Distribution and determinants of early marriage and motherhood: a multilevel and geospatial analysis of 707 districts in India.

BACKGROUND: Early marriage and motherhood have long been prevalent in India, with 44.5% of women aged 20-24 reporting marriage before 18 in NFHS 3 (2005-2006), dropping to 26.8% in NFHS 4 (2015-2016). Early motherhood has also seen a significant decline, with first births by age 18 decreasing from 34.3% in NFHS I to 8.2% in NFHS V. Despite these improvements, significant regional disparities persist due to social, normative, and legal factors. This study investigates the spatial heterogeneity of early marriage and motherhood across Indian districts, offering a multilevel analysis that reveals critical local variations often obscured at broader levels. Understanding these patterns is crucial for targeted policy interventions and addressing the root causes of early marriage and motherhood. METHODS: Utilizing data from the fifth round of National Family Health Survey, this study employs multilevel logistic regression and geospatial analysis to assess the determinants and spatial distribution of early marriage and early motherhood among ever-married women in India. The analysis incorporates individual, household, and community-level variables, complemented by spatial analysis techniques, including Empirical Bayes Bivariate Moran's I values and LISA cluster maps, to identify regional patterns and hotspots. RESULTS: This study revealed that educational attainment emerged as a critical determinant, with uneducated women significantly more likely to marry early. Socioeconomic factors, such as poverty and limited mass media exposure, also heightened the risk of early marriage and motherhood. Caste and religion were significantly associated with these events, with marginalized groups facing higher prevalence. Spatial analysis revealed significant geographic disparities, with central and eastern regions showing higher concentrations of early marriage and motherhood. District-level characteristics and the influence of neighboring districts were also significant, highlighting the importance of localized interventions. CONCLUSIONS: The findings underscore the critical role of education, economic empowerment, and media literacy in mitigating early marriage and motherhood risks. The study calls for multi-sectoral interventions in geographical hotspots to break the cycle of early family formation and promote reproductive health. Policies enhancing educational opportunities, addressing economic disadvantages, and considering district-specific factors are essential. Comprehensive strategies are necessary to empower women, foster reproductive health, and address the multifaceted nature of early marriage and motherhood in India.

Exploring the child marriage practices and their impact on women's lives in Pakistan: A qualitative analysis.

The study aimed to qualitatively explore the relationship between intimate partner violence and early marriage, focusing on the psychological and physical health issues faced by married women in rural Pakistan. Specifically, it investigated how resilience moderates the effects of early marriage, physical health problems, intimate partner abuse, and psychological issues. Using an intrinsic qualitative approach, the research involved interviews with 20 household heads, 62 husbands, and 40 wives in Sindh province. The findings indicated significant differences related to early marriage, intimate partner abuse, physical health issues, stress, anxiety, and depression. The results align with other South Asian studies, highlighting early marriage as a major risk factor for physical health issues and intimate partner violence. Additionally, the study underscores the widespread nature of violence as a social problem affecting married couples' health in Pakistan.

L'étude visait à explorer qualitativement la relation entre la violence conjugale et le mariage précoce, en se concentrant sur les problèmes de santé psychologique et physique rencontrés par les femmes mariées dans les zones rurales du Pakistan. Plus précisément, elle a étudié comment la résilience atténue les effets du mariage précoce, des problèmes de santé physique, de la violence conjugale et des problèmes psychologiques. Utilisant une approche qualitative intrinsèque, la recherche a impliqué des entretiens avec 20 chefs de famille, 62 maris et 40 épouses dans la province du Sind. Les résultats ont indiqué des différences significatives liées au mariage précoce, à la violence conjugale, aux problèmes de santé physique, au stress, à l'anxiété et à la dépression. Les résultats concordent avec d'autres études sud-asiatiques, soulignant le mariage précoce comme un facteur de risque majeur de problèmes de santé physique et de violence conjugale. En outre, l'étude souligne le caractère répandu de la violence en tant que problème social affectant la santé des couples mariés au Pakistan.

Investigating the relationship between internet addiction, domestic violence, and emotional divorce among married women in Tehran.

