6th UK Implementation Science Research Conference
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PRESENter
Kelechi Udoh
presenter biography
Kelechi Udoh is currently a Doctor of Health student, at the University of Bath, UK, where he is studying child sexual abuse assessment and treatment in Nigeria. He also works in international development research across sub-Saharan Africa and South Asia, on a range of topics including public health (sexual and reproductive health; humanitarian health; health systems strengthening; infectious diseases; nutrition; water, sanitation, and hygiene; reproductive, maternal, newborn and child health); child protection; youth development; livelihoods; conflict and peace building; resilience; and education.
background
Elimination of Female Child Marriage (FCM) remains a global health priority because FCM is associated with adverse health outcomes like teenage pregnancy and corresponding higher risks of puerperal endometritis, eclampsia, and systemic infections [1]. In 2016, the National Strategy to End Child Marriage in Nigeria (NSECMN) was introduced while in 2018, the National Plan of Action to End Child Marriage (NPAECM) was launched in Bangladesh, to amongst other priorities, address gender norms which evidence suggests remains the most potent and important factor underpinning FCM in both countries. Gender norms impact FCM by influencing whether (and to what extent) societies ascribe value to female children based on their ability to reproduce and provide care, compared to accomplishment of other life goals [2,3,4]. Despite these efforts, by 2021, the FCM rates in Nigeria and Bangladesh remained persistently high at 44% and 66%, respectively, which provided impetus for an analysis which would inform future endeavors to address the problem, in both countries [5,6].
MEthod
Guided by the Consolidated Framework for Implementation Research (CFIR), this study analysed the contextual factors impacting NSECMN and NPAECM’s efforts at addressing gender norms underpinning FCM, using a document analysis method [7].
results
Nigeria and Bangladesh’s spending on social programs (including for the implementation of both policies) was low during the reference period at approximately 2% of GDP, between 2016 and 2019, in Nigeria, and at approximately 2.5% of GDP, between 2018 and 2019, in Bangladesh [8,9]. As such, financial and human resource support from international donors and non-governmental organisations ensured implementation feasibility [10,11]. While in both countries, the policies were backed by legislation, weak implementation remained a challenge [12,13]. This challenge was exacerbated by Nigeria and Bangladesh’s multilateral legal systems which prevented the government from restricting FCM conducted under Islamic or customary laws [12,13]. Furthermore, in both countries, poverty fostered the norm of dowry payment, which promoted FCM [14,15].
Conclusion
Both countries need to increase national spending on FCM policy implementation, to reduce overreliance on international actors. They also need to introduce legislation that mandates adherence to civil law and adopt a holistic approach that ensures FCM policies are implemented in coordination with poverty alleviation programs.