Prohibition of Child Marriage Act, 2006 is in place in India. Still, country is a home to the world’s largest number of child brides with at least 1.5 million girls under 18 get married each year. Many research studies have shown the socio-economic impacts of of early marriage and consequent pregnancy on child bride, on the family she raises and on overall society.
But there is a dearth of evidence on the long-term health consequences associated with early marriage and early child bearing in Indian women. A group of Indian scientists at Augusta University, USA, examined whether these child brides are at a higher risk of hypertension compared to women who were not married before 18 years or did not give birth by 19 years of age.
Researchers found that child brides and adolescent mothers were about 1.2 times more likely to have hypertension later in life. The elevated risk of hypertension among these women is irrespective of their socio-economic backgrounds.
Early onset of hypertension causes adverse heart issues later in life and is a leading cause of women’s death worldwide. This makes hypertension in women an important public health issue of concern.
Hypertension in women is mainly studied in postmenopausal-, oral contraceptive induced- and pregnant women but there is paucity of data on the hypertension in women in the reproductive age group (20-49 years) from Low- and Middle-Income Countries like India. These researchers have done India specific study using the most recent and nationally representative data.
They obtained the data on 5,82,358 women in the age group of 20 to 49 years from the India National Family Health Survey (NFHS-5, year 2019-21) which is a nationally representative survey. These women were classified in the age groups of 20s, 30s and 40s. Subgroups were done on socioeconomic factors like, urban or rural and poor or rich. Their study published in Journal of Human Hypertension has shown significant findings related to health as well as social issues in India .
The study says, about one third of the women are still child brides or adolescent mothers in the country. There is higher prevalence of hypertension among these women across all subgroups compared to women who are not child brides and adolescent mothers. The risk of hypertension in these women increases with their age.
These ﬁndings support previous studies indicating that child brides experience more problems like pregnancy loss or child death, marital control, and spousal violence, in comparison to women who married in adulthood. Such problems may also increase the chances of being hypertensive later in their life. With the natural aging process, the risk of hypertension in women may gradually increase with age.
Researchers say, there is limited data available as far as consequences of adolescence pregnancy is concerned. Earlier studies on child marriage and adolescent motherhood mostly focused on maternal and child health and obstetric outcomes. Evidence on the later life health consequences of child marriage and adolescent childbearing, however, is less visited. Our study has filled this gap by examining the later life risk of chronic conditions among Indian women.
“In many developing countries like India, there are barriers and socioeconomic inequalities in hypertension management/treatment. Child brides especially those which are economically vulnerable may experience disparities in accesss to needed treatment. As a result, child marriage may compound the long-term consequences of hypertension if left unaddressed”, says Biplab Kumar Datta, lead author of the research paper.
“Poor people, who are typically underserved, are developing hypertension at an increasing rate in India. The greater share of child brides and adolescent mothers living in such households ampliﬁes the severity of the problem. Thus, these women may bear a disproportionately higher risk of adverse and untreated cardiovascular outcomes. Orchestrated policy efforts are required to mitigate their health risks in later life”, adds Datta. An important question arises here- aren’t these child brides deserve free or low-cost medical treatment in public or private medical center?
Compared to late-onset hypertension, early-onset hypertension is associated with a higher risk of heart and other long-term problems. The risk of coronary heart disease is relatively higher among hypertensive individuals. It is important to ensure adequate treatment and control of hypertension in this population. Offering focused hypertension management programs to these child brides may assist in improving their long-term health.
As an additional preventive measure, child brides and adolescent mothers alive to-date should be recognized as a priority group for hypertension management programs.
As per this study, women which are in their 40’s, almost half of them (46% women) are child brides and 27% of women in their 20’s are child brides. Though these numbers show declining trend of child marriage, numbers are still high.
It clearly shows that child marriage is still in practice in spite of existing law in the country. Under India’s Prohibition of Child Marriage Act, 2006 the legal age of marriage for girls is 18 years. If this is the case, then what are the reasons, the government is unable to protect these girls from becoming brides before the prescribed age?
As per UNICEF report, these child brides are from rural areas and poorer households with no or little education. One in three of the world’s child brides live in India’s 5 states- Uttar Pradesh, Bihar, West Bengal, Maharashtra and Madhya Pradesh. If the law mandates punitive measures against all who perform, permit, or promote child marriage, then why some states fail to prevent, detect, register and investigate this crime and prosecute the criminals?
“The programmatic responses to end child marriage include strengthening of laws, better access to health services, increasing educational opportunities, and creating awareness. These initiatives play an important role in preventing child marriage and subsequent adolescent childbearing”, saysAshwini Tiwari, one of the co-authors of the study
Tiwari adds ahead, “There is hardly any program that aims to enhance healthcare access for child brides at their adulthood. This is mainly due to the dearth of evidence on how child marriage is associated with later life health outcomes. Our research findings thus have important implications for public health efforts to improve health of not only Indian child brides but of more than 650 million child brides globally alive today”.
These findings provide strong support for global campaigns and policy movements, which aid in the prevention of child marriage and subsequent adolescent motherhood. Will these research findings be considered by arguing lawyers and court judges while processing a legal matter, particularly in which woman is a child bride?
Every scientific organization In India is funded by the government through tax payers’ money. If such research findings will not be considered by the four pillars of the democracy, then these findings as well as research funding will get converted to dead assets.