Department of Population and Health, University of Cape Coast, Cape Coast PMB TF0494, Ghana.
School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia.
Int J Environ Res Public Health. 2021 Apr 3;18(7):3754. doi: 10.3390/ijerph18073754.
Child marriage has a variety of undesirable consequences at the peril of women's health and autonomy. In this study, we examined the association between child marriage and sexual autonomy among women in sub-Saharan Africa. We utilised data from the most recent Demographic and Health Surveys conducted in 31 countries in sub-Saharan Africa between 2010 and 2019. A total of 218,578 women aged 20-49 were included in this study. Multivariable binary logistic regression models were used to show the association between child marriage and sexual autonomy. Crude odds ratio (cOR) and adjusted odds ratio (aOR) were used in presenting the results. The prevalence of child marriage and sexual autonomy was 44.51% and 83.35%, respectively. Compared to women who married at 18 years or above, those who married at less than 18 were less likely to have sexual autonomy, and this persisted after controlling for important covariates. In terms of the country-specific results, women who experienced child marriage were less likely to have sexual autonomy in Burundi, Congo DR, Nigeria, and Niger. With the covariates, lower odds of sexual autonomy were found among women with no formal education, those whose partners had no formal education, those who were not exposed to media, and non-working women. Child marriage was found to be associated with sexual autonomy. There is a need to strengthen policies and programmes such as compulsory basic education, poverty alleviation, and an increase in access to media that aim at reducing child marriage. These interventions will help to improve sexual autonomy among women, especially in this 21st century where individuals and organisations incessantly advocate for gender equality.
童婚对妇女的健康和自主权造成了各种不良后果。在这项研究中,我们考察了撒哈拉以南非洲地区童婚与妇女性行为自主权之间的关系。我们使用了 2010 年至 2019 年间在撒哈拉以南非洲 31 个国家进行的最新人口与健康调查的数据。这项研究共纳入了 218578 名 20 至 49 岁的妇女。采用多变量二项逻辑回归模型来显示童婚与性行为自主权之间的关联。使用未调整比值比 (cOR) 和调整比值比 (aOR) 来呈现结果。童婚和性行为自主权的流行率分别为 44.51%和 83.35%。与 18 岁及以上结婚的妇女相比,未满 18 岁结婚的妇女更不可能拥有性行为自主权,而在控制了重要的协变量后,这种情况仍然存在。就国家特定的结果而言,在布隆迪、刚果民主共和国、尼日利亚和尼日尔,经历过童婚的妇女更不可能拥有性行为自主权。在考虑了协变量后,发现没有接受过正规教育、其伴侣没有接受过正规教育、没有接触过媒体以及不工作的妇女,其性行为自主权的可能性较低。童婚与性行为自主权有关。需要加强政策和方案,如义务教育、扶贫和增加媒体接触,以减少童婚。这些干预措施将有助于提高妇女的性行为自主权,特别是在这个 21 世纪,个人和组织不断倡导性别平等。