Age at First Birth in Uttar Pradesh: How Much Has It Actually Changed? Over Inter-NFHS Period?

Culturally, there is always pressure among newly-wed to conceive early and have births in India. Previous studies have documented relationship between age at first birth & fertility, besides the socio-demographic factors that influence age at first birth. The current study aims answering directions and quantum of such relationships using frailty models. The successive rounds of NFHS data (1, 2, 3 & 4) from Uttar Pradesh is used in the study. Fertility in India is characterized as too-early-too-fast. By age-30 majority women would have completed the childbearing. However, the data from NFHS-4 shows some striking changes in the initiation of child bearing in Uttar Pradesh breaking away from the stereotypes of too early too fast characterization. While 44.67 percent of the women aged 30-34 had experienced first birth by age 18 in the year 1992-93 (NFHS-1), the percentages declined during 2015-16 (NFHS-4) to 28.25%. However, by ages 26 majority of women (>95%) aged 30-34 have had experienced first birth. Births at younger age are also a reflection on enforcement of child-marriage restraint act & adherence to legal minimum age at marriage which is 18 for girls & 21 for boys. The data from NFHS-4 have some quality issues. Women aged as low as 5 have shown to have experienced first birth by that age. This may not be possible. The Kaplan Meier survival Graph provided the survival probabilities with respect of each predictor sub groups. The log rank test was used to test the equality of survivor function for each sub group of the predictor variable. The survivor function was significantly different among sub groups of the predictor variables except for the categories of ever use of contraception at NFHS1 and categories of religion across rounds of NFHS data. The Cox Proportional Hazards model was used to study the risk of first birth by socio demographic characteristics. The Frailty model capturing the unobserved heterogeneity in the event time was preferred over standard survival model. For the current study, gamma frailty with Weibull-hazard is used as it fits the data well. Age at marriage and women’s literacy significantly determines the Age at First Birth. The inverse relationship with regard to ever use of contraception needs further analysis. The model also predicts significant frailty with variance parameter (theta) greater than one across the NFHS datasets.

Sexual Dysfunction in Postmenopausal Women

Nowadays, women have a longer menopausal duration due to the worldwide dramatic life expectancy increase. Sexual dysfunction is one of the most prevalent problems during menopause that affect women`s quality of life, mental health, and interpersonal relationship. This study aimed to investigate sexual dysfunction and its contributing factors amongst married postmenopausal women. This cross-sectional study was conducted among 164 postmenopausal women who attended the menopause clinic of the academic hospitals in Mashhad during 2017-2018. Data were collected using a checklist that included demographic and reproductive information and the validated Persian version of the Female Sexual Function Index questionnaire (FSFI). The mean age of participants was 53.55±6.25 years. The mean FSFI score was 20.06±6.66, and 65.2% of women had sexual dysfunction. The most disturbed sexual domains were; desire (86%, n: 141), arousal (82.3%, n: 135), lubrication (71.3%, n: 117) and sexual satisfaction (70.1%, n: 115), respectively. The partner`s age (P=0.01), time since menopause onset (P=0.01), age at marriage (P=0.02), and frequency of sexual intercourse (P˂0.0001) had a significant relationship with sexual function. The sexual function of postmenopausal women in this study was highly deteriorated. The associated factors were; older age of the spouse, younger age at marriage, longer time since menopause onset, and lower frequency of sexual intercourse. It is important to determine perimenopausal women who are at potential risk of sexual dysfunction and consult them for preventive programs and strategies.

THE CORRELATION OF MOTHER'S AGE AT MARRIAGE AND MOTHER'S WORK STATUS WITH EXCLUSIVE BREASTFEEDING

The best nutrition for babies is breast milk. Breast milk should be given exclusively without any additions in the first six months. According to previous research, a woman’s age at marriage will affect the practice of exclusive breastfeeding to their babies, as young mothers are often not ready to have and care for babies. The work status of mothers also has a large impact on exclusive breastfeeding practices. The goal of this study was to discover the correlation between age at marriage and the work status of mothers with exclusive breastfeeding practices. This research was an observational study with the subjects being 94 mothers of children aged 0-5 years in Ngringinrejo Village, Kalitidu District, Bojonegoro Regency from 3 July to 9 August, 2019. This study used data from the professional placement activity or Praktik Kerja Lapangan (PKL) conducted by the students of the public health study program of Airlangga University. The outcome of this research showed that there was no meaningful relationship between the age of marriage of mothers and practices of exclusive breastfeeding (p-value = 0.973) and there is also no statistical relationship between the work status of mothers and exclusive breastfeeding practices (p-value = 0.276). However, it was discovered that mothers who gave exclusive breastfeeding were mostly not working, and mothers who did not breastfeed exclusively were mostly in employment. The conclusion of this research is the absence of a correlation between age at marriage and the work status of mothers with exclusive breastfeeding.

PENGEMBANGAN MODEL PENDIDIKAN KESEHATAN REMAJA DALAM PENDEWASAAN USIA PERKAWINAN

This research aims to develop a model instrument for adolescent health education in maturing the age of marriage. At adolescence, the female reproductive organs are psychologically well developed and strong and ready to give birth to offspring and physically begin to mature. For that, it needs a method of health education that can reach teenagers. This research used a development method that also includes the instrument standardization process. The model used is a 4-D model development consisting of define, design, develop, and disseminate. The subjects of this study consisted of adolescents aged 10-15 years and 16-21 years in Tangerang City. The sample was selected in this study through cluster random sampling technique. This study indicates that reproductive health education can increase the knowledge of adolescents in Tangerang City about maturing the age of marriage. Health education activities through reproductive education have shown quite effective results in increasing adolescent knowledge about maturing age at marriage. At the pretest, adolescents' knowledge was included in the poor category because the teenagers had not received direct information about maturing age at marriage. However, indirectly some teenagers get information from the mass media without further knowledge, namely at the knowing stage. However, during the posttest, there was a significant increase in respondents' knowledge about reproductive health education. Of the 13 indicators, all experienced an increase in the average value of knowledge compared to the reproductive health education pretest.

