Association Between Girl-child Marriage and Intimate Partner Violence in Sub-Saharan Africa: Insights From a Multicountry Analysis of Demographic and Health Surveys

Abstract

While considerable attention has been given to the health consequences of child marriage in Sub-Saharan Africa (SSA), limited studies exist on its impact on intimate partner violence (IPV) in the region. We address this gap by examining the link between child marriage and IPV. We tested our study hypothesis using demographic and health survey data of 28,206 young women aged 20-24 years from 16 SSA countries with recent surveys (2015-2019). Binary logistic regression models were used to examine the effect of child marriage on IPV. Child marriage prevalence ranged from 13.5% in Rwanda, in East Africa, to 77% in Chad, in Central Africa, while IPV ranged from 17.5% in Mozambique in Southern Africa to 42% in Uganda, in East Africa. Past year experience of IPV was higher among young women who married or begun cohabiting before the age of 18 (36.9%) than those who did at age 18 or more (32.5%). This result was consistent for all forms of violence: physical violence (22.7% vs 19.7%), emotional violence (25.3% vs 21.9%), and sexual violence (12% vs 10.4%). After controlling for covariates, we found that young women in SSA who married before 18 years were more likely to experience IPV than those who married as adults (AOR: 1.20; 95% CI [1.12, 1.29]). Significant heterogeneity was observed in the country-level results, with a higher likelihood of IPV found in 14 of the 16 countries and lower in Angola and Chad. Child marriage is associated with a higher likelihood of IPV in most SSA countries, suggesting that ending child marriage will result in a substantial reduction in IPV. There is a need to institute policies to support and protect women who marry as children from abusive relationships in SSA.

Keywords

child marriage intimate partner violence domestic violence sub-Saharan Africa

Introduction

Child marriage is defined as “any legal or customary union involving a boy or girl below the age of 18” (Parsons et al., 2015). Globally, over 700 million women today were married before they were aged 18, with over one-third reported to have gone into the union before age 15 (Parsons et al., 2015). The highest rates of child marriage are found in South Asia and sub-Saharan Africa (UNICEF, 2017) and mostly occurs among individuals with low socio-economic status (Parsons et al., 2015). Child marriage is allowed by some parents on the grounds that it would provide financial and social benefits to the girls’ family (UNICEF, 2005). However, this has produced contrary effects, especially for the girl child, as several reports have shown that this practice constitutes a major impediment to her social and economic development (Parsons et al., 2015; UNICEF, 2005).

Child marriage has far-reaching consequences for girls, not only limited to their sexual and reproductive health and rights but also encompassing their overall health and socio-economic well-being, the survival of their children, and the prosperity of their family and community (Parsons et al., 2015; Rumble et al., 2018). Culturally, there is an expectation for married girls to become pregnant within a year of marriage, thus exposing child brides to risks of childbirth complications and deaths during pregnancy. Pregnancy-related complications are the leading causes of death among adolescent girls (Gibbs et al., 2012; Rumble et al., 2018). Moreover, studies have shown that child brides are more likely than adults to have preterm and low birth weight babies and, consequently, a disproportionate rate of infant mortality (Dahl, 2010; Manning & Cohen, 2015; Nour, 2009; Raj & Boehmer, 2013; Seiler, 2002). Child marriage also places child brides at a higher risk of cervical cancer and contracting HIV and other sexually transmitted infections (Kelly et al., 2003; Nour, 2006). Women who married before they were aged 18 are thrice more likely to develop antisocial personality disorder and more likely to experience depression and suicidal ideation (Le Strat et al., 2011). The socio-economic cost of child marriage is also significant. A significant number of child marriages end up in divorce (Hamilton, 2012), and child brides experience intergenerational poverty arising from their forgone educational attainment (Dahl, 2010; Hamilton, 2012).

Just as child marriage is a grave human rights abuse across the globe (Rumble et al., 2018), so also is intimate partner violence (IPV; Adıbelli et al., 2019). Injuries, extended hospital stay, disabilities, and deaths are common among women who suffered IPV (Fanslow & Robinson, 2011; Sabri et al., 2014). The health and socio-economic implications of IPV are similar to that of child marriage earlier described. Studies have also linked IPV to pregnancy loss, infant and child mortality, mental distress, and low self-esteem (Alhusen et al., 2015; Johri et al., 2011; Memiah et al., 2019; Tiruye et al., 2020; Umubyeyi et al., 2014; Weitzman & Smith-Greenaway, 2020; Zakar et al., 2016). The toll of IPV on women is burdensome, draining household resources, distressing families and communities, and debilitating their productivity and contributions to the economy.

