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. Author manuscript; available in PMC: 2021 Sep 1.
Published in final edited form as: Stud Fam Plann. 2020 Jul 27;51(3):251–272. doi: 10.1111/sifp.12133

The Psychological Benefits of Marriage and Children in Rural Malawi

Shelley Clark 1, Cassandra Cotton 2, Rachel Margolis 3, Hans-Peter Kohler 4
PMCID: PMC7778373  NIHMSID: NIHMS1620703  PMID: 32720321

Abstract

Despite an extensive literature on the psychological rewards to marriage and children in high-income countries, research on these relationships in low-income countries remains limited. This paper draws on data from 4,133 adult women and men interviewed in the Malawi Longitudinal Study of Families and Health to examine how marital status, categorized as never, formerly, monogamously, and polygynously married, and number of children are associated with psychological well-being. With respect to marital status, we find that women in polygynous unions fare worse than monogamously married women and this detrimental effect is stronger for women than for men. Formerly married men and women of reproductive age experience the worst psychological outcomes, although this association wanes with age. In contrast, the benefits of having children is only evident among older Malawian women. These findings offer novel insights into the patterns of nearly universal marriage and high fertility that characterize Malawi and much of sub-Saharan Africa.

There is a large and robust literature that debates the psychological benefits (and costs) of marriage and children in high-income countries (for recent reviews see Kohler and Mencarini 2016; Nelson et al. 2014; Umberson et al. 2013). This work is at least partly motivated by a desire to gain insights into the retreat from marriage and persistent low fertility that many countries in North America and Europe have experienced over the last few decades. In contrast, only a few studies have investigated the potential psychological implications of marriage and children in low-income countries (Cetre et al. 2016; Conzo et al. 2017; Deaton and Stone 2014; Margolis and Myrskylä 2011; Myroniuk 2017; Myroniuk et al. 2020; Peiró 2006).

Studies situated in sub-Saharan Africa may be especially valuable as they could yield novel insights into the patterns of nearly universal marriage and sustained high fertility. They can also explore whether, and if so how, the psychological benefits of marriage and children differ in starkly different social, cultural, political, and economic contexts. Whether marriage and children are associated with better or worse psychological outcomes in sub-Saharan Africa is not immediately obvious. On the one hand, in settings where being married and having multiple children are fundamental to gaining social standing, one may anticipate that men and women reap large psychological rewards from both marriage and children. For women, the psychological value of having a spouse and children may be magnified by the practical assistance in housework provided by younger children and the economic support given by spouses and potentially adult children. Further, greater levels of kin assistance in raising children may help reduce some of the stress and anxiety commonly associated with motherhood in Western contexts (Blanc and Lloyd 1994; Sear and Mace 2008). These potentially large psychological returns may at least partially explain the persistently high rates of marriage and rather slow declines in fertility found in much of sub-Saharan Africa (Bongaarts and Casterline 2013; Shapiro and Gebreselassie 2014).

On the other hand, compared to high-income countries, decisions to marry and have children in sub-Saharan Africa may be more predicated on kinship obligations, economic considerations, and gender norms than anticipated psychological benefits. To the extent that cultural norms shape emotional bonds between spouses, African men and women in unions may experience fewer of the psychological benefits derived from intimate relationships in western societies (Wilson and Oswald 2005). Moreover, the high-costs of raising children in poor families with limited institutional support may increase parental stress and diminish children’s psychological rewards (Aassve et al. 2015; Pollman-Schult 2014). Despite these potentially different implications for psychological well-being, longitudinal research in Africa that focuses on the relationship between adults’ psychological well-being and either children (Conzo et al. 2017) or marital status (Myroniuk 2017; Myroniuk et al. 2020) is currently rather limited.

This paper builds on this small body of research in low-income countries by focusing on Malawi, a comparatively poor African country with nearly universal marriage and high fertility. Our study uses three waves of the Malawi Longitudinal Study of Families and Health (MLSFH) to examine the relationship between adult psychological well-being and marital status (assessed as monogamously, polygynously, never, and formerly married) and fertility (measured as the number of children).

Because previous research indicates that these relationships vary across different measures of psychological well-being, we measure both overall mental health and reported life satisfaction (Deaton and Stone 2014). In addition, we disaggregate our analyses by age and sex and investigate whether these relationships differ by gender or period of the life course (Aassve et al. 2012; Kohler et al. 2005). Finally, because there are likely strong selection effects into having more children and both into and out of marriage and because demographic events that occurred recently may have a different impact on psychological well-being than those that occurred long ago (Hagedoorn et al. 2006; Myrskylä and Margolis 2014; Strohschein et al. 2005; Williams and Umberson 2004), we also examine these relationships using fixed-effects analyses.

Background

Psychological Benefits of Marriage

Studies based primarily in high-income contexts offer several plausible mechanisms through which marriage may yield psychological benefits. First, because marriage often brings social status, more economic security, and represents an important life goal for many, it is likely to be positively associated with measures of overall life satisfaction (Waite and Lehrer 2003). Second, theories of social integration and emotional support suggest that marriage should also reduce individuals’ feelings of isolation and help shield them from stress, anxiety, and depression (Wilson and Oswald 2005). Studies further show that the psychological advantages of marriage in high-income countries often vary by sex and age. Men, for example, tend to derive more psychological benefits from marriage than women (Kim and McKenry 2002; Kohler et al. 2005; Stutzer and Frey 2006; Williams and Umberson 2004). Age may also modify the psychological gains of marriage. Although little is known about the psychological rewards of marriage over the life course (Umberson et al. 2013), the protective effects were evident at older ages (Hagedoorn et al. 2006).

