How Much Education Is Needed to Delay Women's Age at Marriage and First Pregnancy

Bibliographic Data

ID22084685
AuthorsAkanksha Marphatia (0000-0002-4277-435X, University of Cambridge, corresponding author), N Saville (0000-0002-1735-3684, University College London), Gabriel S Amable (University of Cambridge), D S Manandhar (0000-0001-8699-6774, Mother and Infant Research Activities), Mario Cortina-Borja, Mario Cortina‐borja (0000-0003-0627-2624, Great Ormond Street Hospital), J Wells (0000-0003-0411-8025, Great Ormond Street Hospital), Jonathan C Wells, A Reid (0000-0003-4713-2951, University of Cambridge), Alice M Reid
Year2020
Volume7
Pages396-396
Publication date2020-01-09
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2019.00396
PMID31993411
OpenAlexW2999540133
LanguageEN
Citations received27
References cited33

Background: Early childbirth is associated with adverse maternal and child health outcomes. In South Asia, where women generally marry before having children, public health efforts need to focus on delaying marriage. Female education is widely considered the primary means to achieve this. However, it remains unclear how much education is required to delay marriage to the universal minimum age of 18 years, or what predicts marriage age in women lacking any education. This is crucial to address in the Terai region of Nepal which has the highest proportion of children out of school and where girls marry and have their first pregnancy early. Methods: We analysed data from 6,406 women aged 23-30 years from a cluster-randomised trial in lowland Terai Nepal. Using Kaplan-Meier survival analysis, multivariable logistic and Cox proportional hazards regression models, we investigated associations between women’s education level and age at marriage and first pregnancy, and the interval between these events. Among the uneducated women, we investigated associations of husband’s education level with the same outcomes. Results: Compared to uneducated women, educated women had a greater probability of delaying marriage until the age of 18 years and of pregnancy until 20 years. Women needed to complete grade 9, and ideally 11, to substantially increase their odds of marrying after 18 years. Delaying first pregnancy to 20 years was largely due to marrying later; education had little extra effect. The association of marriage with first pregnancy age worked independently of education. However, later-marrying women, who generally had completed more education, had their first pregnancy sooner after marriage than earlier marrying women. Most uneducated women, regardless of their husbands' level of education, still married under the legal age of marriage. Conclusion: Delaying marriage to majority age requires greater efforts to ensure girls get to school in the first place, and complete secondary education. Since currently only 36% of girls in the Terai attend secondary school, parallel efforts to delay marriage are crucial to prevent early childbearing. Sexual and reproductive health programmes in school and in women’s groups for married and uneducated adolescents may help prepare for marriage and pregnancy

Age at first marriage · Child marriage · Childbirth · Environmental health · Fertility · Logistic regression · Odds ratio · Population · Pregnancy · Demographic Trends and Gender Preferences · Demography · Global Maternal and Child Health · Medicine · Poverty, Education, and Child Welfare