Between 2007 and 2017, 15,000 cases of child marriages were reported in Malaysia, and as of 2018, 1,500 children marry annually.
These numbers may only be the tip of the iceberg as many child marriages are unregistered and unrecorded due to lack of updated statistical data and an existing legal framework.
Unicef defines child marriage as “any formal marriage or informal union between a child under 18 and an adult, or another child”, and this globally affects 12 million young women every year.
In our local setting, the definition of child marriage differs due to the country’s dual-legal system.
For Muslims, the minimum legal marriage age is 16 for the females and 18 for the males, whereas for non-Muslims, it is 18 for both genders.
However, girls below the legal marriage age are allowed to get married with the approval of a Shariah court for Muslims and with the approval of the state’s chief minister for non-Muslims.
In March 2022, the Women, Family and Community Development Ministry stated that it would not legislate against child marriages but would however curb and address underage marriages through the implementation of the National Strategic Plan in Handling the Causes of Child Marriage (2020-2025).
This National Plan has identified six risk factors for child marriage: poverty, social acceptance of child marriage, lack of access to education, legislation that allows marriage under the age of 18, lack of legal status and rights for undocumented children, and lack of access to sexual and reproductive services.
Local data is certainly eye-opening, knowing the number of children being robbed of their right to dream and achieve their fullest potential.
Child marriages deprive them of their childhood, adolescence, as well as mental and physical well-being.
And while it is in the interest of the child to curb this practice, there are various factors that make child marriages a difficult issue to tackle.
Lack of knowledge
Due to religious and ethnic factors in a multicultural country such as Malaysia, there is a taboo surrounding discussing sexual issues with adolescents.
Thus far, sex education among adolescents has not been effectively implemented because of the belief that sex education encourages sexual activity.
Studies have reported sexual debut among Malaysian youth at 15 years old, with an alarming increase in sex-related risky behaviour in recent years.
Lack of knowledge and poor awareness of sexual and reproductive health will have serious implications on adolescent health.
In a study done in Sarawak, most child marriages in Malaysia are preceded by premarital pregnancy.
Another study from Kelantan reported immaturity in decision-making, poverty, and religious and cultural norms as the grounds for child marriage.
According to the study, premarital sex and/or pregnancy out of wedlock is considered as a sinful act and the child or youth is stigmatised and stereotyped as non-religious.
Child marriage is often a cover up for unexpected or unwanted pregnancies, and to get away from punishment and justice due to statutory rape.
Also, a legitimate marriage allows the children to have access to family inheritance and to be guardian for their siblings’ marriage after the father’s death, which would be forbidden otherwise as an illegitimate heir.
In essence, premarital sex is the unspoken predominant reason for child marriages, and the marriage is needed to uphold the religious and cultural values of society.
Legal concerns
Adolescent pregnancy can be a consequence of rape, consensual intimate relationships, or statutory rape (defined by law as sex with a girl under the age of 16, regardless of consent). The statutory rape law is intended to protect vulnerable teenagers from being taken advantage of at their tender age.
The 2015 statistics revealed that more than 50% of cases engaged in sexual intercourse by mutual consent, which is sexual misconduct and a crime according to Shariah law, and 70% of the males responsible were either boyfriends or acquaintances.
If the girl’s parents know about the pregnancy and the male party does not want to take responsibility, this turns into an alleged rape offence. To escape prosecution, the parents negotiate marriage as a quick fix.
Health concerns
Child marriages involving adolescent girls significantly impact their physical, psychological and social well-being.
It also has profound short and long-term consequences on health and their livelihood.
In Malaysia, more than 10,000 adolescent girls (10-19 years) give birth every year.
Anatomical and physiological immaturity poses risks for adolescent girls during pregnancy and childbirth. The female pelvis is not fully developed and can result in childbirth complications and entails Caesarean delivery.
Childbirth can also be too soon, too close, or too many, which further escalate the health risks for the young girl.
