Child marriage among Somali refugees in Ethiopia: a cross sectional survey of adolescent girls and adult women.
Ontology highlight
ABSTRACT: Background
Despite child marriage receiving increased attention over the past two decades, research on child marriage in humanitarian settings remains scarce. This study sought to quantify child marriage among Somali adolescent girls residing in Kobe refugee camp in Ethiopia and to identify its correlates and consequences.Methods
A cross-sectional survey was conducted using multi-stage cluster-based sampling with probability proportional to size. We randomly sampled households that have at least one female aged 15-49 and at least one adolescent female aged 10-19. In addition to calculating the proportion of girls married under age 18, we used survival methods - namely Kaplan Meier graphs and Cox proportional hazard models - to identify risk factors associated with child marriage in this context. We also used descriptive statistics to describe marital age preferences among female adults and presented measures of important sexual and reproductive health indicators among married adolescent girls.Results
A total of 603 adult women were surveyed and a household roster was created with information on 3319 household members, of whom 522 were adolescent girls aged 15-19. Of those, 14% were currently married (95% Confidence Interval [CI] 0.11-0.18), and 11% were ever married under age 18 (95% CI 8-15%). Several variables were found to be significantly associated with hazard of child marriage including schooling, sex and employment status of head of household, as well as number of girls under age 18 in the childhood home.. Adult women tended to incorrectly identify minimum legal age at marriage and preferred low marital age for boys and girls - particularly in households of child brides. Among married adolescent girls, contraceptive use was very low (11%; 95% CI 4.94-22.40), and early childbearing was common (60%; 95% CI 45.56-72.89).Conclusions
This research contributes to the evidence base on child marriage in humanitarian settings. Insights generated from this study have the potential to inform programs and interventions aiming to prevent and mitigate the impacts of this harmful practice.
SUBMITTER: Elnakib S
PROVIDER: S-EPMC8173891 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:BackgroundChild marriage is a violation of children's rights and it exposes them to social isolation and psychological damages. These negative effects are not limited to them and expands to the family and society as well. The present research aimed at determining the knowledge and viewpoint of adolescent girls regarding child marriage, its causes and consequences in the city of Tabriz-Iran, in 2020-2021.MethodsThis cross-sectional study was carried out on 300 adolescent girls who had records in the health centers in the city of Tabriz. The data were collected using the sociodemographic characteristics questionnaire, questionnaire of knowledge, and view of adolescent girls regarding child marriage, and its causes and consequences. The multivariate logistic regression model with adjusting the sociodemographic characteristics was used to determine the relationship between the viewpoint of adolescent girls about child marriage and their knowledge in this regard.ResultsThe mean (SD) knowledge about child marriage was 6.70 (3.09) (score range: 0-11). The majority of the girls (85.4%) were against marriage before the age of 18 and only 16 girls (5.1%) of them agreed with marriage before the age of 18. Investigating the viewpoint of adolescent girls regarding the causes of child marriage revealed that the important issue leading to reduction of child marriage can be "intellectual, emotional, social, and economic maturity of girls plus their physical puberty (92.4% agree), increase in the girls' education (79% agree) and increasing girls' awareness regarding the consequences of early marriage in schools and media (69.6% agree). Illiteracy or lack of education of parents (64% agree), meeting the emotional needs (59.3% agree), family problems and conflicts (59.6% agree), and lack of exhilaration in daily life, especially in the rural regions and suburbs (58.3% agree) were among the reasons of increase of child marriage. The most important consequence of child marriage from the viewpoint of the girls is deprivation from the chance of education. The results of multivariate logistic regression model by adjusting the possible confounding variables, showed that girls who believed the appropriate age for marriage is under 20 were almost 13 times more likely to agree with child marriage than girls who believed the appropriate age for marriage is over 20 years (aOR = 13.82; 95% Cl 2.61-71.16 p = 0.002) and girls who opposed their parents' decision to marry under the age of 18 were less likely to agree with the child marriage than girls who did not oppose their decision (aOR = 0.09; 95% Cl 0.01-0.63 p = 0.016).ConclusionsThe results revealed a good level of knowledge and negative attitude to child marriage among the girls. The girls who disagreed with child marriage were more knowledgeable than the girls who agreed with child marriage. Thus, the increase of the level of knowledge of girls and their families regarding the consequences of early marriage and developing the culture for correcting the cultural beliefs and wrong social beliefs to prevent child marriage can decrease this damage to a great extent.
