Being dragged into adulthood? Young people’s agency concerning sex, relationships and marriage in Malawi, Mozambique and Zambia

Kok, Maryse; Eldik, Zoe van; Kakal, Tasneem; Munthali, Alister; Menon, J. Anitha; Pires, Paulo; Baatsen, Pam; Kwaak, Anke van der

doi:10.1080/13691058.2021.1881618

Cited by 13 publications

(12 citation statements)

References 32 publications

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“…Our ndings also corroborate with the notion that in various settings, marriage is perceived to be central to women's life, it provides them a way to 'adulthood' and community respect which, in particular in the absence of alternative economic and social opportunities, can contribute to (choosing) early marriage (34)(35)(36).…”

Section: Discussionsupporting

confidence: 85%

Drivers of child marriage in specific settings of Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia – findings from the Yes I Do! baseline study

Kok

Kakal

Kassegne

et al. 2022

Preprint

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BackgroundChild marriage persists in many countries and has severe impacts on health, education, economic and social status of girls. Child marriage has many interlinked causes. This study aimed to explore the drivers of child marriage in specific contexts in Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia.MethodsThe study combined a household survey among youth (15-24 years) with focus group discussions and interviews conducted with youth (15-24 years) and parents. A variety of community stakeholders were interviewed as well. Logistic regression was done to explore associations between individual and family-level characteristics of young women and the occurrence of child marriage. Transcripts were analysed using an inductive approach. Narratives on the main drivers of child marriage across study contexts were written and inspired by the theory of normative spectrum.ResultsA lack of education was associated with the occurrence of child marriage in Ethiopia, Kenya and Zambia. In all countries, teenage pregnancy was associated with child marriage. In Ethiopia, Kenya and Mozambique, fathers’ education seemed a protective factor for child marriage. Narratives of study participants showed that in Ethiopia, Indonesia and (to a lesser extent) Kenya, child marriage was perceived as an ‘appropriate practice’ to avoid premarital sex or pregnancy, whether it involved sex with or without consent. In all countries, child marriage was driven by difficult economic circumstances, which were often intertwined with disapproved social circumstances, in particular teenage pregnancy, in case of Kenya, Malawi, Mozambique and Zambia. These circumstances made child marriage an ‘acceptable practice’. Some youth, particularly in Indonesia, made their own choices to marry early, making child marriage a ‘possible practice’.ConclusionsMultiple intersecting drivers, which were present in different degrees in each country setting, influenced the occurrence of child marriage. We found that child marriage is a manifestation of social norms, particularly related to girls’ sexuality, which are intersecting with other factors at individual, social, material, and institutional level – most prominently poverty or economic constraints. Child marriage was, in some cases, a result of girls’ agentic choices. Efforts to prevent child marriage need to take these realities of girls and their families into account.

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Section: Discussionsupporting

confidence: 85%

Drivers of child marriage in specific settings of Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia – findings from the Yes I Do! baseline study

Kok

Kakal

Kassegne

et al. 2022

Preprint

Self Cite

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“…We found multiple descriptions of nonconsensual experiences, and a concerning lack of consent vocabulary and understandings. We found that MRY do hold agency, but, as with young people in areas of East Africa, 58,67 East and South Asia, 60,62,68 and the Pacific, 64 this was compromised by contextual, structural and social factors. Often, MRY engaged 'subtle' or 'thin' agency, navigating within and around constraints.…”

Section: Discussionmentioning

confidence: 69%

“…Often, MRY engaged 'subtle' or 'thin' agency, navigating within and around constraints. 58,67 Relationships were highly significant to MRY; relationships with family, community, peers and partners could impede and enable rights actualisation. Migration disrupts social networks, heightening the importance of family and community connections in resettlement, or bringing pressure to maintain bonds.…”

Section: Discussionmentioning

confidence: 99%

Migrant and refugee youth perspectives on sexual and reproductive health and rights in Australia: a systematic review

et al. 2022

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Migrant and refugee youth (MRY) in Australia face specific experiences that inform their sexual and reproductive health and rights (SRHR). Migrant and refugee communities experience poor health outcomes and low service uptake. Additionally, youth are vulnerable to poor sexual health. This review examines the understandings and perspectives of MRY. A systematic review was conducted as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol is registered with PROSPERO: CRD42021241213. Nine databases were systematically searched. Inclusion criteria specified literature reporting on migrant and/or refugee youth perspectives and attitudes towards sexual and reproductive health; peer-reviewed qualitative, mixed-methods and/or quantitative studies or grey literature reports; records using Australian research; literature published in English between January 2000 and March 2021. Records that did not report on MRY and did not examine participant views or perspectives; were abstract-only, reviews, pamphlets, protocols, opinion pieces or letters; did not include Australian research; were published before 2000 and/or in a language other than English were excluded. Two reviewers screened titles, abstracts and full-text articles. The Mixed Method Appraisal Tool was used to assess studies' methodological quality. Thematic synthesis methods guided data extraction and analysis. Twenty-eight papers were included in the final review. Three themes were identified in MRY constructions of SRHR: (1) experiences of silence and shame; (2) understandings of and responses to SRHR risks; (3) navigation of relationships and sexual activity. Socioecological factors shaped MRY perspectives at individual, interpersonal, institutional and societal levels. Societal factors and interpersonal relationships significantly influenced decision making.

