Exploring the determinants of child marriage, development and implementation of intervention program for the decision-making skills promotion of parents about child marriage in Sanandaj city: A mixed method design

Abstract

Introduction: Child marriage, which is especially true for girls, is a violation of human rights. This phenomenon threatens the health and well-being of children worldwide and can have harmful consequences for both boys and girls. The present study was conducted to discover the determining factors of child marriage, design, and implement an intervention program to improve parents' decision-making skills in preventing the marriage of girls under 18 years old in Sanandaj City. Method: A multi-method approach was used. The study was promoted in three stages to achieve the objectives. In the first stage, for the qualitative part, 41 participants were included in the study with the purposeful sampling method and with maximum diversity. Semi-structured interviews were used to collect data. After extracting the phrases from the qualitative research, a literature review was done to add the determinants that were not identified in the qualitative study to the extracted phrases. In the next step, using the opinions of key informants and experts and the panel of experts, the cognitive determinants of children's marriage were prioritized, then the strategies to improve the cognitive determinants of children's marriage among parents were determined. The second phase was a descriptivecross-sectional study and was conducted to prepare the tools and the psychometric properties (the measurement of the cognitive determinants of children's marriage and the decision-making skills tool. In the third phase, using the obtained strategies, an intervention program was developed in the form of training packages to improve parents' decision-making skills. Findings: The themes extracted from the interviews that show the reasons for child marriage in Sanandaj summarized: the neutralization of girls, customs and beliefs supporting early marriage, the determining power of the males, technology and facilitations, the positive role of the law and agents of law/religion, religious beliefs, concern for protection of family/daughter, parents' desperation, lack of wise authority in the family, double-edged sword of economy, demographic dynamics of society, naivety of ages youth. Using the codes extracted from the qualitative study and literature review, two tools were extracted, including the cognitive determinants of children's marriage (49 items) and the parents' decision-making skills tool (10 items). In the third phase of the study, to check the effectiveness of the intervention program, the improvement of parents' decision-making skills was evaluated using the decision-making skills questionnaire. The results showed that the difference in the total score before the intervention and after 3 months in the two groups was statistically significant. Also, after 6 months of the intervention, there was a significant difference between the scores and the average scores in the intervention group. Furthermore, among the dimensions of the questionnaire, there was a significant difference between the average dimensions of accuracy andcontrol between the two groups at the beginning of the intervention and after 6 months. However, no significant difference was observed between the two groups at different times in terms of distinctiveness and optimization. Conclusions: Strong cultural norms left from the past, kinship systems, and neighborhood environments, directly and indirectly, perpetuate the early marriage of boys and girls in Sanandaj City. Therefore, to reduce the phenomenon of child marriage, it seems necessary to emphasize cultural elements in all kinds of research and micro and macro health promotion policies. The law marriage age of 13 years for girls and its Shariah support in Iran-Sanandaj is the most important context in which child marriage takes place. With the decrease in the demand for child marriage in families, the mechanism of the law will automatically change. Also, the tool which was designed is a comprehensive, specific local reliable, and stable tool in the area of decision-making skills and cognitive determinants of marriage of girls under 18.