Ever-married Women Research Articles

Associations of Power Relations, Wife-Beating Attitudes, and Controlling Behavior of Husband With Domestic Violence Against Women in India: Insights From the National Family Health Survey-4.

This study assesses the relationship of power relations, attitudes toward wife-beating, and controlling behavior of husband with violence against women in India using the recent National Family Health Survey (NFHS-4). In India, about 31% of ever-married women experienced domestic violence committed by their partner during 2015-16. Women's decision-making power was associated with a decreased likelihood of spousal violence. However, the justification of wife-beating and controlling behavior of husband increased the risk of intimate partner violence. This study emphasizes the need for prioritizing girls' education, enhancing women's autonomy, prevention of child marriage, and promoting gender equality in society to address the problem of spousal violence.

Consanguineous marriage and its relevance to divorce, polygyny and survival of marriage: evidence from a population-based analysis in Jordan

Background Consanguinity has been extensively studied in the context of its negative health outcomes for offspring and socio-demographic factors, but little evidence-based research has been done on its potential social benefits. Aim To examine the association between consanguineous marriage and the risk of divorce or separation, polygyny, and survival of marriage in Jordan. Subjects and methods Data were obtained from the 2018 Jordan Population and Family Health Survey, covering a nationally representative sample of ever-married women of reproductive age. Descriptive statistics, multiple logistic regression, and survival analysis techniques were used for data analysis. Results The prevalence of consanguineous marriage was found to be 27.5% in Jordan in 2018, while the prevalences of polygyny and divorced/separated rates were 4.4% and 4.7%, respectively. Both consanguineous and polygyny rates showed declining trends, but divorce/separation rate showed an increasing trend. Compared to non-consanguineous marriages, the risk of divorce/separation and polygyny were found to be lower among women with consanguineous marriage, while the survival of marriages was found to be higher for consanguineous marriages than for non-consanguineous marriages. Conclusions Findings revealed that consanguinity has some social benefits as it plays protective roles against divorce or separation, polygyny and enhances the survival of marriages.

Trends in body mass index among ever-married Bangladeshi women, 2004-14: evidence from nationally representative population-based surveys.

Both high and low body weight are associated with adverse health risk for both mother and children. Studies evaluating trends in the coverage of undernutrition and overnutrition among ever-married Bangladeshi women are limited. The objective of the present study is to assess the trends and develop future projections of body weight status among Bangladeshi women and to estimate the smoothed mean BMI by women's age for the national level and across urban and rural areas. Data from Bangladesh Demographic and Health Surveys conducted between 2004 and 2014 were used. The annual rate of change in the prevalence of underweight, overweight, and obesity, and smoothed age-specific mean BMI was estimated. During 2004-14, the prevalence of underweight reduced with an annual rate of 5⋅9 % at the national level, while the prevalence of overweight and obesity increased with an annual rate of 8⋅6 and 9⋅6 %, respectively. With the recent trends, the prevalence of underweight is expected to reduce from 11⋅9 % in 2020 to 6⋅5 % by 2025. In 2020, the prevalence of overweight and obesity were 30⋅0 and 6⋅9 %, respectively, which are projected to increase to 38⋅5 and 9⋅0 %, respectively, by 2025, if present trends continue. By 2030, the prevalence of overweight was predicted to be much higher in urban areas (44⋅7 %) compared with rural areas (36⋅5 %). Multifaceted nutrition programme should be introduced for rapid reduction of undernutrition and to halt the rise of the prevalence of overweight and obesity.

Prevalence of spousal violence among married women in a rural area in North Kerala.

