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BMC Public Health Oct 2015Most pregnancies among adolescent girls and young women aged 15-24 years occur in low- and middle-income countries (LMICs), and do so within marriage. The mortality... (Review)
Review
BACKGROUND
Most pregnancies among adolescent girls and young women aged 15-24 years occur in low- and middle-income countries (LMICs), and do so within marriage. The mortality rates and pregnancy-related morbidities are significantly higher among the women of younger age group in many South Asian and Sub-Saharan African countries. This paper presents a review of the available evidence on the effectiveness of community-based health interventions to improve the reproductive health status of young married couples in LMICs.
METHOD
We carried out a systematic review of research studies and evaluation reports of different community-level initiatives in improving access to contraception, pregnancy care and safe abortion services by young married couples, where women were in the age-group of 15-24 years.
RESULTS
Of the 14 projects, which met inclusion criteria, eight met the quality criteria and were included in the review (five from India, two from Nepal and one from Malawi). Our analysis shows that community-based interventions consisting of counseling of young married women, and their husbands, family and community members, as well as capacity building of health workers were some of the effective measures in increasing contraceptive use, delaying pregnancy and improving pregnancy care. Stratifying young women in line with their specific reproductive health needs (newly married woman, pregnant woman, mother of one/more children) was found to be a successful innovative strategy. None of these projects explicitly addressed improving access to safe abortion care.
CONCLUSION
Our review suggests that multi-layered community-based interventions, targeting young married women, their families and the health system can improve utilization of reproductive health services among young couples in resource-constrained settings. There is less focus on strategies to delay first pregnancy as compared to spacing among young women. Further, family and community level barriers in most of the project settings restricted its effective implementation. The paper emphasizes the need for further research to fill the knowledge gaps that exist about improving utilization of reproductive healthcare services, especially safe abortion care among young married women in LMICs.
Topics: Abortion, Induced; Adolescent; Adult; Community Health Services; Contraception; Contraception Behavior; Family Planning Services; Female; Health Promotion; Humans; Male; Marriage; Pregnancy; Reproductive Health; Young Adult
PubMed: 26452750
DOI: 10.1186/s12889-015-2352-7 -
PloS One 2024Utilization of modern contraceptives increases over time but it was still low and varies across ages among married youth woman. This study revealed the prevalence of...
Modern contraceptive utilization and associated factors among younger and older married youth women in Ethiopia: Evidence from Ethiopia Mini Demographic and Health Survey 2019.
INTRODUCTION
Utilization of modern contraceptives increases over time but it was still low and varies across ages among married youth woman. This study revealed the prevalence of modern contraceptives and its associated factors among younger and older married youth women.
METHODS
A cross-sectional study design was applied to the sample of EMDHS 2019. Multilevel logistic regressions were carried out using STATA version 16 to identify the individual and community-level factors of modern contraceptive utilization. Adjusted odds ratios with a 95% confidence interval and variables with a p-value < 0.05 were considered to be significant determinants of modern contraceptive utilization.
RESULT
In the EMDHS 2019, a total of 3290 married women between ages 15 and 34 were included. Among these 1210 (36.7%) and 2080 (63%) women, they were age groups of 15-24 and 25-34 years, respectively. Modern contraceptive utilization among women aged 15-24 and 25-34 years was 54.23% and 52.6%, respectively. Injection is a commonly used modern contraceptive method. In this study, factors associated with modern contraceptive utilization among women aged 15-24 years include women who had primary education [AOR = 2.22; 95% CI: 1.02-4.83], who had three or more children in the household [AOR = 14.29; 95% CI: 1.61-126.25], Protestants [AOR = 0.29; 95% CI: 0.14-0.61], five to seven households [AOR = 0.34; 95% CI: 0.17-0.69], and region [AOR = 6.98; 95%:2.30-21.16]. On other hand, factors associated with modern contraceptive utilization among women aged 25-34 were women who had one or two under-five children in the household [AOR = 1.66; 95% CI: 1.03-2.68] and region [AOR = 3.54; 95%CI: 1.79-6.97].
CONCLUSIONS
More than 50% of participants used modern contraceptives in both age groups and, the associated factor of modern contraceptive utilization varied among this age group. Health managers and policymakers need to consider age group, region, educational status, religion, and fertility level in planning of family planning program.
