Abstract:

Nigeria is the most populous country in Africa and projected to be the 3rd in the World by 2050. Despite measures to control the country’s population over the years, the total fertility rate has remained high. Fertility rate is associated with various factors but there is limited evidence on the role of early marriage as a predictor or barrier to fertility outcome. This study determined the association between early marriage and fertility outcome in Nigeria. This study is based on secondary data analysis of the 2018 Nigeria Demographic and Health Survey (NDHS). It is a descriptive cross-sectional study with sample that comprised of married women aged 20-24 years old. Data was analyzed using SPSS version 20. The multivariate regression analysis revealed higher likely of women in early marriage to have childbirth in the first year of marriage (OR=2.26, 95%CI=1.96-2.61); and number of children ever born (OR=4.24, 95% CI=3.40-5.27) but lower odd of repeated childbirth in less than twenty-four months (OR=0.66, 95%CI=0.52-0.83) and ever use of contraceptive (OR=0.52, 95%CI=0.45-0.61). However, the adjusted odd ratio only showed significant association between early marriage and number of children ever born (AOR=10.28, 95%CI=2.57-41.13). The nuanced analysis indicates that marriage at any age below 18 had higher effect on fertility than marriage at 18 and above. Early marriage predisposes married women to higher fertility and women with lower age of marriage have likelihood of higher fertility. Improving access of girls to education and contraceptives will delay the timing of pregnancy and childbirth.

Keywords: Child marriage, Childbirth, Contraceptive, Early marriage, Fertility, Nigeria.

References:

[1] World Bank (2022). Health Nutrition and Population Statistics: Population estimates and projections. Data Bank. https://databank.worldbank.org/Population/id/fdaa1724.

[2] World Population Review (2023). Total Fertility Rate 2023. https://worldpopulationreview.com/country-rankings/total-fertility-rate.

[3] Olaosebikan, J.S., Ogundana, C.F, Sunmola, K.A (2021). Contextual Determinants of Children ever born among women of Reproductive Age in selected Southwest State in Nigeria. European Journal of Sociology ISSN 2709-5886 (online) Vol.4, Issue 1, pp 15 – 24.

[4] World Health Organization (2019). Trends in maternal mortality 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division. Geneva: Licence: CC BY-NC-SA 3.0 IGO.

[5] Anthony Mark Ochen, Primus Che Chi and Stephen Lawoko (2019). Predictors of teenage pregnancy among girls aged 13–19 years in Uganda: a community-based case-control study. BMC Pregnancy and Childbirth 19:211 https://doi.org/10.1186/s12884-019-2347-y.

[6] Finlay JE, Mejı´a-Guevara I, Akachi Y (2018) Inequality in total fertility rates and the proximate determinants of fertility in 21 subSaharan African countries. PLoS ONE 13(9): e0203344. https://doi.org/10.1371/journal. pone.0203344.

[7] UNICEF (2020). UNICEF Global Data Bases. Data.unicef.org. Accessed 25^th August 2020

[8] Nasrullah, M., Muazzam, S., Bhutta, Z. A., & Raj, A. (2014). Girl child marriage and its effect on fertility in Pakistan: findings from Pakistan Demographic and Health Survey, 2006-2007. Maternal and child health journal, 18(3), 534–543. https://doi.org/10.1007/s10995-013-1269-y.

[9]  Yaya, S., Odusina, E.K. & Bishwajit, G. (2019). Prevalence of child marriage and its impact on fertility outcomes in 34 sub-Saharan African countries. BMC Int Health Hum Rights 19, 33. https://doi.org/10.1186/s12914-019-0219-1.

[10] Uche C. Isiugo-Abanihe , Kola A. Oyediran, Olufunke A. Fayehun (2022). Differentials in girl-child marriage and high fertility in Nigeria. African Journal of Reproductive Health; 26 (9):103 DOI:10.29063/ajrh2022/v26i9.11.

[11] World Health Organization. (‎2007)‎. Report of a WHO technical consultation on birth spacing: Geneva, Switzerland 13-15 June 2005. World Health Organisation. https://apps.who.int/iris/handle/10665/69855.

[12] Onukwugha, F.I., Magadi, M.A., Sarki, A.M. et al. (2020). Trends in and predictors of pregnancy termination among 15–24 -year-old women in Nigeria: a multi-level analysis of demographic and health surveys 2003–2018. BMC Pregnancy Childbirth 20, 550. https://doi.org/10.1186/s12884-020-03164-8.