In addition, beyond simply whether men or women are currently married or unmarried, studies from high-income countries show that the psychological benefits differ according to the types of union status (e.g. never vs. formerly married; first marriage vs. remarriage, cohabitation vs. marriage) (Umberson et al. 2010). Among unmarried men and women, those who were divorced or widowed have worse mental health outcomes than those who were never married (Kim and McKenry 2002; Williams 2003). Longitudinal studies suggest that accounting for time-constant selection effects reduced, but do not eliminate, the beneficial effects of being married compared to being never married (DeMaris 2018; Musick and Bumpass 2012; Zimmermann and Easterlin 2006). In contrast, the immediate negative effects of being formerly married are often stronger, suggesting a significant short-term mental toll of divorce and widowhood (Ballas and Dorling 2007; Strohschein et al. 2005).

Research linking union status to psychological well-being in low-income countries, including those in sub-Saharan Africa, is scarce. Many of the psychological gains afforded by marriage in high-income countries may be even stronger in sub-Saharan Africa, since marriage is central to one’s social standing, economic security, and integration to kinship networks. However, some of the psychological benefits derived from intimate spousal emotional bonds may be weaker. Throughout sub-Saharan Africa, traditionally “[m]arriage was concerned with kinship rather than with the interaction of spouses, so affection was not much involved” (Karandashev 2017, p 235). Over the past four decades, however, there has been a notable rise in companionate marriages with individuals choosing their spouses based on feelings of physical and emotional attraction, although kin continue to play an important role in approving and supporting marriages (Smith 2001). As a result, conjugal bonds have strengthened, potentially augmenting the psychological returns to marriage.

Nonetheless, cross-sectional analyses finds a generally positive association between marriage and life satisfaction across 15 countries with the notable exception of the only African county included, Nigeria (Peiró 2006). Studies in Africa, which employ dichotomous measures of marital status or focus on older adults (age 45 and above), typically report no difference or only slightly better mental health or quality of life among those married compared to those unmarried (most of whom were formerly married) (Kohler et al. 2017; Myroniuk 2017; Myroniuk et al. 2020; Ralston 2017).

Unfortunately, these previous studies in sub-Saharan Africa rarely go beyond simple dichotomous measures of marital status or focus exclusively on older adults, leaving unanswered questions about differences among marital status categories, how changes in union status among adults of reproductive age are related to psychological well-being, and how the psychological benefits of marriage may differ by gender and age. Given the pronounced cultural differences pertaining to gender norms, expectations within marital relationships, and the engagement of broader kinship networks, these factors may follow different patterns from those found in higher income settings.

For example, the psychological benefits may differ across types of union status. In contexts where nearly all men and women enter into marriage and decisions about union formation are more strongly influenced by economic considerations and kin preferences, the psychological rewards associated with entering into a union, compared to remaining never married, may be modest. In contrast, the adverse psychological effects of being divorced or widowed may be more acute. Although divorce and widowhood are common in many parts of sub-Saharan Africa, remarriage is also very high, suggesting that those who are formerly married face substantial economic consequences and stigma associated with union dissolution (Clark and Brauner-Otto 2015; Richter and Morrell 2008). Lastly, although polygyny remains common in many parts of sub-Saharan Africa, no previous study has assessed differences in the psychological implications of monogamous versus polygynous unions. Nonetheless, men and women in polygynous unions may have worse psychological outcomes both because individuals in polygynous unions tend to be poorer, less educated and less physically healthy, and because these more complex union structures may lead to greater intra-household competition and conflict (Bove and Valeggia 2009; Madhavan 2002; Smith-Greenaway and Trinitapoli 2014).

The psychological implications of being in a particular type of union may also vary by gender, age, and how recently a union transition occurred. Specifically, formerly married women of reproductive age are likely to experience greater psychological stress than men, as divorced or widowed mothers are often burdened with financially supporting and caring for themselves and their children with little assistance from the child’s father or kin (Clark et al. 2017). As in high-income countries, the negative shock of divorce or widowhood will likely be strongest shortly after the event as both men and women adjust to their loss and adapt to their new living environments. However, in contrast to findings from high-income countries, it is plausible that being formerly married poses fewer psychological costs for older Africans, who are less dependent on co-parents to help raise young children. Furthermore, the stigma associated with being formerly married, particularly widowed, may diminish as it becomes increasingly more common. Findings among older adults in Malawi show a weak negative correlation between being formerly married and physical health and no association with having recently been widowed or divorced (Myroniuk 2017). Furthermore, preliminary studies suggest that the number of union dissolutions may be positively associated with the mental health of older women (Myroniuk et al. 2020).

With respect to polygyny, limited prior quantitative research makes it difficult to speculate about differences by gender, age, or transitions in union status. Nonetheless, previous research shows a negative association between polygyny and women and children’s physical health (Bove and Valeggia 2009; Lawson and Gibson 2018; Madhavan 2002; Smith-Greenaway and Trinitapoli 2014). Further studies find that although there is often cooperation among polygynous wives, there is also considerable conflict, suggesting that women in polygynous unions may experience lower levels of psychological well-being than women in monogamous unions (Bove and Valeggia 2009; Madhavan 2002). In qualitative interviews, polygynous women in Ghana often expressed negative emotions including anger, jealousy, and unhappiness (Tabi et al. 2010). The relationship between men’s psychological well-being and polygyny is more ambiguous. On the one hand, men with multiple wives may enjoy greater social prestige. On the other hand, the emotional and economic stress of maintaining more than one household may be a psychological drain as polygynous unions are prone to more intra-family conflicts (Bove and Valeggia 2009). As with those who are formerly married, recently entering into polygynous unions may exacerbate these negative effects, as both men and women adjust to these new marital arrangements. Similarly, being in a polygynous union may be associated with fewer detrimental effects for older individuals who have grown accustomed to their co-wives or who have exited from emotionally fraught polygynous unions.

Psychological Benefits of Children

The relationship between children and psychological well-being is also likely to differ in low- and high-income countries. In both contexts, many people view having children as an important life goal. One would, therefore, expect that having children would be positively associated with overall life satisfaction, but the evidence from high-income countries is surprisingly mixed (Kohler et al. 2005; Myrskylä and Margolis 2014; Pollman-Schult 2014). Although having children may enhance adults’ life satisfaction, several studies found associations between having children and recent experiences of negative emotions, including stress, anxiety, depression, and frustration (Evenson and Simon 2005; Nelson et al. 2014).

