International Food Policy Research Institute, Washington, DC.
International Food Policy Research Institute, Delhi, India.
Ann N Y Acad Sci. 2021 May;1491(1):60-73. doi: 10.1111/nyas.14531. Epub 2020 Dec 1.
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.
早婚（EM）和早育（ECB）会产生深远的影响。本研究使用 13 年间 8 轮人口与健康调查数据，描述了南亚早婚和早育的流行率、趋势、不平等和驱动因素。我们报告了 18 岁以下结婚的 20-24 岁已婚妇女比例（n=105150）和 20 岁以下生育的比例（ECB）。通过平均年减少率（AARR）来检查相对趋势。通过地理、婚姻家庭财富、居住地和教育程度来检查不平等。使用回归分解分析评估 EM 变化的社会人口学驱动因素。我们发现，孟加拉国（69%/69%）、尼泊尔（52%/51%）、印度（41%/39%）和巴基斯坦（37%/38%）仍然普遍存在早婚/早育现象，大多数国家的次国家差异很大。印度（AARR 为-3.8%/年）、巴基斯坦（-2.8%/年）和孟加拉国（-1.5%/年）的早婚率下降最快，但按照这些速度，早婚将无法在 2030 年前消除。公平性分析表明，贫穷、受教育程度低的农村妇女承受着不成比例的负担。回归分解分析表明，财富和教育的改善解释了印度（44%）到尼泊尔（96%）实际 EM 减少的 44%到 96%。需要跨多个部门进行投资，以了解和解决普遍存在的母婴健康的社会决定因素——早婚和早育问题。
