Knowledge Brief Health, Nutrition and Population Global Practice CHILD MARRIAGE AND FERTILITY IN THE REPUBLIC OF THE CONGO Adenike Onagoruwa and Quentin Wodon June 2017 Child Marriage Series with Education Global Practice KEY MESSAGES: • In the Republic of the Congo, women who marry as children have on average 9-30 percent more births over their life time as compared to women marrying after the age of 18. • Controlling for socio-economic and other characteristics, the average number of births per woman would be reduced by 0.35 births or about seven percent if child marriage could be eliminated. This in turn would have a substantial effect on demographic growth. Box 1: Brief and Series Primer Girls marrying early tend to have children earlier than girls who marry later. They also have more children over their How is child marriage defined? Child marriage is defined as a lifetime. Given the importance of population growth, marriage or union taking place before the age of 18. assessing the impact of child marriage on fertility matters. Why a series on child marriage? Child marriage has significant negative impacts – not only for girls, but also for a range of Child marriage is associated with higher fertility. development outcomes. Demonstrating these impacts will assist governments and others to make the case for intervening to The relationship between child marriage and fertility could reduce the practice. be due in part to the socio-economic and cultural context in which girls who marry early tend to live. But child marriage What are the topics discussed in the series? The series looks may also have a direct impact on fertility after controlling at the impacts of child marriage on health, population, education, for socio-economic and cultural context. Marrying early is employment, agency, and violence, among other outcomes. The often associated with a lack of agency for girls, including in welfare, budget, and non-monetary costs of child marriage are terms of access to family planning that could help delay or estimated. Legal/institutional aspects and options to reduce the practice are also discussed. reduce births if women so desire. For societies, higher total fertility rates lead to higher population growth, lower growth What is the question asked in this brief? The question is: To in GDP per capita, slower poverty reduction, and difficulties what extent would the number of live births that women have over for governments to provide basic services to a growing their lifetime decrease if child marriage were eliminated? population. This brief estimates the impact of child marriage on the number of children that women have over How is the question answered? Econometric analysis of their lifetime in the Republic of the Congo, as part of a Demographic and Health Survey data is used to estimate the series of standardized briefs on this topic for multiple impact of child marriage on the number of births women have. countries. Page 1 HNPGP Knowledge Brief • Statistically, women marrying as children have 1.13 Controlling for socio-economic and other characteristics, more live births than women marrying after 18. women who marry as children have on average 9-30 percent more than women marrying after the age of 18. The analysis is based on data from the Demographic and Health Survey for the Republic of the Congo implemented With the baseline specification, table 2 suggests that in 2011-2012. The focus is on the number of births that marrying at age 17 increases the number of births by 16.1 women have over their lifetime. For sample size reasons, percent in comparison to marrying at age 18 or later. we focus on women between 35 and 49 years of age. Marrying earlier often has a larger impact. Overall, the Some women continue to have children after age 35, so that the total number of births considered here may be impacts vary from 30.0 percent for girls marrying at age 13 slightly underestimated, but this should not affect too much to 16.1 percent for girls marrying at age 17. The marginal effects of early marriage do not change much when the estimate of the difference in the total number of births additional controls are added to the regressions. There is for women marrying as children (before age 18) or not. thus some evidence that after controlling for a wide range of other variables, child marriage may contribute to higher Women ages 35-49 who married after 18 have on average fertility, but prudence remains needed when interpreting 4.26 live births by that age. For women who married before these results given the risk of omitted variable bias (see 18, the average is higher at 5.39 births. box 2). As shown in table 1, women ages 35-49 who married after Table 2: Impact of Child Marriage on Number of 18 have on average 4.26 births by that age. For women Children Ever Born by Age of Marriage, 2011-12 DHS who married before 18, the average is 5.39 births. The Age at first Baseline Extended difference (1.13 births) is statistically significant. Except for marriage model model girls marrying at 12 or earlier (these are extreme cases that Married <= 12 1.091 1.204** may have specific circumstances), the number mostly Married at 13 1.301*** 1.399*** increases when girls marry earlier, as expected. Married at 14 1.252*** 1.224*** Married at 15 1.219*** 1.173*** Table 1: Mean Number of Children Ever Born by Age Married at 16 1.219*** 1.173*** of First Marriage, 2011-12 DHS Married at 17 1.161*** 1.162*** Age 35-49 Source: Authors. Sample as a whole 4.59 (0.075) Levels of statistical significance: *** 1%, ** 5%, * 10%. Married after 18 years of age 4.26 (0.076) Married before 18 years of age 5.39 (0.091) Box 2: Risk of Omitted Variable Bias Married at 17 5.12 (0.191) Married at 16 5.36 (0.193) Child marriage appears to be positively correlated with fertility Married at 15 5.58 (0.203) after controlling for other factors that may also contribute to Married at 14 5.78 (0.269) fertility. This could indicate a causal effect. However, other Married at 13 5.70 (0.307) variables correlated with both child marriage and fertility not Married at 12 /below 4.86 (0.341) included in the analysis could be at the source of the correlation Source: Authors. Standard error in parentheses. observed