Child Marriage in South Asia: Comparison
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Please note this is a comparison between Version 2 by Vivi Li and Version 1 by Blessing Akombi-Inyang.

Child marriage is a serious public health issue with dire implications at the individual and societal level. Child marriage refers to formal marriages and informal unions in which one or both parties are under 18 years of age and live with a partner as if married. Almost half of all child marriages globally originate from South Asia. 

  • child marriage
  • teenage marriage
  • adolescent marriage
  • educational attainment
  • mass media exposure
  • patriarchy

1. Background

Child marriage, also referred to as early marriage, is a serious human rights violation and detrimental practice that exposes children to increased risk of violence, exploitation, and abuse. It requires serious deliberation and action. Child marriage refers to formal marriages and informal unions in which one or both parties are under 18 years of age and live with a partner as if married [1,2][1][2]. Child marriage affects girls and boys, but disproportionately and negatively affects girls, who are more likely to be married off earlier in life than boys, especially in South Asia and Africa. This forced alliance is rooted in harmful pre-existing traditional norms and practices passed down through generations with debilitating effects on the girl child, their families, and society at large [3]. This harmful practice significantly undermines the best interests of the girl child at the individual, societal and national levels [4]. Besides being a human rights issue, child marriage has dire reproductive and sexual health consequences for girls, impeding their overall development and wellbeing [4].
Globally, more than 12 million girls marry at a young age (under 18 years) each year, that is, around 21% of young women marry before the age of 18 [1]. About 37% of these child marriages occur in sub-Saharan Africa, and 30% in South Asia [1]. In 2010, nearly 46% of women aged 20–24 years in South Asia reported being married before the age of 18. This translates to about 24.4 million women in the region, with projections that about 130 million girls are likely to be victims of child marriage between 2010 and 2030 [5].
In recent years, South Asia has experienced a significant decline in child marriage, especially among girls under 15 years [1,2][1][2]. This decline is driven predominantly by India, where child marriage rate declined from 47% in 2005 to 27% in 2016 [6]. However, despite the observed decline in child marriage in South Asia from 63% in 1985 to 45% in 2010 and 32% to 17% for girls under 15 years of age [1], this practice continues to be widespread and often concentrated in certain geographic regions or among specific cultural groups, necessitating more targeted efforts to protect adolescents from marriage. These targeted efforts must consider the predisposing factors associated with child marriage within the region.
Previous studies conducted in countries outside South Asia have reported some individual-level factors as being associated with child marriage, including place of residence (mostly rural) [7[7][8][9],8,9], low education level [7[7][8][9],8,9], poverty [7,8][7][8], culture [3], lack of exposure to mass media [7[7][8],8], low decision-making capacity [10[10][11],11], and religion [7,12][7][12]. Besides these associated factors, several other factors have also been reported to result from child marriage such as increased school dropouts [12], increased marital violence [10[10][13],13], increased maternal morbidity and mortality [14[14][15],15], increased risk of unintended pregnancies [16], decreased utilization of antenatal care and postnatal care services [17,18][17][18], decreased institutional delivery in health care facilities [17[17][19],19], and decreased deliveries assisted by skilled birth attendants [4,17,19][4][17][19]. However, no study has collectively and systematically analyzed the most consistent factors across the entire South Asia region to guide region- and country-specific interventions, which could lead to a decline in child marriage within each South Asian country and across the region. 

2. Child Marriage and Socio-Demographic Factors

Studies conducted in Bangladesh [23][20], Nepal [25][21] and India [26][22] reported an association between no/low exposure to mass media and child marriage. In India [21[22][23],26], Bangladesh [23,27,28[20][24][25][26],33], and Nepal [25[21][27],30], children from low SES households were found to be more susceptible to child marriage. Studies conducted in Bangladesh [23[20][24][28],27,29], India [26][22], and Pakistan [31][29] reported an association between rural residence and child marriage. In contrast, a study conducted in Nepal [25][21] found that child marriage was prevalent among children in urban areas. Studies conducted in Nepal [22,30][27][30], Bangladesh [23,28[20][25][28][31][32],29,34,35], India [21[22][23],26], and Pakistan [31][29] reported low educational attainment among most children, their parents and husbands exposed to child marriage. On the other hand, a study from Nepal [25][21] showed that early married women had husbands with a secondary or higher education level, and two studies conducted in Nepal [25][21] and Bangladesh [27][24] reported child marriage among women with a secondary or higher level of education. Five studies from Nepal [25,30][21][27] and Bangladesh [27,29,34][24][28][31] reported child marriage as prevalent among Hindus and Muslims.

