The case of premature marriages occurred in many parts of the world with different backgrounds.

Has been a concern of the international community given the risks arising from a forced marriage,
sexual intercourse at an early age, pregnancy at a young age, and sexually transmitted infections.
Poverty is not the only important factor that plays a role in early marriage. Another thing to note is
the risk of complications that occur during pregnancy and during childbirth at a young age, thus
contributing to improving maternal and infant mortality. Moreover, marriage at an early age can also
cause developmental disorders of personality and put the children born at risk for the incidence of
violence and neglect. Problems early marriage was a failure in the protection of children's rights. It is
hoped that all parties, including pediatricians, will raise awareness in stopping the practice of early
marriage. ( Sari Paediatrics 2009; 11 parties, including pediatricians, will raise awareness in stopping
the practice of early marriage. ( Sari Paediatrics 2009; 11 parties, including pediatricians, will raise
awareness in stopping the practice of early marriage. ( Sari Paediatrics 2009; 11 (2): 136-41).

Keywords: early marriage, child rights

Pernikahan early age had diminished P ernikahan early age had diminished in various parts of the
country in the last thirty years, but in reality is still prevalent in developing countries, particularly in
remote corners. Early marriage occurred in both rural and urban areas in Indonesia as well as
covering a wide range of economic strata with diverse backgrounds. 1 diverse backgrounds. 1

Based on Demographic Data Survey Indonesia (IDHS) 2007, in some areas found that a third of the
number of recorded marriages performed by couples aged under 16 years. The number of cases

early marriage in Indonesia reached 50 million people with an average age of 19.1 years of marriage.
In East Java, South Kalimantan, Jambi, and West Java, the incidence of early marriage row 39.4%,
35.5%, 30.6% and 36%. Even in some rural areas, weddings are often performed immediately after
the girl's first menstrual period. 2 menstrual period. 2 Married at the age of 18 years is a reality that
must be faced by some children around the world, particularly developing countries. 3-6 Although
the Declaration of Human developing countries. 3-6 Although the Declaration of Human developing
countries. 3-6 Although the Declaration of Human Rights in 1954 explicitly opposed child marriage,
but ironically, the practice of early marriage is still going on in various parts of the world and it
reflects the protection of human rights younger age groups are neglected. 3 Implementation human
rights younger age groups are neglected. 3 Implementation human rights younger age groups are
neglected. 3 Implementation UndangUndangpun often ineffective and broken by the customs and
traditions of social norms of a community group. 4-6 group. 4-6

Early Marriage and Its Problems

Eddy Fadlyana, Shinta Larasaty Child Health Department, Faculty of Medicine University of
Padjadjaran / Dr Hasan Sadikin Hospital

The case of premature marriages occurred in many parts of the world with different backgrounds.
Has been a concern of the international community given the risks arising from a forced marriage,
sexual intercourse at an early age, pregnancy at a young age, and sexually transmitted infections.
Poverty is not the only important factor that plays a role in early marriage. Another thing to note is
the risk of complications that occur during pregnancy and during childbirth at a young age, thus
contributing to improving maternal and infant mortality. Moreover, marriage at an early age can also
cause developmental disorders of personality and put the children born at risk for the incidence of
violence and neglect. Problems early marriage was a failure in the protection of children's rights. It is
hoped that all parties, including pediatricians, will raise awareness in stopping the practice of early
marriage. ( Sari Paediatrics 2009; 11 parties, including pediatricians, will raise awareness in stopping
the practice of early marriage. ( Sari Paediatrics 2009; 11 parties, including pediatricians, will raise
awareness in stopping the practice of early marriage. ( Sari Paediatrics 2009; 11 (2): 136-41).

Keywords: early marriage, child rights Keywords: early marriage, child rights

address correspondence Dr. Eddy Fadlyana, Sp.A (K)., M Kes. Subdivision Growth / Social Paediatrics
Child Health Department, Faculty of Medicine UNPAD / Dr Hasan Sadikin Hospital. Jl. Pasteur 38,
Bandung, Indonesia. Phone / Fax: (022) 2035957, E-mail: edfadlyana@yahoo.com

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A UNICEF literacy studies found that the interaction of various factors cause children risked marriage
at an early age. It is widely known that the marriage of children related to the tradition and culture,
making it difficult to change. 4.6 to 8 to the tradition and culture, making it difficult to change. 4.6 to
8

Economic reasons, hopes of reaching social and financial security after marriage causes many
parents encourage their children to get married at a young age. 5 children to get married at a young
age. 5

