Original article
Child Marriage and Its Associations With Controlling Behaviors and Spousal Violence Against Adolescent and Young Women in Pakistan

https://doi.org/10.1016/j.jadohealth.2014.06.013Get rights and content

Abstract

Purpose

Child marriage (before 18 years) is widely prevalent in Pakistan, and disproportionately affects young girls in rural, low-income, and poorly educated households. Our study aims to determine the associations between child marriage and controlling behaviors (CB) and spousal violence by husbands against adolescent and young women in Pakistan beyond those attributed to social vulnerabilities.

Methods

We analyzed data from the Pakistan Demographic and Health Survey, 2012–2013, of currently married women aged 15–24 years who had participated in the domestic violence module (n = 589, 22.5% [589/2,615] of the subsample aged 15–24 years) to identify differences in CB and spousal violence experiences between early (<18 years) and adult (≥18 years) ages at marriage. Associations between child marriage and CB and spousal violence by husband were assessed by calculating adjusted odds ratios (AOR) using logistic regression models after controlling for demographics, social equity indicators (education, wealth index, and rural residence), spousal age gap, and husband's education.

Results

Overall, 47.8% of currently married women aged 15–24 years in Pakistan were married before the age of 18 years. About one third of women aged 15–24 years in Pakistan reported experiencing CB (31.8%) and spousal violence (31.1%) by their husbands. Compared with adult marriage, child marriage was significantly associated with CB (AOR = 1.50; 95% confidence interval [CI], 1.042–2.157), any form of spousal violence (physical or emotional) (AOR = 2.03; 95% CI, 1.392–2.969), emotional violence (AOR = 1.86; 95% CI, 1.254–2.767), and physical violence (AOR = 2.44; 95% CI, 1.582–3.760), including severe physical violence (AOR = 2.57; 95% CI, 1.122–5.872).

Conclusions

Effective interventions are needed to prevent child marriages and raise awareness about their negative consequences, with special reference to spousal violence.

Section snippets

Sample of participants

We selected participants from the Pakistan Demographic and Health Survey (PDHS) carried out by the National Institute of Population Studies, Islamabad, Pakistan and ICF International, Calverton, Maryland between October 2012 and March 2013 [7]. PDHS is the third national survey conducted in Pakistan under the umbrella of the global program of Demographic and Health Surveys. Depending on the preference of household members, trained interviewers verbally administered the survey. A nationally

Results

The median age of participants in the sample was 22 years (minimum = 15 years; maximum = 24 years). The median age of participants' husbands was 27 years (minimum = 16 years; maximum = 60 years). Around 30% of the participants reported that they had been married for a total of 5–9 years. The most participants (47.8%) were married before the age of 18 years. Around 3% and 13% of participants were married before the age of 14 and 16 years, respectively. Of those married before the age of

Discussion

Almost one third of women aged 15–24 years in Pakistan reported experiencing CB by their husbands. This is in line with previous international literature, which has shown that women, especially in Asian [23], African [22], and Middle-Eastern regions [24], experience CB by their husbands. Our study adds to the literature by showing that, among women who experienced CB, those married as children experienced significantly more CB from their husbands compared with those married as adults.

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    • Conflicts of Interest: None.

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    Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.