Early Marriage, Cohabitation, and Childbearing in West Africa (original) (raw)
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Journal of Global Health, 2021
Background Early marriage and maternity prevalence rates among adolescent girls remain alarmingly high in West and Central Africa (WCA). This study aims to explore the associations between socioeconomic factors and the prevalence of early marriage and maternity, thus contributing to the identification of girls at risk of early pregnancy or marriage. Methods We pooled data from national representative surveys (1986-2017) for 23 countries in WCA to examine associations between wealth, educational attainment, religious affiliation, and place of residence with adolescent marriage and maternity. We decomposed the wealth and education gradients for individual countries, while controlling for common characteristics of the local environment via the use of primary sampling unit fixed-effects. The pooled sample provides information on 262 721 girls (age 15-19 years). Survey weights and population share weights were used in the estimations. Results The prevalence of adolescent maternity and marriage exhibited a wealth and education gradient. Prevalence of marriage in the poorest wealth quintile was 41.1% (95% confidence interval (CI) = 38.8%-43.5%) and 10.5% (95% CI = 9.5%-11.6%) in the richest. For maternity it was 38.3% (95% CI = 36.4%-40.3%) in the poorest quintile and 12.7% (95% CI = 11.5%-13.9%) in the richest. Marriage/maternity is three/two times more likely to occur among girls with incomplete primary or no formal education than in those with at least primary. Maternity and marriage among adolescents exhibit a geographical pattern and differences between religious groups. Adolescent marriage prevalence was 34.4% (95% CI = 32.9%-35.8%) in rural areas compared to 13.3% (95% CI = 12.3%-14.2%) in urban areas. Adolescent maternity prevalence was 32.8% (95% CI = 31.7%-33.9%) in rural compared to 16.3% (95% CI = 15.3%-17.3%) in urban areas. Finally, the prevalence of adolescent marriage was substantially higher among Muslims compared to all other religious groups. Conclusions Our results highlight the disparities in the prevalence of adolescent marriage and maternity and confirm the existence of wealth and education gradients. These findings can help to improve targeting of vulnerable adolescents and to identify areas for policy implementation.
Marriage in Sub-Saharan Africa: Trends, Determinants, and Consequences
Population Research and Policy Review, 2013
Several decades ago, marriage among women in most of sub-Saharan Africa could reasonably be described as early and near-universal. However, it is apparent from a number of studies published in the past two decades that in many countries in the region, there is a trend toward delays in the onset of marriage, with early marriage becoming less prevalent. This trend is most notable among the urban and better-educated segments of the population. Rising age at first marriage, in turn, has played an important role in the ongoing fertility transition in some parts of sub-Saharan Africa. This paper examines union patterns of young women (aged 15-29) in more than two dozen countries in sub-Saharan Africa, with the objective of documenting and analyzing the extent and nature of the ongoing changes in entry to union that are taking place in the region. We use data from the Demographic and Health Surveys (DHSs), and focus on those countries that have had multiple DHSs, so as to allow examination of within-country trends in union patterns. These countries represent nearly three-quarters of the population of sub-Saharan Africa. In addition to examining national-level data, the paper looks at data separately for urban and rural places, and includes as well an examination of data on union patterns in capital cities. After looking at trends in marriage, we analyze factors associated with these trends, most notably women's education and economic wellbeing. The final part of the paper assesses the role of the observed declines in the percentages of women in union in contributing to the fertility transition that is taking place in sub-Saharan Africa.
