Infertility Risk and Child Marriage

Sammanfattning

Infertility – the impaired ability to conceive or carry a pregnancy to term – is
widespread in many low-income countries. Beyond the consequences suffered
by those directly affected, high infertility rates can have broad societal impacts,
as people may respond by marrying and having children at younger ages to
achieve their fertility target. I study the link between infertility risk and marriage
timing in Madagascar, focusing on child marriage. To study this I use spatial
variation in infertility risk caused by the parasitic disease schistosomiasis and
compare the effect of two endemic strains of this parasite. Both strains share
key transmission mechanisms and have comparable health impacts, except that
one leads to infertility while the other does not. I show that community-level
exposure to the infertility-causing strain increases the probability that a woman
is infertile by 20–40 percent. Exposure to this strain also increases the probability
of child marriage by up to 22 percent, with similar effects on the probability of
giving birth during adolescence. Parents may invest less in schooling for girls
who are expected to marry young. I find that women exposed to the infertilitycausing
strain are less likely to have any education.