Social norms and barriers hindering the elimination of child, early, and forced marriage in Mozambique, Uganda, and Ethiopia and policy responses: a qualitative study

Main Article Content

Joseph Mumba Zulu
Thera Rasing
Pezo Mateo
George Sichone
Emilia Martins
Abebaw Getachew
Ogwang Martin
Lynn Chinene
Mwimba Chewe
Malizgani Paul Chavula
Adam Silumbwe
Moses Tetui

Abstract

Introduction: Child, early and forced marriage (CEFM) remains a problem in many low- and middle-income countries. This study aimed to investigate contextual social norms on CEFM and explore barriers to implementation of policies designed to address these norms in Mozambique, Uganda, and Ethiopia.


Methods: Qualitative data was collected from a total of 90 respondents. Forty-two (n=42) interviews were conducted with adolescents, parents, traditional leaders, government officials and civil society organizations. Four (n=4) focus group discussions (FGDs) were held with parents, adolescents, community members and community leaders, comprising a total of 48 participants. Data were analyzed using thematic analysis.


Results: The main social norms which contributed to CEFM in the three countries included the high social value attached to the motherhood status; the commodification of marriage; marriage as a rite of passage into adulthood, social construction of sexuality and the collective moral judgment about responsible parenthood. The norms were sustained by allowing those who abide by them to accumulate social and economic benefits such as stronger social ties within the community and improved social status. Although several policies and laws have been enacted to address these social norms, their impact has been limited. The main policy implementation barriers were the inadequate consideration of social norms that promote CEFM within the policy and legal framework, limited collaboration among key stakeholders, lack of comprehensive monitoring processes, and difficulties among community members to understand the policies due to low literacy levels and poor policy monitoring.


Conclusion: Enhancing the policy response to social norms that perpetuate CEFM will require strengthening collaboration between non-governmental organizations, government departments and community leaders in implementation and monitoring of the policies.

Article Details

How to Cite
1.
Mumba Zulu J, Rasing T, Mateo P, Sichone G, Martins E, Getachew A, Martin O, Chinene L, Chewe M, Paul Chavula M, Silumbwe A, Tetui M. Social norms and barriers hindering the elimination of child, early, and forced marriage in Mozambique, Uganda, and Ethiopia and policy responses: a qualitative study . J Community Syst Health [Internet]. 2025 Apr. 16 [cited 2025 May 14];2(1). Available from: https://journals.ub.umu.se/index.php/jcsh/article/view/1082
Section
Original research
Author Biographies

Joseph Mumba Zulu, Department of Health Promotion and Education, School of Public Health, University of Zambia, Lusaka, Zambia; Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia; Center for Community Health Systems and Implementation Research, Lusaka, Zambia

Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia

Thera Rasing, Participatory Research and Innovations Management, Lusaka, Zambia

Participatory Research and Innovations Management, Lusaka, Zambia  

Pezo Mateo, Participatory Research and Innovations Management, Lusaka, Zambia

Participatory Research and Innovations Management, Lusaka, Zambia  

George Sichone, Participatory Research and Innovations Management, Lusaka, Zambia

Participatory Research and Innovations Management, Lusaka, Zambia  

Emilia Martins, Department of Community Health, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique; Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique

Department of Community Health, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique

Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique.

Abebaw Getachew, Department of Animal Science, College of Agriculture and Environmental Science Debark University, Ethiopia

Department of Animal Science, College of Agriculture and Environmental Science Debark University, Ethiopia

Ogwang Martin, Plan International, 18+ Center of Excellence on Ending Child Marriage and Teenage Pregnancy – Central, Eastern and and Southern Africa

Plan International, 18+ Center of Excellence on Ending Child Marriage and Teenage Pregnancy – Central, Eastern and Southern Africa

Lynn Chinene, Plan International, 18+ Center of Excellence on Ending Child Marriage and Teenage Pregnancy – Central, Eastern and and Southern Africa

Plan International, 18+ Center of Excellence on Ending Child Marriage and Teenage Pregnancy – Central, Eastern and and Southern Africa

Mwimba Chewe, Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia

Department of Health Policy and Management, School of Public Health, University of Zambia, Lusaka, Zambia

Moses Tetui, School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada; School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada; Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden

School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada

School of Pharmacy, University of Waterloo, Waterloo, Ontario, Canada

References

Budu E, Adu C, Seidu A-A, Agbaglo E, Osei B, Ahinkorah BO. Child marriage and sexual autonomy among women in Sub-Saharan Africa: evidence from 31 demographic and health surveys. Int J Environ Res Public Health. 2021;18(7):3754.

