Child marriage as a public health challenge: Addressing the hidden burden on adolescent health and development

Background:
Child marriage—defined as a formal or informal union where one or both partners are under the age of 18—remains a major global public health and human rights challenge. Each year, an estimated 12 million girls are married before their 18th birthday (UNICEF, 2024). Although long recognised as a social and gender justice issue, child marriage has profound implications for adolescent health and development. Framing it as a public health concern underscores the intersection between social determinants, health inequities, and lifelong wellbeing (WHO, 2021).

Objective:
This presentation examines child marriage as a critical determinant of adolescent health, highlighting its physical, psychological, and intergenerational consequences. It seeks to inform pediatric and health professionals about the epidemiology, underlying causes, and evidence-based interventions necessary to mitigate its impact.

Methods:
Drawing upon global health and social science literature, this presentation synthesizes data from WHO, UNICEF, and UNFPA, alongside empirical research from low- and middle-income countries. Using a socio-ecological model (Bronfenbrenner, 1979; Blum et al., 2019), it explores how structural determinants—poverty, gender inequality, lack of education, and entrenched cultural norms—sustain early marriage and restrict girls’ access to health information, education, protection, and services.

Findings:
Child marriage has extensive and preventable health consequences. Adolescent brides are far more likely to experience early and repeated pregnancies, preterm birth, obstetric fistula, and maternal mortality (UNFPA, 2023; Neal et al., 2018). Complications from pregnancy and childbirth remain the leading cause of death among girls aged 15–19 worldwide (WHO, 2023). They also face elevated risks of malnutrition, anemia, and exposure to sexually transmitted infections, including HIV (Santhya et al., 2011). Beyond physical health, early marriage contributes to depression, anxiety, intimate partner violence, and chronic social isolation (Kidman, 2017; Le Strat et al., 2011). These outcomes reverberate across generations, entrenching cycles of poor health, poverty, and limited educational attainment.

Discussion:
Child marriage impedes progress toward key United Nations Sustainable Development Goals (SDGs), notably SDG 3 (Good Health and Wellbeing), SDG 4 (Quality Education), and SDG 5 (Gender Equality). Health professionals, particularly those working in pediatrics and adolescent health, are strategically positioned to intervene through early detection of risk factors, provision of adolescent-friendly reproductive and mental health services, and cross-sector collaboration with education and social welfare systems (WHO, 2021). Integrating prevention strategies within maternal and child health programmes and engaging communities in norm change initiatives have demonstrated positive outcomes (Malhotra et al., 2021).

Conclusion:
Recognising child marriage as a public health challenge reframes it as a preventable determinant of adolescent morbidity and mortality. Ending this practice requires coordinated, multisectoral responses linking healthcare, education, legal reform, and community empowerment. By mobilizing the health sector as a central actor in prevention and advocacy, we can safeguard girls’ rights, health, and futures—ensuring that every girl can grow, learn, and thrive before marriage and motherhood.

Dr. Mohinder Watson is a social scientist and advocate for women’s and girls’ rights. She holds a PhD in Health Sciences from Queen Margaret University, Edinburgh, and a Master’s in Public Health from the University of Geneva, Switzerland. For over a decade, she led an NGO addressing child marriage, conducting research and raising global awareness of its health and social impacts. She has published and presented widely on gender and health issues. As the Main United Nations Geneva Representative for the International Council of Women, she works with UN agencies and partners to end child marriage and promote gender equality.