The international community is aware also that the problem of child marriage is a very serious
problem. 1 Implications problem of child marriage is a very serious problem. 1 Implications problem
of child marriage is a very serious problem. 1 Implications in general that women and children will
bear the risks in the various aspects related to the marriage unwanted sexual intercourse imposed,
pregnancy at a very young age, as well as increased risk of HIV infection, other sexually transmitted
diseases, and cancer cervix. 3-10 Reaching transmitted diseases, and cancer cervix. 3-10 Reaching
transmitted diseases, and cancer cervix. 3-10 Reaching consequences in many aspects of life is
certainly an obstacle in achieving Millennium Developmental Goals. 4,8,10obstacle in achieving
Millennium Developmental Goals. 4,8,10obstacle in achieving Millennium Developmental Goals.
4,8,10

Definition

Son is a person who is formed from the time of conception to the end of adolescence. Definition of
the child's age in Law (UU) 10 Election of 2008 (article 19, ayat1) until the age of 17 years. While the
Marriage Act 1 of 1974 describes the minimum age limit of 16 years married to women and men 19
years. The definition of a child under the Law 23 in 2002, is a person under 18 years, including the
child still in the womb. 11 Child marriage is defined as marriages that the womb. 11 Child marriage is
defined as marriages that the womb. 11 Child marriage is defined as marriages that occurred before
the child reaches the age of 18, before the children mature physically, physiologically, and
psychologically to be responsible for marriage and children resulting from the marriage. 13 resulting
from the marriage. 13

Epidemiological Overview of child marriage around the world

The results of the UNICEF study in Indonesia (2002), found the incidence of child marriage ranges
from 15 years old 11%, while married

The exact moment 18 years of age about 35%. 8 The practice The exact moment 18 years of age
about 35%. 8 The practice The exact moment 18 years of age about 35%. 8 The practice of early
marriage is most prevalent in Africa and Southeast Asia. Data obtained in Southeast Asia that about
10 million children aged under 18 are married, while in Africa an estimated 42% of the pediatric
population, were married before they were 18 years old. In Latin America and the Caribbean, 29% of
young women married when they were 18. The high prevalence of early marriage cases recorded in
Nigeria (79%), Congo (74%), Afghanistan (54%) and Bangladesh (51%). 8 In general, child marriage is
more Bangladesh (51%). 8 In general, child marriage is more Bangladesh (51%). 8 In general, child
marriage is more common in girls than boys, approximately 5% of boys get married before they are
19 years old. Additionally found also that women are three times as many married earlier than men.
3 men. 3

Analysis of inter-census population survey (SUPAS) 2005 from the National Family Planning
Coordinating Board (BKKBN) obtained the number of marriages in urban areas is lower than in rural
areas, for the age group 15-19 years the difference is quite high at 5.28% in urban areas and 11.88 %
in rural areas. This suggests that young women in rural areas who do a lot more marriages at a young
age. 2 Although rural areas who do a lot more marriages at a young age. 2 Although rural areas who
do a lot more marriages at a young age. 2 Although child marriage is a predominant problem in
developing countries, there is evidence that this incident is also ongoing in developed countries
where parents agree to his son's wedding less than 15 years old. 5 wedding less than 15 years old. 5

Problems in child marriages

Some of the problems in the marriage of children include factors that encourage proliferation of child
marriage, the impact on education, domestic violence, the impact on reproductive health, children
who were born and psychological health of children, and review laws relating to child marriage.

Factors that encourage widespread child marriage

In many parts of the world, child marriage Meru ma pa sa lah kan social and economic, which is
complicated by the

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tra dition and culture in the community. The stigma is so unlucky as to marriage after going through
puberty is considered a disgrace in certain circles, has also increased the incidence of child marriage.
4incidence of child marriage. 48.10 Economic motives, hopes of achieving social and 8.10 Economic
motives, hopes of achieving social and financial security after marriage causes many parents agree to
early marriage. Reasons parent approves child marriage is often based on also by the fear of
pregnancy outside of marriage due to promiscuity or to strengthen kinship. 7 marriage due to
promiscuity or to strengthen kinship. 7

In general, child marriage is more common among poor families, although there were also among
upper-income families. In many countries, child marriage is often associated with poverty. 5,6,8
Countries with cases of child associated with poverty. 5,6,8 Countries with cases of child associated
with poverty. 5,6,8 Countries with cases of child marriage, generally have a low gross domestic
product. 8.9 Child marriage, generally have a low gross domestic product. 8.9 Child marriage,
generally have a low gross domestic product. 8.9 Child marriage makes families, communities, even
countries find it difficult to escape from the poverty trap and it is certainly cause the quality of health
and well-being are low both children and families and communities. 6,8,13 children and families and
communities. 6,8,13

