Perceptions and Practices of Early marriage of female child from 2009 to 2013 in Sinane district Northwest Ethiopia

Female child early marriage has numerous challenges both at global and regional level. It denied access to education and economic opportunities and has a big impact on the health of the child with its complex problem on maternal and child mortality. Ethiopia is one of the countries that female child marriage practice has more prevalent and from the regions of Ethiopia. Amahra region has the highest prevalence. The main objective of this study is to assess the prevalence of early marriage practice among female child from 2009 to 2013 in Sinane district northwest Ethiopia. Community-based cross sectional study design was carried out. The data were analyzed using SPSS version 20 statistical software. A total of 802 participants responded for the interviews making the response rate 96.2%. Majority (74.6%) of the respondents were fathers and 151 (18.8%) of household heads were mothers. About 615 (76.7%) respondents wedded their daughters before 18 years of age. Sixty percent of girls married before their 15 years old. The mean marital age was (14.78 ±4.1). More than half 473 (59%) of respondents wedded one daughter each and the remaining 288 (35.9%) and 41 (5.1%) parents wedded two and three daughters respectively within the last five years. The prevalence of early marriage practice is high in the study area. Awareness has to be created in the community regarding the legal marital age and the possible devastating consequences of early marriage for the girl, family and the community as a whole.


Introduction
Child marriage, also known as early marriage, is defined as "any marriage carried out below the age of 18 years, before the girl is physically, physiologically, and psychologically ready to shoulder the responsibilities of marriage and childbearing. It therefore has major consequences for public health, national security, social development, human rights, economic development and gender equality 1 .
These days, the devastating impact of female child marriage continues to be ignored in the developing world. Millions of child brides, some only just past puberty, are denied access to health, education and economic opportunities. The majority of them are burdened with the roles and responsibilities of wives and mothers without adequate support, resources or capabilities. Girls are either seen as an economic burden or valued as capital for their exchange value in terms of goods, money or livestock that is for economic and social reasons, controlling girls" sexuality which is directly linked to family honor and status for strong social pressure on families to either conform or face ridicule, disapproval or family shame for traditional practices 2 .
In the world 10 million girls under the age of 18 marry each year that is around 833,333 a month 192,307 a week 27,397 a day 19 every minute or, around one girl every three seconds 3 . Among these 40 percent and 49 percent of girls were in Central and West Africa respectively. More over 27 per cent were in East Africa and 20 percent in Northern and Southern Africa 4 The Convention on the Elimination of all forms of discrimination against Women as the current estimates show that approximately 82 million girls in the world between 10-17 years will be married before they reach 18 years of the 331 million girls aged 10-19 in developing countries (excluding China), 163 million will be married before they are 20. 5 In Ethiopia, female child early marriage is seen as a way to improve the economic status of the family, to strengthen ties between families, to ensure that girls are virgins when they marry, and to avoid the possibility of a girl reaching an age where she is no longer desirable as a wife ("QomaQerech"). The practice of female child early marriage is now (for a while) understood to have very harmful effects on the health, psychological, physiological and socio-economic well-being of young girls (as well as for the newborns). However, this knowledge is not broadly shared across most of the population 6 .
Ethiopia has one of the highest rates of female child early marriage in the world, with one in two girls marrying before her 18th birthday and one in five girls marrying before the age of 15.However, prevalence rates vary greatly by region and are often higher than national figures, such as in the Amhara region in northern Ethiopia, where almost 50 percent of girls are married by age 15. 3 Female child early marriage is a public health concern that violates international human rights laws and seriously compromises the development and health of individuals, households, community and countries.Female child marriage has a direct effect on realizing at least six of the MDGs such as causes for poverty, denies to access education, against gender equality and empowerment, increase child mortality and maternal health problems. It has also a risk factor in the spread of HIV and other STIs and erodes the health and well-being of girls and the overall welfare of communities 4 .
Among the factors for female child early marriage are sociocultural, religious, economic security and dependency are some that contribute for the practices of female early child marriage: In many communities, child marriage is a long-standing tradition, since a delayed" marriage would not be acceptable in the eyes of the community. Getting a daughter married early may be seen as a means of ensuring her and families safety, sexual abstinence and virginity are also considered important values that if not protected will affect the family honor. Moreover,

