Transcript Child Marriage Predictors, Hotspots

From Awareness to Action:
Child Marriage Predictors, Hotspots,
and Program Approaches
Kathleen Kurz and Saranga Jain
IGWG Technical Update on Child Marriage
July 11, 2006
Outline of Presentation
Background
Prevalence
Consequences
Reasons
From Awareness to Action
Predictors
Hotspots
Program Scan
Recommendations
Prevalence of Child Marriage –
Top 20 Countries
Girls Married Before Age 18 (%)
1
2
3
4
5
6
7
8
9
10
11
12
13
13
15
16
17
18
18
20
Niger (1998)
Chad (2004)
Bangladesh (2004)
Mali (2001)
Guinea (1999)
CAR (1994/95)
Nepal (2001)
Mozambique (2003)
Uganda (2000/01)
Burkina Faso (2003)
India (1998/99)
Ethiopia (2000)
Liberia (1986)
Yemen (1997)
Cameroon (2004)
Eritrea (2002)
Malawi (2000)
Nicaragua (2001)
Nigeria (2003)
Zambia (2001/02)
76
71
68
65
64
57
56
55
54
51
50
49
48
48
47
47
46
43
43
42
Child Marriage (CM):
Constraints to Health & Development
• Worse reproductive health outcomes
• Wasted investment in development efforts
Maternal mortality
rate (per 100,000 live
births)
1400
Maternal Mortality by Age
1270
1200
20-34 years
15-19 years
1100
1000
800
575
600
526
436
400
223
200
6.2
6.6
0
Ethiopia
Indonesia
Nigeria
Sources: Family care international, 1998; CDC 2002 Vital Statistics Report
United States
Infant Mortality Rates by Age of the Mother
Poor Health Outcomes
Outcomes
•Maternal mortality
•Maternal morbidities
•Low birth weight & prematurity
•Infant mortality
Reasons
•Still growing
•First birth
•Inadequate prenatal care
•Low socioeconomic status
Child Marriage and Rank on
Human Development Index (HDI)
% married girls
aged 15-19
60
Mali
Bangladesh
50
India
40
Chad
30
20
U.S.
10
Brazil
Indonesia
0
0
20
40
60
Sources: PRB 2000 State of the World's Youth; UNDP HDR 2002
80
100
HDI Rank
120
140
160
180
Reasons:
Why Does Child Marriage Persist?
•Gender roles
– Families see girls as financial and social burdens
– Lack of socially acceptable alternatives for girls
•Family and community honor tied to early marriage
– Reinforce ties between families and communities
– Desire to protect girls
•Lack of political will
•Cultural norm
Outline of Presentation
Background
Prevalence
Consequences
Reasons
From Awareness to Action
Predictors
Hotspots
Program Scan
Recommendations
Possible Predictors of CM
Considered in the Multivariate Analysis
Practices programs could support
to reduce CM
• Primary Education
• Secondary Education
• Higher Education
• Primary Education -- Partner
• Secondary Education -- Partner
• Higher Education -- Partner
• Lower Age Gap Husband-Wife
Factors programs could target
to reduce CM
• Current Place of Residence
• Childhood Place of Residence
• Region
• Ethnicity
• Religion
• Polygyny
• Number of Siblings
• Wealth/Electricity
Number of
Countries
20
18
16
14
12
10
8
6
4
2
0
Strength of Predictors of CM
<18 yrs vs ≥18yrs
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"Tipping Point" Age
at which CM Accelerates:
Example Bangladesh - Age 13
Cumulative
Percent of CM
100
90
80
70
60
50
40
30
20
10
0
10
11
12
13
14
15
16
17
Age
18
19
20
21
22
23
24
Tipping Point Age
and Median Age of Marriage
Country
Tipping
Point Age
Median Age of
Marriage
Cameroon, India, Mozambique
13
17
Uganda, Zambia, Malawi
14
17
Burkina Faso
15
17
Ethiopia
12
16
Nigeria, Mali, Liberia, Nicaragua
13
16
Central African Republic, Nepal
14
16
Bangladesh, Niger, Chad, Guinea
13
15
Prevalence of CM by
Secondary School Enrollment
Prevalence of CM by
Age Gap Husband-Wife
Prevalence
of CM
100%
90%
80%
70%
Guinea
60%
Bangladesh
Nigeria
Mali
50%
Niger
Burkina Faso
40%
Cameroon
Chad
Ethiopia
Zambia
30%
Uganda
Malawi
20%
Central
African
Rrepublic
Mozambique
India
Nicaragua
Nepal
10%
0%
42
43
43
47
47
49
50
52
54
56
Median Age Gap (yrs)
56
57
65
65
69
72
77
A Variety of Religious Affiliations
Associated with Higher CM
Country
Religious Affiliation and
Highest CM in Country
Malawi
Catholic
Chad
Muslim
Cameroon
Catholic
Ethiopia
Orthodox
Nigeria
Catholic
Burkina Faso
Muslim
India
Hindu
Bangladesh
Muslim
Are Regional Differences
within Countries Significant?
