Understanding the mechanisms influencing the maternal and infant health outcomes from early marriage in the Madhesh Province of Nepal

This is a mixed-methods exploration of the associations between early marriage and maternal and infant health outcomes. Early marriage is intimately connected with cultural and gender norms which simultaneously drive the practice of early marriage and mediate experiences at the local level, meaning rigorously-designed and contextualised research at the local level is required to embrace this complexity. This study uses an exploratory sequential mixed-method design, in which an initial participatory qualitative study will inform the design and interpretation of quantitative causal models.

The overarching research aim is:
What are the mechanisms involved in associations between does early marriage and maternal and infant health outcomes in the Madhesh Province of Nepal?

Objectives
i) Explore how experiences of pregnancy differ according to age at marriage and pregnancy in the Madhesh Province of Nepal using qualitative, participatory research methods, to develop a framework to present the mechanisms involved between early marriage and maternal and infant health in the Madhesh Province of Nepal
ii) Estimate the mediating effect of pathways between early marriage and preterm delivery, low infant weight, and infant mortality, using data from the Low Birth Weight South Asia Trial (LBWSAT) and structural equation modelling (SEM), as informed by the findings from objective i
iii) Synthesise the findings from objectives i and ii using a dialectical pluralistic approach.