Background:Domestic violence has substantial public health consequences. More than one-third of women globally suffer from physical and sexual violence, mostly by an intimate partner with a lifetime prevalence of 10%–69%. In India, 28.8% of the ever-married women in the reproductive age group, reported domestic violence. Although Kerala, in southern India, performs better than other Indian states on a host of human development indicators for women, 15.8% among the women in this group have ever experienced physical or sexual violence in the past 12 months, the most common perpetrator being the husband.Methodology:A community-based cross-sectional study was carried out among the ever-married women, residing in a selected area of northern Kerala, who have been married for at least 1 year. One to one structured interview was conducted with a pretested structured questionnaire by the investigator. Spousal violence was defined as proportion of ever-married women with a lifetime experience of violence perpetrated by their spouse, manifested through acts of physical, sexual, and/or emotional violence, even threat.Results:A total of 290 women were interviewed. The age of the participants ranged from 18 years to 64 years; majority were Muslims. Only 16.5% were college-educated and over 90% were homemakers. 29% reported having experienced spousal violence; with the most common being emotional violence (19%) closely followed by sexual violence (18.6%) and physical violence (14.8%). A little over one-third (39.7%) reported controlling behaviour of their husband. Age of the participant (P = 0.019), absence of social support (P = 0.034), employment status of husband (P = 0.026), controlling behaviour of husband (P < 0.001), alcohol abuse by husband (P = 0.004) and extra-marital relationship of spouse (P < 0.001) were found to have significant influence on spousal violence experience.Conclusion:More than a quarter of the married women in this rural setting have experienced one or the other form of violence.Recommendation:A multifaceted approach needs to be employed which takes into consideration legal measures, social sciences, women empowerment, mental health systems and educate the men to curb this menace.

Domestic Violence Against Women by Their Intimate Partner: A Cross Sectional Analysis on Amalgamation of Women's Individual Health Status and Various Risk Factors in Indian

Background: Intimate Partner Violence (IPV) is a severe public health issue, and nowadays, it has reached with an acute state in the society. Using a sample of 62,090 ever-married Indian women, this study investigated the impact of women’s individual health condition and various factors associated with respondent’s household, personal, and partner’s socio-economic, demographic & cultural risk behaviors on women’s experience of IPV offense. Method: Multivariable binary logistic regression method (Main effect & Interaction effect) was applied to evaluate the extent of association of risk factors at various levels with the past year's experience of any form of IPV. In the past year prevalence of any form of IPV among Indian ever-married women (n = 62,090) was 32.7 %. Findings: Selected Household-level characteristics, women’s health condition and Individual-level characteristics, and partner’s characteristics are significantly associated with the past-year prevalence of any form of IPV offense against women. Risk behaviors such as conservative family ideology, addiction to alcohol consumption, child marriage, education, women’s financial autonomy, chronic health illness (AOR: 1.43; CI: 1.33-1.53), partner’s domineering attitude, and unemployment were identified as the most important risk factors. Interaction analysis between residential places and selected covariates showed a difference in likelihood between rural and urban parts. Interpretation: Actions to prevent and eliminate IPV offences in India demand collaborative efforts of the national government and public agencies, and local government. Improvement in household level wellbeing, a woman’s personal and partner’s level characteristic is very much necessary to minimize the violence against women by their intimate partner. Funding: None to declare. Declaration of Interest: None to declare.

Cost Estimation of the New HPV/DNA Test Screening Procedure per Person among 35 Years Old Ever-Married Women in a District of Sri Lanka

Background: HPV/DNA screening test has an optimum sensitivity (92.9%) to detect cervical lesions. The objective of the study was to estimate the cost of cobas 4800 HPV/DNA test in thin prep cell collection media. Methods: The cost estimation of the HPV/DNA specimen collection was done at a randomly selected community Well Woman Clinic (WWC) in the district of Sri Lanka. Five women, who were attended WWC for HPV/DNA specimen collection in September, October, and November 2018 were randomly selected for the cost estimation. To estimate the cost incurred in laboratory screening of the HPV/DNA specimen by cobas 4800 HPV/DNA PCR test, a reference laboratory in the district was utilized. Checklists were developed to record all instruments and consumable items used in the clinic and laboratory, while record sheets were developed to record the time taken to complete all activities associated with taking an HPV/DNA specimen by the clinic and laboratory staff. Five HPV/DNA specimen collection procedures were randomly selected at each of three sessions and the average time per procedure was calculated. Categories of staff involved in the procedure and staff time spent on the procedure were measured and recorded on three clinic days. Staff time spent on HPV/DNA specimen screening by an HPV/DNA testing machine in the laboratory was calculated on three working days (One day per month). Results: The total estimated cost of the HPV/DNA specimen collection procedure incurred by the government in the community WWC was Rs.2569.38 (USD 13.81), while the total estimated unit cost in the laboratory procedure for HPV/DNA screening was Rs. 50.57(USD 0.27).Therefore the total estimated cost of the HPV/ DNA specimen screening procedure was Rs. 2619.95(USD 14.08). The estimated unit cost including administrative cost was Rs. 2881.95(USD 15.49). Conclusion: Cobas HPV/DNA test is economically feasible to be incorporated into the national cervical cancer screening programme in Sri Lanka. It is necessary to further attempt alternative methods of cobas 4800 HPV/DNA test (i.e. dry swabs) to determine the most appropriate method for resource limited settings.

