Spatial analysis of individual- and village-level sociodemographic characteristics associated with age at marriage among married adolescents in rural Niger

Measuring social norms related to child marriage among married women and men in Niger

BACKGROUND

Child marriage remains prevalent in the Sahel region. Pervasive norms regarding child marriage, and sexual behavior persist. We explored norms from multiple perspectives to strengthen interventions aimed at delaying age at marriage.

METHODS

This study analyzed a cross-sectional household survey conducted in Niger in 2022 with women aged 15-49 (n = 2,726) and a subset of their male household members aged 15-59 (n = 1,136). Separate logistic regression models assessed factors associated with three descriptive (e.g., perception of what others do) and injunctive (e.g., perception of a group's approval or disapproval) normative outcomes related to practices that support marriage as soon as a girl reaches puberty and beliefs related to premarital sex.

RESULTS

Our study found a greater proportion of men described early marriage as protective from the fear of socially induced ruined marital prospects for women (70% vs. 64%), while women expressed its protection from being harassed (62% compared to 42%). The injunctive norm outcome that "my neighbors think that one should marry off one's daughter as soon as she reaches puberty" was significantly associated with the belief that child marriage was protective for females among women (OR = 4.49; 95% CI 3.13. 5.50) and men (OR = 8.21; 95% CI 5.88, 11.45).

CONCLUSIONS

Programs addressing child marriage should consider both male and female perspectives to address differences and foster an environment where communities and families shift norms to delay early marriage.

Measuring social norms of intimate partner violence to exert control over wife agency, sexuality, and reproductive autonomy: an item response modelling of the IPV-ASRA scale

BACKGROUND

The field of violence prevention research is unequivocal that interventions must target contextual factors, like social norms, to reduce gender-based violence. Limited research, however, on the social norms contributing to intimate partner violence or reproductive coercion exists. One of the driving factors is lack of measurement tools to accurately assess social norms.

METHODS

Using an item response modelling approach, this study psychometrically assesses the reliability and validity of a social norms measure of the acceptability of intimate partner violence to exert control over wife agency, sexuality, and reproductive autonomy with data from a population-based sample of married adolescent girls (ages 13-18) and their husbands in rural Niger (n = 559 husband-wife dyads) collected in 2019.

RESULTS

A two-dimensional Partial Credit Model for polytomous items was fit, showing evidence of reliability and validity. Higher scores on the "challenging husband authority" dimension were statistically associated with husband perpetration of intimate partner violence.

CONCLUSIONS

This brief scale is a short (5 items), practical measure with strong reliability and validity evidence. This scale can help identify populations with high-need for social norms-focused IPV prevention and to help measure the impact of such efforts.

A multilevel analysis of prevalence and factors associated with female child marriage in Nigeria using the 2018 Nigeria Demographic and Health Survey data

BACKGROUND

Globally, there has been a decline in female child marriage (FCM) from 1 in 4 girls married a decade ago to approximately 1 in 5 currently. However, this decline is not homogenous because some regions are still experiencing a high prevalence of FCM. As such, the United Nations reiterated the need for concentrated efforts towards ending FCM to avoid more than 120 million girls getting married before their eighteenth birthday by 2030. Following this, we examined the prevalence and factors associated with FCM in Nigeria using multi-level analysis.

METHODS

We used cross-sectional data from the women's file of the Nigeria Demographic and Health Survey (NDHS) conducted in 2018. A sample of 4143 young women aged 20-24 was included in the study. Our analysis involved descriptive, chi-square (χ2) and multi-level analyses. Results were presented in percentages, frequencies, and adjusted odds ratios (aOR) with their respective confidence intervals (CIs).

RESULTS

The prevalence of FCM in 2018 was 65.30%. Young Muslim women aged 20-24 [aOR = 1.40; 95% CI (4.73-7.52)], those with parity between one and two [aOR = 5.96, 95% CI 4.73-7.52], those residing in North East [aOR = 1.55; 95% CI (1.19-2.10)] and North West [aOR = 1.59; 95% CI (1.18-2.16)] had a higher odd of practicing FCM respondents with secondary education and above [aOR = 0.36; 95% CI (0.29-0.46)], those within the richer wealth index [aOR = 0.35; 95% CI (0.23-0.54)] and young women living in communities with high literacy level [aOR = 0.74; 95% CI (0.59-0.92)] were less likely to get married before age 18 years.

CONCLUSION

Our findings indicate that FCM is high in Nigeria. Formal education, being rich and living in communities with high literacy levels were some protective factors that can be strengthened to ensure that FCM is reduced or eliminated in Nigeria. On the other hand, residing in North-East or North-West and having children between one and two were some prevailing factors that exacerbated the odds of experiencing FCM in Nigeria. Therefore, attention should be channelled towards mitigating these prevailing negative factors.

Associations of Age at Marriage With Marital Decision-Making Agency Among Adolescent Wives in Rural Niger

PURPOSE

Child marriage is associated with multiple adverse health and social outcomes. Although evidence suggests that child marriage is associated with reduced participation in personal and household decisions for women, less is known about the association between age at marriage and decision-making among married adolescent girls. This study assesses associations between adolescents' age at marriage and two dimensions of decision-making (participation and satisfaction) in the high early marriage prevalence settings of Niger.

METHODS

Cross-sectional data from a cluster-randomized control trial of a community-level program to increase the use of modern contraceptives among married adolescents in the Dosso region of Niger were analyzed. Multiple logistic regression models were used to determine the association of age at marriage with married girls' participation in and satisfaction with decision-making processes.

