Increases in child marriage among the poorest in Mali: 'Reverse policies' or data quality issues?

Child marriage is associated with adverse outcomes related to women's well-being. Many countries have introduced laws banning this practice, and a number of studies have evaluated their impact. Scant research has focused on instances where countries have lowered the legal minimum age at marriage, even though such 'reverse policies' could result in stalled or uneven progress in eradicating child marriage. Using visualization techniques, regression analyses, and multiple robustness checks, we document changes in the prevalence of child marriage in Mali, where in 2011 the general minimum age at marriage of 18 was lowered to 16. Since 2011, the prevalence of child marriage has progressively increased among women with no education and women living in communities characterized by low local development. We reflect on the role that data collection processes may play in explaining some of these findings and stress how repealing existing provisions aiming to protect girls can have adverse consequences on the most vulnerable social strata.

Human fertility after a disaster: a systematic literature review.

Fertility is a key demographic parameter influenced by disaster. With the growing risk of disasters, interest in the fertility response to a disaster is increasing among the public, policy makers and researchers alike. However, a systematic literature review on how disaster affects live birth counts does not yet exist. We reviewed 50 studies retrieved from a systematic search based on a pre-registered protocol. We found an overall negative impact of disasters on fertility. If any, increases in fertility were mostly linked with weather-related physical disasters. We also identified 13 distinct mechanisms which researchers have considered as underlying the fertility effects of disaster. By contrast to the common belief that disasters are more likely to increase fertility in contexts with already high fertility, we found little evidence to suggest that the total fertility rate of the studied populations was an important predictor of the direction, timing or size of fertility impacts. While this may be because no relationship exists, it may also be due to biases we observed in the literature towards studying high-income countries or high-cost disasters. We summarize the methodological limitations identified from the reviewed studies into six practical recommendations for future research. Our findings inform both the theories behind the fertility effects of disasters and the methods for studying them.

Forecasting of cohort fertility by educational level in countries with limited data availability: The case of Brazil.

The Brazilian period total fertility rate (PTFR) dropped to 1.8 in 2010 (1.5 among those with high education). Due to shifts in fertility timing, the PTFR may provide a misleading picture of fertility levels. The consequences of these changes for the cohort total fertility rate (CTFR)-a measure free from tempo distortions-and for educational differences in completed fertility remain unknown. Due to data limitations, CTFR forecasts in low- and middle-income countries are rare. We use Brazilian censuses to reconstruct fertility rates indirectly and forecast the CTFR for all women and by educational level. Four forecasting methods indicate that the CTFR is unlikely to fall to the level of the PTFR. Educational differences in the CTFR are likely to be stark, at 0.7-0.9, larger than in many high-income countries with comparable CTFRs. We show how the CTFR can be forecasted in settings with limited data and call for more research on educational differences in completed fertility in low- and middle-income countries.

Union formation, within-couple dynamics, and child well-being: A global macrolevel perspective.

Studies on global changes in families have greatly increased over the past decade, adopting both a country-specific and, more recently, a cross-national comparative perspective. While most studies are focused on the drivers of global changes in families, little comparative research has explored the implications of family processes for the health and well-being of children. This study aims to fill this gap and launch a new research agenda exploring the intergenerational implications of union-formation and within-couple dynamics for children's health and well-being across low- and middle-income countries (LMICs), both globally, regionally, and by the stage of fertility transition. We do so by adopting a macro-level perspective and a multi-axis conceptualization of children's outcomes - health at birth, health in later life, and schooling - and leveraging Demographic and Health Survey and World Bank data across 75 LMICs. Our results show that in societies where partnerships are characterized by more equal status between spouses - i.e., where the age range between spouses and differences in years of schooling between partners are narrower - children fare better on several outcomes. These associations are particularly strong in mid- and high-fertility settings. Despite a series of regularities, our results also highlight a set of findings whereby, at a macro-level, the prevalence of marriage and divorce/separation are not invariably associated with children's outcomes, especially in LMICs where fertility is comparatively lower. We document little cross-regional heterogeneity, primarily highlighting the centrality of demographic factors such as age vis-à-vis, for instance, region-specific characteristics that are more tied to the social fabric of specific societies.

Unequal Transitions to Adulthood: Widening Disparities in Age at First Union, Sex, and Birth in Many Low- and Middle-Income Countries.

