1. Home
  2. Vol 26, No 12s (2022)
  3. Loutet

Sexual and reproductive health factors associated with child, early and forced marriage and partnerships among refugee youth in a humanitarian setting in Uganda: Mixed methods findings

Miranda G. Loutet(1), Carmen H. Logie(2), Moses Okumu(3), Isha Berry(4), Simon O. Lukone(5), Nelson Kisubi(6), Alyssa McAlpine(7), Simon Mwima(8), Peter Kyambadde(9),


(1) Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
(2) Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
(3) School of Social Work, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
(4) Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
(5) Uganda Refugee and Disaster Management Council, Yumbe, Uganda
(6) Uganda Refugee and Disaster Management Council, Yumbe, Uganda
(7) Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
(8) National AIDS Coordinating Program, Ugandan Ministry of Health, Kampala, Uganda
(9) Most at Risk Population Initiative (MARPI), Mulago Hospital, Kampala, Uganda
Corresponding Author

Abstract


Preventing early and forced marriage is a global priority, however, sexual and reproductive health (SRH) among youth remains understudied in humanitarian settings. This study examined child, early and forced marriage and partnership (CEFMP) among young refugees in Bidi Bidi refugee settlement, Uganda, and associations with SRH outcomes among young women. This mixedmethods study involved a qualitative phase with young (16-24 years) sexual violence survivors (n=58), elders (n=8) and healthcare providers (n=10), followed by a quantitative phase among refugee youth (16-24 years; n=120) during which sociodemographic and SRH data were collected. We examined SRH outcome differences by CEFMP using Fisher’s exact test. Qualitative data showed that CEFMP was a significant problem facing refugee young women driven by stigma, gender norms and poverty. Among youth refugee survey participants, nearly one-third (31.7%) experienced CEFMP (57.9% women, 42.1% men). Among women in CEFMP compared to those who were not, a significantly higher proportion reported forced pregnancy (50.0% vs. 18.4%, p-value=0.018), forced abortion (45.4% vs. 7.0%, p-value=0.002), and missed school due to sexual violence (94.7% vs. 63.0%, p-value=0.016). This study illustrates the need for innovative community-engaged interventions to end CEFMP in humanitarian contexts in order to achieve sexual and reproductive health and rights for youth. (Afr J Reprod Health 2022; 26[12s]: 66-77).

References


UNICEF. Child Marriage. https://data.unicef.org/topic/childprotection/child-marriage/. 2021.

United Nations High Commissioner for Human Rights.

Child, early and forced marriage in humanitarian

settings: Report of the United Nations High

Commissioner for Human Rights [Internet]. 2019.

Available from:

www.ohchr.org/EN/Issues/Women/WRGS/Pages/D

ocumentation.aspx.

Ahinkorah BO, Onayemi OM, Seidu AA, Awopegba OE and

Ajayi AI. Association Between Girl-child Marriage

and Intimate Partner Violence in Sub-Saharan

Africa: Insights From a Multicountry Analysis of

Demographic and Health Surveys. Journal of

Interpersonal Violence. 2021;37:15–6.

Petroni S, Steinhaus M, Fenn NS, Stoebenau K and

Gregowski A. New Findings on Child Marriage in

Sub-Saharan Africa. Annals of Global Health. 2017

Sep 1;83(5–6):781–90.

Global Affairs Canada. Child, early and forced marriage.

https://www.international.gc.ca/worldmonde/issues_developmentenjeux_developpement/human_rightsdroits_homme/child_marriagemariages_enfants.aspx?lang=eng. 2020.

Psaki SR, Melnikas AJ, Haque E, Saul G, Misunas C, Patel

SK, Ngo T and Amin S. What Are the Drivers of

Child Marriage? A Conceptual Framework to Guide

Policies and Programs. Journal of Adolescent Health.

Dec 1;69(6):S13–22.

Muthengi E, Olum R and Chandra-Mouli V. Context

Matters—One Size Does Not Fit All When

Designing Interventions to Prevent Child Marriage.

