ICRH Monographs: Alexia Sabbe: Forced and child marriage at the intersection of health, gender and human rights : understanding the determinants in Morocco and the impact of the migratory context in Belgium

SUMMARY
Introduction
With over 650 million women alive today already suffering the consequences of child marriage, the practice of forced and child marriage disproportionally impacts girls and women. Not only does it violate their fundamental human rights to bodily and sexual integrity, it is a public health problem on  a  global  scale,  effectively  preventing  women  around  the  world  from  achieving  their  full  potential.  
Given  its  impact  on  physical  and  psychological  wellbeing,  child  and  forced  marriage,  as  a  serious form of  violence  against  women,  has  long-term  detrimental  effects  on  individuals,  family  and communities as a whole. It brings about a wide range of specific health consequences. A growing body of research is also pointing to the huge economic costs of child and forced marriage, including the direct costs to health care, law enforcement, etc. Considering that the detrimental repercussions are  intergenerational,  affecting  their  children  as  well,  full  implementation  of  human  rights  and access  to  appropriate  health  care  for  women  and  girls  is  a  prerequisite  for  global  progress  and sustainable well-being for all.
In  Morocco,  the  changes  to  the  social  and  legal  framework  surrounding  sexual  and  reproductive rights since 2004 seemed very promising to target violence against women in particular. Yet rates of child marriage and violence against women in general remain high, and appear to be on the rise.  
Furthermore,  due  to  globalisation,  increased  mobility  and  large  numbers  of  migrants  in  host societies, the issue of child and forced marriage has become a concern on an international scale. In Europe, the issue is most often discussed within the contexts of immigration and integration on the one hand, and domestic violence on the other. Migration also includes marriage migration of second and subsequent generations bringing partners from their homeland into the host country. Spurred on by policies at European Union level, Member States have been implementing laws and action plans
to tackle the practice. As a result, minority groups have been specifically targeted by a combination of stringent criminal and immigration regulations. It is therefore important to understand the impact of this legal framework on the migrants in Europe for whom the policies were designed. As one of the largest minority groups in Belgium, the Moroccan community is directly affected.  
Objectives and Methods
Given  the  global  magnitude  of  forced  and  child  marriage,  and  the  increasing  numbers  of  international  migrants,  the  general  objective  of  our  research  is  to  ascertain  the  determinants  of forced and child marriage in Morocco and the impact of the migratory context on the issue among Moroccan migrants in Belgium. To this end, specific objectives were set forward. First we analysed the  prevailing  policies  and  laws  regarding  forced  and  child  marriage  in  Europe  and  Belgium, including the risk factors and challenges in addressing the issue in Belgium. We also attempted to identify  what  the  overall  impact  is  of  the  (institutional)  context  and  social  environment  on  the practice among minority communities. Second, we aimed to understand the (institutional) context, social environment and cultural perceptions regarding forced and child marriage in Morocco. Third, we  aspired  to  ascertain  the  determinants  of  forced  and  child  marriage  at  the  community  level  in  Morocco, and among the Moroccan communities in Belgium, including the impact of the migratory context.  And  fourth,  our  aim  was  to  provide  recommendations  to  prevent  and  efficiently  target  
forced  and  child  marriage  in  Morocco  and  in  Belgium.  By  providing  stakeholders  and  policy makers with pertinent contextual knowledge and insights into constraints to decision-making power of women, we aim to contribute to the prevention of forced and child marriage, and enhance sexual and reproductive rights of women and girls.
This  study  was  conducted  using  a  predominantly  qualitative  approach;  comprising  the  Multiple Streams  Approach  and  participatory  research.  Kingdon’s  Multiple  Streams  Framework is  applied to  shed  light  on  the  policy  process  regarding  forced  marriage  in  Europe  and  its  outcome.  Furthermore,  obtaining  a  genuine  understanding  of  the  context,  and  elements  within  each  context,  that  are  influencing  child  and  forced  marriage  can  only  be  achieved  through  a  participatory  approach  with  the  involved  parties,  in  which  Focus  Group  Discussions  (FGDs),  stakeholder
interviews  and  household  interviews  are  central  to  the  research.  The  Intergenerational  Dialogue method  was  applied  in  FGDs  in  Morocco  and  Belgium.  Additionally,  Intercultural  Dialogue  was conducted  in  Belgium.  Data  collected  from  FGDs  was  useful  in  triangulating  and  validating  the information  from  the  household  interviews  and  stakeholder  interviews.  Respectively  7  (Morocco)  and  9  (Belgium)  FGDs  were  held  in  the  research  settings.  In  order  for  the  data  to  be  as  representative  as  possible,  the  locations  of  the  FGDs  incorporated  rural/provincial  and  urban  settings in accordance with the country in which they took place. In each country/research setting,
approximately 20 households were targeted for in-depth semi-structured interviews. An overall total of  125  women  in  Morocco  and  106  woman  in  Belgium  participated  in  the  FGDs  and  household interviews.  Finally,  interviews  were  held  with  22  stakeholders  in  Morocco  and  25  stakeholders  in Belgium with firsthand experience of child and forced marriage.
