The Roots of Equality?: Marital Age Homogamy and Female Agency in Lesotho, 1880-Present

With half a female population, empowering women can be a key factor in our country's global advancement. Focusing on household decision-making and attitudes toward wife beating, our study addresses the dearth of research exploring how different socio-economic and demographic factors associated with women's empowerment evolve over the past decade in Bangladesh (from BDHS 2007 to BDHS 2017-18). Data from four waves of Bangladesh Demographic and Health Survey (BDHS, 2007 to BDHS, 2017-18) were used in this study. We put forth two domains-household decision-making and attitudes toward domestic violence-to assess women's empowerment. Principal component analysis (PCA) was employed to create women's empowerment index. To assess the unadjusted association between the selected covariates and women's empowerment, Pearson Chi-square test and ANOVA F test have been used, while adjusted association has been analyzed through proportional odds model (POM). In BDHS 2017-18, women from urban areas experienced 'high' empowerment than women in rural areas (56.08% vs. 45.69%). A notable change has been observed in the distribution of women's empowerment index by education over the survey years. Findings also showed that in all the survey years, division, place of residence, education level, number of living children, media exposure, wealth index, working status, and relationship with household head have been found to have significant association with women's empowerment index. For instance, women who completed secondary education in 2007, 2011, 2014, and 2017-18, respectively have 14.4%, 31.8%, 24.6%, and 39.6% higher odds of having empowerment compared to those who were uneducated. Further, age at first marriage, spousal age gap, NGO membership etc. emerged as a contributing factor in specific survey years. Our study affirmed that, over a ten-year period, women were more likely to protest against physical violence and to participate in various decision-making regarding their personal and social life. Empowerment is notably higher among women in urban residents, those with secondary education, 1-2 children, media exposure, and employment. Policy recommendations should emphasize targeted measures to raise awareness and empower uneducated, unemployed, economically disadvantaged, and physically oppressed women.

Marriage and power: Age at first marriage and spousal age gap in lesser developed countries

ObjectivesThe objective of this study was to examine the prevalence of adolescent motherhood among married adolescent girls and its associations with their partners’ characteristics in low-income and middle-income countries (LMICs).DesignPopulation-based...

<i>Background</i>: The focal point of this study is to investigate the current scenario of age at first motherhood among ever married adolescents in Bangladesh because early initiation into childbearing is generally the most important determinant of reproductive span, large family size, and population growth. <i>Methods</i>: The study uses the 2017-18 nationally representative Bangladesh Demographic and Health Survey (BDHS) data. In addition to the descriptive measures, Pearson’s Chi-square test and binary logistic regression analysis are employed to determine the significant association and impact of explanatory variables on age at adolescent first motherhood, respectively. <i>Results</i>: The overall mean age at adolescents’ first motherhood is 16.34±1.45 years, with marked variations by available explanatory variables. The bivariate analysis shows that the variables: current age, respondents’ education, place of residence, access to mass media, wealth index, age at first cohabitation, continue studies after marriage, spousal age difference, education, and occupation of husbands are significantly associated with age at adolescents’ motherhood. Multivariate binary logistic regression reveals that current age, respondents’ education, wealth index, age at first cohabitation, spousal age gap, and husbands’ occupation significantly impact the age at first motherhood among adolescents in Bangladesh. <i>Conclusions</i>: This study’s results will be helpful for the policymakers to take necessary steps to increase the age at first cohabitation to raise the age of adolescent first motherhood by increasing the literacy rate, minimizing the spousal age difference, and improving the socio-economic conditions for good reproductive health, and further reducing fertility in Bangladesh.

Child Marriage and Its Associations With Controlling Behaviors and Spousal Violence Against Adolescent and Young Women in Pakistan

Using data from 165 participants in a survey experiment in six Ban-gladeshi villages, we explored the levels and correlates of women's indeterminate responses to a five-part attitudinal question on intimate partner violence (IPV) against women from the 2007 Bangladesh Demographic and Health Survey. Over 80 % had indeterminate responses to all five parts of the question. Indeterminate responses included silence or initial non-response (53-58 %), misunderstanding the question (30-37 %), and conditional opinions (7-13 %). The percentages of women who justified IPV were lower when indeterminate responses were permitted (7-12 %) than when they were not (37-57 %). Older women (≥26 years) with less schooling (≤2 grades) whose husbands were older (≥36 years), had less schooling (≤8 grades), and were at least 7 years older than the respondent often had higher odds of giving indeterminate responses. Husbands' attributes and spousal age gaps were most consistently associated with women's indeterminate responses. Latent power, or fears of expressing transgressive views, may underlie women's indeterminate responses to attitudinal questions about IPV against women. Recommendations for further research are discussed.