[13] Sagalova V, Nanama S, Zagre NM, Vollmer S. (2021). Long-term consequences of early marriage and maternity in West and Central Africa: Wealth, education, and fertility. J Glob Health. 10;11:13004. doi: 10.7189/jogh.11.13004. PMID: 34484711; PMCID: PMC8397277.

[14] Bolarinwa OA, Ahinkorah BO, Seidu A-A, Mohammed A, Effiong FB, Hagan JE Jr, et al. (2023) Predictors of young maternal age at first birth among women of reproductive age in Nigeria. PLoS ONE 18(1): e0279404. https://doi.org/10.1371/journal.pone.0279404.

[15] Negash WD, Asmamaw DB (2022). Time to first birth and its predictors among reproductive age women in high fertility countries in Sub-Saharan Africa: Inverse Weibull gamma shared frailty model. BMC Pregnancy Childbirth. 16;22(1):844. doi: 10.1186/s12884-022-05206-9. PMID: 36384519; PMCID: PMC9670487.

[16] Melesse et al. (2021). Inequalities in early marriage, childbearing and sexual debut among adolescents in sub-Saharan Africa. Reprod Health, 18(Suppl 1):117 https://doi.org/10.1186/s12978-021-01125-8.

[17] Fagbamigbe, A.F., Idemudia, E.S. (2016). Survival analysis and prognostic factors of timing of first childbirth among women in Nigeria. BMC Pregnancy Childbirth 16, 102. https://doi.org/10.1186/s12884-016-0895-y.

[18] Winfred A. Avogo and Oluwaseyi D. Somefun (2019). Early Marriage, Cohabitation, and Childbearing in West Africa. Hindawi Journal of Environmental and Public Health Volume, Article ID 9731756, 10 pages https://doi.org/10.1155/2019/9731756.

[19] Olowolafe TA, Adebowale AS, Fagbamigbe AF, Bolarinwa OA, Akinyemi JO (2023) Shifts in age pattern, timing of childbearing and trend in fertility level across six regions of Nigeria: Nigeria Demographic and Health Surveys from 2003–2018. PLoS ONE 18(1): e0279365. https://doi.org/10.1371/journal.pone.0279365.

[20] Bola Lukman SOLANKE (2015). Marriage Age, Fertility Behavior, and Women’s Empowerment in Nigeria. SAGE Open: 1–9. DOI: 10.1177/2158244015617989 sgo.sagepub.com.

[21] Afeez O. Akintayo, Mutiu A. Sulaimon, Lateefat O. Akinwale (2021). Structural Equation Modeling of Factors Influencing Fertility among Married Women of Reproductive Age in Kaduna State, Nigeria. International Journal of Innovative Science and Research Technology. Volume 6, Issue 5. ISSN No: -2456-2165.

[22] Amusa, L., & Yahya, W. (2019). Stepwise Geoadditive Modelling of the Ideal Family Size in Nigeria. Türkiye Klinikleri Biyoistatistik, 11(2), 123-132.

[23] Nyarko, S. H. (2021). Socioeconomic determinants of cumulative fertility in Ghana. Plos one, 16(6), e0252519.

[24] Fouelifack, F.Y., Tameh, T.Y., Mbong, E.N. et al. (2014). Outcome of deliveries among adolescent girls at the Yaoundé central hospital. BMC Pregnancy Childbirth 14, 102. https://doi.org/10.1186/1471-2393-14-102.

[25] Fawole, A. O., Shah, A., Fabanwo, A. O., Adegbola, O., Adewunmi, A. A., Eniayewun, A. B., Dara, K., El-Ladan, A. M., Umezulike, A. C., Alu, F. E., Adebayo, A. A., Obaitan, F. O., Onala, O. E., Usman, Y., Sullayman, A. O., Kailani, S., & Sa'id, M. (2012). Predictors of maternal mortality in institutional deliveries in Nigeria. African health sciences, 12(1), 32–40.

[26] Onagoruwa, A., & Wodon, Q. (2018). Measuring the Impact of Child Marriage on Total Fertility: A Study for fifteen Countries. Journal of Biosocial Science, 50(5), 626-639. doi:10.1017/S0021932017000542.

[27] Wegbom, A. I., Bademosi, A., Edet, C. K., Green, K. I., Sapira-Ordu, L., & Fagbamigbe, A. F. (2022). Rural-urban disparities in birth interval among women of reproductive age in Nigeria. Scientific reports, 12(1), 17488. https://doi.org/10.1038/s41598-022-22142-y.