The  systematic  framework  developed  by  Hooghiemstra  was  applied.  Besides  structural  macro-level factors in the wider societal and demographic context, this model also encompasses the role of social  networks  and  community  (meso-level)  in  the  more  immediate  environment  and  micro-level facets  such  as  personal  characteristics  (including  beliefs  and  preferences)  and  direct  family  to explain  decisive  factors  in  partner  choice  and  marriage  formation,  thus  uncovering  any  form  of  pressure  or  duress  in  this  complex  process.  In  addition,  the  correlation  between  the  multi-level  factors was taken into consideration.  
We  then  applied  thematic  qualitative  analysis,  in  which  patterns  or  themes  within  the  data  were reported  and  analysed  using  framework  grids.  Raw  data  was  sorted  by  theme  and  placed  in  the relevant  part  of  the  theoretical  model  through  which  a  conceptual  framework  of  themes  and  sub-themes was developed, allowing significant factors to emerge.  
Results
Despite  the  reform  of  the  Moroccan  Moudawana  (Family  Code)  in  2004,  establishing  a  minimum  age for marriage, child and forced marriage remains common. The law presents the opportunity to request a judge to authorize marriage before the age of 18, a provision that is effectively used to a great extent.
From  the  viewpoint  of  professionals  who  are  closely  involved  in  tackling  the  issue  in  Morocco,  policy measures and the law do have considerable potential in bringing child marriages and forced marriages to a halt. Yet despite reforms, equality gaps between men and women remain in a number of  laws,  particularly  in  relation  to  family  matters,  which  continue  to  weaken  women’s  agency.  
Women  are  still  not  sufficiently  protected  from  violence.  The  problem  lies  in  the  fact  that  the  applicable legal frameworks are interpreted through the lens of restrictive social norms, thus further reinforcing  the  bias  towards  women.  Social  norms  in  Morocco  impact  on  all  aspects  of  agency,  including  economic  participation,  roles  in  family  life  and  the  ability  to  participate  in  public  life.  
They  are  often  maintained  and  strengthened  through  biased  delivery  of  services  by  public  sector  institutions, failing to comply with applicable legal and administrative frameworks. This is the case, for example, when judges in family courts use the loophole in the law to apply their own viewpoints and beliefs to authorize underage marriages.  
The combination of unequal treatment in legislation together with limiting social norms that affect women’s  behaviour  cause  severe  obstacles  preventing  women’s  agency.  Legal  restrictions  reflect  the prevailing social norms, especially with regards to family and personal life, where the concept of  family  honour  is  effectively  upheld  by  the  law.  This  is  evident  in  the  criminalization  of  consensual  sexual  relations  outside  of  marriage,  yet  marital  rape  is  not  punished.  Norms  are enforced through family and community pressure on the one hand, and through self-enforcement by
the individual on the other hand. Shame is an inherent part of the culture. This is also discernible in the Moroccan Belgian community, where it lives on in shame around premarital relationships.
The  importance  of  specifically  directing  efforts  towards  the  older  generation  of  parents  and  grandparents  emerged  from  the  research.  As  a  result  of  the  use  of  the  Intergenerational  Dialogue  method,   participants   repeatedly   emphasized   the   need   for   more   opportunities   to   have   open communication  between  parents  and  children.  The  pressure  on  young  women  and  girls  from  the elders  is  often  considerable,  effectively  discouraging  daughters  from  claiming  their  right  to  freely enter into marriage. Women in Morocco who openly oppose the will of their fathers are subject to intimidation  and  ostracism  from  their  families,  rendering  them  cut-off  and  alone  in  a  male dominated public space.
