The effect of early marriage timing on women's and children's health in Sub-Saharan Africa and South West 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 Saharan Africa (SSA) and South West Asia (SWA). Methods. We use data for 39 countries (Demographic and Health Surveys) to estimate the effects of postponing early marriage for women’s health care and children’s health outcomes and immunisation using matching techniques. We also assess if 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 above leads to an increase of maternal neotetanus vaccinations of 2.4% and 3.2% respectively, while gains on the likelihood of postnatal checks is larger for delaying marriage among the youngest wives (age 10- 14). In SWA, the number of antenatal visits increases by 34%, while 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 had married between age 15-17 instead of at age 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% (SWA) fewer antenatal visits and 13% less chances (SSA) of attending postnatal checks. Conclusion. Delaying age of marriage among young wives can lead to considerable gains in health care utilisation and children health in SSA and SWA if supported by policies that lessen supply constraints and raise women's health empowerment