Child marriage and education degrees

The younger the age of marriage, the lower the level of education achieved by the child. Child
marriage often leads to children dropping out of school, because now he has new responsibilities,
namely as wives and mothers, or head of the family and the prospective father, who is expected to
more care of the household and become the backbone of the family and the need to earn a living.
Another pattern that is because the cost of education is unattainable, children dropping out of school
and then married to shift the onus of parents to support the child to her partner. 8 parents to
support the child to her partner. 8

From various research shows that there is a correlation between level of education and age at
marriage, the higher the child's age when she married the child's education is relatively higher and
vice versa. Marriage at an early age according to the UNICEF study in 2006 seemed to relate well
with the degree of education. Delaying the age of marriage is one way for children to higher
education. 5,8,13 marriage is one way for children to higher education. 5,8,13

Domestic problem in the marriage early age

Gender inequality is a consequence in child marriages. Bride children have a limited capacity to voice
their opinions, negotiate the desire to have sex, using contraception and childbearing. Similarly,
other domestic aspects. 8.13 aspects. 8.13

The dominance of the pair often causes children vulnerable to domestic violence. Domestic violence
was highest in India, especially in women aged 18 years. 3 India, especially in women aged 18 years.
3

Women who marry at a younger age are often subjected to violence. Children who face domestic
violence tend to not take the fight, as a result, they would not get the fulfillment of a sense of
security in social and financial. 5,6,8 In addition, of a sense of security in social and financial. 5,6,8 In
addition, of a sense of security in social and financial. 5,6,8 In addition, the marriage with a partner
far adrift of age increases the risk of becoming incomplete families due to divorce, or widowhood
because the couple died. 8.13 widowhood because the couple died. 8.13

Reproductive health and early marriage

It is important to note that the gestational age less than 17 years increases the risk of medical
complications, both the mother and the child. Pregnancy at a very young age it turns correlated with
maternal mortality and morbidity. Mentioned that girls aged 10-14 are five times the risk of dying
during pregnancy or childbirth compared to 20-24 years age group, while the risk is doubled in the
age group 15-19 years. 5,9,10 The maternal mortality rate under the age of 15-19 years. 5,9,10 The
maternal mortality rate under the age of 15-19 years. 5,9,10 The maternal mortality rate under the
age of 16 years in Cameroon, Ethiopia, and Nigeria, even higher up to six-fold. 5 up to six-fold. 5

Anatomy of a child's body is not ready to contain and childbirth process, so that there can be
complications such as obstructed labor and as obstructed labor and as obstructed labor and obstetric
fistula. Data from UNPFA 2003, showed a 15% obstetric fistula. Data from UNPFA 2003, showed a
15% -30% among labor at an early age is characterized by a chronic complications, namely obstetric
fistula. Fistula is the damage to the female organs that obstetric fistula. Fistula is the damage to the
female organs that causes leakage of urine or feces into the vagina. Women younger than 20 years
are particularly vulnerable to obstetric younger than 20 years are particularly vulnerable to obstetric
fistula. obstetric fistula This occurs as a consequence of sexual fistula. obstetric fistula This occurs as
a consequence of sexual intercourse at an early age. 5.10 Related child marriage intercourse at an
early age. 5.10 Related child marriage intercourse at an early age. 5.10 Related child marriage

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2009 linked to high

fertility, pregnancy at a short distance, as well as the

occurrence of unwanted pregnancies. 14,15 occurrence of unwanted pregnancies. 14,15

Younger age at first sexual intercourse also increases the risk of sexually transmitted diseases and HIV
infection. Many teenagers who married early drop out of school when they are tied in the institution
of marriage, they often do not understand basic reproductive health, including the risk of HIV
infection. The HIV infection is obtained as a direct transmission from an infected partner who has sex
before. Furthermore, the age difference is too much causes the child almost impossible ask for safe
sex due to the dominance of the pair. Marriage a young age is also a risk factor for cervical
carcinoma. 5-10.13 Limitation of movement as factor for cervical carcinoma. 5-10.13 Limitation of
movement as factor for cervical carcinoma. 5-10.13 Limitation of movement as a wife and a lack of
support for health services due to hit husband permit conditions, economic limitations, then this
barrier would contribute to increased morbidity and mortality in pregnant teenagers. 14,15 in
pregnant teenagers. 14,15
Children born premature marriages

When children who are still growing experience the process of pregnancy, there is competition with
the nutrition of the fetus, so pregnant women weight loss is often difficult to ride, may be associated
with nutritional deficiency anemia, as well as the risk of having a baby with low birth weight. It was
found that about 14% of babies born to teenage mothers under 17 years is premature. Pelvic
anatomy are still in the growth of risk for the occurrence of prolonged labor thereby increasing infant
mortality and neonatal mortality. 16.17 mortality. 16.17

