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2	Outline Current status of child marriage Extent of the practice International and national policy and law Programmatic void surrounding married adolescents Potential disadvantages of child marriage for girls Unique assets & position of faith-based organizations Three areas for potential action
3	Child marriage: Still with us Demographic and Health Surveys (DHS) indicate about 38% of young women currently aged 20-24 in 50 least developed countries were married before age 18 If present patterns continue, over 100 million girls will be married as children in the next decade
4	Child marriage: Substantial variation across the regions of the world
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6	Laws Governing Child Marriage Convention on the Rights of the Child Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) Legal minimum age at marriage is 18 in majority of countries worldwide, yet issues persist: Enforcement Parental consent Applies only to civil unions Contradictions in civil law (i.e. Tanzania)
7	Lack of programs and policies for married adolescents Traditionally, married adolescents have been omitted from the adolescent/youth policy and program agenda – a dangerous omission given that: Most sexually active girls aged 15-19 are married Most births to adolescent girls take place within marriage
8	Why the Omission? Western focus on unmarried, in-school adolescents Assumption that “married” implies “adult” and access to services/entitlements Marriage thought to provide protection Married adolescents relatively invisible and difficult to reach – more socially isolated
9	Outline Current status of child marriage Extent of the practice International and national policy and law Programmatic void surrounding married adolescents Potential disadvantages of child marriage for girls Unique assets & position of faith-based organizations Three areas for potential action
10	Marriage brings many disadvantages to adolescent girls Married adolescents are typified by: High levels of unprotected sexual relations Large age gaps with sexual partners Intense pressure to become pregnant Highly limited or absent peer networks Restricted social mobility/freedom of movement Little access to modern media (TV, radio, newspapers) Limited education attainment and no schooling options
11	Married girls are many times more likely to have had unprotected sexual relations than sexually active unmarried
12	The younger the bride, the larger the spousal age difference
13	Even when pregnancy is not desired, child brides are unable to negotiate condom use
14	Access to schooling
15	Exposure to HIV/AIDS information in the last year, by sex and marital status
16	Participation in social events and media exposure, by sex and marital status
17	Emerging evidence of links between early marriage and HIV infection
18	HIV Risk factors among sexually active girls aged 15 to 19 in Kisumu, Kenya
19	Child marriage and HIV: Risk without guidance Older partners Higher sexual frequency Intense pressure for pregnancy Greater social isolation Unable to benefit from any of the conventional HIV protection messages:
20	Outline Current status of child marriage Extent of the practice International and national policy and law Programmatic void surrounding married adolescents Potential disadvantages of child marriage for girls Unique assets & position of faith-based organizations Three areas for potential action
21	Unique position of churches and other faith-based organizations Long-term view to development and transformation Excellent coverage in the field Regular contact with community (same place, same time) in large and small groups Critical life transitions are marked (potential points of intervention – baptism, confirmation, marriage …) Moral authority and leadership Responsibility to nurture and protect the children of the community Trusted by the community
22	Outline Current status of child marriage Extent of the practice International and national policy and law Programmatic void surrounding married adolescents Potential disadvantages of child marriage for girls Unique assets & position of faith-based organizations Three areas for potential action
23	Three overlapping clusters of concern for policy activity and public education: Raising consciousness about child marriage Promoting later, legal, and chosen marriage Supporting married adolescent girls
