Centre for the Study of Regional Development, School of Social Sciences, Jawaharlal Nehru University, New Delhi 110067, India.
Department of Geography, University of Gour Banga, Malda 732103, West Bengal, India.
Midwifery. 2019 Aug;75:66-71. doi: 10.1016/j.midw.2019.04.007. Epub 2019 Apr 18.
In an effort to improve utilization of maternal health care services, age at marriage of girls has gain very little attention by the policy maker and programmer. Studies have indicated that child marriage has serious negative consequences on maternal health. Moreover, there is a paucity of research on explaining the links between child marriage and maternal health care utilization. In this study, we aimed to examine the association between child marriage and utilization of maternal health care services using nationally representative sample survey of India.
Cross-sectional observational study.
India.
A total number of 190,898 ever-married women who had at least one live birth during the last five years preceding the survey from the 2015 to 2016 National Family Health Survey (NFHS) were utilized.
Outcome measures: At least four antenatal visits (ANC), ANC visit within first trimester, institutional delivery, delivery by skilled health personnel, and postnatal care (PNC) within 42 days of delivery. Predictor variable: Child marriage. Control variables: Socio-economic and demographic characteristics of women. Bivariate and multivariate analyses were performed for the analyses of the study data.
The results of our study revealed that women who married at <18 years were significantly less likely to use maternal health care services than those married at ≥18 years even after accounting for socio-economic and demographic characteristics of women. Furthermore, nuanced analysis revealed that the odds of maternity care services is much lower for those women who married at ≤14 years compared with later married groups.
The findings of our study suggest that efforts should be made to increase age at marriage of girls which could have positive impact on utilization of maternal health care services. Moreover, targeted intervention is needed to improve the utilization of maternity care especially among socio-economically vulnerable women.
为了提高孕产妇保健服务的利用率，决策者和规划者几乎没有关注女孩的初婚年龄。研究表明，童婚对产妇健康有严重的负面影响。此外，关于童婚与孕产妇保健服务利用之间联系的研究很少。本研究旨在利用印度具有全国代表性的抽样调查，研究童婚与孕产妇保健服务利用之间的关系。
横断面观察性研究。
印度。
利用了 2015-2016 年全国家庭健康调查（NFHS）中至少有一名在调查前五年内活产的、曾有过婚姻经历的 190898 名已婚妇女。
结局指标：至少进行了 4 次产前检查（ANC）、在妊娠早期进行 ANC 检查、在医疗机构分娩、由熟练的卫生人员分娩以及在分娩后 42 天内进行产后护理（PNC）。预测变量：童婚。控制变量：妇女的社会经济和人口特征。对研究数据进行了单变量和多变量分析。
本研究结果表明，即使考虑到妇女的社会经济和人口特征，与 18 岁及以上结婚的妇女相比，18 岁以下结婚的妇女使用孕产妇保健服务的可能性显著降低。此外，细致的分析表明，与较晚结婚的组相比，14 岁及以下结婚的妇女获得产妇保健服务的可能性要低得多。
本研究结果表明，应努力提高女孩的初婚年龄，这可能对孕产妇保健服务的利用产生积极影响。此外，需要有针对性的干预措施来提高孕产妇保健服务的利用率，特别是在社会经济弱势群体中。