It is important to note, however, that while much of the research in high-income, low-fertility countries focuses on the psychological impact of becoming a parent (i.e. having a first child), the work in low-income, high-fertility countries has assessed the relationship between psychological well-being and fertility (i.e. number of children), as virtually all adults become parents. African cultures place a particularly high social value on children and having children is essential to securing and maintaining one’s marriage and broader social standing within kinship networks (Smith 2001). Numerous studies in Africa find that women who are unable to have children are more likely to suffer from depression and childlessness, whether voluntary or involuntary, is viewed with strong disapproval and is highly stigmatized (Barden-O’Fallon 2005; Hess et al. 2018 Ibisomi and Mudege 2014). Yet, somewhat surprisingly, most studies find a strong negative association between the number of children and measures of life satisfaction in most low-income countries (Cetre et al. 2016; Deaton and Stone 2014; Margolis and Myrskylä 2011). Hence, although becoming a parent is expected and essential to one’s psychological well-being, higher fertility brings few psychological rewards. Limited social policies, which offer parental leave, access to affordable early childcare or tax relief, may partially explain these findings as African parents must fully bear the financial costs of raising children (Margolis and Myrskylä 2011).

The psychological costs and benefits of raising children may also differ by gender. Research from high-income countries typically finds that having young children is more disadvantageous to women’s psychological well-being than men’s, presumably because of persistent gender inequalities which oblige women to perform the majority of the more mundane, tedious, and stressful tasks of child care (Kohler et al. 2005; Scher and Sharabany 2005). In sub-Saharan Africa, pervasive gender norms likely dictate that mothers shoulder more of the burden of childrearing than fathers. Although fathers’ participation in direct child care may be increasing in some African contexts, fathers remain largely responsible for children’s economic support rather than their daily care (Richter and Morrell 2008). However, African women may also receive greater social approbation for such care and both older children and extended kin may assist with child care (Blanc and Lloyd 1994; Sear and Mace 2008). These countervailing factors may dampen any overall gender differences with respect to the total number of children among young African parents.

Gender differences, however, may be more pronounced shortly after a child is born as young children under the age of five typically require more care and offer less assistance with household tasks. Longitudinal studies in high-income contexts generally show that life satisfaction often goes up in anticipation of childbirth, but may fall in the years after childbirth when parents are caring for young children (Clark and Georgellis 2013; Clark et al. 2008; Frijters et al. 2011; Rizzi and Mikucka 2015). These findings are broadly consistent with the only longitudinal analyses conducted in Africa, which found that rural Ethiopian women who gave birth in the last five years reported significantly lower levels of life satisfaction (Conzo et al. 2017). Hence, African mothers, like mothers living elsewhere, may experience substantial psychological strain while caring for young children, which is not shared by African fathers.

The relationship between number of children and psychological well-being may also change as both parents and children get older. Evidence from high-income countries demonstrates that older parents often benefit from the social interaction and emotional support provided by adult children (Umberson and Williams 1999). In sub-Saharan Africa the rewards to having adult children may be even greater (Conzo et al. 2017; Deaton and Stone 2014; Margolis and Myrskylä 2011). Given the very limited social security programs available for the elderly in most African countries, older adults are more likely to depend on their adult children for economic security (Aassve et al. 2015; Margolis and Myrskylä 2011; Pollmann-Schult 2018). Furthermore, research from rural South Africa suggests that older women, in particular, are likely to receive considerable emotional support from relatives (many of whom are presumably their adult children) (Jennings et al. 2018). Hence, while both older men and women may reap psychological benefits from having more adult children, these gains may be even larger for older women than for older men.

Study Site

Our analysis is situated in rural Malawi where both marriage and parenthood are nearly universal. Malawi is one of the poorest countries in the world, ranking 170 out of 188 countries according to the Human Development Index (UNDP 2016). Although its population is small (less than 20 million), it hosts considerable religious, ethnic, and cultural diversity. The northern region of Malawi is patrilineal and largely Christian, whereas residents in southern Malawi are primarily Muslim and follow matrilineal kinship practices. Consequently, although fertility is high across all regions, Malawians follow an array of marital practices.

Despite this regional diversity in kinship systems, over 99% of both men and women have married by age 40. Women continue to marry at a comparatively young age (17.8 years for women and 22.6 for men) (NSO and ICF Macro 2011), however many marriages do not last. Within 20 years of marriage, 44% of unions will dissolve through divorce (77%) or widowhood (23%) (Clark and Brauner-Otto 2015). Remarriage rates are also very high. Hence, despite considerable union instability, a relatively small percentage are currently formerly married (13% of women and only 4% of men report being currently divorced or widowed) (NSO and ICF Macro 2011). Polygyny is common, with more than 15% of rural women reporting being in a polygynous union (NSO and ICF Macro 2011). With respect to children, Malawi, like other countries in sub-Saharan Africa, is strongly pro-natalist (Dyer 2007). During the period of our study (2006–2010), fertility rates in rural areas declined only slightly from 6.4 to 6.1 (NSO and ICF 2005, 2011).

Data and Methods

Data

We draw on one of the only large-scale longitudinal studies in sub-Saharan Africa with repeated measures of adult mental health, union status, number of children, and important socio-demographic variables — the Malawi Longitudinal Study of Families and Households (MLSFH). The MLSFH was conducted in three rural sites: Rumphi in the northern region, Mchinji in the central region, and Balaka in the southern region. Previous analyses indicate that the sample is broadly comparable to that of rural Malawi as a whole (Kohler et al. 2015). We use data from three waves of the MLSFH, conducted in 2006, 2008, and 2010, which included both reproductive age and older adults and asked questions on mental health.1 Further details about the MLSFH cohort and the data collection process are available in Kohler et al. (2015). The MLSFH data used in these analyses are available at https://malawi.pop.upenn.edu/malawi-data-mlsfh.

