How Much Education Is Needed to Delay Women's Age at Marriage and First Pregnancy?
Saville, Naomi M
Manandhar, Dharma S
Wells, Jonathan C
Frontiers in public health
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Marphatia, A., Saville, N. M., Amable, G., Manandhar, D. S., Cortina-Borja, M., Wells, J. C., & Reid, A. (2019). How Much Education Is Needed to Delay Women's Age at Marriage and First Pregnancy?. Frontiers in public health, 7 396. https://doi.org/10.3389/fpubh.2019.00396
Abstract 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.
This analysis builds directly on AM’s Ph.D thesis, which was fully funded by the Economic and Social Research Council (ESRC) Doctoral Training Centre, University of Cambridge. It is part of a project investigating the predictors and consequences of variability in women’s marriage age in lowland Nepal funded by the Leverhulme Trust. Data for this analysis comes from the LBWSAT, which was funded by the Department for International Development (DFID) South Asian Research Hub.
External DOI: https://doi.org/10.3389/fpubh.2019.00396
This record's URL: https://www.repository.cam.ac.uk/handle/1810/300869
Attribution 4.0 International (CC BY)
Licence URL: http://creativecommons.org/licenses/by/4.0/