MEDIA RELEASE: Goal of full choice and full access to family planning and improved maternal health is not possible without tackling child marriage

• Child marriage is a major driver of adolescent births; 90% of births to adolescents in developing countries are to girls who are already married.
• Compared to older groups, adolescents who are married or in a union have both the lowest use of contraception and the highest levels of unmet need.
• Progress on maternal health will be limited as long as child marriage persists.

MEDIA RELEASE (Télécharger le communiqué de presse en français)

13 November 2013, Addis Ababa

We cannot achieve full access and full choice in family planning unless we address child marriage, argues Girls Not Brides Global Coordinator Lakshmi Sundaram as policymakers, health practitioners, donors and civil society gather in Addis Ababa, Ethiopia, for the third International Conference on Family Planning, described by organisers as the largest meeting on family planning to date.

Girls Not Brides urged the global health community to do more to ensure that family planning programmes integrate efforts to address child marriage and support married girls.

“Family planning programmes aim to give girls choice, power and autonomy, yet child marriage denies girls these very rights,” stated Lakshmi Sundaram, Global Coordinator of Girls Not Brides. “The ultimate aim of family planning must be to allow women and girls the choice of when and whether to have children, but this is rarely an option for child brides who are trapped in marriages where they have little say.”

Evidence shows that girls who marry before the age of 18 are more likely to become pregnant early and often. To be effective, family planning programmes must target adolescent girls and address the unique needs and circumstances of girls who are married or in unions.

“As long as child marriage persists, our efforts to improve maternal health worldwide will not be fully realised,” stated Ms Sundaram. “In particular, the needs of married girls must be included in discussions about family planning, as they are often missed by programmes that target unmarried adolescents or older married women.”

Life for a child bride: isolation, social pressure, powerlessness

Compared to older groups, adolescents who are married or in a union have both the lowest use of contraception and the highest levels of unmet need (UNFPA, 2013).

Child brides usually face intense social pressure to bear children, which makes them more likely to experience early and frequent pregnancies. It is often difficult for child brides to assert their wishes and needs to their husbands, particularly when it comes to negotiating safe sexual practices and the use of family planning methods.

Child marriage encourages the initiation of sexual activity at an age when girls know little about their bodies, their sexual and reproductive health, or their right to access contraception. Married girls are hard to reach with family planning services and are often unaware that such services exist. This is especially the case for younger girls who are not in school and have virtually no access to sexuality education.

“In many contexts, child brides are married off to older men and lack the power to participate in the major decisions that affect their lives,” said Ms Sundaram. “They may not even realise that they have a right to use family planning methods, and to choose if, when and how many children to have.”

Progress on maternal health will be limited as long as child marriage persists

Child brides give birth at an age when it is highly dangerous for them to do so. Girls who give birth before the age of 15 are five times more likely to die in childbirth than women in their 20s (WHO, 2011). They are also at increased risk of pregnancy-related complications: 65% of all cases of obstetric fistula occur in girls under the age of 18 (WHO, 2008).

Child marriage is a major barrier to improving maternal health worldwide. Complications in pregnancy and childbirth are the leading cause of death in girls aged 15-19 in low- and middle-income countries (WHO, March 2012). 95% of the world’s births to adolescents occur in developing countries, and 90% of these are to girls who are already married (UNFPA, State of the World’s Population 2013).

Child marriage: a global problem

Child marriage is a large-scale problem: worldwide more than 400 million aged 20–49 were married before the age of 18 years. If present rates continue, it is estimated that between 2010 and 2020, 142 million girls will marry as children (UNFPA, October 2012).

• 1 in 3 girls in the developing world is married by age 18, and 1 in 9 is married by age 15, some as young as eight or nine (UNICEF, 2012)
• Child marriage occurs around the world, and cuts across countries, cultures, religions and ethnicities: 46% of girls under 18 are married in South Asia; 38% in sub-Saharan Africa; 29% in Latin America and Caribbean; 18% in the Middle East and North Africa; and in some communities in Europe and North America too (UNICEF, The State of the World’s Children 2013)
• 15 of the 20 countries with the highest rates of child marriage are in Africa.
• In Ethiopia, 41% of girls are married before their 18th birthday; 16% of girls are married before they turn 15 (UNICEF, The State of the World’s Children 2013).

What needs to be done to address the needs of child brides and girls at risk of child marriage?

Existing maternal health and family planning programmes need to be designed so that they reach adolescent girls – both married and unmarried – and are tailored to address their unique needs. For example, they should incorporate the creation of “safe spaces”, where married girls and those vulnerable to early marriage can support one another and learn about their rights and the services and options available to them.

Governments, donors and civil society should work together to prioritise efforts to bring an end to child marriage, including by integrating a focus on child marriage into existing work on health, education, poverty reduction and child protection.

Editor's Notes:

Girls Not Brides: The Global Partnership to End Child Marriage is a partnership of over 300 non-governmental organisations, based across more than 50 countries, committed to ending child marriage.

The International Conference on Family Planning is co-hosted by The Bill & Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins Bloomberg School of Public Health and the Federal Ministry of Health of Ethiopia.

Interviews are available with the following child marriage experts:

• Lakshmi Sundaram, Global Coordinator, Girls Not Brides (French and English speaking)
• Professor Anita Raj, University of California, San Diego (English only)

A small selection of photos is available: http://flic.kr/s/aHsjwaA43L Credit: Ashenafi Tibebe|Girls Not Brides

Media contact: Laura Dickinson, Laura.Dickinson@GirlsNotBrides.org, +447500864871, @GirlsNotBrides