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PloS One 2022Considering the persistent poor maternal and child health outcomes in sub-Saharan Africa (SSA), this study undertook a comparative analysis of the timing and adequacy of...
CONTEXT
Considering the persistent poor maternal and child health outcomes in sub-Saharan Africa (SSA), this study undertook a comparative analysis of the timing and adequacy of antenatal care uptake between women (aged 20-24 years) who married before age 18 and those who married at age 18 or above.
METHOD
Data came from Demographic and Health Surveys of 20 SSA countries. We performed binary logistic regression analysis on pooled data of women aged 20-24 (n = 33,630).
RESULTS
Overall, the percentage of child brides in selected countries was 57.1%, with the lowest prevalence found in Rwanda (19.1%) and the highest rate in Chad (80.9%). Central and West African countries had the highest prevalence of child marriage compared to other sub-regions. Bivariate results indicate that a lower proportion of child brides (50.0%) had 4+ ANC visits compared to the adult brides (60.9%) and a lower percentage of them (34.0%) initiated ANC visits early compared to the adult brides (37.5%). After controlling for country of residence and selected socio-economic and demographic characteristics, multivariable results established significantly lower odds of having an adequate/prescribed number of ANC visits among women who married before age 15 (OR: 0.63, CI: 0.57-0.67, p<0.001), and women who married at ages 15-17 (OR: 0.81, CI: 0.75-0.84, p<0.001) compared to those who married at age 18+. Similar results were established between age at first marriage and timing of first ANC visit. Other interesting results emerged that young women who married earlier than age 18 and those who married at age 18+ differ significantly by several socio-economic and demographic characteristics.
CONCLUSION
Efforts to improve maternal and child health outcomes in SSA must give attention to address the underutilization and late start of antenatal care uptake among child brides.
Topics: Adolescent; Africa South of the Sahara; Age Factors; Family; Female; Humans; Marriage; Patient Acceptance of Health Care; Pregnancy; Prenatal Care; Prevalence; Socioeconomic Factors; Young Adult
PubMed: 35025949
DOI: 10.1371/journal.pone.0262688 -
PloS One 2021The present global study attempts to verify the links between marital satisfaction and the number of children as well as its moderators in an international sample. Data...
The present global study attempts to verify the links between marital satisfaction and the number of children as well as its moderators in an international sample. Data for the study was obtained from our published dataset and included 7178 married individuals from 33 countries and territories. We found that the number of children was a significant negative predictor of marital satisfaction; also sex, education, and religiosity were interacting with the number of children and marital satisfaction, while there were no interactions with economic status and individual level of individualistic values. The main contribution of the present research is extending our knowledge on the relationship between marital satisfaction and the number of children in several, non-Western countries and territories.
Topics: Child; Databases, Factual; Family Characteristics; Female; Humans; Male; Marriage; Personal Satisfaction; Socioeconomic Factors; Spouses; Surveys and Questionnaires
PubMed: 33886597
DOI: 10.1371/journal.pone.0249516 -
Reproductive Health Jul 2021Over the past 25 years, tremendous progress has been made in increasing the evidence on child marriage and putting it to good use to reduce the prevalence of child...
Over the past 25 years, tremendous progress has been made in increasing the evidence on child marriage and putting it to good use to reduce the prevalence of child marriage and provide support to married girls. However, there is still much to be done to achieve the Sustainable Development Goal target 5.3 of ending child marriage by 2030, and to meet the needs of the 12 million girls who are still married before age 18 each year. To guide and stimulate future efforts, the UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction, the World Health Organization, the UNICEF-UNFPA Global Programme to End Child Marriage, and Girls Not Brides: The Global Partnership to End Child Marriage convened an expert group meeting in 2019 to: (1) review the progress made in building the evidence base on child marriage since the publication of research priorities in this area in 2015, (2) identify an updated set of research priorities for the next ten years, and (3) discuss how best to support research coordination, translation, and uptake. This article provides a summary of the progress made in this area since 2015 and lists an updated set of research gaps and their rationale in four key areas: (1) prevalence, trends, determinants, and correlates of child marriage; (2) consequences of child marriage; (3) intervention effectiveness studies to prevent child marriage and support married girls; and (4) implementation research studies to prevent child marriage and support married girls. It also highlights a number of calls-to-action around research coordination and knowledge translation to support the emerging and evolving needs of the field.
