Influence of child marriage on institutional delivery and high-risk births among young women in 31 sub-Saharan African countries

Women Health. 2022 Jan;62(1):85-93. doi: 10.1080/03630242.2021.2020201. Epub 2021 Dec 22.

Abstract

While child marriage persists in sub-Saharan Africa (SSA), little is known about its influence on institutional delivery/high-risk births (IDHRB). We analyzed pooled data on young women aged 15-24 (N = 113,588) from the most recent Demographic and Health Surveys of 31 SSA countries to examine the influence of child marriage on IDHRB. Binary logistic regression analysis was done to explore statistically significant relationships. Findings showed that unskilled delivery was significantly higher among women who married before age 15 (67.2%) and at ages 16-17 (48.2%) compared to those who married at age 18+ (30.2%). The prevalence of high-risk birth was higher among women who married before age 15 (97.2%) and at ages 16-17 (80.8%) compared to those who married at 18+ (48.4%). Inferential analysis showed that respondents who married before age 15 and at ages 16-17, respectively, had five-fold and two-fold higher odds of experiencing unskilled delivery compared to those who married at age 18 +. Odds of having high-risk births were significantly higher among child-brides compared to those who had first marriage as adults. This study concludes that policies/programs that would successfully delay first marriage among women must be pursued to reduce high-risk births and unskilled delivery in SSA.

Keywords: Child marriage; high-risk births; institutional delivery; sub-Saharan Africa; young women.

MeSH terms

  • Adolescent
  • Adult
  • Africa South of the Sahara / epidemiology
  • Female
  • Humans
  • Marriage*
  • Parturition*
  • Pregnancy
  • Prevalence