Child marriage and IPV are intrinsically connected through the bond of culture. Cultural traditions and practices create an enabling environment for the social production of both child marriage and IPV, as well as the reproduction of violence through child marriage. For instance, child marriage thrives within the ambiance of culture that believes in male child superiority and its concomitant social positioning of a girl child as subordinate, and necessarily subservient (Burn & Evenhuis, 2014; Parsons et al., 2015). This is also the same with cases of IPV, a social ill that flourishes under the cultural justification, acceptance, and supports for male dominance (Bolis & Hughes, 2015; Sunmola et al., 2018).

Moreover, studies have found low marital satisfaction, conflicting spousal ideology, spousal income inequality (wife earning more than her husband), economic dependence, inter alia, as notable correlates of IPV (Astin et al., 1993; Hindin & Adair, 2002). This further explains other pathways, other than culture, through which child marriage could be associated with IPV. Often, girl brides are married to men much older than them (Oranje, 2016). Spousal age difference informs power dynamics (UNICEF, 2005). Age gap in child marriages may encourage the acceptance of abusive wielding of power, where wife-beating may be justified (Tiemoko, 2001). What is more, the sexual activities between a child bride and her husband inherently constitute sexual violence, a critical component of IPV. Further, the economic dependency that characterizes child marriage continues to be a consideration that yields more tolerance for aggression, including sexual aggression, due to wanting of social and economic resources arising from their disadvantaged economic position (Bettio & Ticci, 2017; Tenkorang, 2012). As such, women who wish to leave an abusive marriage are inhibited by poor economic conditions and dependency.

Although child marriage practice is declining globally, especially the incidence of marriage among girls under age 15 (UNICEF, 2017), many SSA countries have seen little or no reduction (Petroni et al., 2017). Child marriage among girls below the age of 15 has not decreased in more than 15 countries with high rates in SSA (Koski et al., 2017). Despite SSA’s countries commitment to and ratification of several regional and international legal frameworks for the protection of the human rights of children (Convention on the Rights of the Child, African Charter on the Rights and Welfare of the Child, Africa Youth Charter, Maputo Protocol, and Convention on the Elimination of all Forms of Discrimination Against Women and Youths), several countries in the region have not prohibited child marriage, permitting girls below 18 to be married to older men and leaving no legal recourse (Maswikwa et al., 2015).

Hence, up-to-date and country disaggregated evidence is needed to support policies, guidelines, and advocacies to ensure SSA leaders domesticate these regional and international frameworks and fulfill their commitments of ending this harmful cultural practice by 2030. However, a huge body of research on child marriage and its effect on IPV has emanated from South-Asia (Godha et al., 2013; Hong Le et al., 2014; Rahman et al., 2014; Raj et al., 2010; Santhya et al., 2010; Yount et al., 2016), which also accounts for a disproportionate burden of child brides (Petroni et al., 2017). These studies show strong and robust evidence of the link between child marriage and IPV. Yount et al. (2016) indicate that marrying as an adult is associated with reduced odds of physical IPV but the protective effect of marrying later was negated in settings where early child marriage was prevalent. Santhya and colleagues (2010) argue that girls who married at age 18 or older are more likely to have been involved in planning their marriages, reject wife beating and less likely to experience physical and sexual violence. However, Raj and colleagues (2010) only found significant association between marrying as a minor and physical violence, but not sexual violence. Meanwhile, a Vietnam study suggests that early marriage was positively associated with experience of IPV only among females but not among males (Hong Le et al., 2014).

