‘Child marriages hinder meeting health targets’

LAHORE : Child marriages in Pakistan are considered one of the stumbling stones in achieving health targets committed under Sustainable Development Goals (SDGs-2016-2030) after suffering humiliation for being off-track on health indicators under Millennium Development Goals (MDGs-2000-2015).

The relationship between underage marriages and maternal mortality rate is especially significant as pregnancy and childbirth are the main cause of death for 15-19 years old married girls. “The MMR among the under 20 age group is staggering 242 deaths per 100,000 live births, strongly underscoring the need to further constrain underage marriages and by extension prevent the deaths of women,” claimed an NGO while giving a report on national figures for mother and child mortality, especially after the proposed amendment in Child Marriage Restraint Act, 1929, recently-tabled in the Senate to increase the minimum marriageable age for girls from existing 16 to 18 years, could not be passed.

The report said perinatal mortality rate (PMR-stillbirths and early neonatal deaths) in Pakistan has slightly increased from 73 per 1,000 births in 2006-07 to 75 per 1,000 births in 2012-13, based on Pakistan Demographic Health Survey (PDHS). Maternal age is an important factor which affects perinatal mortality.

Similarly, Pakistan has one of the highest infant mortality (78/1000) and under five mortality rates (94/1000) in South Asia. Babies born to teenage mothers are more likely to die in the first year of life compared with babies born to mothers older than 20 years of age. Besides, greater vulnerability to morbidities like obstetric fistula due to early childbirth is a direct consequence of child marriage. According to UNICEF, based on PDHS 2012-2013, as many as 21 per cent are married by the age of 18 years in Pakistan. Child marriages are far more prevalent in Pakistan’s rural areas than in its urban areas. Pakistan has ratified major international conventions such as Convention on the Rights of Child (CRC) and Convention for Elimination of Discrimination Against Women (CEDAW) – the former deals with harmful consequences of child marriages i.e. right to protection from violence, health, education and abuse; while the latter recognised women’s rights such as the issue of consent and a minimum marriage age of 18 years which outlaws discriminatory ages for males and females.

While apprising the journalists at a consultative workshop on child marriages, Executive Director, NGO, Dr Atif Ikram Butt outlined the reasons of child marriages in Pakistan as lack of education, poverty, gender inequalities, traditional customs and notion of family honour, interpretation of religious injunctions, conflict and humanitarian crises and weak enforcement of relevant laws. He believed the child marriages have far-reaching effects on overall economic and health and education indicators of the country than just been limited to individuals or families and communities.

He said that the child marriages compromise girls’ right to free will and have grave consequences such as illiteracy and poverty, malnutrition and morbidities leading to mother and child mortality, gender-based violence, etc.

Dr Atif Butt also believed that economic cost of child marriages and early childbirth is massive as, according to World Bank study, in a set of 18 countries including Pakistan could lower its population growth just by ending child marriages to reap its benefit of up to $17 billion per year by 2030, which would enable each of them to spend more on health and education to further improve their respective economic indicators.

Besides ensuring maternal health, he added, prevention of early childbirths would help save the life of three of every 100 children dying by the age of five years. It would help avoid stunting for one of every 100 stunted children below five years of age, he added.