Droughts, cyclones, and intimate partner violence: A disastrous mix for Indian women

India has reported a high prevalence of Intimate Partner Violence (IPV) against women over the years. Previous Western research has found an increased IPV risk among women in the aftermath of natural disasters, underscoring the need for such studies in India. We could not locate any study focusing on the impact of slow-onset versus rapid-onset disasters, which might have differing impacts on the vulnerable, especially on the incidence of IPV in India. Using data on ever-married women from the National Family Health Survey-4 (2015–16), we investigated the association of residing in districts exposed to a drought (N = 31,045), and separately, to two cyclones (N = 8469), with three forms of self-reported IPV against women (emotional, physical, and sexual). Survey-adjusted logistic regression models showed that exposure to cyclone was positively associated with emotional IPV (AOR: 1.59, 95% CI: 1.20, 2.10) after adjusting for sociodemographic covariates. Although not statistically significant, exposure to cyclone was also positively associated with physical and sexual IPV, and drought with physical IPV. However, we did not find an association of drought with emotional and sexual violence. We corroborated previous findings that women from wealthier households, with greater education, and whose husbands had no history of alcohol consumption, were less likely to experience any form of IPV independent of the influence of other factors. These results highlight the potential increased risk of IPV following natural disasters. In patriarchal societies such as India vulnerable to climate-change, these sobering results highlight the need to prepare for the social disasters that might accompany natural disasters.

Factors associated with divorce from first union among women in Ethiopia: Further analysis of the 2016 Ethiopia demographic and health survey data.

BackgroundGlobally, divorce is a common phenomenon in couples' marital life. As a result, many divorced couples and their children face several social, economic, and health problems after dissolution. There is little information on the magnitude and determinants of divorce in developing countries including Ethiopia. Therefore, this study aimed to estimate the prevalence of divorce from the first union and its predictors among reproductive-age women in Ethiopia.MethodsWe used the 2016 Ethiopia demographic and health survey data for this analysis. The survey was a community-based cross-sectional study conducted from January 18 to June 27, 2016. The survey employed a two-stage stratified cluster sampling technique. A total of 11,646 ever-married women were included in the analysis. Bivariate and multivariable logistics regression was done to identify the determinants of divorce from the first marriage. A p-value < 0.05 was used to declare statistical significance.ResultsAbout 25% (95%CI: 23.4% - 26.6%) ever-married women were divorced from their first marital relationship. Women who were married at age < 15 years (AOR = 1.34; 95%CI: 1.07–1.68), urban women (AOR = 1.69; 95%CI: 1.22–2.35), women who did not attend formal education (AOR = 4.36; 95%CI: 3.14–6.05), women who were employed (AOR = 1.51; 95%CI: 1.31–1.73), and being childless (AOR = 1.34; 95%CI: 1.07–1.69) had higher odds of experiencing a divorce. Similarly, women who experienced partner violence, women with no house ownership, and women in the Amhara region had higher odds of divorce from their first marital union. Conversely, women in Oromia, SNNPR, the metropolis, and the pastoral regions had lower odds of divorce from their first marital union.ConclusionDivorce from the first marriage is high in Ethiopia. Preventing early marriage and partner violence and promoting girls’ education would reduce the divorce rate in Ethiopia.

Prevalence of under-5 mortality and its associated risk factors in Afghanistan

Abstract Introduction Under-five mortality rate (U5MR) is a crucial indicator of the health in a society. The determinant of under-five mortality is essential for designing effective intervention programs that enhances the survival of young children. Objectives The present study aims to determine the prevalence of under-five mortality and its associated risk factors in the country of Afghanistan. Methods Latest round of Afghanistan Demographic and Health Survey (AfDHS, 2015) was used in the present study. The sample size was 1640 ever-married women (15–49 years) with at least one child younger than five years preceding the survey. Bivariate and multivariate regression analysis was applied to examine the risk factors associated with U5M. Results The results of the present study found that those mothers delivered babies with birth size small or very small and birth interval 2 years were 31% [HR = 0.69, 0.57–0.82] and 28% [HR = 0.72, 0.61–0.86] less likely to have the risk of under-five mortality than their counterparts at significant level. Conclusion The finding concludes that birth size (small or very small), birth interval (

Influence of women's empowerment indices on the utilization of skilled maternity care: evidence from rural Nigeria.

