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. 2023 Jun 15;13(6):e070056.
doi: 10.1136/bmjopen-2022-070056.

Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys

Shatha Elnakib  1 , Ligia Paina  2 , Bothaina Attal  3   4 , Rumana Akter  5 , Ghada Khoury  6 , Loqman Karim  7 , Hemeda Houssein Barkat  8 , Anand Tamang  9 , Gayane Yenokyan  10 , Janna Metzler  11 , Courtland Robinson  2
Affiliations

Incidence of child marriage among refugees and internally displaced persons in the Middle East and South Asia: evidence from six cross-sectional surveys

Shatha Elnakib et al. BMJ Open. .

Abstract

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.

Keywords: Child protection; EPIDEMIOLOGY; REPRODUCTIVE MEDICINE.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Map of study sites. *Map generated by the author using ArcGIS Pro.
Figure 2
Figure 2
Survival function of time to marriage among 10–19 years old displaced versus host girls in four countries: Bangladesh, Djibouti, Iraq and Yemen—plotted using ‘Stcurve’. IDPs, internally displaced populations.
Figure 3
Figure 3
Survival function of time to marriage among pooled sample of 10–19 years old displaced versus host girls—plotted using ‘Stcurve’.
Figure 4
Figure 4
Survival function of time to marriage among age cohorts of displaced populations in four countries: Bangladesh, Djibouti, Iraq and Yemen—plotted using ‘Stcurve’.
Figure 5
Figure 5
Survival function of time to marriage among pooled sample of age cohorts—plotted using ‘Stcurve’.
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