Knowledge Brief Health, Nutrition and Population Global Practice BASIC PROFILE OF EARLY CHILDBIRTH IN NIGER Chata Malé and Quentin Wodon March 2016 Child Marriage Series with Education Global Practice KEY MESSAGES:  Measures of early childbirth are high in Niger. The share of women ages 18-22 who had a child before 18 is 47.1 percent and it has increased slightly over time. The share of girls who had a child before the age of 15, at just under ten percent, has also increased slightly.  Early childbirth is associated with lower wealth, lower education levels, and employment without cash earnings. These are however only correlations, not necessarily causal effects. In order to design programs and policies to reduce the Box 1: Brief and Series Primer prevalence of early childbirth, information is needed on its How is child marriage defined? Child marriage is defined as a trend over time, where it is most prevalent in a country, marriage or union taking place before the age of 18. and what the characteristics of girls giving birth early are. Why a series on child marriage? Child marriage has Measuring early childbirth is needed to inform policy. significant negative impacts – not only for girls, but also for a range of development outcomes. Demonstrating these impacts Early pregnancy and childbirth are important issues in will assist governments and others to make the case for intervening to reduce the practice. many countries. Early childbirth is associated with higher health risks for the mother and the child as well as higher What are the topics discussed in the series? The series fertility. It may lead girls to drop out of school. In most looks at the impacts of child marriage on health, population, countries, most early childbirths take place after marriage. education, employment, agency, and violence, among other But in some countries, it may also often take place without outcomes. The welfare, budget, and non-monetary costs of child a marriage or union. To reduce the prevalence of early marriage are estimated. Legal/institutional aspects and options childbirth, specific programs and policies are required, for to reduce the practice are also discussed. which basic information is needed. Using techniques inspired by the poverty literature, this brief provides a What is the question asked in this brief? The question is: How widespread is early childbirth, not only in terms of the share basic profile of early childbirth in Niger. The brief of girls affected by it, but also in terms of how early births occur? documents the extent of early childbirth, its trend over time, in which areas it is most prevalent, and what some How is the question answered? Measures and a profile of of the characteristics of the girls affected by early early childbirth inspired by the literature on poverty are provided. childbirth are. The brief is part of a series of standardized briefs on this topic for several countries. Page 1 HNPGP Knowledge Brief  One in two women has an early childbirth. The consequences of early childbirth for girls and their The analysis relies on data from the latest Demographic children are not the same whether girls have a child at 12 and Health Survey (DHS) for Niger for 2012, the latest or 17. Measures inspired from the poverty literature help DHS available. Table 1 provides basic statistics on the in capturing how early girls have children (see the annex). age at first birth. Two samples are considered: women The headcount (H) measures the share of girls with an ages 18 to 22, the youngest age group that can be used early childbirth. The early childbirth gap (ECG) measures to measure early childbirth1 and women 18-49 (the the “depth” of early childbirth, taking in to account how women’s questionnaire in the DHS collects data for early girls have children. The squared gap (SG) puts even women up to age 49). Almost half of women have their more weight on the girls who have children very early. first child before 18, and one in ten do before 15. There is a decrease in the mean age at first birth between the 18- Early childbirths have increased over time. 49 sample and the 18-22 sample. This is in large part because many women ages 18 to 22 did not yet have a Table 3 provides trends over time in the measures of birth and is therefore not worrying in itself. But as will be shown below, there is also a slight increase in the