There is increasing evidence that women with the ability to exercise control over their sexual and reproductive lives have greater access to prompt prevention and treatment of maternal health disorders, resulting in a concomitant reduction in maternal morbidity and mortality. This study assessed the association between indices of women's empowerment and utilization of skilled antenatal, intrapartum and postnatal maternity care in two rural Local Government Areas in Edo State, Nigeria. Data were taken from a household survey conducted in July and August 2017, and the study sample comprised 1245 ever-married women currently in a union who had given birth in the 5 years preceding the survey. A Gender Roles Framework guided the selection of independent women's empowerment variables. Using hierarchical logistic regression, the likelihood of receiving all three levels of skilled maternal health care service (antenatal, intrapartum and postnatal) by women's empowerment variables, grouped into resource, decision-making and influencer domains following the model of Anderson and Neuman, was assessed. Of the resource domain variables, respondent's education and respondent's participation in payment for their own health care positively predicted their use of all three levels of skilled maternal care, whereas their ownership of land negatively predicted this. Two decision-making domain variables were significantly associated with respondent's use of all three levels of service: those who made decisions alone about major household purchases were twice as likely to use all three levels of services than when decisions were made by their partners or others, while respondent making decisions alone about what food to cook each day was a negative predictor. Of the influencer variables, religion and a large spousal education gap were strong positive factors, whereas living in a consensual union rather than being legally married was a negative factor. Although health system factors are important, interventions geared towards changing gender norms that constrain women's empowerment are critical to achieving maternal health-related development goals in Nigeria. A composite strategy that targets all women's empowerment indices is recommended, as Nigeria strives towards achieving SDG-3.

Trends in contraceptive use, unmet need and associated factors of modern contraceptive use among urban adolescents and young women in Guinea

BackgroundIn Guinea, high fertility among adolescents and young women in urban areas remains a public health concern. This study describes trends in contraceptive use, unmet need, and factors associated with the use of modern family planning (FP) methods among urban adolescents and young women in Guinea.MethodsWe used four Guinea Demographic and Health Surveys (DHS) conducted in 1999, 2005, 2012, and 2018. Among urban adolescents and young women (15–24 years), we examined trends over time in three key indicators: 1. Modern Contraceptive use, 2. Unmet need for FP and 3. Modern contraceptive use among those in need of FP (demand satisfied). We used multivariable logistic regression to examine association between socio-demographic factors and modern FP use on the most recent DHS dataset (2018).ResultsWe found statistically significant changes over the time period examined with an increase in modern contraceptive use (8.4% in 1999, 12.8% in 2018, p < 0.01) and demand satisfied (29.0% in 1999, 54.1% in 2018, p < 0.001), and a decrease in unmet need for FP (15.8% in 1999, 8.6% in 2018, p < 0.001). Factors significantly associated with modern FP use were; young women aged 20–24 years (AOR 2.8, 95% CI: 1.9–4.1), living in urban areas of Faranah (AOR: 2.6, 95% CI: 1.1–6.5) and Kankan (AOR: 3.6, 95% CI: 1.7–7.8), living in households in the middle (AOR: 7.7, 95% CI: 1.4–42.2) and richer wealth quintiles (AOR: 6.3, 95% CI: 1.0–38.1). Ever-married women (AOR: 0.5, 95% CI: 0.3–0.9) were less likely to use modern FP methods than never married as were those from the Peulh (0.3, 95% CI: 0.2–0.4) and Malinke (0.5, 95% CI: 0.3–0.8) ethnic groups compared to Soussou ethnic group.ConclusionDespite some progress, efforts are still needed to improve FP method use among urban adolescent and young women. Age, administrative region, wealth index, marital status, and ethnic group are significantly associated with modern FP use. Future policies and interventions should place emphasis on improving adolescents’ reproductive health knowledge, increasing FP availability and strengthening provision. Efforts should target adolescents aged 15–19 years in particular, and address disparities between administrative regions and ethnic groups, and health-related inequalities.