This article analyses trends in early marriage in Turkey over a period of 30 years from 1978 to 2008, and factors associated with early marriage, based on data from the 1978 Turkish Fertility Survey and 2008 Turkey Demographic and Health Survey. The proportion of all women aged 20 to 24 who married before age 18 declined from 38% in 1978 to 14% in 2008. For ever-married women aged 20 to 24 years, the article examines risk factors for the common explanatory variables such as educational level of women, childhood place of residence, type of place of residence, region and spousal age gap, using logistic regression analysis. For women, early marriage is associated with all the explanatory variables in both surveys. Increasing women’s education and achievement of gender equality in all spheres of life emerge as essential steps to cope with the problem of early marriage and to eliminate child marriage.

BackgroundMalaria in pregnancy (MiP) poses significant risks in sub-Saharan Africa. Intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) is a key WHO-recommended intervention. However, its implementation faces challenges, particularly in fragile, diverse malaria transmission settings like Somalia, where data on uptake is limited. Critically, a substantial majority of recently pregnant women in Somalia do not access formal antenatal care (ANC) at all, with only ~ 31% attending one or more visits, severely limiting the primary platform for IPTp-SP delivery. This study aimed to identify factors associated with reported use of any sulfadoxine-pyrimethamine (SP/Fansidar) during pregnancy in Somalia, and specifically, factors associated with its uptake within antenatal care (ANC) services, contextualized by the low ANC attendance rates.MethodsThis study analysed data from the 2020 Somalia Demographic and Health Survey (SDHS) to identify factors associated with the self-reported use of SP/Fansidar during women’s most recent pregnancy in the preceding 5 years. This cross-sectional study analysed data from 7124 women aged 15–49 with a live birth in the preceding 5 years, using the 2020 Somalia Health and Demographic Survey (SDHS). The outcome was self-reported use of any SP/Fansidar during the last pregnancy (Yes/No), acknowledging this measure does not quantify dose number or adherence to WHO guidelines. To provide a more nuanced understanding of programmatic uptake, the analysis was stratified by ANC attendance (at least one visit vs. no visits). Multilevel logistic regression models were employed to assess associations with individual, household, and community-level factors, accounting for data clustering.ResultsOverall reported SP/Fansidar use was extremely low at 6.3%. A striking 69.0% of women reported no ANC visits during their last pregnancy, while 22.0% reported 1–3 visits, and only 9.0% reported 4 + visits. Reported SP/Fansidar use was highest among women with 1–3 ANC visits (e.g., 10.5%), significantly lower in those with 4 + visits (e.g., 4.2%), and lowest among those with no ANC visits (e.g., 1.8%). Multilevel analysis revealed that nulliparous women had significantly lower odds of reported SP use (AOR = 0.6; 95% CI 0.4–0.9) compared to women with 1–3 children. Women attending 4 or more ANC visits had significantly lower odds of reported SP use (AOR = 0.38; 95% CI 0.25–0.58) compared to those with no ANC visits. Women whose husbands had no education also had lower odds (AOR = 0.68, 95% CI 0.51–0.91), while women whose husbands were unemployed had higher odds (AOR = 1.6, 95% CI 1.32–2.1). Compared to the poorest, women in the fourth wealth quintile had lower odds (AOR = 0.51, 95% CI 0.29–0.89). Nomadic women had higher odds than rural women (AOR = 3.7, 95% CI 2.2–6.4). Profound regional disparities were observed, with significantly lower reported SP use in many regions compared to Awdal. Community-level factors explained 7.4% of the residual variance (ICC = 7.4%) in the overall model.ConclusionThe overall reported use of SP/Fansidar in Somalia is critically low, indicative of significant gaps in maternal healthcare delivery and falling far short of WHO coverage goals. This is fundamentally driven by the very low overall ANC attendance rate (31.0%) and further exacerbated by paradoxical findings, such as lower reported SP use among those who do attend, despite higher ANC attendance, which suggest severe systemic barriers and potential issues with service quality or SP availability. Interventions are needed to improve both initial access to ANC and the quality of ANC delivery, ensure SP availability and administration during visits, address regional inequities, and strengthen the health system to protect pregnant women and newborns from malaria.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12936-025-05673-3.