Topics: Adolescent; Child; Family; Female; Humans; Marriage; World Health Organization
PubMed: 34284797
DOI: 10.1186/s12978-021-01176-x -
BMC Infectious Diseases Nov 2023Research indicates that women in polygamous relationships may be exposed to unique sexual and reproductive health challenges. However, there are very few studies that...
BACKGROUND
Research indicates that women in polygamous relationships may be exposed to unique sexual and reproductive health challenges. However, there are very few studies that examine whether polygamy is associated with safe sex negotiation among married women in sub-Saharan Africa, including Cameroon.
METHODS
Using the 2018 Cameroon Demographic and Health Survey, we apply logistic regression analysis to compare two indicators of safe sex negotiation (i.e., the ability to ask for condom use and refuse sex against their partner) between polygamous (n = 1,628) and monogamous (n = 5,686) women aged 15-49 years old.
RESULTS
We find that 67% and 50% of married women can ask for condom use and refuse sex against their partner, respectively. Multivariate analysis further reveals that women in polygamous relationships are less likely to report they can ask for condom use (OR = 0.71, p < 0.001) and refuse sex (OR = 0.64, p < 0.001) in comparison to their monogamous counterparts.
CONCLUSIONS
Our analysis found that in Cameroon, women in polygamous relationships, Muslim women, married women with inadequate HIV knowledge, those who had never been tested for HIV and women with lower socioeconomic status are less likely to negotiate for safe sex. Based on these findings, we discuss several implications for policymakers, including the establishment of a comprehensive family planning educational program and the deployment of community health workers to disseminate educational initiatives pertaining to safe sex negotiation to community members.
Topics: Humans; Female; Adolescent; Young Adult; Adult; Middle Aged; Safe Sex; Marriage; Negotiating; Cameroon; Sexual Behavior; HIV Infections; Condoms
PubMed: 37993765
DOI: 10.1186/s12879-023-08826-4 -
International Journal of Environmental... Jan 2023The current study investigated the trends and factors associated with the unmet need for family planning (FP) for limiting and spacing births among married Tanzanian...
The current study investigated the trends and factors associated with the unmet need for family planning (FP) for limiting and spacing births among married Tanzanian women between 1999 and 2016. The study used Tanzania Demographic and Health Survey (TDHS) data for the years 1999 ( = 2653), 2004-2005 ( = 2950), 2010 ( = 6412), and 2015-2016 ( = 8210). Trends in the unmet need for FP were estimated over the study period. Multivariable multinomial logistic regression models were used to investigate the association between community-level, predisposing, enabling, and need factors with the unmet need for FP in Tanzania. The results showed no significant change in percentage of married women with an unmet need for birth spacing between 1999 and 2016. The proportion of married women with an unmet need for limiting births decreased from 9.5% (95% confidence interval (CI): 7.9%, 10.6%) in 1999 to 6.6% (95% CI: 5.9%, 7.3%) in 2016. Residing in a rural area, parity between 1-4 and 5+, visiting a health facility for any health services within twelve months, and planning to have more children (after two years and/or undecided) were factors positively associated with the unmet need for FP-spacing. Women with parity of 5+ were more likely to experience an unmet need for FP-limiting. Women's age between 25-34 and 35-49 years, women's employment status, watching television, women's autonomy of not being involved in household decisions, and planning to have more children were factors associated with lower odds of having an unmet need for FP-spacing. Women's age between 25-34 years, watching television, autonomy, and planning to have more children were factors with lower odds of having an unmet need for FP-limiting. Improving FP uptake among married Tanzanian women can reduce the unmet need for FP. Therefore, reducing unmet needs for FP is attainable if government policies and interventions can target women residing in rural areas and other modifiable risk factors, such as parity, health facility visits, planning to having more children, employment, watching television, and women's autonomy.