early childbirth inspired by the poverty literature. Consider measures of early child birth over time, which is worrying. first the age group 18-22. In that age group, almost half of women had their first child before the age of 18 (47.1 Table 1: Age at First Birth for Women (%) percent for the 18-22 age group). The early childbirth gap 18-22 18-49 (CBG) is at 6.4 percent and the squared gap (SG) at 1.1 years years percent for that group. By estimating the same measures No live birth 25.2 7.7 on older groups, the table provides the trend in early Age at first birth childbirth over time. There has actually been an increase 18 or above 27.7 47.6 over time in early childbirth, at least comparing the Below 12 0.1 0.4 youngest with the two oldest age groups. In other words, 12 0.8 1.0 while child marriage can be shown to have been reduced 13 3.0 2.1 slightly, this may not be the case for early childbirth. This 14 5.6 5.2 is a surprising result, but the same is observed when 15 10.9 11.2 considering very early childbirth before the age of 152. 16 12.7 12.0 17 14.0 12.8 Total 100.0 100.0 Table 3: Trend in Early childbirth (%) Mean age at 1st birth 16.8 18.2 18 years 15 years Source: Authors’ estimation. H CBG SG H CBG SG All 18-49 years 44.7 6.2 1.1 8.7 1.0 0.1 Most early childbirths take place after marriage. Age group 18-22 years 47.1 6.4 1.1 9.6 1.0 0.1 23-30 years 47.4 6.7 1.2 9.8 1.1 0.2 In Niger, there is a strong relationship between the age at 31-40 years 42.7 5.8 1.0 7.2 0.9 0.1 first birth and the age at first marriage as communities do 41-49 years 37.2 5.2 0.9 7.8 0.8 0.1 not look favorably at births out of wedlock. Table 2 Source: Authors’ estimation. Values rounding to 0.0 not shown. displays the shares of girls with an early childbirth according to four categories in terms of the timing (or The incidence of early childbirth in Niger in 2012 was absence) of marriage among women ages 18-22. Most higher than that observed 25 years ago. There has been early childbirths take place after marriage, hence delaying an increase over time in how early girls have children. the age at marriage is essential to avoid early childbirth. Table 2: Marriage and Early Childbirth, Age 18-22 (%) Girls are more likely to have children early if they live Categories Share in rural areas and are from poorer backgrounds. Early childbirth without marriage or before marriage 0.3 Early childbirth without marriage or before marriage 3.7 As expected, early childbirth is much more prevalent in Early childbirth in the same year as marriage 24.1 rural than in urban areas. There are also large differences Early childbirth at least one year after marriage 71.9 between regions, with the lowest measures observed in Source: Authors’ estimation. the capital city of Niamey, and the highest measures observed (according to the headcount index with the 18 1 years threshold) in Maradi, Zinder, and Diffa. Early Early childbirth measures must be estimated on the population older than 18, because some younger girls who did not yet have a child by 18 could still have a child by the time they reach 18. It 2 is best to measure early childbirth as early as possible after the Note that the various measures have standard errors (not age of 18 to provide data on conditions as current as possible, shown here to save space). While some of the differences in the which is why the age bracket 18-22 is used here. trends over time are statistically significant, some are not. Page 2 HNPGP Knowledge Brief  childbirth is less prevalent in Agadez. The ranking of the Table 6 provides data on early childbirth by level of regions in terms of the measures obtained with the 15 and education of the women, as well as literacy. Early 18 years thresholds tends to be similar. childbirth affects education attainment negatively, because girls often drop out of school when they have Table 4: Early childbirth by Location, Age 18-22 (%) their first child. The causality goes the other way as well, 18 years 15 years as the ability to pursue one’s education may help delay H CBG SG H CBG SG the age at marriage and thereby the age at first birth. As All 18-22 years 47.1 6.4 1.1 9.6 1.0 0.1 seen in table 6, early childbirth measures are strongly Region correlated with education levels. The same is observed Agadez 29.1 4.0 0.7 6.3 0.6 0.1 when considering literacy where three categories are Diffa 57.5 8.1 1.5 