Influence of child marriage on institutional delivery and high-risk births among young women in 31 sub-Saharan African countries

2021 ◽  
pp. 1-9
Author(s):  
Sunday A. Adedini ◽  
Jacob Wale Mobolaji ◽  
Olufemi Mayowa Adetutu ◽  
John Olugbenga Abe ◽  
Funmilola F. Oyinlola
Keyword(s):  
High Risk ◽  
Young Women ◽  
Institutional Delivery ◽  
Child Marriage ◽  
African Countries ◽  
Sub Saharan

scholarly journals Prevalence of child marriage and its impact on fertility outcomes in 34 sub-Saharan African countries

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Sanni Yaya ◽  
Emmanuel Kolawole Odusina ◽  
Ghose Bishwajit
Keyword(s):  
Pregnancy Termination ◽  
Binary Logistic Regression ◽  
Adverse Outcomes ◽  
Sub Saharan Africa ◽  
Child Marriage ◽  
Modern Contraceptive ◽  
Contraceptive Methods ◽  
African Countries ◽  
Sub Saharan ◽  
Children Ever Born

Abstract Background The issue of child marriage is a form of human rights violation among young women mainly in resource-constrained countries. Over the past decades, child marriage has gained attention as a threat to women’s health and autonomy. This study explores the prevalence of child marriage among women aged 20–24 years in sub-Saharan Africa countries and examines the association between child marriage and fertility outcomes. Methods Latest DHS data from 34 sub-Saharan African countries were used in this study. Sixty thousand two hundred and fifteen women aged 20–24 years were included from the surveys conducted 2008–2017. The outcome variables were childbirth within the first year of marriage (early fertility), first preceding birth interval less than 24 months (rapid repeat of childbirth), unintended pregnancy, lifetime pregnancy termination, the use of modern contraceptive methods, lifetime fertility and any childbirth. The main explanatory variable was child marriage (< 18 years) and the associations between child marriage and fertility outcomes were examined from the ever-married subsample to estimate odds ratios (ORs) and 95% CIs using binary logistic regression models. Results In the study population, the overall prevalence of women who experience child marriage was 54.0% while results showed large disparities across sub-Saharan African countries ranging from 16.5 to 81.7%. The prominent countries in child marriage were; Niger (81.7%), Chad (77.9%), Guinea (72.8%), Mali (69.0%) and Nigeria (64.0%). Furthermore, women who experience child marriage were 8.00 times as likely to have ≥3 number of children ever born (lifetime fertility), compared to women married at ≥18 years (OR = 8.00; 95%CI: 7.52, 8.46). Women who experience child marriage were 1.13 times as likely to use modern contraceptive methods, compared to adult marriage women (OR = 1.13; 95%CI: 1.09, 1.19). Those who married before the legal age were 1.27 times as likely to have lifetime terminated pregnancy, compared to women married at ≥18 years (OR = 1.27; 95%CI: 1.20, 1.34). Also women married at < 18 years were more likely to experience childbirth, compared to women married later (OR = 5.83; 95%CI: 5.45, 6.24). However, women married at < 18 years had a reduction in early childbirth and a rapid repeat of childbirth respectively. Conclusion Implementing policies and programmmes against child marriage would help to prevent adverse outcomes among women in sub-Saharan Africa. Also, social change programmes on child-marriage would help to reduce child marriage, encourage the use of modern contraceptive, which would minimize lifetime terminated pregnancy and also children ever born.

