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      Early marriage and early childbearing in South Asia: trends, inequalities, and drivers from 2005 to 2018

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          Abstract

          Early marriage (EM) and early childbearing (ECB) have far‐reaching consequences. This study describes the prevalence, trends, inequalities, and drivers of EM and ECB in South Asia using eight rounds of Demographic and Health Survey data across 13 years. We report the percentage of ever‐married women aged 20–24 years ( n = 105,150) married before 18 years (EM) and with a live birth before 20 years (ECB). Relative trends were examined using average annual rate of reduction (AARR). Inequalities were examined by geography, marital household wealth, residence, and education. Sociodemographic drivers of changes for EM were assessed using regression decomposition analyses. We find that EM/ECB are still common in Bangladesh (69%/69%), Nepal (52%/51%), India (41%/39%), and Pakistan (37%/38%), with large subnational variation in most countries. EM has declined fastest in India (AARR of –3.8%/year), Pakistan (–2.8%/year), and Bangladesh (–1.5%/year), but EM elimination by 2030 will not occur at these rates. Equity analyses show that poor, uneducated women in rural areas are disproportionately burdened. Regression decomposition analysis shows that improvements in wealth and education explained 44% (India) to 96% (Nepal) of the actual EM reduction. Investments across multiple sectors are required to understand and address EM and ECB, which are pervasive social determinants of maternal and child wellbeing.

          Abstract

          Early marriage (EM) and early childbearing (ECB) have far‐reaching consequences. This study describes the prevalence, trends, inequalities, and drivers of EM and ECB in South Asia using eight rounds of Demographic and Health Survey data across 13 years.

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          Most cited references31

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          The history, geography, and sociology of slums and the health problems of people who live in slums

          Massive slums have become major features of cities in many low-income and middle-income countries. Here, in the first in a Series of two papers, we discuss why slums are unhealthy places with especially high risks of infection and injury. We show that children are especially vulnerable, and that the combination of malnutrition and recurrent diarrhoea leads to stunted growth and longer-term effects on cognitive development. We find that the scientific literature on slum health is underdeveloped in comparison to urban health, and poverty and health. This shortcoming is important because health is affected by factors arising from the shared physical and social environment, which have effects beyond those of poverty alone. In the second paper we will consider what can be done to improve health and make recommendations for the development of slum health as a field of study.
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            The effect of maternal child marriage on morbidity and mortality of children under 5 in India: cross sectional study of a nationally representative sample

            Objective To assess associations between maternal child marriage (marriage before age 18) and morbidity and mortality of infants and children under 5 in India. Design Cross-sectional analyses of nationally representative household sample. Generalised estimating equation models constructed to assess associations. Adjusted models included maternal and child demographics and maternal body mass index as covariates. Setting India. Population Women aged 15-49 years (n=124 385); data collected in 2005-6 through National Family Health Survey-3. Data about child morbidity and mortality reported by participants. Analyses restricted to births in past five years reported by ever married women aged 15-24 years (n=19 302 births to 13 396 mothers). Main outcome measures In under 5s: mortality related infectious diseases in the past two weeks (acute respiratory infection, diarrhoea); malnutrition (stunting, wasting, underweight); infant (age <1 year) and child (1-5 years) mortality; low birth weight (<2500 kg). Results The majority of births (73%; 13 042/19 302) were to mothers married as minors. Although bivariate analyses showed significant associations between maternal child marriage and infant and child diarrhoea, malnutrition (stunted, wasted, underweight), low birth weight, and mortality, only stunting (adjusted odds ratio 1.22, 95% CI 1.12 to 1.33) and underweight (1.24, 1.14 to 1.36) remained significant in adjusted analyses. We noted no effect of maternal child marriage on health of boys versus girls. Conclusions The risk of malnutrition is higher in young children born to mothers married as minors than in those born to women married at a majority age. Further research should examine how early marriage affects food distribution and access for children in India.
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              Measures of health inequalities: part 2.

              This is the second part of a two part glossary on measures of health inequalities.
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                Author and article information

                Contributors
                samuel.scott@cgiar.org
                Journal
                Ann N Y Acad Sci
                Ann N Y Acad Sci
                10.1111/(ISSN)1749-6632
                NYAS
                Annals of the New York Academy of Sciences
                John Wiley and Sons Inc. (Hoboken )
                0077-8923
                1749-6632
                01 December 2020
                May 2021
                : 1491
                : 1 , Annals Reports ( doiID: 10.1111/nyas.v1491.1 )
                : 60-73
                Affiliations
                [ 1 ] International Food Policy Research Institute Washington DC
                [ 2 ] International Food Policy Research Institute Delhi India
                [ 3 ] Bill and Melinda Gates Foundation New Delhi India
                [ 4 ] Aga Khan University Karachi Pakistan
                [ 5 ] BRAC University Dhaka Bangladesh
                Author notes
                [*] [* ]Address for correspondence: Samuel Scott, International Food Policy Research Institute, Dev Prakash Shastri Marg, Pusa, New Delhi 110012, India. samuel.scott@ 123456cgiar.org

                Author information
                https://orcid.org/0000-0002-5564-0510
                https://orcid.org/0000-0003-3418-1674
                https://orcid.org/0000-0003-2977-0896
                https://orcid.org/0000-0003-0637-599X
                https://orcid.org/0000-0002-5197-8151
                https://orcid.org/0000-0001-5988-2894
                Article
                NYAS14531
                10.1111/nyas.14531
                8247060
                33258141
                00a6a2bd-7f2e-493c-b0d9-04e36c6f6518
                © 2020 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals LLC on behalf of New York Academy of Sciences

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 17 October 2020
                : 20 July 2020
                : 22 October 2020
                Page count
                Figures: 7, Tables: 2, Pages: 14, Words: 7006
                Funding
                Funded by: Agriculture for Nutrition and Health/IFPRI
                Categories
                Nyaspubl8657
                Nyasdeve3255
                Nyassoci9990
                Original Article
                Original Articles
                Custom metadata
                2.0
                May 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.2 mode:remove_FC converted:01.07.2021

                Uncategorized
                early marriage,early birth,south asia,women,inequalities
                Uncategorized
                early marriage, early birth, south asia, women, inequalities

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