BACKGROUND: Identifying the factors affecting emotional divorce due to the negative consequences of this social problem in women can play an important role in preventing its occurrence. Therefore, the present study aimed to investigate the relationship between internet addiction, domestic violence, and emotional divorce among married women in Tehran. METHODS: A cross-sectional survey was conducted among married women in Tehran, Iran. Sampling was conducted first through a multi-stage cluster method and then continued using a random method. Tehran was divided into five parts: central, northern, southern, eastern, and western. The sample size was divided by 5, resulting in 80 participants selected from each part. In each part, two regions were selected, and in each region, 40 houses were randomly selected. Researchers visited the selected houses, and the questionnaires were filled out at home by the women. Tools such as Gottman's Emotional Divorce Test, Young's Internet Addiction Test, and the Domestic Violence against Women Survey were used to collect data. Descriptive and inferential statistics were used to analyze the data in SPSS (version 24) software. RESULTS: A total of 400 women participated in the study. 46% of all married women suffered emotional divorce. The analysis of these tests showed that are positive and significant relationships between emotional divorce and internet addiction (r = 0.626, p < 0.0001), emotional divorce and domestic violence (r = 0.632, p < 0.0001), and internet addiction and domestic violence (r = 0.455, p < 0.0001). It was also found that there are significant negative relationships between emotional divorce and both the level of education (r=-0.115, p = 0.021) and employment status (r=-0.512, p < 0.0001). Additionally, there are significant negative relationships between internet addiction and age (r=-0.285, p < 0.0001), duration of marriage (r=-0.237, p < 0.0001) and employment status (r=-0.694, p < 0.0001). Furthermore, it was revealed that there are significant negative relationship between domestic violence and age (r=-0.104, p = 0.037) and level of education (r=-0.156, p = 0.002). CONCLUSION: Almost half of the married women in this study experienced emotional divorce, internet addiction, and domestic violence. These factors have a direct relationship with emotional divorce. Future studies are needed to understand how internet addiction might be associated with separation, emotional divorce and family problems.

Serial Multiple Mediation of the Marital Satisfaction and Parenting Competence in the Relationship Between Postpartum Depression and Parent-Infant Attachment in First-Time Parents With Low- and High-Risk Pregnancy Experiences: A Cross-Sectional Study.

Little is known regarding the effects of postpartum depression on parent-infant attachment in high-risk parents. Based on Mercer's theory of becoming a mother, this study aimed to (1) examine the mediating effects of marital satisfaction and parenting competence in the relationship between postpartum depression and parent-infant attachment using a serial mediation model in first-time parent couples during the first 6 months postpartum, and (2) compare the serial mediation models between parents who had experienced low-risk and high-risk pregnancies. In this cross-sectional study, a total of 194 first-time parent couples at 1 to 6 months postpartum were included. Participants completed an online survey on postpartum depression, marital satisfaction, parenting competence, and parent-infant attachment. In both low- and high-risk groups, parenting competence was a common mediator of the impact of postpartum depression on parent-infant attachment. A sequential mediation effect involving both marital satisfaction and parenting competence was observed in high-risk mothers. Our findings suggest that the adverse impacts of postpartum depression on parent-infant attachment can be mitigated by boosting parenting competence or improving the marital satisfaction in couples experiencing first high-risk pregnancy.

Individual empowerment and community norm effects of engaging young husbands in reproductive health in rural India: findings from a pilot study.

BACKGROUND: Despite decades of a call to action to engage men in reproductive health, men are often left out of programs and interventions. In India, where half of pregnancies are reported as unintended, patriarchal gender norms and still dominant patterns of arranged marriages make engaging men in family planning and strengthening couples communication critical in increasing reproductive autonomy and helping young couples meet their reproductive goals. This study explores the feasibility and acceptability from the men's perspective of the pilot of a gender transformative intervention for newly married couples in India. METHODS: A pilot study was conducted of TARANG, a 4 month intervention for newly married women, with light touch engagement of husbands (4 sessions). A total of 41 husbands participated in the pilot, and we collected baseline knowledge and endline feasibility and acceptability data from them, along with in depth qualitative interviews with 13 men. The study was conducted in June 2023-January 2024. RESULTS: Men had low levels of knowledge about biology, family planning, with the majority of men reporting that no one had provided them information about these topics. Most men wanted to delay the first birth by at least 2 years, yet less than a quarter had discussed childbearing plans with their partner or engaged in family planning methods. While all men reported high acceptability (satisfaction and usefulness), feasibility (participation) was low, with only 43% attending 2 or more sessions. Main barriers to participation included commitments due to work and migration. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. CONCLUSIONS: Men in these rural communities are not receiving the information that they need to meet their reproductive goals, however, they greatly desire this information and ways to improve relationships with their new wives. Such an intervention appears to have the potential to help change norms and spread information in the community and provide men with positive, life affirming feelings. Providing information through technology could address barriers to in-person engagement. TRIAL REGISTRATION CLINICALTRIALS.GOV : 03/13/24.NCT06320964.