Analytic Sample

We divide our sample into reproductive age (<50) and older Malawians (ages 50+). A total of 2,965 respondents aged 15 to 49 were interviewed at least once about their psychological well-being between 2006 and 2010, yielding a total of 6,774 observations. As has been documented in previous studies, we find inconsistencies in the reported total number of children ever born across early waves of the MLSFH (Bignami-Van Assche et al. 2003). These discrepancies likely reflect the erroneous inclusion of foster children, or omission of deceased children in the reported number of children ever born because respondents did not fully understand the distinction between children ever born and children alive. We find a decrease in the number of children ever born between waves for 421 observations with a decrease of four or more children reported in 32 of these observations. In addition, in 54 observations, respondents reported an improbably large increase in the number of children born between waves (greater than four children). To maintain a reasonably large and representative sample, we remove the 86 observations (1.3%) where respondents report a positive or negative change of more than four children, but retain those with decreases of four or fewer children (5.7%). Sensitivity analyses, which remove all respondents who experience any decrease in the number of children ever born, produce broadly similar results and we note substantial differences in the footnotes. After further excluding 495 observations missing independent variables, our analytic sample consists of 6,193 observations of 2,912 reproductive age adults (1,727 women and 1,185 men). In addition, we identify a sample of 1,281 adults aged 50 years or older interviewed at least once between 2006 and 2010, who contribute at total of 2,662 observations. Applying the same exclusion criteria, we remove 117 observations (4.4%) where respondents report a positive or negative change of more than four children, and 160 observations missing at least one independent variable. Our analytic sample of 2,385 observations is reported by 647 women and 574 men aged 50 years or older.

Measures

Dependent Variables

In this paper, we use two indicators of psychological well-being, life satisfaction and overall mental health, as their relationships with fertility and marital status may differ (Deaton and Stone 2014). For our measure of overall mental health, we use the Short Form-12 (SF-12), a widely used measure of overall social/emotional functioning. The SF-12 ranges from 0 to 100 with higher scores associated with better mental health. This measure has been implemented and validated in many different contexts, including Malawi (Corcoran and Fischer 2007; Gandek et al. 1998; Ohrenberger et al. 2020; Ware et al. 1998). The SF-12 is especially useful for screening for depression. Mental health scores of 45 or less have been used as a cut-off point to identify those likely suffering from depression (Gill et al. 2007). To assess life satisfaction, respondents were asked “I am interested in your general level of well-being or satisfaction with life. How satisfied are you with your life, all things considered?” Responses range from 1 (very unsatisfied) to 5 (very satisfied).

Independent Variables

Our key independent variables capture union status and measures of fertility at each interview. Union status is coded as: never, formerly, monogamously, and polygynously married. For our analyses of respondents aged 50 and older, no respondents reported being never married. Among those who are formerly married, the majority of men (87%) and women (71%) below the age of 50 are divorced, whereas widowhood is more common among older respondents (71% of women and 64% men).2 Monogamously married individuals serve as our reference group as it is the most common marital state. Fertility is measured by the total number of children, which ranges from 0 to 14 for women and 0 to 25 for men with the upper bounds driven by polygynous unions.

All models also control for respondent’s age, schooling, physical health, religion, and region. Education is measured as none, primary, or secondary or higher schooling. Religion is categorized into six broad groups, including Catholic, Muslim, Protestant, African Independent Churches, Pentecostal, and other or no religion. To account for the likely correlation between physical and mental health, models control for respondent’s physical health, using the SF-12 Physical Health Component Score, which ranges from 0 to 100. Lastly, we include a control for the region of the study site. Since many of the potential psychological advantages of marriage and children may be tied to their economic costs and benefits, we do not include any measures of wealth in the models shown in Tables 2, 3, and 4. In Appendices A, B, and C, respectively, we present the corresponding results from models that include a count of household ownership of 14 different assets. Findings from these sensitivity analyses suggest that although wealth is associated with greater life satisfaction, it is not the main mechanism through which marriage and children yield psychological benefits.

TABLE 2.

Mental Health and Life Satisfaction of Women and Men Aged 15–49 (Random Effects Regressions).

Mental Health
 Life Satisfaction
Women
Model 1
 Men
Model 2
 Women
Model 3
 Men
Model 4
Coef. Std. Err. Sig. Coef. Std. Err. Sig. Coef. Std. Err. Sig. Coef. Std. Err. Sig.
Marital Status (ref=Monogamous)
 Polygynous −1.27 0.35 *** 0.31 0.59 −0.10 0.04 ** 0.07 0.07
 Formerly −3.24 0.48 *** −3.27 0.83 *** −0.28 0.05 *** −0.16 0.10
 Never 0.72 0.79 −0.66 0.49 0.01 0.08 −0.03 0.06
Number of Children 0.02 0.08 0.02 0.09 −0.01 0.01 0.01 0.01
SF12 Physical Health Scale 0.21 0.02 *** 0.11 0.03 *** 0.04 0.00 *** 0.04 0.00 ***
Age −0.04 0.03 −0.06 0.03 * 0.00 0.00 −0.01 0.00 **
Religion (ref=Catholic)
 Muslim 0.00 0.61 0.21 0.67 0.06 0.06 0.08 0.08
 Protestant −0.10 0.50 −0.24 0.52 0.04 0.05 0.03 0.06
 African Traditional −0.12 0.53 −0.58 0.59 −0.06 0.05 −0.05 0.07
 Pentecostal −0.44 0.50 0.37 0.54 0.02 0.05 0.03 0.06
 Other or No Religion −0.67 0.68 −0.57 0.68 −0.04 0.07 −0.14 0.08
Education (ref=None)
 Primary −0.55 0.41 −0.66 0.54 0.03 0.04 0.11 0.06
 Secondary or higher −0.41 0.66 −1.02 0.66 0.06 0.07 0.10 0.08
Region (ref=Central)
 South −0.69 0.53 −0.42 0.59 −0.18 0.05 ** −0.26 0.07 ***
 North 0.26 0.39 0.72 0.41 −0.25 0.04 *** −0.32 0.05 ***
Wave (ref=2006)
 2008 −1.40 0.34 *** −0.80 0.36 * 0.10 0.04 ** 0.11 0.05 *
 2010 −2.60 0.34 *** −2.42 0.35 *** 0.16 0.04 *** 0.17 0.04 ***
Flag for Fewer Children 0.59 0.44 −0.57 0.50 0.01 0.04 −0.07 0.06
LR chi2 285.31 *** 122.49 *** 515.51 *** 253.33 ***
N (Observations) 3,763 2,436 3,759 2,433
N (Groups) 1,727 1,185 1,727 1,184
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Sig.:

