Page 171 - GHES-3-3

Global Health Economics and
Sustainability
Path model of child marriage in Africa

20 – 24 years–were married before the age of 18 (UNICEF, contraception (Irani & Roudsari, 2019; Molitoris et al.,
2024; UNFPA & UNICEF, 2018). Specifically, Niger has 2023; Pourtaheri et al., 2023). In 2017, although they made
the highest rate of child marriage globally at 76%, followed up 10% of the sub-Saharan African population, girls and
by the Central African Republic at 68%, and Chad at 67% young women aged 15 to 24 were accounted for 20% of
(UNFPA & UNICEF, 2018). new HIV infections, according to UNAIDS (2019).

Marriage laws differ from country to country, and their Child marriage may lead to unintended or unwanted
enforcement is inconsistent. In Mali, the legal age for a girl pregnancies at an early age. In sub-Saharan Africa, over
to marry is 15 with the consent of her parents; however, a 50% of initial births by girls who get married before they
vast majority of young girls marry before the legal age. In are 18 years old take place after 7 months of marriage,
Niger, there is an unequal law of consent, which has led particularly in Ethiopia (88%), Burkina Faso (80%),
to high prevalence rates of early marriage among young Nigeria (80%), and Senegal (80%) (Molitoris et al.,
girls (Brown, 2012). Factors such as poverty, sociocultural 2023). Young girls who marry before turning 18 have less
practices, religious beliefs, patriarchal norms, customary authority over their fertility, potentially resulting in shorter
laws, and inadequate legislative framework have led to gaps between childbirths. Furthermore, they face a higher
high prevalence rates of child marriage (Budu et al., 2021; risk of complications during childbirth such as eclampsia,
Rasmussen et al., 2019; UNICEF, 2024). post-partum hemorrhage, sepsis, and obstructed labor,
which can lead to maternal mortality (Pourtaheri et al.,
Poverty is a contributing factor for the high prevalence
of child marriages among girls in poorer regions because 2023; Mahato, 2016). In addition, HIV infection, malaria,
inadequate nutrition, physical and emotional immaturity,
girls are considered financial burdens (Rasmussen et al., and limited access to social and reproductive services may
2019; Budu et al., 2021). After the girls get married, their contribute to increased morbidity and mortality rates
parents are no longer responsible for their financial support, among young women (Mahato, 2016).
obligations, and educational expenses, as these become the
responsibility of the husband’s family (Irani & Roudsari, The global community and experts in human rights
2019; Brown, 2012). Early marriage is seen as a method acknowledge the significance of eradicating child marriage
to ensure the economic stability of the family, resolve due to its detrimental effects, including depression, suicidal
familial debts or conflicts, and elevate their social standing tendencies, impaired sexual and reproductive health, and
(Rasmussen et al., 2019; Belachew et al., 2022). Moreover, increased risk of domestic violence (Molitoris et al., 2023;
parents view early marriage as a strategy to safeguard their Belachew et al., 2022; Budu et al., 2021). As a result, the
daughters from unwanted sexual advancements, since fifth Sustainable Development Goal aims to achieve gender
there is significant emphasis placed on maintaining purity. equality and to empower all women and girls, including
Marrying girls at a young age is perceived as a strategy to the elimination of child marriage (marriage by women
shield them from engaging in non-marital sexual activities before the age of 18 years old) and all forms of violence
that might lead to non-marital pregnancies (Belachew against women and girls by 2030 (United Nations, 2025;
et al., 2022; Irani & Roudsari, 2019). Molitoris et al., 2023; Pourtaheri et al., 2023). While there
is growing research on methods to combat child marriage,
Although early marriage is often regarded as a technique there is a scarcity of studies that comprehensively analyze
to safeguard young girls, getting married at a young age the socioeconomic and reproductive factors linked
raises the likelihood of contracting sexually transmitted to child marriage in Africa. With the guidance of the
infections (STIs) such as human papillomavirus (HPV) and Socioecological Model of Health, this study seeks to fill
human immunodeficiency virus (HIV) (Irani & Roudsari, this gap by constructing a path model illustrating the
2019). Child marriage contributes to cervical cancer socioeconomic and reproductive factors connected to
among African women, mainly due to HPV. In Africa, the child marriage in Africa.
prevalence of cervical cancer in women is notably high due
to the lack of access to effective HPV or cervical cancer 2. Data and methods
screening (Irani & Roudsari, 2019). In addition, women
are two to three times more vulnerable to HIV infection 2.1. Study design
from a single unprotected sexual encounter compared to After the research protocol was reviewed by the
men (Irani & Roudsari, 2019). Specifically, young girls are Institutional Review Board of the University of Toledo
more susceptible to HIV infection due to the transmission and was determined as non-human subject research
of STIs such as herpes simplex type II, chlamydia, and (protocol number 302140), we conducted this ecological
gonorrhea because of their physical immaturity and lack (correlational) study to investigate the relationships
of education about STIs, family planning, and access to between child marriage and eight possible determinants

Volume 3 Issue 3 (2025) 163 https://doi.org/10.36922/ghes.7117