Despite many years of calls to engage men in reproductive health programming, there are still a paucity of interventions that engage men. In the Indian context, with high prevalence of arranged marriages, strict gender norms, and patrilocal marriage patterns where women move into their husbands family's home, engaging men is especially important as they are critical decision-makers. With this in mind, we designed an intervention for newly married women, with an add on component for their husbands, to help young couples meet their reproductive goals. In this paper we report on the feasibility and acceptability of a 6 month pilot of this intervention with 40 newly married men in Rajasthan, India using mixed methods. We find that the intervention was highly feasibility and acceptable, and men felt that the intervention had value and should be considered. However, attendance was low due to work commitments and migration. The intervention appeared to change norms and increase knowledge about family planning and communication about childbearing. Men reported that the intervention led to improvements in their relationships with their wives, gave them a sense of empowerment, and led them to become resources for other men in their community. This suggests that engaging newly married men is possible, but interventions must be designed carefully to be sure to be able increase participation.

Explaining maternal antenatal attachment by psychological, clinical and sociodemographic factors: a path analysis study.

BACKGROUND: Antenatal attachment is a fundamental concept relative to human transition to parenthood and may be influenced by several factors. The aim of this study is to find the best model to explain maternal antenatal attachment based on the interaction among sociodemographic, clinical, and psychological variables. METHODS: Pregnant women (N = 407) were interviewed during the second trimester of pregnancy while waiting for medical consultations. A sociodemographic, obstetric, and psychometric protocol was used. STATISTICAL ANALYSES: path analysis. INDEPENDENT VARIABLES: psychopathological symptomatology, depression, anxiety, stress, occupational stress, attitudes about pregnancy and motherhood, coping styles, marital satisfaction, sociodemographic, and clinical variables. DEPENDENT VARIABLES: maternal antenatal attachment in its several dimensions; quality of attachment (QA), intensity of preoccupation (IP), and global attachment (GA). RESULTS: Depression, anxiety, attitudes, and marital satisfaction explained 37% of maternal antenatal QA. Age, depression, anxiety, attitudes, and marital satisfaction explained 26% of maternal antenatal IP. Age, depression, anxiety, attitudes, and marital satisfaction explained 34% of the statistical variance of maternal antenatal GA. CONCLUSIONS: Factors like emotional states (depression and anxiety), attitudes towards pregnancy and motherhood, marital satisfaction, and a sociodemographic variable (age) contribute significantly for the explanation of maternal antenatal attachment.

Variations in the association between polygyny and experience of intimate partner violence by husband's alcohol consumption: a cross-sectional study among postpartum women in Thailand.

BACKGROUND: Intimate partner violence is more common in polygynous couples than monogamous couples, but the extent that this association is modified by the husband's alcohol consumption is unknown. The objectives of this study are: (1) To describe the extent to which polygyny is associated with self-reported experience of intimate partner violence among women receiving postpartum care; (2) To describe the extent to which the mentioned association is modified by the husband's alcohol consumption. METHODS: We conducted a hospital-based cross-sectional study among women age 18 years or older receiving postpartum care at 8 public hospitals in 3 provinces in Northern and Northeastern Thailand using self-administered questionnaires. We analyzed data using descriptive statistics, logistic regression, and stratified analyses. RESULTS: A total of 1207 women agreed to participate in the study, 8% of whom reported that their husbands practiced polygyny. Women in a polygynous relationship were more likely than women in monogamous relationships to experience intimate partner violence (11.7% vs. 3.6%, Adjusted OR = 2.23; 95% CI = 0.94, 5.26). The prevalence of intimate partner violence was relatively low in both groups among women whose husbands did not drink (2.9% vs. 0%, Adjusted OR = N/A), and very high in both groups among those whose husbands binge-drank (46.2% vs. 20.8%, Adjusted OR = 9.54; 95% CI = 1.10, 82.54). However, the Breslow-Day Test of Homogeneity suggested that there was no statistically significant effect modification (p-value = 0.259). CONCLUSION: Stakeholders in intimate partner violence should consider both alcohol use (particularly binge-drinking) and polygyny as risk factors for intimate partner violence. However, caveats regarding study design, misclassification and potential information bias, and lack of generalizability should be considered in the interpretation of the study findings.

COVID-19 and Female Genital Mutilation/Cutting and child marriage: An online multi-country cross sectional survey.

