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Despite laws, too many girls marry early.

The health consequences of child marriage have been well documented: girls who marry at a very young age are more likely than women who marry after age 18 to experience early, frequent, and unplanned pregnancies, which raise the risk of complications and death during childbirth. Adolescent brides, some as young as 10, typically lack the skills to negotiate safe sex, placing them at increased risk for HIV and other sexually transmitted infections. Additionally, girls who marry early may stop attending school. Recognition of these threats, along with increasing acknowledgment of early marriage as a violation of girls' human rights, has led most countries to strengthen laws against child marriage--defined by UNICEF as marriage before age 18.

Yet in many countries, especially in South Asia and sub-Saharan Africa, the laws are poorly enforced, and more than 100 million girls under age 18 are expected to marry in the next decade. These girls, and the 60 million girls under age 18 worldwide who are already married, need support and information.

In India, where the legal age for marriage was increased from 12 to 18 in 1978, the prevalence of child marriage remains unacceptably high, say the authors of a paper in the May 30 issue of The Lancet. In the study, Population Council demographer Niranjan Saggurti and colleagues from Boston University School of Public Health, the Harvard School of Public Health, and the Indian Council for Medical Research use data from India's 2005-06 National Family Health Survey to document the country's prevalence of child marriage.

Early marriage often leads to high fertility

Although data suggest that early marriage in India is slowly decreasing, with a 5 percent reduction since 1999, the authors' analysis shows that some 45 percent of Indian women aged 20-24 years were married before age 18. Rural, poor, less educated girls and those from the central and eastern regions of the country were most likely to have married early.

Child marriage affects not only adolescents aged 16-17, but also large numbers of pubescent girls aged 14-15, they note. "The numbers suggest that neither recent economic progress nor policy gains or programmatic efforts to prevent child marriage have been sufficient to reduce the prevalence of child marriage in India to levels found in most other developing nations," Saggurti says.

The researchers also found an association between early marriage and reduced contraceptive use, multiple unwanted pregnancies, terminated pregnancies, and repeat childbirths less than 24 months apart.

For women who married as children, the median age at first childbirth was 17 years, while women who married as adults had a median age at first childbirth of 20. Women married as children were more likely to have had three or more children and a repeat childbirth in less than 24 months than were those who married as adults.

Council programs target social, economic, and health needs

These findings underscore the need to address the underlying causes of child marriage. While programmatic efforts should be centered on women's needs, the authors add that husbands and in-laws must be included since in some cases they are the ones who make decisions about family planning. A Council initiative known as the First-time Parents Project, undertaken in partnership with Deepak Charitable Trust in Vadodara and the Child In Need Institute in Kolkata, shows how programs can empower these girls by working within their communities. Designed to boost girls' reproductive health knowledge and increase their ability to act in their own interests, the project had significant, positive effects on girls' autonomy, reproductive health knowledge and practice, and couple relations. "Our findings are very encouraging--both in exerting significant effects on the lives of married girls and in demonstrating the feasibility of implementing a program for this vulnerable population of girls," notes Nicole Haberland, a researcher in the Council's Poverty, Gender, and Youth program.

Other Council projects aim to improve educational and job opportunities for girls in rural areas so that child marriage is not the only economically feasible and socially acceptable option for many impoverished families. For example, in the Amhara region of Ethiopia, where rates of child marriage are among the highest in the world and half of all girls marry before their 15th birthday, a project is underway to promote girls' functional literacy, life skills, reproductive health education, and opportunities for saving money. Economic incentives encourage families to allow their daughters to participate in girls' groups that meet five days per week, and to remain in school. An evaluation of the project, called Berhane Hewan, found that significantly fewer girls in the experimental area had been married during early adolescence compared to girls of similar age in the control site.

Similar Council projects are underway in Bangladesh, Guatemala, India, Kenya, Nigeria, and elsewhere.

SOURCES

Amin, Sajeda, Erica Chong, and Nicole Haberland. "Programs to address child marriage: Framing the problem," Promoting Healthy, Safe, and Productive Transitions to Adulthood Brief no. 14. New York: Population Council. (updated January 2008)

Raj, Anita, Niranjan Saggurti, Donta Balaiah, and Jay G. Silverman. 2009. "Prevalence of child marriage and its effect on fertility and fertility-control outcomes of young women in India: A cross-sectional, observational study," The Lancet 373(9678): 1883-1889.

Santhya, K.G., Nicole Haberland, Arup Das, Aruna Lakhani, F. Ram, R.K. Sinha, Usha Ram, and S.K. Mohanty. 2008. Empowering Married Young Women and Improving Their Sexual and Reproductive Health: Effects of the First-time Parents Project. New Delhi: Population Council.

OUTSIDE FUNDING

The Andrew W. Mellon Foundation, The Community Foundation for National Capital Region, Indian Council for Medical Research, The John D. and Catherine T. MacArthur Foundation, The Summit Foundation, The Turner Foundation, Inc., UK Department for International Development, United Nations Children's Fund (UNICEF), United Nations Population Fund (UNFPA), U.S. National Institutes of Health, The William and Flora Hewlett Foundation
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Title Annotation:TRANSITIONS TO ADULTHOOD
Publication:Population Briefs
Geographic Code:9INDI
Date:Dec 1, 2009
Words:960
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