Child marriage and associated outcomes in northern Ghana: a cross-sectional study
Child marriage and associated outcomes in northern Ghana: a cross-sectional study
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DOI：
10.1186/s12889-018-5166-6
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发表时间：
2018-02-26
影响因子：
4.5
通讯作者：
Palermo, Tia
中科院分区：
文献类型：
--
作者：
de Groot, Richard;Kuunyem, Maxwell Yiryele;Palermo, Tia
背景：童婚是一种侵犯人权的行为，对中低收入国家的女孩造成不成比例的影响，并对公共卫生造成严重影响。在加纳，五分之一的女孩在18岁生日之前结婚，每20个女孩中就有一个在15岁生日之前结婚。本文使用来自加纳北部的一个独特的数据集，在一个特殊的弱势群体中检验童婚和妇女不良后果之间的联系。方法：使用了政府运营的现金转移计划正在进行的影响评估的基线数据。样本包括来自加纳北部和上东部地区2497个家庭的1349名20-29岁的已婚妇女。结果：在控制个人特征和家庭因素的情况下，童婚与健康、生育、避孕、儿童死亡率、社会支持、压力和机构结果之间的关系。结果：在这个样本中，童婚与以日常活动困难衡量的健康不良的几率增加有关(OR=2.08；在20-24岁的女性中，CI为1.28-3.38，OR=1.58；在20-29岁的妇女中，儿童死亡的几率增加(OR=2.03；在20-24岁的妇女中，CI为1.09-3.77)；在20-24岁的妇女中，认为一个人的一生是由自己的行为决定的几率较低(OR=0.42；CI为0.25-0.72，OR=0.54；在20-29岁的妇女中，CI为0.39-0.75)。相反，童婚与较低的报告压力水平相关(回归系数=-1.18；20-29岁女性的CI-1.84-0.51)。结论：童婚在加纳北部很常见，与健康状况不佳、儿童死亡率增加以及极端贫困家庭中妇女的代理能力低下有关。虽然人们对加纳打击童婚的有效措施知之甚少，但应审查解决早婚主要驱动因素的方案，如经济不安全和中学入学率，以确定其在减少早婚方面的有效性。试验登记：2015年7月1日在国际发展影响评价登记处登记，编号为RIDIE-Study-ID-55942496d53af。
Background: Child marriage is a human rights violation disproportionately affecting girls in lower-and middle-income countries and has serious public health implications. In Ghana, one in five girls marry before their 18th birthday and one in 20 girls is married before her 15th birthday. This paper uses a unique dataset from Northern Ghana to examine the association between child marriage and adverse outcomes for women among a uniquely vulnerable population.Methods: Baseline data from on ongoing impact evaluation of a government-run cash transfer programme was used. The sample consisted of 1349 ever-married women aged 20-29 years from 2497 households in the Northern and Upper East regions of Ghana. We estimated a series of ordinary least squares (OLS) and logistic regression models to examine associations of child marriage with health, fertility, contraception, child mortality, social support, stress and agency outcomes among women, controlling for individual characteristics and household-level factors.Results: Child marriage in this sample was associated with increased odds of poorer health, as measured by difficulties in daily activities (OR = 2.08; CI 1.28-3.38 among women 20-24 years and OR = 1.58; CI 1.19-2.12 among women 20-29 years), increased odds of child mortality among first-born children (OR = 2.03; CI 1.09-3.77 among women 20-24 years) and lower odds of believing that one's life is determined by their own actions (OR = 0.42; CI 0.25-0.72 among women 20-24 years and OR = 0.54; CI 0.39-0.75 among women 20-29 years). Conversely, child marriage was associated with lower levels of reported stress (regression coefficient = -1.18; CI -1.84-0.51 among women 20-29 years).Conclusions: Child marriage is common in Northern Ghana and is associated with poor health, increased child mortality, and low agency among women in this sample of extremely poor households. While not much is known about effective measures to combat child marriage in the context of Ghana, programmes that address key drivers of early marriage such as economic insecurity and school enrolment at the secondary level, should be examined with respect to their effectiveness at reducing early marriage. Trial registration: Registered in the Registry for International Development Impact Evaluations (RIDIE) on 01 July 2015, with number RIDIE-STUDY-ID-55942496d53af.