The Influence of Child Marriage on Fertility, Fertility-Control, and Maternal Health Care Utilization: A Multi-country Study from South Asia

Although substantial progress has been made in reducing the prevalence of child marriage (marriage before the age of 18 years), it remains a pervasive problem in South Asia and sub-Saharan Africa, with female children being disproportionately at risk. Despite the pervasiveness of child marriage and its potentially adverse consequences on reproductive health outcomes, there is relatively little empirical evidence available on this issue, which has hindered efforts to improve the targeting of adolescent health programs. The purpose of this study is to assess the influence of child marriage on fertility, fertility-control, and maternal health care utilization in four South Asian countries India, Bangladesh, Nepal, and Pakistan after controlling for other individual-, household-, and community-level factors. Data for the study come from the most recent Demographic and Health Surveys conducted in the study countries. Descriptive and multivariate methods are used to assess whether child marriage is associated with fertility, fertility control, and maternal health outcomes among women 20-24 years of age and whether these associations are statistically significant across countries. The results of this study provide strong evidence that, in the South Asian context, child marriage is significantly associated with many negative outcomes of fertility and fertility control, as well as maternal health care utilization. Furthermore, women who married in early adolescence and childhood show a higher propensity towards most of the negative health outcomes as compared to women who married in middle adolescence. The study concludes that child marriage adds a layer of vulnerability to women that leads to poor fertility control and fertility related outcomes, and maternal care utilization. It is imperative that laws against child marriage be strictly reinforced and that reproductive health programs be developed to reach these women better.