Early Marriages Among Adolesencent Girls in Afyonkarahisar , Turkey

Aim: Early marriages have considerable adverse effects on adolescents and children health. To determine the factors associated with early marriages, this study was conducted in a forensic sample of Afyonkarahisar province. Method: Between 2005–2006, Adolesencent women who were admitted to the court subsequently referred to the psychiatric outpatient clinics of the univercity. The authors who are psychiatrist individually interviewed all subjects by using a sociodemographic questionnaire form which was applied to 61 women aged between 15-17 years. Result: Most of adolescents in our sample were from rural area and about 65.5 % of participants did not view early marriage as a problem. Of all cases the rate of consanguineous marriage was 23.0 %. More than half of participants reported that their knowledge of sexuality were none or little, and the most common sources of information on sexuality were relatives and friends. Conclusion: It was detected that most adolescents in our sample were from a low socio-economic class, and after finishing the primary school, they wait for a marriage. Furthermore, they receive very little sex education from their parents and a modern institutional education programme in their school is needed.


INTRODUCTION
Civil marriages are quite common in Turkey, having a structure containing social and cultural diversity.Religious marriages, although they constitute an important place among all marriages, the most common form of marriages is to solemnize both religious and civil marriages.The ratio of religious marriages is higher among marriages of girls under the legally marriageable age (1,2).Marriages of girls and boys under the legally marriageable age stipulated in the Turkish Civil Code are described as early-age marriages, and men and women cannot marry unless they turn 17 under the same Code.However, the courts are authorized to permit the marriages of men and women who turned 16 under extraordinary circumstances and for an important reason (3).In these judicial applications, the judge asks for a report from the Departments of Forensic Medicine and Psychiatry to ensure that the physical and psychological status of the person to marry is convenient for marriage.
Literature on this subject report that child or adolescent marriages are common in eastern cultures and in developing countries, with estimates that more than one third of girls aged between 10-19 entered or will enter their 18th year married (4,5).In our society, the general trend toward male marriages allows a marriage after a certain level of education, performing military service and being employed.To this respect, marriage ages of males are more advanced ages compared to females.In general, there is no such concern for women.In this regard, according to Turkish Statistics Agency data, while the number of first-time marriages was at the ages of 16-19 for 2.7% of males, this ratio was 22.8% in females, in 2008 (6).As in many countries, it is stated that "making a good marriage" is one of the leading values for the socialization of female children in Turkey, and that it is with the marriage relationship that women can satisfy their social, emotional, sexual and economic needs in a socially acceptable manner (2,7).According to Turkish Statistics Agency data, 27.5% of women married in 2004, and 24,6% of women married in 2008 was aged between 16 and19 years, while the average marriage age was 26,1 years in men and 22,8 in women.Marriages under the age of 16 are legally impossible, so they are off the record and are not included in the statistics (6).It is stated that earlyage marriage affects education level importantly; furthermore, theratio of early-age marriages is lower among adolescents with higher levels of education (8)(9)(10)(11)(12).
It is also stated that another risk factor for early-age marriages is consanguineous marriages, which is more common in traditional societies, that one in every five marriages in Turkey is a consanguineous marriage.The women who practiced consanguineous marriages married one year earlier than women who did not practice consanguineous marriages.The age of first marriage was reported as 18 in consanguineous marriages whereas this number is 19 for those who did not practiced consanguineous marriage (1,11).
Marriage age is a rather important demographical indicator because marriages are common nationwide, in Turkey, and that almost all childbirths are in the marriage.As a matter of fact, adolescents married at early-age become pregnant before they are ready physical and psychological for maternity.Relevant literature state that pregnancy in early-age marriages negatively affects both the women's health, and pregnancy and child health thereafter (11,(13)(14)(15)(16)(17)(18)(19).

MATERIALS AND METHODS
The cases in our study are composed of persons sent by the courts, between the years 2005-2007, to the Polyclinics of Psychiatry-Forensic Medicine, Faculty of Medicine, Afyon Kocatepe University, who were asked to be determined for suitability for marriage with regards their physical and psychological development.Sixtyone persons composed of adolescence age femalesliving in central and rural areas of Afyonkarahisar were questioned by a detailed sociodemographic data form created by us, after their written consent is obtained.
For physical abuse in the questions such as, 'Has she been physically/sexually/verbally abused in her family?',explanations were made such as, 'Have you ever been the subject of non-accidental incidents like beating, biting, punching, kicking, burning, poisoning in the family?','Have you ever had any attitudes with any member of your family (your parents, your elder brother/sister or a person close in age acting by force) with sexual content?' for sexual abuse, and 'Have you ever been the subject of insulting, threatening, humiliation, ridiculing, contempt in the family?' for verbal abuse.Acts of violence among individuals in the family, parents-children and siblings, were studied.