Meanwhile, only a few studies have examined the link between child marriage and IPV in SSA, and most of these studies focused on individual country analysis. A previous study by Kidman (2017) that focused on low and middle-income countries is the only study to broadly examine the link between child marriage and IPV SSA countries. Kidman’s study covered 34 countries in six regions and found a higher physical/or sexual IPV among women who married as children. The study reported a measure of heterogeneity between countries, where nine countries reports show that women who married before they were 15 had a disproportionate experience of physical and/sexual IPV. Also, reports from 19 countries show women who married between 15 and 17 reported, within the last one year, an increased risk of physical/sexual IPV. This study, however, concluded that more studies are required to understand the SSA’s pattern of the relationship between child marriage and IPV. Given that Kidman’s study utilized demography and health survey (DHS) data up till 2013, it is important to have a study focusing solely on SSA and using recent dataset to support all the policy and advocacy processes to end child marriage and protect the rights of girls in the region.

We re-examined the link between child marriage and IPV in SSA, using demographic and health data of 16 SSA countries with more recent surveys between 2015 and 2019. Our study focused on country-level analysis, facilitating between-country comparisons in the region and attempted to explain the heterogeneity in the results of the association between child marriage and IPV earlier observed by Kidman (2017). The necessity of separately exploring the evidence from SSA rests on the variations in context and varying macro and micro factors such as policies, country economic, varying degree of State interventions that possibly provide unique experiences across regions and states. The findings of our study will contribute to the further marshaling of current and timely country disaggregated evidence on child marriage and IPV.

Methods

Data Source

This cross-sectional study was carried out using DHS of 16 SSA countries. DHS is a nationally representative survey collected every five years, using multistage sampling design, across low- and middle-income countries. Details on the sampling methodology and data collection used by the DHS are published elsewhere (Corsi et al., 2012). Countries were included in this study if they had information on child marriage and domestic violence and have openly available datasets obtained between 2015 and 2019. Limiting our analysis to recent DHS reflects the overarching need for current, up-to-date evidence to inform policy debates on ending child marriage in SSA. Only 16 of the 18 countries with surveys over the period had data on domestic violence. The countries included are shown in Table 1.

Table 1.

Sample Distribution by Country.

Survey Countries	Survey Year	Unweighted Observations Remaining	Weighted Observations Remaining
Central Africa
Angola	2016	1,650	1,724
Cameroon	2018	1,200	676
Chad	2015	2,392	668
West Africa
Benin	2018	1,944	706
Mali	2018	1,530	605
Nigeria	2018	4,326	1,246
East Africa
Burundi	2017	1,454	1,005
Ethiopia	2016	1,783	677
Rwanda	2016	845	230
Tanzania	2016	1,457	1,228
Uganda	2016	2,453	1,417
Southern Africa
Malawi	2016	3,556	1,078
Mozambique	2015	903	522
South Africa	2016	231	198
Zambia	2018	1,423	1,148
Zimbabwe	2015	1,059	892

Study Population

Our study population was limited to currently married and cohabiting young women aged 20-24 years because this age cohort is used by the UN to estimate child marriage and represents the recent trend in child marriage and IPV (Kidman, 2017). The study sample was, thus, an unweighted distribution of 28,206 young women.

Study Variables

Outcome variable.

The outcome variable for the study was IPV. This variable was derived from the optional domestic violence module, where questions are based on a modified version of the conflict tactics scale (Kishor, 2005; Straus, 1979). Questions asked are related to the experience of physical, emotional, or sexual violence. Questions on physical violence used in this study include whether respondents’ last partner ever: pushed, shook or threw something at them; slapped her; punched her with his fist or something harmful; kicked or dragged her; strangled or burnt her; threatened her with a knife, gun or other weapons, and twisted her arm or pulled her hair. On emotional violence, questions asked included whether their last partner ever: humiliated them, threatened them with harm, and insulted or made them feel bad. There are three standard questions on sexual violence: whether the partner ever physically forced the respondent into unwanted sex; whether the partner ever forced her into other unwanted sexual acts, and whether the respondent has been physically forced to perform sexual acts she did not want to. For each of these questions, the responses were “never,” “often,” “sometimes,” and “yes, but not in the last 12 months.” For physical, emotional and sexual violence, a dichotomous variable was created to represent whether a respondent had experienced any of these forms of violence in the past 12 months by coding never and yes, but not in the last 12 months together as “no” and often and sometimes, coded together as “yes.” We also created a third dichotomous variable, known as experienced IPV in the last 12 months, to represent whether a respondent had reported experiencing either physical, emotional and/or sexual violence in the past 12 months. We limited our analysis to experience of IPV in the past 12 months to limit the bias lifetime experience of IPV could bring to our analysis given that those who married as children had been in union longer than those who married as adults.