Female Genital Mutilation/Cutting (FGM/C) and child marriage are prevalent in many countries in Asia and Africa. These practices are a violation of human rights and have significant impacts on the physical and mental well-being of those affected. COVID-19 restrictions such as lockdowns and closure of schools may have influenced the occurrence of FGM/C and child marriage. This analysis reported on the impact of these restrictions on FGM/C and child marriage. The International Sexual Health And REproductive Health (I-SHARE) research team organised a multi-country online survey. Sampling methods included convenience samples, online panels, and population-representative samples. Data collected included the impact of COVID-19 restrictions on the occurrence, intention to practice and change in plans to organise FGM/C and child marriage. Data were analysed from 14 countries that reported on FGM/C and child marriage using basic descriptive statistics. Given it was an online survey, we had more responses from urban areas. Among the 22,724 overall participants, 8,829 participants (38.9%) responded to the survey items on FGM/C and child marriage and were included in this analysis. 249 (3.4%) participants stated that FGM/C occurred in their community during COVID-19. Out of this, COVID-19 affected the plans of 26 (20%) participants intending to organise circumcision and 15% of participants planned to organise FGM/C earlier. People with a worry about finances during COVID-19 were more likely to have an earlier plan to organise FGM/C during COVID-19. In total, 1,429 (13%) participants reported that child marriage occurred in their community. The pandemic affected plans of 52 (13%) participants intending to arrange child marriage and 7.7% (29/384) participants expressed intent to arrange the marriage sooner than planned. People with financial insecurities during COVID-19 were more likely to arrange a child marriage earlier. Thus, our study found that the pandemic impacted plans related to FGM/C and child marriage practices, resulting in many carrying out the practices sooner or later than initially planned.

Effects of an online program about intimate and romantic relationships for people with mental disorders (AIRIKI): a study protocol for a randomized controlled trial.

BACKGROUND: The concept of recovery has become internationally widespread. To promote personal recovery of individuals with mental disorders, it is important that they live life on their own terms. Many people with mental disorders wish to build intimate relationships and marry. However, people with mental disorders face obstacles in building such relationships and communicating with their partners. The program AIRIKI, which means "power to love," was developed to help people with mental disorders gain confidence in building intimate relationships. The AIRIKI pilot study with one-group pre post test showed positive effects on self-esteem, hope, and communication. Therefore, the purpose of the proposed randomized controlled trial (RCT) is to determine the effects of the videoconferencing program on self-esteem, hope, and self-confidence in communication among un-married people with mental disorders. METHODS: The proposed randomized controlled trial has two arms (intervention group and control group). After baseline questionnaire assessment, participants will be allocated randomly. Within two months of allocation, the intervention group will participate in videoconferences about intimate relationships and marriage with 2-5 participants and 3 facilitators, which will last 3 h, for two days. Three facilitators will support participants in each session. The intervention group will complete a questionnaire for outcome assessment at termination and one month after the program. The control group will complete the outcome questionnaire at one month after baseline and two months after baseline. The questionnaire will include the Rosenberg Self-Esteem Scale (RSES), Herth Hope Index (HHI), and Self-confidence in Communication Scale (SCS). Control group members can participate in a videoconference program, which will be held separately from the intervention group, after completing their outcome assessments. DISCUSSION: This trial is the first randomized controlled trial of which we are aware to test the effects of an online program for un-married people with mental disorders to consider and discuss their romantic relationship and marriage. The results will provide information on the effectiveness of an online program for people with mental disorders to imagine their romantic relationships and marriages. TRIAL REGISTRATION: This trial has been registered with the UNIN Clinical Trials Registry (UMIN000052027; 2023/08/28).

Exploring determinants of early marriage among women in Bangladesh: A multilevel analysis.

INTRODUCTION: Early marriage, defined as marriage under the age of 18, is widely recognized as a human rights violation with deleterious consequences on women's health and well-being. It persists as a significant global public health issue, predominantly being practiced in South Asian countries. In Countries like Bangladesh, this practice contributes to an increase in early pregnancies among women of reproductive age, further exacerbating adverse maternal and child health outcomes. While certain predictors of early marriage are recognized, additional investigation is warranted due to diverse socio-economic and demographic circumstances. This study, therefore, aimed to identify the prevalence and determinants of early marriage among women in Bangladesh. METHODS: This study included a total weighted sample of 18,228 married women aged 18 to 49 years, extracted from the most recent nationally representative Bangladesh Demography and Health Survey (2017-18). We estimated the survey weighted pooled prevalence of early marriage among women and stratified by their different characteristics. We used multilevel mixed-effect binary logistic regression model and estimated the odds ratios (ORs) with their 95% confidence intervals (CIs) to identify the individual-, household-, and community-level factors associated with early marriage practice. All analyses were performed by Stata software version 18. RESULTS: Overall, 74.27% [95% CI: 73.15, 75.35] women got married before reaching the age of 18 years. Early marriage was more prevalent in Rajshahi (82.69%), Rangpur (81.35%), and Khulna division (79.32%). Women with higher education (OR = 0.10, 95% CI: 0.08, 0.12), husband's higher education (OR = 0.57, 95% CI: 0.48, 0.67), and non-Muslim women (OR = 0.46, 95% CI: 0.40, 0.52) were associated with a lower likelihood of experiencing early marriage. Compared to those household heads aged ≤35 years, the likelihood of early marriage among women was lower for those household heads aged 36-55 years (OR = 0.84, 95% CI: 0.76, 0.93) and >55 years (OR = 0.78, 95% CI: 0.69-0.88). Women aged 18-24 years (OR = 1.24, 95% CI: 1.10, 1.40), husbands with agricultural occupation (OR = 1.22, 95% CI:1.06, 1.41), middle wealth index level (OR = 1.14, 95% CI: 1.02, 1.28), family size five or more (OR = 1.21, 95% CI: 1.11, 1.31), and rural residence (OR = 1.17, 95% CI: 1.04, 1.30) were more likely to experience early marriage. CONCLUSION: This study underscores the alarming prevalence of early marriage among women in Bangladesh, with three-fourths experiencing early marriage, particularly in specific regions. Notably, women education and older household heads were significantly associated with a reduced likelihood of early marriage. Our findings suggest that culturally sensitive interventions should focus on empowering older household heads, alongside initiatives to increase awareness among younger household heads, and enhance education, particularly in rural and impoverished households. These efforts could potentially alter socio-cultural practices and reduce early marriage in Bangladesh.

