Factors Affecting Child Marriage in West Nusa Tenggara

socio-economic relations between generations. This encourages forced marriage or matchmaking by parents who come from economically weak circles because marriage can reduce the burden of the family's economic responsibilities and improve the welfare of someone Background: Child marriage is a significant problem millions of girls face every year. During the period of 2015 – 2018, the increase and decrease in prevalence at the provincial level varied in magnitude. There are 11 provinces that experience marriage for the first time in less than 18 years. One of them is the Province of Nusa Tenggara by 15.48%. The purpose of this research is to observe the factors affecting the incidence of child marriage. Method: This is a quantitative research using secondary data from the Survey of Program Accountability and Performance (SKAP) in West Nusa Tenggara Province, Indonesia as many as 1,292 women of childbearing age. Independent variables included age, education level, occupation, and area of residence; while dependent variable referred to child marriage. Results: There was a significant relationship between age and 95% CI = 1.151-1.754 (p = 0.00), education level and 95% CI = 1.997-3.111, (p = 0.00), employment status and 95% CI = 0.564-0.895, (p = 0.00), information exposure and 95% CI = 1.178-2.672, (p = 0.00), on the incidence of child marriage. Respondents not attending school had a 2.4 times risk of child marriage, while information exposure has a chance of child marriage, as indicated by a prevalence ratio of 1.7. The area of residence did not have a significant relationship with child marriage with 95% CI = 0.821-1.305, (p = 0.76). The results showed that there was a significant relationship between age, education level, employment status, and information exposure to child marriage. The area of residence did not have a significant relationship with child marriage. Therefore, it is necessary to increase the knowledge of women of childbearing age by providing education such as counseling about the impacts of child marriage. ABSTRACT


INTRODUCTION
Child marriage, or marriage before the age of 18, is a significant problem that millions of girls face every year. 1 Child marriage (or early marriage) can be defined as either a formal marriage or an informal one in which a girl lives with her partner or is married before the age of 18. 2 Child marriage among girls is most common phenomenon in South Asia and sub-Saharan Africa, and the 10 countries with the highest rates are found in these two regions. 3 It is a manifestation of gender inequality, reflecting social norms that perpetuate discrimination against girls. 3 In developing countries, it is estimated that one of seven girls is married before the age of 15 and 38% are married before the age of 18. 4 During the 2015 -2018 period, the increase and decrease in prevalence at the provincial level varied in magnitude. 11 provinces experienced an increase in the prevalence of women 20-24 years old whose first marriage was in the age of below 18 years. The highest prevalence increase was found in North Maluku, i.e. 3.35 percentage points (10.01 to 13.36%); while in West Nusa Tenggara Province, the highest prevalence of child marriage was found in Java, Bali, and Nusa Tenggara (15.48%). 3 The factors of child marriage are dependent upon the context, but most of researches have shown that the gender inequalities such as the low status of women and girls, religious norms determining the timing of marriage, the importance of motherhood, and limited alternatives are important factors of child marriage. 5 An early marriage that occurs in Indonesia is due to the norms applied in traditional societies with close socio-economic relations between generations. This encourages forced marriage or matchmaking by parents who come from economically weak circles because marriage can reduce the burden of the family's economic responsibilities and improve the welfare of someone married, although this is not necessarily proven. Meanwhile, according to the BKKBN (2018), child marriage might be determined by low level of education, economic needs, young marriage culture, arranged marriages, free sex among adolescents, and pregnancy out of wedlock. 6 The impacts of child marriage include domestic violence, family subordination, increased school dropouts, increased opportunities for maternal death, low reproductive rights (BKKBN, 2018), sexual, physical, and psychological violence due to unbalanced power dynamics in marriage due to burdens. and the responsibilities they have to face, 7 contracting HIV and experiencing domestic violence and mental health disorders, 8 increasing the risk of obstetric complications, 9 limitations in decision making due to imbalance strength in their marriages, 10 adverse economic outcomes, including lower levels of education, lower socioeconomic status, and higher rates of poverty, 11 the lack of use of contraception results in unwanted pregnancies resulting in delivery at shorter intervals compared with girls who married at the age of more than 18 years. 12 Efforts to reduce the incidence of child marriage are by encouraging girls to stay in school by providing school allowances, 13 providing information training on gender, reproductive health, and marriage, 14 improving the state's legal and policy framework to protect children, expansion of education, empowerment of boys and girls through the provision of critical life skills and information, as well as changing mindsets and beliefs of various communities/tribes related to child marriage. 15 In addition to overcoming poverty and lack of education, the use of modern contraceptive methods can help to reduce child marriage, especially among women who enter marriage due to the unwanted pregnancies. 16 Several studies that support the above factors are research conducted by another stating that the level of education affects the occurrence of child marriage and the area of residence in rural areas also affects a person to marry at a relatively young age. 4,17 Women aged 18 who live in rural areas are twice as likely to marry at an early age compared to women aged 18 who live in urban areas and girls who do not attend school is three times more likely to marry at a young age compared to women who have completed education up to secondary education. 10 Social norms, sexual relations, unplanned pregnancies, poverty, and unemployment among girls have been identified as the factors of child marriage. 18 Several previous studies have examined the factors determining child marriage in West Nusa Tenggara Province. From the results of these studies, several policies have been made to suppress the case of child marriage. However, the cases of child marriage are still high, exceeding the target of the National Population and Family Planning Agency. Based on this background, this study aims to analyze the factors that cause child marriage.