Key explanatory variable.

The key explanatory variable in this study was child marriage. This variable has been defined by the United Nations as marriages involving a person under 18 (United Nations, 2014). To obtain this variable, the DHS provides the age at which women were first married or began cohabitating. We created a dichotomous variable using this information and grouped it into whether a respondent married as a child (less than 18 years) or as an adult (18-24 years).

Covariates.

We included important socio-demographic covariates (educational level, place of residence, wealth status, media exposure, and justification of violence) in our adjusted model. Educational level was classified as “no formal education,” “primary,” and “secondary and higher.” Place of residence was divided into “rural” and “urban”. Wealth status was assessed as an index of household assets and utilities and categorized as “poorest,” “poorer,” “middle,” “richer,” and “richest.” Media exposure was created from three variables on the frequency of watching television, listening to radio, or reading newspaper/magazine. The respondents were assigned 0 for “not at all,” 1 for “less than once a week,” and 2 for “at least once a week.” These responses were further re-categorized into “no” (not at all) and “yes” (less than once a week and at least once a week). After this, a dichotomous variable was created from a composite of exposure to the three media sources and defined as “no” and “yes”. With attitudes toward violence, respondents were asked of a husband’s justification of wife beating for the following reasons: (a) burning food, (b) arguing with him, (c) going out without telling him, (d) neglecting the children, and (e) refusing to have sexual intercourse with him (Hamilton, 2012). A binary variable was created to reflect attitudes toward wife beating. Justification of violence was coded as “no” if the respondent did not agree with any of the five reasons and “yes” if she agreed to at least one of these reasons for wife beating.

Statistical analysis.

The analyses were carried out using STATA Version 14.0. First, using descriptive statistics, the proportion of young women who had experienced IPV in the last 12 months, and those who had gone through child marriage were presented using percentages. Next, we presented the results of the distribution of physical, emotional, sexual, and IPV using bar charts. We also performed Pearson’s chi-square test analysis to examine the relationship between child marriage and physical, emotional, sexual, and IPV. Furthermore, we presented the effect of child marriage on IPV in each of the selected SSA countries using both bivariate and multivariate models. Finally, both bivariate and multivariable logistic regression models were used to examine the association between child marriage and IPV. The results of the regression analyses were presented as unadjusted odds ratios (UOR) and adjusted odds ratios (AOR), with their corresponding 95% confidence intervals (CI) signifying significance and precision. The women’s sample weights for the domestic violence module (d005/1,000,000) were applied to obtain unbiased estimates, according to the DHS guidelines.

Results

Descriptive Results

We presented the prevalence of child marriage and IPV in each of the 16 SSA countries included in the study in Table 2. We found that child marriage ranged from 13.5% in Rwanda in East Africa to 77% in Chad in Central Africa. We also observed that IPV ranged from 17.5% in Mozambique in Southern Africa to 42% in Uganda in East Africa.

Table 2.

Prevalence of Child Marriage and IPV by Country.

Survey Countries	Prevalence of Child Marriage	Prevalence of IPV
Central Africa
Angola	51.4	39.6
Cameroon	57.2	29.2
Chad	77.0	24.3
West Africa
Benin	43.9	32.1
Mali	63.3	34.3
Nigeria	63.1	32.2
East Africa
Burundi	34.5	38.9
Ethiopia	58.0	27.2
Rwanda	13.5	28.6
Tanzania	45.2	41.6
Uganda	44.7	42.0
Southern Africa
Malawi	52.0	30.3
Mozambique	62.5	17.5
South Africa	15.0	19.7
Zambia	46.5	35.3
Zimbabwe	46.5	35.7

IPV was higher among young women who married or begun cohabiting before the age of 18 (36.9%) than those who did at age 18 or more (32.5%) in the past year, as shown in Figure 1. This result is consistent for all forms of violence: physical violence (22.7% vs 19.7%), emotional violence (25.3% vs 21.9%), and sexual violence (12% vs 10.4%).

Table 3 shows the prevalence of child marriage and past year experience of IPV by countries. In general, past year experience of any IPV was higher among young women who married as children compared to those who did not in all countries studied except for Angola and Cameroun, where the reverse was true.

Table 3.

Child Marriage and Past Year IPV by Countries.

