Centre for International Education (CIE), University of Sussex, Brighton, UK.
Centre for International Education (CIE), University of Sussex, Brighton, UK.
Ann Glob Health. 2017 May-Aug;83(3-4):557-567. doi: 10.1016/j.aogh.2017.10.005. Epub 2017 Nov 8.
Age of marriage is a barrier to mother's health care around pregnancy and children health outcomes.
We provide evidence on the health benefits of postponing early marriage among young wives (from age 10-14 to age 15-17) on women's health care and children's health for sub-Saharan Africa (SSA) and Southwest Asia (SWA).
We use data for 39 countries from the Demographic and Health Surveys to estimate the effects of postponing early marriage for women's health care and children's health outcomes and immunization using matching techniques. We also assess whether women's health empowerment and health constraints are additional barriers.
We found that in SSA, delaying the age of marriage from age 10-14 to age 15-17 and from age 15-17 to age 18 or older leads to an increase in maternal neotetanus vaccinations of 2.4% and 3.2%, respectively; gains in the likelihood of postnatal checks are larger for delayed marriage among the youngest wives (aged 10-14). In SWA, the number of antenatal visits increases by 34% and the likelihood of having a skilled birth attendant goes up to 4.1% if young wives postpone marriage. In SSA, the probability of children receiving basic vaccinations is twice as large and their neonatal mortality reduction is nearly double if their mothers married between ages 15-17 instead of at ages 10-14. The extent of these benefits is also shaped by supply constraints and cultural factors. For instance, we found that weak bargaining power on health decisions for young wives leads to 11% fewer antenatal visits (SWA) and 13% less chance of attending postnatal checks (SSA).
Delaying age of marriage among young wives can lead to considerable gains in health care utilization and children health in SSA and SWA if supported by policies that lessen supply constraints and raise women's health empowerment.
结婚年龄是影响孕产妇保健和儿童健康结局的一个障碍。
我们为撒哈拉以南非洲(SSA)和西南亚(SWA)的年轻妻子(从 10-14 岁推迟到 15-17 岁,再推迟到 18 岁或以上)提供关于推迟早婚对妇女保健和儿童健康以及免疫的健康益处的证据。
我们使用来自人口与健康调查的 39 个国家的数据,使用匹配技术估计推迟早婚对妇女保健和儿童健康结果和免疫的影响。我们还评估了妇女健康赋权和健康约束是否是额外的障碍。
我们发现,在 SSA,将结婚年龄从 10-14 岁推迟到 15-17 岁,再推迟到 18 岁或以上,分别使母亲接受新生儿破伤风疫苗接种的比例增加 2.4%和 3.2%;对于最年轻的妻子(10-14 岁),推迟婚姻的情况下,产后检查的可能性增加更大。在 SWA,如果年轻妻子推迟婚姻,产前检查次数增加 34%,有熟练接生员的可能性增加 4.1%。在 SSA,如果母亲在 15-17 岁而不是 10-14 岁结婚,儿童接受基本疫苗接种的概率增加一倍,新生儿死亡率降低近一倍。这些益处的程度也受到供应约束和文化因素的影响。例如,我们发现,年轻妻子在健康决策方面的议价能力较弱,导致产前检查次数减少 11%(SWA)和产后检查次数减少 13%(SSA)。
如果政策能够减轻供应约束并提高妇女健康赋权,那么在 SSA 和 SWA 中,推迟年轻妻子的结婚年龄可以带来相当大的收益,改善孕产妇保健和儿童健康。