Exploring the impact of perceived early marriage on women's education and employment in Bangladesh through a mixed-methods study.

Child marriage negatively affects women's socio-economic empowerment, particularly in education and employment. This study aimed to explore women' perspectives on the timing of their marriages, considering their educational and employment status at the time. It also sought to identify factors influencing early married women's perception of their marriages as timely. We analyzed both quantitative and qualitative data. The quantitative data included a sample of 5,596 women aged 15-24 from the 2017/18 Bangladesh Demographic and Health Survey. Additionally, we collected qualitative data through six in-depth interviews, two focus group discussions, and 13 key informant interviews. We used a multilevel mixed-effects Poisson regression model to examine the relationship between women's formal employment, education, and child marriage. Thematic analysis was employed for the qualitative data. Around 62% of the total women analysed reported their married occurred early with the mean age at marriage was 15.2 years. Approximately 55% of the total early married women believed their marriages occurred at the right time, especially among those who were employed at the time of their marriage. Among this subset, we also noticed a higher likelihood of discontinuing work and education following marriage. Qualitative findings revealed reasons behind this perception, such as escaping poverty, safety concerns, limited job prospects, and the impact of non-marital relationship and societal norms. While many early-married women perceived their marriage as timely, particularly those initially employed, this decision often coincides with a subsequent withdrawal from work and education. This underscores the pressing need for policies and programs aimed at educating women about the legal age for marriage and the negative consequences associated with early marriage while also equipping them with knowledge and resources for informed decision-making.

Child marriages in Senegal: Qualitative study on the perceptions of adolescents in Kaolack and Gossas.

An estimated 650 million girls worldwide are married before their 18th birthday. The phenomenon is recurrent in sub-Saharan Africa with a prevalence of 18% and particularly in Senegal where one in three girls is married before the age of 18, i.e. a prevalence of 31%. Despite the legislative and legal arsenals, the laws on the legal age of marriage are not respected. The general objective of this study is to document the way in which gender norms define and influence the perceptions of adolescents in Gossas and Kaolack on child marriages and to collect possible solutions proposed to prevent/ reduce the practice. We used qualitative data collected in the two study sites. These were individual interviews with adolescents aged 10-19 (n=30) and focus groups (n=8) with the same target. The interviews were conducted in Wolof and transcribed into French then coded using Dedoose software. The results are presented for each age group and each gender then triangulated in order to highlight similarities and divergences according to the different perspectives. The results show that child marriages are rooted in patriarchal social and cultural norms, while reflecting gender inequalities. Thus, adolescents' arguments regarding the causes of child marriage align with those described in the literature on gender norms. Most adolescents cited poverty, tradition, fear of early pregnancy, and concern to preserve the girl's honor as the main factors contributing to the persistence of child marriages.

On estime à 650 millions le nombre de filles mariées dans le monde avant leur 18e anniversaire. Le phénomène est récurrent en Afrique subsaharienne avec une prévalence de 18% et particulièrement au Sénégal où, une fille sur trois est mariée avant l'âge de 18 ans, soit une prévalence de 31%. Malgré l'arsenal juridique législatif, les lois sur l'âge légal du mariage ne sont pas respectées. L'objectif général de cette étude est de documenter la manière dont les normes de genre définissent et influencent les perceptions des adolescent(e)s de Gossas et de Kaolack sur les mariages d'enfants et de recueillir les pistes de solutions proposées pour prévenir/réduire la pratique. Nous avons utilisé les données qualitatives collectées dans les deux sites de l'étude. Il s'agit d'entretiens individuels avec des adolescent(e)s de 10-19 ans (n=30) et de groupes de discussion (n=8) avec la même cible. Les entretiens ont été conduits en wolof et transcrits en Français puis codés à l'aide du logiciel Dedoose. Les résultats sont présentés pour chaque groupe d'âge et chaque sexe puis triangulés afin de ressortir les similarités et divergences selon les différentes perspectives. Les résultats montrent que les mariages d'enfants sont ancrés dans des normes sociales et culturelles patriarcales, tout en reflétant les inégalités de genre. Ainsi, les arguments des adolescent(e)s par rapport aux causes des mariages d'enfants s'alignent avec celles décrites dans la littérature sur les normes de genre. La plupart des adolescent(e)s ont évoqué la pauvreté, la tradition, la peur d'une grossesse précoce, le souci de préserver l'honneur de la fille comme étant les principaux facteurs contribuant à la persistance des mariages d'enfants.

