Every year, an estimated 21 million girls aged 15–19 years in low- and middle-income countries become pregnant. Adolescent pregnancy leads to higher risks of maternal and infant mortality, a greater chance of mental health problems, and constraints for educational and economic prospects, which contributes to cycles of poverty and inequality that can span across generations
In many parts of the world, adolescents lack access to the information and resources necessary to make informed decisions about their sexual and reproductive health (SRH). This leaves them vulnerable to unintended pregnancies; child marriage further fuels the risk.
The World Health Organization (WHO) recently released an updated guideline for preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income countries, providing evidence-based normative guidance in two key areas: preventing child marriage and improving adolescents’ access to contraception. The recommendations highlight the importance of enabling laws and policies and education to achieve these goals.
The power of policy
Many countries around the world have recently stepped up to make child marriage illegal. Colombia is one of these, with members of congress abolishing a law in November 2024 that allowed marriages from the age of 14. Importantly, the new bill they introduced also includes measures to restore the rights of children and adolescents affected by underage marriages and unions, with a special emphasis on supporting indigenous people and other vulnerable communities.
A joint effort by authorities and society is required to eradicate this practice and guarantee the protection of girls' rights.
Tamara Ospina / Government of Colombia’s Vice Minister of Women
“The effective implementation of this law shows a change in the social norms that perpetuate child marriage. A joint effort by authorities and society is required to eradicate this practice and guarantee the protection of girls' rights,” said Tamara Ospina, the Government of Colombia’s Vice Minister of Women. "It is essential to advance a campaign for cultural change that allows for the dismantling of traditional family views and promotes the participation of girls in different sectors, especially in the educational sector, to foster greater opportunities."
The WHO guideline recommends the formulation and implementation of such laws and policies that prevent marriage before age 18, in line with human rights standards. However, the guideline acknowledges, in agreement with the Human Right Council Resolution, that simply making child marriage illegal is not enough. Without additional support programmes, this approach could marginalize and stigmatize girls and families, and lead to more informal or unregistered marriages, unintentionally increasing the practice.
This is why a comprehensive approach, that includes efforts to address the root causes of child marriage, such as poverty, gender inequality and access to education, is so important. The guideline also suggests the approach should also mobilize youth and adolescents, as well as political and governmental leaders, alongside religious, traditional and other influential people in the community to promote girls’ rights.
The importance of comprehensive sexuality education
The WHO guideline reinforces the interagency technical guidelines on sexuality education, emphasizing that comprehensive sexuality education is key to preventing adolescent pregnancy and improving contraceptive uptake. In Colombia, implementation of the law is facilitated by work led by adolescent girls to ensure that girls have access to sexuality education.
Ángela Rosa Cervantes Bravo is a teen activist from a rural indigenous village in Colombia where she is heavily involved in an NGO called Sinumar Foundation that focuses on girls and sexuality education with the aim to prevent adolescent pregnancy in her community. Every year, the foundation organizes an entire week of speakers on sexual education. “During this time, our mothers, children in the community, and we, as young women, are guided and filled with knowledge about our bodies, contraceptive methods, and more. We sit down with boys and girls in mixed circles, talking about sexual education, violence and any other issue that might be relevant to the community,” Cervantes Bravo said.
Discussing topics, such as adolescent pregnancy or child marriage, comes with its challenges due to the social stigma and traditional beliefs around it. “Some parents still get upset when they hear us discussing these things, but they need to understand that we are at a stage where these conversations are necessary,” she said. The experiences of Cervantes Bravo reinforce the need to engage parents and other community members in supporting adolescents, which is highlighted as another recommendation in the updated guideline.
Support tools for policy makers and programme managers will be rolled out to guide decision making and ensure that interventions are contextually relevant, to support the work of countries like Colombia and of NGO’s like Sinumar Foundation.
Avni Amin, Unit Head of Rights and Equality Across the Life Course at WHO and the UN Special Programme on Human Reproduction (HRP) concludes: “While these guidelines offer a solid foundation for countries to address adolescent pregnancy and prevent child marriage, the true measure of their success lies in their implementation. It is essential that these guidelines are not only read but acted upon, integrated into national policies, and adapted to fit local contexts. Our goal is to see tangible changes on the ground that will empower young girls and protect their rights.”
Other countries that have taken recent measures to act on child marriage include Sierra Leone and Belize. Sierra Leone's Prohibition of Child Marriage Act eliminated all exceptions that previously allowed marriage under 18, ensuring a strict nationwide ban. Similarly, Belize amended its Marriage Act to raise the legal marriage age from 16 to 18, without any exceptions, reinforcing its commitment to ending child marriage.