Topics: Pregnancy; Child; Female; Humans; Adult; Family Planning Services; Tanzania; Family Conflict; Sex Education; Marriage; Contraception
PubMed: 36767627
DOI: 10.3390/ijerph20032262 -
PloS One 2021A growing body of literature provides important insights into the meaning and impact of the right to marry a same-sex partner among sexual minority people. We conducted... (Review)
Review
A growing body of literature provides important insights into the meaning and impact of the right to marry a same-sex partner among sexual minority people. We conducted a scoping review to 1) identify and describe the psychosocial impacts of equal marriage rights among sexual minority adults, and 2) explore sexual minority women (SMW) perceptions of equal marriage rights and whether psychosocial impacts differ by sex. Using Arksey and O'Malley's framework we reviewed peer-reviewed English-language publications from 2000 through 2019. We searched six databases (PubMed, PsycINFO, CINAHL, Web of Science, JSTOR, and Sociological Abstracts) to identify English language, peer-reviewed journal articles reporting findings from empirical studies with an explicit focus on the experiences and perceived impact of equal marriage rights among sexual minority adults. We found 59 studies that met our inclusion criteria. Studies identified positive psychosocial impacts of same-sex marriage (e.g., increased social acceptance, reduced stigma) across individual, interpersonal (dyad, family), community (sexual minority), and broader societal levels. Studies also found that, despite equal marriage rights, sexual minority stigma persists across these levels. Only a few studies examined differences by sex, and findings were mixed. Research to date has several limitations; for example, it disproportionately represents samples from the U.S. and White populations, and rarely examines differences by sexual or gender identity or other demographic characteristics. There is a need for additional research on the impact of equal marriage rights and same-sex marriage on the health and well-being of diverse sexual minorities across the globe.
Topics: Adult; Humans; Marriage; Sexual and Gender Minorities; Social Stigma
PubMed: 33956825
DOI: 10.1371/journal.pone.0249125 -
PloS One 2020Child marriage, defined by the United Nations as marriage before the age of 18, is considered a violation of human rights with negative consequences for girls' health....
Child marriage, defined by the United Nations as marriage before the age of 18, is considered a violation of human rights with negative consequences for girls' health. We systematically reviewed existing academic literature and news media to learn what is known about the frequency of child marriage in Canada and its effects on health. Approximately 1% of 15-19-year-olds in Canada were married or in common law unions in 2016. News reports document cases of child marriage among religious minority communities but no nationwide estimates of the frequency of marriage before the age of 18 were identified. Sources consistently show girls are more likely to marry as teens than boys. Information on married teens between 15 and 19 years of age suggests similarities in marriage patterns among this age group in Canada and child marriage practices globally. Further research is needed to measure Canada's progress toward eliminating child marriage.
Topics: Adolescent; Age Factors; Canada; Child; Educational Status; Female; Health Status Disparities; Human Rights; Humans; Male; Marriage; Socioeconomic Factors; Young Adult
PubMed: 32126116
DOI: 10.1371/journal.pone.0229676 -
Social Science Research Sep 2021This article documents how opportunity and change in the U.S. occupational structure shaped patterns of occupational assortative mating between 1970 and 2015-2017....
This article documents how opportunity and change in the U.S. occupational structure shaped patterns of occupational assortative mating between 1970 and 2015-2017. Trends in occupational assortative mating have often been cited as potentially contributing to the rise in economic inequality-the idea that doctors increasingly marry doctors instead of nurses-thereby exacerbating the concentration of resources among advantaged households. Previous estimates of trends in occupational assortative mating are now decades old and their impact on household inequality has not been quantified. Our results show large-scale change. The prevalence of dual-professional couples nearly tripled between 1970 and 2015-2017. Changes were especially large among particular occupational combinations. For instance, male doctors have become increasingly likely to be married to female doctors, and male lawyers to female lawyers. Almost all of the changes in occupational assortative mating patterns, however, are accounted for by changes in the distributions of spouses' occupations, for example, the rise of women in professional occupations. Because of this, the contribution of occupational assortative mating to the rise in economic inequality has been small. In the absence of any association between spouses' occupations, observed increases in household earnings inequality would have been reduced by 5%. Although this is a small portion of overall changes in inequality, it is much larger than prior estimates of the effects of educational assortative mating on inequality, which recent studies have estimated to be essentially zero.