The Changing Educational Gradient in Marriage: Evidence from Malaysia

The rising age at marriage and non-marriage has been occurring concurrently with the rising educational level in many developing countries. This paper examines the changing relationship between educational attainment and the marriage rate (per cent ever married) and timing (age at marriage) in Malaysia over the past four decades, using multiple waves of Labour Force Survey data. Bivariate analyses show significant educational differentials in the proportion ever married and mean age at marriage for males and females, across ethnic groups and urban-rural locations. The educational effect on the rate and timing of marriage varied over time. Results from binary logistic regression show that controlling for ethnicity, urban-rural location, and age, the negative educational effect on the rate of marriage has turned positive in recent years. The change in the direction of the relationship between education and marriage rate was more pronounced for males than for females. The reduction in the educational gradient and a shift from negative to positive effect means that the conventional hypothesis of the education-marriage nexus needs to be re-assessed. The effects of rising education on the rate and timing of marriage should be considered in the implementation of the National Family Policy.

Correlates and Consequences of Delayed Marriage in Malaysia

This paper aims to examine the correlates of age at first marriage and the consequences of late marriage. Data for this paper were drawn from the 2014 Malaysian Population and Family Survey. Simple cross-tabulation and multiple classification analysis were used for the analysis. Age at marriage of women varied across socio-economic groups. Among the ethnic groups, the Other Bumiputera entered marriage earliest, followed by the Malays, Indians and Chinese. Age at marriage was positively associated with urbanisation, educational level, and women’s autonomy in marriage. The assumption of modern norms and ideas, and escalating cost of marriage are important determinants of marriage postponement. Late marriage has a direct impact on demographic outcomes, resulting in ultra-low fertility for some groups of the population. Marriage postponement has positive socio-economic outcomes for individuals. However, postponing marriage beyond the prime reproductive age may result in some reproductive health problems.

Prevalence and predictors of institutional delivery in Lumjung, Tanahun and Gorkha district of Nepal: a community-based cross-sectional study

Background: The Maternal mortality rate (MMR) in Nepal had dropped from 444 per 1, 00,000 live births in 2005 to 239 per 1, 00,000 live births in 2016. However, the MMR of Nepal is still highest in the South Asian countries except Afghanistan. Although maternal mortality has declined noticeably in Nepal, there still persists a low proportion of institutional deliveries. The aim of the study was to assess the factors influencing the utilization rate of institutional delivery.Methods: A cross-sectional study was conducted in selected village development committee of Lamjung, Tanahun and Gorkha district using semi-structured interview schedule. A random sample of 1410 married women who gave birth in the last two years were included in the study. Multiple logistic regression analysis was carried out to identify the factors associated with institutional delivery. Results: The prevalence of institutional delivery in three districts was 73.1%, highest in Lamjung (78.8%) and lowest in Gorkha (67.8%). Employed women (aoR=1.7, CI=1.05-2.80), seeking antenatal check-up (aoR=5.8, CI=3.00-11.16), secondary (SLC) or above education (aoR= 3.3, CI=1.93-5.54), more than 20 years of age at marriage (aoR=1.5, CI=1.02-2.04), Kshetri by cast (aoR=1.7, CI=1.11-2.64) were statistically significant and associated with an increased rate of institutional delivery.Conclusions: Occupation, education, antenatal check-up, age at marriage, and ethnicity/cast are major factors for determining institutional delivery. The concerned authorities have to consider the predictors of institutional delivery in formulating the policy and plan for implementing safe motherhood delivery.

Child Marriage and Intimate Partner Violence: An Examination of Individual, Community, and National Factors

Despite being a human rights violation, child marriage still takes place across the globe. Prior scholarship has shown early marriage to be associated with an increased risk of intimate partner violence (IPV). Drawing on data from the nationally representative Demographic and Health Surveys—conducted in developing and transitional nations where rates of child marriage tend to be higher—the current study provides a cross-national examination of individual-, community-, and national-level predictors of child marriage and their association with physical and emotional IPV. The sample of ever married women includes 281,674 respondents across 46 developing and transitional nations. Findings reveal the prevalence of child marriage was largely consistent with worldwide estimates. Over half of the sample (59.97%) were over the age of 18 when they married and about 1 in 10 women were married at age 14 or younger. A later age at marriage, measured continuously, was associated with lower odds of physical and emotional IPV. When considering the 18 and over cutoff traditionally used to operationalize child marriage, the odds of physical and emotional IPV were lower for women who married over the age of 18 than women who were 14 and younger when they married. However, there was a confounding effect when considering age at marriage as 18 and over when community-level predictors were not included in the model estimating physical abuse. This underscores the need to consider the nested nature of respondents’ experiences. Further, national legislation that protects against child marriage was not associated with risk of physical or emotional IPV. However, population size increased the odds of physical IPV and lowered the odds of emotional IPV. Such findings can be interpreted in light of opportunity theory and provide direction for prevention and intervention programming.