Vol. 69, Journal of Adolescent Health. Elsevier Inc.;

p. S1–3.

Kidman R. Child marriage and intimate partner violence: A

comparative study of 34 countries. International

Journal of Epidemiology. 2017;46(2):662–75.

McCleary-Sills J, Hanmer L, Parsons J and Klugman J. Child

Marriage: A Critical Barrier to Girls’ Schooling and

Gender Equality in Education. Review of Faith and

International Affairs. 2015 Jul 3;13(3):69–80.

Freccero J and Whiting A. Lessons from Research and

Practice in Development and Humanitarian Sectors.

Wodon Q, Male C, Nayihouba A, Onagoruwa A, Savadogo

A, Yedan A, Edmeades J, Kes A, John N, Murithi L,

Steinhaus M and Petroni S. Economic Impacts of

Child Marriage: Global Synthesis Report [Internet].

Available from:

www.costsofchildmarriage.org.

United Nations. Convention on the Elimination of All

Forms of Discrimination against Women: General

recommendation No. 30 on women in conflict

prevention, conflict and post-conflict situations.

Mlaba K. How Do Women and Girls Experience the Worst

of War? Global Citizen. [Internet]. 2022 Mar 23.

Available from:

https://www.globalcitizen.org/en/content/womenand-girls-impacts-war-conflict/.

Ivanova O, Rai M and Kemigisha E. A systematic review

of sexual and reproductive health knowledge,

experiences and access to services among refugee,

migrant and displaced girls and young women in

Africa. International Journal of Environmental

Research and Public Health. 2018;15(8):1583.

Svanemyr J, Chandra-Mouli V, Raj A, Travers E and

Sundaram L. Research priorities on ending child

marriage and supporting married girls. Reproductive

Health. 2015;12(1):1-4.

Logie CH, Okumu M, Lukone SO, Loutet M, McAlpine A,

Latif M, Berry I, Kisubi N, Mwima S, Kyambadde P,

Neema S, Small E, Balyejjusa SM and Musinguzi J.

Ngutulu Kagwero (agents of change): study design

of a participatory comic pilot study on sexual

violence prevention and post-rape clinical care with

refugee youth in a humanitarian setting in Uganda.

Glob Health Action. 2021;14(1):1940763.

Logie CH, Okumu M, Loutet M, Berry I, Lukone SO,

Kisubi N, Mwima S and Kyambadde P. Mixedmethods findings from the Ngutulu Kagwero (agents

of change) participatory comic pilot study on postrape clinical care and sexual violence prevention

with refugee youth in a humanitarian setting in

Uganda. Global Public Health. 2022:1–19.

Raj A, Saggurti N, Balaiah D and Silverman JG. Prevalence

of child marriage and its eff ect on fertility and

fertility-control outcomes of young women in India:

a cross-sectional, observational study. The Lancet.

;373:1883–9.

Raj A and Boehmer U. Girl Child Marriage and Its

Association With National Rates of HIV, Maternal

Health, and Infant Mortality Across 97 Countries.

Violence Against Women. 2013 Apr;19(4):536–51.

Avogo WA and Somefun OD. Early marriage, cohabitation,

and childbearing in West Africa. Journal of

Environmental and Public Health. 2019;2019:1–10.

Sah R, Gaurav K, Baral D, Subedi L, Jha N and Pokharel P.

Factors affecting Early Age Marriage in Dhankuta

Municipality, Nepal. Nepal Journal of Medical

Sciences. 2014;3(1):26-30.

Prakash R, Beattie TS, Javalkar P, Bhattacharjee P,

Ramanaik S, Thalinja R, Murthy S, Davey C, Gafos

M, Blanchard J, Watts C, Collumbien M, Moses S,

Heise L and Isac S. The Samata intervention to

increase secondary school completion and reduce

child marriage among adolescent girls: Results from

a clusterrandomised control trial in India. Journal of

Global Health. 2019;9(1):010430.

Glynn JR, Sunny BS, DeStavola B, Dube A, Chihana M,

Price AJ and Crampin AC. Early school failure

predicts teenage pregnancy and marriage: A large population-based cohort study in northern Malawi.

