Page 60 - IJPS-11-4

International Journal of
Population Studies Early marriage and infant mortality in SSA

in 2020 alone, and more than half of these deaths occurred financial autonomy appear to allocate increased resources
in sub-Saharan Africa (SSA; UNICEF et al., 2020b). to the health of their children (Pratley, 2016). Births may
Prior studies have established many factors influencing occur in marital contexts or outside of marriage; however,
child mortality in SSA. These determinants include low literature clearly indicates that early marriage is strongly
maternal education (Adedini et al., 2015b; Kravdal, 2004), linked with younger ages of mothers at birth; meanwhile,
sociocultural practices such as gender inequality and the while teenage pregnancy is viewed as a motivational factor
desire for high fertility (Adedini et al., 2015a; Mobolaji for early marriage, as families evaluate the costs of their
et al., 2020), insufficient women’s empowerment (Adedini daughters raising children born out of wedlock (Schaffnit
et al., 2019; Akinyemi et al., 2017), low or non-use of & Lawson, 2021).
contraception (Adedini et al., 2015c; Bitew & Nyarko, The children of child brides may be predisposed to
2019), poor or limited access to health care interventions poor health outcomes such as childhood stunting, wasting,
such as antenatal care and skilled delivery (Adedini et al., and being underweight due to the pressures of the mother
2014; Vieira-Meyer et al., 2019), and biomedical causes raising children at a young age with little or no knowledge of
(Breiman et al., 2021; Fottrell et al., 2015; Salzberg et al., childbearing and childrearing (Kidman, 2017). Moreover,
2019). giving birth before the body is fully mature is a major risk
A significant gap exists in the literature; child marriage factor for poor maternal and child health and may result
constitutes a conceivable risk factor for child mortality that in stillbirths, miscarriages, or infant deaths. Furthermore,
remains inadequately explored. Several countries in SSA early marriage is associated with mistimed or unwanted
exhibit a high prevalence of child marriage (Adedini et al., pregnancies, susceptibility to domestic violence, poor
2022; Fatusi et al., 2021); however, the implications of child participation in family decision-making, and poor agency
marriage for infant mortality have rarely been investigated. (Godha et al., 2013; Santhya et al., 2010). Given that
Child marriage is defined as matrimony involving at least pregnancy among child brides places the mother as well
one individual under the age of 18 years; this custom as the fetus at a higher risk of adverse reproductive health
represents a key global public health concern because it outcomes, this study aimed to examine the influence of
adversely affects the sexual and reproductive health and child marriage on infant mortality (and the impact of
rights of women and girls (Nour, 2006; Raj, 2010; Raj & controlling for women’s empowerment) in 28 selected
Boehmer, 2013). Both boys and girls are involved in early countries in SSA.
marriage; however, girls are disproportionately affected 1.1. Some theoretical perspectives on early
(Nour, 2006; UNICEF, 2019; 2020). A recent overview of the marriage, women’s agency, and child survival
available evidence indicated that an estimated 115 million
boys and men were married as children compared with The study was guided by the ecological model (EM)
over 650 million girls and women. This statistic translates and the human behavioral ecology (HBE) theory to
to around 765 million child grooms and brides globally highlight the relationships among early marriage, women’s
(UNICEF, 2019). Approximately two-fifths of women aged empowerment, and child survival. EM emphasizes the
20 – 24 who were married before they were 18 years old multidimensionality of human behaviors and recognizes
live in SSA; therefore, a majority of global early marriages the role of structural and contextual factors (including
happen in SSA (Walker, 2012). socioeconomic issues and political environment)
in determining individual behaviors. HBE uses the
Women’s empowerment is a critical factor in the
promotion of child health, and the extant literature evolutionary approach to study human behaviors and
posits that the patterns we observe in human behaviors are
elucidates that child brides tend to belong to poorer
socioeconomic strata compared with women who marry shaped by certain selective pressures present in the social
as adults (Ortigoza et al., 2021). For instance, a recent study and ecological environment in which individuals live. HBE
has been widely applied in a range of domains including
found that girls who married as child brides are more likely anthropology, archeology, and demographic transition
to be unemployed, uneducated, poor, multiparous, rural (Winterhalder & Smith, 2000, 2017). A recent study
residents, and engage in non-professional occupations in
comparison with women who married as adults (Adedini conducted by Schaffnit & Lawson (2021) utilized HBE to
et al., 2022). Furthermore, high education levels in offer perspectives on four alternative hypotheses sustaining
women of reproductive age are linked with reduced infant the practice of child marriage in low- and middle-income
mortality through decreases in adolescent birth rates countries.
and premature births and through improved caregiving The prevalence of child marriage persists in developing
skills (Gakidou et al., 2010). Similarly, women with more countries despite its many negative consequences

Volume 11 Issue 4 (2025) 54 https://doi.org/10.36922/ijps.2411