*

p<0.05,

**

p<0.01,

***

p<0.001

TABLE 3.

Mental Health and Life Satisfaction of Women and Men Aged 15–49 (Fixed Effects Regressions).

Mental Health
 Life Satisfaction
Women
Model 1
 Men
Model 2
 Women
Model 3
 Men
Model 4
Coef. Std. Err. Sig. Coef. Std. Err. Sig. Coef. Std. Err. Sig. Coef. Std. Err. Sig.
Marital Status (ref=Monogamous)
 Polygynous −0.41 0.60 −1.58 1.09 0.04 0.06 −0.28 0.14 *
 Formerly −2.27 0.84 ** −5.25 1.29 *** −0.15 0.09 −0.16 0.16
 Never 0.29 1.55 −1.63 0.93 −0.09 0.16 0.04 0.12
Number of Children (ref=No Change)
 Decrease in Children −0.28 0.95 −0.57 1.04 −0.19 0.10 0.01 0.13
 Increase in Children −0.71 0.94 −0.97 1.02 −0.25 0.10 * 0.08 0.13
SF12 Physical Health Scale 0.09 0.03 ** 0.07 0.04 0.03 0.00 *** 0.03 0.00 ***
Wave (ref=2006)
 2008 −1.67 0.41 *** −1.10 0.44 * 0.08 0.04 0.07 0.06
 2010 −3.15 0.44 *** −2.62 0.48 *** 0.16 0.05 ** 0.08 0.06
F test 14.02 *** 10.23 *** 16.94 *** 6.92 ***
N (Observations) 3,760 2,433 3,756 2,430
N (Groups) 1,727 1,185 1,727 1,184
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Sig.:

*

p<0.05,

**

p<0.01,

***

p<0.001

TABLE 4.

Mental Health and Life Satisfaction of Women and Men Aged 50 and Above (Random Effects Regressions).

Mental Health
 Life Satisfaction
Women
Model 1
 Men
Model 2
 Women
Model 3
 Men
Model 4
Coef. Std. Err. Sig. Coef. Std. Err. Sig. Coef. Std. Err. Sig. Coef. Std. Err. Sig.
Marital Status (ref=Monogamous)
 Polygynous −0.27 0.77 −0.32 0.73 −0.03 0.06 0.00 0.08
 Formerly −1.38 0.74 −1.92 1.31 −0.07 0.06 0.08 0.14
 Never
Number of Children 0.26 0.11 * −0.07 0.07 0.02 0.01 * 0.01 0.01
SF12 Physical Health Scale 0.25 0.03 *** 0.21 0.03 *** 0.04 0.00 *** 0.04 0.00 ***
Age −0.03 0.04 −0.07 0.03 * 0.00 0.00 0.00 0.00
Religion (ref=Catholic)
 Muslim −0.86 1.13 2.45 0.99 * −0.01 0.09 −0.19 0.11
 Protestant 0.67 0.98 0.44 0.88 0.08 0.08 −0.05 0.09
 African Traditional 0.68 1.14 −0.55 0.95 −0.05 0.09 −0.03 0.10
 Pentecostal 0.83 1.17 0.46 0.95 0.02 0.09 −0.06 0.10
 Other or No Religion −0.14 1.49 −1.01 1.23 0.09 0.12 −0.06 0.13
Education (ref=None)
 Primary −0.17 0.72 −0.48 0.70 0.12 0.06 * −0.03 0.08
 Secondary or higher 1.56 2.03 0.96 1.08 0.29 0.17 0.09 0.12
Region (ref=Central)
 South 0.09 1.03 −2.03 0.84 * 0.03 0.08 0.03 0.09
 North −1.21 0.85 −1.44 0.69 * −0.21 0.07 ** −0.27 0.07 ***
Wave (ref=2006)
 2008 −2.31 0.76 ** 0.12 0.61 0.12 0.07 0.06 0.07
 2010 −2.89 0.77 *** −2.39 0.61 *** 0.18 0.07 ** 0.08 0.07
Flag for Fewer Children −0.54 0.68 −0.34 0.55 −0.03 0.05 0.10 0.06
LR chi2 148.03 *** 157.48 *** 322.82 *** 197.25 ***
N (Observations) 1,267 1,118 1,267 1,118
N (Groups) 647 574 647 574
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Sig.:

*

p<0.05,

**

p<0.01,

***

p<0.001

Analytic Approach

We estimate separate models for each outcome: overall mental health and life satisfaction. Random effects models by sex and age group (reproductive ages and older adults) examine the cross-sectional association between current marital status and number of children, controlling for respondent’s age, schooling, religion, physical health score, region, and study wave. In addition, these models include a flag for whether the respondent reported a decrease in the number of children between waves. Fixed effects models estimate changes in psychological well-being in response to recent changes in marital status and number of children among women and men in reproductive ages. These analyses assess the relationships for respondents who recently (within the last two years) entered into a marriage, left a marriage or transitioned into or out of a polygynous union. To test for potential different psychological effects for the recent addition of a new child as opposed to the recent loss of child, we created a categorical variable for whether the respondent reported more or fewer children than their average number of children in each wave. Our fixed effects models, therefore, capture any recent increases in the number of children, presumably from birth within the last two years, and a decrease in the reported number of children, which likely indicates the loss of a child in the last two years. In these models, we also control for changes in respondents’ physical health, and for general time trends. These fixed effects models implicitly control for all observed and unobserved time-invariant characteristics of respondents that may influence selection into and out of marriage and having additional children. We do not estimate fixed effects models for men and women aged 50 and above because, as expected, too few older adults report changes in numbers of children.

