The Effect of Early Marriage Timing on Women's and Children's Health in Sub-Saharan Africa and Southwest Asia.

BACKGROUND Age of marriage is a barrier to mother's health care around pregnancy and children health outcomes. OBJECTIVE We provide evidence on the health benefits of postponing early marriage among young wives (from age 10-14 to age 15-17) on women's health care and children's health for sub-Saharan Africa (SSA) and Southwest Asia (SWA). METHODS We use data for 39 countries from the Demographic and Health Surveys to estimate the effects of postponing early marriage for women's health care and children's health outcomes and immunization using matching techniques. We also assess whether women's health empowerment and health constraints are additional barriers. FINDINGS We found that in SSA, delaying the age of marriage from age 10-14 to age 15-17 and from age 15-17 to age 18 or older leads to an increase in maternal neotetanus vaccinations of 2.4% and 3.2%, respectively; gains in the likelihood of postnatal checks are larger for delayed marriage among the youngest wives (aged 10-14). In SWA, the number of antenatal visits increases by 34% and the likelihood of having a skilled birth attendant goes up to 4.1% if young wives postpone marriage. In SSA, the probability of children receiving basic vaccinations is twice as large and their neonatal mortality reduction is nearly double if their mothers married between ages 15-17 instead of at ages 10-14. The extent of these benefits is also shaped by supply constraints and cultural factors. For instance, we found that weak bargaining power on health decisions for young wives leads to 11% fewer antenatal visits (SWA) and 13% less chance of attending postnatal checks (SSA). CONCLUSIONS Delaying age of marriage among young wives can lead to considerable gains in health care utilization and children health in SSA and SWA if supported by policies that lessen supply constraints and raise women's health empowerment.