Married very young adolescent girls in Niger at greatest risk of lifetime male partner reproductive coercion and sexual violence.

Stephanie M Delong,Caitlin Corneliess,Rebecka Lundgren,Mohamad I Brooks,Sani Aliou,Giovanna Lauro,Nicole E Johns,Nicole Carter,Jay G Silverman,Sneha Challa,Andrew R Dalby

doi:10.1371/journal.pone.0231392

Abstract

ObjectiveThe purpose of this analysis was to compare and contrast reproductive health (RH), gender equity attitudes, and intimate partner violence (IPV) among married very young adolescent (VYA) girls with married older adolescent girls and young women (AGYW) in rural Niger given limited literature on the topic.MethodsWe conducted an exploratory analysis of baseline data from the Reaching Married Adolescents Trial in Dosso region, Niger. We report counts and percents, by age group (13–14 years (VYA), 15–16 years, 17–19 years), of AGYW’s self-efficacy to use family planning (FP), accurate knowledge of FP, current use of modern FP, and unintended last pregnancy (UIP); lifetime reproductive coercion (RC), physical IPV, and sexual IPV; and gender equity attitudes. We also assess whether percents differ between VYA and older groups using Pearson’s Chi-Square and Fisher’s exact p-values. Results are stratified by parity. Finally, we use logistic regression to consider associations.ResultsThere were 49 VYA, 248 girls aged 15–16, and 775 AGYW aged 17–19 in our sample (n = 1072). Accurate knowledge of FP, self-efficacy to use FP, current use of modern FP, and UIP increased with age; all percents between VYA and AGYW 17–19 were marginally or statistically significantly different. We also saw VYA report higher lifetime RC and sexual IPV versus older groups, with sexual IPV statistically different between VYA and girls 17–19. Parous VYA reported a significantly higher percent of lifetime RC versus older AGYW. Among 17–19 year-olds, odds of current use of FP were higher among AGYW who reported physical IPV, and odds of UIP were higher among those reporting more gender equitable attitudes, both adjusted for parity.ConclusionsWe observed differences in RH, RC, and sexual IPV among married VYA and older AGYW in rural Niger. VYA should be prioritized in research to confirm and further understand their RH needs.

Highlights

Niger is a mainly rural country of approximately 23 million people (2019)[1], with problems of food scarcity[2] and lack of economic opportunity[3]
Accurate knowledge of family planning (FP), self-efficacy to use FP, current use of modern FP, and unintended last pregnancy (UIP) increased with age; all percents between very young adolescent (VYA) and AGYW 17–19 were marginally or statistically significantly different
Among 17–19 year-olds, odds of current use of FP were higher among AGYW who reported physical intimate partner violence (IPV), and odds of UIP were higher among those reporting more gender equitable attitudes, both adjusted for parity

Summary

Introduction

Niger is a mainly rural country of approximately 23 million people (2019)[1], with problems of food scarcity[2] and lack of economic opportunity[3]. Qualitative data from Maradi, Niger, suggests a husband’s permission, or fear of not getting that permission, limits some women from starting FP[10]. This evidence is supported by qualitative data from Niamey, Tahoma, and Zinder, Niger, that suggests husbands may control or advise women about their FP use[11]. Wives may be at risk of reproductive coercion (coerced pregnancy, contraceptive sabotage; RC) when their views diverge from those of their husbands[12] These same women may be at greater risk of experiencing intimate partner violence (IPV) given its association with RC[13]

Methods

Results

Conclusion