Results

Descriptive Characteristics

Table 1 provides descriptive characteristics for men and women in our sample in 2006. On average, both women and men reported being somewhat satisfied with their lives with a standard deviation of about one on the five-point Likert scale. Women, however, reported significantly lower life satisfaction than men in both age groups (p<=0.001). Men’s and women’s mental health scores were around 55, roughly 10 points higher than the cut-off point for depression. In our younger sample, this is equivalent to slightly more than one standard deviation below the mean for women and almost two standard deviations below the mean for men. Both older women and older men had lower mental health scores and life satisfaction than their younger counterparts (p<=0.001).

TABLE 1.

Sample Characteristics of Women and Men in 2006.

Women
 Men
Aged 15–49 Aged 50+ Aged 15–49 Aged 50+
% or Mean (sd)
 % or Mean (sd)
 % or Mean (sd)
 % or Mean (sd)
Dependent Variables
SF12 Mental Health Scale 55.5 (8.5) 53.7 (9.6) 57.3 (6.4) 56.0 (7.8)
Life Satisfaction Scale 3.9 (0.99) 3.7 (0.9) 4.2 (0.9) 3.9 (0.9)
Independent Variables
Marital Status
 Monogamous 58.1 50.5 62.9 76.6
 Polygynous 24.2 31.1 8.9 21.5
 Formerly 9.7 18.3 2.4 1.9
 Never 8.0 25.9
Number of Children 4.0 (2.8) 7.8 (2.9) 3.0 (3.2) 9.0 (3.9)
Age 29.3 (8.3) 52.8 (6.1) 29.3 (8.6) 55.4 (7.2)
Schooling
 None 25.3 49.1 13.3 23.7
 Primary 64.1 48.1 63.0 66.5
 Secondary or higher 10.5 2.8 23.7 9.8
Religion
 Catholic 18.2 15.2 16.7 15.5
 Muslim 23.3 27.7 23.9 29.2
 Protestant 19.1 22.8 22.2 18.8
 African Traditional 17.0 15.9 13.6 18.3
 Pentecostal 17.2 12.5 17.2 13.9
 Other or No Religion 5.2 5.9 6.3 4.4
SF12 Physical Health Scale 52.4 (7.3) 49.6 (9.1) 54.1 (5.6) 51.6 (8.2)
Region of Residence
 Central 32.1 24.2 32.4 24.8
 South 33.7 40.5 32.1 41.1
 North 34.1 35.3 35.5 34.1
N 1,310 289 932 367
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More than half of men and women in both age groups were in monogamous unions. Younger men were three times as likely as younger women to be never-married due to their later age of marriage. In comparison, younger women were more likely to be in a polygynous union or formerly married than younger men. Older women were almost twice as likely as younger women to be formerly married, while older men experienced almost no change. In fact, comparatively few men (<3%) in either age group were formerly married, reflecting gender disparities in age of divorce and widowhood as well as rates of remarriage. Younger men had, on average, fewer children than younger women (3 vs. 4), while older men and women both reported having more than seven children.

Multivariate Results

The first set of results presented in Table 2 focuses on the overall mental health and life satisfaction of women and men of reproductive age. Marital status was strongly associated with women’s psychological well-being. Women in polygynous unions reported significantly worse mental health (Model 1) and life satisfaction (Model 3) than women in monogamous marriages. The magnitude of these effects, however, are relatively small with polygynous women scoring 1.27 points lower on the mental health scale and one-tenth of a point lower on the life satisfaction Likert scale. The poorest mental health and lowest life satisfaction was experienced by formerly married women, who scored more than three points lower on the mental health scale (two-fifths of a standard deviation) compared to monogamously married women. They also reported significantly worse mental health than never married and even polygynously married women and report having lower levels of life satisfaction. Women in monogamous unions and those who had never been married reported similar levels of psychological well-being.

Formerly married younger men also reported a lower mental health score (about 3.3 points) (Model 2), but not significantly lower levels of life satisfaction (Model 4) compared to monogamously married men. These findings are notable given that only about two percent of younger men were formerly married.3 Unlike for women, men in polygynous unions did not have worse psychological outcomes than men in monogamous unions. In fact, polygynous men reported slightly (but not significantly) better psychological outcomes. Neither overall mental health nor life satisfaction was significantly associated with the number of children for men or women (Table 2).

To test whether these gender differences in marital status are significant, we pooled the sample of men and women aged 15 to 49 and estimated an interaction term between gender and union type (shown in Appendix D). We found that there are no statistically significant gender differences with respect to the effects of being never married or formerly married, but that the negative effect of polygnynous marriage on mental health and life satisfaction was larger for women than for men. Not surprisingly there were no statistically significant gender differences with respect to the effects on mental health and life satisfaction of fertility among men and women of reproductive age.