Malé C, Wodon Q. Basic profile of child marriage in Mozambique. Washington (DC): World Bank Group; 2016.

Ministry of Health, Republic of Mozambique. National Demographic and Health Survey. Maputo: Ministry of Health; 2019.

Wodon Q, Nguyen MC, Tsimpo C. Economic impacts of child marriage in Ethiopia: synthesis report. Washington (DC): World Bank Group; 2018.

Jones N, Presler-Marshall E, Hicks J, Baird S. Constrained choices: exploring the complexities of adolescent girls’ voice and agency in child marriage decisions in Ethiopia. Prog Dev Stud. 2020;20(4):296–311.

Yakubu I, Salisu WJ. Determinants of adolescent pregnancy in sub-Saharan Africa: a systematic review. Reprod Health. 2018;15(1):1–11.

Horii H. Child marriage as a ‘solution’ to modern youth in Bali. Prog Dev Stud. 2020;20(4):282–95.

Neema S, Atuyambe L, Kagaayi J, Tumwesigye NM, Wanyenze RK. “Trading daughters for livestock”: an ethnographic study of facilitators of child marriage in Lira district, Northern Uganda. Afr J Reprod Health. 2021;25(3):83–93.

Issa R, Groot R, Mweemba M, van Dijk L, Meuwissen L. Yes I Do: Final report. Amsterdam: Rutgers International; 2019.

Rasing T. The bush burnt, the stones remain: female initiation rites in urban Zambia. Münster: LIT Verlag; 2002.

Kok MC, Namakhoma I, Broerse JEW, Dieleman M, Zulu JM. Being dragged into adulthood? Young people’s agency concerning sex, relationships and marriage in Malawi, Mozambique and Zambia. Cult Health Sex. 2022;24(6):767–81.

Schlecht J, Rowley E, Babirye J. Early relationships and marriage in conflict and post-conflict settings: vulnerability of youth in Uganda. Reprod Health Matters. 2013;21(41):234–42.

Greene ME, Stiefvater E. Social and gender norms and child marriage. Washington (DC): ALIGN; 2019.

Kohno A, Dalamba MN, Amegah AK, Kanja W, Machiyama K. Investigation of the key factors that influence the girls to enter into child marriage: a meta-synthesis of qualitative evidence. PLoS One. 2020;15(7):e0235959.

Pulerwitz J, Boyce C, Davis T, Lippman SA. Proposing a conceptual framework to address social norms that influence adolescent sexual and reproductive health. J Adolesc Health. 2019;64(4 Suppl):S7–S9.

Cislaghi B, Shakya H. Social norms and adolescents’ sexual health: an introduction for practitioners working in low and mid-income African countries. Afr J Reprod Health. 2018;22(1):38–46.

Svanemyr J. Adolescent pregnancy and social norms in Zambia. Cult Health Sex. 2020;22(6):615–29.

Bhargava A, Bhargava M. Tuberculosis deaths are predictable and preventable: comprehensive assessment and clinical care is the key. J Clin Tuberc Other Mycobact Dis. 2020;19:100155.

Creswell JW. Steps in conducting a scholarly mixed methods study. Lincoln (NE): University of Nebraska; 2013.

Chavula MP, Zulu JM, Simuyaba M, Daka A, Michelo C. Unlocking policy synergies, challenges and contradictions influencing implementation of the Comprehensive Sexuality Education Framework in Zambia: a policy analysis. Health Res Policy Syst. 2023;21(1):97.

Blystad A, Zulu JM, Kamanga M, et al. Vanilla bisquits and lobola bridewealth: parallel discourses on early pregnancy and schooling in rural Zambia. BMC Public Health. 2020;20:1–11.

Daka H. The effects of chinamwali initiation schools on girl child education: a case of selected public primary schools of Katete district, Zambia. 2020.

Rasing T. Female initiation rites as part of gendered Bemba religion and culture: transformations in women’s empowerment. Zambia Soc Sci J. 2021;7(2):5.

Rasing T. Female blood ties: ideas on menstruation and female initiation rites in the context of purity in Zambia. Stor Donne. 2021;17:61–83.

Rasing T. Passing on the rites of passage: girls' initiation rites in the context of an urban Roman Catholic community on the Zambian Copperbelt. 1995.

Kok MC, Zulu JM, Namakhoma I, et al. Drivers of child marriage in specific settings of Ethiopia, Indonesia, Kenya, Malawi, Mozambique and Zambia–findings from the Yes I Do! baseline study. BMC Public Health. 2023;23(1):794.

Bantebya GK, Muhanguzi FK, Watson C. Adolescent girls in the balance: changes and continuity in social norms and practices around marriage and education in Uganda. London: Overseas Development Institute; 2014.

