Time to first birth and its predictors among reproductive age women in high fertility countries in Sub-Saharan Africa: Inverse Weibull gamma shared frailty model

Abstract

Background Early initiation of childbearing leads to an increase in total fertility rate and population growth. It has been linked with both maternal and child morbidity and mortality. However, there is limited information on the timing of the first birth and its predictors in the area so far. Therefore, determining the time to first birth and its predictors will help to design strategies to improve fertility rate, maternal and child survival. Methods The survey used recent (2010 – 2018) Demographic and Health data; a stratified, two-stage cluster sampling technique was used to select the sample. Inverse Weibull gamma shared frailty model was used to model the data at 95% confidence interval. Adjusted hazard ratio (AHR) and median hazard ratio (MHR) were reported as effect size. Statistical significance was declared at p value < 0.05. Results The overall median age at first birth was found to be 19 years (IQR: 16, 21 years). Rural residency (AHR = 1.02, 95%, CI 1.00,1.04), agricultural employee (AHR = 1.14, 95%, CI 1.13, 1.17), and nonagricultural employee (AHR = 1.06, 95%, CI 1.05, 1.08), marriage below 15 years (AHR = 5.47, 95%, CI 5.37, 5.57) and 15–17 years (AHR = 3.27, 95%, CI 3.22, 3.32), had sex below 15 years (AHR = = 1.57, 95%, CI 1.54, 1.61) and 15–17 years (AHR = 1.38, 95%, CI 1.38, 1.43), women who had unmet need for contraceptive (AHR = 1.39, 95%, CI 1.37, 1.42), and met need (AHR = 1.32, 95%, CI 1.30, 1.35), high spousal age gap (AHR = 1.17, 95%, CI 1.15, 1.19), not heard family planning message (AHR = 1.02, 95%, CI 1.01,1.04) were the higher hazard of early childbirth. Conclusion The median age at first birth was found to be 19 years. This is lower than the optimal age for giving first birth, which is between late 20 s and early 30 s years. Rural residences, occupation, hearing family planning massage in the media, early sexual intercourse, early age at first marriage, high spousal gap, and unmet need for family planning were predictors of first birth at an early age. Thus, governments and non-governmental organizations should strive to implement programs that aim to reduce early age at first birth by considering these factors.

Time to first birth and its predictors among reproductive-age women in Ethiopia: multilevel analysis using shared frailty model

“…This result is comparable with the finding by Negash et al in SSA countries where there is a high fertility rate. 12 However, when compared with the analysis done using the 2016 EDHS data, there is a reduction in age to first birth between 2016 and 2019. 11 13 The time to first birth in this study is also low when compared with that of Nigeria 15 and other developed countries like Switzerland, Japan, Spain, Italy and South Korea, where the average age of first birth is 31 years.…”

“…This is supported by the study in SSA level. 12 13 20 The reason for this might be because those women residing in rural areas are less knowledgeable, have less accessible to health information and could not easily access and utilise family planning services compared with urban dwellers. The presence of low utilisation of modern contraceptive methods might contribute to hastened first child birth in rural areas.…”

“…Accordingly, northern (Tigray and Amhara regions), Oromia, Southern Nations and Nationalities and Peoples (SNNP), eastern (Somalia and Afar regions), western (Benishangul-Gumuz and Gambella regions), and urban (Addis Ababa and Dire Dawa city administration and Harari). 12 …”

Association between women’s empowerment and demand for family planning satisfied among Christians and Muslims in multireligious African countries

“…The stronger association was identified among DFPS by traditional methods and the social independence domain. Variables within this domain, such as women’s education, age at first birth and first cohabitation, and spousal differences in age and education, have been associated with contraceptive use 3 45–47. This association may be influenced by a range of factors related to both the health system and sociocultural norms.…”

Investigating time to first birth among women of reproductive age in Bangladesh: a survival analysis of nationwide cross-sectional survey data

“…The potential determinants used in this study were motivated by the availability in the BDHS dataset, field expertise and relevant literature [ 2 , 19 , 21 , 30 , 40 – 44 ]. The socio-demographic factors, husband-related factors, reproductive factors, media exposure, etc., are included as potential determinants of age at first birth in the analysis.…”