Systematic scoping review of interventions to prevent and respond to child marriage across Africa: progress, gaps and priorities

Abstract

ObjectivesDespite the high prevalence of child marriage in Africa, little is known about the current state of the evidence on interventions to prevent and respond to child marriage in the region. The objectives of this systematic scoping review are to describe the breadth of existing evidence on child marriage prevention and response interventions, analyze where these interventions have been implemented, and identify research gaps and priorities for moving forward.MethodsThe inclusion criteria incorporated publications that: (1) focused on Africa, (2) described interventions to address child marriage, (3) were published 2000–2021 and (4) were published as peer-reviewed articles or reports in English. We searched seven databases (PubMed, PsychINFO, Embase, Cinahl Plus, Popline, Web of Science and Cochrane Library), hand-searched the websites of 15 organisations and used Google Scholar to identify research published in 2021. Two authors independently screened titles and abstracts followed by full-text reviews and data extraction for included studies.ResultsOur analysis of the 132 intervention studies identified highlights important disparities by intervention type, sub-region, and intervention activities, focus populations and impact. The greatest number of intervention studies focused on Eastern Africa. Health and empowerment approaches were most represented, followed by education and laws and policies. Norms or livelihoods approaches were least represented.ConclusionOur review finds few high-quality impact evaluations, most of which assess cash transfer programmes. There is a need to strengthen evaluative evidence on other intervention approaches including empowerment and norms change interventions, in particular. Given the linguistic and cultural diversity of the continent, more country-specific studies and research published in languages other than English are needed, particularly in high-prevalence Middle African countries.

Drivers of child marriage in Eastern and Western Provinces in Zambia and effective preventive interventions: Findings from a rapid document review and three stakeholder meetings

“…In Western province, these dynamics lead more often to pregnant girls being kept in the family, while pregnant girls in Eastern province are more likely to be married off. While the issue of shame is hardly directly addressed, we found that child marriage programming over the years has shifted towards focusing on girls' development, preferences, and decisions, moving away from viewing them solely as victims of parental and spousal pressures (45).…”

“…Among 132 African child marriage interventions reviewed, 38 publications focusing on educational interventions, particularly targeting unmarried girls, emphasized the importance of increasing enrolment, retention, completion, and transition rates (i.e. from primary to secondary school) for girls' schooling to delay marriage (45). Looking at interventions addressing education more broadly, the Zambian School Re-Entry Policy from 1997 for adolescent mothers to return to school is crucial in preventing child marriage.…”

“…A review by Greene et al (45) showed that interventions to support the health of married and unmarried girls mainly focus on reproductive health services, but no information on the effectiveness of such interventions to prevent child marriage exists.…”

“…Yet, we agree with Cornwall (57) that this shift often results in an overemphasis on individual self-assertion rather than addressing the structural basis and root causes of gender inequalities. The lack of conceptual clarity and measurement of girls' empowerment and little evidence on the required length of such interventions further make it challenging to evaluate and compare intervention outcomes, as some programmes emphasize the relational nature of empowerment and other assets and opportunity structures (45). Despite empowerment efforts, girls still face structural inequalities that marginalize them, leaving them at greater risk, especially when interventions end and NGO staff depart, resulting in a state of "informed powerlessness" (58).…”

“…To focus more on gender and social norms change, programmes need to involve boys and men in programmes and address gender dynamics in relationships as well as within marriage. New technologies may have the potential to play a role as an affordable and user-friendly platform for sharing information in empowerment-based child marriage interventions (45), which has been insu ciently documented this far.…”