Jones N, Presler-Marshall E, Tefera B, et al. Early marriage and education: the complex role of social norms in shaping Ethiopian adolescent girls’ lives. Country Rep Shaping Policy Dev. 2014:1–103.

Muyonga M, Ssemata AS, Kafuko A, et al. Socio-cultural drivers and barriers to addressing repeat teenage pregnancies and early child/forced marriages in Central and Eastern Uganda. Afr J Reprod Health. 2024;28(12):148–64.

Nalwadda G, Mirembe F, Byamugisha J, Faxelid E. Persistent high fertility in Uganda: young people recount obstacles and enabling factors to use of contraceptives. BMC Public Health. 2010;10:1–13.

Reading R. Teenage pregnancy and social disadvantage: systematic review integrating controlled trials and qualitative studies. Wiley Online Library. 2010.

Munakampe MN, Zulu JM, Michelo C. Contraception and abortion knowledge, attitudes and practices among adolescents from low and middle-income countries: a systematic review. BMC Health Serv Res. 2018;18(1):1–13.

Silumbwe A, Nkole T, Munakampe MN, et al. Community and health systems barriers and enablers to family planning and contraceptive services provision and use in Kabwe District, Zambia. BMC Health Serv Res. 2018;18(1):1–11.

Chavula MP, Zulu JM, Michelo C. Factors shaping responsiveness towards sexual gender-based violence during the COVID-19 pandemic in Africa: a systematic review. Cogent Public Health. 2023;10(1):2234600.

Musonda P, Michelo C, Zulu JM, et al. HIV, syphilis and sexual-risk behaviours’ prevalence among in-and out-of-school adolescent girls and young women in Zambia: a cross-sectional survey study. PLoS One. 2024;19(6):e0294545.

Triandafyllidou A. Contemporary Polish migration in Europe: complex patterns of movement and settlement. 2006.

Jewkes R, Vundule C, Maforah F, Jordaan E. Relationship dynamics and teenage pregnancy in South Africa. Soc Sci Med. 2001;52(5):733–44.

Chilambe K, Zulu JM, Chavula MP, et al. Experiences of teachers and community-based health workers in addressing adolescents’ sexual reproductive health and rights problems in rural health systems: a case of the RISE project in Zambia. BMC Public Health. 2023;23(1):335.

Ngoma-Hazemba A, Michelo C, Zulu JM, et al. Exploring the barriers, facilitators, and opportunities to enhance uptake of sexual and reproductive health, HIV and GBV services among adolescent girls and young women in Zambia: a qualitative study. BMC Public Health. 2024;24(1):2191.

Zuilkowski SS, Jukes MC, Dubeck MM. Zambia’s school re-entry policy for adolescent mothers: examining impacts beyond re-enrollment. Int J Educ Dev. 2019;64:1–7.

Haaland ME, Mæhle M, Pons-Vignon N, et al. When abortion becomes public: everyday politics of reproduction in rural Zambia. Soc Sci Med. 2020;265:113502.

Zulu JM, Michelo C, Hurtig A-K, et al. Community engagement for the Voluntary Medical Male Circumcision (VMMC) program: an analysis of key stakeholder roles to promote a sustainable program in Zambia. Gates Open Res. 2022;6.

Zulu JM, Michelo C, Munsaka E, et al. Why teach sexuality education in school? Teacher discretion in implementing comprehensive sexuality education in rural Zambia. Int J Equity Health. 2019;18(1):116.

Chavula MP, Zulu JM, Hurtig A-K. Factors influencing the integration of comprehensive sexuality education into educational systems in low- and middle-income countries: a systematic review. Reprod Health. 2022;19(1):196.

Chavula MP, Michelo C, Zulu JM, et al. Experiences of teachers and community health workers implementing sexuality and life skills education in youth clubs in Zambia. Glob Public Health. 2022;17(6):926–40.

Zulu JM, Munsaka E, Michelo C, et al. Exploring politics and contestation in the policy process: the case of Zambia’s contested community health strategy. Int J Health Policy Manag. 2022;11(1):24.

Chavula MP, Zulu JM, Hurtig A-K. Factors influencing the integration of comprehensive sexuality education into educational systems in low- and middle-income countries: a systematic review. Reprod Health. 2022;19(1):1–25.

Schneider H, Lehmann U, Sanders D, et al. The multiple lenses on the community health system: implications for policy, practice and research. Int J Health Policy Manag. 2021;11(1):9.

Byskov J, Maluka S, Marchal B, et al. A systems perspective on the importance of global health strategy developments for accomplishing today’s Sustainable Development Goals. Health Policy Plan. 2019;34(9):635–45.