Prevalence of domestic violence against women in informal settlements in Mumbai, India: a cross-sectional survey

ObjectivesDomestic violence against women harms individuals, families, communities and society. Perpetrated by intimate partners or other family members, its overlapping forms include physical, sexual and emotional violence, control and neglect....

Demand- and supply-side factors associated with the use of contraceptive methods in Pakistan: a comparative study of demographic and health surveys, 1990\u20132018

BackgroundA remarkable decline in fertility rates has been observed in many countries, with a primary determinant being an increase in the use of contraceptives. However, the birth rate in Pakistan is still higher compared to the other countries of the region. Therefore, this study aims to assess the effect of demand- and supply-side factors associated with the use of contraceptive measures in Pakistan.MethodsSecondary data analysis of four data series of the Pakistan Demographic and Health Surveys (PDHS 1990–1991, 2006–2007, 2012–2013 and 2017–2018) were used. The data includes ever-married women aged 15–49 years who had given birth in the previous five years and participated in the family planning module of the PDHS. A total of 25,318 women were included in the analysis. Data were analysed by investigating the associations between independent variables (demand- and supply-side factors) and the use of contraceptive measures through unadjusted odds ratios (OR) and adjusted OR (AOR).ResultsThe results among demand-side factors indicated that in 2012–2013, women without media exposure were less likely to use contraceptives and the trend remains almost constant for 2017–2018 (AOR = 0.664, 95% CI 0.562–0.784) in 2012–2013 and (AOR = 0.654, 95% CI 0.483–0.885) in 2017–2018. However, they still show a lower likelihood of using contraceptives without media exposure. The results among supply-side factors indicated that absence of transport (2012–2013) and limited visits by family planning workers over the previous 12 months (2006–2007, 2012–2013 and 2017–2018) remained significant factors for not using contraceptive methods.ConclusionsThe results of the study indicate that certain demand- and supply-side factors are associated with the use of contraceptive measures in Pakistan. It highlights the need for the provision of family planning resources and further structural factors, particularly in remote areas.

Spousal violence against women and its association with sociodemographic factors and husbands’ controlling behaviour: the findings of Myanmar Demographic and Health Survey (2015–2016)

ABSTRACT Background: Spousal violence is the most common domestic violence against women and a growing public health problem globally. As a behaviour, marital control is commonly accepted as a precursor to spousal violence. Objective: This study examines the prevalence of different types of spousal violence among women in Myanmar and their association with sociodemographic factors and husbands’ controlling behaviour. Methods: This study used data from the Myanmar Demographic and Health Survey (MDHS) 2015–2016. Based on the responses of 3,425 ever-married women, cross-tabulations (Chi-squared test) and multivariate logistic regressions were applied to examine the association between controlling behaviour by husbands and lifetime physical, sexual and emotional spousal violence against Myanmar women. Synergy factor and population attributable fraction were estimated to recommend preventive strategies. Results: The prevalence of lifetime physical violence was 16.8%, of sexual violence 3.8%, of emotional violence 15.9%, and of husband’s controlling behaviour 30.2%. Women who were exposed to controlling behaviour by their husbands reported higher likelihoods of lifetime physical spousal violence (OR = 3.7; 95% CI: 3.0–4.7), lifetime sexual spousal violence (OR = 5.3; 95% CI: 3.3–8.6), and lifetime emotional spousal violence (OR = 5.6; 95% CI: 4.4–7.2). Controlling behaviour by husbands was attributed to 22.0% of lifetime physical spousal violence; and to 24.5% of lifetime sexual spousal violence and to 24.8% of lifetime emotional spousal violence in this sample of Myanmar women. Additional associated factors of spousal violence were poor wealth status, women’s wife-beating justification, exposure to parental violence, and alcohol abuse among husbands. Conclusion: Controlling behaviour by husbands was significantly associated with higher likelihoods of lifetime spousal violence among ever-married Myanmar women in this study. These findings reflect an obvious need for policy development and preventive strategies against marital controlling behaviour in Myanmar.

