Mapping the patchwork: Exploring the subnational heterogeneity of child marriage in India.

Despite dramatic reductions in child marriage over the past decade, more than one in four girls in India still marry before reaching age 18. This practice is driven by a complex interplay of social and normative beliefs and values that are inadequately represented in national- or even state-level analyses of the drivers of child marriage. A geographic lens was employed to assess variations in child marriage prevalence across Indian districts, identify hot and cold spots, and quantify spatial dependence and heterogeneity in factors associated with district levels of child marriage. Data were derived from the 2015-16 National Family Health Survey and the 2011 India Census, and represent 636 districts in total. Analyses included global Moran's I, LISAs, spatial Durbin regression and geographically weighted regression. This study finds wide inter- and intra-state heterogeneity in levels of child marriage across India. District levels of child marriage were strongly influenced by geographic characteristics, and even more so by the geographic characteristics of neighboring districts. Districts with higher levels of female mobile phone access and newspaper use had lower levels of child marriage. These relationships, however, were all subject to substantial local spatial heterogeneity. The results indicate that characteristics of neighboring districts, as well as characteristics of a district itself, are important in explaining levels of child marriage, and that those relationships are not constant across India. Child marriage reduction programs that are targeted within specific administrative boundaries may thus be undermined by geographic delineations that do not necessarily reflect the independent and interdependent characteristics of the communities who live therein. The geographic, social and normative characteristics of local communities are key considerations in future child marriage programs and policies.

Associations between village-level norms on marital age and marital choice outcomes among adolescent wives in rural Niger.

Social norms, the often unspoken rules that dictate behavior, are increasingly understood to play a role in child, early and forced marriage (CEFM) practices, but are less frequently examined in quantitative research on CEFM. No research on this topic has focused on Niger, despite the country having the highest prevalence of child marriage in the world. This study examines the associations of community and individual-level norms on marital age and marital choice with the outcomes of girls' age at marriage and choice in marriage. We used data from a family planning evaluation trial conducted in three districts within the Dosso region of Niger. Survey data were collected from adolescent wives and their husbands (N = 582) on demographics, normative beliefs regarding girls' age at marriage and marital choice, and among wives, age at marriage and engagement in marital choice. We developed our community-level norm variables by using the aggregate data from husbands' and wives' norms and wives' CEFM experiences. Using crude and adjusted regression models, we assessed the associations between our norms variables and our CEFM outcomes. In this context of very high prevalence of CEFM, we found that village-level norms related to marital choice, particularly the norms of men, are associated with younger age of girls at marriage. We also found that younger age of girls at marriage is positively associated with lower likelihood of their engagement in marital choice. Further, we find that village-level norms related to a later age of marriage and support for marital choice, as well as adolescent wives' perceptions of community norms related to a higher age of marriage, are associated with higher odds of a wife having had marital choice. These findings suggest the value of community level social norms change on CEFM in Niger, and the importance of focusing on child marriage and girls' marital choice simultaneously given their interconnection.

Effects of Parent-Child Relationships on Child Marriage of Girls in Ethiopia, India, Peru, and Vietnam: Evidence From a Prospective Cohort.

PURPOSE: Parental influence over early marriage of girls is well-documented in qualitative research, but little quantitative work in this area has been conducted. This study assesses the effects of the parent-child relationship in early adolescence (aged 12 years) on early marriage of girls. METHODS: We analyzed survey data from a multicountry prospective cohort of girls (n = 1,648) followed over four rounds from age 8 to 19 years (2002-2013), as part of the Young Lives study in India, Ethiopia, Vietnam, and Peru. Multinomial logistic regression models assessed the effects of parent-child communication and parent-child relationship quality, as reported when girls were aged 12 years on child and early marriage (married <16 years, married 16-17 years, married 18-19 years, unmarried). Covariates were wealth, rural/urban residence, maternal education, parents' value of education, early menarche, and country. RESULTS: One in five girls (18.04%) reported marriage before 18 years of age, and 8.1% reported marrying before 16 years (8.3% and 13.7% in India and Ethiopia). Multinomial regression found that girls reporting good parent-child communication and high parent-child relationship quality at age 12 years were significantly less likely to marry before age 16 years (moderate relationship quality, adjusted relative risk ratio: .23, 95% confidence interval: .07-.72; high relationship quality, adjusted relative risk ratio: .34, 95% confidence interval: .11-.99). CONCLUSION: Parent-child relationship quality and communication in early adolescence are protective against very early marriage of girls cross-nationally, although communication may facilitate marriage soon on completion of school. Primary prevention interventions targeting child marriage may benefit from components focused on improving the parent-child relationship.

Conversation and compliance: role of interpersonal discussion and social norms in public communication campaigns.

This study explores the role of interpersonal discussion and social norms in a public health campaign, the BBC Condom Normalization Campaign, designed to promote conversation and change the public perception of condom use in India. Drawing upon the integrative model of behavioral prediction, attitudes, self-efficacy, subjective norms, and descriptive norms were predicted to relate to behavioral intentions to use condoms. It is important to note that the valence of discussion was hypothesized to relate to each of these more proximal predictors. The authors used structural equation modeling to test the model on 3 separate samples of Indian men between the ages of 15 and 49 years: (a) high-risk men who had sex with nonspouses; (b) low-risk, sexually inactive, unmarried men; and (c) low-risk, monogamous, married men. Results were similar for low- and high-risk audiences, with valence of discussion about condoms predicting condom-related attitudes, self-efficacy, and subjective and descriptive social norms with respect to condom use, which, in turn, predicted behavioral intent to use condoms. These findings underscore the need to take not only the frequency but also the valence of interpersonal discussion into account when assessing the effect of health campaigns. Implications for theory and design of future public communication campaigns are explored.