Community-based empowerment program to delay marriage: Results from the More Than Brides Alliance intervention in India, Malawi, Mali and Niger.

The More Than Brides Alliance (MTBA) implemented an intervention in India, Malawi, Mali and Niger from 2017 to 2020. The holistic community-based program included girls' clubs focused on empowerment and sexual and reproductive health knowledge; work with parents and educators; community edutainment events; and local-, regional-, and national-level advocacy efforts related to child marriage. Using a cluster randomized trial design (India and Malawi), and a matched comparison design (Niger and Mali), we evaluated the effectiveness of the program on age at marriage among girls ages 12-19 in intervention communities. Repeat cross sectional surveys were collected at baseline (2016/7), midline after approximately 18 months of intervention (2018), and endline (2020). Impact was assessed using difference-in-difference (DID) analysis, adjusted for the cluster design. We find that the intervention was successful at reducing the proportion of girls ages 12-19 married in India (-0.126, p < .001). Findings in the other countries did not show impact of the intervention on delaying marriage. Our findings suggest that the MTBA program was optimized to succeed in India, in part because it was built on an evidence base that relies heavily on data from South Asia. The drivers of child marriage in India may be substantially different from those in Malawi, Mali, and Niger and require alternate intervention approaches. These findings have implications for those designing programs outside of South Asia and suggest that programs need to consider context-specific drivers and whether and how evidence-based programs operate in relation to those drivers. Trial registration: This work is part of an RCT registered August 4, 2016 in the AEA RCT registry identified as: AEAR CTR-0001463. See: https://www.socialscienceregistry.org/trials/1463.

"Then I will say that we have to marry each other": A qualitative view of premarital pregnancy as a driver of child marriage in Malawi".

Child marriage is common in Malawi, with 42.1% of women ages 20-24 marrying before age 18. Although global research on child marriage has increased in recent years, the reasons are context-specific and there is limited evidence on specific drivers of child marriage in Malawi. We explored pathways to child marriage in Mangochi and Nkhata Bay, drawing on focus groups (n=20) and in-depth interviews (n=39) with adolescent girls and parents of adolescent girls. We find that pregnancy often determines marriage timing and partner selection among adolescents, due in part to norms of adolescent dating or courtship and premarital sexual activity. Once pregnancy occurs, marriage is nearly inevitable even if the girl is under age 18. These findings have important implications for programs to delay marriage; programs must address weak motivations to prevent pregnancy and work to create alternative livelihood opportunities to foster economic self-sufficiency.

A conceptual framework for understanding child marriage, marriage markets, and marriageability.

The term 'marriageability' is used frequently in child marriage literature but is rarely defined. We propose a conceptual framework to define marriageability and use qualitative case studies to illustrate how ideas about marriageability contribute to child marriage. Pressure to capitalize on a girl's marriageability before it declines in order to secure the 'best' partner may explain why child marriage persists. We find that marriageability involves both eligibility-or perceived readiness for marriage-as well as desirability or 'value' on the marriage market. We propose that understanding marriageability in context, particularly in countries with limited evidence on interventions to address child marriage, is essential for suggesting ways interventions may critically examine notions of marriageability and disrupt pathways to child marriage.

What Are the Drivers of Child Marriage? A Conceptual Framework to Guide Policies and Programs.

PURPOSE: The child marriage field lacks a simplified framework that connects an understanding of the drivers of child marriage for girls to decisions about the design of interventions to delay marriage within different contexts and support married girls. METHODS: We reviewed existing child marriage frameworks and conducted consultations with experts working on child marriage. We then developed a simplified conceptual framework describing the key drivers of child marriage for girls. We explored how these drivers play out and interact using qualitative data from three settings where child marriage is common: Bangladesh, Malawi, and Niger. RESULTS: The final conceptual framework lays out five core drivers of child marriage for girls, which vary and interact across contexts. Social norms and poverty are shown as core drivers that underlie lack of agency, lack of opportunity, and pregnancy/fear of pregnancy. These drivers reflect community, household, and individual-level factors. The case studies highlight the important relationships between these drivers, and the way they interact within each context. We use these examples to explore how policymakers and practitioners might identify the most appropriate interventions to address child marriage across different settings. CONCLUSIONS: We offer this framework as a starting point to guide more targeted interventions and policies that address the complex combination of child marriage drivers within each setting. By adapting this framework to different settings, those designing and implementing child marriage prevention interventions can identify the key drivers in each setting, understand how those drivers interact, and more effectively target effective interventions.

The View From the Bottom: Relative Deprivation and Bullying Victimization in Canadian Adolescents.

We investigated the relation between relative deprivation (RD)-disparity in affluence between adolescents and their more affluent schoolmates-and involvement in bullying among 23,383 students (aged 9-19) in 413 schools that participated in the 2010 Canadian Health Behavior in School-Aged Children survey. Students reported family affluence and frequency of bullying victimization and perpetration during the previous 2 months. Using the Yitzhaki index of RD and multinomial logistic regression analysis, we found that RD positively related to three types of bullying victimization (physical, relational, and cyberbullying) and to two types of perpetration (relational and cyberbullying) after differences in absolute affluence were held constant. These findings suggest that RD uniquely contributes to risk of bullying involvement.

Cyberbullying victimization and mental health in adolescents and the moderating role of family dinners.

IMPORTANCE: This study presents evidence that cyberbullying victimization relates to internalizing, externalizing, and substance use problems in adolescents and that the frequency of family dinners attenuate these associations. OBJECTIVES: To examine the unique association between cyberbullying victimization and adolescent mental health (after controlling differences in involvement in traditional, face-to-face bullying) and to explore the potential moderating role of family contact in this association. DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional, observational study used survey data on 18,834 students (aged 12-18 years) from 49 schools in a Midwestern US state. Logistic regression analysis tested associations between cyberbullying victimization and the likelihood of mental health and substance use problems. Negative binomial regression analysis tested direct and synergistic contributions of cyberbullying victimization and family dinners on the rates of mental health and substance use problems. EXPOSURES: Frequency of cyberbullying victimization during the previous 12 months; victimization by traditional (face-to-face) bullying; and perpetration of traditional bullying. MAIN OUTCOMES AND MEASURES: Five internalizing mental health problems (anxiety, depression, self-harm, suicide ideation, and suicide attempt), 2 externalizing problems (fighting and vandalism), and 4 substance use problems (frequent alcohol use, frequent binge drinking, prescription drug misuse, and over-the-counter drug misuse). RESULTS: About one-fifth (18.6%) of the sample experienced cyberbullying during the previous 12 months. The frequency of cyberbullying positively related to all 11 internalizing, externalizing, and substance use problems (odds ratios from 2.6 [95% CI, 1.7-3.8] to 4.5 [95% CI, 3.0-6.6]). However, victimization related more closely to rates of problems in adolescents that had fewer family dinners. CONCLUSIONS AND RELEVANCE: Cyberbullying relates to mental health and substance use problems in adolescents, even after their involvement in face-to-face bullying is taken into account. Although correlational, these results suggest that family dinners (ie, family contact and communication) are beneficial to adolescent mental health and may help protect adolescents from the harmful consequences of cyberbullying.