Child Marriage & Married Adolescents:

Potential Role for Faith Communities

Judy DiersPopulation Council

CCIH Annual Conference -- 30 May 2005

Outline

Current status of child marriage– Extent of the practice– International and national policy and law– Programmatic void surrounding married

adolescents Potential disadvantages of child marriage for

girls Unique assets & position of faith-based

organizations Three areas for potential action

Child marriage: Still with us

Demographic and Health Surveys (DHS) indicate about 38% of young women currently aged 20-24 in 50 least developed countries were married before age 18

If present patterns continue, over 100 million girls will be married as children in the next decade

Child marriage: Substantial variation across the regions of the world

0 10 20 30 40 50 60 70 80 90 100

LAC

Asia

SSA

WANA

PERCENT

Proportion of girls married before age 18, intra- and inter-regional variation

(21-39%)

(7-79%)

(11-88%)

(23-65%)

= Range

Source: Mensch, 1999.

All data are for 20-24-year-olds, DHS data (compiled by Erica Chong).

Region, country % married by age 15

% married by age 18

Median age at marriage

(years)

Ethiopia - Amhara

1950

4980

18.115.0

Mali - Kayes

2439

6583

16.715.5

Kenya - Nyanza - Coast

4411

253632

20.519.4 19.9

Child marriage: Variation within countries

Regional “hot spots”

Laws Governing Child Marriage

Convention on the Rights of the Child Convention on the Elimination of All Forms of

Discrimination Against Women (CEDAW) Legal minimum age at marriage is 18 in

majority of countries worldwide, yet issues persist:– Enforcement– Parental consent– Applies only to civil unions– Contradictions in civil law (i.e. Tanzania)

Source: Katsive, 2003.

Lack of programs and policies for married adolescents

Traditionally, married adolescents have been omitted from the adolescent/youth policy and program agenda – a dangerous omission given that:

– Most sexually active girls aged 15-19 are married

– Most births to adolescent girls take place within marriage

Why the Omission?

Western focus on unmarried, in-school adolescents

Assumption that “married” implies “adult” and access to services/entitlements

Marriage thought to provide protection Married adolescents relatively invisible and

difficult to reach – more socially isolated

Outline

Current status of child marriage– Extent of the practice– International and national policy and law– Programmatic void surrounding married

adolescents Potential disadvantages of child marriage for

girls Unique assets & position of faith-based

organizations Three areas for potential action

Marriage brings many disadvantages to adolescent girls

Married adolescents are typified by:

– High levels of unprotected sexual relations– Large age gaps with sexual partners– Intense pressure to become pregnant– Highly limited or absent peer networks– Restricted social mobility/freedom of movement– Little access to modern media (TV, radio,

newspapers)– Limited education attainment and no schooling

options

Source: Haberland, Chong, Bracken, 2003.

Married girls are many times more likely to have had unprotected sexual relations

than sexually active unmarried

59.8

43.6

71.9

16.9 12.620.5

0

20

40

60

80

South and EastAfrica

West and CentralAfrica

Latin America andCaribbean

Per

cent Married

Unmarried

Source: Bruce and Clark, 2004.

Percent of sexually active girls aged 15-19 who had unprotected sex last week

The younger the bride, the larger the spousal age difference

0

2

4

6

8

10

12

14

14-15 16-17 18-19 20-21 22-23 24-25

Age at Marriage

Mea

n S

po

use

/Pa

rtn

er A

ge

Dif

fere

nce

South America Central America/CaribbeanMiddle East South Central/South East AsiaFormer Soviet Asia West/Middle AfricaEast/Southern Africa

Mean Spouse/Partner Age Difference, by Woman’s Age at First Marriage

Source: Mensch, 2003

Even when pregnancy is not desired, child brides are unable to negotiate condom use

42

2

14

4

20

9

0

20

40

60

80

100

Condom Use Among Girls Wishing to Avoid Pregnancy

Unmarried, Burkina FasoMarried, Burkina FasoUnmarried, KenyaMarried, KenyaUnarried, ZambiaMarried, Zambia

Per

cent

Sources: Clark, 2004; Bruce and Clark, 2003.

Access to schooling

Education of 15-19-year-old-girls, by marital and parenting status

0

20

40

60

80

100

Brazil Kenya Nigeria

Perc

en

t en

rolled

in

sch

oo

l

Married -Without childrenUnmarried -Without childrenMarried - WithchildrenUnmarried - Withchildren

Exposure to HIV/AIDS information in the last year, by sex and marital status

Participation in social events and media

exposure, by sex and marital status

Emerging evidence of links between early marriage and HIV infection

Married

UnmarriedSexually Active

% Higher

Kisumu, Kenya

32.9% 22.3% 47.5%

Ndola, Zambia

27.3% 16.5% 65.5%

Sources: Glynn (AIDS, 2001) Data from multi-center study, girls 15-19;Bruce and Clark, Involving Married Adolescents in Adolescent Reproductive Health and HIV/AIDS Policy, paper presented at WHO/UNFPA/PC Meeting on married adolescents, December 2003, GenevaClark (SFP, 2004) Early marriage and HIV risks in sub-Saharan Africa

Married girls have more frequent sex, are less likely to use condoms, and are more likely to

have HIV+ partners

Unmarried, sexually active

Married

Had sex in the last week 10.9 64.4

Use condoms often/always 19.5 3.5

HIV prevalence among men with adolescent partners

12.3 31.1

Source: Clark (SFP, 2004)

HIV Risk factors among sexually active girls aged 15 to 19 in Kisumu, Kenya

Older partners

Higher sexual frequency

Intense pressure for pregnancy

Greater social isolation

Unable to benefit from any of the conventional HIV protection messages:

