'It is this which is normal' A qualitative study on girl child marriage and health in conakry, Guinea

Guinea has the eighth highest rate of girl child marriage, as 1 in 2 girls marry before age 18. The aim of this study was to qualitatively explore how women married as children in Conakry, Guinea see their marriage as related to their health and their children's health. This study draws from grounded theory. The primary data sources were in-depth interviews collected from August 2016 to January 2017; during that time, we also conducted brief ethnographic interviews, observation, and participant observation. Purposive sampling was used to identify 19 participants who first married before age 18. We used open coding for data analysis. At the first level of coding, key categories were identified. At the second level of coding, categories were grouped. We secured ethical board approval for all study procedures. Through this study, a new picture emerges about health experiences within girl child marriage. We found that most women perceived health disadvantages of their early marriages (n = 16), captured through themes of poor sexual and reproductive health, intimate partner violence and long-term consequences, poor mental health and psychosocial well-being, and other physical health conditions. Most women also perceived health advantages of their early marriages (n = 15), captured through themes of having children, "good health for me and my children," access to health care, delaying first pregnancy and birth spacing, and positive mental health and psychosocial well-being. Sixty-three percent of participants articulated both disadvantages and advantages of their early marriages as related to health outcomes. These findings could be considered in many marital experiences in several contexts, yet women's reflections point toward the importance of the timing of their early marriages in their experiences. Change in preventing this practice and addressing its full set of consequences will not happen effectively without incorporating the voices and experiences of women affected.