This also highlights the problem with the specific criminal law against forced marriage in Belgium and  other  European  countries.  It  takes  away  the  victim’s  agency,  in  the  sense  that  police-led interventions  and  public  prosecutors  take  over  without  consent  from  the  women  or  girl  herself.  Women’s agency within minorities is effectively ignored, and victims find themselves alone, unable to remain in their family and social environment. Supporting women from within their communities is   overlooked   in   favour   of   governments’   top-down   focus   on   regulation.   Similarly,   linking   
immigration  policy  with  the  issue  of  forced  marriage  redirects  remedial  measures  away  from victims and legitimates the use of state power to punish and restrict. The prevailing policy discourse fails to engage with this dynamic and is at odds with the needs of those it seeks to assist. It may be beside the point whether or not a specific criminal law and tighter immigration controls are effective means to combat forced marriage; at least in the viewpoint of (potential) victims. Law and policy are treating marriage as a matter pertaining to public interest and not purely as a private
matter. Its impact on society and on the lives of those involved legitimizes this interest, yet little or no regard is given to the health effects of victims of forced marriage and those at risk. As attention is  placed  on  criminalization  and  stringent  immigration  policies,  ethnic  minority  population  groups  bear the greatest burden. The conceptualisation and portrayal of forced marriage as a cultural issue acts as a barrier to appropriate intervention. Not only do they suffer reduced accessibility to health providers,  the  potentially  adverse  effects  of  the  current  policy  framework  affects  their  health  and  well-being  at  large.  The  serious  consequences  for  women,  including  sexual  violence,  and  the physical and psychological health risks associated with it, receive little attention. The research also highlighted that (potential) victims feel they are not able to access mainstream service providers for fear that they will not be understood. Participants from the Moroccan Belgian community consider that  they  are  better  off  with  the  help  of  someone  with  the  same  Moroccan  background,  otherwise they would not implicate an aid organisation or social services.  Among the Moroccan Belgian community, forced and child marriage is no longer an acute problem. This doesn’t mean there are no difficulties to overcome. Considerable challenges lie in the “double standards”  that  apply  to  men  and  women  in  the  community.  The  disempowerment  of  women  as  a  result,  only  leads  to  increased  vulnerability  and  violence  in  some  cases,  highlighting  the  need  for tailored support by social services and in health centres.
The  migratory  context  did  not  appear  to  perpetuate  or  give  rise  to  the  occurrence  of  forced marriages and child marriages in a significant way. The results, however, tentatively do point to a strengthening  of  the  element  of  religion.  It  not  only  surfaces  as  the  most  imperative  element  in partner choice, moreover, its re-educating role as a deterrent for forced marriage is notable.
Conclusions and recommendations
The  legal  framework  in  Morocco  fails  to  acknowledge  the  underlying  fundamental  concepts  of  women’s  and  girls’  rights,  instead,  women  and  girls  are  often  conflated  with  their  stereotyped gender roles as wives and mothers, particularly with regard to violence. This bias is reflected in the insufficient  protection  to  women  and  girls  who  fall  outside  stereotyped  gender  roles.  A  holistic  approach  to  violence  against  women  and  girls  is  necessary,  recognizing  that  gender  is  socially  constructed.   Among   the   recommendations,   the   decriminalization   of   sexual   relations   outside   marriage  is  emphasized  and  the  minimum  marriage  age  of  18  should  be  adhered  to,  allowing  no  exceptions.
Pressure  from  older  generations  was  reported  to  be  a  significant  determinant  of  child  and  forced  marriage.  In  Moroccan  society  in  general,  the  desires,  character  and  talents  of  the  individual  are  often  overlooked  in  favour  of  what  is  beneficial  for  the  collective:  family  and  community. Therefore, personal characteristics at the micro-level are overall less impactful. Working directly on education, and above all fostering self-confidence and agency in girls and women can, in the long term,  increase  the  impact  that  micro-level  factors  will  have  on  preventing  a  forced marriage.  This should  go  hand  in  hand  with  sensitization  efforts  geared  towards  the  older  –  often  illiterate  –  
population groups, using television and radio, which is crucial to tackle forced and child marriage. The  results  redefine  the  role  of  women’s  associations,  social  workers  and  so  on,  with  the recommendation to also focus their efforts on awareness raising among older generations. Child  and  forced  marriage  are  an  outcome  of  social  norms  and  community  pressure.  Financial poverty  certainly  adds  to  the  pressure,  making  the  short-term  relief  in  the  burden  of  poverty  by marrying  off  daughters  a  viable  course  of  action.  Yet,  only  relieving  financial  pressure  through  
financial incentives for example is insufficient to achieve the Sustainable Development Goal (SDG) of ending child and forced marriage by 2030. This is demonstrated by the paradoxical experience in the  Marrakech  region,  where  the  prevalence  of  child  marriage  increased  despite  high  rates  of economic  growth  and  decline  in  poverty  in  the  region.  Interventions  that  fail  to  address  the underlying  social  norms  have  limited  effects.  In  light  of  these  findings,  a  long-term  and  holistic view is necessary. Dimensions such as realized rights (gender equality in norms and laws), health, and  access  to  education  should  be  the  focal  point  to  enhance  women’s  and  girls’  agency  on  all  
levels  (micro-,  meso-  and  macro-level).  Rather  than  cost-benefit  based  approaches  that  rely  on single-focused   indicators,   a   multi-dimensional   approach   provides   the   highest   likelihood   of improving overall health and well-being in the long run.  
