Review er’s report  
 
Title: Determinants of early marriage among married women in Injibara town, North West  
Ethiopia: Community -based cross -sectional study  
 
Version: 0 Date: 08 Sep 2019  
 
Reviewer: Hassan Abduljabbar  
 
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BMC Women's Health  
 
Determinants of early marriage among married women in Injibara town, North West Ethiopia: 
Community -based cross -sectional study  
 
Manuscript Number: B MWH -D-19-00585  
 
Full Title: Determinants of early marriage among married women in Injibara town, North West 
Ethiopia: Community -based cross -sectional study  
 
Keywords: Early marriage, prevalence, Injibara town, determinant factors  
 
Generally  
 
The title reflects the study accurately.  
It is interesting subject might be benefice; for social reasons in there country  
The study is (Not Original),  
 
 
Montazeri S, Gharacheh M, Mohammadi N, Alaghband Rad J, Eftekhar Ardabili H. 
Determinants of Early Ma rriage from Married Girls' Perspectives in Iranian Setting: A 
Qualitative Study. J Environ Public Health. 2016;2016:8615929. doi: 10.1155/2016/8615929. 
Epub 2016 Mar 30. PMID: 27123012  
 
 
Erulkar A. Early marriage, marital relations and intimate partner viol ence in Ethiopia. Int 
Perspect Sex Reprod Health. 2013 Mar;39(1):6 -13. doi: 10.1363/3900613. PMID: 23584463  
 
Nasrullah M, Zakar R, Zakar MZ. Child marriage and its associations with controlling behaviors 
and spousal violence against adolescent and young w omen in Pakistan. J Adolesc Health. 2014 
Dec;55(6):804 -9. doi: 10.1016/j.jadohealth.2014.06.013. Epub 2014 Aug 12. PMID: 25123525  
 
 The message of the study might have additional knowledge of medical literature.  
 
 
 
Abstract:  
 
Objective: is clear  
The aim o f this study was to determine the prevalence and determinant factors of early marriage 
among married women in Injibara town, North West Ethiopia( what the benefit of the study)  
The abstract reflects the research and very easy to understand.  
It is a good s ummary it is well written  
 
 
Background  
 
Early marriage is one of the major traditional practice in developing counties  
particularly in Ethiopia;  
which has significant physical, intellectual, psychological and emotional effects and reduces 
educational op portunities and the chance for personal growth for both boys and girls.  
This traditional practice was the common socio -cultural events in the study area. However; there 
is no prior study on the magnitude and its determinant factors  
 
 Good introduction, e xplaining that what is studed in the past of other country   
 
 Some text taken from the web  
 
 
Ethiopia is known to have one of the most service crises of child marriage and harmful 
traditional practice in the world  
 
Global One Health News - August 2019. https://myemail.constantcontact.com/Global -One-
Health -News ---August -2019.html?soid=1105082123243 &amp; aid=VdaTvaqXJOs  
 
These consequences can include health risks that result from early sexual activity and pregnancy, 
including sexually transmitted diseases and maternal mortality (8, 9).  
 
Risk factors associated with the practice of child .... https://data.unicef.org/wp -
content/uploads/2016/04/Child -marriage -among -Roma -girls-in-Serbia_251.pdf  
 
 
 
 
Methods  
 
 The study was con ducted in Injibara town, Amhara region, Ethiopia  
 
 September to December 2018.  
 
Assessment of the Existing Structural Plan Implementation .... 
http://ijarm.com/pdfcopy/apr2017/ijarm3.pdf  
 
 
The legal age of marriage is 18 in Ethiopia,  many females in Inj ibara town enter marriage at 
much younger ages. marriages are typically arranged by parents  
 
'I had to flee by night': Massachusetts child marriage .... 
https://www.masslive.com/boston/2019/03/i -had-to-flee-by-night -massachusetts -child -marriage -
survivors -say-many -were -coerced -endured -years -of-abuse.html  
 
Besides, marriage also practiced through abducting girls, raping them, and  then sending an offer 
of marriage and a bride price back through community elders to the girl's family.  
 
Challenges in Changing S ocial Norms: Evidence from .... https://editorialexpress.com/cgi -
bin/conference/download.cgi?db_name=CSAE2016 &amp; paper_id=1073  
 
At that point, the family will usually accept the marriage  and the offered bride price.  
However; abducting girls and raping t hem was illegal in the country.  
 
Challenges in Changing Social Norms: Evidence from .... https://editorialexpress.com/cgi -
bin/conference/download.cgi?db_name=CSAE2016 &amp; paper_id=1073  
 
Study Design  
 
The community -based cross -sectional study design was used.  
 
Study population  
 
 All married women in Injibara Town were the source population.  
 
 This study included all married women aged from 15 -49 years and who lived at selected 
kebeles in Injibara town .  
 
 Those married women aged from 15 -49 years and who did not stay more than 6month in the 
town were Excluded Sample size determination  
 
 The sample size was determined using a single population proportion formula by assuming a  
 95%CI, 4% marginal of e rror, and the prevalence of early marriage 83% (11).  
 
 After 10% of the non -response rate was added; the final sample size for this study was 373.  
 
Sampling technique and procedure  
A multistage sampling procedure was employed to select study participants . Injibara town has  
five kebeles and three kebeles out of five were selected by a lottery method.  
 
We then further subdivided these kebeles by village/Got and from each village, households were 
selected by simple random sampling, based on the proportional allocation of the size of 
households in each village and using the number of the household as a sampling frame.  
 
