Description
Abstract
Background Although both marriage and childbearing are potentially influenced by humanitarian emergencies, and for many individuals are intrinsically linked life-course events, they are rarely explored together in the literature on humanitarian emergencies. Early marriage and early childbearing have important implications for health that can be exacerbated in contexts of forced migration. Objective To understand how trajectories of family formation for adolescent females and males have been affected by mass displacement. We compare time to first marriage and time to first birth following marriage between age cohorts of 15-19 and 20-24 year-old female and male Forcibly Displaced Myanmar Nationals and between host and internally displaced persons in Yemen. Methods We use data from 1,565 females and 722 males aged 15-24, collected within fifteen camps in Cox’s Bazaar, to estimate hazard of first marriage and of child marriage and data from 643 married females to estimate hazard from marriage to first birth. Additionally, we use data from 1773 IDPs and host females living in three governorates in Yemen, and data form 999 married females. Results Females aged 20-24 in Bangladesh had a 31% increased hazard of marriage overall and 42% increased hazard of child marriage relative to females aged 15-19 (95% CI: 1.07-1.87) and an 84% higher incidence rate (95% CI: 1.46-2.33). For males, there was a higher hazard of marriage by age 25 amongst males aged 20-24 relative to age 15-19 (HR: 1.80, 95% CI: 1.10-2.94), but no statistically significant difference in the hazard of marriage by age 18. Approximately 20% of females gave birth within a year of marriage and 70-75% within three years post-marriage, across age cohort and age at marriage. There were no statistically significant differences in hazard of first birth by either age cohort or age at marriage. Among Yemenis, those who are displaced had 30% higher hazard of overall marriage compared to their host counterparts (HR: 1.30, 95% CI: 1.15 – 1.48), and 26% increased hazard of child marriage (HR: 1.26, 95% CI 1.02 – 1.56). Child brides experienced a 17% lower hazard of first birth (HR 95% CI 0.74 – 0.94). Moreover, the hazard of first birth was higher among IDPs compared to hosts, with IDPs experiencing 15% higher hazard (95%CI 1.01 – 1.31). Discussion Displacement may have increased risk of child marriage for adolescents. Displacement did not affect time to childbirth following marriage in Bangladesh because rates were overall high in both groups, but it was a significant factor in Yemen. Efforts to reduce child marriage and adolescent child marriage must address limited opportunities for adolescents in situations of displacement.
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