All over the world, poor and illiterate girls living in rural areas are at higher risk of becoming underage marriage than well-educated girls living in cities. Early marriages exacerbate inequalities between females and males in society and violate children's and women's rights. This study aimed to demonstrate temporal changes in the prevalence of child marriage and underage childbearing in Turkey by exploring the causes of regional variations in the schooling rate. Our retrospective, descriptive and register-based study obtained input data on childbirth, marriage, population and schooling from official statistics published by the Turkish Statistical Institute (TURKSTAT) and the Republic of Turkey Ministry of National Education. Based on official statistics, underage childbearing rates decreased from 2002 to 2019 in Turkey. This study outlined significant regional variations in the ratio of childbearing female under 18 to the population that were higher in the northeastern, central eastern, and southeastern Anatolia regions of Turkey than in other regions. During the same period, there were downward trends in the number of legal marriages of female aged 16-17 and the number of underage females who gave birth in contrast with an increasing population of girls living in Turkey. In terms of welfare, education and healthcare, developments in Turkey were considered to have contributed to the downward tendency of childbearing and marriages of underage females. However, an increase in the schooling rate of girls was the critical determinant of the observed tendency. Therefore, officially setting the compulsory education age to 18 can help to prevent underage marriage and childbearing. K E Y W O R D S inequality, underage marriages, underage motherhood Key Practitioner Messages • It is recommended to increase compulsory education to the age of 18. • Compulsory education can prevent childbearing and marriage of underage girls. • The risk of childbearing and underage marriage increases in areas with low schooling rates.
Introduction In this study, we evaluated whether it is possible to perform forensic radiological skeletal age estimation via radiological examination of the ilioischial, ischiopubic, and iliopubic synchondrosis regions of the pelvis. Methods This study was conducted by retrospectively examining the abdominopelvic images of individuals aged 8–16 who had applied to the hospital for any reason without having a chronic disorder and who had undergone computed tomography. Two radiologists retrospectively reviewed the images. The BT images of the pelvis ilioischial, ischiopubic, and iliopubic synchondrosis regions were evaluated as follows: 0: open, 1: semiclosed, and 2: closed. The data were evaluated using the SPSS 17 program. Results Two hundred sixty-three children (118 girls and 145 boys) between the ages of 8 and 16 years without any health problems participated. There was a significant difference between the groups for all the evaluated synchondrosis joints in girls and boys (p<0.001 for each group comparison). We observed that ilioischial, ischiopubic, and iliopubic synchondrosis closed earlier in girls than boys. In addition, we found that the joints were closed at the age of 15 and over in boys and at 14 and over in girls. Discussion Some studies have previously evaluated synchondrosis by using computed tomography. We showed that forensic radiological skeletal age estimation could be performed by examining ischiopubic-ilioischial-iliopubic synchondrosis in pelvis computed tomography images. The pelvis is more resistant to decay than other parts of the body. Furthermore, pelvis bones can withst and the effects of postmortem animal attacks for a longer period. Therefore, we believe that forensic age estimation can be made on corpses with no extremity, a damaged chest, or whose only pelvic bones are assessable through the method we use. Conclusion In our study, the ischiopubic-ilioischial-iliopubic joints were open in those aged nine and under and closed in those aged 15 and above. Ilioischial, ischiopubic, and iliopubic synchondrosis were observed to close earlier in girls than in boys. We consider that our study will be beneficial in the 8-16-year-old age group if used. In addition, our study can be used to determine the radiological bone age in cases with wrist bone abnormalities or wrist amputation.
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