Title: Age at First Marriage and Women’s Psychosocial Wellbeing in the Amhara Region,
Ethiopia
Version: 3 Date: 12 Dec 2023
Reviewer's report:
This paper offers a descriptive look into child marriage in Ethiopia, investigating differences
between child and adult brides in psychosocial wellbeing. The paper is nicely written and offers
important context and insight. I would have been interested to hear more about the expected
mechanisms that might lead child brides to have worse (or better) psychosocial outcomes than
adult brides, as well as more interpretation of the qualitative results. My more detailed comments
are below.
Front end:
• The front end offers helpful background into child marriage in Ethiopia. It would also be
helpful to contextualize this study more broadly – either within sub-Saharan Africa and/or more
globally. Are these trends similar to other settings?
• It would also be helpful to know a little more about the context of marriage in this setting.
Are families/marriages patrilocal? Do women/girls tend to move in with their husbands’ family/
into their husbands’ village upon marriage? This information could help contextualize the
social situation that child brides face when they are forced to marry, which could impact their
psychosocial outcomes.
• In the last paragraph on page 4 (running onto page 5), it seems important to offer more examples
of existing research that has found child marriage to be associated with negative outcomes.
Citations in this paragraph are limited, yet the authors make some strong claims here (e.g., “…
generally bring profound psychosocial and emotional problems…”).
• The authors dedicate a lot of space to contextualizing child marriage in this setting, but they
do not spend much space on explaining their hypotheses and the mechanisms they think may
be operating to impact child brides’ psychosocial wellbeing. It seems important to spend more
space/words in this section (Conceptual Framework).
Methods:
• For clarity, the authors may want to revise the first sentence of the “Study population” section
to specify “women who (first?) became married between 2007 and 2017.” This revised language
could help clarify that this population consists of women who entered a marriage during this
period (not just that they were married at all during the period). Can the authors also state the
age range of the women/girls in the study population?
Results:
• In the quote on the bottom of page 14, it is unclear what “medical” means. It would be helpful
if the authors provided some interpretation for readers.
• Overall the authors offer several quotes from the field, but they do not offer interpretation of
the quotes in combination with the survey data results. It would be helpful to see the quotes
better tied in with the quantitative data.
• It is interesting, and perhaps surprising, that child marriages are more likely to end in divorce.
Given that these marriages are typically arranged by parents/relatives, and given the strong
disincentives to leave these marriages (both from parents and society), it seems like women in
these marriages have less freedom to leave. Can the authors provide information on how these
marriages end, and/or how often divorce is the husbands’ or wives’ decision? At minimum, can
they speculate on how women in these seemingly powerless/low power positions may be finding
a way out of the marriages?
• It would be useful to know the average age of wives when their marriages end in divorce, and/
or the average marital duration for marriages that end.
• The authors group all child marriages together, but child marriage at age 17 may result in
different psychosocial outcomes than child marriage at age, e.g., 14. Have the authors looked
at different categories of child marriage, by age at marriage? I wonder if looking separately at
younger child brides would offer results more in the expected directions.
Discussion & Conclusion:
• Especially in light of the results suggesting that child marriage may result in positive outcomes,
the authors should be cautious, throughout the paper, in discussing their results and providing
explanations. The data presented are cross-sectional and do not allow for rigorous testing of the
hypotheses. It is hard to draw strong conclusions from this investigation, and important to avoid
suggesting that child marriage is good for psychosocial outcomes.
• It would be useful to see more discussion of some of the surprising findings, such as why child
brides may make friends more easily than adult brides, why they are more likely to divorce, and
why they are more likely to have supportive husbands.
• In the Discussion, can the authors offer broader implications of what we can take from this
study to better understand child marriage across other settings?
• Minor: The phrase “the absence of no significant differences” is confusing.