More than 700 million women globally have married before the age of 18. In fact, one in three girls in developing countries marry before the age of 18. However, gaps in understanding associations between girl child marriage, a formal union of a female under age 18, and health outcomes remain. Research on girl child marriage has found negative associations with maternal, reproductive, and mental health; however, little is known about its relationship to malnutrition, a leading cause of maternal and child deaths. Additionally, girl child marriage may negatively affect the health of her children. Limited literature has found associations with child diarrhea incidence, underweight, and stunting, yet results are inconsistent across studies. Moreover, there is a dearth of research on the effects of girl child marriage in sub-Saharan Africa, where 16 of the 20 countries with the highest prevalence of early marriages are located. These create research gaps that prevent developing evidence-based policies to improve the health of women and their children. The overall objective of this proposed study is to examine mechanisms through which girl child marriage affects the health and well-being of women and their children in sub-Saharan Africa, as well as the relative magnitude and impact of these mechanisms. This proposal specifically aims to: (1) estimate the associations between girl child marriage and nutritional status among women in sub-Saharan Africa, and (2) quantify the intergenerational effects of girl child marriage by identifying differences in early development and health among children born to women who marry early as compared to after age 18 in sub-Saharan Africa. This proposed study is the first, as far as the authors know, to assess the relationship between girl child marriage and the early development of their children (across cognitive, language, physical, and socioemotional domains). Using all available household data from African countries participating in the Demographic and Health Surveys (DHS) (1991 to 2014) and the Multiple Indicator Cluster Surveys (MICS) (2009 to 2014), research aims will be studied through designing and testing a series of models using regression analyses. Exploring girl child marriage, one psychosocial risk factor, can impact investigation into other social risks that influence child and adolescent health and development. Research findings will, moreover, provide timely data and evidence to guide policies that support the NICHD?s mission to ensure that children and women achieve their developmental potential. The proposed research training plan will support applicant Ms. Yvette Efevbera?s aspirations to become a leader and scholar on child and adolescent health and development. As a doctoral student in the Department of Global Health and Population at the Harvard T. H. Chan School of Public Health, Ms. Efevbera aspires to strengthen her content area knowledge, quantitative methodological skillsets, and ultimately position herself to be a successful independent researcher, with long-term interest informing child and adolescent health policy.
This research will importantly contribute to the evidence base for understanding how girl child marriage, a practice affecting more than 700 million women worldwide, impacts the health and well-being of women and their children. It will contribute to understand barriers toward responding to the NICHD?s mission of ensuring all children and women can achieve their full potential. Girl child marriage violates human rights which has, as this study will show, important public health implications.
