COVID-19 and child marriage: A red flag.

Abstract

Child marriage, also known as early marriage, is an ongoing global humanitarian problem. Widely regarded as a major public health issue, it occurs across cultures, nations, ethnicities and religions, posing a threat to the health, general well-being, and human rights of children and young adults worldwide (United Nations International Children's Emergency Fund [UNICEF], 2021). Child marriage is defined as any formal marriage or informal union between a child under the age of 18 years old and an adult or another child (UNICEF, 2021). It is widely viewed as a human rights abuse that violates several international basic human rights norms, such as the right to enter freely into marriage through the giving of ‘free and full’ consent, and the right to bodily and sexual integrity (United Nations Development Program [UNDP], 2015). In order to protect these rights, the Universal Declaration of Human Rights (1948), the Convention on Consent to Marriage, Minimum Age for Marriage and Registration of Marriages (1964), Convention on the Elimination of All Forms of Discrimination against Women (1979) and the Convention on the Rights of the Child (1989) have all been promulgated in an attempt to guarantee the right to free and full consent to marriage (UNDP, 2015). Several organisations, among them UNICEF, Girls Not Brides [GNB], International Center for Research on Women [ICRW], and Cooperative for Assistance and Relief Everywhere [CARE], have been responsible for promoting full gender equality and introducing programmes to prevent child marriages. The United Nations Sustainable Development Goals has called on the international community for global action to promote equality for all and to end this violation of human rights by 2030 (UNDP, 2015). Yet, considerable challenges remain, including persistent poverty, control by others over the sexuality and reproduction of a girl, social norms (such as maintaining ethnic or community relations and protecting family honour) and gender inequalities with discrimination against girls. In addition, there are grinding humanitarian issues and situations of uncertainty and insecurity such as wars, refugee camps, food crises and disasters. Although both genders can be victims, most cases involve girls and young women, whose gender renders them more vulnerable threats and places them at higher risk (Hampton, 2010). This is confirmed by a recent report by UNICEF (2021)–COVID-19: A Threat to Progress Against Child Marriage–which indicates that the total number of girls at risk, or affected, is significant. Prior to the COVID-19 pandemic, it was anticipated that, in the next decade, more than 100 million girl children would be married before reaching their eighteenth birthdays. However, an additional warning was issued on International Women's Day, indicating that, as a result of the pandemic, girls will be under even more serious threat over the next decade and that up to an additional 10 million girls could be at risk of becoming child brides (UNICEF, 2021). The COVID-19 pandemic has raised the risk of child marriage via five main pathways: interrupted education (school closures), economic shocks (economic insecurity), pregnancy (disruptions in healthcare services), death of a parent (becoming an orphan), and disruption to programmes and services aiming to prevent child marriage (delayed programmes and awareness campaigns) (UNICEF, 2021). Contextual factors also play a role in affecting child marriages in certain settings: these include gender and social norms, the prevalence of child marriage, the amount and direction of marriage payments, the availability of social protection, the availability of poverty alleviation programmes and the presence of displacement, ongoing conflict and forced migration. Even though the international community made a prior commitment to end this harmful practice by 2030, the COVID-19 pandemic is making this global goal increasingly difficult to achieve. Not only are girls more likely to be at risk for experiencing early marriage but the impacts on the health and social situation of these girls are serious due to their vulnerability to sexual abuse, intimate partner violence, premature pregnancy, childbearing and pregnancy-related death, infant mortality, sexually transmitted infections, social isolation, and prohibitions from attending school or finding a job. All of these constitute violations of the rights of the girls: their right to participate in education, their right to freedom from abuse and exploitation, and most importantly, their right to enjoy the highest attainable standard of health (UNDP, 2015; UNICEF, 2021). The prevention of additional child marriages and mitigation of the impact of the COVID-19 pandemic are urgent and require immediate action that extends beyond health and the factors that enable it or the reasons for the occurrence of early marriage. There is a need to prioritise a wider set of rights and to create effective and realistic solutions across different cultures. Recognition and understanding of the problem can aid in promoting the general well-being of girls, in generating equality and justice for them, and thereby, in reducing the toll of COVID-19 on children and their futures. It is critical to have a multisectoral response that unites advocacy communities and healthcare professionals, including nurses and others at a broader level, in order to better assess, understand, implement, and advocate for correct and appropriate responses to this urgent threat. It is equally important to incorporate child marriage prevention strategies into the COVID-19 response strategy and into all other initiatives aimed at stopping the spread of the virus, in order to protect these girls. The adaptation and strengthening of programmes and services, such as child protection systems, social services, social protection programmes, education programmes and poverty alleviation strategies, are central to ensuring the safety of girls, to improving their well-being, and to preventing child marriage. Giving detailed information to the people in the affected communities about the risks of child marriage and having community discussions can make a critical difference and contribute to a reduction in the ongoing risk. The agency of girls and young women is frequently overlooked, and learning to respect the agency of women and supporting them from within their own communities are vital steps towards helping them to exercise their own wills and control their own futures. This simple action can also yield lasting benefits to families and to the community as a whole. Policymakers, healthcare professionals, human rights activists, media commentators and individuals from the entertainment industry have, in the past, all made substantial contributions towards mitigating the threat of child marriage by endorsing human rights, by empowering women and girls, and by increasing the visibility of violence against women and the harmful effects of child marriage. Prior to the COVID-19 pandemic, they had helped to shift the cultural climate in several countries. However, still much remains to be done, particularly in countering the consequences of COVID-19 on child marriage. There is a need to ensure gender equality, to educate communities, to update marriage-related legal structures and policies within affected communities and to ensure the efficacy of legal protection against child marriage. Tackling the emerging risks from the perspective of public health can provide a useful guide in the reshaping of policies and regulations. It is important to focus on the resources on the children and women who are the potential victims, and to engage with these girls as agents of change. It is in the nature of the nursing profession to care for all, protect human rights and promote the well-being of individuals. Both in her personal capacity and as a nurse, both authors believe that every life matters, including the life of every child and woman; thus, they deserve the same rights and protections as every other individual, including men. As a community, nurses have a fundamental commitment and obligation towards the common goal of advocating for the rights of the girls and health with all means at our disposal in order to contribute to putting an end to this violence. Our obligation extends to the 100 million girls who were already at risk of becoming child brides before the COVID-19 outbreak started, together with the 10 million additional girls whose futures are now in jeopardy. This work received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Jawhrah Alqahtani contributed to conceptualisation, writing and original draft preparation. Ibtesam Alqahtani contributed to writing, critical review, commentary and revision. No conflict of interest has been declared by the authors. All authors reviewed, edited and approved the final version.