Journal
HEALTH POLICY AND PLANNING
Volume 38, Issue 4, Pages 421-434Publisher
OXFORD UNIV PRESS
DOI: 10.1093/heapol/czad006
Keywords
Child marriage; early marriage; adolescent health; mental health; change-oriented Delphi
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Despite its inclusion in Sustainable Development Goal 5, child, early and forced marriages remain a global issue with harmful consequences for mental health. A change-oriented Delphi study was conducted to establish consensus on priorities for research and intervention related to mental health consequences of these marriages. Findings highlighted the need for psychosocial and social interventions, as well as advocacy in policy circles, to improve mental health outcomes for women and girls in existing marriages.
Despite its inclusion in Sustainable Development Goal 5 to end all harmful gendered practices by 2030, child, early and forced marriages continue to be a pervasive problem globally. While there is consistent evidence on the physical health consequences of child marriage, there is a lack of evidence and inquiry into the mental health consequence. We completed a change-oriented Delphi study to establish consensus on priority areas of research and intervention in relation to the mental health consequences of child, early and forced marriages. Invited experts (n = 11), survivors (n = 27) and professionals (n = 30) participated in our Delphi. Four rounds of data collection included: a blended in-person and online workshop with invited experts, an online mixed-methods questionnaire, focus groups in Zimbabwe with women who are survivors of child marriage and a repeat questionnaire sent to the first round of experts. Quantitative data were analysed using descriptive statistics and ranking methods, consistent with other Delphi studies. Qualitative data were analysed using thematic network analysis. Findings coalesced around three areas: perspectives on the relationship between mental health and child marriage, policy actions and treatment-driven solutions. Consensus was reached on 16 items across these areas which included the need to prioritize psychosocial and social interventions to improve mental health outcomes for women and girls in existing marriages. They also called for new approaches to advocacy to drive awareness of this issue in policy circles. Implications for future practice are discussed.
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