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Nahla Abdel-Tawab American University in Cairo/ Social Research Center June 18-19, 2014

Survey of married adolescent girls in rural Upper Egypt: A collaborative study with Assiut University. Nahla Abdel-Tawab American University in Cairo/ Social Research Center June 18-19, 2014. Acknowledgements. Dr. Omaima El-Gibaly and Department of Community Medicine, Assiut University

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Nahla Abdel-Tawab American University in Cairo/ Social Research Center June 18-19, 2014

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  1. Survey of married adolescent girls in rural Upper Egypt: A collaborative study with Assiut University Nahla Abdel-Tawab American University in Cairo/ Social Research Center June 18-19, 2014

  2. Acknowledgements • Dr. Omaima El-Gibaly and Department of Community Medicine, Assiut University • Dr. Montasser Kamal and Ford Foundation • Dr. Doaa Oraby and PC /Egypt team

  3. Building capacity of researchers in youth SRH • Phase 1: individual researchers from 8 institutions • Phase 2: groups of researchers from 2-3 institutions • Phase 3: working with one institution to establish a center of excellence in youth SRH

  4. Why a survey of Married Adolescent Girls (MAGs)? • 16% of adolescent girls 15-17 years are either married or engaged (SYPE, 2010) • MAGs are prone to poor SRH outcomes: • Early and closely spaced pregnancies • Complications during pregnancy and childbirth • Sexually transmitted Infections • Intimate partner violence

  5. Why a survey of MAGs? • Very little is known about SRH needs of MAGs or their health-seeking behavior • Most of the evidence derived from small scale qualitative studies or research conducted in South East Asia or sub-Saharan Africa • Most programs geared towards prevention of early marriage

  6. Study objectives • Provide estimates of key sexual and reproductive health indicators among MAGs in rural Upper Egypt; • Measure the extent of MAG exposure to various forms of IPV; • Assess key contextual, attitudinal and cognitive factors that could mitigate effects of early marriage on girls’ SRH • Provide policy recommendations and identify opportunities for interventions

  7. Study methodology • Descriptive cross sectional survey • Four districts in Assiut and Sohag • Sample of 990 MAGs under age 20 (married for at least three months) selected from eight villages • Households that include MWRA will be selected at random using EDHS 2014 sampling frame • Study instruments • Roster of household members • MAG’s questionnaire

  8. MAG’s Questionnaire Divided into 10 sections • Socio-demographic characteristics • RH knowledge • Social support • Access to SRH services • RH seeking behavior • Reproductive history • Engagement and marital relations • Social network, mobility and resources • Exposure to IPV • Suggestions for intervention

  9. Procedures for protection of human subjects • Protocols reviewed and approved by PC and Assiut University Ethics Committees • Informed consent will be obtained from MAG and guardian • Data collectors will be adequately trained in handling sensitive questions • Participation is completely voluntary • Interview will be stopped if participant experiences emotional distress • Precautions will be taken for protection of confidentialty of information provided by MAGs

  10. Potential challenges • Obtaining CAPMAS clearance • Guardian denying presence of MAG / refusing her participation • Finding a private spot for interview • Handling cases of severe forms of IPV or emotional distress

  11. Men and gender based violence • 36% of MWRA experienced any form of physical, emotional or sexual violence by their current or most recent husband • 38% of young men 15-29 years believe a husband is justified in beating his wife if she refuses to have sex with him • 42% of young men believe ‘wasting his money’ is a good reason for beating wife

  12. Men and FGM (EDHS, 2008 & SYPE, 2011) • 91 % of married women aged 15-49 years and 76% of girls 10-29 have been circumcised. • 41 % of women indicted that their husband believed FGM should continue. • More than half of girls were circumcised by medical personnel. • More young men than women 15-29 years believed FGM was a necessary practice (70% vs. 58%).

  13. Men and HIV infection • 40 of infected individuals are women • Marriage is the number 1 risk factor for women • Biologically women are 5 times more vulnerable than men • Socio-cultural factors increase women’s vulnerability to HIV

  14. How can men be involved in RH? • RH services for men • Counseling men about RH needs of women • Brochures and fliers for reaching husbands • Mass media • School curricula for reaching young men

  15. Counseling men about RH needs of women • Assign special hours for men to accompany their wives to the clinic • Train health providers in joint counseling techniques • Counseling men should never be a substitute for counseling women about their own health.

  16. THANK YOU

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