Research on the timing of events during the transition to adulthood, such as first union, sex, and birth in low- and middle-income countries (LMICs), focused predominantly on measures of central tendency, notably median or mean ages. In this report, we adopt a different perspective on this topic by examining disparities in the timing of these events in 46 LMICs spanning four decades. Using Demographic and Health Surveys, we estimate ages at which 25 percent, 50 percent, and 75 percent of women have first union, birth, and sex. We compute interquartile ranges to measure within-country variation and disparities in the timing of sexual initiation and family formation. Variation in the timing of first union, birth, and sex generally increases as the median ages at these events increase. Disparities in the timing of first union and birth grew in West Africa and Latin America, and women who experience these events relatively early increasingly lag behind women who experience them relatively late. Documenting trends in measures of central tendency is insufficient to capture the complexity of ongoing changes because they mask growing disparities in the timing of family formation across many LMICs. These results are important for assessing progress toward the achievement of sustainable development goals related to the reduction of early marriages and pregnancies and highlight a need for more holistic approaches to measure the timing of family formation.

Unintended pregnancy resolution among parous women in twelve low- and middle-income countries.

Around 40% of pregnancies worldwide are unintended and a half of those are terminated. Yet, few international comparisons of unintended pregnancy resolution (choosing birth or abortion) exist. This study analysed how parous women's pregnancy intentions and abortion decisions are associated with their reproductive histories and country contexts using twelve Demographic and Health Surveys representing four context groups: post-Soviet/communist and Asian countries with liberal abortion legislation, and Asian and Latin American countries with restrictive abortion legislation. Similarities were found across contexts: preference to have children of both sexes, space births, stop childbearing after reaching desired family size and an increased likelihood of unintended pregnancy when using less-effective contraceptive methods versus none. Contextual factors most clearly associated with reports of unintended pregnancy resolution were type of abortion legislation and living in post-Soviet/communist contexts. Women's propensity to report abortions and unintended pregnancy varied by context and the decision-making processes for pregnancy versus fertility management were different.

Female Genital Mutilation/Cutting in Mali and Mauritania: Understanding Trends and Evaluating Policies.

Despite international commitments to end female genital mutilation/cutting (FGM/C), very little is known about the effectiveness of national policies in contributing to the abandonment of this harmful practice. To help address this gap in knowledge, we apply a quasi-experimental research design to study two west African countries, Mali and Mauritania. These countries have marked similarities with respect to practices of FGM/C, but differing legal contexts. A law banning FGM/C was introduced in Mauritania in 2005; in Mali, there is no legal ban on FGM/C. We use nationally representative survey data to reconstruct trends in FGM/C prevalence in both countries, from 1997 to 2011, and then use a difference-in-difference method to evaluate the impact of the 2005 law in Mauritania. FGM/C prevalence in Mauritania began to decline slowly for girls born in the early 2000s, with the decline accelerating for girls born after 2005. However, a similar trend is observable in Mali, where no equivalent law has been passed. Additional statistical analysis confirms that the 2005 law did not have a significant impact on reducing FGM/C prevalence in Mauritania. These findings suggest that legal change alone is insufficient for behavioral change with regard to FGM/C. This study demonstrates how it is possible to evaluate national policies using readily available survey data in resource-poor settings.

Non-family Living Arrangements Among Young Adults in the United States.

The share of young adults living in married-couple family households in the USA has declined in recent decades. Research on alternative living arrangements focuses on cohabitation among unmarried couples and parent-adult child coresidence. Less is known about trends in non-family living arrangements and the characteristics of young adults living with non-relatives. This study documents trends over time in non-family living arrangements among young adults in the USA and examines the sociodemographic profile of those living with non-relatives. Using pooled US Census and American Community Survey microdata from 1990 to 2019, the authors document age patterns in non-family living arrangements over time and use logistic regression to estimate the likelihood of living with non-family based on individual-level characteristics. Results indicate that non-family living among young adults has increased over time, and that the arrangement is associated with markers of both advantage and disadvantage. Differences across age groups explain some of these mixed results. Trends among younger groups are linked to socioeconomic patterns around family formation. Among older groups, the demographic and labor force characteristics of the foreign born and constraints of their kin availability may be driving trends. The exploratory analysis provides relevant evidence around an increasingly common living arrangement in the USA and also identifies several areas for future research on living arrangements among young adults and the implications of these trends.

Trends in child marriage and new evidence on the selective impact of changes in age-at-marriage laws on early marriage.