3. Child Marriage and Maternal Health Service

Studies carried out in Bangladesh [23[20][33],32], India [24[33][34],32], Pakistan [31[29][33],32], and Nepal [32][33] reported that the number of ANC visits attended by early married women were less than four, which is the minimum recommended number of visits. Contrary to this, a study conducted in Nepal [25][21] reported that a higher percentage of early married women had four or more ANC visits. Most studies in India [24,32[26][33][34],33], Bangladesh [23[20][33],32], Nepal [25[21][33],32], and Pakistan [31,32][29][33] found that early married mothers reported few or no health facility-based deliveries. Studies conducted in Bangladesh [23[20][33],32], India [24,32][33][34], and Pakistan [31,32][29][33] reported low levels of delivery assistance by skilled birth attendants. On the other hand, a study conducted in Nepal [25][21] showed that delivery for early married mothers was mostly conducted by skilled birth attendants.

4. Discussion

In countries where child marriage is prevalent, it is also reported that the practice is not equally distributed, being geographically clustered and more pervasive in rural areas [28,34][25][31]. In rural settlements, child marriage is mostly seen among girls with low educational attainment and from poor households, which predisposes them to early childbearing and less access to the health system [30][27]. The interplay between place of residence, socio-economic status, educational attainment, and uptake of health services as it relates to child marriage is quite complex. Applying the principle of intersectionality [36][35], it could be inferred that economically disadvantaged girls, with no/low educational attainment, and residing in rural areas are more susceptible to being married off at an early age compared to their more affluent, better-educated counterparts living in urban areas. Rural residence was reported as being associated with child marriage. This could be associated with limited access to education due to fewer educational facilities in rural areas. Fewer schools restrict the number of children who can obtain proper education. In addition, most rural areas have fewer job opportunities [37][36], coupled with reduced access to education, which indirectly impacts the economic stability of most families, leading to parents marrying off their daughters at an earlier age for economic security [38][37]. However, contrary to this finding, a study from Nepal reported that most child marriages occur in urban areas irrespective of the number of educational facilities available [25][21]. This points to the need for interventions to prevent child marriage in both rural and urban areas. Religion was associated with child marriage. Every religion has teachings and doctrines which are upheld within the family. In South Asia, the most common religions are Hinduism, Islam, and Buddhism [39][38]. In this entreviewy, Hindu and Muslim religions were reported as being associated with child marriage. However, this is inconclusive, as studies which reported this were conducted in Nepal and Bangladesh which practice predominantly Hindu and Muslim religions respectively. Similarly, a study conducted in the United States of America (USA), a predominantly Christian country, reported the Christian religion to be associated with child marriage [40][39]. Another consistent factor associated with early marriage is education. The lack of adequate educational opportunities is a significant contributor to child marriage, especially in developing countries. Most often, families facing significant financial hardship resort to marrying off their daughters to relieve some financial burden, instead of paying costly school fees. This practice prevents the girl child from attaining future independence and autonomy through proper education and income-earning jobs. This practice is also prevalent in situations where the parents and the husband have low levels of educational attainment. Education enhances decision-making capacity [41][40] and has been known to help delay the age of marriage. The education level of parents influences their disposition towards child marriage to a great extent, and their willingness to marry off their young daughters [12]. Parents and husbands with low level of education do not seem to understand the detrimental impact child marriage could have on maternal and neonatal health outcomes. In addition, research has shown that marital violence increases in cases of child marriage where husbands are illiterate [42,43][41][42]. In line with our reviewesearchers' entry are studies conducted in Nepal, Zambia, Indonesia, and Bangladesh that showed an inverse association between education and child marriage [7,9,44][7][9][43].