24	1. Raising consciousness about early marriage Clarify and publicize local marriage laws Emphasize the situation of the youngest (under 15) mothers with regard to maternal mortality and morbidity, including risk of obstetric fistula Create awareness that marriage is not a sexual safety zone Raise awareness of the health and rights implications of large spousal age differences and intergenerational sex
25	2. Promoting later, legal marriage Advocate for new laws and/or enforcement of existing laws Develop community-based initiatives that redefine acceptable ages of marriage and offer social and economic supports that allow parents and girls to delay marriage until at least 18. Get girls into school on time and keep them there through secondary school Create new opportunities/safe spaces for girls (particularly those out of school) Increase girls’ access to livelihoods skills/resources
26	3. Supporting married adolescent girls Develop interventions to reduce social isolation and economic vulnerability Refocus maternal and child health information and outreach to actively engage married adolescent girls, first-time parents Develop HIV protection strategies, including VCT, to support girls from engagement through the early years of marriage. Foster more equal and trusting relationships between new spouses Decrease the imminent pressure for pregnancy on the youngest brides De-stigmatize condoms and protection from STIs/HIV within marriage
27	"What are faith-based organizations currently..." What are faith-based organizations currently doing to Raise awareness of child marriage, related health issues Promote delayed marriage Support married adolescents Future strategies Points of entry (group meetings, recognized transitions) Intervention ideas in the three areas above
28	SELECTED RESOURCES Amin, Sajeda, Simeen Mahmud, and Lopita Huq. Baseline survey report on rural adolescents in Bangladesh. Dhaka, Bangladesh: Ministry of Women's Affairs: Government of Bangladesh. 2002. Bruce, Judith. Chapter 2, UNFPA/Population Council background document for the UNFPA workshop on “Adolescent and Youth Sexual and Reproductive Health: Charting Directions for a Second Generation of Programming,” May 2003. Bruce, Judith. “Married Adolescent Girls: Human Rights, Health, and Development Needs of a Neglected Majority,” Economic and Political Weekly, October 2003. Bruce, Judith and Shelley Clark. “Including Married Adolescents in Adolescent Reproductive Health and HIV Policy,” Prepared for for the Technical Consultation on Married Adolescents, WHO, Geneva, December 9-12, 2003. Under review for publication. Also available in Brief form: Bruce and Clark, “The Implications of Early Marriage for HIV/AIDS Policy,” May 2004. Clark, Shelley. “Early Marriage and HIV Risks in Sub-Saharan Africa,” Studies in Family Planning, 35(3), 2004. Erulkar, Annabel and Charles Onoka. Tabulations of data from Adolescent Reproductive Health Information and Services Survey, Central Province, Kenya, 2001, unpublished. Erulkar, Annabel. “Working with Ethiopian Youth Serving NGO’s to Increase their Capacity to Monitor Performance and Identify Gaps in Coverage,” 2004.
29	"Glynn," Glynn, J.R., Caraël, M., Auvert, B., Kahindo, M., Chege, J., Musonda, R., Kaona, F., & Buvé, A., for the Study Group on Heterogeneity of HIV Epidemics in African Cities. “Why do young women have a much higher prevalence of HIV than young men?” A study in Kisumu, Kenya and Ndola, Zambia. AIDS 15(suppl 4), S51-60, 2001. Hallman, Kelly. “Poverty and Unsafe Sexual Behaviors Among Young Women and Men in South Africa.” Population Council Working Paper, 2004. Hallman, Kelly and Judy Diers. “Social Isolation and Economic Vulnerability as Risk Factors for HIV and Pregnancy in South Africa.,” forthcoming. Haberland, Chong, Bracken. “Married Adolescents: An Overview.” Paper prepared for the Technical Consultation on Married Adolescents, WHO, Geneva, Dec 9-12, 2003. Katzive, Laura. “Married Girls and the Law: Directions for Legal Advocacy,” Paper prepared for the Technical Consultation on Married Adolescents, WHO, Geneva, Dec 9-12, 2003. Mensch, Barbara S. Data analysis conducted for National Academy of Sciences report on "Transitions to Adulthood in Developing Countries," 2004. Mensch, Barbara S. “Adolescent Research and Programs: Moving Beyond the Conventional.” Presentation at The World Bank Human Development Week, Washington, March 1999. Population Council analysis of DHS and United Nations Data, 2001. Santhya, K. G. and Nicole Haberland. “Addressing the Social Context of Married Adolescent Girls: The First Time Parents Project.” Presentation given at the Technical Consultation on Married Adolescents, WHO, Geneva, December 9-12, 2003.