Table 3 presents results from fixed effects models to examine changes in psychological well-being in response to changes in marital status and fertility in the last two years. Models 1 and 2 find negative effects of recently becoming formerly married on the overall mental health of men and women. Union dissolution is associated with a decline in mental health scores of 2.27 points (or over a quarter of a standard deviation) for women and 5.25 points (about three-quarters of a standard deviation) for men. Formerly married men and women also reported experiencing a decline in life satisfaction, but this change is not statistically significant (Models 3 and 4).4 Interestingly, despite a negative association between polygyny and psychological well-being in our random effects models for women (Tables 2), this association is not significant in our fixed effects models. In contrast, for men, there are no associations with polygyny in our random effects models, but men who transition into a polygynous union reported a significant decline in life satisfaction of 0.28 points (Model 4).5

With respect to fertility, Table 3 shows that both having recently had a child and having recently lost a child are negatively correlated with women’s and men’s mental health scores, but these associations are not significant. In contrast, women who recently had a child (implying the presence of at least one young child under the age of two in the household) reported being one-quarter of a point less satisfied with their lives, on average. Women who reported a decline in their total number of children over the last two years also reported lower levels of life satisfaction, although the effect is only marginally signficant (p=0.06). Neither the recent loss nor addition of children has any significant impact on men’s life satisfaction.

In our final set of analyses in Table 4, we examine associations between marriage and fertility with psychological well-being for those aged 50 and older. In contrast to our findings for individuals at primary reproductive ages (adults aged 15 to 49), where marital status shaped individuals’ psychological well-being, there are no statistically significant associations between marital status and mental health or life satisfaction for older men or women.6 Fertility is associated with greater psychological rewards for older women, but not for younger women. For each additional (adult) child, older women experienced a small, but nonetheless significant, increase of 0.26 points in their mental health scores and 0.02 points on their life satisfaction scale (Models 1 and 3). Having more adult children is not significantly associated with older men’s psychological well-being.7

In Appendix E, we pool respondents of all ages by gender and test for differences in the effects of marital status and fertility through interactions with age groups. Although the negative psychological implications of being formerly married declined with age for both men and women, this difference by age is not significant for men. For women, being formerly married at a younger age rather than at an older age is associated lower life satisfaction (Model 5). Older women with higher fertility also fared significantly better on both measures of psychological well-being than young women (Models 2 and 6).

Discussion

Our paper offers some of the first insights from quantitative data into the complex relationship between two key demographic factors, union status and number of children, and psychological well-being in sub-Saharan Africa. In particular, it provides a nuanced picture of these relationships by going beyond a simple dichotomous measure of marital status, examining multiple indicators of psychological well-being, and assessing differences by gender and age. With respect to reproductive-aged adults, we find that marital status is more strongly associated with psychological well-being than number of children. However, there are important distinctions across union categories. Among those who are unmarried, formerly married adults of reproductive age fare worse than never-married adults, possibly reflecting the fact that virtually all Malawians eventually marry and that young never-married individuals are likely to be supported by their parents and native kinship networks. In contrast, formerly married men and women of reproductive age suffer the poorest mental health. Given that about 50% of women in Malawi will experience a union dissolution and spend at least some portion of their lives as a formerly married single mother (Clark and Hamplovà 2013), this tax on women’s psychological well-being is appreciable. Nonetheless, despite pervasive gender norms which typically hold women, more than men, accountable for the care and economic support of children following divorce, we find no evidence that being formerly married is more detrimental to women than men. These findings suggest that men who become and remain formerly married experience considerable psychological strain. Findings from our fixed effects analyses, consistent with previous research from high income countries, provide further evidence that the detrimental effects associated with being formerly married are not primarily influenced by selection of individuals out of unions, but rather the process of union dissolution has an acute psychological effect on both men and women.

In addition, our study offers the first evidence of important gender differences with respect to the relative benefits of monogamous and polygynous unions in Africa. Although the practice of polygyny has diminished over the past 50 years, it has not disappeared and remains relatively common in rural areas. In our sample, one in five women were in a polygynous union. Although polygyny may offer women some psychological advantages compared to being formerly married, its benefits are significantly lower than those associated with monogamous unions. Even after controlling for the lower education, greater poverty, and poorer physical health of polygynous women (Bove and Valeggia 2009), they exhibit greater psychological vulnerability. However, our fixed effects results show no statistically significant differences between women transitioning into and out of polygynous unions. These results suggest either that psychologically more vulnerable women select into polygynous unions or that the psychological consequences of being in a polygynous union are not apparent within the first two years of marriage. In comparison, there are no negative implications of polygyny for men, except in men’s reported life satisfaction shortly after taking a new wife. These findings suggest that any stress incurred from maintaining more than one household is short-lived and counterbalanced by the prestige men derive from having multiple wives.

Consistent with previous findings in Africa, the impact of being formerly married is considerably less for Malawians beyond their reproductive years (especially for women). These findings stand in contrast to research from high-income countries that indicates that benefits of marriage extend to older ages (Hagedoorn et al. 2006). The decline in the importance of marriage may reflect the greater social acceptability of being unmarried at older ages, particularly for women. It may also be related to the economic strain facing young formerly married mothers with dependent children compared to the economic support older formerly married women may receive from their adult children. Although these differences persist, even after controlling for household wealth, such measures may fail to fully capture differences in food security or in financial transfers or in-kind support from kin. Finally, it may suggest greater stigma associated with divorce (the primary driver of union dissolution before age 50) than with widowhood, which is more common at older ages.

The relationships between fertility and psychological well-being are quite different than those for marital status. Despite the value and centrality of children in the lives of Malawians (Dyer 2007), the number of children is not correlated with any measure of men’s or women’s psychological well-being during their reproductive years. This is consistent with findings from rural Ethiopia (Conzo et al. 2017), but differs from cross-sectional analyses of low-income countries showing a strong negative association with number of children and life satisfaction (Deaton and Stone 2014; Margolis and Myrskylä 2011). In addition, we find that women who had a child in the previous two years report significantly lower overall life satisfaction, although having recently had a child is not associated with diminished overall mental health for women and has no association with men’s psychological measures. These findings suggest that any overall negative effects may be temporary and associated primarily with the care of infants and toddlers. Furthermore, at least in very poor rural areas of sub-Saharan Africa, the psychological costs of raising children in poor households are largely offset by psychological rewards in settings that highly value children and where the task of child care may be shared with older children and other family members (Blanc and Lloyd 1994; Nauck and Klaus 2007).