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“…Although our study demonstrated increased intention, the intervention was insufficient to open conversations between adults and adolescents and young people, which may make it less likely that adolescents and young people will access STI testing [63]. Modernization in the timing and content of sexual teachings [64,65] and health programs that increase adolescents' and young peoples' assertiveness can increase SRH communication with parents and other significant adults, with anticipated benefits [63]. In addition, parent-based interventions show a significant association with improved condom use and parent-child sexual communication, especially when focused on young adolescents and targeted at both parents and adolescents [66].…”

Section: Principal Findingsmentioning

confidence: 99%

Pilot Implementation of a User-Driven, Web-Based Application Designed to Improve Sexual Health Knowledge and Communication Among Young Zambians: Mixed Methods Study

Sharma¹,

Mwamba²,

N’gandu³

et al. 2022

J Med Internet Res

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Background Digital health interventions show promise in improving the uptake of HIV services among adolescents and young people aged 15 to 24 years in sub-Saharan Africa. Objective This study aimed to pilot-test a theory-based, empirically grounded web-based application designed to increase condom-related knowledge, sexual and reproductive health (SRH) communication, and healthier choices among young Zambians. Methods We conducted a pre-post quasi-experimental evaluation of the user-driven Be in the Know Zambia (BITKZ) web application using web-based surveys and in-depth interviews (IDIs) on the phone. We enrolled participants using social media advertisements. Our final analysis set comprised 46.04% (749/1627) of participants in the intervention group (which received the BITKZ link) and 53.96% (878/1627) of participants in the comparison group (no intervention). We collected survey data at study enrollment (baseline) and 5 weeks after the first enrollment in each group. Approximately 85% (637/749) of BITKZ users completed a user survey, of whom 9.3% (59/637) participated in IDIs. We calculated the time interfacing with BITKZ using the application log files. We conducted descriptive analyses to describe baseline characteristics and the user experience. At the endline, we assessed association using a t test and adjusted logistic regression for binary outcomes and ordinal regression for ordered outcomes, conditioning on age, sex, marital status, and employment status. We used adjusted average treatment effects (aATE) to assess the effects of BITKZ intervention. We conducted rapid matrix analyses of IDI transcripts in Microsoft Excel, sorting the data by theme, gender, and experience rating. Results Users rated BITKZ highly (excellent: 352/609, 57.8%; good: 218/609, 35.8%). At the endline, the intervention group had a higher level of knowledge related to condoms (adjusted odds ratio [aOR]: 1.35, 95% CI 1.06-1.69) and on wearing condoms correctly (aOR: 1.23, 95% CI 1.02-1.49). Those who had full-time employment had increased odds of knowing how to wear condoms correctly (aOR: 1.67, 95% CI 1.06-2.63) compared with those who reported being unemployed, as did men when compared with women (aOR: 1.92, 95% CI 1.59-2.31). Those in the intervention group were more likely to score higher for intention to test for sexually transmitted infections (STIs; aATE 0.21; P=.01) and HIV (aATE 0.32; P=.05), as well as for resisting peer pressure (aATE 2.64; P=.02). IDIs corroborated increased knowledge on correct condom use among men and female condoms among women, awareness of STIs and testing, and resistance to peer pressure. Interviewees provided examples of more open SRH communication with partners and peers and of considering, adopting, and influencing others to adopt healthier behaviors. Conclusions Despite the high baseline awareness of SRH among Zambian adolescents and young people with internet access, BITKZ provided modest gains in condom-related knowledge, resistance to peer pressure, and intention to test for STIs and HIV.

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Being dragged into adulthood? Young people’s agency concerning sex, relationships and marriage in Malawi, Mozambique and Zambia

Cited by 13 publications

References 32 publications

Drivers of child marriage in specific settings of Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia – findings from the Yes I Do! baseline study

Drivers of child marriage in specific settings of Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia – findings from the Yes I Do! baseline study

Migrant and refugee youth perspectives on sexual and reproductive health and rights in Australia: a systematic review

Pilot Implementation of a User-Driven, Web-Based Application Designed to Improve Sexual Health Knowledge and Communication Among Young Zambians: Mixed Methods Study

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