12.9 1.4 0.2 considered: the woman cannot read at all, can read part Dosso 39.5 4.6 0.7 4.3 0.4 - of a sentence, or can read a full sentence. Maradi 58.5 8.0 1.4 12.2 1.2 0.2 Tahoua 46.6 6.0 1.0 8.8 0.9 0.1 Tillaberi 41.8 5.2 0.9 6.3 0.8 0.1 Table 6: Early childbirth by Education Level and Zinder 59.0 9.2 1.8 16.5 1.7 0.2 Literacy Status, Age 18-22 (%) Niamey 16.1 1.8 0.3 1.5 0.2 - 18 years 15 years Residence H CBG SG H CBG SG Urban 23.2 3.0 0.5 3.3 0.4 - All 18-22 years 47.1 6.4 1.1 9.6 1.0 0.1 Rural 53.2 7.3 1.3 11.1 1.1 0.1 Education Source: Authors’ estimation. Values rounding to 0.0 not shown. No education 53.5 7.6 1.4 12.2 1.3 0.2 Primary, some 43.2 5.1 0.8 4.8 0.5 0.1 Rural girls are much more likely to have children early Primary, compl. 30.3 3.1 0.4 0.6 0.1 - Secondary, some 17.5 1.7 0.2 0.3 - - than urban girls. Girls from the bottom four quintiles of Secondary, compl. 6.1 0.3 - - - - wealth are also more likely to have children early. The Higher - - - - - - relationship between early childbirth, literacy, and Literacy education attainment is strong. Early childbirth measures Cannot read 52.3 7.3 1.3 11.4 1.2 0.2 are similar for women who work and those who do not. Limited ability 46.3 5.5 0.8 5.0 0.3 - Full sentence 17.8 1.7 0.2 0.3 - - No card available 58.1 8.2 1.3 - - - Household welfare is measured through a wealth index Source: Authors’ estimation. Values rounding to 0.0 not shown. with households categorized according to five quintiles of wealth. Women who had a birth tend to be married, hence Table 7 provides data on labor force participation. One the level of wealth is that of the household in which the would expect early childbirth to reduce women’s labor women married, not that of the household or origin. Yet force participation, for example through higher fertility. But the quintile of wealth after marriage and first birth may not if early childbirth is associated with poverty, women may be very different from that of the household of origin. On leave little choice but to work. Other effects could also be the other hand, since early childbirth measures are based at work. In Niger, early childbirth measures are similar on young women ages 18-22, their level of assets may be among women who work and those who do not. However, lower than would be the case later in life. In any case, the the type of work associated most closely with early measures of early childbirth do not differ much between childbirth is work without cash earnings (in-kind benefits the three bottom quintiles, and it is only with the top only), which may be work with low productivity. quintile that early childbirth is much less prevalent. Table 7: Early childbirth by Labor Force Participation Table 5: Early childbirth by Quintile, Age 18-22 (%) Status, Age 18-22 (%) 18 years 15 years 18 years 15 years H CBG SG H CBG SG H CBG SG H CBG SG All 18-22 years 47.1 6.4 1.1 9.6 1.0 0.1 All 18-22 years 47.1 6.4 1.1 9.6 1.0 0.1 Wealth quintiles Working Poorest 54.5 7.4 1.3 11.5 1.2 0.2 No 47.1 6.3 1.1 9.2 0.9 0.1 Second 54.5 7.5 1.3 10.5 1.0 0.1 Yes 47.3 6.7 1.2 11.1 1.1 0.1 Middle 52.8 7.4 1.4 13.7 1.5 0.2 Type of work Third 48.1 6.6 1.1 9.7 0.9 0.1 Not paid 33.7 4.4 0.7 8.2 0.6 - Richest 30.9 3.8 0.6 3.9 0.4 0.1 Cash only 46.6 6.3 1.1 7.6 0.9 0.1 Source: Authors’ estimation. Values rounding to 0.0 not shown. Cash and in-kind 50.4 8.3 1.7 22.3 2.3 0.3 In-kind only 81.7 14.5 3.1 48.5 4.2 0.4 Early childbirth is associated with lower education Source: Authors’ estimation. Values rounding to 0.0 not shown. attainment and a lower likelihood of literacy, but not with higher (or lower) labor force participation. Page 3 HNPGP Knowledge Brief  Conclusion The early childbirth gap represents the “depth” of early childbirth. It takes into account not only the share of girls who had their first This brief has provided a basic profile of early childbirth in child early, but also the mean number of years below 18 (or 15) Niger. Measures of early childbirth are high. The share of at which girls had their first child. This matters because even if women ages 18-22 who had their first child before 18 is the share of girls who have their first child early does not change, there may still be improvements in the early childbirth 47.1 percent and it has slightly increased over time. The gap if girls who have their first child early have that child a little share of women with