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Child&Marriage&In&Sub0s CHILD&MARRIAGE&IN&SUB0SAHARAN& AFRICA:& TRENDS,&EFFECTS&ON&HEALTH,&AND& EFFORTS&TO&LIMIT&THE&PRACTICE& Alissa Koski Department of Epidemiology, Biostatistics, and Occupational Health McGill University, Montreal April 2016 A thesis submitted to McGill University in partial fulfillment of the requirements of the degree of Doctor of Philosophy (Ph.D.) © Alissa Koski, 2016 TABLE&OF&CONTENTS& LIST%OF%FIGURES%.........................................................................................................................................................................%3% LIST%OF%TABLES%..........................................................................................................................................................................%4% ABSTRACT%....................................................................................................................................................................................%5% RÉSUMÉ%........................................................................................................................................................................................%7% ACKNOWLEDGEMENTS%..............................................................................................................................................................%9% AUTHOR%CONTRIBUTIONS%......................................................................................................................................................%10% STATEMENT%OF%ORIGINALITY%...............................................................................................................................................%12% CHAPTER(1:(INTRODUCTION(AND(BACKGROUND(INFORMATION(...................................................(13% The%prevalence%of%child%Marriage%in%subRSaharan%Africa%...................................................................................................................%14% Associations%between%child%Marriage%and%health%..................................................................................................................................%16% Legislative%and%programMatic%efforts%to%delay%Marriage%...................................................................................................................%18% CHAPTER(2:(DATA(SOURCES(AND(ANALYTIC(METHODS(......................................................................(21% DeMographic%and%Health%Surveys%................................................................................................................................................................%21% Overview%of%analytic%Methods%.......................................................................................................................................................................%22% CHAPTER(3:(CHANGES(IN(THE(PREVALENCE(OF(CHILD(MARRIAGE(IN(SUB<SAHARAN(AFRICA( OVER(A(TWENTY<YEAR(PERIOD(...................................................................................................................(27% MANUSCRIPT%1:%RECENT%TRENDS%IN%CHILD%MARRIAGE%IN%SUBRSAHARAN%AFRICA%....................................................%28% Abstract%...................................................................................................................................................................................................................%29% Introduction%...........................................................................................................................................................................................................%30% Data%and%Statistical%Analyses%..........................................................................................................................................................................%35% Results%......................................................................................................................................................................................................................%40% Discussion%...............................................................................................................................................................................................................%51% CHAPTER(4:(ESTIMATING(THE(CAUSAL(EFFECTS(OF(CHILD(MARRIAGE(........................................(55% MANUSCRIPT%2:%CHILD%MARRIAGE%AND%THE%RISK%OF%DOMESTIC%VIOLENCE%IN%KENYA%.............................................%57% Abstract%...................................................................................................................................................................................................................%58% Introduction%...........................................................................................................................................................................................................%59% Methods%...................................................................................................................................................................................................................%62% Results%......................................................................................................................................................................................................................%65% Discussion%...............................................................................................................................................................................................................%74% CHAPTER(5:(EFFORTS(TO(DELAY(MARRIAGE(..........................................................................................(77% MANUSCRIPT%3:%TUITIONRELIMINATION%POLICIES%DELAY%AGE%AT%MARRIAGE:%%%%%%%%%%%%%A%QUASIREXPERIMENTAL% EVALUATION%IN%SIXTEEN%AFRICAN%COUNTRIES%.................................................................................................................%78% Abstract%...................................................................................................................................................................................................................%79% Introduction%...........................................................................................................................................................................................................%80% Methods%...................................................................................................................................................................................................................%82% RESULTS%..................................................................................................................................................................................................................%88% DISCUSSION%...........................................................................................................................................................................................................%93% CHAPTER(6:(SUMMARY(AND(CONCLUSIONS(.............................................................................................(97% Directions%for%future%research%....................................................................................................................................................................%101% Conclusion%...........................................................................................................................................................................................................%102% REFERENCES(.....................................................................................................................................................(104% & & & 2 LIST&OF&FIGURES& FIGURE%1R1.%PERCENTAGE%OF%20R24%YEAR%OLD%WOMEN%MARRIED%AS%CHILDREN%IN%SUBRSAHARAN%AFRICA%............%15% FIGURE%2R1.%CONCEPTUAL%ILLUSTRATION%OF%EFFECT%IDENTIFICATION%USING%THE%DIFFERENCERINRDIFFERENCES%% METHOD%...............................................................................................................................................................................%25% FIGURE%3R1.%WEIGHTED%ESTIMATES%OF%THE%PREVALENCE%OF%CHILD%MARRIAGE%AMONG%WOMEN%AGED%20R24%YEARS% IN%WEST%AFRICA.%.................................................................................................................................................................%41% FIGURE%3R2.%WEIGHTED%ESTIMATES%OF%THE%PREVALENCE%OF%CHILD%MARRIAGE%AMONG%WOMEN%AGED%20R24%YEARS% IN%EAST%AFRICA.%..................................................................................................................................................................%42% FIGURE%3R3.%WEIGHTED%ESTIMATES%OF%THE%PREVALENCE%OF%CHILD%MARRIAGE%AMONG%WOMEN%AGED%20R24%YEARS% IN%CENTRAL%AND%SOUTHERN%AFRICA.%.............................................................................................................................%43% FIGURE%3R4.%WEIGHTED%PREVALENCE%DIFFERENCE%ESTIMATES%COMPARING%THE%PREVALENCE%OF%CHILD%MARRIAGE% AMONG%WOMEN%BORN%BETWEEN%1970R74%TO%THE%PREVALENCE%AMONG%WOMEN%BORN%BETWEEN%1985R89 %...............................................................................................................................................................................................%45% FIGURE%3R5.%TRENDS%IN%THE%PREVALENCE%OF%CHILD%MARRIAGE%BY%PROVINCE%IN%MADAGASCAR%................................%54% FIGURE%4R1.%DISTRIBUTION%OF%PROPENSITY%SCORES%AMONG%WOMEN%MARRIED%AS%CHILDREN%AND%WOMEN%MARRIED%
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