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World Health Assembly recognises we must address early marriage. It’s now time for WHO action

What does last week’s debate on early marriage and adolescent pregnancies at the World Health Assembly mean for teenage girls in the developing world? And what can the WHO do to support them?

On 25 May 2012, one of the world’s most credible, respected bodies on global health held a debate on early marriage, adolescent and youth pregnancies. The discussion at the World Health Assembly, a body that determines the policies of the World Health Organization (WHO), formally recognised that we need to act across all health sectors if we’re to achieve a reduction in early marriage and save the lives of millions of young mothers.

Early marriage and adolescent pregnancy are closely linked. Child brides are often pressured to prove their fertility soon after marriage and the consequences can be dangerous. The WHO finds that complications in pregnancy and childbirth are the leading cause of death in girls aged 15-19 in the developing world.

What happened at the World Health Assembly?

The annual World Health Assembly is attended by all countries that are members of the WHO. All Member States of the United Nations can be a member of the WHO, so wherever you’re from, it’s likely that your country was represented at last week’s Assembly.

At the Assembly, almost 30 countries from across the WHO’s six regions spoke during the discussion. Many highlighted the detrimental health and social consequences of early marriage on adolescent girls, their families and communities. They also welcomed a report submitted by the WHO secretariat – “Early marriages, adolescent and youth pregnancies” – and the WHO’s Guidelines on preventing early pregnancy and poor reproductive outcomes in adolescents in developing countries.

One of the recommendations made in the Guidelines is to reduce marriage before the age of 18 years. As part of this effort, the Guidelines call on political and community leaders to formulate and enforce laws and policies to prohibit the marriage of girls under 18.

The WHO Secretariat’s report also calls for action to influence family and community attitudes related to early marriage and to do more to keep girls in school, both at primary and secondary level. The implementation of sex education and improved access to contraceptives for adolescents, as well as the censuring of coerced sex, were also recommended by the WHO to address early marriage and poor maternal health outcomes for teenage girls.

Why does this matter?

It is very important that the WHO takes a lead in efforts to address both early marriage and adolescent pregnancy. According to its own findings, in low and middle-income countries still births and death in the first week and month of life are 50% higher among babies born to mothers younger than 20 years-old than those born to mothers aged 20-29 years. The younger the mother, the higher the risk to her children.

By noting the WHO report on early marriage and adolescent pregnancy, and by debating the two issues together, delegates at the World Health Assembly recognised that partnership and action across sectors is vital if we are to achieve better health outcomes for adolescent girls and their children.

Strong support by the World Health Assembly can also help to drive investment towards more programmes to prevent early marriage and to provide those girls who are already married with life-saving information.

So, what next?

The debate at the World Health Assembly was a welcome step, but the WHO needs to do more to put addressing child marriage at the top of its agenda. Only then will words translate into action for the girls who need it most.

As the WHO Secretariat noted in its report, adolescents face significant barriers to health services. This is particularly the case for child brides who are often isolated from their own family, are obliged to drop out of school or lack a voice in their relationship with older husbands.

The WHO can do much to overcome these obstacles by, for example, helping national governments where child marriage is prevalent to train health workers on how to reach child brides, making healthcare facilities adolescent-friendly and sensitising communities about the risks of early marriage.

More than 60 million women aged 20-24 years were married before the age of 18, calculates the WHO. Faced with the largest generation of adolescents in history, it is crucial to take action now to bring down that number. As an influential body that can have a direct impact on country health outcomes, it’s time that the WHO takes a lead in ending child marriage.