This research has two main goals: (i) to examine fertility desires (number of children) in sub-Saharan Africa: levels as compared to other major regions and recent trends; and (ii) to assess the extent to which fertility decline in sub-Saharan Africa is contingent on decline in fertility desires (singly and in combination with other reproductive changes).

BackgroundThe majority of feto-maternal morbidities and mortalities in sub-Saharan Africa, happen during the intrapartum period. Maternal mortality and morbidity have not decreased as much as anticipated, despite the significant progress made by many nations to improve access to maternity services. There are currently no nationally representative studies in sub-Saharan Africa assessing the quality of intrapartum care and its associated factors. Hence, this study aimed to determine the quality of intrapartum care and identify its associated factors using Demographic and Health Survey data from 35 countries.MethodsData from the most recent health and demographic surveys, which were carried out between 2006 and 2022 in 35 sub-Saharan African countries, were used. This analysis included a weighted sample of 353,483 women who had given birth within the last five years. STATA/SE version 14.0 statistical software was used to clean, recode, and analyze data that had been taken from DHS data sets. Utilizing multilevel mixed-effects logistic regression, the factors associated with the outcome variable were identified. Model comparison and fitness were assessed using deviance (-2LLR), likelihood ratio tests, median odds ratios, and intra-class correlation coefficient values. Ultimately, factors were deemed statistically significant if they had a p-value < 0.05.ResultsAbout 28.58% (95% CI: 28.43–28.73) of the study subjects had received quality intrapartum care. Factors the like respondent’s age [AOR = 1.49; 95% CI (1.42, 1.57)], educational status [AOR = 1.80; 95% CI (1.76, 1.85)], working status [AOR = 1.03; 95% CI (1.01, 1.05)], media exposure [AOR = 1.19; 95% CI (1.16, 1.21)], household wealth index [AOR = 1.53; 95% CI (1.49, 1.56)], family size [AOR = 0.90; 95% CI (0.88, 0.92)], healthcare decisions [AOR = 1.04; 95% CI (1.01, 1.06)], sex of the household head [AOR = 1.08; 95% CI (1.05, 1.10)], ANC visits attended during pregnancy [AOR = 0.60; 95% CI (0.59, 0.61)], number of children ever born [AOR = 0.57; 95% CI (0.55, 0.58)], age at first birth [AOR = 1.06; 95% CI (1.04, 1.08)], mode of delivery [AOR = 0.71; 95% CI (0.68, 0.73)], and residence [AOR = 1.09; 95% CI (1.06, 1.11)] were significantly associated with the quality of intrapartum care.ConclusionsIn the present study, less than one in three mothers had received quality intrapartum care. Respondent’s age, educational status, working status, media exposure, household wealth index, healthcare decisions, sex of the household head, age at first birth, and residence were associated with the quality of intrapartum care. Health policy makers and program planners should empower women through comprehensive education and mass media campaigns in order to maximize the quality of intrapartum care. It is also advised that each country’s Ministry of Health assess its community health professionals and medical facilities in order to boost funding for rural inhabitants and lower-class households.

Association between having no sons and using no contraception among a nationally representative sample of young wives in Nepal

ABSTRACTMuch research has been conducted on the extent of violence against women (VAW) and the underlying risk factors associated with VAW. Unfortunately, research into the implications of spousal age-related factors for VAW remains underexplored. This study explored the implications of spousal age gaps for VAW in Tanzania and Nigeria. Data from the 2008 Nigeria (n = 33,385) and 2010 Tanzania Demographic and Health Surveys (DHS) (n = 10,139) for women aged 15–49 years were used. We used univariate and multivariate statistical analyses to assess the relationship between VAW and spousal age-related contextual factors. Nearly half (44.00%) of Tanzanian participants and 42.48% of Nigerian participants reported having experienced VAW. Results from the multiple logistic regression models across the two countries showed that a spousal age gap of more than 15 years, region of residence, lower age at marriage, and lower educational attainment were statistically associated with VAW. The contexts in which women live are associated with their experiencing violence. Less educated women and young women were more likely to report having experienced partner violence compared to their older, more educated counterparts in both countries.