Abstract
Female child early marriage has numerous challenges both at global and regional level. It denied access to education and economic opportunities and has a big impact on the health of the child with its complex problem on maternal and child mortality. Ethiopia is one of the countries that female child marriage practice has more prevalent and from the regions of Ethiopia. Amahra region has the highest prevalence.
The main objective of this study is to assess the prevalence of early marriage practice among female child from 2009 to 2013 in Sinane district northwest Ethiopia. Community-based cross sectional study design was carried out. The data were analyzed using SPSS version 20 statistical software. A total of 802 participants responded for the interviews making the response rate 96.2%. Majority (74.6%) of the respondents were fathers and 151 (18.8%) of household heads were mothers. About 615 (76.7%) respondents wedded their daughters before 18 years of age. Sixty percent of girls married before their 15 years old. The mean marital age was (14.78 ±4.1). More than half 473 (59%) of respondents wedded one daughter each and the remaining 288 (35.9%) and 41 (5.1%) parents wedded two and three daughters respectively within the last five years.
The prevalence of early marriage practice is high in the study area. Awareness has to be created in the community regarding the legal marital age and the possible devastating consequences of early marriage for the girl, family and the community as a whole. Keywords: Early, marriage, child IJBAR (2014) 05 (11) www.ssjournals.com in families where parents cannot provide daughters" a safe space to live, child marriage is considered to be a protection from risks such as abuse than giving prioritizes for education. In the orthodox religion for deacon to become a priest he should have to marry the virgin girl. According to the orthodox religion ethics the age of marriage is (13 -15 for girls). Religious leaders further argue that even "Eve" married Adam at the age of 15 years;religious people said that it will be difficult to get virgin if the girls are left to get older, because virginity could be lost without engaging in sexual intercourse such as heavy work and carrying heavy load they believe that virginity can only be assured at early age 7 . The Amhara region of Ethiopia is extremely impoverished; it is served by few roads, children rarely get more than a few years of education and those who do go to school often walk many miles. It also has one of the highest rates of child marriage worldwide: eighty percent of girls in Amhara are married by the time they are eighteen, half by the age of fifteen; and the most common age for a girl to marry is twelve. Child marriage is rooted in religious and cultural traditions based around protecting a girl"s honor, since sex before marriage is seen as an extremely shameful act. A girl"s worth is therefore based on her virginity and her role of being a wife and mother 8 All relevant laws of Ethiopia, including Article 7 of Ethiopia"s revised family code of 2000 established a legal minimum age at marriage of 18 years for boys and girls as well as much of the education on early marriage prevention clearly indicate that the legal minimum age for marriage is 18 years for both girls and boys. However, a study done in Amhara region shows clearly that the general public"s definition of early marriage for girls uses a much lower cut-off than the legal definition indicating the age cut-off for defining early marriage for female adolescents considered marriages occurring before age 15.3. Moreover, rural respondents reported slightly lower age cut-offs for defining early marriage for girls than urban respondents. Sixty six percent of caretakers knew that the legal minimum age at marriage was 18. Among rural caretakers the proportion who knew that this age was 18 years was 69 percent. The most commonly recognized consequences of early marriage by care takers were increased poverty (54 percent), more obstructed labor (47 percent), high obstetric fistula (30 percent), higher maternal mortality (22 percent), and less education for girls (21 percent) 9 .
A survey conducted in Ethiopia shows that among women married before age 15, 82% resided in rural areas and among respondents married before age 15, 97% had mothers with no education and 91% had fathers with no education. In this survey, Mothers and fathers were the main decision makers in arranging these marriages, and the younger the bride, the more pronounced their influence was. Among women married before age 15, some 81% said that their mother had been a primary arranger or supporter of the marriage. In this study the strongest reason for early marriage is the desire or need to maintain the family"s good name and social standing. For some families, the desire to get 'macha' (money paid to the girl"s family by the boy"s family upon agreement to marriage) is an incentive to arrange a marriage and family believe that for girls beyond the of age 15 will not get husband because she cannot be managed easily by her husband (she will be stronger than the boy physically and mentally) 10 .
Early marriage in Amhara region is still high regardless of tremendous efforts attempted by government agencies different nongovernmental organizations. Showing the magnitude and contributing factors for early marriage exploring form the practicing community will have a very important contribution for intervention. The findings of this study will help as an input for the policy makers and planners in the area as well as the regional government to respond to the practicing devastating problem; early marriage at all levels of governmental and nongovernmental sectors. Furthermore, it will help also as an initiative for further investigation and intervention in the area regarding early marriage for those who will be interested in studying its consequences and related issues.