What's driving girls' adolescent marriage decline in Rakai, Uganda? The interplay between adolescent pregnancies and social determinants, 1999 - 2018.

Few studies have sought to untangle the influence of social determinants and pregnancy on adolescent marriage declines. Using longitudinal data from 15- to 17-year-old girls in the Rakai Community Cohort Survey, we assessed how education, socio-economic status, orphanhood and pregnancy contributed to trends in adolescent marriage. We examined descriptive trends and logistic regressions of the associations between social determinants and adolescent marriage, and conducted causal mediation analysis to assess the extent that pregnancy mediated the effect of education on marriage. Between 1999-2018, adolescent marriages and pregnancies dropped substantially (24%-6% and 28%-8%). Girls' secondary schooling was strongly associated with lower marriage risk (aOR marriage=0.09; 95%CI=0.07-0.12), accounting for time. Lower pregnancy rates partially explained the effect of secondary schooling on lower adolescent marriage (aOR indirect effect=0.55; 95%CI=0.421-0.721). Findings affirm the importance of education in preventing adolescent marriages but call attention to the role of pregnancies in influencing adolescent marriages.

Where have I got to? Associations of age at marriage with marital household assets in educated and uneducated women in lowland Nepal.

Background: Women's underage marriage (<18 years) is associated with adverse maternal and child health outcomes. Poverty in the natal household has been widely considered to be a key risk factor for underage marriage, but the evidence base is unreliable. When investigating this issue, most studies use marital wealth inappropriately, as a proxy for wealth in the natal household. In contrast, we investigated whether the timing of women's marriage was associated with the wealth of the households they marry into, and how this may vary by women's education level. This approach allows us to explore a different set of research questions which help to understand the economic value placed on the timing of women's marriage. Methods: We used data on 3,102 women aged 12-34 years, surveyed within 1 year of marriage, from the cluster-randomized Low Birth Weight South Asia Trial in lowland rural Nepal. Linear mixed-effects regression models investigated independent associations of women's marriage age and education level with marital household wealth, and their interactive effects. Models adjusted for marital household traits. We analysed the full sample, and then only the uneducated women, who comprised a substantial proportion in our sample. Results: In the full sample, we found that each later year of women's marriage was associated with 1.5% lower asset score for those with primary education, and with 0.3% and 1.3% higher asset score for those with lower secondary or secondary/higher education, respectively. For uneducated women, relative to marrying ≤14 years, marrying at 15, 16, 17 and ≥18 years was associated with 1.5%, 4.4%, 2.4% and 6.2% greater marital asset score respectively. Conclusion: On average, marrying ≥18 years was associated with greater marital assets for secondary-educated women. There were only very modest benefits in terms of marital household wealth for delaying marriage beyond 16 years for uneducated women or those with low education. These findings elucidate potential trade-offs faced by families, including decisions over how much education, if any, to provide to daughters. They may help to understand the economic rationale underpinning the timing of marriage, and why early marriage remains common despite efforts to delay it.

Maternal victimization and neglected offspring: Child marriage, IPV and depression symptoms among Salar Muslim women.

BACKGROUND: Child neglect is prevalent in western rural China, yet there is limited research among ethnic minority communities. The Salar, a Turkic-Muslim ethnic minority residing primarily in western China, also face this specific problem. The group is deeply influenced by ethnicity, Islam and Chinese Confucianism, which in turn makes women vulnerable to child marriage and IPV. These victimizations, coupled with various life stressors, further complicate the challenges of providing adequate care for their children. OBJECTIVE: This study hypothesizes a relationship between child neglect and maternal child marriage, IPV victimization, and depression symptoms. PARTICIPANTS AND SETTING: 201 married Salar women from five villages in Xunhua Salar Autonomous County, China, were randomly selected to participate in the study. METHOD: A probability proportional to size (PPS) sampling approach was used to collect a random representative multi-stage cluster sample in 2022. Random effects Poisson regression models were used to test the hypotheses. RESULTS: The participants reported a 65.6 % rate of child neglect and a 30.8 % rate of IPV in the past year. 37.6 % experienced child marriage. Results revealed significant associations between child neglect and child marriage, IPV, and depression symptoms. A two-way interaction between IPV and depression symptoms was strongly positively associated with child neglect. CONCLUSIONS: This research indicates that Salar Muslim mothers who have experienced child marriage, adulthood victimization, and depression are at a higher risk of neglecting their children. The findings represent a valuable initial step toward researching and addressing the protection needs of women and children from Muslim ethnic minorities in China.