Topics: Educational Status; Family Characteristics; Female; Humans; Income; Male; Marriage; Spouses
PubMed: 34429208
DOI: 10.1016/j.ssresearch.2021.102600 -
Reproductive Health Jun 2023Niger has the highest rate of adolescent fertility in the world, with early marriage, early childbearing and high gender inequity. This study assesses the impact of... (Randomized Controlled Trial)
Randomized Controlled Trial
Effects of the reaching married adolescents program on modern contraceptive use and intimate partner violence: results of a cluster randomized controlled trial among married adolescent girls and their husbands in Dosso, Niger.
BACKGROUND
Niger has the highest rate of adolescent fertility in the world, with early marriage, early childbearing and high gender inequity. This study assesses the impact of Reaching Married Adolescents (RMA), a gender-synchronized social behavioral intervention designed to improve modern contraceptive use and reduce intimate partner violence (IPV) among married adolescent couples in rural Niger.
METHODS
We conducted a four-armed cluster-randomized trial in 48 villages across three districts in Dosso region, Niger. Married adolescent girls (ages 13-19) and their husbands were recruited within selected villages. Intervention arms included home visits by gender-matched community health workers (CHWs) (Arm 1), gender-segregated, group discussion sessions (Arm 2), and both approaches (Arm 3). We used multilevel mixed-effects Poisson regression models to assess intervention effects for our primary outcome, current modern contraceptive use, and our secondary outcome, past year IPV.
RESULTS
Baseline and 24-month follow-up data were collected April-June 2016 and April-June 2018. At baseline, 1072 adolescent wives were interviewed (88% participation), with 90% retention at follow-up; 1080 husbands were interviewed (88% participation), with 72% retention at follow-up. Adolescent wives had higher likelihood of modern contraceptive use at follow-up relative to controls in Arm 1 (aIRR 3.65, 95% CI 1.41-8.78) and Arm 3 (aIRR 2.99, 95% CI 1.68-5.32); no Arm 2 effects were observed. Relative to those in the control arm, Arm 2 and Arm 3 participants were significantly less likely to report past year IPV (aIRR 0.40, 95% CI 0.18-0.88 for Arm 2; aIRR 0.46, 95% CI 0.21-1.01 for Arm 3). No Arm 1 effects were observed.
CONCLUSIONS
The RMA approach blending home visits by CHWs and gender-segregated group discussion sessions is the optimal format for increasing modern contraceptive use and decreasing IPV among married adolescents in Niger. Trial registration This trial is retrospectively registered with ClinicalTrials.gov, Identifier NCT03226730.
Topics: Humans; Female; Adolescent; Marriage; Intimate Partner Violence; Contraception Behavior; Spouses; Niger; Rural Population; Family Planning Services
PubMed: 37277837
DOI: 10.1186/s12978-023-01609-9 -
BMC Public Health Oct 2020An estimated 650 million girls and women alive today married before their 18th birthday. Referred to as girl child marriage, the formal or informal union of the... (Review)
Review
An estimated 650 million girls and women alive today married before their 18th birthday. Referred to as girl child marriage, the formal or informal union of the girl-child before age 18, the practice is increasingly recognized as a key roadblock to global health, development, and gender equality. Although more research than ever has focused on girl child marriage, an important gap remains in deconstructing the construct. Through an extensive review of primary and secondary sources, including legal documents, peer-reviewed articles, books, and grey literature across disciplines, we explore what the term "girl child marriage" means and why it more accurately captures current global efforts than other terms like early, teenage, or adolescent marriage. To do this, we dive into different framings on marriage, children, and gender. We find that there has been historical change in the understanding of girl child marriage in published literature since the late 1800s, and that it is a political, sociocultural, and value-laden term that serves a purpose in different contexts at different moments in time. The lack of harmonized terminology, particularly in the global public health, prevents alignment amongst different stakeholders in understanding what the problem is in order to determine how to measure it and create solutions on how to address it. Our intent is to encourage more intentional use of language in global public health research.
Topics: Adolescent; Age Factors; Child; Female; Global Health; Humans; Marriage
PubMed: 33054856
DOI: 10.1186/s12889-020-09545-0