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

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.

Prevalence of and factors associated with female child marriage in Indonesia

Statistics from the 2018 National Social and Economic Survey revealed that one out of nine young females in Indonesia have been in female child marriage, and the prevalence remains high. Considering the serious consequences of female child marriage and that Sustainable Development Goal 5 on gender equality has targeted the elimination of female child marriage by 2030, a study concerning the prevalence and determinants of female child marriage needs to be conducted in Indonesia. In this paper, we examined the prevalence of and factors associated with female child marriage in Indonesia using binary logistic regression. We examined data from the Indonesia Demographic and Health Survey conducted in 2017. A sample of 9,333 young females aged 15-20 years was included in the study. Our analysis involved descriptive and binary logistic regression analysis. The results are presented in percentages and odds ratios (OR), with their respective confidence intervals. Our findings indicate that health insurance and sex of household head did not significantly influence female child marriage. The prevalence of female child marriage in Indonesia was quite high, reaching about 12.53%. Females with no education [OR = 76.448; (CI = 29.73-196.70)], not working [OR = 1.662; (CI = 1.41-1.94)], those with the poorest wealth index [OR = 3.215; (CI = 2.336-4.425)], those living in the east of Indonesia [OR = 1.451; (CI = 1.132-1.862)], and those living in rural areas [OR = 0.718; (CI = 0.609-0.844)] had the higher odds of experiencing female child marriage. Meanwhile, females with a secondary education level [OR = 16.296; (CI = 11.098-23.930)], those with a rich wealth index [OR = 1.940; (CI = 1.404-2.681)], and those living in the middle of Indonesia [OR = 1.263; (CI = 1.074-1.487)] were less likely to experience female child marriage. Educational background was the most significant factor influencing the high prevalence of female child marriage in Indonesia. Female empowerment through education as well as poverty alleviation were factors that could be strengthened to ensure that female child marriage is reduced or eliminated in Indonesia. Equality of access to information and better quality of education also need to be prioritized.

Factors Associated with Utilization of Sexual and Reproductive Health Services among Married Adolescent Girls in Kano, Northern Nigeria

Background and Objective

Married adolescents face significant obstacles in making informed reproductive health decisions and accessing sexual and reproductive health (SRH) services. It is important to identify barriers hindering these adolescents from accessing SRH services. The aim of this study was to identify factors associated with the utilization of SRH services among married adolescent girls in northern Nigeria.

Methods

We used a cross-sectional study design. The study population comprised of married female adolescents aged 14-19 years who were residents in the study areas for at least six months. The outcome measure was SRH service utilization, defined as the use of any of the conventional SRH services (ante/postnatal care, human immunodeficiency virus (HIV) testing and counseling, sexually transmitted infections (STI) treatment, family planning, and post-abortion care). Predictor variables included the sociodemographic, obstetric, and gynecological characteristics of the respondents. An adapted, pretested, interviewer-administered, and semi-structured questionnaire was employed for data collection. Multivariable logistic regression was used to explore the independent association between selected variables and utilization of SRH services.

Results

A total of 200 respondents were surveyed (100 each from an urban and a rural community in Kano, Nigeria), survey response rate: 94.5%. The age of respondents ranged from 14 to 19 years, with mean age (± standard deviation) of 18.5 (±1.1) years and 17.5 (±1.3) years for urban and rural respondents, respectively. All respondents were aware of the available SRH facilities and preferred public facilities (92.6% urban respondents and 67.0% rural respondents). Ever-use of SRH services was higher among urban than rural respondents (86% vs. 56%, respectively). Geographic proximity was a key factor for urban respondents (64.2%), while affordability was considered important by rural respondents (47.9%). Respondent's age and partner's occupation were independently associated with utilization of SRH services. Urban respondents whose husbands were businessmen were seven times more likely to use SRH services than those whose partners were civil servants (adjusted odds ratio [aOR] = 6.80, 95% confidence interval [CI]: 1.29-35.84, P = 0.02). Rural respondents 18 years of age and older were approximately six times more likely to utilize SRH services than those <18 years (aOR = 5.71, 95% CI: 1.56-12.78, P = 0.01).

Conclusion and Global Health Implications

Awareness of available SRH services was high in the study population, and service utilization was influenced by the respondent's age and partner's occupation. Findings from this study can help inform the development of age-appropriate and accessible SRH services tailored to married adolescents in similar settings.

Nutrition knowledge and health vulnerability of mothers of pre-school children in north-central, Nigeria

OBJECTIVE

This study explores the contribution of nutrition knowledge to the health status of pre-school children's mothers in Niger State, North-Central, Nigeria.

DESIGN

The study is a descriptive cross-sectional design using a quantitative data collection method.

SETTING/PARTICIPANTS

A multi-stage sampling technique was used to recruit 450 mothers of pre-school children across Niger state, Nigeria. Chi-square and linear regression were used to test the level of statistical significance (at p < 0.05). Socioeconomic and demographic information, anthropometric indices and nutrition knowledge were obtained using semi-structured questionnaires. Feeding patterns were also assessed using a qualitative 7-day dietary recall.

RESULT

The results showed that the majority (63.8%) of the mothers were within 26-35 years, and more than half (51.6%) of the mothers lacked knowledge of a "balanced diet". Fruits, vegetables, and dairy products were the least consumed food group among the mothers (7.1% and 9.1%, respectively). Place of residence, occupation, and method of waste disposal were significantly associated with maternal minimum dietary diversity adequacy (p<0.05). Over half (57.6%) of the mothers were within the normal BMI range, and the mean waist/hip ratio was 0.82± 0.08. Social media/online was the most (36.4%) explored source of nutrition information among the mothers. This study shows no significant association between nutrition knowledge and adequacy of minimum dietary diversity among the mothers of preschool children (p = 0.09, χ2 = 13.682).