New perspectives on fighting violence against women.

Gender-based violence (GBV) and, more specifically, violence against women (VAW) are commonly considered a consequence of a patriarchal structure-a social system granting the senior male absolute authority over the family and the community as a whole. Anthropologists have documented that human male dominance is rooted in evolution, with male violent behavior observed among the great apes. Given that evolution is a continuous process, human progress over millennia has modified pre-existing behavior, demonstrating that humans can move beyond ancestral ways of life over time. Precisely because of the imperative to change and improve, at the global international level as well as in individual countries, strong movements are in action to eliminate GBV/VAW. FIGO has been and continues to be at the forefront of the battle for equality, with initiatives that cover many aspects of this, including the imperative to involve men, who-in the majority of cases-are the perpetrators. Since men are often the root of the problem, they must also be at the forefront of the battle to eradicate it. GBV/VAW comprises many facets, including selective female abortion, infanticide, femicide, honor killing, female genital mutilation, and child marriage. These deeply rooted forms of violence continue to perpetuate gender inequalities, remain major obstacles to health and societal progress, and violate the most basic human rights.

Prevalence and Risk Factors of Child Marriage Among Madhesi Women in Nepal's Terai Region.

Objective: Child marriage is a detrimental practice with negative consequences for girls' health and well-being. This study aims to identify the prevalence of child marriage and associated risk factors within the Madhesi community. Materials and methods: A cross-sectional study was conducted in a sub-metropolitan city of Lumbini Province, Nepal, in 2023. A total of 352 married women were randomly selected using simple random sampling and interviewed using a structured questionnaire between March 28th and April 17th. Descriptive categorical variables were expressed as proportions. Risk factors associated with child marriage were measured using the Chi-square test and multivariate logistic regression analysis. All statistical analyses were performed using SPSS version 26. Results: The majority of respondents (36.1%) were in the age group 21-25, with a mean age of 25.90 years ± 4.6 years. Most respondents (48.9%) received only basic-level education, with the majority (72.4%) reporting their parents as having no formal education. The primary family occupation was farming (40.1%). The prevalence of child marriage was high (77.0%), with a median marriage age of 18 years. Logistic regression analysis revealed significant risk factors including lower education levels of respondents and their parents, husband's occupation, lack of awareness about the legal marriage age, limited decision-making power regarding marriage, belief in the dowry system, discussions with friends about child marriage, and occurrence of child marriage among friends. Conclusion: Despite legal prohibition, child marriage remains prevalent in the Madhesi community. Educational interventions targeting women and parents, empowering women with decision-making authority, and addressing the dowry system are crucial for reducing this harmful practice.

Social protection as a strategy for HIV prevention, education promotion and child marriage reduction among adolescents: a cross-sectional population-based study in Lesotho.