between child marriage and fertility. Because of the risk of omitted variable bias, the results cannot be considered as fully Controlling for other factors, child marriage still conclusive regarding a causal impact of child marriage on fertility, increases the number of live births substantially. even though in this specific case causality is very likely. In order to measure the impact of child marriage at the Because early marriage also has an impact on other margin on the number of births, regression analysis is variables used as controls in the regression, the overall needed. Details of the methodology is provided in the effect of child marriage on the number of births including annex. Table 2 shows the results for the variables of through indirect effects could be larger than the direct interest with two models: a baseline specification and the estimates observed from the regression coefficients. For specification with the largest number of added variables as example, for some girls marrying early, child marriage has controls. The interpretation of the coefficients is in terms of a negative effect on education attainment, and it may also incident rate ratios. A coefficient of 1.15 for girls marrying contribute to lower household wealth. Still, in terms of at the age of 17 suggests that if a girl marries at that age, magnitude, those indirect effects are likely to be small in the number of children she will have over her lifetime will comparison to direct effects. Only a relatively small share be 15 percent higher than the number of children she would of girls marrying early would have been able to complete have had if she had married at age 18 or later. their secondary education if they had married later and the coefficient of secondary education on the number of births in the regression is close to one, suggesting limited impact of a secondary education on fertility in comparison to a Page 2 HNPGP Knowledge Brief lower level of education. This implies that one may rely on number of births that women would have. Given the the estimated direct effects of child marriage on the number observed average number of children of over four births per of births that women have over their lifetime in order to woman in the country (first column in table 3), this suggests simulate the impact of the elimination of child marriage on that the average number of births (essentially the total total fertility. Not factoring in indirect effects in the fertility rate) would be reduced by about seven percent if simulations does not entail large mismeasurement. child marriage could be eliminated. This in turn would have a substantial effect on demographic growth in the country. A number of other factors not shown in table 2 lead to differences in the number of births for women. As already Eliminating child marriage could reduce the country’s total mentioned, better educated women, especially those with fertility rate by 0.35 births or about seven percent. This a higher degree, tend to have fewer children. The would help reduce population growth substantially. differences by wealth quintiles are statistically significant in the second, fourth and fifth quintiles, with women from Table 3: Impact of the Elimination Child Marriage wealthier households tending to have fewer children. under the Baseline Model for the Estimations Younger women within the sample have fewer births, but Women 35+ Observed Predicted Simulated may still get more later on in their life. Differences (n=3,368) Mean Mean Mean according to some religions are statistically significant, as All 4.59 4.69 4.34 well differences according to some geographic areas Age at first marriage (provinces). Most of the additional control are not 30-34 2.72 3.94 3.94 associated with statistically significant effects on fertility, 25-29 3.46 4.07 4.07 especially in the last model. 20-24 4.56 4.33 4.33 18 and above 4.26 4.26 4.26 Eliminating child marriage would help reduce the 18 4.71 4.30 4.30 number live births for women marrying early by 0.93. 17 5.12 5.12 4.41 16 5.36 5.36 4.39 15 5.58 5.58 4.58 The last step in the analysis consists in assessing the 14 5.78 5.78 4.61 impact of eliminating child marriage on the total fertility rate. 13 5.70 5.70 4.38 Results in table 3 are obtained by predicting the number of 12 or below 4.86 4.86 4.46 births that women who married as children would have had Never married 1.83 - - if they had married later. The first column in table 3 17 and below 5.39 5.39 4.46 provides the estimates of the number of births in the Source: Authors’ estimations. sample. The second column provides the predicted values under the baseline model (results are similar with other Conclusion models). The third column provide the simulated number of births without child marriage. Note that for all women who Child marriage is linked to higher and less controlled fertility marry after the age of 18, there are no differences between for girls who marry early. In the Republic of the Congo, the predicted and simulated number of births marriage under the baseline specification, girls marrying before the since these women did not marry early. age of 18 have one fifth more births over their lifetime than women who marry after the age of 18. This translates on For women who did marry early, the simulated number of average for all girls who marry early in an increase in the births are substantially lower than the predicted values number of children ever born of 0.93 children versus the taking into account the fact that they married early. With the number of children born for girls who marry at 18 or later. baseline model, women who married early have on For the country as a whole, the average number of births average 0.93 more children than if they had married later. (essentially the total fertility rate) would be reduced by The difference between predicted and simulated numbers about 0.35 births or about seven percent if child marriage of children for women who married early or not with the were to be eliminated. expanded model is similar, at 0.95 fewer children. References The top row in table 3 provides the difference that child marriage makes for the average number of births nationally Centre Nationale de la Statistique et des Études