Child Marriage: HPV Vaccine A Must On Bride Price List
By Aderonke Olisa Editor, Loretta Enofe-LaurelIt all started with mild vaginal bleeding which she felt was an irregular menstrual period. Don’t go to the village clinic, instructed her husband. As months passed, it became severe with worsened symptoms accompanying the bleeding. Aisha, 31 years got married when she clocked 15 to enter into the rite of marriage. Without wanting to be a disrespectful wife, she neither went for a health checkup nor informed her family to maintain her husband’s dignity amongst them and in the community. Two years into consistent discomforting abnormal vaginal bleeding, she heard a jingle via the radio about Cervical Cancer and the symptoms with an offer for a free screening in her community clinic. Secretly visiting the clinic, she was diagnosed to be in Stage 3 Cervical Cancer. With a broken heart and regrets for seeking late medical help, she informed her husband and managed for a few months before her demise - leaving behind six children.
Cervical Cancer is the 2nd most prevalent cancer among women in Nigeria with 65.7% occurring in Northern Nigeria, home to the practice of child marriage. According to the report by ICO/IARC Human Papilloma Virus (HPV) Information Centre, 12,075 new cases of Cervical Cancer occurs annually in Nigeria among women aged 15-44 years of age. In a study by Adewuyi, Shittu, and Rafindadi (2008), it was reported that among the risk factors of Cervical Cancer, early initiation of sex by virtue of early marriage was mostly responsible for cervical cancer in the patients, as 86% of them started sex before age 17. It further stated many were also multiparous and had a history of treating HPV which is the leading cause of Cervical Cancer.
Aisha represents many who were married as a child bride with lack of skills to navigate life, access to health information and services, and resources for their empowerment, hence limiting their potentials and sadly, lifespan.
Child marriage is most common in the North West and North East of Nigeria, where 68% and 57% of women aged 20-49 were married before their 18th birthday.Child marriage is particularly common among Nigeria’s poorest, rural households and the vast northern ethnic groups. It is both a cultural and religious issue in Northern Nigeria, hence, a different approach is needed to save the girls from the repercussions such as Cervical Cancer. Advocacy has been on for years to stop early child marriage and it even passed up to the policy stage but of course, it didn’t fly, with a core reason of having male-dominated legislators who unfortunately can’t understand women’s sexual and reproductive health and right, nor prioritize it.
…the legislation will not regulate the age of marriage because ‘it’s controversial and alien to predominant religion and culture of the residents’
Where do we go from here?It is my recommendation that while the advocacy for legislation on the age of marriage continues to end Child Marriage, there should be more work with key stakeholders at the community level (e.g. traditional leaders, elders, etc) to discuss the effects of the practice one of which is Cervical Cancer.
Discussions and resolutions can also be made on how they can include healthcare bills for Cervical Cancer screening and HPV vaccination as part of the bride price so that young brides can have financial capacities to access these services. If this is mandated for all suitors, I believe there will be a decline in the practice as some of the suitors may be unable to meet up with the financial obligation.A Nigeria without a child bride is possible, collaboration and smart advocacy are key to achieving it. -----
Adewuyi SA, Shittu SO, Rafindadi AH (2008) Sociodemographic and clinicopathologic characterization of cervical cancers in northern Nigeria Eur J Gynaecol Oncol 29 61–4 PMID: 18386466
Oguntayo O. A., Zayyan M., Kolawole A.O.D., Adewuyi S.A., Ismail H. and Koledade K. (2011). Ecancer 2011, 5:219 DOI: 10.3332/ecancer.2011.219