BACKGROUND: Lesotho's government has shown consistent efforts to implement social protection programmes. However, while recent evidence established a positive causal relationship between some of these programmes and food security there is little evidence on the extent to which these initiatives are associated with better educational and sexual and reproductive health outcomes among vulnerable adolescents in Lesotho. METHODS AND FINDINGS: The study uses cross-sectional, nationally representative data from the 2018 Lesotho Violence Against Children and Youth Survey. Our research examined the association between social protection receipt and educational and sexual and reproductive health outcomes among adolescents and young people (13-24 years) living in poverty. We employed multivariate logistic regression controlling for age, orphanhood, HIV status and sex. Social protection receipt was defined as household receipt of financial support from a governmental, non-governmental, or community-based program that provides income. Additionally, we fitted a marginal effects model by sex. Among the 3,506 adolescent females and males living in the two lowest poverty quintiles, receipt of social protection was associated with improvements in multiple adolescent outcomes: higher odds of consistent condom use (aOR 1.64, 95% CI 1.17-2.29), educational attainment (aOR 1.79, 95% CI 1.36-2.36), and school enrolment (aOR 2.19, 95% CI 1.44-3.34). Stratified analyses by sex showed that social protection receipt was also associated with reduced likelihood of child marriage among females (aOR 0.59, 95% CI 0.42-0.83) and higher odds of educational attainment and school enrolment among males (aOR 2.53, 95% CI 1.59-4.03 and aOR 3.11, 95% CI 1.56-6.19, respectively). CONCLUSIONS: Our study provides evidence that social protection programs are associated with improved educational, sexual and reproductive health and child marriage prevention outcomes among adolescents living in poverty. Implementing and expanding such social protection initiatives could prove instrumental in improving the well-being of vulnerable adolescents. CONTRIBUTIONS: Social protection programs have been increasing in sub-Saharan African countries, playing a pivotal role in poverty reduction, with Lesotho being no exception. Despite the optimistic outlook brought about by the implementation of the National Social Protection Strategy Lesotho I (2014-19) and II (2021-2031), the impact of these programs on some specific outcomes that concern the lives of the most vulnerable adolescents in Lesotho remains to some extent unexplored. Additionally, Lesotho grapples with high rates of HIV, adolescent pregnancy, child marriage and early school dropout, which can further contribute to poor long-term health and social outcomes among adolescents. In this study, we used data from the 2018 Lesotho Violence Against Children and Youth Survey (VACS) to examine the association between receiving social protection and multiple adolescent outcomes: educational, sexual and reproductive. The findings revealed that social protection programs, particularly the existing government-provided cash transfers, are significantly associated with multiple better outcomes among adolescents living in the poorest households in Lesotho. Such cash transfer schemes in Lesotho are associated with improved sexual and reproductive health outcomes for adolescent females, including reduced child marriage rates, and improved educational outcomes for males. These findings indicate that government-led social protection programmes are positively associated with favourable outcomes that can improve the quality of life for adolescents in resource-limited settings.

'We did not want to marry then, but': understanding early marriage among Muslims in the context of the 'Kerala model' of development.

Kerala, the Indian state with the highest reported level of social development, faces a challenge with persistent early marriage, particularly among Muslims in Malappuram. This study explores the sociocultural factors influencing this situation, in which child marriage rates among Muslims are significantly higher than those of Hindus and Christians. Employing a qualitative research strategy within a specific Malappuram mahallu, a Muslim-majority village cluster encompassing three villages, we identify a multifaceted interplay of micro and macro forces perpetuating early marriage. Lack of social networks, stemming from limited higher education options and career opportunities, restricts girls' choices and makes them susceptible to parental pressure to marry early. Parents, on the other hand, often view early marriage as an appropriate solution to their anxieties concerning parental responsibility, dowry and family honour. This pressure is amplified by the narrative promoted by religious leaders who portray early marriage as the ideal path. This narrative, in turn, resonates with a subset of young men, particularly temporary Gulf migrants who prefer to marry adolescent girls, thereby perpetuating the cycle. We also argue that, unlike most regions in India, poverty and illiteracy are not the primary drivers of early marriage among Muslims in Malappuram.

Risk factors associated with Rohingya refugee girls' education in Bangladesh: A multilevel analysis of survey data.

In Bangladesh, the world's largest refugee settlement currently shelters approximately one million Rohingya refugees who fled Myanmar to escape military persecution. Educating a significant number of young Rohingya, roughly half of whom are female, presents a significant challenge. Despite the presence of learning centres (LCs) across refugee camps, Rohingya girls may encounter specific barriers to accessing education due to exposure to various risks, such as violence, child marriage, and trauma stemming from past military oppression. This paper investigates the association between these risk factors and Rohingya girls' likelihood of attending LCs, and how this association may vary across refugee camps. Using survey data and employing three-level multilevel logistic regression models, I find that girls are less likely to attend LCs if they are at risk of encountering sexual abuse, child marriage, and psychological distress or trauma. These factors explain considerable variation in girls' LC attendance between camps and between households. In addition to providing more schooling opportunities to Rohingya children, prioritising girls' safety, protecting them from forced and child marriage, and supporting their psychological well-being require increased policy attention.

Association of child marriage and nutritional status of mothers and their under-five children in Bangladesh: a cross-sectional study with a nationally representative sample.