| S-EPMC8495953 | biostudies-literature
Project description:BackgroundAdolescent girls have a higher risk of anemia due to an increased requirement, low intake of hematopoietic nutrients and low intake of a nutrient that enhance absorption of these hematopoietic nutrients. Adolescent girls living in refugee camps are more vulnerable to anemia. The study aimed to determine the prevalence of anemia and associated factors among adolescent girls aged 10-19 years in Aw-Barre refugee camp, Somalia regional state, Southeast Ethiopia.MethodsA cross-sectional study design was employed. Study participants were recruited using a simple random sampling technique. A structured questionnaire was used to collect the data. Hemoglobin level was tested using HemoCueHb 301 from 10μl finger prick blood samples. Adolescents with a hemoglobin level of <12.5gm/dl after altitude adjustment were classified as anemic. Data were entered using Epi Info version 7.0 and analyzed using SPSS version 20.0. Binary logistic regression was used to explore the association of independent variables with anemia. Variables having P-value ≤ 0.05 was considered to be statistically significant.ResultsFour hundred thirty-seven adolescent girls participated in the study with a response rate of 95.83%. The prevalence of anemia was 22% (95% CI (17.6, 26.1)). Late adolescents were 2 times more likely to have anemia as compared to early adolescents (AOR: 1.95, 95% CI (1.09, 3.47). Those who stayed ≥8 years in the camp were 3 times more likely to develop anemia (AOR: 2.92, 95% CI (1.14, 7.50)). Those who ate heme iron food sources less than one time per month were 11 times more likely to develop anemia compared to those who ate more than twice within a week (AOR: 11.42, 95% CI (3.42, 38.18)).ConclusionsThe prevalence of anemia among adolescent girls was a moderate public health problem. Education and awareness on adolescent nutrition with special attention of late adolescents and duration in the refugee camps is warranted. Moreover, promoting the intake of foods rich in heme iron is suggested.
| S-EPMC6181359 | biostudies-literature
Project description:BackgroundStrong social norms around early marriage put pressure on parents to marry off their adolescent girls at an early age. Early marriage is widely practiced in many parts of Ethiopia. However, early marriage studies rarely address the role of social norms. This study aims to examine the role of social norms on parents' intention to marry off adolescent girls early in Eastern Ethiopia.MethodA community-based cross-sectional study was conducted from September to November 2019. A multistage sampling procedure was applied to select the study participants. Factors related to parents' intention for early marriage were assessed through the lens of the Theory of Planned Behavior (TPB). Adjusted Prevalence Ratio (PR) was calculated using a log-binomial model to identify factors associated with intention toward early marriage.ResultsA total of 859 mothers and 859 fathers of unmarried girls were included in the study. The prevalence of intention to marry off their daughter early among mothers was 39.70% (95% CI = 36.4-43.0%) and 43.54% (95%CI = 40.2-47.1%) among fathers of adolescent girls [chi2(1) = 41.8; P < 0.001]. The intention for an early marriage was higher among mothers and fathers with favorable attitude towards early marriage, in those who believe that most people in their reference group conform to early marriage norms (empirical expectation), in those who believe that most people in their reference group expect them to conform to early marriage norms (normative expectation) and among fathers who did not know the legal age of marriage for adolescent girls and those who did not know the health consequences of early marriage. The prevalence of intention toward early marriage was lower among mothers (APR = 0.49; 95% CI: 0.36-0.65) and fathers (APR = 0.62; 95% CI: 0.49-0.78) in urban areas; and among mothers (APR = 0.41; 95% CI: 0.27-0.62) and fathers (APR = 0.50; 95% CI: 0.38-0.67) with higher educational level.ConclusionThe social norms that promote intention for early marriage are still high among parents, especially among those living in rural areas and uneducated. Hence, interventions that aim to reduce early marriage need to address locally relevant social norms.