Countries	Physical Violence			Emotional Violence			Sexual Violence			Any IPV
	<18 Years	≥18 Years	p-Values	<18 Years	≥18 Years	p-Values	<18 Years	≥18 Years	p-Values	<18 Years	≥18 Years	p-Values
Central Africa
Angola	29.6	31.2	.411	24.4	28.4	.115	12.3	8.4	.374	36.1	43.3	.012
Cameroon	16.9	19.1	.959	18.9	20.6	.585	3.6	7.6	.361	27.3	31.7	.791
Chad	15.4	16.4	.913	14.3	23.9	.169	5.6	13.7	.184	21.6	33.4	.100
West Africa
Benin	9.3	8.8	.215	29.2	25.8	.134	6.3	5.8	.423	32.3	31.9	.214
Mali	20	23.8	.946	29.1	22.4	.010	9.4	9.8	.868	35.9	31.6	.074
Nigeria	13.7	15	.450	28.7	26.8	.706	8.3	6.4	.243	33	30.8	.618
East Africa
Burundi	25	22.7	.129	18.2	17.9	.546	21.9	22.1	.996	41.5	37.6	.100
Ethiopia	21.3	15.5	.413	19.5	17.4	.913	7.7	6.4	.727	28.2	25.7	.716
Rwanda	42.8	15	.006	49.5	14.4	.001	13.4	6.8	.187	59.2	23.8	.010
Tanzania	37.2	25.7	<.001	34.7	24.2	<.001	14.2	8.9	.077	49.8	34.9	<.001
Uganda	33.1	18	<.001	36.3	25.4	<.001	19.5	14.7	.005	50.6	35	<.001
Southern Africa
Malawi	17.4	13.2	.052	19.1	18.3	.694	17.7	13	.039	33.5	26.8	.057
Mozambique	17.3	6.9	.004	12.4	8.6	.416	2	2.4	.750	21.3	11	.027
South Africa	9.4	12.4	.768	29.8	11.6	.683	14.8	7.4	.474	38.3	16.4	.330
Zambia	27.9	20.7	.003	28	18.1	.008	17.2	8.8	.057	40.8	30.4	.004
Zimbabwe	20.7	20.7	.069	29.4	22.6	.001	14.6	8.5	.013	38.3	33.5	.008

Note. Pearson chi-squared test was used to obtain p-values.

Multivariable Results

To examine the effect of child marriage on IPV, we fitted two models and presented results in Table 4. Model 1 was an unadjusted model with no covariates, while Model 2 controlled for the covariates. In Model 1, we found a statistically significant effect of child marriage on IPV in Angola, Mozambique, Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe. After controlling for the covariates, the magnitude and direction of effect persisted, showing a strong and robust effect of child marriage on IPV. However, whereas the odds of IPV increased with child marriage in all these countries, the odds decreased in Angola (AOR: 0.78; 95% CI [.63, .97]) and Chad (AOR: 0.79; 95% CI [.50, 112]).

We also presented the adjusted and unadjusted results of the pooled datasets of all the 16 countries included in Table 4 to examine our hypothesis for the SSA region. After controlling for relevant covariates, including countries, we found that young women who married before 18 years were more likely to experience IPV than those who married at age 18 years or more (AOR: 1.20; 95% CI [1.12, 1.29]).

Table 4.

Multivariable Models Showing the Effect of Child Marriage on IPV in Selected SSA Countries.

Countries	UOR [95% CI]	AOR [95% CI]
SSA region	1.02 [.96, 1.08]	1.20*** [1.12, 1.29]
Central Africa
Angola	0.77* [.62, .94]	0.78* [.63, .97]
Cameroon	1.04 [.76, 1.42]	1.15 [.82, 1.60]
Chad	0.72 [.49, 1.07]	0.79 [.50, 1.12]
West Africa
Benin	1.20 [.90, 1.60]	1.24 [.92, 1.66]
Mali	1.35 [.97, 1.87]	1.29 [.92, 1.82]
Nigeria	1.06 [.85, 1.31]	1.01 [.79, 1.28]
East Africa
Burundi	1.22 [.96, 1.54]	1.22 [.95, 1.56]
Ethiopia	1.06 [.77, 1.45]	1.04 [.74, 1.45]
Rwanda	2.13* [1.19, 3.83]	2.01* [1.10, 3.66]
Tanzania	1.79*** [1.45, 2.24]	1.64*** [1.29, 2.11]
Uganda	1.59*** [1.32, 1.90]	1.44*** [1.18, 1.74]
Southern Africa
Malawi	1.25 [.99, 1.56]	1.14 [.90, 1.45]
Mozambique	1.73* [1.06, 2.82]	2.07** [1.24, 3.46]
South Africa	1.51 [.65, 3.49]	1.34 [.50, 3.56]
Zambia	1.40** [1.11, 1.76]	1.28* [1.01, 1.64]
Zimbabwe	1.43** [1.11, 1.87]	1.40* [1.06, 1.85]

