Prevalence of child marriage and its eff ect on fertility and fertility-control outcomes of young women in India: a cross-sectional, observational study.


Child marriage—defined by UNICEF as marriage before 18 years of age—is a reality for more than 60 million women worldwide.1 The practice has become increasingly recognised as a human-rights violation,2,3 and has decreased worldwide during the past 20 years.4 Nonetheless, child marriage remains pervasive in south Asia, where more than half of all child marriages occur. Previous data indicate that about 30–70% of married young women (aged 20–24 years) in Bangladesh, Nepal, India, and Pakistan were married before 18 years of age.1,5 Child marriage has serious consequences for national development, stunting educational and vocational opportunities for a large sector of the population.1,5 Furthermore, marriage at a very young age has grave health consequences for both the young women and their children. These women are more likely than those who are married as adults to report early, frequent, and unplanned pregnancies, typically from lack of contraceptive use. Such pregnancies have been consistently linked to increased risk of maternal and infant morbidity and mortality.1,2,6 Adolescent mothers are also more likely to experience fistula, pregnancy complications, and death during childbirth than are older mothers.2,5,6 The UN have prioritised maternal health, infant mortality, and women’s empowerment with the inclusion of these issues in the Millennium Development Goals.7 This action has reinforced the urgent need to understand and reduce child marriage and its effect on maternal and child health, particularly in south Asia, where more than a third of all maternal and child deaths occur.8 Despite the pervasiveness and severe consequences, little empirical research has been published in the past decade about child marriage or the related public-health effects. This gap in knowledge hinders the work of both practitioners and policy makers. India, the largest and most prosperous nation in south Asia, has maintained laws against child marriage since 1929, although at that time the legal age of marriage was set at 12 years. For girls, defined as female children younger than 18 years of age, the legal age for marriage was increased to 18 years in 1978. The most recent population-based estimate for child marriage (1998–99) shows that 50% of Indian women aged 20–24 years were married as children.1,5 Although these

Lancet 2009; 373: 1883–89

Anita Raj,



Contact Details

  Dr Anita Raj, Department of Social and Behavioral Sciences, Boston University School of Public Health, 801 Massachusetts Avenue, c/o 715 Albany Street, Boston, MA 02118, USA

Year Of Publication