Interventions to Address the Health and Well-Being of Married Adolescents: A Systematic Review

Summary & Objectives

This systematic review synthesises global evidence on interventions designed to respond to the needs of adolescents married before age 18, a population largely overlooked in child marriage programming. It reviews evaluated interventions published between 2000 and 2022 to assess what types of programmes exist, where they are implemented, which outcomes they target, and what evidence exists of effectiveness. The objective is to shift the child marriage field from a near-exclusive focus on prevention toward evidence-informed responses that mitigate harm and support married adolescents, particularly girls.

Findings

The review identifies only 29 evaluated interventions globally, most implemented at small scale and concentrated in South Asia and sub-Saharan Africa. The majority focus narrowly on sexual and reproductive health and maternal health, with far less attention to education, livelihoods, mental health, legal rights, agency, or violence prevention. Evidence suggests some improvements in contraceptive use, service uptake, and partner communication, but impacts are uneven and often limited when interventions fail to engage husbands, families, and communities. Married girls remain especially constrained by social norms and household power dynamics, and boys married as children are almost entirely absent from programming and research.

Recommendations

The review calls for greater investment in targeted, scalable interventions that address the full spectrum of married adolescents’ needs, not only their reproductive health. Programming should integrate education, economic strengthening, agency, and violence prevention, while systematically engaging husbands and key family gatekeepers. Future efforts should strengthen implementation quality, expand geographic coverage, improve measurement of norms and non-health outcomes, and generate stronger evidence through robust evaluation designs. Responding to child marriage must include sustained support for those already married, alongside prevention.

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