Among older Malawians, having more (adult) children is associated with better outcomes across both psychological measures for older women. Our findings differ from the study in rural Ethiopia which found that only older men who had more children experienced heightened life satisfaction (Conzo et al. 2017). These results highlight the importance of having adult children for women particularly in contexts of high poverty and limited social safety nets (Margolis and Myrskylä 2011). The relatively greater benefits for older women than men likely reflects women’s greater dependence on adult children for both economic and emotional support at older ages (Jennings et al. 2018).

Limitations

The MLSFH is one of only two extant longitudinal surveys that capture both measures of psychological well-being and demographic events in sub-Saharan Africa. Such data collection, however, presents multiple theoretical and logistical challenges. One challenge is whether measures of mental health used in high-income countries are valid in rural sub-Saharan Africa. Although the instrument used in this study has been used and validated in several different settings (Corcoran and Fischer 2007; Ware et al. 2001), concepts about emotional states and mental health may vary considerably across contexts. Similar concerns have been raised with respect to measures of overall life satisfaction. To some extent, these issues are mitigated in fixed effects models, assuming that respondents interpret the questions in the same manner across waves. Cross-national comparisons of our findings, however, should bear this concern in mind.

Another issue is properly capturing number of children in a context where child fostering is widely practiced and child mortality is comparatively high. Malawians may include co-residential children as their own when asked questions about their total number of children ever born, and (incorrectly) exclude children who have died (Bignami-Van Assche et al. 2003). Hence, our results likely reflect social, rather than strictly biological, parenting of living children. We have endeavored to account for this by removing improbably large increases and decreases in the total number of children and including a flag for any reported decrease. We have also conducted sensitivity analyses in which respondents with decreases are removed and noted any discrepancies.

Furthermore, although our analyses go beyond a simply binary measure of marital status, due to data limitations, we do not capture other potentially important marital characteristics, such as whether the union was arranged by kin, the involvement of marriage advisors (ankhoswe), wives’ rank within polygynous unions, or the exchange of bridewealth. Nor are we able to distinguish between formerly married women who are divorced and those who are widowed, although the psychological implications may be quite different and may vary by age and gender. Lastly, we estimate the average effects of marital status and children on psychological well-being, but such effects are likely to be heterogeneous depending on, for example, the quality of the marital union and whether children live nearby, are both able and willing to contribute financially, and have an emotionally close and supportive relationship with their parents. These differences in marital characteristics and parent-child relationships may also influence their psychological returns and, hence, should be considered in future research.

Despite these limitations, by providing a more detailed picture of the relationships between fertility, marriage, and psychological well-being in a low-income setting, our paper makes several contributions. First, we provide further insights into the high rates of marriage and remarriage in rural Malawi, and elsewhere in sub-Saharan Africa, by highlighting the psychological strain experienced formerly married individuals, particularly for women of reproductive age. These findings reinforce other studies on the challenges of single motherhood in sub-Saharan Africa and the need to develop more programs and social policies to assist these women and their children (Clark and Hamplovà 2013; Clark et al. 2017). Second, given that women in polygynous unions suffer worse mental health than women in monogamous unions, further studies are required to investigate whether these psychological factors contribute to higher levels of union instability or overall declines in polygyny in sub-Saharan Africa. Third, our findings coupled with those from Conzo and colleagues (2017) suggest that in rural Africa children come at minimal psychological cost for younger adults and offer significant psychological benefits at older ages. Such findings can help explain why fertility rates remain persistently high in these areas and suggest that greater social and economic support for the elderly in rural Africa could undermine one of the key benefits of having many children. In sum, additional research, especially studies drawing on longitudinal data, is required to corroborate or refute these claims. Such studies should consider important differences by type of union, age, and sex and across multiple indicators of psychological well-being.

Supplementary Material

supp mat

Acknowledgements:

We gratefully acknowledge the assistance of Ann-Marie Helou and Madeleine Henderson, McGill University, in preparing this manuscript. Funding was provided for the Malawi Longitudinal Study of Families and Health (MLSFH) by the National Institute of Child Health and Human Development (NICHD, grant numbers R03 HD05 8976, R21 HD050653, R01 HD044228, R01 HD053781, R01 HD087391) and by the Population Aging Research Center and the Population Studies Center at the University of Pennsylvania (supported respectively by NIA P30 AG12836 and NICHD R24 HD044964).

Footnotes

1

The MLSF began in 1994 with a sample of about 1,500 married women and their partners. In 2004, a sample of about 1,500 youths (aged 15 to 24), many of whom where unmarried, were added to the study. Lastly, about 800 parents of participants were included in 2008 to capture an older population.

2

Limited sample size prohibits further disaggregating formerly married men into those who are widowed or divorced and there were no statistically significant differences in the psychological well-being of divorced or widowed women.

3

Never married men report significantly lower mental health than monogamously married men in our sensitivity analyses which remove respondents who report a decrease in children ever born.

4

The decline in life satisfaction experienced by formerly married women is significant at the 5% level in supplemental analyses, which remove respondents who report any decline in children ever born.

5

This association is only marginally significant at the 10% level in sensitivity analyses which exclude declines in children ever born.

6

Further analyses (not shown) indicate that older formerly married adults, like their younger counterparts, experience worse psychological well-being than monogamously married adults, but this is largely driven by their worse physical health. Including controls for physical health reduces the magnitude and significance of the associations between being formerly married and psychological well-being.

7

In analyses which remove older men who report a decrease in children ever born, having more children is associated with higher levels of life satisfaction at the 5% significance level.

Contributor Information

Shelley Clark, McGill University.

Cassandra Cotton, Arizona State University.

Rachel Margolis, Western University.

Hans-Peter Kohler, University of Pennsylvania.

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