I'm from India. India is a large country. In India, there are currently 113 million adolescent girls. We expect 45%—this is the national average—to get married before 18 years of age, which amounts to 51 million girls. Every year, roughly 8 million to 10 million are getting married and becoming mothers. That's the magnitude of the problem.
We've been doing this now since 1998. We realize that unless there's an integrated approach, we will not be able to really address all of the determinants that result in early marriage and in the disempowerment, the discrimination, for adolescent girls.
There are three components that we are implementing.
First is the empowerment of unmarried adolescent girls, both school-going and non-school-going girls, with an emphasis on girls living in villages and in the slums of India. What do we expect as an outcome of this empowerment? We expect better self-esteem and better self-efficacy in these girls, but above all else, the ability to negotiate with their parents to delay the age of marriage and to continue with their education. The outcomes would be better educated girls and a delayed age of marriage, thereby delaying and preventing some of the very adverse consequences of early marriage.
Second, while we are trying to prevent child marriage, we realize that there are still girls getting married at an early age and that they will continue to get married at an early age. We are providing primary level access to sexual and reproductive health services to these married adolescent girls. The reason this is so is that we have done research which indicates that 75% of these married adolescent girls, girls who get married before 18 years of age, suffer from a severe burden of morbidity, particularly at the time of pregnancy. Unless we address that burden of morbidity, they will suffer the consequences of this for the rest of their lives.
The third piece of the integrated program is dealing with boys and young men and making them gender sensitive, making them caring individuals, and reducing sexual abuse and domestic violence in our communities, because that is an additional load of morbidity that these girls suffer from.
If we do adopt an integrated approach, and if we do have a focused intervention on adolescent girls, we're confident that it would be a much better way of reducing maternal and neonatal mortality worldwide. Globally, there's a trend that there is a reduction in maternal and neonatal mortality. If we were to have a focused intervention for these girls, we would be able to reach our goals much faster. The reason is very simple. Mortality among these girls is five times higher as compared to women of more than 20 years of age. It's a win-win situation if we focus on adolescent girls, both the married and unmarried adolescent girls.
I would like to share this experience with you. We've been doing this since 1998, and at least in India, nobody really talked about this as an important national level issue until 2011, when we were invited to Ethiopia to establish Girls Not Brides. Suddenly, over the last three years, it has become an international issue. It has become a national issue. There are countries talking about it. There are governments that are ready to do something about this grave issue.
One of the things I would really like to leave behind, is that if we do address this huge burden of morbidity that these girls suffer from, we'll be saving billions of dollars every year. That's the kind of expenditure that the costs of early marriage and motherhood have. The thing that we really need to do collectively is ensure that this is on the post-2015 development agenda, because as I said earlier, when internationally there is pressure, there is also national pressure and there is pressure on the states and at the local level to perform.
Thank you.