The first households were  selected from the town using the town's house number registration by 
lottery method.  
In cases of selected househol d with more than one eligible study subject, only a single 
respondent was  chosen by random method. In cases where no eligible respondent found in the 
chosen household,  the data collectors have gone to the next household until they found an 
eligible subject . 
 
 
Data Collection Instruments and technique  
 
Data was collected using a structured interview administered the questionnaire.  
 
The questionnaire was adopted and modified from previous similar literature after considering 
the local situations(8, 10, 12, 13). Is it validated and in which language  
 
Before the actual data collection period; the questionnaire was pretested on 5% of married 
women at Bahir dar town, thereby adjustment was made on the tool.  
 
Data was collected by 4 n urses and 4 health extension workers who took 2 days of training. Data  
on age at first marriage was found by asking respondents retrospectively their age at which their  
marriage contract was made between them and their first spouse.  
 
Early marriage in Sout h Wollo and East Gojjam zones of the .... 
http://bdu.edu.et/fss/sites/bdu.edu.et.fss/files/Early%20Marriage%20in%20South%20Wollo%20
and%20East%20Gojjam%20Zone.pdf  
 
 
 
Data management and analysis  
 
Data were checked for completeness and inconsistencies. Then the data were coded and entered  
into EPI data version 3.1 then exported to SPSS version 23 for analysis. Descriptive and analytic  
statistics were computed.  
 
Variables with p -values ≤ 0.2 in bivariate analysis remained in the model as potential  
confounders for the next level analysis. In multivariable logistic regression; statistical  
significance was considered at P &lt;0.05. AOR with 95% CI was used to measure the strength of  
association between early marriage and predictor variables. Backward stepwise logis tic 
regression method was used in multiple logistic regression.  
 
 
Results:  
 
 The prevalence of early marriage was 167(44.8%).The minimum and maximum ages at first 
marriage were 9 and 23 respectively. Non formal education status of the father  
 
 AOR=2.32; 95%CI=1.33 -4.05), family's average monthly income &lt; 1000 Ethiopian birr  
 [AOR=2.32; 95%CI=1.27 -4.24], non -formal education status of the husband  
 [AOR=1.87; 95%CI=1.07 -3.26] and non -formal education status of the respondents  
 [AOR= 5.16; 95%CI=2.87 -9.28] were found to be associated with early marriage.  
 
 Table 1: Reasons for early marriage among married women  
 
 Table 3: Bivariate and multivariable association of early marriage and independent factors 
among married women in In jibara town  
 
 
Discussion  
 
 The prevalence of early marriage in Injibara town was 44.8% with[95%CI=39.5 -49.9].  
 
 This finding was lower than a study finding in Bangladeshi (78.2%)(14).  
 
 This could be due to the difference in implementation of regulato ry and legislative measures, 
cultural, traditional, religious and social norms and values between the study areas.  
 
 This finding was also lower than a study conducted in Sub -Saharan Africa (55%)(15) and East 
Gojjam Zones, Amhara region (83%) (11).  
 
 The difference might be due to this study was conducted more recently in which concerns of 
child marriage and the wellbeing of girls have  
This finding was higher than a study conducted in Latin America (16 %)(16).  
 
Kindie, Etsegenet, et al. "Time to Development of Adverse Drug Reactions and Associated 
Factors among Adult HIV Positive Patients on Antiretroviral Treatment in Bahir Dar City, 
Northwest Ethiopia." PLoS One, vol. 12, no. 12, Public Library of Science, Dec.  2017, p. 
e0189322.  
 
Family's average monthly income &lt;1000birr was significantly associated with early marriage.  
 
Evidence also indicated  that early marriage occurs primarily in lower and middle -income 
families, which is more as a  social form of divisio n of roles and responsibilities from the female's 
family to the husband(18).  
 
Nigussie, Azezu. "Knowledge of Health Professionals on Folic Acid Use and Their Prescribing 
Practice in Bahir Dar City Administration, Northwest Ethiopia: Cross -Sectional Study."  PLoS 
One, vol. 12, no. 1, Public Library of Science, Jan. 2017, p. e0170116.  
 
 
The age was self -reported and hence this study may be prone to bias due to social desirability 
and recall. Since there is no vital registration system and because of memory lap se, respondents 
may not know or remember their exact age at their first marriage.  
 
Early marriage in South Wollo and East Gojjam zones of the .... 
http://bdu.edu.et/fss/sites/bdu.edu.et.fss/files/Early%20Marriage%20in%20South%20Wollo%20
and%20East%20Gojjam% 20Zone.pdf  
 
 
Conclusion  
 
Conclusion: The prevalence of early marriage was high in Injibara town, Ethiopia. Factors that 
tend to facilitate early marriage in this town include family income, family size, the educational 
level of the father and that of the r espondent. Improving on the strategies that promote formal 
education will reduce the level of early marriage in Injibara town, Ethiopia.  
 
Very simple  
Delicate  
Expected  
 
 
The manuscript is written in simple (English language with few spelling and grammar  mistakes.)  
Statistical analysis  used is appropriate  
 
Methods clear Community -based cross -sectional study (questionnaire is it validated)  
 
The table illustrates the result very clearly    
 
The length of the manuscript is appropriate.  
 
Plagiarism .. There are few sentences in the manuscript taken from the web   
 
No conflicts of interests  
 
Ethically approved, registered  
 
References; many references are old before 2009 not verified or not checked)  
Are the methods approp riate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions d rawn adequately supported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manus cript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please speci fy what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the stati stics 
 
Quality of written English  
Please indicate the quality of language in the manuscr ipt: 
 
Acceptable  
 
Declaration of competing interests  
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