Joint Leisure Activities of Older Vietnamese Married Couples.

Leisure activities enjoyed by older married couples play an important part in creating more meaningful married lives. The study focuses on the prevalence of joint leisure activities by older couples, the factors influencing older adults' engagement in leisure activities together, and the relationship between joint participation in leisure activities and marital satisfaction of older couples. The quantitative sample included 414 married respondents aged 55 years and above from different parts of Vietnam. The leisure activities analyzed in the paper include vacation/travel, watching movies, music, karaoke singing outside the house, walking around the house, attending cultural events and festivals, watching TV, drinking tea, and doing exercise. The study results showed that the level of joint engagement in leisure activities in places near home with less cost was higher than those engaged in elsewhere. Couples with better living standards, higher education, better health, and who lived in urban areas more actively participated in leisure activities far from home. Vietnamese couples who engage in more leisure activities together had a higher level of overall satisfaction with their marriage, and greater satisfaction in several dimensions of their marital relationship than those who did not participate in leisure activities with their partners.

Regional distribution and factors associated with early marriage in Ghana: a cross-sectional study.

BACKGROUND: Early marriage, the formal or informal union before age 18, remains a critical challenge in several low-and middle-income countries. It has adverse health and education-related implications on child brides. This study examined the regional distribution of early marriage and its associated factors in Ghana. METHODS: We performed a cross-sectional analysis of data extracted from the 2022 Ghana Demographic and Health Survey. Our study comprised 10,098 ever married/cohabiting aged 15 to 49. Regional variations in the prevalence of child marriage were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was performed to assess the factors associated with early marriage. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI). RESULTS: The prevalence of early marriage was 29.2% [27.9, 30.6] in Ghana. Women in the North East 38.2% [33.4, 43.2], Western North 36.7% [32.1, 41.5] and Ahafo regions 35.8% [32.0, 39.8] had the highest prevalence of early marriage, whilst women in the Western 22.2% [18.4, 26.5] and Greater Accra 19.7% [15.8, 24.3 regions] had the lowest prevalence of early marriage in Ghana. The odds of early marriage was lower among women aged 20-49 compared to those aged 15-19. Women with secondary [aOR = 0.40; 95% CI 0.33, 0.48] and higher education [aOR = 0.07; 95% CI 0.04, 0.12], those who belonged to the Gurma ethnic group [aOR = 0.59; 95% CI 0.41, 0.84], and women from richer [aOR = 0.64; 95% CI: 0.47, 0.87] and richest [aOR = 0.42; 95% CI 0.28, 0.64] households were less likely to be married early compared to those with no education, those belonging to the Akan ethnic group, and those from the poorest wealth quintile households, respectively. The odds of early marriage was higher among women whose family size was five or more [aOR = 1.50; 95% CI 1.31, 1.72] and women living in the Central [aOR = 1.72; 95% CI 1.16, 2.54], Volta [aOR = 1.97; 95% CI 1.17, 3.30], Eastern [aOR = 1.53; 95% CI 1.01, 2.29], Ashanti [aOR = 1.98; 95% CI 1.33, 2.97], Western North [aOR = 1.77; 95% CI 1.18, 2.65], and Ahafo regions [aOR = 1.74; 95% CI 1.18, 2.56]. CONCLUSION: About one in three marriages were early in Ghana, with variations across the regions. Age, wealth index, ethnicity, level of education, family size, and region were identified as factors associated with early marriages. The government and policymakers in Ghana should increase access to and completion of secondary education for girls, as it is crucial in reducing early marriage. Providing programmes that economically empower women and girls can decrease their vulnerability to early marriage. More vigorous enforcement of laws against early marriage is necessary. Engaging with communities, including tribal leaders, is essential to shift cultural attitudes toward early marriage.

Sharing Your Husband: Adult Attachment Styles and Emotional Responses of Israeli Bedouin-Arab Women to Potential Polygynous Marriage.