RESULTS

More than half of married adolescents (N = 796) were married before reaching the age of 15 years. Older age at marriage was associated with adolescents' increased participation in decisions related to economics (adjusted odds ratio: 1.23; 95% confidence interval: 1.05-1.43) and health-care access (adjusted odds ratio: 1.18; 95% confidence interval: 1.01-1.40), but not with greater reported satisfaction with their control over these decisions.

CONCLUSIONS

The study suggests that marrying as a very young adolescent places girls in even more disadvantaged positions regarding decision-making. These findings indicate the need to design programs targeted at addressing inequitable gender norms to reduce early child marriage and increase participation in decision-making. Further study of satisfaction with participation in decision-making is recommended, including consideration of whether it is related to gender norms for participation in decisions rather than actual participation.

Drivers of Marriage and Health Outcomes Among Adolescent Girls and Young Women: Evidence From Sub-Saharan Africa and South Asia

PURPOSE

Previous studies have examined the relationship between age at marriage and health outcomes, but few have explored how marriage drivers are associated with health outcomes. In this study, we examine the relationship between two marriage drivers, premarital pregnancy and agency, and several health outcomes (use of maternal health care services, child health outcomes, and change in depressive symptoms) among married adolescent girls and young women (AGYW) in sub-Saharan Africa and South Asia.

METHODS

We use three panel data sets collected by the Population Council: the Adolescent Girls Empowerment Program from Zambia (N = 660), the Malawi Schooling and Adolescent Study from Malawi (N = 1,041), and Understanding the Lives of Adolescents and Young Adults from India (N = 894 in Bihar, N = 599 in Uttar Pradesh). Our analytical models use logistic and multinomial logistic regression.

RESULTS

We find mixed evidence of the association between marriage drivers and health outcomes. Results show that having agency in marital partner choice in India is associated with both an increase and decrease in reported depressive symptoms. In addition, pregnancy before marriage is associated with fewer antenatal visits and hospital-based births in Malawi than pregnancy after marriage. However, we find no evidence that it is associated with worse child health outcomes than pregnancy after marriage in Malawi and Zambia.

CONCLUSIONS

Overall, our study suggests that the relationship between marriage drivers and AGYW's health outcomes after marriage is not consistent across contexts. We highlight the importance of interpreting marriage drivers within prevailing norms to understand their impact on married AGYW's health.

Planning for work: Exploring the relationship between contraceptive use and women's sector-specific employment in India

While the health-related benefits of contraceptive use for women are well documented, potential social benefits, including enabling women’s employment, have not been well researched. We examine the relationship between contraceptive use and women’s employment in India, a country where both factors have remained relatively static over the past ten years. We use data from India’s 2015–16 National Family Health Survey to test the association between current contraceptive use (none, sterilization, IUD, condom, pill, rhythm method or withdrawal) and current employment status (none, professional, clerical or sales, agricultural, services or production) with multivariable, multinomial regression; variable selection was guided by a directed acyclic graph. More than three-quarters of women in this sample were currently using contraception; sterilization was most common. Women who were sterilized or chose traditional contraception, relative to those not using contraception, were more likely to be employed in the agricultural and production sectors, versus not being employed (sterilization adjusted relative risk ratio [aRRR] = 1.5, p<0.001 for both agricultural and production sectors; rhythm aRRR = 1.5, p = 0.01 for agriculture; withdrawal aRRR = 1.5, p = 0.02 for production). In contrast, women with IUDs, compared to those who not using contraception, were more likely to be employed in the professional sector versus not being employed (aRRR = 1.9, p = 0.01). The associations between current contraceptive use and employment were heterogeneous across methods and sectors, though in no case was contraceptive use significantly associated with lower relative probabilities of employment. Policies designed to support women’s access to contraception should consider the sector-specific employment of the populations they target.

Mapping the patchwork: Exploring the subnational heterogeneity of child marriage in India

Despite dramatic reductions in child marriage over the past decade, more than one in four girls in India still marry before reaching age 18. This practice is driven by a complex interplay of social and normative beliefs and values that are inadequately represented in national- or even state-level analyses of the drivers of child marriage. A geographic lens was employed to assess variations in child marriage prevalence across Indian districts, identify hot and cold spots, and quantify spatial dependence and heterogeneity in factors associated with district levels of child marriage. Data were derived from the 2015-16 National Family Health Survey and the 2011 India Census, and represent 636 districts in total. Analyses included global Moran's I, LISAs, spatial Durbin regression and geographically weighted regression. This study finds wide inter- and intra-state heterogeneity in levels of child marriage across India. District levels of child marriage were strongly influenced by geographic characteristics, and even more so by the geographic characteristics of neighboring districts. Districts with higher levels of female mobile phone access and newspaper use had lower levels of child marriage. These relationships, however, were all subject to substantial local spatial heterogeneity. The results indicate that characteristics of neighboring districts, as well as characteristics of a district itself, are important in explaining levels of child marriage, and that those relationships are not constant across India. Child marriage reduction programs that are targeted within specific administrative boundaries may thus be undermined by geographic delineations that do not necessarily reflect the independent and interdependent characteristics of the communities who live therein. The geographic, social and normative characteristics of local communities are key considerations in future child marriage programs and policies.

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Child marriage prevalence is highly heterogeneous across Indian districts.

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Districts near state border districts tend to have higher levels of child marriage.

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Characteristics of districts and their neighbors influence child marriage.

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Geography affects the relationship between social normative factors and child marriage.

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Child marriage interventions may require joint action across states.