Child marriage and HIV: Risk without guidance

1. Abstinence

2. Reduce sexual frequency

3. Reduce number of partners

4. Use condoms

5. Observe mutually monogamous relations with an uninfected partner

Outline

Current status of child marriage– Extent of the practice– International and national policy and law– Programmatic void surrounding married

adolescents Potential disadvantages of child marriage for

girls Unique assets & position of faith-based

organizations Three areas for potential action

Unique position of churches and other faith-based organizations

Long-term view to development and transformation Excellent coverage in the field Regular contact with community (same place, same

time) in large and small groups Critical life transitions are marked (potential points of

intervention – baptism, confirmation, marriage …) Moral authority and leadership Responsibility to nurture and protect the children of the

community Trusted by the community

Outline

Current status of child marriage– Extent of the practice– International and national policy and law– Programmatic void surrounding married

adolescents Potential disadvantages of child marriage for

girls Unique assets & position of faith-based

organizations Three areas for potential action

Three overlapping clusters of concern for policy activity and public education:

1. Raising consciousness about child marriage

2. Promoting later, legal, and chosen marriage

3. Supporting married adolescent girls

1. Raising consciousness about early marriage

– Clarify and publicize local marriage laws

– Emphasize the situation of the youngest (under 15) mothers with regard to maternal mortality and morbidity, including risk of obstetric fistula

– Create awareness that marriage is not a sexual safety zone

– Raise awareness of the health and rights implications of large spousal age differences and intergenerational sex

2. Promoting later, legal marriage

– Advocate for new laws and/or enforcement of existing laws

– Develop community-based initiatives that redefine acceptable ages of marriage and offer social and economic supports that allow parents and girls to delay marriage until at least 18.

– Get girls into school on time and keep them there through secondary school

– Create new opportunities/safe spaces for girls (particularly those out of school)

– Increase girls’ access to livelihoods skills/resources

3. Supporting married adolescent girls

– Develop interventions to reduce social isolation and economic vulnerability

– Refocus maternal and child health information and outreach to actively engage married adolescent girls, first-time parents

– Develop HIV protection strategies, including VCT, to support girls from engagement through the early years of marriage.

– Foster more equal and trusting relationships between new spouses

– Decrease the imminent pressure for pregnancy on the youngest brides

– De-stigmatize condoms and protection from STIs/HIV within marriage

What are faith-based organizations currently doing to– Raise awareness of child marriage, related health issues– Promote delayed marriage– Support married adolescents

Future strategies– Points of entry (group meetings, recognized transitions)– Intervention ideas in the three areas above

Dialogue with faith-based organizations

SELECTED RESOURCES

Amin, Sajeda, Simeen Mahmud, and Lopita Huq. Baseline survey report on rural adolescents in Bangladesh. Dhaka, Bangladesh: Ministry of Women's Affairs: Government of Bangladesh. 2002.

Bruce, Judith. Chapter 2, UNFPA/Population Council background document for the UNFPA workshop on “Adolescent and Youth Sexual and Reproductive Health: Charting Directions for a Second Generation of Programming,” May 2003.

Bruce, Judith. “Married Adolescent Girls: Human Rights, Health, and Development Needs of a Neglected Majority,” Economic and Political Weekly, October 2003.

Bruce, Judith and Shelley Clark. “Including Married Adolescents in Adolescent Reproductive Health and HIV Policy,” Prepared for for the Technical Consultation on Married Adolescents, WHO, Geneva, December 9-12, 2003. Under review for publication. Also available in Brief form: Bruce and Clark, “The Implications of Early Marriage for HIV/AIDS Policy,” May 2004.

Clark, Shelley. “Early Marriage and HIV Risks in Sub-Saharan Africa,” Studies in Family Planning, 35(3), 2004.

Erulkar, Annabel and Charles Onoka. Tabulations of data from Adolescent Reproductive Health Information and Services Survey, Central Province, Kenya, 2001, unpublished.

Erulkar, Annabel. “Working with Ethiopian Youth Serving NGO’s to Increase their Capacity to Monitor Performance and Identify Gaps in Coverage,” 2004.

Glynn, J.R., Caraël, M., Auvert, B., Kahindo, M., Chege, J., Musonda, R., Kaona, F., & Buvé, A., for the Study Group on Heterogeneity of HIV Epidemics in African Cities. “Why do young women have a much higher prevalence of HIV than young men?” A study in Kisumu, Kenya and Ndola, Zambia. AIDS 15(suppl 4), S51-60, 2001.

Hallman, Kelly. “Poverty and Unsafe Sexual Behaviors Among Young Women and Men in South Africa.” Population Council Working Paper, 2004.

Hallman, Kelly and Judy Diers. “Social Isolation and Economic Vulnerability as Risk Factors for HIV and Pregnancy in South Africa.,” forthcoming.

Haberland, Chong, Bracken. “Married Adolescents: An Overview.” Paper prepared for the Technical Consultation on Married Adolescents, WHO, Geneva, Dec 9-12, 2003.

Katzive, Laura. “Married Girls and the Law: Directions for Legal Advocacy,” Paper prepared for the Technical Consultation on Married Adolescents, WHO, Geneva, Dec 9-12, 2003.

Mensch, Barbara S. Data analysis conducted for National Academy of Sciences report on "Transitions to Adulthood in Developing Countries," 2004.

Mensch, Barbara S. “Adolescent Research and Programs: Moving Beyond the Conventional.” Presentation at The World Bank Human Development Week, Washington, March 1999.

Population Council analysis of DHS and United Nations Data, 2001.

Santhya, K. G. and Nicole Haberland. “Addressing the Social Context of Married Adolescent Girls: The First Time Parents Project.” Presentation given at the Technical Consultation on Married Adolescents, WHO, Geneva, December 9-12, 2003.