BACKGROUND: Child marriage remains an important problem around the world with young mothers and their under-five children often experiencing under-nutrition. The problem is rarely studied in the Bangladeshi population. This paper was designed to identify the association between child marriage and nutritional status of mothers and their under-five children in Bangladesh. METHODS: Nationally representative secondary data was used for this study, data was extracted from the Bangladesh Demographic and Health Survey (BDHS) 2017-18. The sample consisted of 7235 mothers aged 18-49 years and their under-five children. The mothers were classified into two classes according to their age at first marriage: (i) child marriage (marriage at < 18 years) and (ii) not child marriage (marriage at ≥ 18 years). The nutritional status of mothers was measured by body mass index (BMI), and under-five children's nutritional status was measured by (i) height-for-age (z-score) (stunting), (ii) weight-for-age (z-score) (underweight), and (iii) weight-for-height (z-score) (wasting). The chi-square test and two-level logistic regression model were used for data analysis using SPSS software (IBM version 20). RESULTS: The prevalence of child marriage among Bangladeshi women was 69.0%, with the mean and median of age at the first marriage being 16.57 ± 2.83 years and 16 years, respectively. Of the mothers, 15.2% suffered from chronic energy deficiency (underweight), and 72.8% were married at < 18 years. The prevalence of stunting, underweight, and wasting among under-five children in Bangladesh was 31.0%, 22.0%, and 8.5%, respectively. Compared to women married at the age of ≥ 18 years, there was a significantly higher likelihood of chronic energy deficiency among women who married at < 18 years [Adjusted OR = 1.27, CI: 1.05-1.82; p < 0.05]. Under-five children of mothers married before the age of 18 were more likely to have stunting [Adjusted OR = 1.201, CI: 1.11-1.72; p < 0.05], wasting [Adjusted OR = 1.519, CI: 1.15-2.00; p < 0.01], and underweight [Adjusted OR = 1.150, CI: 1.09-1.82; p < 0.05] compared to children of mothers who married at age ≥ 18. CONCLUSION: The rate of child marriage among Bangladeshi women is high, and it is significantly associated with malnutrition among mothers and their under-five children. The Bangladesh government can use the findings of this study to prevent and reduce child marriage and malnutrition among mothers and their under-five children to achieve sustainable development goals by 2030.

Drivers of child marriages for girls: A prospective study in a low-income African setting.

Child marriage has adverse consequences for young girls. Cross-sectional research has highlighted several potential drivers of early marriage. We analyse drivers of child marriage using longitudinal data from rural Malawi, where rates of child marriage are among the highest in the world despite being illegal. Estimates from survival models show that 26% of girls in our sample marry before age 18. Importantly, girls report high decision-making autonomy vis-à-vis the decision to marry. We use multivariate Cox proportional hazard models to explore the role of 1) poverty and economic factors, 2) opportunity or alternatives to marriage, 3) social norms and attitudes, 4) knowledge of the law and 5) girls' agency. Only three factors are consistently associated with child marriage. First, related to opportunities outside marriage, girls lagging in school at survey baseline have significantly higher rates of child marriage than their counterparts who were at or near grade level. Second, related to social norms, child marriage rates are significantly lower among respondents whose caregivers perceive that members of their community disapprove of child marriage. Third, knowledge of the law has a positive coefficient, a surprising result. These findings are aligned with the growing qualitative literature describing contexts where adolescent girls are more active agents in child marriages.

Long-term impacts of a cash plus program on marriage, fertility, and education after six years in pastoralist Kenya: A cluster randomized trial.

Background: Preventing early marriage by increasing girls education has shown promise. We assessed the effects of a two-year cash plus program on marriage and fertility in a pastoralist setting in Northeastern Kenya, six years after it began. Methods: A prospective 80-cluster randomized trial followed 2,147 girls 11-14 years old starting in 2015, re-interviewing 94.2% in 2021. Interventions included community dialogues (violence prevention), a conditional cash transfer (education), health and life skills training (health), and financial literacy (wealth creation). Villages were randomized to one of four study arms: (1) violence prevention only (V-only); (2) + education (VE); (3) + health (VEH); or (4) + wealth creation (VEHW). We used analysis of covariance to estimate intent-to-treat impacts of each study arm with an education component, as well as a pooled (weighted average) study arm combining VE, VEH and VEHW, in reference to V-only, four years after the intervention ended when girls were 17-20 years old. Findings: Base specification estimates show reductions in the primary outcomes, though none statistically significant in the full sample. Estimates with extended controls are larger and the pooled study arm had significantly lower marriage and pregnancy. There are considerably larger statistically significant effects for the baseline out-ofschool subsample. Pooled estimates indicate 18.2 percentage point lower marriage compared to V-only and 15.1 percentage point lower pregnancy. For the same group pooled estimates indicate a 27.9 percentage point increase in current enrollment (compared to 7.1% in V-only) and a 1.8 grades increase (compared to 1.2 in V-only). Conclusion: This study shows the potential for interventions in early adolescence with an education component to delay marriage and fertility into late adolescence and early adulthood in a marginalized and socially conservative setting with low education and high rates of child marriage.