Notes. Model 1: Unadjusted model examining the independent association of child marriage and IPV; Model 2: adjusted for socio-demographic factors (educational level, residence, wealth index, media exposure, and justification of violence); AOR = adjusted odds ratio; UOR = unadjusted odds ratio; 95% confidence intervals in brackets.

^* p < .05, ^** p < .01, ^*** p < .001.

Discussion

Progress toward ending child marriage in SSA remains slow and uneven. Also, several countries still maintain laws that allow girls to be married before their eighteenth birthday (Maswikwa et al., 2015). Achieving the Sustainable Development Goal 5.3, which seeks to end all harmful practices such as child marriage by 2030, will require the deployment of relevant and up-to-date evidence of its adverse effects. We examined the association between child marriage and IPV in SSA, using recent DHS. Our analysis showed that Uganda had the highest prevalence of IPV among young women (aged 20-24 years). The prevalence of IPV is relatively high in Uganda, with the 2016 DHS showing a national IPV prevalence of 58.4% among married women (Uganda Bureau of Statistics, 2017). This high IPV prevalence in Uganda has also been confirmed by various community-based studies, with others reporting as high as 80% prevalence (Black et al., 2019). The results further showed that Chad, a Central African country, had the highest prevalence of child marriage. This is consistent with UNICEF’s (2018) report, which indicated that Chad is the third country with the highest prevalence of child marriage apart from Niger and the Central African Republic globally (UNICEF, 2018). From the report, the drivers of child marriage were displacement, low level of education, religion, polygyny, and female genital mutilation (UNICEF, 2018).

Our findings support the hypothesis that child marriage is associated with higher odds of experiencing IPV. This observation is consistent with previous studies in other settings such as Vietnam (Hong Le et al., 2014), India (Santhya et al., 2010), Pakistan (Nasrullah et al., 2014), Nepal (Oshiro et al., 2011), and other low and middle-income countries (Kidman, 2017). While our results largely support the hypothesis that child marriage is associated with IPV, the heterogeneity of the effect in the SSA regions cannot be overlooked. In 14 countries, the results indicated that women who married before the age of 18 had a heightened risk of IPV, with a larger effect size observed in Rwanda and Mozambique. The effect size was not significant in eight of these 14 countries. This finding overall explains the diverse cultural context of the SSA region, suggesting that other factors are more important in explaining IPV in countries where we did not find significant results. Child marriage and IPV thrive within the ambiance of culture that believes in male child superiority and its concomitant social positioning of a girl child as subordinate, and necessarily subservient (Burn & Evenhuis, 2014; Parsons et al., 2015). Both child marriage and IPV flourish under the cultural justification, acceptance, and supports for male dominance (Bolis & Hughes, 2015; Sunmola et al., 2018). But we must emphasize that SSA countries differ significantly culturally, with more countries more tolerant of child marriage and IPV than others. We believe it is plausible that the cultural differences in SSA countries may well explain the heterogeneity in the association between child marriage and IPV. Where marital abuse is culturally tolerated, the prevalence of child marriage is high. Countries, where tolerance of IPV is lower, have lower prevalence of child marriage. Fighting permissive cultural norms that make men unaccountable is critical to ending both child marriage and IPV.