[28] Pimentel, J., Ansari, U., Omer, K. et al. (2020). Factors associated with short birth interval in low- and middle-income countries: a systematic review. BMC Pregnancy Childbirth 20, 156. https://doi.org/10.1186/s12884-020-2852-z.

[29] Desta Hailu, Teklemariam Gulte (2016). "Determinants of Short Interbirth Interval among Reproductive Age Mothers in Arba Minch District, Ethiopia", International Journal of Reproductive Medicine, vol. 2016, Article ID 6072437, 17 pages, https://doi.org/10.1155/2016/6072437

[30] Mihretie GN, Getie SA, Shiferaw S, Ayele AD, Liyeh TM, Kassa BG, et al. (2022). Interbirth interval practices among reproductive age women in rural and Urban kebeles in Farta Woreda: Casecontrol study. PLoS ONE 17(1): e0256193. https://doi.org/10.1371/journal.pone.0256193.

[31] Dim, C. C., Ugwu, E. O., & Iloghalu, E. I. (2013). Duration and determinants of inter-birth interval among women in Enugu, south-eastern Nigeria. Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology, 33(2), 175–179. https://doi.org/10.3109/01443615.2012.747494.

[32] Ahinkorah, B.O., Aboagye, R.G., Okyere, J. et al. (2023). Correlates of repeat pregnancies among adolescent girls and young women in sub-Saharan Africa. BMC Pregnancy Childbirth 23, 93. https://doi.org/10.1186/s12884-023-05361-7.

[33] Nnaji, H. C., Asimadu, E. E., & Aniebue, U. U. (2022). The effect of short interpregnancy interval on birthweight and other pregnancy outcomes in Enugu, Southeast Nigeria. Journal of obstetrics and gynaecology: the journal of the Institute of Obstetrics and Gynaecology, 42(2), 244–247. https://doi.org/10.1080/01443615.2021.1904230.

[34] Onwuka, C. C., Ugwu, E. O., Obi, S. N., Onwuka, C. I., Dim, C. C., Eleje, G. U., Ezugwu, E. C., Agu, P. U., Nwagha, U. I., & Ozumba, B. C. (2020). Effects of short inter-pregnancy interval on maternal and perinatal outcomes: A cohort study of pregnant women in a low-income country. Nigerian journal of clinical practice, 23(7), 928–933. https://doi.org/10.4103/njcp.njcp_423_19.

[35] Islam, M. Z., Billah, A., Islam, M. M., Rahman, M., & Khan, N. (2022). Negative effects of short birth interval on child mortality in low- and middle-income countries: A systematic review and meta-analysis. Journal of global health, 12, 04070. https://doi.org/10.7189/jogh.12.04070.

[36] Ba DM, Zhang Y, Pasha-Razzak O, Khunsriraksakul C, Maiga M, Chinchilli VM, et al. (2023) Factors associated with pregnancy termination in women of childbearing age in 36 low-and middle-income countries. PLOS Glob Public Health 3(2): e0001509. https://doi.org/10.1371/journal.pgph.0001509.

[37] Ojo, I. E., Ojo, T. O., & Orji, E. O. (2021). Why do married women procure abortion? Experiences from Ile-Ife, southwestern Nigeria. African health sciences, 21(1), 327–337. https://doi.org/10.4314/ahs.v21i1.42.

[38] Bankole, A., Adewole, I. F., Hussain, R., Awolude, O., Singh, S., & Akinyemi, J. O. (2015). The Incidence of Abortion in Nigeria. International perspectives on sexual and reproductive health, 41(4), 170–181. https://doi.org/10.1363/4117015.

[39] Shallon Atuhaire (2019). Abortion among adolescents in Africa: A review of practices, consequences, and control strategies. The International Journal of Health Planning and Management. Volume34, Issue4. https://doi.org/10.1002/hpm.2842.

[40] National Population Commission (NPC) [Nigeria] and ICF (2019). Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF.

[41] Hutchinson, P.L., Anaba, U., Abegunde, D. et al. (2021). Understanding family planning outcomes in northwestern Nigeria: analysis and modeling of social and behavior change factors. BMC Public Health 21, 1168. https://doi.org/10.1186/s12889-021-11211-y

[42] Speizer, I.S., Lance, P. (2015). Fertility desires, family planning use and pregnancy experience: longitudinal examination of urban areas in three African countries. BMC Pregnancy Childbirth 15, 294. https://doi.org/10.1186/s12884-015-0729-3.