| S-EPMC9581299 | biostudies-literature
Project description:BackgroundThere has been much speculation about the role of inequitable gender norms and early marriage in mental health and suicide risks in girls and young women, but no prospective study has yet investigated this relationship. Understanding these links has become particularly important in the context of the COVID-19 pandemic which has led to increased risk of child marriage in the most vulnerable girls.MethodsWe examined the association between early marriage and mental health in girls using data from Understanding the Lives of Adolescents and Young Adults (UDAYA), a longitudinal study in adolescents in Uttar Pradesh and Bihar, India. The study included girls who were unmarried at wave 1 (2015-2016) and participated at wave 2 data collection (2018-2019). Information on mental health (Patient Health Questionnaire-9 (PHQ-9)), suicidal thoughts, plans and attempts were collected at both waves. Logistic regression with survey weights was used to estimate the association between marrying between the two waves and mental health.FindingsBetween waves 1 and 2, 1825 (23%) participants (n = 7864) married. Unmarried girls with depressive symptoms (PHQ score≥9) at wave 1 had greater odds of transitioning into marriage by wave 2 than those without (adjusted-OR 1.5; 95% CI 1.1 to 2.0). The odds of wave 2 depressive symptoms were higher in newly married vs unmarried girls (adjusted-OR 2.0; 95% CI 1.6-2.5). Among newly married girls, the odds of depressive symptoms were higher for those who experienced any abuse than those who did not (adjusted-OR 1.6; 95% CI 1.2-2.2). This effect was larger for girls who had not given birth (adjusted-OR 2.2; 95% CI 1.4-3.3).InterpretationOur findings show poor mental health preceded and was a consequence of child marriage. Mental health should be considered in policies and programming aimed at reducing early marriage; equally the mental health of young brides should be a focus for community and maternal health services.FundingBill and Melinda Gates Foundation and David and Lucile Packard Foundation.
| S-EPMC10306007 | biostudies-literature
Project description:Early marriage practices undermine girls' autonomy and seriously affect their physical and mental wellbeing. Monitoring the trends and understanding the drivers is essential in intervening against early marriage. However, many studies on early marriage in Ethiopia are cross-sectional, focusing only on the magnitude at a single point in time. Hence, we extracted data of girls of 10-17 years from Kersa Health and Demographic Surveillance System (Kersa HDSS) database for the period of 2008-2018 in order to examine the trends of early marriage. In this data note we provide the details of a research database of 24,452 girls in the age group of 10-17 years. The extracted data include date of marriage and the girls' socio-demographic variables. Other variables considered to be potentially associated with timing of marriage were also extracted. The purpose of this publication is to describe the dataset for external researchers who may be interested in making use of it as a secondary use of their routinely collected data. This dataset is available at https://doi.org/10.6084/m9.figshare.15034812.
| S-EPMC10345594 | biostudies-literature
Project description:Introduction and backgroundEarly marriage and maternity represent a violation of human rights and a barrier to achieving gender equality in education. Studies conducted across various regions and countries, including Mozambique, have highlighted the negative consequences of early marriage and maternity, particularly on adolescent girls' physical, educational and mental health. Adolescent girls who marry before the age of 18 are more prone to a broad spectrum of mood, anxiety, and other psychiatric disorders. In the districts of Maganja da Costa and Morrumbala in Zambézia Province, Mozambique, high rates of early marriage persist despite government policies and interventions.Purpose statementThis study aims to understand early marriage's socio-cultural, economic, and psychological drivers and impacts on adolescent girls' lives, focusing on education, mental health, and well-being.Design and methodsThis paper used a qualitative research design. We employed a life-story approach and used purposeful sampling to identify participants. Semi-structured interviews were conducted with 25 participants and the data were analysed using Tesch's thematic analysis approach.ResultsElements contributing to early marriage and pregnancy are intricately linked with socio-cultural elements. These include the induction into specific societal roles, the affirmation of childbearing, the perceived importance of dowry, the impact of rite-of-passage ceremonies, and the cultural significance associated with a girl's initial menstruation. School dropout often originates from geographical and transportation challenges, nudging adolescent girls towards early marriage. In some instances, termination of pregnancy was viewed as a solution, while engaging in sexual activities was seen as a means to inject purpose into their lives or as a response to poverty. Positive changes and emotions were evident, yet regrettably, the ramifications of early pregnancy and marriage were primarily detrimental. These influenced the adolescent girls' interpersonal connections, educational and career opportunities, emotional well-being, and access to support networks.ConclusionsThe modern perspective, which advocates for equal educational rights for boys and girls and posits that marriage should occur after the age of 18, contradicts the socio-cultural perspective of adulthood.ContributionThis study adds to the ongoing efforts to prevent and combat early marriage and maternity in Africa.