Predictors of hookah smoking frequency among women in the South of Iran: A cross-sectional study

The prevalence of hookah smoking has grown over the past decades in Iran especially in the south of the country. This study aimed to determine the behavioral and socio-demographic predictors of the hookah smoking frequency among women in southern Iran. This research was conducted on 400 women hookah smokers selected through multi-stage sampling method. Data were collected from October 2018 to September 2019 using a questionnaire guided by literature. Ordinal logistic regression analysis was run to determine the influential behavioral and socio-demographic predictors involved in the frequency of hookah smoking. Variables with a P-value of less than 0.05 in the final fitting model were associated with the outcome variable (frequency of hookah smoking per day1 = once a day, 2 = twice a day, 3 = three times a day, 4 = more than three times a day). We found that the longer duration of hookah smoking, family usage of hookah smoking, beginning to smoke hookah with peers, absence of either parent in family (single-parent families and a lack of prior intention to cease smoking), ever-married women and low socio-economic status (SES) predicted the frequency of hookah smoking. To prevent the behavior and make effective interventions to reduce hookah smoking, policy-makers should stay focused on factors other than internal motivations. Focus on the companies surrounding women smokers, quitting the habit of hookah smoking and effective interventions to decrease one's intention to smoke hookah can help reduce such unhealthy behaviors.

Polygyny and Intimate Partner Violence (IPV) Among Ethiopian Women

Polygyny is marriage between a man and multiple women and is mostly practiced in sub-Saharan African countries. Some of the common attributes of this family structure include perennial conflicts and marital discord, which can expose women to intimate partner violence (IPV). Nonetheless, there is limited research on the intersection between such family structures and IPV in the Ethiopian context. Thus, we examined data from ever-married women (n = 4469) between 15 and 49 years of age collected in the 2016 Ethiopia Demographic and Health Survey (EDHS-2016). Overall, the proportion of polygynous marriages among ever-married Ethiopian women was 10.4% (confidence interval (CI): 8.7–12.4). The prevalences of emotional, physical, and sexual abuse among ever-married women were 24%, 23.1%, and 10.1%, respectively. Women who reported being in polygynous marriages were 1.82 times more likely to report emotional abuse by their husbands (odds ratio (OR) = 1.82; CI: 1.256–2.628). However, the type of marriage had no significant association with physical and sexual violence among ever-married women. The results suggest that polygynous family structures may expose women to IPV. Thus, health and social service providers should be aware of the vulnerability to psychological distress of women in such unions.

Predicting the Vulnerability of Women to Intimate Partner Violence in South Africa: Evidence from Tree-based Machine Learning Techniques.

Intimate partner violence (IPV) is a pervasive social challenge with severe health and demographic consequences. Global statistics indicate that more than a third of women have experienced IPV at some point in their lives. In South Africa, IPV is considered a significant contributor to the country's broader problem with violence and a leading cause of femicide. Consequently, IPV has been the major focus of legislation and research across different disciplines. The present article aims to contribute to the growing scholarly literature by predicting factors that are associated with the risk of experiencing IPV. We used the 2016 South African Demographic and Health Survey dataset and restricted our analysis to 1,816 ever-married women who had complete information on the variables that were used to generate IPV. Prior research has mainly used regression analysis to identify correlates of IPV; however, while regression analysis can test a priori specified effects, it cannot capture unspecified inter-relationship across factors. To address this limitation, we opted for machine learning methods, which identify hidden and complex patterns and relationships in the data. Our results indicate that the fear of the husband is the most critical factor in determining the experience of IPV. In other words, the risk of IPV in South Africa is associated more with the husband or partner's characteristics than the woman's. The models developed in this study can be used to develop interventions by different stakeholders such as social workers, policymakers, and or other interested partners.

Spatial Distribution and Determinants of Early Marriage among Married Women in Ethiopia: A spatial and Multilevel Analysis