their first child before 15 is at just less early. under 10 percent. Other measures of early childbirth have also not declined, with increases in some cases over the Finally, the squared early childbirth gap measures the “severity” last 25 years. Early childbirth is associated with lower of early childbirth. While the early childbirth gap takes into wealth and lower education levels, and employment account the average number of years of early marriage for girls without cash earnings. These are however only who have their first child early, the squared gap takes into correlations, not necessarily causal effects. Other briefs in account the square of that number, thereby putting more emphasis on girls who have their first child very early. Together this series look at potential causal effects. the three measures provide a better diagnostic of early childbirth than the headcount index alone. The measures also have References attractive properties that are beyond the scope of this brief. Foster, J., J. Greer, and E. Thorbecke, 1984, A Class of The headcount index, early childbirth gap, and squared gap are Decomposable Poverty Measures, Econometrica 52: 761–776. the first three measures of the so-called FGT class (Foster et al., 2014). Denote by q the number of girls who have their first child Nguyen, M. C., and Q. Wodon, 2012, Measuring Child Marriage, early and by n the number of girls in the overall population. Economics Bulletin 32(1): 398-411. Denote by yi the age at which girl i had her first child and by z the age threshold defining early childbirth (18 years of age, but a Annex: Methodological Note lower age threshold such as 15 can also be used to measure extremely early childbirth). The general formula for the FGT While many studies have discussed trends in child marriage, class of measures depends on a parameter α which takes a less work has been done on trends in early childbirth. When value of zero for the headcount, one for the early childbirth gap, conducted, measurement of early childbirth (or early pregnancy) and two for the squared gap in: has focused on one simple statistic such as the share of girls  1 q  z  yi  who have a live birth before the age of 18 or 15. Such statistics are useful, but they do not capture well the distribution of the P   z  n i1   age at first birth in the form of aggregate statistics that tell us about the depth and severity of the problem. Basic statistics on the share of girls having an early childbirth also do not facilitate testing for the robustness of comparisons of trends in early This brief was produced as part of the Economic Impacts of Child childbirth between countries, between groups within countries, Marriage study, a joint project of the International Center for Research or between time periods. on Women (ICRW) and the World Bank, which is supported by the Bill & Melinda Gates Foundation and the Children’s Investment Fund Foundation (CIFF). More details on the research can be found at the Following the approach used by Ngyuen and Wodon (2012) for project’s website: www.costsofchildmarriage.org. Partial funding for the child marriage, this brief relies on methods from the poverty work related to child marriage and education, labor force participation, literature to measure early childbirth. Three measures are used: earnings, and program responses has been provided by the Global the incidence of early childbirth or headcount index, the early Partnership for Education. Comments from Jeff Edmeades and Michele childbirth gap, and the squared early childbirth gap. The Gragnolati are gratefully acknowledged. The opinions expressed in this headcount index is simply the share of the girls who have their brief are those of the authors only and need not reflect the views of the first live birth before the age of 18. The headcount index can be World Bank, its Executive Directors, of the countries they represent. computed for other age thresholds, such as 15 years of age. The Health, Nutrition and Population Knowledge Briefs of the World Bank are a quick reference on the essentials of specific HNP-related topics summarizing new findings and information. These may highlight an issue and key interventions proven to be effective in improving health, or disseminate new findings and lessons learned from the regions. For more information on this topic, go to: www.worldbank.org/health. Page 4