Purpose: Child marriage (before 18 years) is widely prevalent in Pakistan, and disproportionately
affects young girls in rural, low-income, and poorly educated households. Our study aims to
determine the associations between child marriage and controlling behaviors (CB) and spousal
violence by husbands against adolescent and young women in Pakistan beyond those attributed to
social vulnerabilities.
Methods: We analyzed data from the Pakistan Demographic and Health Survey, 2012e2013, of
currently married women aged 15e24 years who had participated in the domestic violence
module (n ¼ 589, 22.5% [589/2,615] of the subsample aged 15e24 years) to identify differences in
CB and spousal violence experiences between early (<18 years) and adult (18 years) ages at
marriage. Associations between child marriage and CB and spousal violence by husband were
assessed by calculating adjusted odds ratios (AOR) using logistic regression models after controlling
for demographics, social equity indicators (education, wealth index, and rural residence),
spousal age gap, and husband’s education.
Results: Overall, 47.8% of currently married women aged 15e24 years in Pakistan were married
before the age of 18 years. About one third of women aged 15e24 years in Pakistan reported
experiencing CB (31.8%) and spousal violence (31.1%) by their husbands. Compared with adult marriage,
child marriage was significantly associated with CB (AOR ¼ 1.50; 95% confidence interval [CI],
1.042e2.157), any form of spousal violence (physical or emotional) (AOR ¼ 2.03; 95% CI, 1.392e2.969),
emotional violence (AOR ¼ 1.86; 95% CI, 1.254e2.767), and physical violence (AOR ¼ 2.44; 95% CI,
1.582e3.760), including severe physical violence (AOR ¼ 2.57; 95% CI, 1.122e5.872).
Conclusions: Effective interventions are needed to prevent child marriages and raise awareness
about their negative consequences, with special reference to spousal violence.