Topics: Humans; Female; Adolescent; Ethiopia; Adult; Young Adult; Contraception Behavior; Cross-Sectional Studies; Contraception; Marriage; Health Surveys; Family Planning Services; Age Factors; Contraceptive Agents
PubMed: 38805520
DOI: 10.1371/journal.pone.0300151 -
The Gerontologist Nov 2018In later life, adults' social networks grow smaller through a combination of intentional selection and involuntary loss. This study examined whether older adults who...
PURPOSE OF THE STUDY
In later life, adults' social networks grow smaller through a combination of intentional selection and involuntary loss. This study examined whether older adults who lack a high-quality marriage compensate for this using support from other ties. We analyzed how relationships with family and friends are associated with depressive symptoms across multiple marital statuses.
DESIGN AND METHODS
Data from 3,371 older adults who participated in the most recent wave of the National Social Life, Health, and Aging Project (NSHAP) were analyzed using analysis of variance (ANOVA) and ordinary least squares (OLS) regression.
RESULTS
Individuals in high-quality marriages experienced fewer depressive symptoms than the widowed, never married, divorced/separated, and those in lower-quality marriages. Older adults' perceived family support, family strain, and friend strain were all significantly associated with depressive symptoms. The only difference in these effects according to marital status was for perceived family support, which was strongest for the never married.
IMPLICATIONS
The never married may depend more on family and friends than the previously or unhappily married. Any compensation efforts among the latter failed to reduce depressive symptoms relative to happily married others. Older adults in high-quality marriages benefit from their marital relationship, and also benefit from supportive family and friend ties.
Topics: Aging; Depression; Female; Humans; Interpersonal Relations; Male; Marital Status; Marriage; Mental Health; Middle Aged; Single Person; Social Networking; Social Support
PubMed: 28962022
DOI: 10.1093/geront/gnx151 -
Reproductive Health May 2020Infertility is detrimental to the health of married couples, especially women. Despite the consequences associated with the condition, little is done to reduce the... (Review)
Review
BACKGROUND
Infertility is detrimental to the health of married couples, especially women. Despite the consequences associated with the condition, little is done to reduce the repercussions. This study throws more light on the lived experiences of infertile women and on how they can be helped to improve their own condition.
METHODOLOGY
We interviewed 30 infertile married women in the Northern and Ashanti regions of Ghana, 15 from each region. A qualitative method, phenomenological study design and thematic analysis was employed to explore their lived experiences.
RESULTS
Due the huge stigma, some women reported that their loved ones encouraged them to try to conceive. Others revealed that, they were considering relocating from their current communities to reduce the insults, intense pressure, stress, and stigma. Though some revealed maltreatment from their husbands and in-laws, others stated their husbands disclosed their fertility status to their own family members to avoid these families pressuring these women.
CONCLUSIONS
To reduce the stigma, pronatalist societies urgently need education and sensitization. Would-be couples should be counselled to have a plan to deal with such occurrences should they experience them.
Topics: Adult; Emotions; Female; Ghana; Humans; Infertility, Female; Marriage; Qualitative Research; Social Stigma
PubMed: 32434580
DOI: 10.1186/s12978-020-00920-z -
BMC Psychiatry Sep 2022Depression affects about 3.8% of the world's population. Although marriage may contribute to subjective well-being, some marital variables could increase women's risk...
BACKGROUND
Depression affects about 3.8% of the world's population. Although marriage may contribute to subjective well-being, some marital variables could increase women's risk for depression. This study aimed to determine the prevalence of depressive symptoms and their correlates among married females attending primary healthcare facilities.
METHODS
A cross-sectional study was conducted on a purposive sample of 371 married women at the primary healthcare centers, Assiut Governorate, Upper Egypt. In this study, an interviewer-administered questionnaire was used for data collection. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9) and marital satisfaction using the ENRICH Marital Satisfaction Scale (EMS). Standardized measurements of weight and height were performed.
RESULTS
According to the PHQ-9 diagnostic criteria, the prevalence of depressive symptoms among the studied married females was 30.2%. The significant predictors of depressive symptoms were advanced husbands' ages, living with an extended family, exposure to spousal verbal violence, high body weight, and low marital satisfaction levels.
