“He is suitable for her, of course he is our relative”: a qualitative exploration of the drivers and implications of child marriage in Gezira State, Sudan

Dean, Laura ORCID: https://orcid.org/0000-0002-4910-9707, Obasi, Angela ORCID: https://orcid.org/0000-0001-6801-8889, El Sony, Asma, Fadul, Selma, El Hassan, Hanaa, Thomson, Rachael and Tolhurst, Rachel ORCID: https://orcid.org/0000-0002-3005-6641 (2019) '“He is suitable for her, of course he is our relative”: a qualitative exploration of the drivers and implications of child marriage in Gezira State, Sudan'. BMJ Global Health, Vol 4, Issue 3, e001264.

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Abstract

Introduction Child marriage is a fundamental development challenge for women and girls, with significant negative health and social outcomes. Sudan has a high rate of child marriage, with 34% of women aged 20–24 married before their 18th birthday. Since limited preventive interventions exist, we aimed to inform the evidence base to strengthen strategic action, using mixed qualitative methods to enhance study credibility. This study is the first to conduct a rigorous qualitative examination of the drivers of child marriage from the perspective of key stakeholders involved in marriage decision making within Sudan, and makes a significant contribution towards global knowledge by developing an evidence-based conceptual framework.
Methods Initially, we completed 14 focus group discussions separated by gender with mothers, fathers, and girls married as adolescents, and 23 key informant interviews. We then used a critical incident case study approach to explore 11 ‘cases’ of child marriage (46 interviews).
Results Findings indicate that gendered social norms and values, underpinned by religious beliefs and educational accessibility, interconnect to shape marriage decisions. In this context, many child marriages are triggered by an intrakinship proposal and further enabled by the relative lack of autonomy and influence of girls and women in marriage decision-making processes.
Discussion Interconnected drivers demand context-specific holistic and multisectoral approaches, which should include simultaneous strategies to expand access to education, health services and livelihood opportunities, and evoke legal change, and participatory social and attitudinal processes that include the engagement of religious leaders and men.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.

Item Type:	Article
Subjects:	WA Public Health > Health Problems of Special Population Groups > WA 309 Women's health WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries WS Pediatrics > By Age Groups > WS 460 Adolescence (General)
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI):	https://doi.org/10.1136/bmjgh-2018-001264
Depositing User:	Stacy Murtagh
Date Deposited:	10 Jun 2019 12:02
Last Modified:	08 Sep 2020 10:07
URI:	https://archive.lstmed.ac.uk/id/eprint/10980

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