Gender norms in a context of legal pluralism: Impacts on the health of women and girls in Ethiopia.

To achieve Sustainable Development Goal 5 for gender equality by 2030, it is crucial for health and development professionals and governmental officials to understand how legal systems empower or oppress populations on the basis of gender worldwide, including opportunities and challenges of statutory provisions created by legal pluralism. Using Ethiopia as a case study, this paper examines how local laws applied in Sharia and Customary Dispute Resolution courts impact gender equality and the health of women and girls inspite of the inculcation of human rights statutes into national legislation, including the Constitution. We identify several key issues with the substantive law and its enforcement. First, laws which have been instituted at the national level to improve gender equally have been poorly enforced at the local level. Second, there is a sustained enforcement of laws that oppress women and that protect male perpetrators of gender-based violations. Third, local courts limit female representation and uphold patriarchy. To improve the health of women and girls, stakeholders must take into consideration the ways in which legal systems uphold harmful gender norms and obstruct and/or advance progress towards equal representation, opportunities, and constitutionally-mandated protections for all.

Evaluating the impact of using storytelling and visual multimedia music intervention to improve knowledge of the Child Rights Act and reduce the propensity to engage in child marriage.

Child marriage has continued to rear its ugly head in Nigerian society. This study aimed to evaluate the impact of storytelling and multimedia music interventions in improving knowledge of the Child Rights Act and reducing the propensity to engage in child marriage. The researchers applied a quasi-experimental design and collected data using a structured questionnaire. The children were assigned into three groups (control, storytelling and multimedia music) of 173 participants. It was found that the interventions were effective. In particular, while storytelling contributed more to reducing the propensity to engage in child marriage, multimedia music contributed more to improving knowledge of the Child Rights Act. These results suggest that storytelling and multimedia music interventions can be effective approaches for addressing the lingering problem of child marriage in Nigeria.

Socio-ecological factors of girl child marriage: a meta-synthesis of qualitative research.

BACKGROUND: Child marriage of girls is one example of human rights violations, and is increasingly recognized as a key obstacle to global public health. Given the importance of a comprehensive understanding of the motivations for child marriage, this study aimed to identify socio-ecological factors contributing to gills child marriage. METHODS: A comprehensive search was conducted of all English-language studies measuring causes of child marriage between 2000 and October 2022 in the Web of Science, PubMed, Scopus, PsycInfo, ProQuest, Poplin and Google Scholar databases. Girl child marriage is defined as a marriage under the age of 18. In this study, the CASP evaluation checklist was used to collect data. Two independent reviewers reviewed all articles. RESULTS: A total of 34 eligible qualitative articles were included. The most salient causes of child marriage among girls include low skills and knowledge, internal and external beliefs and motivations, and physical advantages at the individual level. Family characteristics and structure contribute to child marriage at the interpersonal level, while environmental and economic factors play a role at the community level. Social factors and cultural norms, as well as the shortcomings and weaknesses of legislation, are also contributing factors at the society level. CONCLUSION: The results showed that cultural beliefs supporting gender inequality and economic status were the most important causes of child marriage. These results can help policymakers and decision-makers implement strategies to reduce gender inequality to prevent child marriage.

Associations between child marriage and food insecurity in Zimbabwe: a participatory mixed methods study.