Polygynous marriage is prevalent among Israel's Bedouin-Arab community, despite being explicitly banned by state law. Cultural traditions and customs permit men to take multiple wives, and Islamic teachings do not prohibit the practice. The impact of polygyny is significant, affecting women, children, and society as a whole in various ways. We examined the connections that attachment anxiety and attachment avoidance had with hypothetical responses to the potential threat of polygynous marriages in a community sample of young unmarried Israeli Bedouin-Arab women (n = 306). Participants were randomly assigned to imagine either a high-threat scenario (i.e., finding that their husband decided to take a second wife; n = 151) or a low-threat scenario (i.e., their husband would not decide to take a second wife; n = 155) and report their anticipated responses to these scenarios. Results showed that attachment anxiety was positively associated with anticipated negative emotional responses in the high-threat condition but not in the low-threat condition. However, neither attachment anxiety nor attachment avoidance were associated with the perceived threat of polygyny to their marriage. The findings of this study suggest that attachment styles play a significant role in shaping women's perceptions and reactions to hypothetical polygynous marriages. Women with anxious attachment styles are more likely to experience intensified negative emotions regarding such marriages, while those with avoidant attachment styles may display greater tolerance toward polygyny. These results highlight the need for tailored interventions and support systems that take into account individual psychological profiles as well as the broader cultural context of Israeli Bedouin-Arab society.

Dowry demand, perception of wife-beating, decision making power and associated partner violence among married adolescent girls: A cross-sectional analytical study in India.

BACKGROUND: Violence against women is considered a fundamental violation of their human rights. According to the world health organization (WHO), one-third of women worldwide experience some form of intimate partner violence (IPV). This study aimed to investigate the relationship between dowry demand, perception of wife-beating, decision-making on work and household purchases and physical, sexual, and emotional violence against married adolescent girls in India by using a large dataset. METHODS: Data from the Understanding the lives of adolescents and young adults (UDAYA) project survey were used in this study. The final sample size included 4893 married adolescent girls. Descriptive statistics and bivariate analyses were performed to examine preliminary results. Multivariate logistic regression analysis was used to analyze the associations between dowry demand, perception of wife-beating, decision-making and types of IPV. RESULTS: The prevalence of emotional, physical, and sexual violence among married adolescent girls were 28.6%, 22.9%, and 26.1%, respectively. Approximately 44% of married adolescent girls have experienced some form of violence (emotional, physical, or sexual). The likelihood of experiencing violence was 3.64 times more likely among adolescent girls who reported that dowry was demanded by their in-laws than their counterparts [aOR: 3.64; CI: 3.05-4.35]. Moreover, married girls who justified wife-beating were more likely to face any violence than their counterparts [aOR: 1.56; CI: 1.28-1.90]. Similarly, adolescent girls whose work decisions were made by others had higher odds of experiencing any violence than those who decided their work themselves/jointly with others [aOR: 1.34; CI: 1.07-1.68]. The odds of any violence were higher among adolescent girls whose decisions on household purchases were made by others compared to those who decided to make purchases themselves or jointly with others [aOR: 1.37; CI: 1.09-1.71]. CONCLUSIONS: The findings revealed significant associations between dowry-demand, justification of wife-beating, decision making power and IPV among married adolescent girls, and suggest policies that help reduce violence related to the predominantly practiced dowry system in the country, and programs aimed at educating adolescent married girls about their rights against violence and empowering them to retain equal decision-making power within their families and reduce their vulnerability to domestic violence.

Addressing disparity in attitudes and utilization of family planning among married couples in the pastoralist community of Fentale District, Eastern Ethiopia.

BACKGROUND: Despite progress in national reproductive health programs, pastoralist regions like Fentale District in Eastern Ethiopia face challenges with low contraceptive coverage, attributed to insufficient positive attitudes and uptake among couples. METHODS: This cross-sectional study was conducted from October 1 to December 25, 2021, in Fentale District, Eastern Ethiopia. It involved 1,496 couples selected using multistage sampling. Data were entered into EPI Data and analyzed with SPSS (v23.0) and STATA (v14.0), employing descriptive statistics, bivariate analysis, and binary logistic regression to identify predictors of contraceptive attitudes and use. RESULTS: The study's response rate was 93.8%, with 1,404 pastoralist couples participating, equally split between women and men. A nomadic-pastoralist lifestyle was common (64.6%), and family planning discussions were rare (93.2%). Gender disparities in contraceptive attitudes and use were evident. Contraception use was reported by 27.4%, with women (41.2%) outnumbering men (13.5%). Women showed more positive attitudes towards contraception (87.9% vs. 31.9% for men). Only 33% had favorable attitudes towards different contraceptive methods, with women more likely to be positive. Modern contraception use was low (18.2%), with women (34.8%) predominating over men (1.7%). Among users, women had a more favorable attitude (78.5% vs. 6.6% for men). Health extension workers were key information providers. Predictors of contraceptive attitudes and use included sex, education, occupation, electronic device ownership, migration frequency, treatment preferences, and family planning discussions. CONCLUSION: The limited positive attitude towards and use of family planning in Fentale District may stem from unfavorable attitudes, low adoption, and couple disparities. Key factors include gender, education, occupation, electronic device ownership, migration, treatment preferences, and family planning discussions. Targeted educational campaigns for men are needed to address these issues and reduce the gender gap in contraceptive attitudes and use.