[43] Muhammad Murtala Ibrahim (2020). Sources of Contraceptive Information as Predictors of Contraceptive Use among Women in Tarauni Local Government Area of Kano State, Nigeria. Texila International Journal of Public Health ISSN: 2520-3134 DOI: 10.21522/TIJPH.2013.08.01.Art020.

[44] Irit Sinai, Jennifer Anyanti, Mohsin Khan, Ramatu Daroda and Olugbenga Oguntunde (2017). Demand for Women’s Health Services in Northern Nigeria: A Review of the Literature. Afr J Reprod Health 2017; 21[2]: 96-108).

[45] Idris, S. H., Sambo, M. N., & Ibrahim, M. S. (2013). Barriers to utilisation of maternal health services in a semi-urban community in northern Nigeria: The clients' perspective. Nigerian Medical Journal: Journal of the Nigeria Medical Association, 54(1), 27–32. https://doi.org/10.4103/0300-1652.108890.

[46] Muhammad Murtala Ibrahim (2019). An Assessment of Socioeconomic Determinants of Contraceptive use among Women of Reproductive Age in Tarauni Local Government Area of Kano State, Nigeria. Texila International Journal of Public Health, Volume 7, Issue 4, DOI: 10.21522/TIJPH.2013.07.04.Art029 ISSN: 2520-3134.

[47] D. J. P. K Hedo, and N. Simarmata (2022) "What Predict Modern Contraception Use? A Study of Reproductive Age Married Couples in Indonesia," Journal Promosi Kesehatan Indonesia, vol. 18, no. 1, pp. 1-7. https://doi.org/10.14710/jpki.18.1.1-7.

[48] Audu Alayande, Bahijjatu Bello-Garko, Zubaida Abubakar, Hafsat Kagara1 and Islamiyat A. Nuhu (2019) Medical Perspective of Childhood Marriage in Nigeria: Body of Evidence from 2013 Nigeria Demographic and Health Survey. Current Women’s Health Reviews, 15, 188-195. DOI: 10.2174/1573404814666181026095357.

[49]Sebany, M., Barre, I., and John, N. (2018). The Power of Choice: How early & delayed marriage impact decisionmaking in Ibadan, Nigeria. Washington, DC: International Center for Research on Women.

[50] Ganchimeg T, Ota E, Morisaki N, Laopaiboon M, Lumbiganon P, Zhang J, Yamdamsuren B, Temmerman M, Say L, Tuncalp O, € Vogel JP, Souza JP, Mori R, on behalf of the WHO (2014). Multicountry Survey on Maternal Newborn Health Research Network. Pregnancy and childbirth outcomes among adolescent mothers: a World Health Organization multicountry study. BJOG 121 (Suppl. 1): 40–48.

[51] Fan, S., Koski, A. (2022). The health consequences of child marriage: a systematic review of the evidence. BMC Public Health 22, 309. https://doi.org/10.1186/s12889-022-12707-x.

[52] Nour N. M. (2006). Health consequences of child marriage in Africa. Emerging infectious diseases, 12(11), 1644–1649. https://doi.org/10.3201/eid1211.060510.

[53] Belachew, T.B., Asmamaw, D.B. & Negash, W.D. (2023). Short birth interval and its predictors among reproductive age women in high fertility countries in sub-Saharan Africa: a multilevel
analysis of recent Demographic and Health Surveys. BMC Pregnancy Childbirth 23, 81. https://doi.org/10.1186/s12884-023-05403-0.

[54] Muhammad Murtala Ibrahim and Tinuola Femi Rufus (2023). The Effects of Early Marriage on the Utilization of Maternal Health Services in Nigeria. Texila International Journal of Nursing ISSN: 2520-3126 DOI: 10.21522/TIJNR.2015.09.01.Art002.

[55] M. A. Mowafy, N. M. Kamal Elden (2020). Assessment of Contraception Use among Early Married Females in Rural Districts in Giza Governorate, Egypt. Egyptian Family Medicine Journal (EFMJ) Vol .4(1), www.efmj-eg.org.

[56] Bolarinwa, O.; Olagunju, O.; Olaniyan, A. (2020). Influence of Husband Consent to Family Planning and Spousal Communication on the Use of Family Planning among Young Mothers in Peri-Urban, Nigeria. Preprints 2020, 2020090148. https://doi.org/10.20944/preprints202009.0148.v1.

[57] Srivastava, S., Mohanty, P., Muhammad, T. et al. (2023). Socio-economic inequalities in non-use of modern contraceptives among young and non-young married women in India. BMC Public Health 23, 797. https://doi.org/10.1186/s12889-023-15669-w.