Study Design
Community-based cross sectional design was carried out.

Study areas and period
The study was conducted in Sinane district Northwest, Ethiopia from June to August, 2014.

Populations
The source population was all community members in Sinan district who practiced marriage in the last five years prior to the study and the study populations were community members in selected kebekes of Sinan district who practiced marriage in the last five years prior to the study.

Sampling techniques and procedures
Stratified multistage sampling technique was used to select the study participants. First, four out of 17 rural kebeles and 1 out of two urban kebeles were selected by simple random sampling techniques, and households from each kebele were selected by systematic random sampling technique. The sample size for each kebele was allocated proportionally to the size of households. In case, when eligible were absent in the selected household, the next household was considered for interview.

Eligibility criteria
Inclusion criteria: All community members in the study area who practiced marriage in the last five years prior to the study. Exclusion criteria: Those seriously ill and unable to respond for the interviews.

Variables of the study Dependent variable: Female child Marriage Independent Variables
Age, Sex, Education, Families/guardians knowledge regarding early marriage, Religiosity, Social pressure/reasons, Family income/Economic reasons, Parents perceptions regarding early marriage.

Data collection
Data were collected using semi-structured questionnaires adapted by reviewing literatures and suited to the local situation. The questionnaire was prepared first in English and was translated to Amharic (local) version and the local version was used to collect the data. For the validation of the language translation the local language had retranslated to English by language experts. The data were collected by trained health extension workers and was supervised by 3 supervisors. During data collection, if there were more than one eligible parent / care takers in households, one parent/ care taker was selected randomly. IJBAR (2014) 05 (11) www.ssjournals.com

Data Quality control
In order to maintain quality of data, data collectors and supervisors ware trained and questionnaire guide was prepared. Pre-test was done on 5% of the total sample and based on the findings of the pre-test the questions were modified. At every night of data collection day the collected data were checked for completeness and consistency by the principal investigator and supervisors and were communicated to data collectors.

Data management and analysis
The collected data were cleaned and fed to Epi Data version 3.1 and analysis was done by using SPSS version 20 statistical software.

Operational definitions
Female child early marriage: is used to refer to girl child making formal union with partner below the age of 18 years. Knowledge: parent"s knowledge of the minimum legal age of marriage; awareness on child marriage practices and the related reproductive health consequence or not.

Ethical consideration
Ethical clearance was obtained from Ethical review committee of Debre Markos University College of medicine health science. Confidentiality of the participants" response was maintained throughout the research work. Participants were also informed that they will had full right to discontinue or refuse to participate in the study. Each respondent was informed about the objective of the study and its contribution to the society.

Demographic and socio-economic characteristics
A total of 802 participants responded for the interviews making the response rate 96.2%. Majority (74.6%) of the respondents were fathers and 151 (18.8%) of household heads were mothers. All of respondents were Amhara Ethnically and almost all (99.8 %) were orthodox Christians regarding religion (Table1).

Early marriage practices
About 615 (76.7%) respondents wedded their daughters before 18 years of age. Sixty percent of girls married before their 15 years old. The mean marital age was (14.78 ±4.1). More than half 473 (59%) of respondents wedded one daughter each and the remaining 288 (35.9%) and 41 (5.1%) parents wedded two and three daughters respectively within the last five years. Only 95 (11.8%) of the marital processes were decided by the girls themselves and the other, 546 (68.1%) and 161 (20.1%) of marital processes were decided by parents alone and both parents and close relatives respectively. More than half (58%) of respondents thought that, the practiced under eighteen marital ages so far were appropriate. In the other hand, about 77.3 % of respondents believe that delaying marriage to eighteen and above would have negative consequences of social outcast and losing families values in the community. Of these, 65.1% had wedded their daughters before 18. Of the parents who practiced early marriage, 121 (19.7%) wedded their daughters for nobles (dakons). One of their reasons to practice these early marriages was to get respect by the community by making priest relation which accounts 57.3% and the remaining one is to get respect by the community by married virgin girl early.