| S-EPMC11199522 | biostudies-literature
Project description:BACKGROUND:Despite an understanding of the circumstances of child marriage, including how it limits agency and erodes childhood support systems, not much is known about the relationship between child marriage and mental health of child brides, especially in the sub-Saharan African context. To address this gap, we use large-scale population-based data from ever-married women aged 18-45 in Niger (n?=?2764) and Ethiopia (n?=?4149) to examine the association of child marriage with overall psychological well-being and its sub-domains: depression, anxiety, positive well-being, vitality, self-control and general health. We complement this with qualitative data from Ethiopia to further contextualize the psychological well-being of child brides. METHODS:Multivariate linear regressions were conducted to estimate the association between child marriage and overall psychological well-being and its sub-domains. Thematic qualitative analysis was conducted to further understand the lives of child brides. RESULTS:Our regression analysis found significant negative associations between very early marriage (marriage at 15?years or earlier) and overall psychological well-being in both Niger and Ethiopia. With the exception of self-control, all sub-domains of psychological well-being - depression, anxiety, positive well-being, vitality and general health - were negatively associated with very early marriage. In addition, in the qualitative analysis, Ethiopian child brides reported suffering emotional distress and depression induced by the burden of handling marital responsibilities at an early age. CONCLUSION:The study highlights that even in settings where child marriage is normative, marrying very early is associated with negative outcomes. Further research is needed to understand the mechanisms that make those married during early adolescence particularly vulnerable to psychological distress, so that programs can address those vulnerabilities.
| S-EPMC6670185 | biostudies-literature
Project description:School dropout and child marriage are interrelated outcomes that have an enormous impact on adolescent girls. However, the literature reveals gaps in the empirical evidence on the link between child marriage and the dropout of girls from school. This study identifies the 'tipping point' school grades in Nepal when the risk of dropout due to marriage is highest, measures the effect of child marriage on girls' school dropout rates, and assesses associated risk factors. Weighted percentages were calculated to examine the grades at highest risk and the distribution of reasons for discontinuing school. Using the Nepal Multiple Indicator Cluster Survey (MICS) 2014 data, we estimated the effect of marriage on school attendance and dropout among girls aged 15-17 by constructing logistic regression models. A multivariate logistic regression model was used to assess risk factors of school dropout due to child marriage. It was found that early marriage is the most common reason given for leaving school. Overall, the risk of school dropout due to marriage heightens after girls complete the fifth or sixth grade. The risk of girls' dropping out peaks in the seventh and eighth grades and remains noteworthy in the ninth and tenth grades. Married girls in Nepal are 10 times more likely to drop out than their unmarried peers. Little or no education of the household head, belonging to the Kirat religion, and membership of a traditionally disadvantaged social class each elevate the risk of school dropout due to early marriage. The findings underscore the need to delay girl's marriage so as to reduce girls' school dropout in Nepal. School-based programmes aimed at preventing child marriage should target girls from the fifth grade because they are at increased risk of dropping out, as well as prioritizing girls from disadvantaged groups.
