United Nations University--International Institute of Global Health (UNU-IIGH), Kuala Lumpur, Malaysia.
Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
J Adolesc Health. 2021 May;68(5):847-862. doi: 10.1016/j.jadohealth.2020.11.017. Epub 2021 Jan 12.
This review assesses evaluations published from 2000 to 2019 to shed light on what approaches work, especially at scale and sustainably, to prevent child marriage in low- and middle-income countries.
We conducted a search of electronic databases and gray literature and evaluated the methodological quality and risk of bias of included studies.
A total of 30 studies met the inclusion criteria. Interventions that support girls' schooling through cash or in-kind transfers show the clearest pattern of success in preventing child marriage, with 8 of 10 medium-high quality studies showing positive results. Although limited in number, five studies on favorable job markets and targeted life skills and livelihoods training show consistent positive results. Comparatively, asset or cash transfers conditional on delaying marriage show success only among two of four evaluations, and the three studies on unconditional cash transfers for poverty mitigation show no effect. Findings also show a low success rate for multicomponent interventions with positive results in only one of eight medium-high quality studies. Further, single component interventions were much more likely to be at scale and sustainable than multicomponent interventions.
These results indicate that enhancement of girls' own human capital and opportunities is the most compelling pathway to delaying marriage. In contrast, low rates of success, scale-up, and sustainability of multicomponent programs requires reconsideration of this approach.
本综述评估了 2000 年至 2019 年发表的评估报告,旨在阐明哪些方法在低中等收入国家具有可扩展性和可持续性,从而有效预防童婚。
我们对电子数据库和灰色文献进行了检索,并评估了纳入研究的方法学质量和偏倚风险。
共有 30 项研究符合纳入标准。通过现金或实物转移支持女孩接受教育的干预措施在预防童婚方面显示出最明确的成功模式,10 项中等高质量研究中有 8 项显示出积极的结果。尽管数量有限,但五项关于有利就业市场和针对性生活技能和生计培训的研究显示出一致的积极结果。相比之下,有条件的婚姻延迟资产或现金转移在四项评估中仅有两项成功,三项用于减轻贫困的无条件现金转移研究则没有效果。研究结果还表明,多组分干预措施的成功率较低,只有一项中等高质量的研究显示出积极的结果。此外,单一成分干预措施比多成分干预措施更有可能达到规模和可持续性。
这些结果表明,增强女孩自身的人力资本和机会是延迟婚姻的最有力途径。相比之下,多组分方案成功率低、规模扩大和可持续性要求需要重新考虑这种方法。