METHOD
This is a quantitative study using secondary data from the Accountability and Performance Survey Program (Survei Kinerja dan Akuntabilitas Program or SKAP) conducted by the West Nusa Tenggara Provincial Population Family Planning And Family Development (KKBPK or Kependudukan Keluarga Berencana dan Pembangunan Keluarga) in 2019. The research design was observational with a cross-sectional approach. 1292 women of childbearing age were involved as the sample of this research. The independent variables included age, education level, occupation, area of residence, and exposure to information, while the dependent variable referred to child marriage.
This study used frequency distribution for univariate analysis, cross tabulation method for bivariate analysis, and logistic regression technique for multivariate analysis. The frequency distribution procedure for each variable was explained by univariate analysis and crosstabulation was applied to observe the relationship between variables by category. Further, logistic regression analysis was used to determine the impacts of age, education, and information exposure on the survival of child marriage.
The Research Ethics Commission for the Regional General Hospital of West Nusa Tenggara Province has given permission to conduct this research with an endorsement letter number 070.1/18/KEP/2021.

RESULTS AND DISCUSSION
In this study, the characteristics of respondents included age, education level, occupation, area of residence, and exposure to information on child marriage in West Nusa Tenggara Province. Table 1 shows that most of the respondents were aged >35 years, i.e. 49.7% with the status of unemployed as much as 57.6%, the majority of mothers had low education (55.4%) and most of the respondents lived in rural areas (57,4%). The majority of respondents have never been exposed to information related to child marriage (89.4%) and 65.2% married at the age of 21 years.
Age affects the maturity of thinking and experience gained, increasing in line with age so that it can be explained that age affects one's knowledge. To the law according to the marriage law, the minimum age for marriage is 16 years for women and 19 years for men (Article 7 of Law No. 1/1974 on marriage). The law considers people above that age to be no longer children so they can get married. This age limit is intended to prevent any so earlier marriage. However, as long as a person has not reached the age of 21 years, parental permission is still required to marry off their child. After being over 21 years old, a person can marry without parental permission. The higher the education, the easier it will be to understand the information in the health sector. This will affect the formation of new, healthier behaviors. The low level of education and knowledge of parents, and the community, causes a tendency to marry off minors. 19 Couples who marry underage are influenced by educational factors. Higher education does not determine the amount of information obtained about the impact of early marriage. The researcher argued that the majority of respondents had a level of education (elementary school and junior high school), and this was due to economic factors in the surrounding environment. Many parents do not concern with their children's education for the reason of financial ability to send their children to school. Also, parents think that teenage daughters do not need to go to high school. After all, the cost of living will be borne by the husband. The low levels of education and knowledge can affect a limited mindset that will have an impact on individual behavior. 20 Research conducted in Zambia, Bangladesh, and Indonesia showed that low education was significantly associated with early marriage and education was identified as a significant predictor of age at marriage. 21,22,23 Other research showed that education, family monthly income, religion are the most influential factors in determining the possibility of early age at marriage. 24 Other socio-demographic such as age, caste/ethnicity, family type, and family size are related to early marriage. 25 Economic status is one of the most important factors in the family. In this case, the economic function of the family is intended to fulfill and regulate the economy of family members, especially work and income. To meet the needs of daily life, a person or family must have a job. The level of one's income will affect one's way of life. The low economic level of a person will lead to early marriage. Parents will immediately marry off their children, for the reasons of economic life, such as the inability of parents to support their families, so, they will immediately marry off their children to reduce the burden. 26 Other research showed that family economic factors are the cause of early marriages at most. 27,28 High family income can statistically reduce the incidence of early marriage. 29 Household economic status is significantly related to child marriage. Young women with high economic status are significantly less likely to marry at a young age compared to young women with low one. 30 This finding is corroborated by findings from qualitative data showing that poverty is also an important factor influencing child marriage. Parents who cannot meet the needs of their daughters then encourage or force them to marry early. 31 The dominant factors of early marriage are pregnancy out of wedlock, environment, parents, education, economic, individual, and social media. The number of teenagers who have premarital sex is determined by mass media and electronics. 