Abstract

The short or long birth interval is a common public health issue that affects women’s and children’s health in sub-Saharan Africa. Despite a higher burden of short or long birth intervals, establishing causal relationships between birth intervals and their determinants remains challenging due to the potential for unobserved confounding factors. The objective of this research is to apply parametric and semiparametric survival mixed-effects regression, especially the shared frailty model to model the length of time to successive second births within the reproductive mothers and identify the sociodemographic and sociocultural factors that cause variation in the length of the birth interval using 2015-16 Malawi Demographic Health Survey data. Weibull mixed-effects survival model with gamma-distributed random effects provides a better fit for describing the birth interval data than Cox proportional hazard mixed-effects with normal and gamma random effects, exponential mixed-effects with normal and gamma random effect, and Weibull mixed effects with normal random effect. The findings also revealed that mothers from rural areas, the central region, and those who use traditional or modern contraceptive methods had a higher likelihood of having a second child. In contrast, women from middle or rich families, those with secondary or tertiary education, and those who had their first child alive had a lower likelihood of giving birth to a second child. This study uses gamma and normal densities for random effects distribution, suggesting future studies should consider other random effects distributions like positive stable, compound poisson, and inverse Gaussian.

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School	: School of Natural and Applied Sciences
Issued Date	: 2024

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