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Effect of Child Marriage Prevention Education on Knowledge of the Health Consequences of Child Marriage among Adolescent Girls in Nigeria

Abstract

Child marriage remains an important public health, social, educational, and human rights concern in Nigeria, particularly among adolescent girls who may be exposed to early marriage because of poverty, cultural and social norms, gender inequality, family pressure, insecurity, limited educational opportunities, and other socioeconomic factors. Marriage during childhood or adolescence may have significant health consequences, including early pregnancy, pregnancy and childbirth complications, increased risk of maternal and newborn health problems, sexually transmitted infections, poor mental health, nutritional challenges, and reduced access to reproductive and other essential health services. It may also interrupt girls' education and limit their future social and economic opportunities. Limited knowledge of these health consequences may reduce adolescent girls' ability to understand the potential risks associated with child marriage and make informed decisions about their health and future. Child marriage prevention education provides an opportunity to improve girls' understanding of the health consequences of early marriage, strengthen awareness of their health and reproductive rights, and promote access to appropriate support services. Against this background, this study investigates the effect of child marriage prevention education on knowledge of the health consequences of child marriage among adolescent girls in Nigeria. The study will be anchored on the Health Belief Model, Social Ecological Model, and Social Cognitive Theory. The Health Belief Model explains how adolescent girls' perceptions of susceptibility to health consequences associated with child marriage, perceived severity, perceived benefits of delaying marriage, perceived barriers, self-efficacy, and cues to action may influence their knowledge and health-related decisions. The Social Ecological Model emphasizes the influence of individual, family, peer, school, community, cultural, economic, and broader societal factors on girls' knowledge and attitudes toward child marriage. Social Cognitive Theory emphasizes observational learning, social modelling, self-efficacy, reinforcement, peer influence, and environmental factors in shaping adolescent girls' understanding and responses to child marriage. Collectively, these theoretical perspectives provide a suitable framework for explaining how child marriage prevention education may influence knowledge of the health consequences of child marriage among adolescent girls in Nigeria. The study will adopt a quantitative quasi-experimental or analytical cross-sectional research design. The study population will comprise adolescent girls aged 10–19 years enrolled in selected secondary schools across Nigeria. A multistage sampling technique will be used to select geopolitical zones, states, local government areas, communities, schools, classes, and eligible adolescent girls. Child marriage prevention education will be assessed using indicators such as exposure to educational sessions, frequency and duration of education, information on the definition and consequences of child marriage, early pregnancy, pregnancy-related complications, childbirth risks, maternal and newborn health consequences, sexually transmitted infections, mental health consequences, nutritional risks, reproductive-health challenges, school interruption, gender inequality, reproductive rights, available adolescent-friendly health services, protection mechanisms, and sources of support. Knowledge of the health consequences of child marriage will be assessed using indicators such as recognition of risks associated with early pregnancy, awareness of pregnancy and childbirth complications, knowledge of maternal and newborn health risks, understanding of sexually transmitted infection risks, awareness of psychological and mental health consequences, recognition of nutritional and reproductive-health challenges, understanding of the relationship between child marriage and access to healthcare, and ability to distinguish evidence-based information from myths and misconceptions. Data will be collected using structured questionnaires, standardized knowledge assessment tools, age-appropriate scenario-based questions, school health education records where available, and pre-test and post-test assessments where a quasi-experimental intervention is adopted. Descriptive statistics will be used to summarize participants' demographic and educational characteristics, exposure to child marriage information, sources of information, and knowledge levels. Inferential statistical techniques, including chi-square tests, paired and independent t-tests, correlation analysis, and logistic or multiple regression analysis where appropriate, will be used to determine the effect of child marriage prevention education on knowledge of the health consequences of child marriage. Where a quasi-experimental design is adopted, knowledge scores before and after the educational intervention may be compared with those of a comparison group to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that child marriage prevention education has a significant positive effect on knowledge of the health consequences of child marriage among adolescent girls in Nigeria. Adolescent girls exposed to structured, age-appropriate, evidence-based, culturally sensitive, and participatory child marriage prevention education are expected to demonstrate greater knowledge of the health risks associated with early marriage than girls without comparable exposure. Education may improve understanding of early pregnancy, pregnancy and childbirth complications, maternal and newborn health risks, sexually transmitted infections, mental health consequences, nutritional challenges, and reduced access to healthcare. It may also help girls understand the importance of completing their education, delaying marriage until adulthood, accessing adolescent-friendly health services, and seeking support from trusted adults and appropriate institutions when faced with pressure to marry early. However, poverty, family pressure, cultural and religious norms, gender inequality, peer influence, insecurity, limited educational opportunities, stigma, and inadequate access to adolescent-friendly health and protection services may reduce the effectiveness of education alone. The study therefore expects accessible, age-appropriate, culturally sensitive, sustained, and community-supported child marriage prevention education to contribute significantly to improved knowledge of the health consequences of child marriage among adolescent girls in Nigeria. The study is expected to contribute to the literature on child marriage, adolescent health, reproductive health, maternal and child health, sexual and reproductive health education, health literacy, girls' education, gender inequality, harmful social practices, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Education, National Primary Health Care Development Agency, state ministries of health and education, secondary schools, healthcare professionals, community health workers, women's and children's health organizations, development partners, child-protection organizations, and policymakers regarding strategies for strengthening child marriage prevention and adolescent health education. The study will also provide evidence-based recommendations for integrating child marriage prevention education into school health programmes, strengthening comprehensive adolescent reproductive-health education, improving girls' access to education and adolescent-friendly health services, engaging parents and communities in prevention efforts, addressing harmful social and cultural misconceptions, strengthening protection and referral systems, and developing sustainable interventions that promote informed decision-making and protect adolescent girls from the health consequences of child marriage across Nigeria.

Keywords: Child marriage prevention education, knowledge of health consequences, child marriage, adolescent girls, adolescent health, reproductive health, maternal health, child health, girls' education, health education, Nigeria, public health.