Ending Child Marriage in a Generation: What Research is Needed?

In recent years, the obstacles that child marriage poses to development and to the achievement of the Millennium Development Goals have been widely recognized. Varied responses to the problem have been devised. The number of programs testing different approaches to ending child marriage has grown, and many have been evaluated. We are starting to get a sense of what works and the general areas in which investing in research could make a difference.The purpose of this paper is to identify gaps in the research on child marriage in which additional investment could catalyze change. Much remains to understand about child marriage and how to influence it. By mapping out current knowledge of child marriage and the programs designed to address it, and by highlighting questions to which we do not yet know the answers, the paper is intended to generate discussion in the field and clarify what we need to know to bring an end to this deeply harmful practice.The paper also moves us closer to the development of a shared theory of change for this field: given that many organizations are now working in this area, how can their programs and related research be understood -- aligned -- in such a way that their work feeds into a single theory of change?The research gaps on their own should not drive investments in child marriage. A worthy research mandate must also be driven by programmatic and advocacy needs. The recommended areas for research are not meant to provide a definitive menu, but rather to describe the general contours of what we know and what we need to understand better

Changing Women and Avoiding Men

Summaries Health care researchers have documented that in many settings male social prerogatives powerfully condition women's relationship to health care systems. Particularly in the area of reproductive health care, the decision?making privileges enjoyed by men fundamentally affect women's health status. Yet population policy and reproductive health programming has been slow to respond to this insight. Unrecognized or unacknowledged assumptions about women's ‘natural’ responsibility for childbearing and child?rearing, coupled with an acceptance of the rights of men to make family health care decisions have impeded policy responses to these research findings. By accepting these static characterisations of men rather than assuming that gender relations are dynamic and that men are as capable of change as women, research and programmes have often implicitly accepted men's power and women's subordination. Effective reproductive health care programming needs to recruit men's support and participation in creative ways

Girls Speak: A New Voice in Global Development

Presents adolescent girls' views on the value of education and its impact on their lives, their aspirations, and barriers to long-term change as guidance for targeting interventions to improve self-determination and health, social, and economic outcomes

Girls Count: A Global Investment & Action Agenda

Explains how girls' welfare affects overall economic and social outcomes. Outlines steps to disaggregate health, education, and other data by age and gender; invest strategically in girls' programs; and ensure equitable benefits for girls in all sectors

Absent and problematic men: Demographic accounts of male reproductive roles

Both men and women make important contributions to the production of children, yet demographic studies of fertility and family planning have tended to focus on women alone. This paper traces the development of demography’s emphasis on women and describes how the limitations of its theoretical approaches to reproduction and empirical neglect of men have been mutually reinforcing. The paper is structured around four aims: 1) to describe why men have had a relatively low profile as subjects in demographic research on reproduction; 2) to explain growing interest in studying men’s roles; 3) to evaluate existing research on men in developing countries; and 4) to suggest directions for future research on men’s reproductive roles. We argue that men, once neglected, now feature prominently in demographic research but principally from a problem-oriented perspective and on a limited range of topics. Our review of existing studies, though, does not fully support a problem-oriented approach. Demographic research should examine men not only as women’s partners, but also as individuals with distinct and interesting reproductive histories of their own. As the links between marriage and childbearing continue to weaken around the world, the differences in men’s and women’s reproductive experiences and their costs and benefits related to parenting will become even more salient for future research

Preparing Family Caregivers to Recognize Delirium Symptoms in Older Adults After Elective Hip or Knee Arthroplasty

Objectives To test the feasibility of a telephone-based intervention that prepares family caregivers to recognize delirium symptoms and how to communicate their observations to healthcare providers. Design Mixed-method, pre–post quasi-experimental design. Setting A Midwest Veterans Affairs Medical Center and a nonprofit health system. Participants Forty-one family caregiver-older adult dyads provided consent; 34 completed the intervention. Intervention Four telephone-based education modules using vignettes were completed during the 3 weeks before the older adult\u27s hospital admission for elective hip or knee replacement. Each module required 20 to 30 minutes. Measurements Interviews were conducted before the intervention and 2 weeks and 2 months after the older adult\u27s hospitalization. A researcher completed the Confusion Assessment Method (CAM) and a family caregiver completed the Family Version of the Confusion Assessment Method (FAM-CAM) 2 days after surgery to assess the older adults for delirium symptoms. Results Family caregivers’ knowledge of delirium symptoms improved significantly from before the intervention to 2 weeks after the intervention and was maintained after the older adult\u27s hospitalization. They also were able to recognize the presence and absence of delirium symptoms in the vignettes included in the intervention and in the older adult after surgery. In 94% of the cases, the family caregiver rating on the FAM-CAM approximately 2 days after the older adult\u27s surgery agreed with the researcher rating on the CAM. Family caregivers expressed satisfaction with the intervention and stated that the information was helpful. Conclusion Delivery of a telephone-based intervention appears feasible. All family caregivers who began the program completed the four education modules. Future studies evaluating the effectiveness of the educational program should include a control group

The Uncharted Passage: Girls\u27 Adolescence in the Developing World

Adolescence is a formative time of transition to adulthood. What happens between the ages of 10 and 19 shapes how girls and boys live out their lives as women and men—not only in the reproductive arena, but in the social and economic realm as well. Yet, despite its impact on human development, adolescence has been sidelined as a research and policy subject in developing countries. While all adolescents deserve our attention, the needs of adolescent girls in the developing world are particularly pressing. This monograph focuses on these girls, presenting statistics to examine the social and economic context of their lives at home, school, and work, and to investigate adolescent reproductive health, marriage, and childbearing. Distinctive features of adolescent girls’ lives include confinement to domestic roles; restricted mobility; inadequate schooling; insufficient opportunities to work for wages; pressure, in many countries, to marry early and to begin childbearing immediately after marriage; and limited control over their reproductive health and fertility. This monograph outlines an agenda for policy, programs, and research, and provides illustrations of successful local efforts to improve the lives of adolescents

Star Formation Suppression by Tidal Removal of Cold Molecular Gas from an Intermediate-redshift Massive Post-starburst Galaxy

Observations and simulations have demonstrated that star formation in galaxies must be actively suppressed to prevent the formation of overly massive galaxies. Galactic outflows driven by stellar feedback or supermassive black hole accretion are often invoked to regulate the amount of cold molecular gas available for future star formation but may not be the only relevant quenching processes in all galaxies. We present the discovery of vast molecular tidal features extending up to 64 kpc outside of a massive z = 0.646 post-starburst galaxy that recently concluded its primary star-forming episode. The tidal tails contain (1.2 ± 0.1) × 1010 M⊙ of molecular gas, 47% ± 5% of the total cold gas reservoir of the system. Both the scale and magnitude of the molecular tidal features are unprecedented compared to all known nearby or high-redshift merging systems. We infer that the cold gas was stripped from the host galaxies during the merger, which is most likely responsible for triggering the initial burst phase and the subsequent suppression of star formation. While only a single example, this result shows that galaxy mergers can regulate the cold gas contents in distant galaxies by directly removing a large fraction of the molecular gas fuel, and plausibly suppress star formation directly, a qualitatively different physical mechanism than feedback-driven outflows