Problems and Prospects of Implementing Harm Reduction for HIV and Injecting Drug Use in High Risk Sub-Saharan African Countries

1997 ◽  
Vol 27 (1) ◽  
pp. 97-116 ◽  
Author(s):  
Moruf L. Adelekan ◽  
Gerry V. Stimson
Keyword(s):  
High Risk ◽  
Drug Use ◽  
Harm Reduction ◽  
Psychosocial Problems ◽  
Causative Factor ◽  
Injecting Drug Use ◽  
Hiv And Aids ◽  
African Countries ◽  
Demand Reduction ◽  
Sub Saharan

The use and misuse of a broad spectrum of psychoactive substances, including heroin and cocaine, is of growing concern in many African countries. Approximately one-third of global HIV and AIDS cases are reported from Africa, but injecting drug use has not yet been documented as a causative factor. The drug supply control strategy has recorded only limited success in Africa, and the currently adopted demand reduction programs are beset with many problems. In this paper we review possible constraining and facilitating factors in the adoption of harm reduction approaches in high risk sub-Saharan African countries. We conclude that appropriate needs assessments are urgently required to establish the extent of problem drug use and of injecting. This exercise may identify clinical and psychosocial problems that could benefit from an intervention approach based on a combination of the principles of harm reduction and demand reduction.

scholarly journals Pernikahan Dini Dalam Hukum Perkawinan di Indonesia

2009 ◽  
Vol 8 (2) ◽  
pp. 223
Author(s):  
Eko Mardiono
Keyword(s):  
High Risk ◽  
Sexual Intercourse ◽  
Young Women ◽  
Social Engineering ◽  
Child Marriage ◽  
Medical Studies ◽  
Marriage Law ◽  
The Law

Contemporary Indonesians witness the rise of the popularity of marriage of the minors, despite the application of the Indonesian Marriage Law no 1/1974 that forbids child marriages for decades. The enactment of the Law decades ago was meant to be a social engineering mean to erase the practice of child marriage with social compromises. Recent research in medical studies show that there is significantly high risk for young women under 18 years old who do sexual intercourse to be infected with servick cancer. Many other research on child marriage using psychological and social approaches also suggest that actors of child marriage are of high risk of suffering from social and psychological troubles. Now, what can we do with the Indonesian Marriage Law that still endorse marriage for girls under 18 years old? This paper discusses the issues from different perspectives.

TIMING OF SEXUAL DEBUT AMONG UNMARRIED YOUTHS AGED 15–24 YEARS IN SUB-SAHARAN AFRICA

2017 ◽  
Vol 50 (2) ◽  
pp. 161-177 ◽  
Author(s):  
Joshua Amo-Adjei ◽  
Derek Anamaale Tuoyire
Keyword(s):  
Young People ◽  
Young Women ◽  
Rural Areas ◽  
Sexual Debut ◽  
Household Wealth ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Sub Saharan ◽  
Female Headed Households ◽  
The Impact

SummaryThis study aimed to contribute to the evidence on the timing of sexual debut in young people in sub-Saharan African countries. Data were extracted from 34 nationally representative surveys conducted in the region between 2006 and 2014. The study sample comprised unmarried women (n=167,932) and men (n=76,900) aged 15–24 years. Descriptive techniques and Cox proportional regression models were used to estimate the timing of sexual debut, and Kaplan–Meier hazard curves were used to describe the patterns of sexual debut in each country by sex. For the countries studied, sexual debut for both women and men occurred between the ages of 15 and 18 years, with median ages of 16 for women and 17 for men. Overall, education and household wealth provided significant protection against early sexual debut among women, but the reverse was found among men for wealth. Women in rural areas, in female-headed households and in Central, South and West Africa reported higher hazards of early commencement of sexual activity than their counterparts in urban, male-headed households and East Africa. However, the impact of these variables on male sexual debut did not follow a consistent pattern. Varied timing, as well as country-specific risk factors associated with sexual debut for young women and men across sub-Saharan Africa, were identified. Sexual health programmes and interventions for young people may require different approaches for young women and men.

scholarly journals Socio-economic and demographic predictors of unmet need for contraception among young women in sub-Saharan Africa: evidence from cross-sectional surveys

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Bright Opoku Ahinkorah ◽  
Edward Kwabena Ameyaw ◽  
Abdul-Aziz Seidu
Keyword(s):  
Young Women ◽  
Formal Education ◽  
Economic Status ◽  
Unmet Need ◽  
Wealth Quintile ◽  
Sub Saharan Africa ◽  
African Countries ◽  
Socio Economic Status ◽  
Sub Saharan ◽  
Unmet Need For Contraception

