Child Marriage and Intimate Partner Violence: An Examination of Individual, Community, and National Factors

Associations between child marriage and reproductive and maternal health outcomes among young married women in Liberia and Sierra Leone: A cross-sectional study

BACKGROUND

Child marriage has been associated with a range of negative maternal and reproductive health outcomes. This study explored these associations in Liberia and Sierra Leone and examined how child marriage intersected with other measures of social disadvantage.

METHODS

Data were derived from 631 and 1,325 married or cohabitating women aged 20-24 interviewed in the 2019-2020 Liberia and 2019 Sierra Leone Demographic and Health Surveys, respectively. Analyses were stratified by country. Regression models examined associations between age at first marriage (<15, 15-17, and 18+ years) and reproductive and maternal health outcomes, as well as interactions between child marriage and measures of social disadvantage. Multivariable regression results were presented as adjusted odds ratios and 95% confidence intervals.

RESULTS

Over half of currently married/cohabitating women aged 20-24 in Liberia (52%) and Sierra Leone (54%) married before age 18, and over one in 10 married before age 15. In both countries, after adjusting for other factors, being married before the age of 18 was significantly associated with early fertility, high fertility, and low fertility control. Associations were particularly strong among women who first married before age 15. In Liberia, women who married at age 15-17 had significantly lower odds of skilled attendance at delivery and institutional delivery if they lived in the North Central region. Sierra Leonean women who married before age 15 had lower odds of institutional delivery and lower odds of four or more ANC visits if they lived in the North Western region.

CONCLUSION

This study found clear associations between child marriage and negative reproductive health outcomes in Liberia and Sierra Leone, with stronger associations among women married in early adolescence. Child marriage and region of residence intersected to shape young women's access to skilled attendance at birth and institutional delivery. These findings call for further investigation and targeted intervention.

Trends in child marriage, sexual violence, early sexual intercourse and the challenges for policy interventions to meet the sustainable development goals

INTRODUCTION

Child marriage remains a prevalent issue in low- and middle-income countries (LMIC) despite global declines. Girls are disproportionately affected, facing health risks, limited education, and restricted decision-making power. We aim to provide insights for child marriage prevalence across LMIC from 1990 to 2020, with a focus on sexual violence and early sexual intercourse for public health policy interventions.

METHODS

This study used World Bank datasets to assess progress in addressing child marriage in LMIC countries. Statistical analyses, including trend analysis and compound annual growth rate (CAGR), were conducted to evaluate indicators of first marriage, sexual violence, and sexual intercourse. Countries with sufficient data were categorized based on prevalence rates and trends, and detailed analysis focused on significant indicators.

RESULTS

While significant reductions were observed in the prevalence of child marriage before the age of 15 and 18 and early sexual intercourse in most countries, few countries show increasing trends, and others could not demonstrate statistical trends due to data limitations, such as scarcity of data for boys. Overall, many countries showed a decline in sexual violence and early sexual intercourse before the age of 15, but some exhibited increasing trends. For instance, Zambia and Senegal showed a decreasing trend of sexual violence, while Nigeria exhibited an increasing trend. Notably, Uganda, Cameroon, and Sierra Leone for women, and Namibia, Zambia, and Kenya for men, experienced substantial decline in early sexual intercourse.

CONCLUSION

There is a decline in child marriage, sexual violence, and early sexual intercourse in most countries independent from the income group. Only a few countries show slight increasing trends. The improvements confirm that policies that address education, employment, and deep-rooted gender inequality at the societal level seem to be effective and help reach the SDG. However, better data are needed to enhance the understanding of the development of child marriage in these countries to improve the effectiveness of policy intervention. Therefore, we recommend that policymakers not only include existing evidence that continues progress but also increase and improve the monitoring of relevant indicators.

Cross-National Associations between Age at Marriage and Intimate Partner Violence among Young Women: An Analysis of Demographic and Health Surveys from 48 Countries

We estimated the associations between age at first marriage and recent intimate partner violence (IPV) among women young women aged 20-24 years using data from demographic and health surveys (DHS) conducted at 48 low- and middle-income countries (LMICs). We fitted a multilevel logistic regression model controlling for sociodemographic covariates. Our pooled analyses revealed that age at marriage is strongly associated with past year IPV in a non-linear way, with steep reductions in violence when young women marry after age 15 and a continued decline in IPV for every year marriage is delayed up to age 24. The risk of physical IPV was 3.3 times higher among women married at age 15 (24.4%, 95% CI 19.7; 29.2%) compared to young women married at age 24 (7.5%, 95% CI 5.8; 9.2%). For sexual IPV, girls married at 15 had 2.2 times higher risk compared to those married at 24 (7.5%, 95% CI 5.6; 9.5% vs. 3.4%, 95% CI 2.7; 4.2%, respectively). For psychological IPV, the relative risk was 3.4 for the same comparison (married at 15: 20.1%, 95% CI 14.6; married at 24: 25.5% vs. 6.0%, 95% CI 3.4; 8.6%). Country specific analyses showed that, age at marriage was negatively associated with physical and psychological IPV in nearly half of the countries (n/48) and with sexual IPV in ten countries. Our findings underscore the importance of integrating violence prevention and response interventions into efforts to prevent child marriage, as well as the health, educations and social services young women access.

Association Between Disabilities, Educational Attainment, Literacy, and Intimate Partner Violence: Findings from the Indian National Family Health Surveys

Intimate partner violence (IPV) is widespread across the Global South, including India, due to cultural and patriarchal norms that encourage and facilitate such behaviors. These include age at marriage, community- and individual-level encouragement of IPV, and limited access to education across the Global South, particularly for women. Despite this, little research has sought to disentangle the role that disabilities play in affecting women's risk of IPV in India. The current study analyzes a sample of currently married women (N = 114,901) from the nationally representative 2015-2016 and 2019-2021 National Family Health Surveys (NFHS) to assess whether a relationship exists between these dimensions, while controlling for well-known IPV correlates, with physical IPV and controlling behaviors. Logistic regression analyses revealed that persons with cognitive/intellectual disabilities as well as blind respondents were more likely to experience physical IPV. Blind respondents were also more likely to experience controlling behavior. Further, findings indicate that those with no or some education were more likely to experience physical IPV relative to those with higher education. Findings from the current study demonstrate the need for IPV reduction policies to ensure that adequate accommodations are available to facilitate help-seeking behaviors among persons with disabilities. Tailored prevention policies are also needed which consider both context- and location-specific factors associated with risk.

Intimate Partner Violence and Age at Marriage in Mali: The Moderating Influence of Polygynous Unions

Polygyny and early marriage - both prevalent in Mali - are risk factors for intimate partner violence (IPV). Relying on data from the 2018 Malian Demographic and Health Surveys, the study examines the effects of polygyny and age at marriage, while controlling for known risk factors of IPV, on the likelihood of experiencing IPV. Findings reveal that polygyny is associated with IPV. However, polygyny has a moderating influence on the association between age at marriage and the experience of physical abuse and controlling behavior. The complex nature of women's experiences and the need for culturally specific programming are reviewed.