Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys
Objective To examine incidence of child marriage among displaced and host populations in humanitarian settings.Design Cross-sectional surveys.Setting Data were collected in Djibouti, Yemen, Lebanon and Iraq in the Middle East and in Bangladesh and Nepal in South Asia.Participants Adolescent girls ag...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/6/e070056.full |
| _version_ | 1797748807168950272 |
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| author | Ligia Paina Gayane Yenokyan Bothaina Attal Anand Tamang Courtland Robinson Shatha Elnakib Rumana Akter Ghada Khoury Loqman Karim Hemeda Houssein Barkat Janna Metzler |
| author_facet | Ligia Paina Gayane Yenokyan Bothaina Attal Anand Tamang Courtland Robinson Shatha Elnakib Rumana Akter Ghada Khoury Loqman Karim Hemeda Houssein Barkat Janna Metzler |
| author_sort | Ligia Paina |
| collection | DOAJ |
| description | Objective To examine incidence of child marriage among displaced and host populations in humanitarian settings.Design Cross-sectional surveys.Setting Data were collected in Djibouti, Yemen, Lebanon and Iraq in the Middle East and in Bangladesh and Nepal in South Asia.Participants Adolescent girls aged 10–19 in the six settings and age cohort comparators.Outcome measures Cumulative incidence of marriage by age 18.Results In Bangladesh and Iraq, the hazard of child marriage did not differ between internally displaced populations (IDPs) and hosts (p value=0.25 and 0.081, respectively). In Yemen, IDPs had a higher hazard of child marriage compared with hosts (p value<0.001). In Djibouti, refugees had a lower hazard of child marriage compared with hosts (p value<0.001). In pooled data, the average hazard of child marriage was significantly higher among displaced compared with host populations (adjusted HR (aHR) 1.3; 95% CI 1.04 to 1.61).In age cohort comparisons, there was no significant difference between child marriage hazard across age cohorts in Bangladesh (p value=0.446), while in Lebanon and Nepal, younger cohorts were less likely to transition to child marriage compared with older comparators (p value<0.001). Only in Yemen were younger cohorts more likely to transition to child marriage, indicating an increase in child marriage rates after conflict (p value=0.034). Pooled data showed a downward trend, where younger age cohorts had, on average, a lower hazard of child marriage compared with older cohorts (aHR 0.36; 95% CI 0.29 to 0.4).Conclusions We did not find conclusive evidence that humanitarian crises are associated with universal increases in child marriage rates. Our findings indicate that decision-making about investments in child marriage prevention and response must be attuned to the local context and grounded in data on past and current trends in child marriage among communities impacted by crisis. |
| first_indexed | 2024-03-12T16:11:08Z |
| format | Article |
| id | doaj.art-137775eb89144a8a96526d62d7433b8b |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-12T16:11:08Z |
| publishDate | 2023-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-137775eb89144a8a96526d62d7433b8b2023-08-09T13:40:08ZengBMJ Publishing GroupBMJ Open2044-60552023-06-0113610.1136/bmjopen-2022-070056Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveysLigia Paina0Gayane Yenokyan1Bothaina Attal2Anand Tamang3Courtland Robinson4Shatha Elnakib5Rumana Akter6Ghada Khoury7Loqman Karim8Hemeda Houssein Barkat9Janna Metzler10International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USADepartment of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USACentre for Business Research, Cambridge Judge Business School, Cambridge, UKCenter for Research on Environment Health and Population Activities, Kathmandu, NepalDepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USADepartment of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USACommunity Partners International, Cox`s Bazar, BangladeshSchool of Pharmacy, Lebanese American University, Byblos, LebanonUniversity of Sulaimani, Irbil, Northern IraqGender Observatory, Ministry of Women and Family, Djibouti City, DjiboutiWomen’s Refugee Commission, New York, New York, USAObjective To examine incidence of child marriage among displaced and host populations in humanitarian settings.Design Cross-sectional surveys.Setting Data were collected in Djibouti, Yemen, Lebanon and Iraq in the Middle East and in Bangladesh and Nepal in South Asia.Participants Adolescent girls aged 10–19 in the six settings and age cohort comparators.Outcome measures Cumulative incidence of marriage by age 18.Results In Bangladesh and Iraq, the hazard of child marriage did not differ between internally displaced populations (IDPs) and hosts (p value=0.25 and 0.081, respectively). In Yemen, IDPs had a higher hazard of child marriage compared with hosts (p value<0.001). In Djibouti, refugees had a lower hazard of child marriage compared with hosts (p value<0.001). In pooled data, the average hazard of child marriage was significantly higher among displaced compared with host populations (adjusted HR (aHR) 1.3; 95% CI 1.04 to 1.61).In age cohort comparisons, there was no significant difference between child marriage hazard across age cohorts in Bangladesh (p value=0.446), while in Lebanon and Nepal, younger cohorts were less likely to transition to child marriage compared with older comparators (p value<0.001). Only in Yemen were younger cohorts more likely to transition to child marriage, indicating an increase in child marriage rates after conflict (p value=0.034). Pooled data showed a downward trend, where younger age cohorts had, on average, a lower hazard of child marriage compared with older cohorts (aHR 0.36; 95% CI 0.29 to 0.4).Conclusions We did not find conclusive evidence that humanitarian crises are associated with universal increases in child marriage rates. Our findings indicate that decision-making about investments in child marriage prevention and response must be attuned to the local context and grounded in data on past and current trends in child marriage among communities impacted by crisis.https://bmjopen.bmj.com/content/13/6/e070056.full |
| spellingShingle | Ligia Paina Gayane Yenokyan Bothaina Attal Anand Tamang Courtland Robinson Shatha Elnakib Rumana Akter Ghada Khoury Loqman Karim Hemeda Houssein Barkat Janna Metzler Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys BMJ Open |
| title | Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys |
| title_full | Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys |
| title_fullStr | Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys |
| title_full_unstemmed | Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys |
| title_short | Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys |
| title_sort | incidence of child marriage among refugees and internally displaced persons in the middle east and south asia evidence from six cross sectional surveys |
| url | https://bmjopen.bmj.com/content/13/6/e070056.full |
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