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

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          Abstract

          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.

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          Most cited references52

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          Demographic and health surveys: a profile.

          Demographic and Health Surveys (DHS) are comparable nationally representative household surveys that have been conducted in more than 85 countries worldwide since 1984. The DHS were initially designed to expand on demographic, fertility and family planning data collected in the World Fertility Surveys and Contraceptive Prevalence Surveys, and continue to provide an important resource for the monitoring of vital statistics and population health indicators in low- and middle-income countries. The DHS collect a wide range of objective and self-reported data with a strong focus on indicators of fertility, reproductive health, maternal and child health, mortality, nutrition and self-reported health behaviours among adults. Key advantages of the DHS include high response rates, national coverage, high quality interviewer training, standardized data collection procedures across countries and consistent content over time, allowing comparability across populations cross-sectionally and over time. Data from DHS facilitate epidemiological research focused on monitoring of prevalence, trends and inequalities. A variety of robust observational data analysis methods have been used, including cross-sectional designs, repeated cross-sectional designs, spatial and multilevel analyses, intra-household designs and cross-comparative analyses. In this profile, we present an overview of the DHS along with an introduction to the potential scope for these data in contributing to the field of micro- and macro-epidemiology. DHS datasets are available for researchers through MEASURE DHS at www.measuredhs.com.
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            Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study.

            Child marriage is a substantial barrier to social and economic development in India, and a primary concern for women's health. We assessed the prevalence of child marriage-ie, before 18 years of age-in young adult women in India, and the associations between child marriage and women's fertility and fertility-control outcomes. Data from the National Family Health Survey-3 (2005-06) were limited to a sample of Indian women aged 20-24 years (n=22 807), of whom 14 813 had been or were presently married (ever-married). Prevalence of child marriage was estimated for the whole sample. We used regression models adjusted for demographics, and models adjusted for demographics and duration of marriage to estimate odds ratios (ORs) for the associations between child marriage and both fertility and fertility-control outcomes, in the ever-married subsample. 44.5% of women aged 20-24 years were married before age 18 years, 22.6% were married before age 16 years, and 2.6% were married before age 13 years. Child marriage was significantly associated with no contraceptive use before first childbirth (adjusted OR 1.37 [95% CI 1.22-1.54]), high fertility (three or more births) (7.40 [6.45-8.50]), a repeat childbirth in less than 24 months (3.00 [2.74-3.29]), multiple unwanted pregnancies (2.36 [1.90-2.94]), pregnancy termination (1.48 [1.34-1.63]), and female sterilisation (6.68 [5.78-7.60]). The association between child marriage and high fertility, a repeat childbirth in less than 24 months, multiple unwanted pregnancies, pregnancy termination, and sterilisation all remained significant after controlling for duration of marriage. Increased enforcement of existing policies is crucial for prevention of child marriage. Improved family-planning education, access, and support are urgently needed for women married as children, their husbands, and their families to reduce the high fertility and poor fertility-control outcomes of this practice. US National Institutes of Health and Indian Council of Medical Research.
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              Early Marriage, Age of Menarche, and Female Schooling Attainment in Bangladesh

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                Author and article information

                Contributors
                tadelebiresaw01@gmail.com
                wubshetdn@gmail.com
                getateshale1221@gmail.com
                tesfahunzemene4@gmail.com
                desalebihonegn1988@gmail.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                15 December 2022
                15 December 2022
                2022
                : 22
                : 2355
                Affiliations
                [1 ]GRID grid.59547.3a, ISNI 0000 0000 8539 4635, Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, , University of Gondar, ; P.O.Box: 196, Gondar, Ethiopia
                [2 ]GRID grid.59547.3a, ISNI 0000 0000 8539 4635, Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, , University of Gondar, ; Gondar, Ethiopia
                Article
                14840
                10.1186/s12889-022-14840-z
                9756671
                36522773
                03c20018-c7f1-41d1-8359-50ddc59b3fb6
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 17 May 2022
                : 8 December 2022
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Public health
                early marriage,female,multilevel,factors,sub-saharan africa
                Public health
                early marriage, female, multilevel, factors, sub-saharan africa

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