Community knowledge, attitudes, and health consequences of child marriage in Nsukka, Nigeria

Background: Child marriage, defined as marriage before 18 years, remains a significant public health and human rights concern globally and in Nigeria. In southeastern Nigeria, socio-cultural norms, family expectations, and economic pressures perpetuate early marriage despite legal restrictions. This study assessed community knowledge, attitudes, and perceptions of child marriage and its health consequences in Nsukka, Enugu State, Nigeria. Methods: A mixed-methods cross-sectional study was conducted from March to May 2025 among 412 adults sampled from five wards in Nsukka LGAof Enugu, Nigeria. Structured questionnaires captured socio-demographics, awareness, knowledge, and attitudes, scored and graded as good/fair/poor and negative/neutral/supportive. Qualitative data from six focus group discussions and ten key informant interviews were analyzed thematically. Quantitative data were summarized with descriptive statistics and multivariate logistic regression to identify predictors of supportive attitudes. Results: Participants were mostly female (56.3%) and aged 25–34 years (38.6%). Awareness was high (82.3%), but only 58.2% correctly identified the legal minimum age. Negative attitudes predominated (69.4%), with 30.6% supportive or neutral. Low education, poverty, and poor knowledge predicted supportive attitudes. Recognized maternal and neonatal risks included obstructed labour (44.2%), anaemia (38.8%), and low birthweight (34.5%). Conclusion: Child marriage persists in Nsukka due to socio cultural and economic factors. Targeted health education, legal enforcement, socio-economic empowerment, community engagement, and adolescent-friendly health services are needed to reduce early marriage and improve maternal and neonatal outcomes.