The continuous occurrence of child marriages in Zimbabwe has left the girl child with no other choice but to succumb to living a life of pain and misery. Extreme poverty, lack of knowledge of both sexual reproductive health and educational services as well as backward cultural and religious beliefs being experienced in the country’s rural communities are pushing girls to the edge. Girls as young as 12 years are getting married in search of better lives.

Although some of the girls might be considered fortunate to be married off to mature and understanding men, others usually find themselves in the wrong hands. Despite living in good conditions the young girls’ lives and health are risked the moment they become pregnant.

Adolescent pregnancies are a global problem occurring in high, middle, and low-income countries. However, they are more likely to occur in a country’s marginalized communities, commonly driven by poverty and lack of education and employment opportunities which push young girls into early marriages in search of a better living or as a way of escaping from the harsh reality they encounter. This is the case in Zimbabwe’s Mashonaland East province’s remote areas.  For instance, in Makaha motherhood is often valued and marriage and childbearing may be the best of the limited options available for the young helpless girls.

Statistics on maternal mortality have shown how societies have failed young women, as many die each year from complications of pregnancy and childbirth. According to the fifth annual State of the World’s Mothers report, published by the international charity Save the Children, 13 million births (a tenth of all births worldwide) each year are to women aged under 20, and more than 90% of these births are in developing countries. Obstructed labour was found to be common in teenage girls, resulting in an increased risk of infant death and of maternal death or disability.

Early pregnancies among adolescents have major health consequences for adolescent mothers and their babies. Pregnancy and childbirth complications are the leading cause of death among girls under the age of 18, with low- and middle-income countries accounting for 99% of global maternal deaths of women aged 15–49 years. Adolescent mothers aged 10–19 years face higher risks of eclampsia, puerperal endometritis and systemic infections than women aged 20–24 years. While complications during childbirth account for almost 25 per cent of newborn deaths, preterm delivery and low birth weight being some of the other reasons for deaths among infants born to adolescent mothers.

“Immature reproductive tract compromise the health of the pregnant adolescents. Early childbirths alienate girls from experiencing a normal childhood and sometimes they end up undergoing unsafe abortions. These abortions have overwhelming consequences such as cervical tearing, perforated uterus, haemorrhage, chronic pelvic infection, infertility, and death,” said a nurse from Mudzi’s local clinics during an interview.

Listen here

As one of the cultural factors that work against adolescent women child marriage weakens the girl child. Girls married under the age of 18 report being less able than older married women to discuss contraceptive use with their husbands. Thus they end up bearing children at an early age. For instance, in Makaha – one of Mudzi’s rural communities, where child marriage is prevalent, half of the population of all teenage girls give birth before turning 18 years.

Meanwhile, social consequences for unmarried pregnant adolescents may include stigma, rejection or violence by partners, parents and peers. Also, adolescent pregnancy and childbearing often lead girls to drop out of school, although the government allowed pregnant girls to be allowed to go to school, this may jeopardize the girl child’s future education and employment opportunities as it can be difficult for young pregnant mothers to participate or concentrate with school while pregnant.

During the early part of the Millennium Development Goals era, prevention of adolescent pregnancy and related mortality and morbidity and prevention of HIV and HIV related mortality in adolescents and young people were not given sufficient attention due to competing priorities. However, the World Health Organisation (WHO) worked with partners to advocate for attention to adolescents, to build the evidence and epidemiologic base for activities such as “WHO’s Guidelines for preventing early pregnancy and poor reproductive outcomes in adolescents in developing countries”, to develop and test programme support tools, to build capacity, and to pilot initiatives in the small but growing number of countries that recognised the need to address adolescent health.

Although adolescents have moved to the centre of the global health and development agenda as a result of the transitioning of the world to the Sustainable Development Goals Era, gender inequities continue to greatly risk girls lives than boys and are affecting many aspects of young women’s lives including reduced opportunities for education, employment, and control over their own reproductive health.

Hence, the reproductive health of adolescent women depends on biological, social, cultural, and economic factors. And more educational programmes that provide education, family planning services, and pre-and postnatal care must be conducted to reduce morbidity and mortality among young women.

Listen here

WHO continues its work on advocacy, evidence generation, tool development and capacity building, the focus has shifted to strengthening country-level action. It is working closely with partners within and outside the United Nations system to contribute to the global effort to prevent children from becoming wives and mothers.

The World Health Organisation works to strengthen the evidence base for action and to support the application of the evidence through well-designed and well-executed national and sub-national programmes. For example, it’s a partnership with the UNICEF, UNFPA and UN Women on a global programme to accelerate action to end child marriage and its collaboration with Family Planning 2020 ─ a global partnership in which it aimed to enable 120 million more women and girls to have access to contraceptives by 2020.

Nongovernmental organizations have been at forefront of efforts to prevent adolescent pregnancy in many countries through bold and innovative projects. There is now a small but growing number of successful government-led national programmes, for example, in Chile, Ethiopia and the United Kingdom. These countries show what can be achieved with the application of good science combined with strong leadership, management, and perseverance. They challenge and inspire other countries to do what is doable and what urgently needs to be done.