National Day of the Girl Child 2022: our response to child marriage cannot rely solely on the use of legal instruments

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New Delhi: Health, as a concept, goes far beyond medical science. Good health and well-being are the results of a series of non-medical factors that impact people throughout their lives. Some of these important ‘social determinants of health’, which can profoundly influence health care seeking behavior, health equity, include income and social protection, education, child development childhood, non-discrimination, social inclusion and access to affordable and quality health services. Gender inequalities in these social determinants of health, which have persisted for centuries, are at the heart of health inequalities for women and girls across the world, including in India.

By definition, gender refers to the socially constructed roles, behaviors and attributes considered “appropriate” for both men and women. These are determined by the power structures in society. Although gender inequality in all spheres is not unique to any country, in the Indian context it has manifested itself in patriarchal norms and harmful practices such as son preference, gender selection and child marriage.

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Child marriage not only undervalues ​​girls and robs them of childhood, it also damages their health and well-being. Child marriage impacts girls throughout their lives, increasing their vulnerability to early pregnancy, unsafe abortions, maternal mortality, poor health and nutritional status of the adolescent mother and of the child. Poverty, lack of education, security concerns and control over sexuality are additional factors that perpetuate the practice. Child marriages are widely accepted by several communities, who see them as a solution to “protect” and “secure” the future of their daughters. Families are motivated by the feeling that they are acting in the “best interest” of their daughters. It is therefore not surprising that child marriages have continued to prevail despite existing laws (such as the legal age of marriage of 18 for girls and 21 for boys) in place for more than four decades. Despite large-scale programmatic efforts to raise awareness of the harmful effects of child marriage, the last five years have seen a slight decline (from 27% in 2015-2016 to 23% in 2019-21), as evidenced by the last two National Family Health Survey series conducted by the Ministry of Health and Family Welfare, Government of India. The need to end child marriage takes on greater significance in the context of the COVID-19 pandemic. Several reports and anecdotal evidence suggest that many young girls may never return to school due to COVID-induced school closures and being married off and forced to avoid any plans to pursue higher education and employment opportunities.

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In a recent turn of events, the Prohibition of Child Marriage (Amendment) Bill 2021, which seeks to raise the legal age of marriage for women from 18 to 21, was sent to a parliamentary standing committee for further deliberation on December 22, 2021. While legal enactment is required, our challenge is also to change perspectives on child marriage at the community level and to do so with the factors and societal pressures that drive communities to make such decisions. Our response to child marriages cannot therefore rely solely on the use of legal instruments. Instead, we need a more holistic approach that includes empowering girls and their families with the right knowledge and means to understand why the practice is more of a problem than a solution.

Going forward, existing policies and strategies need to be more responsive to their health and well-being throughout their lives. Addressing the social determinants of health, which impact women and girls differently, will require a “health in all policies” approach. We must optimize investments in the health of women and girls. This can be done by:

1. Increased investment in secondary education for girls and there is a direct correlation between education and later age at marriage. Enabling girls to complete their education, especially up to upper secondary level, will also give them the opportunity to be financially independent.

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2. Include comprehensive sex education (CSE) in the school curriculum and for out-of-school adolescents. Adolescents need access to CSE to develop the knowledge, attitudes, skills and values ​​that will enable them to take charge of their health and well-being in addition to normalizing conversations about sexual and reproductive health issues ( SSR).

3. Ensure universal access to family planning and SRH services: Improving family planning and SRH service delivery has enormous benefits, such as preventing unwanted and teenage pregnancies, unsafe abortions, and lower infant and maternal mortality rates.

4. Invest in gender equality initiatives that promote equitable gender norms. This will not only empower girls from an early age to take charge of their lives and decisions, but also educate young boys on gender issues.

As we celebrate the International Day of the Girl Child today, we must recognize the extraordinary contributions of women and girls to families, societies, economies and nations. Going forward, the needs of women and girls must be embedded in all aspects of decision-making. This will require action by ministries of health, both alone and in collaboration with other ministries, the private sector and civil society organizations.

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(Written by Sanghamitra Singh, Senior Manager, Knowledge Management and Partnerships, Population Foundation of India.)

Disclaimer: The opinions expressed in this article are the personal opinions of the author. The facts and opinions appearing in the article do not reflect the views of NDTV and NDTV assumes no responsibility or liability for them.

NDTV – Dettol have been working for a clean and healthy India since 2014 through the The Banega Swachh India initiative, led by Campaign Ambassador Amitabh Bachchan. The campaign aims to highlight the interdependence of humans and the environment, and of humans on each other, with an emphasis on One Health, One Planet, One Future – Leaving No One Behind. It emphasizes the need to care for and consider the health of everyone in India – especially vulnerable communities – the LGBTQ population, indigenous peoples, various Indian tribes, ethnic and linguistic minorities, people with disabilities, migrants, geographically distant populations, gender and sexual minorities. With the current Covid-19 pandemic, the need for WASH (The water, Sanitation and Hygiene) is reaffirmed because handwashing is one of the ways to prevent coronavirus infection and other diseases. The campaign will continue to raise awareness of the same while emphasizing the importance of nutrition and health care for women and children, the fight malnutrition, mental well-being, self-care, science and health, adolescent health and gender awareness. Along with the health of people, the campaign realized the need to also take care of the health of the ecosystem. Our environment is fragile due to human activity, which not only overexploits available resources, but also generates immense pollution due to the use and extraction of these resources. The imbalance has also resulted in an immense loss of biodiversity which has caused one of the greatest threats to human survival – climate change. It has now been described as a “code red for humanity”. The campaign will continue to cover issues such as air pollution, Waste Management, plastic ban, manual scan and sanitation workers and menstrual hygiene. Banega Swasth India will also advance the dream of Swasth Bharat, the campaign believes that only a clean Swachh or India where bathroom are used and without open defecation (ODF) status obtained under the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014 can eradicate diseases like diahorrea and the country can become a healthy Swasth or India.

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