Socio-Economic and Demographic Determinants of Open Birth Intervals Among Rural Women in Manipur, North East India

Abstract

Background: Open birth interval (OBI) is an important measure of fertility behaviour, providing insights into reproductive decision-making, birth spacing, and fertility limitation within populations. Objectives: This study aims to examine the socio-economic and demographic determinants of OBI among currently married women in the rural valley districts of Manipur, North-East India. Materials and Methods: A cross-sectional, community-based survey was carried out among 1,059 currently married women with at least one live birth in Bishnupur, Imphal East, Imphal West, and Thoubal districts. Primary data were collected through personal interviews using a pre-tested semi-structured schedule between February and August 2024, with February 10, 2024, as the reference date. OBI was defined as the duration (in months) between the most recent live birth and the survey date, incorporating right-censored observations. Survival analysis techniques, particularly the Log-rank (Mantel–Cox) test, were applied to assess differences in OBI across selected socio-economic and demographic variables. Findings: The analysis revealed significant differentials in OBI across both socio-economic and demographic characteristics. Type of family and educational qualification emerged as highly significant socio-economic determinants (p < 0.01), with women from joint families and those with lower educational attainment exhibiting longer OBIs. Among demographic factors, age at current marriage, duration of current marriage, and present age showed highly significant associations with OBI (p < 0.01), while contraceptive use was also significant (p < 0.05). A clear life-course pattern was observed, with median OBI increasing steadily with advancing age and marital duration, indicating fertility limitation and cessation behaviour. Contraceptive users recorded substantially longer OBIs than non-users. Conclusion: The study demonstrates that open birth intervals in rural valley Manipur are shaped by a complex interaction of socio-economic conditions, demographic progression, and reproductive practices, underscoring the need for policies promoting female education, delayed marriage, and improved access to effective contraception to support optimal birth spacing.