Analyzing Factors Affecting Age at First Birth among Married Women in Somalia: A Bayesian Shared Frailty Modeling Approach using SDHS 2020

Abstract

The birth of the first child primarily influences fertility, with young mothers accounting for one in ten childbirths worldwide. Somalia faces challenges in achieving Sustainable Development Goals, particularly SDG 3 on maternal and child health, owing to its fragmented health system and high maternal mortality rates. The study investigates factors affecting the age at first birth among married women in Somalia, including sociodemographic, economic, and health-related factors. It uses shared frailty modeling and evaluates the Bayesian shared frailty model's performance in capturing variation in birth timing. The Bayesian shared frailty model was applied to identify factors influencing the time to first birth among married women in Somalia. Weibull, log-normal, and log-logistic models were compared, and based on their LOOIC and WAIC values, the log-normal model was found to be the most appropriate, as it had the lowest values, indicating a better fit. Consequently, the Bayesian approach and log-logistic AFT model analysis revealed that Region, Residence, and Husband's desire for children are statistically significant factors for married women’s survival time to first birth in Somalia. The study recommends promoting early marriage, preventing underage marriages, expanding education access, addressing maternal health disparities, and strengthening family planning programs for Somali women's reproductive health, especially in rural and nomadic areas.