This study adopts a cohort perspective to explore trends in child marriage - defined as the proportion of girls who entered first union before the age of 18 - and the effectiveness of policy changes aimed at curbing child marriage by increasing the minimum legal age of marriage. We adopt a cross-national perspective comparing six low- and middle-income countries (LMICs) that introduced changes in the minimum age at marriage over the past two decades. These countries belong to three broad regions: Sub-Saharan Africa (Benin, Mauritania), Central Asia (Tajikistan, Kazakhstan), and South Asia (Nepal, Bhutan). We combine individual-level data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys with longitudinal information on policy changes from the PROSPERED (Policy-Relevant Observational Studies for Population Health Equity and Responsible Development) project. We adopt data visualization techniques and a regression discontinuity design to obtain estimates of the effect of changes in age-at-marriage laws on early marriage. Our results suggest that changes in minimum-age-at-marriage laws were not effective in curbing early marriage in Benin, Mauritania, Kazakhstan, and Bhutan, where child marriage showed little evidence of decline across cohorts. Significant reductions in early marriage following law implementations were observed in Tajikistan and Nepal, yet their effectiveness depended on the model specification and window adopted, thus making them hardly effective as policies to shape girls' later life trajectories. Our findings align with existing evidence from other countries suggesting that changes in age-at-marriage laws rarely achieve the desired outcome. In order for changes in laws to be effective, better laws must be accompanied by better enforcement and monitoring to delay marriage and protect the rights of women and girls. Alternative policies need to be devised to ensure that girls' later-life outcomes, including their participation in higher education and society, are ensured, encouraged, and protected.

Changing gender gaps in the timing of first union formation and sexual initiation in sub-Saharan Africa.

Gender differences in union formation and sexual initiation in sub-Saharan Africa remain poorly documented, in large part due to a scarcity of research on the transition to adulthood among men. We adopt a novel perspective on this topic by examining gender gaps in the ages at first union and sex in 24 countries, focusing on measures of central tendency and dispersion. Gender differences in age at first union decreased, driven by postponement among women with relatively late union formation. Yet, due to concurrent persistence of early unions among a sizable portion of women's populations, within-country heterogeneity in ages at first union increased substantially among women. Thus, although forces responsible for earlier union formation among women than men are weakening, these changes affect population strata unequally. Gender differences in age at first sex decreased to a lesser extent, but in some countries, they disappeared or reversed, uncovering a shift in the relationship between gender and timing of sexual initiation. Changes in union formation and sexual initiation are more heterogeneous across countries among men than women, indicating that these processes among men are more context specific. We show importance of studying men's behavior and exploring heterogeneity in union formation and sexual initiation both within and between populations of women and men.

Contraceptive Use Behavior Change After an Unintended Birth in Colombia and Peru.

CONTEXT: No studies using longitudinal contraceptive histories have investigated whether having an unintended birth (i.e., one resulting from an unintended pregnancy) is associated with change in contraceptive behavior, including in Colombia and Peru, where levels of unintended fertility remain high. METHODS: Monthly reproductive history calendar data from the 2010 Colombia and 2012 Peru Demographic and Health Surveys were used to study contraceptive behavior among 13,373 and 7,425 women, respectively. Transition matrices and hazard models were utilized to identify associations between prepregnancy and postpartum contraceptive methods used, and to assess how these relationships differed between women who reported an unintended birth and those with an intended birth. RESULTS: Women who had been using a traditional, barrier or (in Colombia) short-acting hormonal method before pregnancy were more likely to choose a more effective method postpartum, than to use no method, if their birth had been unintended rather than intended (relative risk ratios, 1.2-1.3 in Colombia; 1.6 in Peru). Compared with their counterparts whose birth had been intended, women with an unintended birth who had been utilizing the most effective methods used in the country (IUD or implant in Colombia, pill or injectable in Peru) were less likely to resume using them postpartum than to use no method (0.7 in Colombia; 0.8 in Peru). CONCLUSIONS: Unintended birth is associated with change in contraceptive behavior. Efforts to understand postpartum contraceptive choices of women who have had an unintended birth should take into account contraceptive behavior at more than one point in women's reproductive lives.