CONCLUSIONS
Approximately one-third of married Egyptian women experienced depressive symptoms. In addition to high body weight, some social and marital factors contributed to the increase in women's vulnerability to depressive symptoms. Egyptian primary healthcare physicians should be trained to identify females with depressive symptoms and refer them to specialists if need be. To combat depression in women, it may be helpful to construct qualified marital counseling centers. This may improve marital satisfaction, decrease the negative consequences of spousal violence, and ensure the value of independence for new families.
Topics: Body Weight; Cross-Sectional Studies; Depression; Egypt; Female; Humans; Marriage; Prevalence; Primary Health Care
PubMed: 36088377
DOI: 10.1186/s12888-022-04239-w -
Psychology and Aging Aug 2021Late-life marital status is associated with cognitive aging; however, the influence of life course marital biography (i.e., changes in marital status) on late-life...
Late-life marital status is associated with cognitive aging; however, the influence of life course marital biography (i.e., changes in marital status) on late-life cognitive trajectories, as well as gender differences in the effects of marital biography, remain to be explored. Associations between (a) marital status at study baseline (currently married, previously married, never married) and (b) retrospectively reported life course marital biography (i.e., age at first marriage, time spent unmarried following initial marriage, history of divorce, history of widowhood) and up to 20 years of subsequent episodic memory trajectories were examined using latent growth curve models in 3,061 participants aged 51 + in the Health and Retirement Study 2017 Life History Mail Survey. Gender differences were examined with multiplicative interaction terms and stratified models. Participants who were married at study baseline demonstrated higher initial memory than previously and never married individuals. Older age at first marriage and shorter duration spent unmarried were each associated with better initial episodic memory among previously married individuals only; longer duration spent unmarried was associated with slower memory decline. Stratified models suggested that these associations may be driven by women. These results highlight the importance of considering multiple aspects of marital biography, not just current marital status, in cognitive aging research. Marital biography may have an enduring influence on cognitive aging, particularly among previously married older women. Future work is needed to identify mechanisms (e.g., socioeconomic resources, cognitive stimulation, self and spousal health, emotional support) through which marital histories influence cognitive aging. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Cognition; Cognitive Aging; Female; Health Status; Humans; Male; Marital Status; Marriage; Memory Disorders; Memory, Episodic; Middle Aged; Retrospective Studies; Social Support; Socioeconomic Factors; Spouses; Time Factors; Young Adult
PubMed: 34166026
DOI: 10.1037/pag0000617 -
The Journal of the Egyptian Public... Dec 2017Early marriage is associated with many social, physical, and health problems and it is common in many developing countries including Egypt. Many factors affect the...
BACKGROUND
Early marriage is associated with many social, physical, and health problems and it is common in many developing countries including Egypt. Many factors affect the decision of the timing of marriage. In this study, we aim to estimate the prevalence, social and health hazards and to identify the attitudes and factors that affect attitudes toward early marriage.
MATERIALS AND METHODS
This cross-sectional study was done in Sohag, Upper Egypt. Random samples of ever-married women aged 20-60 years were taken from six districts. A questionnaire was designed to collect the data.
RESULTS
The prevalence of early marriage is about 60%. The associated self-reported health and social hazards included: anemia (18%), hemorrhage (27.5%), uterine prolapse (37%), preterm (36%), low birth weight (31%), delayed immunization of infants (94%), separation from the husband (17%), and discontinuation of education (23%). About 42% of the studied population supported early marriage. Reasons for supporting include: to prevent premarital promiscuity (35%) and difficulty to get married later (28%). Reasons for not supporting include: being harmful to mothers (26%), difficulty in childcare, and discontinuation of education (18% each). Final models of factors significantly affecting women's attitudes indicated that the factors for not supporting early marriage were: attaining higher education and believing that early marriage is due to ignorance, is more common among relatives, and causes health or social problems.
CONCLUSION
Early marriage is still very common in Sohag. Including the hazards of early marriage in the curriculum of preparatory and secondary schools as well as encouraging girls to complete their education up to the university stage will help in decreasing this problem.