Perceptions and knowledge of early marriage
Regarding perceived social benefits of early marriage, 49.2% of respondents reported as it has benefit of avoiding social stigma (kumaker-local term used in case if a girl/woman stays unmarried) and 65.1% reported as it has economic benefit of getting assets from her husband"s family. In the other hand, participants were also asked for what possible consequences will the girl face and who will be accountable for the crime of early marriage. In this regard, about 30.5% responded that possible consequence of early marriage as school termination and majority (61.2%) reported that family/parents will be accountable for early marriage crimes (Table 2).
Regarding knowledge of legal marital age, slightly more than the half (53.5%) of participants responded as it is eighteen years of age. One third of the participants did not mention any actual age for legal marriage and the remaining 132 (16.5%) reported 9-17 years of age as legal marital age. About half (49.4%) of those who reported legal marital age as eighteen, knew individuals in their community who were accused for early marriage crimes. IJBAR (2014) 05 (11) www.ssjournals.com

Discussion
In this study the prevalence of early marriage was 76.7%, which is comparable with prevalence in Niger but higher than different African countries 11 . This finding is slightly lower than the prevalence of early marriage in Amhara region before 8 years which was 81.8%. It is also higher than prevalence"s in Mali (70%) and Burkina Faso (62%) and is much far from prevalence"s in Benin (40%) and Egypt (30%).
The percentage of marriage before 15 years of age was 60% of which 59.6% reside in rural areas of the district. This finding is lower than the findings in Ethiopia country wide finding which was 82%, Amhara region which was 66.5% among rural residents and West Gojjam 966%). Among girls married before age 15, 63% had parents with no education. This is lower than the previous finding in Ethiopia which showed; among girls parents married before 15, 97% of mothers and 90.7 % of fathers were uneducated.
The study revealed that, the mean age at first marriage was 14.78. This is comparable with a finding from north Gondar in Ethiopia which was 14.5 and is slightly lower than the mean marital age in Metema (15.7) and slightly higher than Tencha (12.4). Regarding knowledge of the minimum legal marital age, slightly more than the half (53.5%) of participants responded as it is eighteen years of age. One third of the participants did not mention any actual age for legal marriage and the remaining 132 (16.5%) reported 9-17 years of age as legal marital age. This finding is higher than the finding from baseline survey in north Gondar which showed about 42.6 % of men and 38.7 % of women respondents reported that they were aware of the existence of a legal minimum age for marriage and of those who expressed knowing the minimum legal age, only half of them (51.5 % of men and 57.2 % of women) were able to state age 18 as the legal minimum age of marriage for girls. Another study in Amhara region also showed that 66% of caretakers knew that the legal minimum age at marriage was 18 and among rural caretakers the proportion who knew that this age was 18 years was 59 percent. In this regard the finding of this study showed lower level of knowledge of minimum legal marital age.
Only 37(3.7%) of respondents reported that early marriage has no benefit. This finding is much less than the finding from North Gondar of which 20% respondents reported as early marriage has not any benefit. In the other hand, only 95 (11.8%) of the marital processes were consented by the girls themselves and the other, 546 (68.1%) and 161 (20.1%) of marital processes were arranged by parents alone and both parents and close relatives respectively. This finding is in lin with the finding from a finding of a study done by Annabel Erulkar, in west Gojjam Ethiopia, which showed the vast majority of marriages was arranged, and was not consent by the bride. Overall, 94% of marriages were arranged by parents and only 16% of marriages were agreed by the bride.
About 30.5% of respondents mentioned school termination as a consequence of early marriage and the other 23.5% and 22.8 % of respondents mentioned pregnancy related and inability to manage family as consequence of early marriage. Only 8(0.4%) of respondents reported that early marriage has no any consequence. This finding is in opposite to a finding from a study in Dare salaam which revealed, about 52 percent of the people interviewed seemed to know very little about the consequences of child marriage 12 .

Conclusion and recommendation
The prevalence of early marriage practice is high in the study area. More than half of the marriages were before fifteen. The main reasons for early marriage practices are perceived social and economic benefits and little knowledge of the consequences of early marriage. The knowledge regarding the minimum legal marriage is low. Awareness has to be created in the community regarding the legal marital age and the possible devastating consequences of early marriage for the girl, family and the community as a whole.