| S-EPMC5519022 | biostudies-literature
Project description:Adolescent girls in West Africa are migrating in search of educational and livelihood opportunities. In Mali, early marriage (before the legal age of 16) is a common practice. This paper builds on prior research on female migration that focused on the direct influences of migration on marriage and explores the wider social impact of rising female migration in sending communities by examining direct and indirect effects and intended and unintended consequences. This study examines perceptions about migration among girls and their parents including how it influences marital timing, marriage preparations, marriage practices, and marital relations. Qualitative data were collected from 140 adolescent girls and 115 parents of adolescent girls in rural areas in focus group discussions (FGDs) (n = 31) and in-depth interviews (IDIs) (n = 41) to inform how girls' migration patterns might influence program recruitment strategies and content for an intervention aimed at addressing early marriage in Mali. Our findings concur with earlier studies that migration has direct effects on marriage because it allows girls to both avoid early marriage and prepare for marriage through the assembly of goods and wares to bring to their conjugal homes. Despite some of the perceived risks of migration on marriage, the indirect effects of migration include allowing girls to see different types of marriage practices and marital relationships between husbands and wives and potentially allowing migrant girls to exert more influence over the marital process compared to non-migrants. However, migration can expose girls to new ideas and alternatives that may be incongruent with cultural expectations for them once they return to their communities. This study suggests that migration is seen as an inevitable part of life for many adolescent girls in Mali. Girls who migrate may return to their villages with not only items or income that provide direct benefits to a marriage, but also viewpoints on the expectations for women and girls in their communities that indirectly influence marital relationships. Although this can be challenging for individual returned girls in terms of reintegration, these new expectations may, over time, lead to social changes that influence migrants and non-migrants. Program strategies and approaches must consider the possibility of migration as an important aspect of every adolescent girl's opportunity structure. The qualitative data suggests that certain skills are critical for adolescent girls. Programs should emphasize the acquisition of relevant skills such as communication, risk assessment, negotiation and money management in ways that are relevant for migrants and non-migrants.
| S-EPMC7083269 | biostudies-literature
Project description:BACKGROUND:Menstruation is a normal physiological process of females at their reproductive age. However, it is surrounded with social taboos and supernatural beliefs. The poor knowledge and understanding of menstruation may lead to unsafe hygienic practice that intern increases the risk of reproductive and genito-urinary tract infections, cervical cancer, school drop-out, poor academic performance and overall poor quality of life. Despite such clinical and academic effects, the knowledge and hygienic practice of adolescent girls towards menstruation is not well addressed in Ethiopia, particularly among school adolescent girls. Therefore, the main objective of this study was to assess the knowledge and menstrual hygiene practice among adolescent school girls in southern Ethiopia. METHODS:This was an institutional based cross-sectional study conducted at Gedeo zone high schools among 791 randomly selected adolescent girls using multi stage sampling technique. Data were collected using interviewer administered questionnaire. The collected data were entered to EPI-INFO (soft ware) and exported to SPSS version 20 for analysis. Bivariable and multivariable logistics analyses were computed to identify factors associated with the poor menstrual hygienic practice. During bi-variable analysis, variables with P-values of less than 0.25 were entered to multivariable model for further analysis. In the final model, P-value of less than 0.05 was used as a base to identify factors having a statistically significant association with poor menstrual hygiene practice at corresponding 95% confidence interval. RESULT:From a total of 791 adolescent girls participated in this study, 68.3% had poor knowledge of menstruation. About 48.1% of school girls used absorbent materials, and 69.5% clean their external genitalia. Generally, 60.3% of girls had poor menstrual hygienic practice. Age less than 15?years [OR?=?1.71:95% CI (1.22, 2.39)], longer days of menstrual flow [OR?=?2.51:95% CI (1.66, 3.80)] and poor knowledge of menses [OR?=?1.48:95% CI (1.04, 2.1)] had a significantly associated with poor menstrual hygiene practice. CONCLUSION:Majority of adolescent school girls had poor knowledge regarding menstruation and their hygienic practices are incorrect. This demonstrates a need to design acceptable awareness creation and advocacy programs to improve the knowledge and promote safe hygienic practice of adolescent school girls during menstruation.
| S-EPMC6884885 | biostudies-literature