Levels and trends of adolescent marriage and maternity in West and Central Africa, 1986-2017
Journal of Global Health, 2021
Background The world has made considerable progress in the reduction of adolescent maternity and early marriage. However, this progress has been uneven, with many countries finding themselves far from achieving the Sustainable Development Goals in this dimension. We assessed levels and trends over time in adolescent marriage and maternity prevalence within the West and Central African region as well as their correlation with select macro-level indicators for income and social institutions. Methods We estimated country-specific prevalence rates using survey data (pooled cross-sectional) conducted between 1986 and 2017. The pooled sample provides information on 262 721 adolescent girls between the ages of 15 and 19. We assessed the relative country-level trends by comparing prevalence rates from the first and latest available survey in each country. We further analyzed regional trends by country income group (low-and middle-income) and examined the association of prevalence rates with measurements of gender discrimination and social institutions at the country-level. Estimations were conducted using survey weights and country-specific weights for population shares in the pooled sample. Results Prevalence of adolescent maternity declined from 30.1 percent (95% confidence interval (CI) = 29.6%-32.2%) in the 1990s, to 28.7 percent (95% CI = 27.9%-29.6%) in the 2000s and 26.2 percent (95% CI = 25.4%-27.1%) in the 2010s. Adolescent marriage rates decreased from 37.3 percent (95% CI = 35.5%-39.1%) in the 1990s to 27.5 percent (95% CI = 26.5%-28.6%) in the 2000s, and to 24.9 percent (95% CI = 24.1%-25.7%) in the 2010s. Between 1986 and 2017, adolescent marriage decreased in all countries except for the Central African Republic (with a rise from 39% to 55%) and Niger (56% to 61%). The prevalence of adolescent maternity decreased in all but three countries: Congo, Dem. Rep. (25% to 37%), Niger (36% to 40%), and the Central African Republic (36% to 49%). When grouped by income level, the prevalence was 8 percentage points higher in low-income countries than in middle-income countries in both outcomes. We did not establish any statisticly significant association between adolescent marriage and maternity with country-level measures of discrimination against women. However, we found evidence of an association between specific legal measures of protection against early marriage and lower prevalence rates for both early marriage and maternity. Conclusions Despite considerable progress in the reduction of adolescent maternity and marriage over the last 30 years, current levels of both indicators remain overall high in the WCA region, with high heterogeneity across individual countries. Countries with higher income level and higher standard in legal protection of young girls perform consistently better on both indicators. The prevalence rates of adolescent marriage and maternity reversed over the course of three decades, so that nowadays adolescent maternity rates exceed adolescent marriage rates in most countries. Further research is needed to understand the weak or non-existent association between adolescent marriage and maternity with gender discrimination and social institutions.
Reproductive Health
Background Adolescent sexual and reproductive health (ASRH) is a major public health concern in sub-Saharan Africa (SSA). However, inequalities in ASRH have received less attention than many other public health priority areas, in part due to limited data. In this study, we examine inequalities in key ASRH indicators. Methods We analyzed national household surveys from 37 countries in SSA, conducted during 1990–2018, to examine trends and inequalities in adolescent behaviors related to early marriage, childbearing and sexual debut among adolescents using data from respondents 15–24 years. Survival analyses were conducted on each survey to obtain estimates for the ASRH indicators. Multilevel linear regression modelling was used to obtain estimates for 2000 and 2015 in four subregions of SSA for all indicators, disaggregated by sex, age, household wealth, urban–rural residence and educational status (primary or less versus secondary or higher education). Results In 2015, 28% of adolesc...
2016
The present study employed the Cox proportional hazard regression model to examine the effect of select socio-demographic factors on the family formation process in five sub-Saharan African countries using the most recent Demographic and Health Surveys (DHS) data for the respective countries. Specifically, the study examined the effects of education, residence, religion and age at first marriage on age at first marriage, age at first birth and the duration between first marriage and first childbirth in Ethiopia, Ghana, Kenya, Nigeria and Zambia. On the whole, we found that Ghana has the highest median age at first marriage, while Ethiopia has the lowest median age at first marriage. Both level of urbanisation and education were inversely related to the proportion of women ever married in all five countries. While education was positively associated with age at first marriage in all five countries, it was negatively associated with duration between marriage and first birth in all the...
Journal of Global Health, 2021
Objective Early marriage and childbearing have substantial detrimental effects on both, the affected girls and women at the micro level, as well as entire economies on the macro level. West and Central African countries have some of the highest prevalence rates of early marriage and maternity worldwide. This work attempts to quantify the long-term economic, societal, and fertility effects of marriage and pregnancy in early and late adolescence in West and Central Africa. Methods We used pooled cross-sectional data collected between 1986 and 2017 in 21 West and Central African countries within the DHS and MICS programs to estimate the associations of marriage and maternity during early (10-14) and late (15-19) adolescence retrospectively on wealth accumulation, educational attainment, as well as the woman's lifetime fertility. Results Descriptively, women who married or gave birth as young or very young adolescents are overrepresented among the poorest and least educated quintiles of the adult population and underrepresented among the richest and most educated. These gradients were confirmed within a regression analysis which additionally controlled for current age of the woman and PSU fixed effects. Marrying in early/late adolescence was associated with a 12%/6% higher likelihood of being in the poorest wealth quintile in later life and 29%/20% increased likelihood of not completing primary education, as compared to women who married as adults. Maternity in early/late adolescence was associated with a 7%/4% higher likelihood of belonging to the poorest quintile and 17%/10% higher likelihood of being uneducated. Moreover, women who married/gave birth during early or late adolescence, on average, have 2.2/2.3 or 1.4/1.5 more children than those who have married/become mothers as adults. Conclusions Our findings suggest that the dire consequences of early marriage and maternity hit youngest girls the hardest-both immediately and long-term. Hence, it is not only worthwhile to prevent adolescent marriage and pregnancy in general, but also specifically target very young girls below age 15 to attempt to at least delay such far-reaching demographic life events.
