Ending child marriage: ensuring healthy futures for girls
The Lancet
One in five women are married before the age of 18 years. This fact has serious ramifications for health and wellbeing. Child marriage is associated with pregnancy at a young age, dangerous complications during pregnancy and childbirth, HIV acquisition, and intimate partner violence. Demographic changes mean that the number of adolescents is increasing and therefore more people will be at risk of child marriage. Disruption to education and a rise in poverty caused by the COVID-19 pandemic is estimated to put another 10 million girls at risk of child marriage over the next decade, in addition to the 100 million who were already projected to become child brides. Ending child marriage involves health, legislature, the economy, education, culture, and religion, making interventions difficult to coordinate. Harmful norms, including gender inequality and social, religious, and cultural practices, can be difficult to change. For the poorest families, who are struggling to survive, marrying off a child early might appear to be the only option. What, then, will it take to end child marriage globally?
First, is an appreciation that child marriage is a truly global issue. 12 million child marriages happen each year, largely in northwest central Africa, south Asia, and South America. 76% of girls in Niger, 59% in Bangladesh, and 36% in Brazil are married before the age of 18 years. But the idea that child marriage is a concern only in the global south is false. There were nearly 300 000 child marriages during 2000–18 in the USA, where child marriage for girls and boys remains legal in 44 states. In Germany, where child marriage has been illegal since 2017, 813 child marriages were reported in 2017–20.
144 countries have committed to the Sustainable Development Goals target 5.3, to end child marriage to achieve gender equality by 2030. However, essential reproductive health interventions, such as contraception and abortion services, remain illegal or hard to access in many countries, not least in the USA, where the US Supreme Court has rescinded a 50-year-old decision on the constitutional right to abortion. This hypocrisy will lead to more girls and adolescents in poverty, at risk of dying from unsafe abortions, and marrying or cohabiting under the age of 18 years—for some, marriage is the culturally acceptable response to an unintended pregnancy. Keeping child marriage laws in place is often a misguided paternalistic response to the effects of other anti-reproductive health laws that make girls more vulnerable in the first place.
Fortunately, the legal environment surrounding child marriage is not entirely bleak. According to UNICEF, child marriage is decreasing globally because of laws that have raised the marrying age to 18 years and investments in interventions; most progress in the past decade has been in south Asia, where a girl's risk of marrying in childhood has dropped from nearly 50% to less than 30%. In England and Wales, a bill was passed in April, 2022, to raise the marrying age from 16 years to 18 years in the hope of ending forced marriage, with fines and up to 7 years’ imprisonment for any adult facilitating such a marriage. However, punitive laws can lead to unintended consequences, including underground marriages and penalising minors, that might further marginalise families, especially those in poverty. Besides, legal prohibitions are only effective if they are enforced. Rights for children, particularly girls, and women are fragile. Civil society, human rights, and gender watchdog organisations must be supported to hold leaders accountable to rights-based legislation.
Ultimately, raising the legal age of marriage does not address the root causes of child marriage. There are other effective interventions. A 2021 systematic review for the UN found that the most effective interventions to reduce the prevalence of child marriage helped girls to remain in school through cash or in-kind transfers. Expanding labour market opportunities to ensure economic independence and fostering the development of livelihood skills remove the incentives that drive girls into marriage.
Every girl should be able to imagine a future for herself in which she has an education, economic potential, the right to choose when to marry, and the bodily autonomy to decide when and if to have a child. The alternative is a world in which girls are commodities for sexual exploitation and for procreation. Laws permitting child marriage need to change. But the effects will be minimal without investment in programmes that empower girls, change social norms in families and communities, and provide services to address the inequities across health, education, and economic security that cause child marriage to begin with.