Abstract Introduction Globally, sub-Saharan Africa (SSA) bears the highest proportion of women with unmet need for contraception as nearly 25% of women of reproductive age in the sub-region have unmet need for contraception. Unmet need for contraception is predominant among young women. We examined the association between socio-economic and demographic factors and unmet need for contraception among young women in SSA. Methods Data for this study obtained from current Demographic and Health Surveys (DHS) conducted between January 1, 2010 and December 31, 2018 in 30 sub-Saharan African countries. The sample size consisted of young women (aged 15–24), who were either married or cohabiting and had complete cases on all the variables of interest (N = 59,864). Both bivariate and multivariable binary logistic regression analyses were performed using STATA version 14.0. Results The overall prevalence of unmet need for contraception among young women was 26.90% [95% CI: 23.82–29.921], ranging from 11.30% [95% CI: 5.1–17.49] in Zimbabwe to 46.7% [95% CI: 36.92–56.48] in Comoros. Results on socio-economic status and unmet need for contraception showed that young women who had primary [aOR = 1.18; CI = 1.12–1.25, p < 0.001] and secondary/higher levels of formal education [aOR = 1.27; CI = 1.20–1.35, p < 0.001] had higher odds of unmet need for contraception compared to those with no formal education. With wealth status, young women in the richest wealth quintile had lower odds of unmet need for contraception compared with those in the poorest wealth quintile [aOR = 0.89; CI = 0.81–0.97, p < 0.01]. With the demographic factors, the odds of unmet need for contraception was lower among young women aged 20–24 [aOR = 0.74; CI = 0.70–0.77, p < 0.001], compared with 15–19 aged young women. Also, young women who were cohabiting had higher odds of unmet need for contraception compared to those who were married [aOR = 1.35; CI = 1.28–1.43, p < 0.001]. Conclusion Our study has demonstrated that unmet need for contraception is relatively high among young women in SSA and this is associated with socio-economic status. Age, marital status, parity, occupation, sex of household head, and access to mass media (newspaper) are also associated with unmet need for contraception. It is therefore, prudent that organisations such as UNICEF and UNFPA and the Bill & Melinda Gates Foundation who have implemented policies and programmes on contraception meant towards reducing unmet need for contraception among women take these factors into consideration when designing interventions in sub-Saharan African countries to address the problem of high unmet need for contraception among young women.

Association Between Girl-child Marriage and Intimate Partner Violence in Sub-Saharan Africa: Insights From a Multicountry Analysis of Demographic and Health Surveys

2021 ◽  
pp. 088626052110051
Author(s):  
Bright Opoku Ahinkorah ◽  
Olayinka Modupe Onayemi ◽  
Abdul-Aziz Seidu ◽  
Oluwafemi Emmanuel Awopegba ◽  
Anthony Idowu Ajayi
Keyword(s):  
Intimate Partner Violence ◽  
East Africa ◽  
Young Women ◽  
Partner Violence ◽  
Intimate Partner ◽  
Sub Saharan Africa ◽  
Child Marriage ◽  
Demographic And Health Surveys ◽  
Sub Saharan ◽  
Ssa Countries

