of maternal HRFB on under-five children is scant in Ethiopia.

Objective: To determine the burden of maternal HRFB on under-five children's health status in Hadiya zone, Southern Ethiopia.

Design: A facility-based cross-sectional study was conducted.

Setting: All secondary and tertiary public healthcare centres; that are, one referral and three district hospitals providing comprehensive emergency obstetric care services in the Hadiya zone, Southern Ethiopia.

Participants: Three hundred women of reproductive age (15-49 years) who had undergone childbirth in the 5 years preceding this study and living with at least one child younger than 5 years admitted to public hospitals in Hadiya zone were included.

Main Outcome Measure: Under-five children's health status.

Results: The overall proportion of maternal HRFB among currently married women was 60.3%, with 35.0% falling into a single high-risk category and 25.3% falling into multiple high-risk categories. Children younger than 5 years born to mothers having HRFB had an increased chance of acute respiratory infections five times, diarrhoea six times, fever eight times, low birth weight six times and a chance of dying before the fifth birthday two times than children born to mothers with no risk. The risks of morbidity and mortality further increased when children were born to mothers falling into multiple high-risk categories.

Conclusions: The overall proportion of maternal HRFB among currently married women was high in the study area. A statistically significant association was seen between maternal HRFB and health outcomes of children younger than 5 years old. Intervening to avert maternal HRFBs through family planning may help to reduce childhood morbidity and mortality.