Socio-Demographic and Socio-Cultural Factors Associated in SBAs Utilization Among Adolescent Mothers Aged 13 - 19 Years in Afgooye District, Somalia

Pregnancy among Adolescents is still a major public health challenges in Somalia, where high fertility rates (118/1,000 adolescents) and maternal mortality (692 / 100,000 live births) are further exacerbated by child marriage and female genital mutilation. This study was aimed to assess the utilization of skilled birth attendants (SBAs) and associated factors among adolescent mothers in Afgooyo District. A mixed-methods cross-sectional study was applied, involving 339 teenage mothers using structured questionnaires and qualitative interviews. Quantitative data were analyzed using SPSS version 27. The findings revealed that only 17.7% of respondents utilized SBAs, a Figure far below the national estimate of 32%. Factors significantly associated with lower SBA utilization included having non formal education (aOR = 0.062, 95% CI: 0.015–0.263), earning less than USD 50 per month (aOR = 0.125, 95% CI: 0.034–0.465), and delivery decisions being made by partners or in-laws (aOR = 0.130, 95% CI: 0.048–0.355). In contrast, belief in the importance of SBAs increased the likelihood of utilization (aOR = 3.651, 95% CI: 1.202–11.094), while preference for home delivery reduced the likelihood of SBA use (aOR = 0.190, 95% CI: 0.067–0.542). SBAs utilization among teenage mothers in Afgooyo District remains low and is significantly influenced by education, household income, decision-making autonomy, perceptions of SBA importance, and preferred place of delivery. Strengthening girls’ education, economic empowerment, women’s autonomy in healthcare decisions, and positive community perceptions of skilled delivery care could improve SBA utilization.