About DLHS
The District Level Household & Facility Survey is one of the largest ever demography & health survey carried out in India, with a sample a size of about seven lakh households covering all the districts of the country. The ministry of Health & Family Welfare (MOHFW), Govt.of India, initiated DLHS in 1997 to provide district level estimates on health indicators to assists policy makers & program administrator in decentralized planning, monitoring & evaluation.
The DLHS-3 which is the third in the series proceeded by DLHS-1 in 1998-99 & DLHS-2 IN 2002-04 is designed to provide estimates on maternal & child health, family planning & other reproductive health services. For the first time, a population linked facility survey has been conducted in DLHS-3.It covers then all the District Hospitals, Community Health Centre, Primary Health Centers & all Sub Centre. Field work in Madhya Pradesh was conducted during Dec 2007 to May 2008, gathering information from 51,419 households.
Child Marriage Restraint Act, 1929
To eradicate the evil of child marriage, the Child Marriage Restraint Act1 was passed in 1929. The object is to eliminate the special evil which had the potentialities of dangers to the life and health of a female child, who could not withstand the stress and strains of married life and to avoid early deaths of such minor mothers.
It extends to the whole of India except the State of Jammu and Kashmir and it applies also to all citizens of India within and beyond India.
- Child means a person who, if a male, is under twenty one years of age, and if a female, is under eighteen years of age
- Child Marriage means a marriage to which either the contracting parties is a child;
- Minor means a person of either sex who is under eighteen years of age.
Health Problems Associated with Child Marriage
Young brides face the risk of sexual and reproductive ill health because of their exposure to early sexual activity and pregnancy. Risks associated with young pregnancy and childbearing include an increased risk of premature labour, complications during delivery, low birth-weight, and a higher chance that the newborn will not survive. Infants of mothers aged younger than 18 years have a 60 per cent greater chance of dying in the first year of life than those of mothers aged 19 years or older. Babies are born premature or underweight or young mothers simply lack parenting skills and decision-making powers.
Secondly, young girls face the risk of infection with sexually transmitted diseases including HIV. An analysis of the HIV epidemic shows that “the prevalence of HIV infection is highest in women aged 15–24.
Scenario of Girl Child Marriage in Madhya Pradesh
Child marriages continue to be a fairly widespread social evil in Madhya Pradesh. In 2007-08 the DLHS-3 recorded that 40.5% of boys are married below the age of 21 years and 29.2% of girls aged below 18 were married. This showed that child marriage is far more prevalent in the state. The percentage of girl child marriage is much higher in rural areas (34.3%) than in urban areas (13.2%) and exceeded more than 40% in 14 districts in the states. The percentage of women aged 20-24, married by the time they are 18, stood at 53.8% in the state & the share of rural areas is 58.5% followed by 33.5% in urban areas.
The census of India 2001 pointed out 34.1% of women in Madhya Pradesh got married in the aged 15-19 years2. The percentage share of ever married women aged between 15-19 years is more than 50% in the districts of Rajgarh, Shajapur, Sheopur & Tikamgarh. In spite of comparative decline of child marriages after 2001, the increasing trend of child marriage percentage is visible in different districts reveals the DLHS-3.
The DLHS-3 findings further revealed that more than 10% of women aged 15-19 were already mothers or pregnant in 40 districts of Madhya Pradesh at the time of the survey.
About 13 districts in Madhya Pradesh have an overall percentage of child marriage above 35% before completing 18 years of age. This includes tribal inhabited district of Jhabua (36.5%) & Barwani (57.5%).
It was also found that more than 50% of rural girls are married before the legal minimum age of 18 in Barwani district with 64.2% married before 18 followed by Rajgarh ( 63.5%), Shajapur( 60.2%), Sheopur (57.8%), Neemach (52.1%) & Indore (52.1%).
Percentage of births to women during age 15-19 out of total births is more than 20% in Dhar, Shajapur, Narsinhapur & Barwani district of Madhya Pradesh. The situation is more critical in rural areas where all the districts except Bhopal & Balaghat more than 10% birth out of the total birth to women occurs in the age of 15-19 years age.
High risk/complication is associated with the teen age pregnancy. Out of the total deliveries in the state, 6.9%3 of deliveries are having high risk/complication. DLHS-3 unearths the grave situation of the Health institution with shortfall of health infrastructure & manpower to deal with such high risk pregnancies & child birth.
Early marriage is often linked to low levels of schooling for girls. NFHS-3 figures show that 71.6% of Indian women currently aged 20-24 years, who had been married before the age of eighteen years, did not have any education at all.DLHS-3 also reveals that child marriage has direct bearing on literacy & vice versa. The districts with more than 40% child marriage has 60% female literacy. Barwani with highest percentage of child marriage has only 31.8% of female literacy. Also the prevalent mass illiteracy is also the cause of high percentage of child marriage. For example Jhabua, Barwani & Dhar with low literacy rate as having only 31.5%, 37.5% & 47.1% literacy has high percentage of girl child marriage & high Percentage of births to women during age 15-19 out of total births.
It has been said that educated women are more likely to have a say in decision-making regarding the size of their families and the spacing of their children. They are also likely to be more informed and knowledgeable about contraception and the health care needs of their children.DLHS-3 data for all the districts of Madhya Pradesh show that greater than 30 percent of women age 20-24 reported birth of order 2 & above. In Barwani district more then 80% percent of women age 20-24 reported birth of order 2 & above. This indicates the high fertility rate in Madhya Pradesh.
Due to pervasive child marriage & high risk allied with early child bearing often results in maternal & child mortality. The IMR of the state is 72/1000 live birth against the national average of 57/10004 live birth, & Maternal Mortality Rate (MMR) of 3795 per one lakh live births, which is again far behind the national average.
Seema Jain
1Published in the Gazette of India, 1927 Pt. V, p. 28.
2Human Development Report 2007.
3Human Development Report 2007.
4SRS 2007 released in Oct 2008
5National Family Health Survey (NFHS III), 2005 – 06, India: Volume I, International Institute for Population Sciences, Mumbai, September 2007.
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