Yes
Chad
Mali
Mozambique
Ethiopia
Burkina Faso
Zambia
Niger
Uganda
Nepal
Nigeria
Nicaragua
India
No
Bangladesh
Guinea
Central African Republic
Liberia
Cameroon
Malawi
Regional Variation -- Ethiopia
48% of CM in
Ethiopia occurs in
the north:
Amhara 90%
Tigray
82%
Affar
77%
Ben-Gumz 75%
Regional Variation - India
5 states in India have
highest percentages of
child marriage:
Madhya Pradesh: 73%
Andhhra Pradesh: 71%
Rajasthan: 68%
Bihar: 67%
Uttar Pradesh: 64%
Regional Variation – Nigeria
71% of CM in Nigeria
occurs in the north:
83% in North West
78% in North East
9 Other Countries and their Regions
with High CM Prevalence
Country
Region(s) with highest prevalence
Niger
North
(North West, North East)
Chad
South Central
(Hadjer Lumis, Chari Baguirmi, Batha, Guéra, Saramat)
Mali
Western Region Excluding Bamako
(Kayes, Koulikoro)
Nepal
Far-Western
Mozambique
North East
(Nampula, Cabo Delgado, Zambezia, Niassa)
Uganda
Northern and Eastern Regions
Burkina Faso
North and East
(Sahel, Centre-Nord, Est)
Nicaragua
East and Southeast
(Atlantico Sur, Rivas, Atlantico Norte, Chontales, Granada, Rio San
Juan)
Zambia
Central and North East
(Central, Eastern, Northern, Luapula and Copperbelt regions)
Outline of Presentation
Background
Prevalence
Consequences
Reasons
From Awareness to Action
Predictors
Hotspots
Program Scan
Recommendations
Scan of Programs that Address CM:
Methods
• Thinking about child marriage beyond awareness
• Web-based scan of programs
• Directly or indirectly addressing child marriage
• Global Focus
• Search included:
• Search engines (35+ keywords)
• Organization websites
• Online journals, publications and books
Scan of Programs: Methods (cont.)
• Noting:
• Categories of programs
• Location
• Programs and government policy in high prevalence
countries
• Target groups
• Reproductive health component
• Evaluation
• Many double-counted programs (total >100%)
• Gaps: programs without web presence and those that do
not describe CM as an outcome
Where Are CM Programs Found?
1 program
2-4 programs
≥5 programs
Scan by Program Categories
Program Category
No.
%
Education for family & community
35
53
Education for girls
30
45
Law & policy
20
30
Economic opportunities
11
17
Safeguarding rights
9
14
Research
4
6
Health services to married girls
1
2
TOTAL PROGRAMS
66
100
Scan by Program Sub-Categories
Program Category/Sub-Category
Education for family & community
No.
%
35
53
Community sensitization/awareness raising
29
44
Social marketing/edutainment
10
15
Education for girls
30
45
Life skills
15
23
Non-formal education
12
18
Livelihood/vocational skills
9
14
Formal education
7
11
Law & Policy
20
30
Legal mechanisms
10
15
Advocacy
8
12
Community mobilization
6
9
Policy
2
3
Scan by Target Sub-Categories (cont.)
Program Category/Sub-Category
Economic opportunities
No.
%
11
17
Income generation for girls
7
11
Monetary incentives for families
4
6
Safeguarding rights
9
14
Shelter/creating safe spaces
5
8
Keeping birth or marriage records
3
5
Other rights (e.g. to education)
1
2
Research
4
6
Health Services to married girls
1
2
TOTAL PROGRAMS
66
100
Where is Reproductive Health?
• Not a program category
• Not a program sub-category
• But is a component in some sub-categories
47% have some RH component
Including community sensitization, life
skills and/or non-formal education
• What is role of RH?
Scan by Program Target Audiences
Program Target Group
No.
%
Targeting family & community
46
70
Targeting girls
39
59
Only marrieds
1
3
Only unmarrieds
24
62
Both marrieds and unmarrieds
13
33
Targeting policy makers
14
21
Are These Programs
Reducing Child Marriage?
We don’t know –
Evaluations lacking
Recommendations
1) Work early on CM efforts – before tipping points of ages 12-15
2) Vigorously promote secondary school education for girls
3) Investigate age gap between husbands and wives, and how to
reduce its negative consequences
4) Target CM efforts within countries, or regions within
countries, where CM is more prevalent
5) Discuss RH community’s role in reducing CM prevalence –
supporting RH component in existing, integrated programs or
starting one’s own
6) Balance efforts to prevent CM with efforts to meet health
needs of child brides
7) Evaluate programs for reductions in CM