Child marriage in Nepal: a multi-method study on contributing factors, maternal health implications and reduction strategies

Abstract

Abstract: Background and objectives: Child marriage remains common in Nepal, with around 33% of women currently married as children. Multiple factors contribute to child marriage, and it has various implications, including maternal health consequences. Addressing child marriage is complex. This study sought to review the existing literature on child marriage in Nepal and complement it with insights from key informant interviews.

Methods: This study employed a multi-method approach. A scoping review was undertaken to explore literature about child marriage in Nepal. The search was conducted on Ovid Medline, Embase, Web of Science, Scopus, and multiple grey literature databases like Google Scholar and OAister. Government reports were retrieved from various official websites. Additionally, semi-structured interviews were conducted with key informants from Sindhupalchok district in Bagmati province, a district with little research, focusing on reduction strategies.

Results: This multi-method study included 54 articles and 10 semi-structured interviews. Education is one of the key contributing factors to child marriage. A lack of education or low-quality education can elevate the chances of child marriage. In Sindhupalchok district, love marriage among children and a lack of parental guidance are major contributing factors. Women who were married as children are more at risk of early pregnancy and its adverse consequences. Additionally, women who married as children have lower chances of receiving adequate antenatal care, are less likely to have an institutional delivery and are less likely to be attended by a skilled birth attendant during delivery. Results from Sindhupalchok district show a high prevalence of preterm deliveries, low birth weight newborns, and later malnutrition in children. Long-lasting implications such as uterine prolapse, can result from child marriage. Education and contextualized awareness programs are key to reducing child marriage.

Conclusion: Child marriage is influenced by various factors, with education being a key determinant. Marrying before the age of 18 poses significant risks to maternal health, including early pregnancies with adverse health effects, and can lead to long-term and intergenerational health impacts. Comprehensive and multi-sectoral approaches are needed to confront child marriage.