Child marriage and its impact on health: a study of perceptions and attitudes in Nepal

Background In Nepal, child marriage affects approximately 33% of girls prior to the age of 18, and 8% of girls by the age of 15. The practice has various causes, which include a lack of education, poverty and societal norms. Literature indicates that child marriages have a more significant impact on women’s health because of early pregnancies and the consequences of dropping out of school. This study aims to understand the impact of child marriage on health by exploring the perceptions held by women in Nepal. Understanding the opinions of those most affected is imperative to influence and improve policy. Methods 13 semi-structured interviews occurred in the Kathmandu Valley in May 2019. Participants were selected purposively by the project host who acted as a gatekeeper and further participants were identified via snowballing. The data was analysed thematically. Results The perceived causes of child marriage in Nepal were a lack of school level education, poverty, having numerous siblings, a low social status and societal views. The impacts on health include a high incidence of early pregnancy complications, and the effects of dropping out of school. The mental health of young brides was perceived to be affected by pressures to work in the home, being isolated and being too young for marriage. Factors such as awareness, availability, societal pressures and independence affected the health-seeking behaviours of child brides. The participants highlighted that raising awareness, reaching out rurally, and educating and employing women would tackle the problem. Conclusions Many of the themes discussed agreed with the existing literature. The effect of dropping out of school and the impact of child marriage on mental health have not yet been explored qualitatively. Factors that affect health-seeking agree with the limited research available, indicating a need to make services more accessible.