Early Marriage Threatens Youth Reproductive Health

• Spousal age difference can make women more vulnerable to health risks and social isolation by creating power dynamics. These power dynamics can increase girls¡¯ vulnerability to emotional, physical, and sexual abuse. In addition, young married girls are more likely to be illiterate and of low social status. They tend to have no access to financial resources and restricted mobility; they are therefore less likely to leave home to socialize with others, limiting their ability to obtain information on reproductive health, contraception, HIV, and other sexually transmitted infections (STIs). This power differential can also limit girls¡¯ ability to negotiate contraceptive or condom use, putting them at high risk for contracting STIs and HIV.
• Early childbearing poses serious health risks for mother and child. Marriage often signals the beginning of frequent and unprotected sexual activity. Many girls under the age of 18 (and particularly girls under the age of 15) are not physically mature and therefore unprepared for sexual intercourse or childbirth. Sexual intercourse at a young age is associated with physical pain and pregnancy-related complications, such as obstetric fistula. Pregnancy-related health problems can have emotional and social consequences and pose a financial burden to the household.

Key Areas for Policy Action

•  Enforce existing laws and policies. Although laws against child marriage exist in many countries, the implementation and enforcement of such laws is often weak. Technical assistance is needed to increase the number of in-country professionals who can appropriately monitor and evaluate programs to better implement, review, and update laws and policies intended to prevent child marriage. A committed multisectoral approach that integrates action plans from the health, education, legal, economic, and labor sectors can help reduce the incidence of early marriage and pregnancy.
• Provide economic incentives for delayed marriage. In certain settings and cultures, addressing the economic factors associated with early marriage, such as dowry practices, is essential to developing successful programs that delay the age of marriage among girls. 
• Implement community-based mobilization programs. Advocating for changes in social attitudes and norms through multisectoral and integrated community-based programs—such as through religious institutions and associations, health institutions, other local civic organizations, and schools—are the best channels for raising awareness of the negative consequences of early marriage and the many economic, social, and health benefits of delaying marriage.
• Create safe spaces for girls. Social networks and civil society organizations play a critical role in developing sustainable safe spaces for girls to meet to share information and ideas and obtain support and guidance. Using public facilities, such as schools after hours or places of worship during non-worship hours can offer catch-up education, financial literacy instruction, savings clubs, and health services either directly or on referral.
• Support education beyond primary school. Investments must be made to support girls¡¯ education. Evidence suggests that educated girls are less likely to agree to marry at a young age. Development programs need to be creative in implementing programs that support a girl through the critical drop-out period, along with secondary and vocational opportunities that are acceptable to the girls¡¯ families.
• Provide safe and nonexploitative means of livelihood outside the home. Education and professional training that build the capacity of girls and young women to generate income can enable them to postpone marriage. When education is not a feasible option, income-generation programs can empower women and girls with the skills and tools to reduce their dependency on family members and gain some autonomy.