Page 51 - GHES-2-3

Global Health Economics and
Sustainability
Health consequences of child marriage among rural women

marriage (Bappenas, 2017). The microsystem, consisting residing in Etteh and Enugu-Ezike, and expressing a
of immediate interpersonal relationships and cultural willingness to participate in the research. Etteh and
contexts, plays a pivotal role in perpetuating or challenging Enugu-Ezike are towns in the Igbo-Eze North Local
child marriage norms. Government Area of Enugu State. Etteh is characterized
Furthermore, the mesosystemic influence of multilingual population encompassing Idoma, Igala,
institutions and organizations within the community must and Igbo languages, while the people of Enugu-Ezike
be considered. Leveraging existing community structures, predominantly speak Igbo. The choice of study locations
like age-grade associations, can serve as a platform for was deliberate as these areas exhibit a high prevalence of
initiating conversations, dispelling myths, and fostering child marriage in these areas, which are predominantly
change from within. Uche et al. (2023) highlight the agrarian communities. Two villages, namely, Ochigide
effectiveness of community-driven initiatives in South- in Etteh and Aguibeje in Enugu-Ezike were purposively
east Nigeria, emphasizing the importance of strategies that selected for the study. Participants were included based
navigate socio-economic barriers and promote equitable on specific inclusion criteria. The authors used a snowball
healthcare services. sampling approach, starting with two known participants
in the areas, who then helped recruit other participants. An
The exosystem, representing external influences equal number of participants (10) were selected from Etteh
indirectly impacting individuals, encompasses societal (Ochigide) and Enugu-Ezike (Aguibeje), respectively.
norms and expectations related to gender roles and Before commencing the interview sessions, the authors
marriage. By challenging these norms, interventions can provided a comprehensive overview of the study’s goals
disrupt the cycle of child marriage. However, it is essential and objectives to the participants. Subsequently, explicit
to approach this challenge with cultural sensitivity, consent, both written and oral, was sought and obtained
acknowledging the historical significance and context from each participant. Participants had the option to
of these norms (Cornwall & Brock, 2005). Cultural exit the discussion at any time and request the deletion
competence in intervention strategies, as advocated by of their data. Consent from participants was secured
Bappenas (2017), ensures that efforts align with local before recording the conversation. An interview guide
values. was created, outlining all the themes covered during
The macrosystem, representing broader cultural the interviews, including relevant probes to facilitate
patterns, requires a comprehensive approach to shift discussions on the physical health consequences, mental
societal attitudes toward child marriage. This involves health effects, and reproductive health implications of
collaborating with religious and community leaders, child marriage. The authors visited the study location
leveraging their influence to advocate for change. following the approval of ethics by the Institutional
International frameworks, such as the Sustainable Review Board of the University of Nigeria (STRACEP)
Development Goals by the United Nations (2015), provide (UNNEC/05/0022/10-ST03/0024).
a global platform to address child marriage by emphasizing
the elimination of harmful practices. 2.2. Data collection
Social work interventions can target individuals, Data collection was conducted through in-depth
families, and community levels, as well as advocate interviews (IDIs) facilitated exclusively by the female
for policy changes at the societal level (World Bank, author. The IDI guide covered three questions with probes:
2017). The theory recognizes that individuals and their (i) What are the physical health consequences experienced
environments are dynamic and evolve. This understanding by rural women as a result of child marriage? (ii) How do
is crucial for comprehending the changing nature of child mental health outcomes manifest in individuals who have
marriage practices and tailoring interventions to specific undergone child marriage? (iii) What are the reproductive
developmental stages (Hicks & Murray, 2009). health implications associated with child marriage? These
questions guided the study. The interviews deliberately
2. Materials and Methods excluded male presence to encourage participants to freely
share their experiences. All interviews were recorded using
2.1. Study design and participants a recorder, and simultaneous note-taking was conducted.
This qualitative study utilized a phenomenological The author initially collaborated with participants to select
approach focusing on a population of married women a quiet venue for the interviews, ensuring privacy and
who entered into marriage before reaching the age of creating an atmosphere conducive to open communication.
18. Participants were selected based on specific criteria, Participants were guaranteed confidentiality and informed
including having married before the age of 18, currently that the information was purely for academic purposes.

Volume 2 Issue 3 (2024) 4 https://doi.org/10.36922/ghes.2840