References

  1. UNICEF. Child Marriage around the World. 2020. Available online: https://www.unicef.org/stories/child-marriage-around-world (accessed on 13 November 2022).
  2. UNICEF; UNFPA. Mapping of Child Marriage Initiatives in South Asia 2016; UNFPA: New York, NY, USA, 2016; pp. 1–45.
  3. Lowe, M.; Joof, M.; Rojas, B.M. Social and cultural factors perpetuating early marriage in rural Gambia: An exploratory mixed methods study. F1000Research 2019, 8, 1949.
  4. Fan, S.; Koski, A. The health consequences of child marriage: A systematic review of the evidence. BMC Public Health 2022, 22, 309.
  5. UNFPA. Marrying too Young: End Child Marriage; UNFPA: New York, NY, USA, 2012.
  6. International Institute for Population Sciences. National Family Health Survey (NFHS-4), 2015–2016; International Institute for Population Sciences (IIPS): Mumbai, India, 2017; pp. 791–846.
  7. Rumble, L.; Peterman, A.; Irdiana, N.; Triyana, M.; Minnick, E. An empirical exploration of female child marriage determinants in Indonesia. BMC Public Health 2018, 18, 407.
  8. Saleheen, A.A.; Afrin, S.; Kabir, S.; Habib, M.J.; Zinnia, M.A.; Hossain, M.I.; Haq, I.; Talukder, A. Sociodemographic factors and early marriage among women in Bangladesh, Ghana and Iraq: An illustration from Multiple Indicator Cluster Survey. Heliyon 2021, 7, e07111.
  9. Mulenga, J.; Mulenga, M.C.; Bwalya, B.B.; Ngongola-Reinke, C. Too young to be a wife! analysis of the factors influencing child marriages and its influence on the preferred number of children among women in Zambia. Afr. Popul. Stud. 2018, 32.
  10. Nasrullah, M.; Zakar, R.; Zakar, M.Z.; Abbas, S.; Safdar, R. Circumstances leading to intimate partner violence against women married as children: A qualitative study in Urban Slums of Lahore, Pakistan. BMC Int. Health Hum. Rights 2015, 15, 23.
  11. McDougal, L.; Jackson, E.C.; McClendon, K.A.; Belayneh, Y.; Sinha, A.; Raj, A. Beyond the statistic: Exploring the process of early marriage decision-making using qualitative findings from Ethiopia and India. BMC Women‘s Health 2018, 18, 144.
  12. Sekine, K.; Hodgkin, M.E. Effect of child marriage on girls’ school dropout in Nepal: Analysis of data from the Multiple Indicator Cluster Survey 2014. PLoS ONE 2017, 12, e0180176.
  13. Kidman, R. Child marriage and intimate partner violence: A comparative study of 34 countries. Int. J. Epidemiol. 2017, 46, 662–675.
  14. Franjić, S. Adolescent pregnancy is a serious social problem. J. Gynecol. Res. Obstet. 2018, 4, 006–008.
  15. Black, A.Y.; Fleming, N.A.; Rome, E.S. Pregnancy in adolescents. Adolesc. Med. State Art Rev. 2012, 23, 123–138.
  16. Septiarum, R.; Suwarni, L.; Alamsyah, D. Unwanted Pregnancies and Early Marriage Child Aged 13–18 Years. Indian J. Public Health Res. Dev. 2019, 10, 1792–1797.
  17. Olamijuwon, E.O.; Odimegwu, C.O.; Chisumpa, V.H.; Akinyemi, J.O. Unveiling the Realities of Marrying Too Young: Implications of Child Marriage on Reproductive Health and Infant Survival in Sub-Saharan Africa. In Proceedings of the PAA 2017 Annual Meeting, Chicago, IL, USA, 27–29 April 2017.
  18. Elnakib, S.; Elsallab, M.; Wanis, M.A.; Elshiwy, S.; Krishnapalan, N.P.; Naja, N.A. Understanding the impacts of child marriage on the health and well-being of adolescent girls and young women residing in urban areas in Egypt. Reprod. Health 2022, 19, 8.
  19. Ahinkorah, B.O.; Budu, E.; Seidu, A.A.; Bolarinwa, O.A.; Agbaglo, E.; Adu, C.; Arthur-Holmes, F.; Samad, N.; Yaya, S. Girl child marriage and its association with maternal healthcare services utilization in sub-Saharan Africa. BMC Health Serv. Res. 2022, 22, 777.
  20. Uddin, J.; Pulok, M.H.; Johnson, R.B.; Rana, J.; Baker, E. Association between child marriage and institutional delivery care services use in Bangladesh: Intersections between education and place of residence. Public Health 2019, 171, 6–14.
  21. Sekine, K.; Carter, D.J. The effect of child marriage on the utilization of maternal health care in Nepal: A cross-sectional analysis of Demographic and Health Survey 2016. PLoS ONE 2019, 14, e0222643.