Journal of Adolescent Health, 2021
This comparative study explores the connections between potential drivers of child marriage among girls at the individual, household, and community levels. It provides insight into the multilevel influences on child marriage with the goal of informing policies and programs aimed at eliminating the practice. Methods: We conducted a secondary analysis of baseline data from the Building Evidence to Delay Child Marriage Project, a large study undertaken in Burkina Faso and Tanzania. For each country, using data on adolescent girls and parents, we ran a series of nested logistic regression models to identify factors associated with having ever been married among girls aged 15e17 years. Results: Findings indicate that child marriage among girls is shaped by a combination of factors at multiple levels and that the weight of influencing factors varies by context. At the household level, parental relationships were influential in both countries, although in different ways. The influence of the community varied considerably between countries, holding more importance in Burkina Faso than in Tanzania. In Burkina Faso, the importance of schooling and existence of alternative pathways for girls beyond marriage appears crucial to reducing child marriage. Other factors strongly associated with child marriage include girls' agency, the timing of girls' sexual initiation, and community norms, specifically views on child marriage among fathers. In Tanzania, early sexual initiation among girls was common and strongly associated with marriage during childhood; parents' fear of premarital sex and pregnancy also emerged as a significant factor.
Journal of Adolescent Health, 2021
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 ¼ 660), the Malawi Schooling and Adolescent Study from Malawi (N ¼ 1,041), and Understanding the Lives of Adolescents and Young Adults from India (N ¼ 894 in Bihar, N ¼ 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.
Essays on Family Structure and Marriage in Sub-Saharan Africa
2013
The three essays in this dissertation examine issues related to family structure and marriage in Sub-Saharan Africa. The first two essays explore how family structures influence children's outcomes. The third essay focuses on the data quality of marriage histories collected in a longitudinal survey. The first essay examines whether the timing and type of orphanhood is associated with early sexual debut and early marriage among 12-19-year-old adolescents in Burkina Faso, Ghana, Malawi, and Uganda. I also test whether education mediates orphans' risk of early sexual initiation and early marriage. Discrete-time event history models suggest that female double orphans, regardless of timing of orphanhood, have greater odds of early sexual debut than do nonorphans. Education explains little of their increased risk. In contrast, male orphans of any type reveal no increased vulnerability to early sexual debut. Uganda is the only country where female orphans, specifically double orphans and those who are paternal orphans before age 10, have greater odds of early marriage, with education accounting for a small portion of the risk. The second essay investigates the relationship between parental divorce and children's schooling in rural Malawi. Child fixed effects regression models are used to control for unobserved heterogeneity that could affect both parental divorce and children's schooling. Results suggest that children from divorced marriages have completed, on average, fewer grades of schooling than children from intact marriages. No differences in current school enrollment and schooling gap (among children currently in school) are found by parents' marriage status. The third essay measures the reliability of marriage histories collected in two waves of the Malawi Longitudinal Study of Families and Health. Multivariate regression analyses are used to examine the characteristics associated with misreporting marriages and dates of marriage. Paired and unpaired statistical tests assess whether marriage indicators are affected by misreporting. Results indicate that a significant proportion of marriages are underreported and that misreporting is not random. Several individual, marriage, and survey-related characteristics are associated with underreporting marriages and misreporting marriage dates. I also find that misreporting leads to biased marriage indicators.
Determinants of Early Marriage Among Young Women in Homa Bay County in Kenya
2016
Early marriage denies children childhood experience, endangers their health, and terminates their expectations. In Democratic Republic of Congo, though the 2006 sexual violence law criminalizes child marriages in the country, but the practice of early marriage persists. DRC has one of the uppermost child marriage incidence rates in the world, where nearly seventy-four percent of girls and women between 15 and 19 years of age are married. This paper examined the socioeconomic and demographic determinants of early marriage among young women in the DRC. Descriptive and multivariate analyses performed show that young women who faced first sexual intercourse before 16 are 73.5 times more at risk of early marriage more than those who initiated it at the age 18-24. Also, those with no education have a higher risk of early union than their higher educated counterparts. The paper recommends the adoption of a formal sex education framework before first sexual intercourse.