While considerable attention has been given to the health consequences of child marriage in Sub-Saharan Africa (SSA), limited studies exist on its impact on intimate partner violence (IPV) in the region. We address this gap by examining the link between child marriage and IPV. We tested our study hypothesis using demographic and health survey data of 28,206 young women aged 20-24 years from 16 SSA countries with recent surveys (2015-2019). Binary logistic regression models were used to examine the effect of child marriage on IPV. Child marriage prevalence ranged from 13.5% in Rwanda, in East Africa, to 77% in Chad, in Central Africa, while IPV ranged from 17.5% in Mozambique in Southern Africa to 42% in Uganda, in East Africa. Past year experience of IPV was higher among young women who married or begun cohabiting before the age of 18 (36.9%) than those who did at age 18 or more (32.5%). This result was consistent for all forms of violence: physical violence (22.7% vs 19.7%), emotional violence (25.3% vs 21.9%), and sexual violence (12% vs 10.4%). After controlling for covariates, we found that young women in SSA who married before 18 years were more likely to experience IPV than those who married as adults (AOR: 1.20; 95% CI [1.12, 1.29]). Significant heterogeneity was observed in the country-level results, with a higher likelihood of IPV found in 14 of the 16 countries and lower in Angola and Chad. Child marriage is associated with a higher likelihood of IPV in most SSA countries, suggesting that ending child marriage will result in a substantial reduction in IPV. There is a need to institute policies to support and protect women who marry as children from abusive relationships in SSA.

scholarly journals Early age at first childbirth and skilled birth attendance during delivery among young women in sub-Saharan Africa

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eugene Budu ◽  
Vijay Kumar Chattu ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Aliu Mohammed ◽  
...  
Keyword(s):  
Adolescent Mothers ◽  
Young Women ◽  
Skilled Birth Attendance ◽  
Sub Saharan Africa ◽  
Early Age ◽  
First Birth ◽  
African Countries ◽  
Skilled Assistance ◽  
Birth Attendance ◽  
Sub Saharan

Abstract Background Despite the numerous policy interventions targeted at preventing early age at first childbirth globally, the prevalence of adolescent childbirth remains high. Meanwhile, skilled birth attendance is considered essential in preventing childbirth-related complications and deaths among adolescent mothers. Therefore, we estimated the prevalence of early age at first childbirth and skilled birth attendance among young women in sub-Saharan Africa and investigated the association between them. Methods Demographic and Health Survey data of 29 sub-Saharan African countries was utilized. Skilled birth attendance and age at first birth were the outcome and the key explanatory variables in this study respectively. Overall, a total of 52,875 young women aged 20-24 years were included in our study. A multilevel binary logistic regression analysis was performed and the results presented as crude and adjusted odds ratios at 95% confidence interval. Results Approximately 73% of young women had their first birth when they were less than 20 years with Chad having the highest proportion (85.7%) and Rwanda recording the lowest (43.3%). The average proportion of those who had skilled assistance during delivery in the 29 sub-Saharan African countries was 75.3% and this ranged from 38.4% in Chad to 93.7% in Rwanda. Young women who had their first birth at the age of 20-24 were more likely to have skilled birth attendance during delivery (aOR = 2.4, CI = 2.24-2.53) than those who had their first birth before 20 years. Conclusion Early age at first childbirth has been found to be associated with low skilled assistance during delivery. These findings re-emphasize the need for sub-Saharan African countries to implement programs that will sensitize and encourage the patronage of skilled birth attendance among young women in order to reduce complications and maternal mortalities. The lower likelihood of skilled birth attendance among young women who had their first birth when they were adolescents could mean that this cohort of young women face some barriers in accessing maternal healthcare services.

scholarly journals Beyond counting intended pregnancies among young women to understanding their associated factors in sub-Saharan Africa

2021 ◽  
Author(s):  
Luchuo Engelbert Bain ◽  
Bright Opoku Ahinkorah ◽  
Abdul-Aziz Seidu ◽  
Eugene Budu ◽  
Joshua Okyere ◽  
...  
Keyword(s):  
Young Women ◽  
Formal Education ◽  
Binary Logistic Regression ◽  
Wealth Quintile ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Demographic And Health Surveys ◽  
African Countries ◽  
Cross Sectional ◽  
Sub Saharan