34 It is in contrast to other studies that showed that respondents' exposure or lack of exposure to information media will not affect someone to marry at an early age. 35 Table 2 shows the source of information exposed to women. Teenagers who have premarital sex are influenced by mass media and electronics. The number of sites that fully disclose (free) sex life or images that are not suitable for teenagers can have a bad impact on them because during the adolescence period there are a number of psychological changes leading to the changes in attitudes and behavior such as starting to concern with one's physical appearance, being attracted to the opposite sex, trying to attract attention and having a feeling of love that will then lead to a sexual urge. 36 Exposure to mass media, both printed (newspapers, magazines, pornographic books) and electronic (TV, VCD, Internet), has an influence on adolescents to have premarital sexual intercourse. Exposure to sexual information from the mass media (both printed and electronic media), which tends to be pornographic can be an uneducational reference for teenagers. Teenagers who are in a period of curiosity and want to try will imitate what they see or hear from the mass media. 36 Based on Table 3, it can be seen that the age < 20 years had an opportunity to the incidence of marriage at the age of children characterized by a prevalence ratio of 1.4 times compared to those aged > 20 years. There was a significant relationship between age and child marriage with a 95% CI value = 1.151-1.754 (p = 0.00). Respondents who did not go to school were at risk of marriage at the age of children 2.4 times compared to educated respondents. There was a significant relationship between education level and child marriage with 95% CI value = 1.997-3.111, (p = 0.00).
Employment status had no risk with the incidence of child marriage as indicated by a prevalence ratio of 0.7, but there was a significant relationship between employment status and child marriage, indicated by a 95% CI value = 0.564-0.895, (p = 0.00). Furthermore, the area of residence had a chance of the incidence of child marriage, as indicated by a prevalence ratio of 1.03 and there was no significant relationship between the area of residence and child marriage with the indication of a 95% CI value = 0.821-1.305, (p = 0.76). Information exposure had an opportunity to the incidence of child marriage characterized by a prevalence ratio of 1.7 and there was a significant relationship between the area of residence and child marriage, as shown by a 95% CI value = 1.178-2.672, (p = 0.00).  showed that the area of residence in rural areas had no significant effect on early marriage in Indonesia. Residential areas in rural areas are 1.6 times more likely to have an early marriage than those in urban areas. The place of residence was found to be a predictor of the incidence of early marriage. The study found that women in rural areas were more likely to engage in early marriage compared to their urban counterparts. Previous research conducted in Bangladesh and other Asian countries also found similar results. 32 The results of this study are supported by findings regarding the analysis of data on child marriage in Indonesia sourced from Susenas data from 2008-2012 revealing that the percentage of ever-married women was aged 20-24 years who married before the age of 15. The area of residence indicated that child marriage in rural areas was one-third higher than that of urban areas. 33 Other research showed that the area of residence in Bangladesh affected early marriage. 32 This difference is due to the sociological background of the different regions between Bangladesh and Indonesia. Child marriage occurs mostly among girls who live in poorer households, have less education, and live in rural areas. 17 Four variables, namely age, education, occupation, and exposure to information on the social development of children under five met the requirements (p<0.25) to be continued in the multivariate analysis, while the sex of the child, number of children, and accompanying caregivers were not carried out in a multivariate analysis. because p-value > 0.25. The results of the multivariate analysis can be seen in the table listed in the bivariate analysis.
Logistic regression analysis was carried out on 3 models, so that the results showed that the highest R 2 value was model 1 with an R 2 value of 0.16, indicating that the variables of age, education, occupation, and information exposure contributed 10.6% to the incidence of child marriage, the rest (89.4%) was caused by other variables.
Several factors encourage child marriage such as the economic burden on households with less economic status, 37 the need to strengthen social ties and protect girls from sexual harassment and the belief of some parents that marrying their daughters into rich families can improve the family's social status. 38 In addition, women's educational attainment, wealth status, religious beliefs, and place of residence are associated with child marriage. 21,39 Several factors that influence child marriage include: socioeconomic, education, and urban/rural status. Economic factors might play an important role in influencing child marriage. 3, 17 The factors driving marriage are complex especially when viewed from the perceptions of those affected such as low education of girls, social norms, sexual relations, unplanned pregnancy, and movement among girls, 4 rural residence, religious beliefs other than Christian, less educated, households with middle to lower economic status, respondents who do not read newspapers or magazines, listening to radio or watching television less, 16 trust, intimacy, and communication. 40

CONCLUSION
The results showed a significant relationship between age, education level, employment status, and information exposure to child marriage. 672, (p = 0.00), on the incidence of child marriage with child marriage. Respondents who did not attend school had a 2.4 times risk of child marriage, while information exposure had a chance of child marriage, indicated by a prevalence ratio of 1.7. The area of residence did not have a significant relationship with child marriage. Therefore, it is necessary to evaluate policies to reduce the incidence of child marriage with the aim of increasing the knowledge of women of childbearing age by providing education such as counseling about the impact of child marriage.