Girl Child Marriage and Its Effect on Fertility in Pakistan: Findings from Pakistan Demographic and Health Survey, 2006-2007
Girl Child Marriage and Its Effect on Fertility in Pakistan: Findings from Pakistan Demographic and Health Survey, 2006-2007
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DOI：
10.1007/s10995-013-1269-y
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发表时间：
2014-04-01
影响因子：
2.3
通讯作者：
Raj, Anita
中科院分区：
文献类型：
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作者：
Nasrullah, Muazzam;Muazzam, Sana;Raj, Anita
童婚（18岁之前）在巴基斯坦很普遍，这对农村、低收入和低教育家庭的年轻女孩造成了不成比例的影响。我们的研究旨在确定巴基斯坦年轻妇女早婚与高生育率和低生育率健康指标之间的关系，而不是归因于社会脆弱性的关系。2006-2007年巴基斯坦人口与健康调查（一项横断面观察性调查）的全国代表性数据仅限于20-24岁的已婚妇女（n = 1,560; 10,023的15%），以确定不良生育结果的差异[高生育率（三个或更多孩子）；快速重复分娩（分娩间隔< 24个月）；意外怀孕（任何时候）；早期（< 18岁）终止妊娠（任何死产、流产或流产）与成年（千分之一日元）结婚年龄。在控制了人口统计学、社会公平指标（教育、财富指数、农村居住）、避孕措施的使用、婚姻持续时间和文化特定因素（丈夫想要更多孩子、重男重女）后，通过计算调整优势比（AORs），利用logistic回归模型评估童婚与生育结果之间的关系。总体而言，巴基斯坦20-24岁的已婚女性中有50%在18岁之前结婚。女童童婚与低社会公平指标（贫困、农村居住和未接受正规教育）显著相关（p < 0.001）。调整后的logistic回归模型显示，女童童婚与高生育率（AOR 6.62; 95% CI 3.53-12.43）、快速重复分娩（AOR 2.88; 95% CI 1.83-4.54）、意外怀孕（AOR 2.90; 95% CI 1.75-4.79）和终止妊娠（AOR 1.75; 95% CI 1.10-2.78）显著相关。在巴基斯坦，20-24岁的已婚妇女中有一半受到童婚的影响，并增加了她们面临高生育率和生育健康指标不佳的风险，突出表明需要提高巴基斯坦妇女的结婚年龄。通过严格执法，促进妇女的民事、性和生殖健康权利，努力消除女童婚姻，有助于消除巴基斯坦的女童婚姻。
Child marriage (before 18 years) is prevalent in Pakistan, which disproportionately affects young girls in rural, low income and low education households. Our study aims to determine the association between early marriage and high fertility and poor fertility health indicators among young women in Pakistan beyond those attributed to social vulnerabilities. Nationally representative data from Pakistan Demographic and Health Survey, 2006-2007, a cross-sectional observational survey, were limited to ever-married women aged 20-24 years (n = 1,560; 15 % of 10,023) to identify differences in poor fertility outcomes [high fertility (three or more childbirths); rapid repeat childbirth (< 24 months between births); unwanted pregnancy (any ever); pregnancy termination (any stillbirth, miscarriage or abortion ever)] by early (< 18) versus adult (a parts per thousand yen18) age at marriage. Associations between child marriage and fertility outcomes were assessed by calculating adjusted odds ratios (AORs) using logistic regression models after controlling for demographics, social equity indicators (education, wealth index, rural residence), contraception use, marriage duration and culture-specific factors (husband's desire for more children, son preference). Overall, 50 % of ever-married women aged 20-24 years in Pakistan were married before the age of 18 years. Girl child marriage was significantly (p < 0.001) associated with low social equity indicators (poverty, rural residence, and no formal education). Adjusted logistic regression models showed that girl child marriage was significantly associated with high fertility (AOR 6.62; 95 % CI 3.53-12.43), rapid repeat childbirth (AOR 2.88; 95 % CI 1.83-4.54), unwanted pregnancy (AOR 2.90; 95 % CI 1.75-4.79), and pregnancy termination (AOR 1.75; 95 % CI 1.10-2.78). Girl child marriage affects half of all ever-married women aged 20-24 years in Pakistan, and increases their risk for high fertility and poor fertility health indicators, highlighting the need of increasing the age of marriage among women in Pakistan. Efforts to eliminate girl child marriage by strict law enforcement, promoting civil, sexual and reproductive health rights for women can help eliminate girl child marriage in Pakistan.