BackgroundEarly marriage is a global public health problem that is mainly practiced in South Asia, Latin America, and sub-Saharan Africa including Ethiopia. It raises the risk of early childbearing of women, higher rates of divorce, and an increased risk of maternal and child death. However, little is known about the spatial distribution and determinants of early marriage in Ethiopia. Therefore, this study aimed to assess the spatial distribution and determinants of early marriage among ever-married women in Ethiopia.MethodsA detailed analysis of the 2016 Ethiopian Demographic and Health Survey data was conducted. A total weighted sample of 11,646 reproductive-age married women were included in the analysis. To identify significant hotspot areas of early marriage the Bernoulli model was fitted using SaTScan version 9.6 software. Additionally, to explore the spatial distributions of early marriage across the country ArcGIS version 10.1 statistical software was used. For the determinant factors, the multilevel logistic regression model was fitted. Deviance was used for model comparison and checking of model fitness. In the multivariable multilevel analysis, Adjusted Odds Ratio (AOR) with 95% CI was used to declare significant determinants of early marriage.ResultsThe finding of this study revealed that the spatial distribution of early marriage was significantly varied across the country with Global Moran’s I = 0.719 and p value < 0.001. The primary clusters were detected in Tigray, Amhara, and Afar regions. Both individual and community-level factors were associated with early marriage. Having no formal education (AOR = 4.25, 95% CI 3.13–5.66), primary education (AOR = 3.37, 95% CI 2.80–4.92), secondary education (AOR = 1.75, 95% CI 1.32–2.33), and a decision made by parents (AOR = 1.88, 95% CI 1.68–2.09) were individual-level factors associated with higher odds of early marriage. Among the community-level factors, the region was significantly associated with early marriage. Thus, living in Afar (AOR = 1.82, 95%CI 1.37–2.42), Amhara (AOR = 1.77, 95% CI 1.38–2.77), and Gambela (AOR = 1.44, 95% CI 1.09–190) was associated with higher odds of early marriage. Whereas, living in Addis Ababa (AOR = 0.50, 95% CI 0.36–0.68) was associated with a lower chance of early marriage.ConclusionThe spatial distribution of early marriage was significantly varied in Ethiopia. Women’s education, women’s autonomy, and region were found to be the significant determinants of early marriage. Therefore, public health interventions targeting those identified significant hotspot areas of early marriage are crucial to reduce the incidence of early marriage and its consequence. In addition, enhancing women's education and empowering them to make their own choices are vital for changing the customs of the community and eliminating early marriage in Ethiopia.

Bayesian spatial analysis of socio-demographic factors influencing pregnancy termination and its residual geographic variation among ever-married women of reproductive age in Bangladesh

BackgroundUnsafe pregnancy termination is a major public health concern among reproductive-aged women in many developing countries. This study evaluated the socio-demographic characteristics, as well as residual spatial correlation in pregnancy termination among Bangladeshi women.MethodsSecondary data was obtained from the Bangladesh Demographic and Health Survey for the survey year 2014. Data included 17,863 samples of ever-married women between the ages of 15-49 years, which is a national representative sample in Bangladesh. Bayesian spatial logistic regression was used to assess the associations between socio-demographic characteristics and pregnancy termination. We flexibly modeled the non-linear effects of the continuous covariates while accounting for residual spatial correlation at the district level.ResultsOur findings revealed that about 19% of the respondents in Bangladesh reported ever had a pregnancy terminated. The risk of pregnancy termination was higher among women who had been working, had a higher wealth index, were in a conjugal relationship, had no children, were older and started their cohabitation earlier. Residual spatial patterns revealed the areas at a higher risk of pregnancy termination, including Panchagarh, Habiganj, and Sylhet after adjusting for covariates.ConclusionsPrevalence of pregnancy termination remains considerably high in Bangladesh. The study revealed significant associations of women’s age at survey time, age at first cohabitation, occupational status, socio-economic status, marital status and the total number of children ever born with reporting having a history of terminated pregnancy among Bangladeshi ever-married women. The identified socio-demographic characteristics and districts at an increased likelihood of pregnancy termination can inform localized intervention and prevention strategies to improve the reproductive healthcare of women in Bangladesh.

Religion, family structure, and the perpetuation of female genital cutting in Egypt

AbstractHow are harmful social practices brought to an end? Female genital cutting (FGC) is extremely common among ever-married women in Egypt, but the practice has declined among younger women and girls. While much of the recent literature on abatement of FGC has focused on individual-level determinants of a mother's choice to circumcise her daughters, we focus on meso-level factors, particularly norm change within religious communities and attitude formation within families. We find differential FGC trends across Muslim and Coptic Christian communities as well as an effect of the gender of a woman's first-born child—an exogenous variable in Egypt where pre-natal sex selection is rare—on attitudes toward FGC. The effect of the first-born gender varies by religion and birth cohort, however, suggesting ways in which meso-level factors interact to impact women's attitudes and associated FGC outcomes.