Abstract Background In this article we report the prevalence and determinants of intended or wanted pregnancies among young women 15–24 y of age in selected sub-Saharan African countries. Methods This cross-sectional study used pooled data from current Demographic and Health Surveys conducted between 1 January 2010 and 31 December 2019 in 29 countries in sub-Saharan Africa (SSA). The sample size comprised 14 257 young women (15–24 y of age). Multivariable binary logistic regression models were used to present the results as adjusted odds ratios. Results The prevalence of intended pregnancies was 67.7%, with the highest and lowest prevalence in Gambia (89.9%) and Namibia (37.7%), respectively. Intended pregnancy was lower among young women who had knowledge of modern contraceptives, those with a secondary/higher education and those with four or more births. Lower odds of intended pregnancy were observed among young women in the richer wealth quintile and those who lived in southern Africa. Conclusions To reduce intended pregnancies in sub-Saharan African countries such as Gambia, Burkina Faso and Nigeria, there is a need for government and non-governmental organisations to recalibrate current and past interventions such as investment in increasing formal education for women and poverty alleviation programmes, as well as augmenting job creation, including skill-building. These interventions have to be sensitive to the cultural realities of each setting, especially with regards to early marriages and womanhood.

Comparison of HPV detection in HIV-infected and HIV-uninfected Kenyan women with or without cervical dysplasia.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17015-e17015
Author(s):  
Elkanah Omenge ◽  
Yan Tong ◽  
Philip Tonui ◽  
John M. Ong’echa ◽  
Kapten Muthoka ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
High Risk ◽  
Cervical Dysplasia ◽  
Hpv Infection ◽  
Hpv Testing ◽  
African Countries ◽  
Chi Square ◽  
Lower Detection ◽  
Sub Saharan ◽  
High Risk Hpv

e17015 Background: Cervical cancer, a malignancy caused by human papillomavirus (HPV) infection, is the most common malignancy in women living in sub-Saharan African countries including Kenya. HIV co-infection accelerates the natural course of cervical cancer. To determine the specific HPV type distribution in HIV-infected women compared to HIV-uninfected women, with and without evidence of cervical dysplasia. Methods: Demographic information, behavioral data, and a cervical swab were collected from women 18 and 45 years of age, HIV-infected or HIV-uninfected, who presented for cervical cancer screening at Moi Referral and Teaching Hospital in Eldoret, Kenya. Women were triaged based on the presence or absence of cervical dysplasia. HPV testing was performed using the Roche Linear Array Assay. Results were compared between women with or without HIV co-infection and between those with or without cervical dysplasia, using Chi-square tests or Fisher’s exact tests. Results: 223 women had normal VIAs. All had HPV testing, 221 had valid results: 115 HIV-infected women (mean age 37 years) and 106 HIV-uninfected (mean age 33 years). 175 women had abnormal VIAs. 143 women had HPV testing performed, 140 had valid results: 70 HIV-infected women (mean age 38.5 years) and 70 HIV-uninfected (mean age 31.3 years). Greater than 90% of all HIV-infected women in both projects were receiving anti-retroviral therapy at enrollment. HPV of any type was detected in 48% of all women with normal VIA vs. 61% of women with abnormal VIA (P = 0.018). High risk (HR)-HPV was detected in 38% of all women with normal VIA vs. 51% of all women with abnormal VIA (P = 0.012). HIV-uninfected women with normal VIA had significantly lower detection of all HPV (P = 0.026), high risk-HPV (P = 0.018), IARC high risk-HPV (P = 0.047), A9 types (P = 0.050), and individual types HPV 16 (P = 0.0274), HPV 18 (P = 0.007), and HPV 51 (P = 0.009) than HIV-uninfected women with abnormal VIA. Among HIV-infected women, there was no difference in detection of any group of HPV types or individual types with respect to VIA results. Conclusions: HIV-uninfected women without cervical dysplasia had lower detection of oncogenic HPV than HIV-uninfected women with dysplasia. In contrast, HPV detection did not differ among HIV-infected women between those with or without cervical dysplasia. In addition, VIA appears to lack specificity for HPV-associated cervical dysplasia, as 39% of women with abnormal VIA examinations did not have any HPV detected, and 49% of women with abnormal VIA examinations did not have any HR-HPV detected.

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