Even though the rate of child marriage is high in Mozambique, the IPV rate is largely low compared to other SSA countries. Yet women who married as children were twice more likely to be predisposed to IPV. In sharp contrast, Rwanda has a low prevalence of child marriage, but the IPV rate is moderately high relative to other SSA countries. Moreover, similar to Mozambique, women in Rwanda who married as children were twice more likely to be exposed to IPV. In all southern African countries, except South Africa, the effect size of child marriage on IPV was large. The lack of significant effect size in South Africa is possibly due to the sample size. The cross-tabulation result shows that the prevalence of IPV among women who married as children in South Africa was 38% compared to 16% among those married as adults. The difference in the prevalence at least suggests that child marriage is plausibly associated with IPV. More studies are needed to understand this association in South Africa.

The pattern observed in Chad and Angola is, however, inconsistent with other SSA countries. However, the association of child marriage with lower odds of IPV was only statistically significant in Angola. Both countries have a high prevalence of child marriage, with eight in ten girls marrying before age 18 years in Chad, more than half of girls in Angola. However, IPV prevalence is relatively lower in Chad compared to other SSA countries. It is plausible that other factors drive the exposure to IPV in Chad. Also, a study has suggested that the protective effect of marrying as adult against IPV is negated in settings with a very high prevalence of child marriage (Yount et al., 2016). In these settings, child marriage is the norm rather than the exception.

In understanding the reasons for the varying pattern of the association between child marriage and IPV, the differences in child marriage laws among SSA countries should be considered. In countries like Burundi, Uganda, Ethiopia and Rwanda, the law prohibiting child marriage has been consistent (Maswikwa et al., 2015). While the age at marriage is set at 18 in Zimbabwe, Cameroon, Nigeria, Senegal, and Tanzania, there is an exception allowing girls younger than 18 to get married with parental consent (Maswikwa et al., 2015). Also, in several countries, customary and religious laws permit girls younger than 18 to be married out despite the national laws prohibiting such marriages. What is clear is that having a consistent minimum age for marriage is associated with lower prevalence of child marriage (Maswikwa et al., 2015).

There are several plausible explanations for the significant association between child marriage IPV. First, some of the young women who marry early are sometimes limited or prevented from attaining their educational goals, limiting their opportunities to attain better employment opportunities and making them dependent on their partners for economic survival (Tenkorang, 2019). We know from previous studies that educated women and those from high-income households are less likely to suffer IPV compared to those from low-income households (Tenkorang, 2012, 2019). Education empowers women, improves their self-esteem and ability to assert their agency and autonomy. Conditional cash transfer intervention to empower women has demonstrated efficacy in limiting IPV in SSA settings (Buller et al., 2018; Kilburn et al., 2018). Women who marry as children have lower autonomy in household decision making relative to those who married as adults, and as such, are not able to make decisions on issues affecting their lives (Tenkorang, 2019). This includes the capacity to make decisions to move out of violent marriages, unlike those who married as adults. Previous studies also argue that women without autonomy are unable to negotiate safer sex or challenge patriarchal norms (Vogelstein, 2013).

Also, the age differences between child brides and their husbands mean that they have unequal power in the relationship. In the African context, younger people accord respect to older people, and this is expected even in relationships (Tenkorang, 2019). Failure to show respect or be subservient could result in IPV. Besides the role of respect, sex between an adult and child is inherently a form of violence. Child marriage is, therefore, a way of normalizing violence against children. A study has suggested that women who marry as children are more likely to regard violence by their partner as expected (Santhya et al., 2010). Their enduring of IPV, even into adulthood, could make them perceive themselves to be satisfying a marital obligation.

Implications of Findings

We analysed nationally representative surveys of 16 sub-Saharan Africa countries from all the sub-regions of SSA. Our study included diverse groups of respondents, making our findings generalizable to the sub-Saharan Africa region. Beyond generalizability, our findings confirm the diverse cultural context of SSA countries and the heterogeneity of the association between child marriage and IPV. Overall, our study shows that the relationship between child marriage and IPV is more nuanced than earlier thought. In two countries, girls who married later were more likely to experience IPV, but in most countries, the reserve was true. Even in the 14 countries where we found a positive association between child marriage and IPV, the strength of the association was large enough only in six of them.

Nevertheless, ending child marriage is an important global development and human right issue, featuring in all global and regional development agendas, including the sustainable development goal and Agenda 2063, the Africa we want. As such, our article is of interests to the global audience. The results of this study are crucial for policy and practice regarding the elimination of child marriage. Based on our findings, laws prohibiting child marriage should be enacted in SSA countries where such legal provision is lacking. Also, there is a need for strict enforcement of laws prohibiting child marriage in countries where such law exists. Community sensitization efforts by the various governments targeting various stakeholders such as community and religious leaders on the effects of IPV are also crucial.

