Estimated effect of age of marriage on utilisation of India’s Integrated Child Development Service programme

Journal of Epidemiology & Community Health Pub Date : 2023-12-11 DOI:10.1136/jech-2023-221325

Rajesh Kumar Rai, Sabri Bromage

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Abstract

Background Age of marriage among women is considered an important indicator of their readiness for familial integration and parenting. This study estimated the effect of age of marriage of young mothers (aged 15–24 years) on utilisation of various services for their children, provided under the Integrated Child Development Service (ICDS) programme in India. Methods Data from the nationally representative 2019–2021 National Family Health Survey of India were analysed. Mothers’ age of menarche was used as an instrumental variable to isolate the effect of age of marriage on whether their children received (1) food, (2) health check-up, (3) immunisation, (4) early childhood care or preschooling or (5) weight measurement services from ICDS. Results Nationally, 67.9% (95% CI 67.6%, 68.3%) of children received food (sample: 60 578), 61.8% (95% CI 61.4%, 62.1%) received a health check-up (sample: 60 316), 60.0% (95% CI 59.6%, 60.4%) received immunisation services (sample: 60 537), 52.0% (95% CI 51.6%, 52.4%) received early childhood care or preschooling (sample: 60 458) and 62.9% (95% CI 62.5%, 63.3%) received weight measurement services (sample: 60 278). Findings from instrumental variable analysis suggest that a 1-year increase in age of marriage could yield a 9 percentage point increase (95% CI 4%–13%; p<0.001) in utilisation of immunisation services. Although postponement of marriage positively affected utilisation of each of the other four ICDS components, these effects were not statistically significant. Conclusion Postponing age of marriage among young women is an effective intervention for promoting uptake of child immunisation services. Our findings support the Government of India’s 2021 Bill to raise legal age of marriage of women. Data may be obtained from a third party and are not publicly available. The 2019–2021 National Family Health Survey dataset used for this study could be accessed from the official website of DHS Program:

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结婚年龄对印度儿童综合发展服务计划利用率的估计影响

背景妇女的结婚年龄被认为是衡量她们是否准备好融入家庭和养育子女的一个重要指标。本研究估计了年轻母亲（15-24 岁）的结婚年龄对其子女利用印度儿童综合发展服务计划（ICDS）提供的各种服务的影响。方法分析了具有全国代表性的 2019-2021 年印度全国家庭健康调查的数据。母亲的初潮年龄被用作工具变量，以分离出结婚年龄对其子女是否接受 ICDS 提供的（1）食品、（2）健康检查、（3）免疫接种、（4）幼儿保育或学前教育或（5）体重测量服务的影响。结果在全国范围内，67.9%（95% CI 67.6%，68.3%）的儿童获得了食物（样本：60 578），61.8%（95% CI 61.4%，62.1%）的儿童获得了健康检查（样本：60 316），60.0%（95% CI 59.6%，60.4%）接受了免疫接种服务（样本：60 537），52.0%（95% CI 51.6%，52.4%）接受了幼儿保育或学前教育（样本：60 458），62.9%（95% CI 62.5%，63.3%）接受了体重测量服务（样本：60 278）。工具变量分析结果表明，结婚年龄每提高 1 岁，体重测量结果就会增加 9 个百分点（95% CI 4%-13%；p

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Journal of Epidemiology & Community Health

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