Canada tackling link between early marriage, preterm birth

KIGALI, RWANDA—As a humanitarian worker from Ontario, I'm proud to put Canada's feminist foreign policy into action by championing the health and rights of women and girls around the world. Earlier this week, I was in Rwanda for the International Conference on Family Planning, along with the federal government and other international agencies, to advance a critical issue for gender equality: the right for women to choose healthy and timely pregnancies. Foremost in my mind as I meet with policy-makers is my most recent trip to Ethiopia, where Canadian development funds are helping prevent preterm birth for some of the world’s most vulnerable. Globally, preterm birth is the leading cause of death for children under five, according to the World Health Organization. As Canadian funding for global maternal and child health initiatives comes to a close in 2020, I am conscious of the fact that there is still much to be done. Born on Time—a public-private partnership between World Vision, Plan International, Save the Children, Johnson & Johnson, and the government—works in Mali, Bangladesh and Ethiopia, to try and move the needle on preterm birth. Ethiopia is a country of contrasts. On Oct. 25, Ethiopia elected Sahle-Work Zewde, its first female president, just a few days after approving a gender-balanced cabinet. In the midst of the #MeToo movement, it marked a poignant moment of good news for women. At the same time, life for most women in Ethiopia is undeniably difficult. According to statistics from UN Women, Ethiopia has some of the lowest indicators for gender equality in sub-Saharan Africa. The new president will have much to do. One of the most devastating effects of negative gender practices in Ethiopia is preterm birth. Every year, 23,000 babies die from being born too soon in Ethiopia each year, according to Every Preemie Scale, an organization funded by the United States Agency for International Development. This World Prematurity Day, that can’t be allowed to continue. Prevention of these preterm births is complicated. Working for Born on Time, our staff face the weight of generational discrimination against women and girls, which often contributes to preterm births. I came face to face with one of those practices while reviewing registers at an Ethiopian health clinic. Skimming down the ages of women receiving support on family planning, the number 12 jumped off the page. That’s only a few years older than my own daughter. Early marriage in this region of Ethiopia, although illegal, is still a common practice, driven by poverty and discriminatory social norms that value the chastity of girls over their life choices. No one knows the devastating consequences of the practice more than priest Jejaw. The religious leader lost his 14-year-old daughter to a protracted labour. “We didn’t know what to do. She bled in front of our eyes and we didn’t know what to do. I still hold the pain of losing a child,” Jejaw told me. The girl’s small and weak baby struggled to survive over the next few weeks, ultimately winning the fight to live. The child will now move through life without his young mother. Many in these communities are not aware of the dangers of such a young girl birthing a child of her own. Jejaw explained how, with the help of Canadian funds, he now spends his time working with Christian and Muslim religious leaders to teach about the dangers of early marriage for girls and their babies. Together, many religious leaders have vowed to no longer bless any early marriages, which often take place in secret from the law. On the outskirts of Gondar city, I met Tigist—a confident ninth-grader, about the same age that Jejaw’s daughter would have been when she died. Tigist is part of a peer-to-peer group that Born on Time has trained on sexual and reproductive health and rights. A few months ago, Tigist heard a rumour her closest friend Anguach, also a ninth-grader, was to be married. The two friends mustered up enough courage to confront the parents. “They told us that there is no use in educating a girl, that she’s just going to end up a housewife anyway. Her father even tried to beat us with a whip,” Tigist told me. Child marriage has been illegal in Ethiopia for years, and it carries heavy penalties. However, cultural norms have far greater weight in the remote communities that dot this mountain range. Chased away from Anguach’s home and still facing the prospect of an imminent marriage, the girls decided to go to the police. Tigist’s face beamed as she shared her ultimate victory, “The marriage was cancelled!” Addressing risk factors for preterm birth is complicated. However, the work of prevention matters. It matters to Tigist and her friend Anguach, it matters to Priest Jejaw’s two surviving daughters, and it matters to countless other young girls and women around the country. This is the kind of work that Canada is making possible. The world will closely be watching President Zewde’s progress over the coming years, and no one more than these young women defiantly addressing the role gender inequality and power imbalances play in their everyday lives. But they should not have to address them alone. Canadian funding for programs, such as Born on Time, have made a significant impact on women and children’s health globally. As we move towards Canada hosting the 2019 Women Deliver Conference next June, it is critical that we don’t leave these girls and women to fight their fight alone—Canada must continue to be their ally and champion after 2020. Marie Bettings is the program director for Born on Time, a public-private partnership of World Vision, Plan International, Save the Children, Johnson & Johnson, and the Government of Canada. The Hill Times