Background: Pregnancy termination (PT) is a major public health concern in low-and middle-income countries like Bangladesh. This cross-sectional study aimed to determine the prevalence and factors of PT using the nationally representative Bangladesh Demographic and Health Survey data 2017–2018. Materials and Methods: A weighted population-based sample of 8759 ever-married reproductive-aged women (15–49 years) was included in the study. The outcome variable was PT in any of the following forms: miscarriage, induced abortion, and stillbirth. A univariate analysis for mean, frequency, and percentage and multiple logistical regression were used to determine the factors associated with PT. Results: Around 18% of the women were found to have PT. The mean age of the women in the study was 25.79 years; 65.1% lived in the rural areas, and the majority of them were Muslims. Advanced age of the women (AOR:3.49, p = 0.004), residence in the countryside (AOR:0.81, p = 0.002), higher education (AOR:0.72, p = 0.027), not being a Muslim (AOR:0.74, p = 0.010), higher socio-economic status (AOR:1.28, p = 0.027), having a job (AOR:1.15, p = 0.041), being married at the age of >22 years (AOR:0.71, p = 0.036), and using a mobile phone (AOR:1.22, p = 0.002) were significant factors of PT. This study did not find any association between PT and contraceptive use. Conclusions: Age, living region, education, religion, wealth index, working status, marital age, and mobile phone use are the determinants of PT. Interventions including these factors need to be made to reduce PT in Bangladeshi women. These findings could be helpful in undertaking further epidemiological studies to understand the actual causes of PT in various rural and urban settings among different socio-demographic groups in Bangladesh.

ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Islam M, Dey Barna S. Survival analysis of timing of early marriage among women in Bangladesh: evidence from the 2014 Bangladesh demographic and health survey. Family Medicine & Primary Care Review. 2021;23(4):429-436. doi:10.5114/fmpcr.2021.110356. APA Islam, M., & Dey Barna, S. (2021). Survival analysis of timing of early marriage among women in Bangladesh: evidence from the 2014 Bangladesh demographic and health survey. Family Medicine & Primary Care Review, 23(4), 429-436. https://doi.org/10.5114/fmpcr.2021.110356 Chicago Islam, Md. Akhtarul, and Sutapa Dey Barna. 2021. "Survival analysis of timing of early marriage among women in Bangladesh: evidence from the 2014 Bangladesh demographic and health survey". Family Medicine & Primary Care Review 23 (4): 429-436. doi:10.5114/fmpcr.2021.110356. Harvard Islam, M., and Dey Barna, S. (2021). Survival analysis of timing of early marriage among women in Bangladesh: evidence from the 2014 Bangladesh demographic and health survey. Family Medicine & Primary Care Review, 23(4), pp.429-436. https://doi.org/10.5114/fmpcr.2021.110356 MLA Islam, Md. Akhtarul et al. "Survival analysis of timing of early marriage among women in Bangladesh: evidence from the 2014 Bangladesh demographic and health survey." Family Medicine & Primary Care Review, vol. 23, no. 4, 2021, pp. 429-436. doi:10.5114/fmpcr.2021.110356. Vancouver Islam M, Dey Barna S. Survival analysis of timing of early marriage among women in Bangladesh: evidence from the 2014 Bangladesh demographic and health survey. Family Medicine & Primary Care Review. 2021;23(4):429-436. doi:10.5114/fmpcr.2021.110356.

As the result of a rapid decline recently in fertility levels, Viet Nam has largely completed the transition to low fertility. The total fertility rate (TFR) estimated in the 1999 Census was 2.3 children per woman. Previous demographic surveys indicated TFRs of 4.0 in 1987 (Viet Nam Demographic and Health Survey - VNDHS-I), 3.3 for the period 1989-1993 Intercensal Demographic Survey (ICDS 1994), and 2.5 for 1996-1997 Viet Nam Demographic and Health Survey (VNDHS-II). As might be expected, the rapid fertility decline in Viet Nam reflects the significant growth of contraceptive use. VNDHS II data indicate that the all method contraceptive prevalence rate (CPR) had reached 75 per cent by 1997 and the modern method rate 56 per cent.