Last year, a 15-year-old girl from ward no 3 of Nisikhola Rural Municipality, Baglung, got married without the consent of her parents. At the age of 16, the girl is pregnant now. Four other girls, aged 16 and 17, at the same ward have also gotten married. Three of them are expecting babies now.

Nisikhola Rural Municipality is in remote Baglung, a hill district of Gandaki Province. Many girls and women below 20 years of age are married in the local unit’s rural areas. Many of them are pregnant or have already given birth to their babies.

The Civil Code 2017 states that the minimum age for marriage—for both women and men—in Nepal is 20. Though the country abolished child marriage in 1963, the social practice is still rampant in rural areas despite various attempts of the government authorities and social organisations to end the practice. As per Article 173 of the Criminal Code, a person found guilty of either committing or arranging a child marriage is subject to a jail term of up to three years and a fine of Rs30,000. However, in many cases, these legal provisions, aimed at protecting children from child marriage, have ended up being used to penalise them instead.

The adolescent girls and women who got married and conceived at an early age are unaware about the possible health risks. They do not even know about the existing legal provisions regarding child marriage, pregnancy at early age and its subsequent health consequences.

“There are three girls who got married underage and are pregnant now in Bohoragaun of Nisikhola-3,” said Nim Kumari Chand, a female community health volunteer and a member of a local women's group. “We did not know about underage marriage. They are expecting babies now. We have started providing them health counseling about the possible health hazards instead of scolding them.”

According to Chand, the pregnant adolescents are regularly invited at the group’s meeting and suggested for regular health check-up during pregnancy and visit the well-facilitated hospital in case of any health complications. She said that child marriage cases have decreased in the area over the past few years but the social practice could not be reduced to zero.

The rural municipality launches awareness programmes against child marriage and teenage pregnancy time and again. But the efforts are not quite effective to check the deep-rooted social practice. “We tried our best to educate the adolescent girls about the child marriage and early age pregnancy,” said Juni Gharti, health unit chief of Nisikhola Rural Municipality. “But it has been quite difficult to stop them from getting married and subsequently becoming pregnant.”

Of late, the Health Mothers’ Groups have been formed in various settlements to improve maternal and child health. The groups’ meeting is organised in presence of the local female community health volunteer and auxiliary nursing midwife on a monthly basis.

“We visit every house in the settlement and provide counseling to stop child marriage and pregnancy at early age. But they are found marrying off their underage daughter when we visit them next month,” said Shobha Kunwar, chairperson of the Health Mothers’ Group in Kanlechaur of Nisikhola-2. “Though we are unable to control child marriage, we provide health counseling to the pregnant women as well as the women in postpartum period. During the group’s meeting, we encourage pregnant women to carry out regular health checkups and take iron tablets regularly.”

The government authorities as well as several non-governmental organisations have been working to control child marriage, teenage pregnancy and home delivery in Baglung. But the problems still prevail in the district, mainly in the rural areas.

“Child marriage is still a major challenge in the district. Social practice prevails despite our efforts to control it,” said Laxmi Sharma, public health inspector at Baglung Health Office. She estimates that of total cases of deliveries, around two to three percent postpartum mothers are below 20 years of age.

Gender discrimination, lack of opportunity for education and job, dowry system, lack of awareness among the guardians, lack of effective implementation of laws and ineffective monitoring by the concerned authorities, among others, are the main reasons behind the high number of child marriage cases in the district.

The Nepal Demographic and Health Survey-2022 conducted by the Ministry of Health and Population, shows that overall, 14 percent of women aged 15-19 have been pregnant, including 10 percent who have had a live birth, while two percent experienced a pregnancy loss.

Teenage pregnancy is highest in Karnali Province, at 21 percent, followed by Madhesh Province, at 20 percent, Koshi and Gandaki Province, at 13 percent, and Lumbini Province, at 10 percent, according to the 2022 survey.