Pregnant teens are more prone to complications like anaemia, preeclampsia (hypertension in pregnancy), eclampsia (fits in pregnancy), premature birth, stillbirth, difficult labour, puerperal endometritis (infection of uterus after childbirth), systemic infection, and disability like obstetric fistula (leakage of urine from the vagina) than women between 20-24 years.
More alarmingly in developing countries, pregnancy and childbirth complications are the leading causes of death in girls between 10-19 years, accounting for 99% of maternal deaths of women aged 15-49, which are mostly preventable.
Girls under 18 are also 35-55% more likely to experience preterm delivery or low birthweight than those who are older than 19.
Infant deaths and under-five deaths are also reported to be higher by 60% and 28% respectively in mothers under 18 and are attributable to the mother’s poor nutritional status, physical and emotional immaturity, lack of knowledge and awareness of social and reproductive services, and high risk of infectious diseases.
Psychological concerns
Girls married before 18, deprived of a wholesome transition to adolescence, are thrown into adulthood, clueless and without adequate life skills.
They suffer from significant mental health issues and severe mental distress.
The disruption to their childhood isolates them from their family and peers.
Depression is the most common diagnosis reported among this group as they face more stressful life events; unable to cope, they are at higher risk for substance abuse-related disorders.
Suicidal thoughts and attempts were also identified among girls forced into early marriages, used as a form of punishment for their families due to the stigma attached to suicide-related deaths.
Consequently, these girls are at a higher risk of post-traumatic stress disorder, adjustment disorder and anxiety.
Intimate partner violence
Lacking confidence and the ability to maintain a healthy married relationship, girls forced into child marriages are at risk of being controlled by their husband and in-laws.
They lose their individuality as decision-making power about their lives shifts to their spouses and in-laws.
They experience intimate partner violence at the hands of their husbands and their in-laws, drop out of school and usually lack employment. A girl forced into a child marriage is exposed to nearly twice the risk of domestic violence compared to girls married after 18.
The lack of education, empowerment and awareness is an impediment to the girls’ ability to advocate for themselves and hence, they remain trapped in their husband’s homes and unfortunately pass this vicious cycle of poverty, violence and inequality to their own daughters.
Moving forward
To be a developed nation, Malaysia must fill in the gaps in the current policy for child marriage and adopt a team-based holistic approach to reinforce political, economic and social measures effectively to curb this hazardous practice.
Evidence has shown that governmental strategies focused on the risk factors, can put an end to the child marriage issue.
It is important to target not only individuals, but also families, communities and society as a whole to increase social awareness of child marriages.
This approach has proven to be effective in preventing child marriages in some countries and will benefit girls in giving hope and greater opportunities for the future.
We believe it is important to set the legal minimum age at marriage for girls and boys at 18, irrespective of the ethnic or religious background, to respect children’s rights as per the United Nations Convention on the Rights of the Child.
Due to the multiracial composition of our society, engagement sessions need to include religious experts, paediatricians and child psychiatrists to ensure that all opinions and viewpoints are accounted for to move towards a united stand of banning child marriages.
However, this alone may not combat the harmful practice of child marriage unless the change is implemented concurrently at macro, meta and grassroots level – this is challenging.
Our priorities should be pregnancy prevention, sex education and universal access to sexual and reproductive health (SRH) services, especially emergency contraception through addressing the legal and cultural barriers.
Implementing effective SRH counselling at schools and in communities with a non-judgemental approach is crucial since premarital conception is the key risk factor for marriage under 18.
In a nutshell, it is the collective effort of all the stakeholders (policy makers, programme managers, parents, peers, partners and providers of healthcare and school education) to eliminate child marriages by 2030.
We need to provide a safe and supportive environment for our children to reach their acme.
Dr Anitha Ponnupillai is a senior lecturer of obstetrics and gynaecology, and Dr Punithavathy Shanmuganathan is a senior lecturer of family medicine at Taylor’s University School of Medicine. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
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