Peer-reviewed article
Understanding the impacts of child marriage on the health and well-being of adolescent girls and young women residing in urban areas in Egypt
Shatha Elnakib, May Elsallab, Maha Abdel Wanis, Shadia Elshiwy, Nishan Prasana Krishnapalan et al. ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This study looks at how child marriage affects the health and wellbeing of girls and young women in cities in Egypt. It combines an analysis of the 2014 Demographic and Health Survey (1,041 ever-married urban women aged 20-24) with focus groups and interviews in three urban sites. About 13% of the women in the sample married before age 18. Those who married as children were linked to several adverse reproductive, maternal and social outcomes, although many links weakened once length of marriage was taken into account.
Key points
- 13.22% of the urban sample married under age 18.
- Child marriage was associated with multiple births (AOR 12.93), rapid repeat childbirth (AOR 2.20) and pregnancy termination (AOR 1.89).
- Many of these associations disappeared after adjusting for marriage duration.
- Girls married under 18 had larger spousal age gaps (AOR 2.06) and higher odds of FGM (AOR 2.14).
- Qualitative themes were access to sexual and reproductive health services, FGM, marriage and birth registration, marital relations, and relationships with in-laws.
Limitations
The survey analysis shows associations only, not cause and effect, and uses 2014 data from urban women aged 20-24. The abstract gives no detail on how qualitative participants were selected or how far findings apply beyond the three urban sites.
Abstract
Abstract Background Egypt has made progress in delaying age at marriage, but child marriage continues to be practiced in many places across the country. This study investigates the impacts of child marriage on the health and wellbeing of girls residing in urban Egypt using a multi-method approach. Methods The quantitative component leveraged data from the 2014 Egypt Demographic and Health Survey and focused on (1) reproductive health, (2) maternal health and (3) social outcomes among a subsample of ever-married urban women ages 20–24 (N = 1041). Simple and multivariable logistic regressions were used to estimate prevalence odds ratios and 95% confidence intervals for associations between child marriage and the three sets of outcomes. The qualitative component drew from 11 focus groups, 23 in-depth interviews, and 13 key informant interviews conducted in three urban sites in Egypt. The data was thematically analyzed using a combination of inductive and deductive coding. Results The prevalence of marriage under age 18 was 13.22%. Child marriage was significantly associated with ever use of contraception (Adjusted Odds Ratio (AOR) 2.95 95% CI 1.67–5.19), multiple births (AOR 12.93 95% CI 5.45–30.72), rapid repeat childbirth (AOR 2.20 95% CI 1.34–3.63), and pregnancy termination (AOR 1.89 95% CI 1.11–3.23). Many of these associations disappeared after adjusting for marriage duration. Girls married under age 18 had larger spousal age gaps (AOR 2.06; 95% CI 1.24–3.41) and higher odds of FGM (AOR 2.14; 95% CI 1.11–4.13). They were significantly more likely to report receiving no ANC care (AOR 0.39; 95% CI 0.19–0.80), and less likely to deliver through C-section (AOR: 0.53; 95% CI 0.34–0.83). Consequences emerging from the qualitative data centered around five themes: (1) Access to and use of sexual and reproductive health services; (2) exposure to FGM; (3) marriage and birth registration; (4) marital relations; and (5) relationship with in-laws. Conclusion Findings provide important insights into the practice of child marriage in urban areas in Egypt and illustrate a range of adverse consequences associated with the practice.