Interventions to Address the Health and Well-Being of Married Adolescents: A Systematic Review

This review concludes that little research and programmatic attention is paid to the needs and vulnerabilities of married girls as if it were too late to reach them, and limited effort is made to address relationship dynamics and other conditions within marriage other than sexual and reproductive health. Key Findings Despite awareness of the harmful health and social consequences of child marriage, married girls and boys remain an overlooked population in programming. The limited interventions targeting married adolescents are geographically concentrated in sub-Saharan Africa and South Asia, implemented at a small scale, focus on sexual and reproductive health or maternal health to the neglect of other areas, including voice and agency, violence prevention, economic livelihoods, schooling, and rights and access to legal support. There is a lack of programmatic attention to boys and men in the context of child marriage response. Key Implications Program designers and implementers must identify and address the needs of married adolescents through targeted evidence-based interventions that encompass timely identification and referral of adolescents affected by child marriage; collaboration between child protection, education and social protection sectors; and employ evidence-based design and delivery. Policymakers should invest in and scale up programs and services that not only prevent child marriage but also mitigate the harmful consequences faced by survivors of child marriage, particularly girls who remain disproportionately affected by the harmful effects of child marriage. ABSTRACT Child marriage, defined by the United Nations as marriage before the age of 18 years, is a widespread practice with serious health and social consequences. We systematically reviewed academic and gray literature to learn what is known about the current state of the evidence for interventions to respond to the needs of married adolescents. Our analysis of the 29 included intervention studies identified variability across sectors, with most programs focusing on sexual and reproductive health (SRH) and maternal health. We found that interventions occur mostly at a small scale, are geographically concentrated, and focus on SRH to the neglect of other sectors. There is a need for programs to focus on improving educational and economic outcomes among married girls, as well as increased efforts to support equitable marital relations and engage men and boys. The emphasis on preventing child marriage must be matched by efforts to mitigate and respond to the practice.