1. Intra-urban differentials in early marriage: Prevalence and consequences Zeinab Khadr Combating Early Marriage and Young People’s Reproductive Risks in Egypt: Research, Interventions and Policies 18-19 J UNE 2014

2. The project This project is funded by The Ford Foundation It aims to Expand the current knowledge base on early marriage practice and youth reproductive health through identifying socially vulnerable groups in need for policy interventions within the urban context. Identifying the main social and structural factors underlying early marriage and risky youth reproductive health practices and their relative contribution. Defining points of interventions that can tackle the practice of early marriage and adoption of risk reproductive health practices. Duration of the project was two years. Activities of the project: In depth analysis of secondary data. Empirical study.

3. Methodology for The Empirical Study The study was implemented in Cairo governorate. It encompassed both the quantitative and qualitative data gathering approaches. For the qualitative data collections, the study included both in depth interviews (12) with early married young women and focus group discussions (8) for married and unmarried and educated and uneducated young women. For the quantitative data collection, the study included a multistage stratified cluster sample of Cairo neighborhoods (4500 young women 10-29 years).

4. For the quantitative data collection Household and individual Sample distribution by mantiqa type The final individual sample was 4421 respondents StratumNameHH sampleIndividual sample HighEl Hai El Asher600 647 MediumHadaek el Koba600 794 LowDar el Salam and el Basateen 2300 2980

5. Questionnaires Two questionnaires were administered in the study Household questionnaire Section one: Household roster Section Two: Household conditions Section three: Attitudes towards young women reproductive health, marriage and gender roles Individual questionnaire Section one: Respondent background Section Two: Marriage and marital status; Section Three: Premarital stage Section Four: Fertility Section Five: Pregnancy care and contraceptives Section Six: Health status Section Seven: Social relationships and marriage relations Section Eight: Sexual harassment and violence Section Nine: Information, communication and cultural activities

6. Main Findings Marital status of the sample

7. So who is getting married?

8. Early marriage in Cairo among ever married women 20-24 years

9. Early marriage in Cairo among ever married women 10-29 years 17.1% of young married women were married by age 17 years

10. Who is marrying early? Education Wealth

11. Families’ acceptance of early marriage

12. Parents characteristics and approval of early marriage 29% of less than secondary educated mothers and fathers had an early married daughter compared to less than 8% among secondary and higher educated parents. 42.8% of poorest families had an early married daughter compared to 5% among the richest families. 32% of mothers who married early had an early married daughter compared to 8.7% of mothers who married at age 18 and older. 51% and 58% of families with 4-5 and 6 or more daughters had an early married daughter compared to 20.5% for families with 1-3 daughters.

13. What young woman recommends in case her sister has a suitor before age 18

14. Husbands’ attributes Educational difference 55.5% of young women marry husbands’ with same educational level or more Only 39.3% of early married young women marry husbands’ of the same or more level of education compared to 58.9% among those married by age 18 years and older. Work status 80.6% of young women marry husbands working in full time job. Among early married young women, this proportion declines to 68.1% compared to 83.2% among those marrying at age 18 and older. Consanguinity 29.6% of young women marry husbands who are related to them by blood. Among early married young women, this proportion increases to 40.0% compared to 27.4% among those marrying at age 18 and older.

15. Husbands and wives relationship Physical Abuse 26.5% of married young women reported that their husbands have physically abuse them.

16. Verbal Abuse 30.4% of married young women reported that their husbands have verbally abuse them.

17. Impact of early marriage on young women Health Psychological well being Fertility risks Pregnancy care Delivery care

18. Health 5.7% of married young women self-rated their health as bad or very bad. 14% of early married young women self-rated their health as bad or very bad compared to 6.5% among those marrying at age 18 and older and 4.8% among never married young women. More than 20% of early married young women living in non-deprived areas self-rated their health as bad or very bad compared to 13.4% for those living in deprived areas.

19. Psychological profile Using DASS21 to assess the severity of the core symptoms of Depression, Anxiety and Stress, the data proved the negative impact of early marriage on young women.

20. Fertility risks Overall, the average age for getting pregnant is 21.3 years. This age deceases to 16.6 years among early married young women.

21. Parity The overall average of number of living children for ever married young women is 1.87 child Among early married young women this average increases to 2.43 child compared to 1.74 child among those who married at age 18 years and older. Fertility preference o 17.8% of married young women reported that their preferred number children was 4 or more children o This proportion increases to 33% among early married young women and decreases to 14.7% among those married at age 18 and older.

22. Child death 3.9% of married young women experienced a death of a child. 7.3% among early married women 3.1% among those who married at age 18 years and older. Among early married young women, experience of child death was found to be significantly related to education attainment and wealth. Education 8.9% of uneducated, 2.3% of secondary educated Wealth 15.4% of the poorest early married young women 3% for other wealth categories

23. Pregnancy loss 19.2% of married young women experienced a pregnancy loss. Early married young women living in deprived areas (49.7%) are one and a half more likely to experience a pregnancy loss compared to those married at age 18 years and older (16.6%)in the same areas.

24. Pregnancy care 30.6% among uneducated early married young women compared to 0% among secondary educated or more. 24.3% of the uneducated among those married at age 18 and older compared to 5% among secondary educated or more Among early married young women, the proportions receiving any prenatal care were 37.5% of the poorest quintile compared to 13.2% of the richest quintile Among those married at age 18 years and older, the proportions receiving any prenatal care were 19.4% of the poorest and 8.3% of the richest

25. Delivery care Delivering at home Among early married young women, 24.4% of the uneducated and 28.7% of the poorest delivered at home.

26. Among early married young women, 23.3% of the uneducated and 28.0% of the poorest delivered without the assistant of medical personal. In contrast, among early married young women, none of the secondary educated or young women in the richest quintile had unassisted delivery. Having unassisted delivery

27. Conclusion Thank you