BACKGROUND: Child marriage is a global crisis underpinned by gender inequality and discrimination against girls. A small evidence base suggests that food insecurity crises can be both a driver and a consequence of child marriage. However, these linkages are still ambiguous. This paper aims to understand how food insecurity influences child marriage practices in Chiredzi, Zimbabwe. METHODS: Mixed methods, including participant-led storytelling via SenseMaker® and key informant interviews, were employed to examine the relationship between food insecurity and child marriage within a broader context of gender and socio-economic inequality. We explored the extent to which food insecurity elevates adolescent girls' risk of child marriage; and how food insecurity influences child marriage decision-making among caregivers and adolescents. Key patterns that were generated by SenseMaker participants' interpretations of their own stories were visually identified in the meta-data, and then further analyzed. Semi-structured guides were used to facilitate key informant interviews. Interviews were audio-recorded, and transcribed and translated to English, then imported into NVivo for coding and thematic analysis. RESULTS: A total of 1,668 community members participated in SenseMaker data collection, while 22 staff participated in interviews. Overall, we found that food insecurity was a primary concern among community members. Food insecurity was found to be among the contextual factors of deprivation that influenced parents' and adolescent girls' decision making around child marriage. Parents often forced their daughters into marriage to relieve the household economic burden. At the same time, adolescents are initiating their own marriages due to limited alternative survival opportunities and within the restraints imposed by food insecurity, poverty, abuse in the home, and parental migration. COVID-19 and climate hazards exacerbated food insecurity and child marriage, while education may act as a modifier that reduces girls' risk of marriage. CONCLUSIONS: Our exploration of the associations between food insecurity and child marriage suggest that child marriage programming in humanitarian settings should be community-led and gender transformative to address the gender inequality that underpins child marriage and address the needs and priorities of adolescent girls. Further, programming must be responsive to the diverse risks and realities that adolescents face to address the intersecting levels of deprivation and elevate the capacities of adolescent girls, their families, and communities to prevent child marriage in food insecure settings.

Female Genital Mutilation and Sexual Risk Behaviors of Adolescent Girls and Young Women Aged 15-24 Years: Evidence From Sierra Leone.

PURPOSE: Considering the high levels of female genital mutilation (FGM) in Sierra Leone with over 83% of girls and young women aged 15-24 years having undergone the practice, the study explores the potential influence of FGM on sexual behaviors of adolescent girls and young women (AGYW) in Sierra Leone. METHODS: Cross-sectional data from the 2019 Demographic Health Survey were utilized to examine the association between FGM and three sexual behaviors; sexual debut before 18 years, child marriage and adolescent motherhood. To model this association, a generalized estimation equation technique was employed, while controlling for socio-demographic characteristics. Additionally, the study corrected for multiple-hypothesis testing using the Benjamini-Hochberg procedure with a specified false discovery rate of 0.05. Finally, percentage predicted probabilities of occurrence of the sexual risk behaviors in the presence of FGM were also calculated. RESULTS: Of the 5524 AGYW, 76% had undergone FGM. FGM was associated with all three sexual risk behaviors. Sexual debut before 18 years had the highest predicted probability increase (+18.00 ppt, 95% CI: 14.41 to -21.59), followed by adolescent motherhood (+13.38 ppt, 95% CI: 10.16-16.60) and child marriage (+12.61 ppt; 95% CI: 10.22-15.01). Education was found to be protective against all three sexual risk behaviors. DISCUSSION: The findings of this study demonstrate that FGM remains a prevalent practice in Sierra Leone, even among the younger generation. This practice is strongly associated with sexual behaviors that pose a significant risk to the health outcomes of AGYW. Investments in education by removing barriers to access for AGYW could lead to multiple gains.

State and sex-specific trends in the annual incidence of child marriage in the United States since the year 2000.

OBJECTIVES: Child marriage, defined as marriage before 18 years of age, is a violation of human rights with harmful consequences for population health, educational attainment, and economic opportunities. Child marriage is legal across most of the United States but how often it happens is challenging to estimate. We measured state and sex-specific trends in the annual incidence of child marriage in 41 states and the District of Columbia. METHODS: We collected data from marriage certificates filed between 2000 and 2019. These certificates allowed us to identify marriages that occurred within each state and involved a spouse under the age of 18. We divided the number of 15-17-year-olds married in each year by the number of children in that age range living in the state in that year and graphed these annual rates to present trends over time. RESULTS: The rate of child marriage declined substantially across the United States between 2000 and 2019. Over 75 % of all married children in each state were girls. Girls married men who were an average of 4 years older than they were, and the age gap was substantially larger when girls married than when boys married. CONCLUSIONS: Child marriage continues across most of the United States and reflects gender inequities in American society. The continued legality of marriage before the age of 18 is at odds with the country's commitment to eliminate child marriage by the year 2030 and violates the human rights of children, primarily girls, across the country.

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.