RESUMEN Contexto: Ningún estudio basado en historias anticonceptivas longitudinales ha investigado si tener un parto no planeado (es decir, resultante de un embarazo no planeado) se asocia con el cambio en el comportamiento en el uso de anticonceptivos, incluso en Colombia y Perú, en donde los niveles de fecundidad no planeada siguen siendo altos. Métodos: Se utilizaron datos mensuales del calendario de historia reproductiva de las Encuestas Demográficas y de Salud de Colombia 2010 y de Perú 2012, para estudiar el comportamiento anticonceptivo de 13,373 y 7,425 mujeres, respectivamente. Se utilizaron matrices de transición y modelos de riesgo para identificar las asociaciones entre los métodos anticonceptivos usados antes del embarazo y posparto, así como para evaluar la forma en que estas relaciones diferían entre las mujeres que reportaron haber tenido un parto no planeado y aquellas con un parto planeado. Resultados: Las mujeres que habían estado usando un método hormonal tradicional, de barrera o (en Colombia) de corta duración antes del embarazo, tuvieron más probabilidades de elegir un método posparto más efectivo, en lugar de no usar ningún método, si su parto había sido no planeado en lugar de planeado (razones de riesgo relativo, 1.2­1.3 en Colombia; 1.6 en Perú). En comparación con sus contrapartes cuyo parto había sido planeado, las mujeres con un parto no planeado que habían estado utilizando los métodos más efectivos utilizados en el país (DIU o implante en Colombia, píldora o inyectable en Perú) tuvieron menos probabilidades de reanudar su uso que de no usar ningún método después del parto (0.7 en Colombia; 0.8 en Perú). Conclusiónes: El parto no planeado se asocia con un cambio en el comportamiento anticonceptivo. Los esfuerzos para comprender las decisiones anticonceptivas posparto de las mujeres que han tenido un parto no planeado deberían tener en cuenta el comportamiento anticonceptivo en más de un momento de la vida reproductiva de las mujeres.

RÉSUMÉ Contexte: Aucune étude de données historiques longitudinales sur la contraception n'a cherché à établir si une naissance non planifiée (résultat d'une grossesse non planifiée) était associée à un changement de comportement contraceptif, y compris en Colombie et au Pérou où les niveaux de fécondité non planifiée restent élevés. Méthodes: Les données de calendrier historique mensuel ayant trait à la reproduction, extraites des Enquêtes démographiques et de santé 2010 de Colombie et 2012 du Pérou, ont servi à l'étude du comportement contraceptif de 13 373 et 7 425 femmes, respectivement. Des tables de transition et des modèles de risque ont permis d'identifier les associations entre les méthodes contraceptives utilisées avant et après la grossesse, ainsi que d'évaluer la différence de ces rapports suivant que les femmes avaient déclaré une naissance non planifiée ou planifiée. Résultats: Les femmes qui pratiquaient une méthode traditionnelle, barrière ou (en Colombie) hormonale à courte durée d'action avant la grossesse se sont révélées plus susceptibles d'en choisir une plus efficace (plutôt que de n'en utiliser aucune) après la naissance s'il s'agissait d'une naissance non planifiée (par rapport à planifiée) (rapports de risque relatif de 1,2­1,3 en Colombie; 1,6 au Pérou). Par rapport à leurs homologues qui avaient eu une naissance planifiée, les femmes dont la grossesse ne l'avait pas été et qui avaient pratiqué les méthodes les plus efficaces utilisées dans le pays (stérilet/ DIU ou implant en Colombie, pilule ou injectable au Pérou) étaient moins susceptibles d'en reprendre la pratique après la naissance que de n'utiliser aucune méthode (0,7 en Colombie; 0,8 au Pérou). Conclusions: Les naissances non planifiées sont associées à un changement du comportement contraceptif. Les efforts déployés pour comprendre les choix contraceptifs post-partum des femmes qui ont eu une naissance non planifiée doivent tenir compte du comportement contraceptif à plus d'un moment de la vie reproductive des femmes.

The socioeconomic dynamics of trends in female genital mutilation/cutting across Africa.

BACKGROUND: The majority of women who undergo female genital mutilation/cutting (FGM/C) live in Africa. Although the UN Sustainable Development Goals call for intensified efforts to accelerate the abandonment of FGM/C, little is known about where in Africa the declines in prevalence have been fastest and whether changes in prevalence differ by women's socioeconomic status. METHODS: We use data from Demographic and Health Surveys and Multiple Indicator Cluster Surveys for 23 African countries, collected between 2002 and 2016, and covering 293 170 women. We reconstruct long-term cohort trends in FGM/C prevalence spanning 35 years, for women born between 1965 and 1999. We compute absolute and relative changes in FGM/C prevalence and differentials in prevalence by women's education and urban-rural residence. We examine whether socioeconomic differences in FGM/C are converging or diverging. FINDINGS: FGM/C prevalence has declined fastest (in relative terms) in countries with lower initial prevalence, and more slowly in countries with higher initial prevalence. Although better-educated women and those living in urban areas tend to have lower prevalence, in some countries the opposite pattern is observed. Socioeconomic differentials in FGM/C have grown in the majority of countries, particularly in countries with moderate-to-higher overall prevalence. CONCLUSIONS: The documented relationship between absolute and relative FGM/C prevalence rates suggests that in settings with higher initial prevalence, FGM/C practice is likely to be more entrenched and to change more slowly. There is substantial variation between countries in socioeconomic differentials in prevalence and their changes over time. As countries change from higher to lower overall prevalence, socioeconomic inequalities in FGM/C are increasing.