Strength and Limitations

It is worth acknowledging the limitations inherent in this study. The study used cross-sectional data, and due to this, we cannot claim causal interpretations of our findings on the association between child marriage and IPV. The outcome variable was also self-reported, and as a result, there is the possibility of social desirability and recall bias even though privacy was ensured. People in SSA settings are generally reticent in discussing issues concerning their relationships and particularly sexual life with strangers. As such, there is a possibility of under-reporting of IPV. Despite these limitations, the use of relatively large datasets that are nationally representative is a strength of this study.

Conclusion

In sum, our findings add to the body of evidence on the association between child marriage and IPV. The findings also revealed disparities in the prevalence of child marriage across SSA, with Chad having the highest prevalence. The study also showed that Uganda had the highest prevalence of IPV. To aid in the achievement of the Sustainable Development Goal 5.3 on eliminating all harmful practices such as child marriage and IPV by 2030, it is imperative for various stakeholders within the 16 SSA countries to adopt context-specific measures and strengthen existing strategies to end child marriage and IPV. Such measures could include community sensitization, especially among community leaders, to understand the negative impacts of child marriage. There should also be strict enforcement of existing laws and policies prohibiting gender-based violence and child marriages. Traditional and customary authorities could also use traditional festivals and related events to increase the awareness of the effects of child marriage.

Footnotes

Author’s Contributions

AIA conceptualized this study. BOA performed the analysis. BOA, AS, OEA, AIA, and OO contributed to drafting the article and interpreting the results. All authors revised the draft and approved the final version of the manuscript.

Declaration of Conflicting Interests

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Olayinka Modupe Onayemi

Abdul-Aziz Seidu

Anthony Idowu Ajayi

Author Biography

Bright Opoku Ahinkorah, is a PhD (Public Health) candidate at the University of Technology Sydney, Sydney, Australia. He holds an MPhil (Health Education) and Bachelor of Arts (Population and Health) Degrees from the University of Cape Coast, Cape Coast, Ghana. His research interest is in adolescents’ and young women’s sexual and reproductive health and rights. He aims to find solutions to some key health challenges of adolescents and young women such as unintended pregnancies, child marriage and female genital mutilation through research. Bright Opoku Ahinkorah, is motivated to help address the sexual and reproductive health issues of adolescent girls and young women in Africa.

Olayinka Modupe Onayemi, PhD, is a lecturer in the Department of Sociology (Criminology/Deviance and Antisocial Behaviour Unit), Landmark University, Nigeria. Her research interest lies in how human behaviours inform child welfare and the chances of children. She is interested in shaping the life chances of children, especially the less-privileged, via building the capacity of child development workforce and interest groups.

Abdul-Aziz Seidu, is a PhD (Public Health) candidate at James Cook University, Townsville, Australia. He holds an MPhil and Bachelor of Arts Degree in Population and Health from the University of Cape Coast, Ghana. His research interests include adolescents’ sexual and reproductive health and rights, with much emphasis on young people with disabilities; maternal and child health, gender-based violence and women empowerment. Abdul-Aziz always aims to continuously learn to do better and improve the well-being of the marginalized in society.

Oluwafemi Emmanuel Awopegba, is a junior research fellow at the Nigerian Institute of Social and Economic Research. He works as an Economist at the Economics and Business Policy Department. He holds a Master of Science degree in Development Economics from SOAS, University of London, United Kingdom. He has special interests in modeling and data analytics. His general research interests include adolescents’ sexual and reproductive health. Oluwafemi relishes the opportunity for life-long learning and boosting the economic wealth of nations!

Anthony Idowu Ajayi, PhD, is a postdoctoral research scientist at the Population Dynamics and Sexual and Reproductive Health and Rights Unit of Africa Population and Health Research Center. His research focuses on broaden the understanding of sociocultural factors exacerbating the vulnerability of adolescents and young adults to poor sexual and reproductive health outcomes in sub-Saharan Africa. He currently works on a project that aims to address the social exclusion of adolescents, women and gender minority individuals, by generating evidence, engaging with policymakers and building capacity of advocacy partners and policymakers in SSA to use evidence.

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