Abstract
PurposeChild marriage is associated with multiple adverse health and social outcomes. Although evidence suggests that child marriage is associated with reduced participation in personal and household decisions for women, less is known about the association between age at marriage and decision-making among married adolescent girls. This study assesses associations between adolescents' age at marriage and two dimensions of decision-making (participation and satisfaction) in the high early marriage prevalence settings of Niger. MethodsCross-sectional data from a cluster-randomized control trial of a community-level program to increase the use of modern contraceptives among married adolescents in the Dosso region of Niger were analyzed. Multiple logistic regression models were used to determine the association of age at marriage with married girls' participation in and satisfaction with decision-making processes. ResultsMore than half of married adolescents (N = 796) were married before reaching the age of 15 years. Older age at marriage was associated with adolescents' increased participation in decisions related to economics (adjusted odds ratio: 1.23; 95% confidence interval: 1.05–1.43) and health-care access (adjusted odds ratio: 1.18; 95% confidence interval: 1.01–1.40), but not with greater reported satisfaction with their control over these decisions. ConclusionsThe study suggests that marrying as a very young adolescent places girls in even more disadvantaged positions regarding decision-making. These findings indicate the need to design programs targeted at addressing inequitable gender norms to reduce early child marriage and increase participation in decision-making. Further study of satisfaction with participation in decision-making is recommended, including consideration of whether it is related to gender norms for participation in decisions rather than actual participation.
Highlights
Child marriage is associated with multiple adverse health and social outcomes
The present study extends the measures for assessment of decision-making to include satisfaction with the level of participation that married adolescent girls have in decisions across the domains of economic decisions, freedom of movement, and health-care access
More than half of the participants (60.2%) in the present study of married adolescents in rural Niger reported being married in early adolescence, i.e., at the age of 14 years or younger
Summary
Child marriage is associated with multiple adverse health and social outcomes. evidence suggests that child marriage is associated with reduced participation in personal and household decisions for women, less is known about the association between age at marriage and decision-making among married adolescent girls. Niger has the highest prevalence of child marriage (marrying before reaching the age of 18 years) globally, with 76% of women of ages 20e24 years married before the age of 18 years; nearly 40% of these marriages occur before 15 years of age [1,2] This high rate of child marriage in Niger is driven by its high poverty levels, lower education rates, especially female education rate, 1054-139X/Ó 2021 Published by Elsevier Inc. on behalf of Society for Adolescent Health and Medicine. With no significant reduction in child marriage rates over the last 25 years [6], the Niger population, especially girls and women, continues to face multiple harmful effects of child marriage
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