Relationship between Marriage and Prediabetes among Healthcare Workers: Mediating Effect of Triglycerides.

Background and Objectives: In the literature, relationships between being married and having prediabetes or diabetes are inconsistent. We aimed to investigate whether marriage is a protective or risk factor for prediabetes and to uncover new insights into its impact on prediabetes. Materials and Methods: In this cross-sectional observational study, questionnaires were distributed by email to 1039 staff members who participated in an employee health check from a hospital affiliated with a medical university in Taiwan. Fasting blood glucose and triglyceride (TG) levels were checked and the questionnaires elicited basic demographic characteristics and included the Copenhagen Burnout Inventory and Nordic Musculoskeletal Questionnaire. The chi-square test or Fisher's exact test, logistic regression, and mediation analysis were conducted for statistical analysis. Results: Among the group aged 20-37 years, married (OR = 1.89, 95%CI: 1.08, 3.33), obesity (OR = 2.95, 95%CI: 1.49, 5.83), neck and shoulder pain (OR = 1.31, 95%CI: 1.01, 1.69), and elevated TG levels (OR = 1.01, 95%CI: 1.00, 1.01) were independent risk factors for prediabetes (impaired fasting glucose). For those >38 years old, overweight (OR = 2.08, 95%CI: 1.27, 3.43), obesity (OR = 4.30, 95%CI: 2.38, 7.79), and elevated triglyceride (TG) (OR = 1.003, 95%CI: 1.00, 1.01) were the independent risk factors for impaired fasting glucose. Increased TG levels serve as a mediating factor (Zm = 2.64, p < 0.01) linking marriage to an increased risk of prediabetes for the group aged 20-37 years. Conclusions: TGs play a significant role in the association between marriage and prediabetes among the group aged 20-37 years. Therefore, dietary habits, especially those of young adult couples should be considered. Our findings connect marital status to prediabetes, facilitating advances in diabetes prevention.

Ideal Family Size and Reproductive Orientations: An Exploration of Change Over Time in the United States.

Drawing on more than 30 years of nationally representative microdata from the General Social Survey, this article comprehensively updates recent trends in ideal family size in the United States. It first documents stability in ideal family sizes between the mid-1980s and 2018, even in the face of a recent fertility decline. Next, the study adopts a latent class approach that identifies typologies of "reproductive orientations," defined as multidimensional mental models of reproduction encompassing ideal family size, attitudes toward reproductive labor, and views on reproduction contexts. The findings indicate three distinct classes of reproductive orientations: Progressive Familialists, Conservative Familialists, and Blended Egalitarians. Further analyses suggest that the prevalence of these classes has changed over time and that class membership is associated with distinct patterns of childbearing and marriage. These findings deepen contemporary understandings of ideal family size in the United States and have broader implications for how demographers conceptualize and measure fertility preferences across diverse contexts.

Intergenerational Power Shift and the Rise of Nonarranged Marriages Among Refugees.

The experiences of war and refugee status can alter intrafamily dynamics, with implications for family formation, including marriage. We use the nationally representative Syrian Migrant Sample of the 2018 Turkey Demographic Health Survey (TDHS-S) to conduct a duration analysis of marriage outcomes among Syrian refugees in Turkey, tracking women throughout their residence in prewar Syria (before the conflict began in 2011), postwar Syria (after the conflict began but before arrival in Turkey), and Turkey. We find that early marriage was more prominent among refugees who were unmarried at the time of migration than among those married before migration; the mean marriage age dropped from 19.6 in prewar Syria to 19.1 in postwar Syria and 18.1 in Turkey. Using the TDHS-S and prewar Syrian surveys, we show that this finding aligns with the observed declines in household income and young women's opportunity cost of marriage. Our duration analysis also reveals a notable shift from traditional arranged marriages to more modern marriage forms among refugees in Turkey. An intergenerational power shift might drive the shift toward nonarranged marriages. After arrival in Turkey, wealth and employment of parents decline among refugees. In contrast, Syrian youth in Turkey have higher age-adjusted employment rates than in prewar Syria. Moreover, nonarranged marriages increase more among demographic groups with stronger intergenerational power shifts than among groups with weaker shifts.