RESULTS
Average ages of 61 samples included in our study and the age that they intend to marry were 16.46±0.56,21.30±1.98,respectively.Considering their education levels, it is understood that 62.3% (n:38) of them were graduates of the junior divisions of secondary schools.Of all cases 16.4% (n:10) had quitted the junior divisions of secondary schools, 8.2% (n:5) of them quit the high school, 6.6% (n:4) quit the grammar school and 6.6% (n:4) were grammar school graduates (Table 1).We found that the family structure was mostly in the form of nuclear family (62.3%, n:38) and wide family (34.4%,n:21), while 2 persons (3.3%) had single-parent family models.Considering the residential areas of cases, 42.6% (n:26) living in villages ranked first, followed by cases living in towns (37.7%, n:23), living in districts (4.9% n:3) and living in cities (14.8%, n:9), respectively.Nine persons (14.7%) lost their parents, with six persons (9.8%) losing their fathers, 2 (3.3%) losing their mothers, and 1 (%1.6)person losing his/her father-mother.Only two of the cases had migration experiences in the past, with the migration from cities in the Central Anatolian region.It was observed that 55.7% (n:34) of them covered by social security were registered while 15 (24.6%) persons had no social security coverage.Upon examination of employed individuals' kind of employment and level of income, we found that four out of the 61 persons included in our study were employed, 1 was still a student and 56 individuals had not work and described themselves as housegirls or housewives.Findings revealed that fathers of participants were responsible financial income of family (93.4%), while the mother had been working only in one case.Considering the family level of income, we found that monthly family income was 0-499 TL in 67.2% (n:41) of cases.(Table 2).The question of whether or not she was pressured for marriage received 86.9% (n:53) negative and 13.1% (n:8) affirmative replies.Following a brief information about the concepts of physical, sexual and verbal abuse, they were asked whether or not they suffered such incidents in family settings, the answer was yes in 8.2% (n:5) for physical abuse, 8.2% (n:5) for verbal abuse and 0 (zero) for sexual abuse.On family members 8.2% (n:5) had history of police records.We understand that 23% (n:14) of cases had kinship ties with the persons they would marry, and 55.7% (n:34) knew the person they would marry by some means.Upon examination of whether or not the two persons had a flirting phase before taking the traditional steps like binding with a promise to wed, engagement or religious marriage, 39 (63.9%) persons were found to have not experienced such a process.
Upon examination of the shaping of the marriage process, 10 persons showed the attitude of escaping to the person with whom they intended to marry without family permission.Three of the cases expressed that they were pressured to marry with someone else, and 4 of them expressed the non-permission of the family for the person they intended marriage with as justification.Three persons expressed that they were kidnapped without of families' and their own consent and 1 person expressed that she had to marriage out of necessity.The rate of those living with their families during the application to court was 73.8% (n:45), while the rate of those living with their husbands' family was 26.2% (n:16