  22. Mehra, D.; Sarkar, A.; Sreenath, P.; Behera, J.; Mehra, S. Effectiveness of a community based intervention to delay early marriage, early pregnancy and improve school retention among adolescents in India. BMC Public Health 2018, 18, 732.
  23. Binu, V.S.; Sridhar, V.; Subba, S.H.; Prathyusha, P.V.; Sabu, K.M. Direct and indirect factors associated with child marriage: Evidence from India using NFHS-4 data. Child Abus. Negl. 2022, 131, 105785.
  24. Hossain, M.G.; Mahumud, R.A.; Saw, A. Prevalence of child marriage among Bangladeshi women and trend of change over time. J. Biosoc. Sci. 2016, 48, 530–538.
  25. Islam, M.K.; Haque, M.R.; Hossain, M.B. Regional variations in child marriage in Bangladesh. J. Biosoc. Sci. 2016, 48, 694–708.
  26. Santhya, K.G.; Ram, U.; Acharya, R.; Jejeebhoy, S.J.; Ram, F.; Singh, A. Associations between early marriage and young women’s marital and reproductive health outcomes: Evidence from India. Int. Perspect. Sex. Reprod. Health 2010, 36, 132–139.
  27. Sah, R.B.; Gaurav, K.; Baral, D.D.; Subedi, L.; Jha, N.; Pokharel, P.K. Factors affecting early age marriage in Dhankuta Municipality, Nepal. Nepal J. Med. Sci. 2014, 3, 26–30.
  28. Kamal, S.M.; Hassan, C.H.; Alam, G.M.; Ying, Y. Child marriage in Bangladesh: Trends and determinants. J. Biosoc. Sci. 2015, 47, 120–139.
  29. Nasrullah, M.; Zakar, R.; Krämer, A. Effect of child marriage on use of maternal health care services in Pakistan. Obstet. Gynecol. 2013, 122, 517–524.
  30. Yogi, B.N. Factors Associated with Early Marriage in Rural Mid-Western Nepal. J. Health Promot. 2020, 8, 63–72.
  31. Kamal, S.M. Geographical Variations And Contextual Effect On Child Marriage In Bangladesh. Pak. J. Women’s Stud. 2010, 17, 37–57.
  32. Rahman, M.M.; Kabir, M. Do adolescents support early marriage in Bangladesh? Evidence from study. J. Nepal Med. Assoc. 2005, 44, 73–78.
  33. Godha, D.; Hotchkiss, D.R.; Gage, A.J. Association between child marriage and reproductive health outcomes and service utilization: A multi-country study from South Asia. J. Adolesc. Health 2013, 52, 552–558.
  34. Paul, P.; Chouhan, P. Association between child marriage and utilization of maternal health care services in India: Evidence from a nationally representative cross-sectional survey. Midwifery 2019, 75, 66–71.
  35. Atewologun, D. Intersectionality theory and practice. In Oxford Research Encyclopedia of Business and Management; Oxford University Press: Oxford, UK, 2018.
  36. Seth, R.; Bose, V.; Qaiyum, Y.; Chandrashekhar, R.; Kansal, S.; Taneja, I.; Seth, T. Social determinants of child marriage in rural India. Ochsner J. 2018, 18, 390–394.
  37. Shahabuddin, A.; Nöstlinger, C.; Delvaux, T.; Sarker, M.; Delamou, A.; Bardají, A.; Broerse, J.E.; De Brouwere, V. Exploring maternal health care-seeking behavior of married adolescent girls in Bangladesh: A social-ecological approach. PLoS ONE 2017, 12, e0169109.
  38. Mittal, S.; Thursby, G. (Eds.) Religions of South Asia: An Introduction; Routledge: Oxfordshire, UK, 2006.
  39. Uecker, J.E. Religion and Early Marriage in the United States: Evidence from the Add Health Study. J. Sci. Study Relig. 2014, 53, 392–415.
  40. Raj, A.; Salazar, M.; Jackson, E.C.; Wyss, N.; McClendon, K.A.; Khanna, A.; Belayneh, Y.; McDougal, L. Students and brides: A qualitative analysis of the relationship between girls’ education and early marriage in Ethiopia and India. BMC Public Health 2019, 19, 19.
  41. Puri, M.; Frost, M.; Tamang, J.; Lamichhane, P.; Shah, I. The prevalence and determinants of sexual violence against young married women by husbands in rural Nepal. BMC Res. Notes 2012, 5, 291.
  42. Yount, K.; Crandall, A.; Cheong, Y.; Osypuk, T.; Bates, L.; Naved, R.; Schuler, S.R. Child Marriage and Intimate Partner Violence in Rural Bangladesh: A Longitudinal Multilevel Analysis. Demography 2016, 53, 1821–1852.
  43. Razu, S.R. Determinants of early marriage among women: An experience from rural Bangladesh. Gend. Stud. 2018, 17, 127–136.
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