Topics: Adult; Age Factors; Cross-Sectional Studies; Developing Countries; Egypt; Female; Health Knowledge, Attitudes, Practice; Humans; Marriage; Middle Aged; Prevalence; Social Problems; Socioeconomic Factors; Surveys and Questionnaires; Young Adult
PubMed: 30612383
DOI: 10.21608/EPX.2018.22044 -
Journal of Counseling Psychology Jan 2015The first 6 months of marriage are optimal for marriage enrichment interventions. The Hope-Focused Approach to couple enrichment was presented as two 9-hr... (Randomized Controlled Trial)
Randomized Controlled Trial
The first 6 months of marriage are optimal for marriage enrichment interventions. The Hope-Focused Approach to couple enrichment was presented as two 9-hr interventions--(a) Handling Our Problems Effectively (HOPE), which emphasized communication and conflict resolution, and (b) Forgiveness and Reconciliation through Experiencing Empathy (FREE). HOPE and FREE were compared with repeated assessment controls. Couples were randomly assigned and were assessed at pretreatment (t1); 1 month posttreatment (t2) and at 3- (t3), 6- (t4), and 12-month (t5) follow-ups using self-reports. In addition to self-report measures, couples were assessed at t1, t2, and t5 using salivary cortisol, and behavioral coding of decision making. Of 179 couples who began the study, 145 cases were analyzed. Both FREE and HOPE produced lasting positive changes on self-reports. For cortisol reactivity, HOPE and FREE reduced reactivity at t2, but only HOPE at t5. For coded behaviors, control couples deteriorated; FREE and HOPE did not change. Enrichment training was effective regardless of the focus of the training.
Topics: Adult; Communication; Decision Making; Empathy; Female; Forgiveness; Humans; Male; Marriage; Negotiating; Spouses
PubMed: 25264599
DOI: 10.1037/cou0000045 -
BMC Public Health Mar 2018Migration has an influence on health behavior and food intake. Dietary variety is a key component to high-quality diets because a single food item does not contain a...
BACKGROUND
Migration has an influence on health behavior and food intake. Dietary variety is a key component to high-quality diets because a single food item does not contain a variety of nutrients and may not reflect nutritional adequacy. We aimed to compare the dietary diversity scores (DDS), food variety scores (FVS), and nutrient adequacy levels of married Filipino immigrant women in Korea to those of Korean women.
METHODS
We matched the data of 474 participants aged 20-57 years from the Filipino Women's Diet and Health Study (FiLWHEL) by age category with those of married Korean women randomly selected from the Korea National Health and Nutrition Examination Survey (KNHANES). Dietary information in FiLWHEL and KNHANES were assessed through the 24-hour recall method. We calculated the DDS by summing the number of eleven food groups consumed (DDS 10 g if they consumed at least 10 g/day; DDS all if they consumed any amount) and the FVS by counting the number of food items consumed. For nutrient adequacy, we calculated the probability of adequacy (PA) and intake below the estimated average requirement (EAR).
RESULTS
Filipino women had a lower DDS and FVS in comparison to Korean women. The means (±SDs) of DDS 10 g, DDS all, and FVS for Filipino women versus Korean women were 6.0 (±1.6) versus 6.8 (±1.5) (p < 0.001), 6.7 (±1.7) versus 7.9 (±1.4) (p < 0.001) and 9.2 (±3.3) versus 14.7 (±4.9) (p < 0.001), respectively. When we compared each food group, the intakes of fish, other seafood, legumes/seeds/nuts, eggs, vegetables, and fruits were lower for Filipino women than for Korean women. The mean probability of adequacy (MPA) of nutrient intake of the nine selected nutrients was lower for Filipino women in comparison to Korean women. The mean (±SD) was 0.55 (±0.28) versus 0.66 (±0.26), respectively.
CONCLUSIONS
Our findings showed that married Filipino immigrant women in Korea had lower dietary variety scores in comparison to Korean women. This was reflected in their nutritional adequacy. Nutrition education focusing on the promotion of eating a variety of foods may be needed for Filipino immigrant women in Korea.
Topics: Adult; Diet; Emigrants and Immigrants; Female; Humans; Marriage; Middle Aged; Nutrition Surveys; Nutritional Status; Philippines; Republic of Korea; Young Adult
PubMed: 29544458
DOI: 10.1186/s12889-018-5233-z -
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