DISCUSSION
The opinion that there has been an increase in median first marriage age in recent years in Turkey has been confirmed in various studies (1,2).The sample in our study was made of individuals sent by the courts and was not society-based.The sample would not ensure our full understanding of the incidence of early-age marriages in Afyonkarahisar in absolute numbers; however, this may provide important information as to what is behind this phenomenon.
Men have higher first marriage ages for reasons such as higher social acceptance of men's continued education trends compared to women, obligatory military service, and the process they get into to own a business.On the other hand, women marry in earlier ages if they discontinue their education and do not get into the working life (1,2,6).The presence of about 5 years of difference between the two genders, in men's favor, in our study is a factor supporting this.According to the Turkish Population Health Research-2003 data, considering that the median education time for many age groups is 4,6 years.Depending on active modernization process the increase and spread of education, and the 8-year mandatory education practice in recent years, we can conclude that the women of new generation have a higher level of education compared to olders.In parallel to this participants in our samples were more educated compared to 2003 data.On the other hand, their parents had education levels similar to that of the general education level in Turkey, and there was a similarity between the education levels of our cases and their mothers.It is visible that higher level of parents' education reflects positively on their children but mother's education level was more determining.It is stated that educated women married at a later age than uneducated woman worldwide did, could delay having babies, and benefited the practices of family planning at a better level (6,8,11,20).In a study by Ergöçmen et al., it was reported that while the least marriage age was 23.5 in women who are graduates of high schools, this was 17.6 among uneducated women (12).
In addition to being less educated, factors such as limited economic conditions, (21), and living in rural areas and loss of parents (2,20), are associated with early-age marriages in factors like consanguineous marriage (1).It is understood that the samples constituting our study mostly live in rural area (80.3%) being members of lowincome family setting.Additionally, they were unemployed and described themselves as housegirl or housewife having active responsibility after appointment by their families in processes like first degree relative child care.When asked about their marriage at this age, it is seen that 65.5% (n:40) of them consider this as a normal situation.In a setting where marriage consciousness is prepared for since early ages, it become evident that marriage is expected after grammar school years.
In traditional societies where early-age marriages are considered normal, consanguineous marriages are a common problem.It is stated that consanguineous marriage ratio is low among urban people who have high levels of education, raised in developed parts of Turkey (21).In our study, we saw that 23% (n:14) of the cases had consanguineous relationship with the persons they intend to marry.Considering that the incidence of consanguineous marriage in Turkey was found to be 20-21% in past years, which displays that tendency for consanguineous marriages still continues at certain levels in our country.
We observed that 55.7% (n:34) of the cases already knew the person they would marry in advance, but this ratio was 32.7% (n:20) when consanguineous marriages were excluded.When examined whether or not two persons had a flirting stage before taking traditional steps like promise to wed, engagement or religious marriage, it is found that 63.9% (n:39) did not experience such a process, and 18% (n:11) experienced this process for 1-3 months.Results show that spouse selection by young people is mostly led by their families and that the process was kept short.An impression has been made that families did not allow a flirting process long enough to know one another and wanted to take further step between the two families to processes like a promise to wed, engagement or religious marriage.
In our study, we questioned the tradition of dowry, which is varying among different regions in Turkey and continuing in a large scale in the rural parts of the Eastern and Southeastern Anatolia.Only one person practiced this tradition that made us think dowry was not a widely accepted tradition in these regions (21).
According to Turkey Population and Health Research-1993 (21), it is stated that marriage rate among girls aged 15-19 with deceased parents was 3 times as high as those whose parents are alive.Parallel to this in our study in 9 (14.7%)cases mother or father of participants were dead of these, 6 (9.8%) lost their fathers, 2 (3.3%) lost their mothers, and 1 (1.6%) lost both of parents.It can be concluded as loss of one or both of parents is a risk factor facilitating adolescent girls' marriages.
Upon examination of disputes among individuals in the family, most of them responded as none or very few.Likewise, questioning the concept of abuse in its physical, verbal and sexual aspects, affirmative response was 8.2% (n:5) for physical abuse and 9.8% (n:6) for verbal abuse, with no sexual abuse.
Examination of marriages made by escaping or kidnapping revealed that the ratio of this type of marriage is higher in younger ages.(21) In our study, we found that 3 persons (4.9%) were kidnapped for a marriage without consent of women and marriage plans were made after an agreement between the families after some time.In an interview with this person, her saying ''I consented to marriage because I had to'' summarizes the situation reflecting the traditional perspective.The attitude of escaping for purpose of marriage without family consent was encountered in 10 persons, out of whom 3 stated being forced to marry someone else, 4 stated that families did not consent to the person she intended to marry to justify their acts.Although this finding brings into mind that spouse selection of young people was not left to their wishes.What is more striking is that those in child ages who cannot marry the person they want or those forced to marry someone they do not want to marry find the remedy in marriage with someone else or someone their families do not consent to.It has been considered that the main problem is an atmosphere creating the acceptance of marriage attitude at that age as normal by the person herself.As a matter of fact, it is seen that 65.5% of them considers marriage at this age as normal based on their own values.
The question, 'Are you informed about sexual matters (about sexual intercourse, pregnancy etc.)?If yes, how did you acquire such knowledge?'asked to those who had early-age marriages (by religious marriage) or refused by the judge because they wanted to do such a marriage was replied by more than half of them saying no (n:8) or a little (n:24), which is a thought-provoking.When asked about the source of information, it is understood that 1st degree sources as parents were not the primary sources, while friends and relatives are the main source of information compared to mothers.Newspapers-televisions and schools were secondary sources.In 6 to 8th grades of schools, although it is positive but not sufficient as 4 of them were informed by their classroom teachers in the guidance courses about the adolescence period (there were 2 who stated they could ask questions out of the lessons).Besides, this practice is not standard in all schools even in this state.We conclude that sexuality-related subjects have to be handled in elementary school curricula, and the guidance teachers should be trained on such subjects within the frame of a plan.Likewise, 6 persons among those who stated multiple sources mentioned newspaperstelevision, considering the misinformation in this area, makes it imperative to develop strategies to benefit from the power of visual media in the positive sense.
Most adolescents with low socio-economic class, after finishing the primary school, they wait for a marriage.They should receive maternity education from a modern institutional education programme in their school is needed.

Table 1 .
Education Status of Cases and Parents. ).

Table 2 .
Occupations and Economic Status of Families of Cases