Suchergebnisse

AbstractWomen's engagement in the decision to use contraception, an indicator captured in the Demographic and Health Surveys (DHS), is frequently used to assess women's reproductive agency. In 2014, DHS added a corollary question to the women's questionnaire on decision‐making not to use contraception. Study authors hypothesize that women's engagement in decision‐making not to use contraception is also indicative of reproductive agency. Analyzing DHS microdata from 30 countries collected between 2015 and 2020 (n = 292,141), this country‐level study examines data quality in terms of missingness of data (t‐tests), indicator utility in terms of response pattern variability (descriptive statistics), and construct validity in terms of associations between engagement in the decision not to use contraception and engagement in household decision‐making (multivariable linear regression). Findings indicate the measure is of good quality, provides nuanced insight, and has construct validity. Importantly, the new measure deepens our understanding of women's reproductive agency.

BACKGROUND: Adolescent participation in pro-social activities such as sport can promote identity formation, self-efficacy and social support, but its benefits in India remain unassessed. We examined longitudinal effects of adolescent sport participation on economic, social and political engagement, marital health and family planning among young adults in India. METHODS: We analyzed prospective data from unmarried adolescents (n = 2,322, ages 15–19) who participated in the Youth in India 2007–8 study (wave 1) and were followed in the UDAYA study 2015–16 (wave 2), in Bihar, India. Sport participation was assessed in wave 1. Outcomes assessed in wave 2 were economic engagement (vocational training, past year paid employment), social group participation, political participation, marriage (any and prior to 18), and among those married, marital violence [MV] and contraceptive use. We used logistic and multinomial models to assess longitudinal associations between sport and our outcomes, adjusting for age, residence and wealth at baseline and secondary schooling completion at follow-up. RESULTS: In multivariate models for males, adolescent sport participation was associated with higher odds of vocational training [AOR: 1.92, 95% CI: 1.17, 3.15], social program engagement [AOR: 1.89, 95% CI: 1.14, 3.15], and a trend effect for political participation [AOR: 1.47, 95% CI: 0.97, 2.24]. Among females, sport in adolescence was associated with lower child marriage [ARRR = 0.67, 95% CI: 0.48, 0.96], and higher vocational training [AOR = 1.28, 95% CI: 1.03, 1.16] and family planning use [AOR = 1.31, 95% CI: 1.05, 1.63]. Crude effects were noted for delayed marriage, paid work and perpetration of marital violence among males. INTERPRETATION: Evidence from India shows that sport can be an instrument supporting pro-social engagement for boys and girls. Further understanding of the gendered nature of sport and the mechanisms linking sport to agency among youth is needed. FUNDING: This work was supported by the David and Lucile ...

Over the past few years the issue of child marriage has received growing political and programmatic attention. In spite of some progress in a number of countries, global rates have not declined over the past decade. Knowledge gaps remain in understanding trends, drivers and approaches to ending child marriage, especially to understand what is needed to achieve results on a large scale. This commentary summarizes the outcomes of an Expert Group Meeting organized by World Health Organization to discuss research priorities on Ending Child Marriage and Supporting Married Girls. It presents research gaps and recommends priorities for research in five key areas; (i) prevalence and trends of child marriage; (ii) causes of child marriage (iii) consequences of child marriage; (iv) efforts to prevent child marriage; (v) efforts to support married girls.

AbstractResearch on the association between experiences of intimate partner violence (IPV) and contraceptive use discontinuation in low‐ and middle‐income countries (LMICs) is limited. This study aims to fill this important gap using microdata collected from women aged 15–49 in the 2015–2016 National Family Health Survey (NFHS). Analyses used multivariable multinomial logistic regressions stratified by long‐acting reversible contraceptive methods (LARC)/non‐LARC and condom/pill to examine the association between experience of IPV and contraceptive use discontinuation while still in need (DWSIN). Experience of physical violence was associated with DWSIN among LARC/IUD users (RRR: 3.73, 95 percent CI [1.55–8.95]) Among condom users, DWSIN was higher among women who experienced emotional violence compared with women who did not experience any violence (RRR: 4.16, 95 percent CI [1.59–10.90]). Although we did not find an association between IPV and overall contraceptive use discontinuation, we did find compelling evidence of an association between IPV and IUD and condom use discontinuation in India. There is a need to understand women's experience of IPV as a part of a broader strategy to provide high‐quality family planning services to all women while considering individual circumstances and reproductive aspirations to support the uninterrupted use of contraception in India.

Objectives. We examined associations between premigration political violence exposure and past-year intimate partner violence (IPV) perpetration among immigrant men attending community health centers in Boston.

Abstract
Background
Studies from many contexts indicate that proximity to conflict is associated with increased likelihood of intimate partner violence (IPV), and girl child marriage is associated with both proximity to conflict and increased IPV. In this study, we consider whether girl child marriage acts as a mediator of the association between proximity to conflict and IPV in the context of Sri Lanka, which sustained long-term conflict until 2009.

Methods
We analyzed responses of currently partnered women between ages 18 and 49 in the 2016 Sri Lankan Demographic and Health Survey (N = 13,691). Using logistic regression analyses, we measured associations between proximity to conflict (residence in districts which were central, proximal, or distal to the regions where the war occurred) and the outcomes of IPV and girl child marriage, and secondarily assessed girl child marriage as a possible mediator of the association between proximity to conflict and past year IPV.

Results
Women residing in districts central to conflict, as compared to districts distal to conflict, had increased odds of past year sexual, physical, and emotional IPV, with the odds of sexual IPV increasing the most (adjusted odds ratio/aOR 4.19, 95% confidence interval/CI 2.08–8.41). Residing in districts proximal to conflict compared to those distal to conflict was associated with lower odds of past year physical and emotional IPV, with the greatest decrease in emotional IPV (aOR 0.31, CI 0.18–0.54). Girl child marriage was more likely in districts central to conflict as opposed to those distal to conflict (aOR 1.89, CI 1.22–2.93), and partially mediated the relationship between centrality to conflict and IPV.

Conclusions
Our findings demonstrate that residing in districts central to conflict compared to those distal to conflict is associated with greater odds of IPV and girl child marriage in post-conflict Sri Lanka, with girl child marriage partially mediating the association between centrality to conflict and IPV. Residence in districts proximal to conflict appears protective against IPV. Future research should investigate what factors are responsible for decreased IPV in districts proximal to violence, and whether these factors can be reproduced to mitigate the increased prevalence of IPV in districts central to conflict.

AbstractPrevious research on sex ratio at birth (SRB) in India has largely relied on macro‐analysis of census data that do not contain the breadth of factors needed to explain patterns in SRB. Additionally, no previous research has examined the differentiation of factors associated with SRB across birth orders, a key determinant in societies affected by son preference. This study aims to fill these gaps using micro‐data related to 553,461 births occurring between 2005 and 2016 collected as part of the 2015–2016 National Family Health Survey. Analyses used multivariable logistic regressions stratified by birth order to examine associations with SRB at the national level. The SRB at birth order 1 was outside the biological normal limit, and generally increased with birth order. First births in households with wealth in the middle and richest quintiles, with mothers who desired a higher ideal number of sons than daughters, and in lower fertility communities had a higher probability of being male. Most SRB correlates were visible at birth orders 3 or higher. Programs and policies designed to address India's male‐skewed SRB must consider the diverse factors that influence SRB, particularly for higher order births.