Osman Abdisalan Ahmed, Esse Abdisalam Amin, Muse Abdisalam Hassan
Department of Statistics, Jigjiga University, P.O. Box 1020, Jigjiga, Ethiopia.
School of Postgraduate Studies and Research, Amoud University, Amoud Valley, Borama, Awdal, 25263, Somalia.
BMC Womens Health. 2025 Jul 14;25(1):346. doi: 10.1186/s12905-025-03900-2.
This study examines factors influencing the age at first birth among married women in Somalia, focusing on sociodemographic, economic, and health-related determinants. Given Somalia's fragmented health system and high maternal mortality rates, understanding first birth timing is critical for achieving Sustainable Development Goal 3 on maternal and child health. A Bayesian shared frailty model was employed to analyze variations in birth timing, comparing Weibull, log-normal, and log-logistic models using DIC and WAIC values. The results indicate that age at first marriage is the strongest predictor, with a higher age significantly reducing the hazard of first birth (HR = 0.4636, 95% CI: 0.4399-0.4886, p < 0.001). Residence also shows a significant effect, where women in rural areas experience delayed first births (HR = 0.9411, 95% CI: 0.9026-0.9813, p < 0.01). Other factors, including region, education, wealth, contraceptive use, and marital status, were not statistically significant, while the husband's desire for children had a weak association with first-birth timing. The Bayesian log-logistic AFT shared frailty model best predicted age at first birth. Regions like Banadir were linked to earlier births, while higher education, greater wealth, and later age at first marriage were the strongest predictors of delayed childbirth. Contraceptive use, marital status, and media access had minimal impact. Socio-demographic and economic factors, especially age at marriage and education, are key determinants. Finally, the study highlights the influence of social and family dynamics on reproductive health, underscoring the need for targeted interventions to delay early childbearing and improve maternal and child health in Somalia.
本研究考察了影响索马里已婚妇女初育年龄的因素，重点关注社会人口学、经济和健康相关的决定因素。鉴于索马里卫生系统碎片化且孕产妇死亡率高，了解初育时间对于实现关于母婴健康的可持续发展目标3至关重要。采用贝叶斯共享脆弱模型分析生育时间的差异，使用离差信息准则（DIC）和广泛适用信息准则（WAIC）值比较威布尔模型、对数正态模型和对数逻辑斯蒂模型。结果表明，初婚年龄是最强的预测因素，年龄越大，初育风险显著降低（风险比HR = 0.4636，95%置信区间CI：0.4399 - 0.4886，p < 0.001）。居住地也显示出显著影响，农村地区的妇女初育时间延迟（HR = 0.9411，95% CI：0.9026 - 0.9813，p < 0.01）。其他因素，包括地区、教育、财富、避孕措施使用情况和婚姻状况，在统计学上不显著，而丈夫对孩子的生育意愿与初育时间的关联较弱。贝叶斯对数逻辑斯蒂加速失效时间共享脆弱模型对初育年龄的预测效果最佳。像巴纳迪尔这样的地区与较早生育有关，而高等教育、更多财富和较晚的初婚年龄是分娩延迟的最强预测因素。避孕措施的使用、婚姻状况和媒体接触的影响最小。社会人口学和经济因素，尤其是结婚年龄和教育程度，是关键决定因素。最后，该研究强调了社会和家庭动态对生殖健康的影响，突显了在索马里采取针对性干预措施以延迟早育并改善母婴健康的必要性。