Determinants of unmet need for contraceptive method among young married women in Ethiopia: Multilevel analysis of Ethiopia Demographic and Health Survey 2016.

BACKGROUND: The notion of unmet need for family planning indicates the gap between women's contraceptive practice and their reproductive intention. Although universal access to sexual and reproductive health services including contraceptive methods is a bedrock for sustainable development goals, the unmet need for contraception is high among young women in low-income countries including Ethiopia. The unmet need for contraception is associated with unintended pregnancy which most of the time end in unsafe abortion. Hence, this study aimed to assess the determinants of unmet need for family planning among young married women in Ethiopia using nationally representative data. METHOD: This study utilized secondary data collected in the 2016 Ethiopia Demographic and Health Survey (EDHS). A two-stage cluster sampling method was used. The analysis included a total of 2444 sexually active married young women (15-24 years). Multilevel logistic regression analysis was conducted to identify individual and community level factors associated with unmet need for contraceptives and the results were presented as adjusted odds ratio (AOR) at 95% confidence interval (CI), declaring statistical significance at a p-value <0.05 in all analyses. RESULTS: In this study, the prevalence of unmet need for contraceptive method among married young women was 18.4% [95% CI: (16.9, 20.0)]. Female head of the household [AOR: 1.62, CI (1.25, 2.11)], primary level of education [AOR: 1.53, CI: (1.16, 2.03)], family size ≥5 [AOR: 1.53, 95%CI: (1.22, 1.93)], undecided to have child [AOR: 2.86, 95%CI: (1.58, 5.20)] and infecund [AOR: 1.54, 95%CI: (1.08, 2.20)] were factors positively associated with unmet need for family planning. Whereas the odds of unmet need for contraceptive method was lower among women-initiated sex between 15-17 years and >17 years [AOR:0.72, 95%CI (0.53, 0.98)] and [AOR: 0.58, 95%CI: (0.40, 0.85)] respectively and community with high proportion of poverty [AOR: 0.68, 95%CI: (0.46, 0.99)]. CONCLUSION: The prevalence of unmet need for contraceptive methods among young married women was relatively high. Being female household head, age at first sexual intercourse, educational status of the woman, family size, desire for more children, and community poverty were significantly associated with unmet need for family planning. Hence, interventions targeting these special populations at the individual and community level would play a paramount role in meeting the unmet need for contraception among young married women in Ethiopia.

Prevalence of pregnancy termination and associated factors among married women in Papua New Guinea: A nationally representative cross-sectional survey.

BACKGROUND: Pregnancy termination or induced abortion is not decriminalized, and access to safe abortion services is largely unavailable in Papua New Guinea (PNG). However, the practice is common throughout the country. This study aimed to estimate the prevalence and determine factors associated with pregnancy termination among married women aged 15-49 years in PNG. METHODS: Secondary data from the 2016-2018 PNG Demographic and Health Survey (PNGDHS) was used. A total weighted sample of 6,288 married women were included. The Complex Sample Analysis method was used to account for the cluster design and sample weight of the study. Chi-square tests and multivariable logistic regression were used to assess factors associated with pregnancy termination. Adjusted odds ratios (aORs) with 95% Confidence Intervals (CIs) were reported. RESULTS: The prevalence of pregnancy termination was 5.3%. Nearly half (45.2%) of all pregnancy terminations occurred in the Highlands region. Women aged 35-44 years (aOR = 8.54; 95% CI: 1.61-45.26), not working (aOR = 6.17; 95% CI: 2.26-16.85), owned a mobile phone (aOR = 3.77; 95% CI: 1.60-8.84), and lived in urban areas (aOR = 5.66; 95% CI: 1.91-16.81) were more likely to terminate a pregnancy. Women who experienced intimate partner violence (IPV) were 2.27 times (aOR = 2.27; 95% CI: 1.17-4.41) more likely to terminate a pregnancy compared to those who did not experience IPV. Women with unplanned pregnancies were 6.23 times (aOR = 6.23; 95% CI: 2.61-14.87) more likely to terminate a pregnancy. Women who knew about modern contraceptive methods and made independent decisions for contraceptive use were 3.38 and 2.54 times (aOR = 3.38; 95% CI: 1.39-8.18 and aOR = 2.54; 95% CI: 1.18-5.45, respectively) more likely to terminate a pregnancy. CONCLUSION: The findings highlight the role of sociodemographic and maternal factors in pregnancy termination among married women in PNG. Efforts aimed at reducing unplanned pregnancies and terminations should focus on comprehensive sexual and reproductive health education and improving easy access to contraceptives for married couples. Post-abortion care should also be integrated into the country's legal framework and added as an important component of existing sexual and reproductive health services.