CONCLUSION

Dietary diversity among mothers was associated with the socioeconomic status and BMI of the mothers, which were strong determinants of meal quality and health outcomes in Nigeria and other developing countries experiencing food insecurity.

Shifts in age pattern, timing of childbearing and trend in fertility level across six regions of Nigeria: Nigeria Demographic and Health Surveys from 2003-2018

BACKGROUND

Nigeria's population is projected to increase from 200 million in 2019 to 450 million in 2050 if the fertility level remains at the current level. Thus, we examined the shifts in the age pattern of fertility, timing of childbearing and trend in fertility levels from 2003 and 2018 across six regions of Nigeria.

METHOD

This study utilised the 2003, 2008, 2013, and 2018 Nigeria Demographic and Health Survey datasets. Each survey was a cross-sectional population-based design, and a two-stage cluster sampling technique was used to select women aged 15-49 years. The changes in the timing of childbearing were examined by calculating the corresponding mean ages at the birth of different birth orders for each birth order separately to adjust the Quantum effect for births. The Gompertz Relational Model was used to examine the age pattern of fertility and refined fertility level.

RESULT

In Nigeria, it was observed that there was a minimal decline in mean children ever born (CEB) between 2003 and 2018 across all maternal age groups except aged 20-24 years. The pattern of mean CEB by the age of mothers was the same across the Nigeria regions except in North West. Nigeria's mean number of CEB to women aged 40-49 in 2003, 2008, 2013 and 2018 surveys was 6.7, 6.6, 6.3 and 6.1, respectively. The mean age (years) at first birth marginally increased from 21.3 in 2003 to 22.5 in 2018. In 2003, the mean age at first birth was highest in South East (24.3) and lowest in North East (19.4); while South West had the highest (24.4) and both North East and North West had the lowest (20.2) in 2018. Similar age patterns of fertility existed between 2003 and 2018 across the regions. Nigeria's estimated total fertility level for 2003, 2008, 2013 and 2018 was 6.1, 6.1, 5.9 and 5.7, respectively.

CONCLUSION

The findings showed a reducing but slow fertility declines in Nigeria. The decline varied substantially across the regions. For a downward change in the level of fertility, policies that will constrict the spread of fertility distribution across the region in Nigeria must urgently be put in place.

Determinants of early marriage among married women in nine high fertility sub-Saharan African countries: a multilevel analysis of recent demographic and health surveys

BACKGROUND

Early marriage is global issue that seriously harms women's personal development and rights. Regarding this, information about married women's early marriage is inadequate in the world, including sub-Saharan Africa; therefore, this study aimed to assess the early marriage of women in the top nine highly fertile SSA countries.

METHODS

Data for this study was obtained from the most recent Demographic and Health Surveys. A total weighted sample of 121,077 married reproductive-age women was included. A multilevel mixed-effect binary logistic regression model was fitted to identify the significant associated factors of early marriage. As a final step, the Adjusted Odds Ratio (AOR) was used with a confidence interval of 95% in determining statistical significance.

RESULTS

Overall prevalence of early marriage was 55.11% (95% CI: 54.8, 55.4) and ranged from 28.11% in Burundi to 80.77% in Niger. The factors significantly associated with early marriage were women's educational status; primary education (AOR = 0.39; 95% CI: 0.38, 0.41), secondary and higher (AOR = 0.1; 95% CI: 0.09, 0.11), employed (AOR = 0.73; 95% CI: 0.71, 0 .75), classified as rich wealth index level (AOR = 0.87; 95% CI: 0.85, 0.91), a number of family size ≥ 7 (AOR = 1.28; 95% CI: 1.23, 1.33), community-level poverty, (AOR = 1.28; 95% CI: 1.23, 1.33) and rural residency (AOR = 1.16;95% CI: 1.12, 1.21).

CONCLUSION

Marriage before the age of 18 is moderately high in high-fertility countries. Therefore, the respective countries government should give due attention to access to education, and encourage the participation of women in making marriage-related decisions, especially those residing in rural areas.

Spatial distribution and predictors of intimate partner violence among women in Nigeria

Background

Globally, intimate partner violence is one of the major health problems women face every day. Its consequences are enormous. However, our search of the available literature revealed that no study had examined the spatial distribution of intimate partner violence and the predictors of intimate partner violence among women in Nigeria using current nationally representative data. This study, therefore, sought to examine the spatial distribution of intimate partner violence and its predictors among women in Nigeria.

Method

We sourced data from the 2018 Nigeria Demographic and Health Survey for this study. A sample size of 8,968 women was considered for this study. We employed both multilevel and spatial analyses to ascertain the factors associated with intimate partner violence and its spatial clustering.

Results

The hot spot areas for intimate partner violence in Nigeria were Gombe, Bauchi, Adamawa, Plateau, Kogi, Edo, Ebonyi, and Rivers. The likelihood of experiencing intimate partner violence among women in Nigeria was high among women with primary education, those that were previously married, women currently working, women who were Yoruba, women with parity of four and above and women who were exposed to mass media while low odds of intimate partner violence was reported among women who were Muslims. Women who resided in the North East region and those who lived in communities with medium socioeconomic status were more likely to experience intimate partner violence, while women who were within the richest wealth index and those residing in the South West region were less likely to experience intimate partner violence.

Conclusion

The study found regional variations in the prevalence of intimate partner violence among women in Nigeria. Therefore, policymakers should focus their attention on the hotspots for intimate partner violence in the country. There is also the need to consider the factors identified in this study to reduce intimate partner violence among women in Nigeria. Empowering women would yield a significant improvement in the fight against gender-based violence.