In order to successfully address child and forced marriage, programs and interventions are required that  are  tailored  to  the  local  context.  Efforts  to  increase  school  attendance  and  educational attainment  in  the  Marrakech  region  should  be  supported  with  complementary  efforts  such  as gender-conscious  life-skills  programs  in  schools  and  structured  engagement  with  communities.  
Complementary  efforts  should  also  include  addressing  barriers  to  adequate  higher  educational  and employment opportunities for girls as well as ensuring their safety and security in public spaces.  
Seeing that child and forced marriage is deeply rooted within patriarchal societies, the requirement to  include  working  with  men  and  boys  is  paramount.  Our  research  pointed  to  the  need  for  the father’s  authority  to  remain  intact  in  any  intervention,  demonstrating  the  necessity  to  engage fathers,  fathers-in-law,  brothers,  etc.  Most  programs  do  not  meaningfully  address  men  and  boys within  households  to  share  obligations  and  household  responsibilities  set  forth  in  programmatic interventions. Therefore gender relations within families are not configured, which undermines the success of these interventions in the long run. Addressing the engrained ‘double standards’ for men and women in the Moroccan Belgian community would also benefit from directing efforts towards men and boys to level the gender inequality.
A  profound  shift  is  paramount  where  religious  and  traditional  arguments are  deeply  embedded  in the social fabric of the community. Families and parents often look to cultural and religious norms to  justify  child  and  forced  marriage.  In  the  case  of  Morocco,  religious  leaders  can  be  effective advocates in ending child marriage and forced marriage by endorsing to increase the marriage age on the one hand, and by specifying that coercion to marry is not condoned by the Islam. Research in Belgium  indicates  that  religion  is  already  playing  a  re-educational  role  among  the  Moroccan  
Belgian community with regards to forced and child marriage.  
Overall,  in  light  of  developments  over  the  past  decade,  and  the  increased  potential  for  terrorism, policy  choices  in  Europe  have  been  based  on  security  concerns.  Legislation  like  criminalizing forced  marriage  has  detrimental  outcomes  for  the  desired  goal  of  protecting  women  and  children. Prevention  of  forced  marriage  cannot  be  used  to  limit  free  movement  rights  of  third-country  national  family  members  of  EU  citizens  beyond  what  is  allowed  by  the  Free  Movement  Directive (2004/38/EC).  Approaching  forced  and  child  marriage  as  a  human  rights  issue  and  a  form  of  gender-based violence avoids stigmatization of ethnic minorities or communities that are linked to this  type  of  practice.  Moreover,  it  paves  the  way  for  effective  solutions  that  are  not  essentially punitive  or  estrictive.  Health  services  and  programs  are  an  appropriate  entry  point  for  addressing  interpersonal violence against women and girls, such as forced and child marriage, rather than the emphasis  on  prosecution  and  criminalization.  A  coordinated  response  for  (potential)  victims  of  forced  marriages  within  health  facilities  in  Belgium  supports  wellbeing,  health  and  safety  while  simultaneously honouring women’s agency. Trained frontline health care workers, situated in local (community)   health   centres,   offer   the   advantage   of   being   easily   accessible   and   providing   
anonymous care. Women who experience violence are more likely to use health services than those who do not, although they rarely explicitly disclose violence as the underlying reason. Health care providers are often the first point of professional contact for survivors/victims of violence, and yet the underlying violence is frequently invisible to them. In many cases, health services are currently inadequate  due  to  the  invisible  nature  of  the  violence  itself.  Reframing  the  discourse  on  forced  marriage  to  one  focusing  on  wellbeing  and  respecting  women’s  agency,  effectively  embedding  protection  in  a  broader  coordinated  multi-sectoral  policy  is  a  challenge  that  policymakers  should  
embrace. Providing training and tools for health workers and other frontline workers is paramount