Title: A multilevel analysis of prevalence and factors associated with female child marriage in
Nigeria using the 2018 Nigeria Demographic and Health Survey data
Version: 1 Date: 26 Feb 2021
Reviewer's report:
Thank you for the opportunity to review this paper. This study uses cross-sectional data from the
women’s file of the Nigeria Demographic and Health Survey (NDHS) from 2003 to 2018 among
young women aged 20-24 years to examine the factors associated with female child marriage.
The manuscript studies an important topic. However, there are several areas that would benefit
from revision. First, although the title refers to trends and the study evaluates trends, this does not
come across clearly throughout the manuscript in the methods, results or discussion. Secondly,
the study aims and conceptual approach could benefit from some clarification. The authors aim
to examine predictors, but do not provide a rationale for the selection of variables, and seem
to focus on ‘cultural beliefs’ and norms without explaining or theorising why these might be
important. I believe with revisions this will be a good contribution to the literature on child
marriage.
Background
• In the fourth para of the background where the authors describe the health effects of FCM – it
would be helpful to know if this is global evidence/where this evidence comes from.
• Currently the authors state:
For a country that is regarded as Africa’s largest economy and the most populous nation which
is also characterized by a dichotomy of extremes (14); hence, the country’s high prevalence of
FCM are attributed or characterized by unique determinants in additions to those mentioned
above (15, 16).
A more nuanced discussion of the individual, household level, contextual, and structural factors
that drive FCM would strengthen this section. Similarly, later the reference to “traditional
cultural beliefs” could be better contextualised.
• A little more explanation about how the “States policy autonomy” is one of the contributing
factors in regional variation in FCM? What is it about these policies?
• At several points the introduction refers to norms and beliefs as very important, yet there is
no discussion or description of what these are – explicitly describing/discussing these would be
very helpful in framing this paper.
• The study aims need clarification in the introduction and should mirror the approach in the
methods
Methods
• This section is clear and the choice of methods is well defined
• The last section of the second paragraph needs clarification –
The study's sample size includes young women between the ages of 20 and 24 for each survey
period (3, 26).
The sample size for the DHS, as the authors note, is 15-49 years. Does this sentence refer to
the criteria set by the authors?
• How were the wealth quintiles recoded to be a 3 category variable?
• The explanatory variables include sociodemograhics as well as FGM and media exposure –
more information about how these were selected and how they match the study aims would be
helpful
• How did the logistic models deal with the multiple survey waves and the changes over time?
• The title and aims refer to “trends” and yet the focus of the analysis is not trends – could this
be clarified or revised?
Results and discussion
• Descriptive results are about women aged 20-24 years and it would be helpful to describe the
findings as such: instead if “6 out of 10 resides” perhaps “6 out 10 women aged 20-24 years
were living in rural areas…”
• The methods section discusses FGM and the results discusses circumcision, it would be helpful
if these were consistent
• More explanation and discussion is needed about how these models adjust for survey year.
Including sensitivity analyses that examine these models for each time point could also be
helpful and would allow a discussion of whether the role of these predictors changed over time
• It would be helpful to report Table 2 for each survey year and not aggregated all together
• The finding that employment reduces FCM should be interpreted with caution as child marriage
occurred before employment
• The limitations section should also describe how media use, employment, parity are all likely
to have occurred after FCM
• The limitations section should also discuss other variables that were not included
• If the aim of the paper is to assess trends, this should be discussed in more detail in the
discussion section