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Cited by 160Marriage and Family DynamicsGlobal Maternal and Child HealthAdolescent Sexual and Reproductive Health

Child marriage and associated outcomes in northern Ghana: a cross-sectional study

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on behalf of the Ghana LEAP 1000 evaluation team, de Groot, Richard, Kuunyem, Maxwell Yiryele, Palermo, Tia·2018·BMC Public Health
DOI 10.1186/s12889-018-5166-6PMC PMC5827991
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Abstract

BACKGROUND: Child marriage is a human rights violation disproportionately affecting girls in lower- and middle-income countries and has serious public health implications. In Ghana, one in five girls marry before their 18th birthday and one in 20 girls is married before her 15th birthday. This paper uses a unique dataset from Northern Ghana to examine the association between child marriage and adverse outcomes for women among a uniquely vulnerable population. METHODS: Baseline data from on ongoing impact evaluation of a government-run cash transfer programme was used. The sample consisted of 1349 ever-married women aged 20-29 years from 2497 households in the Northern and Upper East regions of Ghana. We estimated a series of ordinary least squares (OLS) and logistic regression models to examine associations of child marriage with health, fertility, contraception, child mortality, social support, stress and agency outcomes among women, controlling for individual characteristics and household-level factors. RESULTS: Child marriage in this sample was associated with increased odds of poorer health, as measured by difficulties in daily activities (OR = 2.08; CI 1.28-3.38 among women 20-24 years and OR = 1.58; CI 1.19-2.12 among women 20-29 years), increased odds of child mortality among first-born children (OR = 2.03; CI 1.09-3.77 among women 20-24 years) and lower odds of believing that one's life is determined by their own actions (OR = 0.42; CI 0.25-0.72 among women 20-24 years and OR = 0.54; CI 0.39-0.75 among women 20-29 years). Conversely, child marriage was associated with lower levels of reported stress (regression coefficient = - 1.18; CI -1.84--0.51 among women 20-29 years). CONCLUSIONS: Child marriage is common in Northern Ghana and is associated with poor health, increased child mortality, and low agency among women in this sample of extremely poor households. While not much is known about effective measures to combat child marriage in the context of Ghana, programmes that address key drivers of early marriage such as economic insecurity and school enrolment at the secondary level, should be examined with respect to their effectiveness at reducing early marriage. TRIAL REGISTRATION: Registered in the Registry for International Development Impact Evaluations (RIDIE) on 01 July 2015, with number RIDIE-STUDY-ID- 55942496d53af .

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  • Few studies have explored how the drivers of child marriage manifest across both micro (individual and household) and macro (community) levels, particularly in sub-Saharan Africa.

    “However, few studies have explored how the drivers of child marriage manifest across both micro (individual and household) and macro (community) levels, particularly in sub-Saharan Africa (SSA) [21, 30, 31].”

    From Individual and Community-level factors associated with early marriage in Zambia: a mixed effect analysis (2023) · cites this paper as [31]

    The Background (Ghanaian context; page not provided) says in-depth studies of child-marriage dynamics in Ghana are scarce, supporting the claim’s general point about limited research. It does not establish that few studies examine drivers across individual, household, and community levels throughout sub-Saharan Africa. (LLM, conf=0.84)

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Cited by

Sorted by citations

Authors
on behalf of the Ghana LEAP 1000 evaluation team, de Groot, R., Kuunyem, M. Y., & Palermo, T.
Affiliations
United Nations Children's Fund (US)
ORCID
Palermo, Tia
Venue
BMC Public Health
Publisher
Springer Science and Business Media LLC
Published
2018-02-26
Volume
18
Issue
1
Pages
285-285
ISSN
1471-2458 (ISSN-L)
DOI
10.1186/s12889-018-5166-6
PMC
PMC5827991
OpenAlex
W2795008256
Cited by
160
References
4
Citations by year
2026: 5 · 2025: 27 · 2024: 16 · 2023: 27 · 2022: 34 · 2021: 33 · 2020: 12 · 2019: 6
FWCI
29.01
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • Greater South Information System
Funders
  • United States Agency for International Development (GHA-G-00-07-00007)
  • Foreign Affairs and International Trade Canada (PO7060382 D0000306-001)
Topics
  • Social Sciences › Sociology and Political Science › Marriage and Family Dynamics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
  • Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
Keywords
early marriage, women's health, child mortality, women's agency, stress, fertility, contraception, social support, cash transfers, economic insecurity, Northern Ghana, women's empowerment, human rights
MeSH terms
Adolescent, Adult, Age Factors, Cross-Sectional Studies, Female, Ghana, Humans, Marriage, Poverty, Rural Population, Women's Health, Young Adult

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