Économiques (this is similar to the total fertility rate), thereby factoring the (CNSEE) [Congo] et ICF International (2013). Enquête Démographique et de Santé du Congo (EDSC-II) 2011-2012. share of women who marry early at different ages. With the Calverton, Maryland, USA : CNSEE et ICF International baseline model, the average number of births that women have over their lifetime is reduced for the country as a Godha, D., Hotchkiss, D. R., & Gage, A. J. (2013). Association whole by 0.35 births without child marriage. The effect is between child marriage and reproductive health outcomes and the same when considering the expanded model (not service utilization: a multi-country study from South Asia. Journal shown), with again a reduction of 0.35 in the average of Adolescent Health, 52(5), 552-558. Page 3 HNPGP Knowledge Brief • Kamal, S. M. (2012). Decline in child marriage and changes in its A few additional explanations on definitions may be useful. In this effect on reproductive outcomes in Bangladesh. Journal of health, brief, the focus is on the impact of child marriage on the number population, and nutrition, 30(3), 317. of children ever born to women towards the end of their fertile life. This is a useful statistic that summarizes the fertility behavior of Kamal, S. M., & Hassan, C. H. (2015). Child marriage and its women who are nearing the end of their reproductive period. If association with adverse reproductive outcomes for women in fertility is stable over time, the mean number of children ever born Bangladesh. Asia-Pacific Journal of Public Health, 27(2), is similar to the total fertility rate (TFR) which refers to the average NP1492-NP1506. number of live births a woman would have if she were subject to current age-specific fertility rates throughout her reproductive Nasrullah, M., Muazzam, S., Bhutta, Z. A., & Raj, A. (2014). Girl years. In other words, under stable conditions, the number of child marriage and its effect on fertility in Pakistan: findings from children ever born is a good proxy for the TFR. If fertility levels Pakistan Demographic and Health Survey, 2006–2007. Maternal have been falling, the TFR will however be (slightly) lower than and child health journal, 18(3), 534-543. the mean number of children ever born. For sample size reasons, we consider women ages 35 to 49 to estimate the number of Raj, A., Saggurti, N., Balaiah, D., & Silverman, J. G. (2009). children ever born, rather than women ages 40-49. This does not Prevalence of child marriage and its effect on fertility and fertility- affect our results substantially given the focus on the differential control outcomes of young women in India: a cross-sectional, impact of child marriage observational study. The Lancet, 373(9678), 1883-1889. As for the regression analysis, given that the variable of interest Santhya, K. G. (2011). Early marriage and sexual and is a count variable (taking values such as 1, 2, 3…), Poisson reproductive health vulnerabilities of young women: a synthesis regressions are estimated. Different models are estimated to test of recent evidence from developing countries. Current opinion in for the robustness of findings to the specification used. Apart from obstetrics and gynecology, 23(5), 334-339. the age at first marriage or union, the baseline model controls for: (1) location (urban versus rural); (2) education level of the Santhya, K. G., Ram, U., Acharya, R., Jejeebhoy, S. J., Ram, F., girl/woman; (3) wealth quintile (from the poorest to the richest); & Singh, A. (2010). Associations between early marriage and (4) religion; (5) geographic area; and (6) age group (35-39, 40-44, young women's marital and reproductive health outcomes: and 45-49). In other models variables capturing agency for evidence from India. International perspectives on sexual and girls/women in the household and additional community-level reproductive health, 132-139. controls are added. The community variables are the leave-out- means of contraceptive use and whether women experienced a Annex: Methodological Note child death before the age of five (leave-out-means are estimated at the level of the primary sampling units in the survey). Overall, Previous research has been conducted on child marriage and the estimated impacts of early marriage on the number of births fertility (e.g., Santhya, 2011; Kamal, 2012; Godha et al., 2013; for women over their lifetime are fairly robust to the choice of Nasrullah et al., 2013; Kamal et al. 2015). This brief has three specification. features that differentiate it from previous work. First, the impact of each additional year of early marriage on the number of births a woman has over her lifetime is estimated. Previous studies typically looked only at the impact of marrying early or not. Here, This brief was produced by a World Bank team as part of the Economic we look at the impact of each single additional year of early Impacts of Child Marriage study. The synthesis report under the study was marriage. Second, we estimate the impact of child marriage on a produced jointly with the International Center for Research on Women. woman’s number of child births over her lifetime. Previous The study benefitted from support from the Bill & Melinda Gates Foundation, the Children’s Investment Fund Foundation, and the Global studies focused mostly on young women (ages 18 to 24). The Partnership for Education. Comments from colleagues and peer reason for considering older women is to account for potential reviewers are gratefully acknowledged. The opinions expressed in this substitution effects whereby if a woman does not have children brief are those of the authors only and need not reflect the views of the early in life, she may want more children later on. World Bank, its Executive Directors, of the countries they represent. In order to look at the impact of child marriage on total fertility, we need to consider women towards the end of their fertile age. Third, we use the estimations from the regression analysis to conduct simulations about the magnitude of the reduction in the average number of children that women are expected to have that could be achieved through the elimination of child marriage. 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