The number of pregnant women below the age 20 in Makawanpur district is alarmingly high, health officials say.

About 18 percent of total pregnant women in the Hetauda Sub-metropolitan City are under the official marriage age of 20, according to Bhola Chaulagain, head of the sub-metropolis’s health unit.

But this is only the number of women who visited health institutions for regular pregnancy check-ups, Chaulagain said.

“We estimate the number of pregnant women below 20 years is higher than our record,” he said. “There are several other women who have not visited the health institutions or don’t have access to health institutions.”

Underage marriage is still pervasive in the district, which falls in Bagmati Province. Early marriage leads to early pregnancy in women, putting their health and that of the foetus at risk. Various governmental and non-governmental organisations have launched programmes to address the practice but with little success.

Officials and experts say a lack of awareness among the public, coupled with social and cultural norms, contributes to the high number of child marriages in the district.

The sub-metropolis is doubling down on its efforts to control child marriage and early pregnancy, claims Bhim Prasad Timalsina, manager of the sub-metropolis’s social development division.

“We have submitted a proposal to the provincial government to conduct a campaign against child marriage in the district,” Timalsina said. “Efforts will be made to stop child marriage by mobilising mothers’ groups and promoting children’s clubs.”

As elopements by young people in the district are high, it is important to target awareness campaigns at them, Timalsina added.

“Most adolescents drop out of school after SEE due to various factors such as lack of access to institutions that offer higher studies,” he said. “If we can give those who elope an access to higher education, there will be an improvement in the current situation.”

The Civil Code, which came into effect in August 2018, sets the minimum legal age for marriage at 20. According to the health unit’s data, in the past six months of the current fiscal year, out of the total 3,364 pregnant women, 710 were under-20.

According to Chaulagain, based on the data of regular pregnancy check-ups conducted in 21 health institutions of Hetauda, those who get pregnant under the age of 20 are found to be from socially and economically disadvantaged backgrounds.

“Children who don’t have access to higher education tend to get married early, out of their own choice or their parents’,” said Chaulagain, adding the number of girls becoming pregnant at 12–13 years is still high in Raksirang Rural Municipality and Kailash Rural Municipality in the western part of the district.

According to Rajiv Jha, information officer at Hetauda Hospital, last year, 2,668 people gave birth at the hospital, 249 of them under the age 20. From mid-July 2022 to mid-January 2023, the hospital recorded 1,379 deliveries. As many as 137 of the women were underage.