Depression at the time of the pregnancy at risk for the incidence of miscarriage, low birth weight and
others. Depression is also associated with increased blood pressure, thus increasing the risk of
preeclampsia are harmful to the fetus or the mother who conceived him. 16 harmful to the fetus or
the mother who conceived him. 16

Good prenatal care can actually reduce the occurrence of complications of pregnancy and childbirth.
But unfortunately due to financial constraints, limited mobility and speech, the young wives often do
not get the health care they need,

thus increasing the risk of maternal complications and mortality. 5.10 mortality. 5.10 Being a parent
at an early age with less skills for parenting as adults have to put the children born at risk of abuse or
neglect. Various studies have shown that children born premature marriages at risk of
developmental delay, learning difficulties, behavioral disorders, and also tends to be a parent at an
early age. 17.20 be a parent at an early age. 17.20

Psychosocial complications as a result of marriage and pregnancy at an early age

Psychosocial complications as a result of marriage and pregnancy at an early age is supported by a

study that showed that long-term social negative output inevitable, pregnant mother at an early age
will experience prolonged trauma, while also experiencing a crisis of confidence. 17 Children trauma,
while also experiencing a crisis of confidence. 17 Children trauma, while also experiencing a crisis of
confidence. 17 Children are psychologically not ready for the responsibility and role as wife, sexual
partner, mother, making it clear that child marriage causes a negative impact on the psychological
well-being and development of their personality. 7 well-being and development of their personality.
7

Legal review in early marriage

Convention on the Rights of the Child (CRC) are acting as international law and CRC, ratified by
Presidential Decree No. 36 of 1990, for further validated as the Child Protection legislation (Law PA)
23 of 2002. 7.18 Ratification of the bill is legislation (Law PA) 23 of 2002. 7.18 Ratification of the bill is
legislation (Law PA) 23 of 2002. 7.18 Ratification of the bill is aimed to realize the protection and
welfare of children. In the PA Act stated clearly that the Unitary Republic of Indonesia guarantees the
welfare of each of its citizens, including the protection of children's rights which are human rights. 18
rights. 18

CRC has become part of the national legal system, so as a consequence we must recognize and fulfill
the rights of children as defined in the CRC. One of the principles in the CRC, namely the "best
interests of the child". The purpose of the principle of "best interests of the child" was in all actions
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relating to children undertaken by the government, the public, legislative and judicial bodies, the
best interests of the child shall be a primary consideration. 9.18 In LOGA article the child shall be a
primary consideration. 9.18 In LOGA article the child shall be a primary consideration. 9.18 In LOGA
article 1, paragraph 2 states that "child protection" means all activities to ensure and protect children
and their rights in order to live, grow, develop, and participate optimally in accordance with human
dignity, and protection from violence and discrimination. 18 violence and discrimination. 18

In a declaration of human rights, said that marriage should be done on a full agreement both
partners. But the reality faced in this early marriage, consent to marry is often an accumulation of
force or coercion parent / guardian of the child, so the child agrees to marry often an act of devotion
and respect for parents. Parents think their children marry means a form of protection for the child,
but this would cause a loss of opportunities for children to develop, grow healthy, and the loss of
freedom in choosing. 7 develop, grow healthy, and the loss of freedom in choosing. 7 to 9.19 A
similar statement was issued by the International to 9.19 A similar statement was issued by the
International to 9.19 A similar statement was issued by the International Humanist and Ethical Union,
that child marriage is a form of Humanist and Ethical Union, that child marriage is a form of abuse in
children ( child abuse). 3,9,10 In this case, considering abuse in children ( child abuse). 3,9,10 In this
case, considering abuse in children ( child abuse). 3,9,10 In this case, considering abuse in children
( child abuse). 3,9,10 In this case, considering the consequences dihada pi children associated with
early marriage as te was in ba has, then the child marriage of course menyebab kan ti dak fulfillment
of the principle of "the best for the child", se until it is a violation of children's rights. 4,5,9 rights.
4,5,9

In the Child Protection Act clearly mentioned also about the obligation of parents and society to
protect children, as well as the obligations of parents to prevent marriage at the age of children
(Article 26). Penal sanctions in the form of punishment in prison and fines brackets set out in Article
77-90 when found violations of child protection provisions. 18 77-90 when found violations of child
protection provisions. 18

The role of pediatricians addressing early marriage

Related to reproductive health and early marriage, then pediatricians participate in outreach to the
youth and parents about the importance of preventing marriage

at an early age as well as helping parents to be able to provide reproductive health education to
children according to age stage. Pediatricians also instrumental in helping adolescents to obtain
reproductive health information and services also contraception, assess the ability of parents in
parenting teens to prevent the neglect or abuse of children, as well as participate in the community
to prevent marriage at an early age. 20 at an early age. 20

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