Impact of family law reform on adolescent reproductive health in Ethiopia: A quasi-experimental study

In sub-Saharan Africa, nearly 2 in 5 girls are married before the age of 18. Child marriage has adverse consequences for women's physical, emotional, and social wellbeing and development. Emerging evidence has identified the importance of gender equality as a social context for shaping adolescent sexual and reproductive health norms. In 2000, Ethiopia's government passed the Revised Family Code, increasing the minimum age of marriage from 15 to 18 for girls without exceptions, and strengthening women's rights within marriage regarding marital property, divorce, and employment. I evaluated the impact of the law on adolescent reproductive health indicators and newborn mortality rates. I used difference in-differences (DID) and synthetic control methods (SCM) to compare cohort trends in Ethiopia to those in comparison countries. I show that implementation of the law was associated with a 9-percentage point reduction in risk of adolescent birth for exposed cohorts, an 8-percentage-point reduction in child marriage, and a 10-percentage-point reduction in sexual initiation before age 18 in SCM models. There was no association of the law with changes in risk of termination of pregnancy, unmet need for contraception, infant mortality rates, or neonatal mortality rates. Results were consistent across SCM and DID models, although DID estimates were slightly attenuated. I discuss mechanisms and policy implications. The results of this study provide evidence that strong legal frameworks for gender equality may be effective catalysts in facilitating social change around child marriage. (C) 2021 Elsevier Ltd. All rights reserved.