الفهرس 
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Abstract
Child marriage usually refers to a social phenomenon practiced
to girls who marry before the 18 th. This horrible phenomena caused by
gender inequality, social norms, perceived low status of girls, poverty,
lack of education, safety concerns about girl children and control over
sexuality are considered to be reasons for prevalence of child marriage
(Lloydandet al., 2015).
Girl children in rural areas are more affected than their urban
counterparts .health consequences result from child marriage are
classified to physical, psychological, socioeconomic, finallyeducational effects. Community nursing role in this issue is to advocate
girl rights in health, educate & assess for negative effects and how to
remain healthy collaborate with other sectors to end this practice
(Pierre, 2017).
Purpose of the study
The purpose of the study is to assess the health consequences ofchild marriage in rural and urban areas.
Research questions:
The following research questions are formulated to achieve the aim
of the study:
1- What is the prevalence of child marriage in rural and urban
communities?
2- What are the perception and attitudes of women toward child
marriage in rural and urban communities?
3- What are the health consequences of child marriage in rural and
urban communities?Study design:
A descriptive comparative design was used to conduct this study.
Study settings
This study was conducted in one maternal & child health center
(MCH)in Al-Shohadaa district as an urban area and one maternal &
child health unit at Meet Abo El-Kom village as a rural area in Tala
district at Menoufia governorate, Egypt according to multistage random
selection.
Study subject
Women attended to two previous mentioned settings. Subjects
were recruited women from Al Shohadaa and Tala as 50% for rural and50% for urban areas that selected from the previously mentioned
settings.
These women were chosen according to the following inclusion
criteria:
- Women who married prior to 18 years of age and have at least
one child birth.
- Women who married for at least 2 years to ensure that they
experienced the marital life.
The word (married) indicate in this study women who are currently
married or previously divorced or widowed and accepted to thestudy
Study sampling
A convenient sample of 2000 women at the child bearing age
was recruited to determine the prevalence of child marriageA purposive sample of 370 women (the prevalence of child
marriage ) attended to settings and have the inclusion criteria to
intervene the study.
Assignment of study setting
A multistage random selection of the setting according to the following
steps as:-
• Two districts from all districts of Menoufia governorate (nine
districts) were selected using simple random sample .These districts
were Al Shohadaa and Tala.
• Al-Shohadaa maternal &child health center represented as an urban
area at Menoufia governorate.
• Meet Abo El-Kom village in Tala district represented as rural area
at Menoufia governorate.
The data was collected in immunization, antenatal and family
planning clinics of previous mentioned areas.Study instrument
Structured interview questionnaire:
Developed by the researcher after reviewing the related national
and international literature, discussion with experts to collect data about
the subjects and wrote in simple Arabic language to suit level of
understanding of the participants. It contained the following parts:-
• Part I: Socio-demographic characteristics included name, age, sex,
marital status, occupation, address, level of education and monthly
income.
• Part II: women perception about child marriage and its reasons
such as tradition, education failure, poverty and endogamy.• Part III: women attitude about child marriage as women
satisfaction with child marriage, negative or positive attitude toward
child marriage.
• Part IV: women Perception about bio-psycho-social health
consequences of child marriage after marriage such as :- physical
health problem, social health consequences such as continuous
conflict with spouse and domestic violence and psychological
health consequences as tension and psychological stress.Results:
The main results of the present study were
Based on the finding of the current study, it can be concluded that:
• Prevalence of child marriage among 2000 of married woman is
18.5%, the studied women who live in urban areas, showed slightly
higher prevalence in age between 14-17 years (97.8 %), with mean
of 16.4 ± 1.7 years, compared to 95.7 % among women who live in
rural areas with mean age of 15.2 ± 2.1 years respectively.
• The majority of the studied women demonstrated child marriage
perception as they do not know the meaning & the legal age of
marriage in Egypt with no statistical difference between rural&urban areas.
• Statistical significant difference regarding to women attitudes
toward the child marriage which were that child marriage increase
the responsibility of the girls after marriage & prevents
spinsterhood and shame and maintain virginity in rural more than
urban areas. But women opinion that child marriage waste their
rights while the majority of studied women mention negative effectshealth problems for mother & child, depression, divorce encourage
the prevention of child marriage in the society.
• No statistical significant difference in the reasons for child marriag
that include :tradition, education failure, insufficient income or
poverty, & the marriage of a cousin or a relative in both areas.
• Physical effect as occasional bleeding, and bad vaginal secretions
between rural and urban areas are high statistical different.
• Psychological effects of child are highly significant difference in
urban areas than in rural areas that classified into increased
responsibility after marriage ,stress , women not share in decision
making with husband & misunderstanding with husband that leadto depression ,but there is no statistical significant difference in
suffering from nervousness because of their marital life .
• Social effects of child marriage among studied women reasons in
both rural and urban areas are highly statistical significant which
seen as conflicts between husbands & wives that resulted from
psychological, marital reasons & exposure to violence so that lead
to divorce& the women in ability to raise their children in both rural
areas and urban areas.
• Economic effects of child marriage among studied women in rural
and urban areas are highly statistical significant as wasting rights is
observed in rural and urban areas. On details these rights are
education, work ,right of health is wasted, also freedom rights.• Educational effects among studied women in rural and urban areas
are highly statistical significant different in rural areas more than in
urban areas which observed that studied women leave education in
primary school level that resulted from failure in education ,far
distance to school &poverty.Statistical significant difference in domestic violence in which the
majority of women living in urban area suffer from domestic
violence than women living in rural area.
Conclusion
Child marriage is a prevalent issue in Egypt. The current study
concluded that, the total prevalence of child marriage was 18.5% among
studied MCHs women. The total negative attitude among the studied
women in both areas was significant higher (77.3) among urban women
than rural women(68.1%). the perception of the causes of child
marriage as tradition, education failure poverty and endogamy
contributed to women early marriage. the current study revealed thatStatistical significant difference in domestic violence in which the
majority of women living in urban area suffer from domestic
violence than women living in rural area.
Conclusion
Child marriage is a prevalent issue in Egypt. The current study
concluded that, the total prevalence of child marriage was 18.5% among
studied MCHs women. The total negative attitude among the studied
women in both areas was significant higher (77.3) among urban women
than rural women(68.1%). the perception of the causes of child
marriage as tradition, education failure poverty and endogamy
contributed to women early marriage. the current study revealed thatdecision
making.
• Priotrization of girls education & decreasing the obstacles that face
in order to end child marriage