PLoS ONE. 2018;13(5):e0196041.

Jones N, Tefera B, Stephenson J, Gupta T, Pereznieto P,

Emire G, Gebre B and Gezhegne K. Early marriage

and education: the complex role of social norms in

shaping Ethiopian adolescent girls’ lives. Country

Report: Shaping policy for development. 2014

Sep:1-03.

Wodon Q, Nguyen MC and Tsimpo C. Child Marriage,

Education, and Agency in Uganda. Feminist

Economics. 2016;22(1):54–79.

Ahonsi B, Fuseini K, Nai D, Goldson E, Owusu S, Ndifuna

I, Humes I and Tapsoba PL. Child marriage in

Ghana: Evidence from a multi-method study. BMC

Women’s Health. 2019;19(126):1–15.

Kamilda MR, Nurhaeni IDA and Adriani RB.

Biopsychosocial Determinants of Early Marriage in

Wonogiri District, Central Java: A Logistic

Regression. Journal of Maternal and Child Health.

;4(3):170–9.

Shakya HB, Weeks J, Challa S, Fleming PJ, Cislaghi B,

McDougal L, Boyce SC, Raj A and Silverman JG.

Spatial analysis of individual-and village-level

sociodemographic characteristics associated with

age at marriage among married adolescents in rural

Niger. BMC Public Health. 2020;20(729):1–15.

Azeez AEP and Poonia A. Determinants, Attitudes and

Practices on Child Marriage: Evidences from Rural

Rajasthan. Social Work Chronicle. 2015;4(1and2).

Misunas C, Erulkar A, Apicella L, Ngô T and Psaki S. What

Influences Girls’ Age at Marriage in Burkina Faso

and Tanzania? Exploring the Contribution of

Individual, Household, and Community Level

Factors. Journal of Adolescent Health.

;69(6):S46–56.

Stark L. Early marriage and cultural constructions of

adulthood in two slums in Dar es Salaam. Culture,

Health and Sexuality. 2018;20(8):888–901.

Soler-Hampejsek E, Kangwana B, Austrian K, Amin S and

Psaki SR. Education, Child Marriage, and Work

Outcomes Among Young People in Rural Malawi.

Journal of Adolescent Health. 2021;69(6):S57–64.

Tomar S, Johns N, Challa S, Brooks MI, Aliou S, AbdoulMoumouni N, Raj A and Silverman J. Associations

of Age at Marriage With Marital Decision-Making

Agency Among Adolescent Wives in Rural Niger.

Journal of Adolescent Health. 2021;69(6):S74–80.

Schlecht J, Rowley E and Babirye J. Early relationships and

marriage in conflict and post-conflict settings:

Vulnerability of youth in Uganda. Reproductive

Health Matters. 2013;21(41):234–42.

Mourtada R, Schlecht J and Dejong J. A qualitative study

exploring child marriage practices among Syrian

conflict-affected populations in Lebanon. Conflict

and Health. 2017;11(Suppl 1):1–27.

UNICEF. Child marriage in humanitarian settings:

Spotlight on the situation in the Arab region

[Internet]. 2018 [cited 2022 Apr 2]. Available from:

https://www.girlsnotbrides.org/learningresources/resource-centre/child-marriage-inhumanitarian-settings-spotlight-on-the-situation-inthe-arab-region/#resource-downloads

Fonseka RW, McDougal L, Raj A, Reed E, Lundgren R,

Urada L and Silverman JG. A mediation analysis of

the role of girl child marriage in the relationship

between proximity to conflict and past-year intimate

partner violence in post-conflict Sri Lanka. Conflict

and Health. 2022;16(1):1–5.

Koski A, Clark S and Nandi A. Has Child Marriage

Declined in sub-Saharan Africa? An Analysis of

Trends in 31 Countries. Population and Development

Review. 2017;43(1):7–29


Full Text: PDF

Article Metrics

Abstract View : 626 times
PDF Download : 307 times

Refbacks

  • There are currently no refbacks.