## I. INTRODUCTION In the Republic of Kyrgyzstan, young women and girls experience pressure to follow traditional gender roles around marriage and childbirth. These pressures to conform to societal norms reduce investment in adolescent girls' educational and career goals. Despite negative attitudes and beliefs around child marriage and legislation that states the minimum age of marriage is 18, child marriage persists in Kyrgyzstan. Early marriage often prevents young women from finishing their education and often results in adverse short and long-term health outcomes among adolescent girls (Reisel and Creighton, 2015). Due to early pregnancy and childbirth, in conjunction with lower access to healthcare, girls marrying as minors are at substantially significant risk for maternal morbidity and mortality, which increases the risk for neonatal death and stillbirth, premature and low birth weight infants, and infant and child morbidity and mortality. Further, even into adulthood, those married as minors are more likely to have significantly more children and experience low birth spacing between children. In addition to these maternal and child health concerns, there is also documentation of the mental health impact of child marriage. Research from Africa and South Asia has found that girls engaged or married as minors are at increased risk for depression and suicidality, linked with varying forms of gender-based violence. Additionally, there is some small but growing evidence that child marriage may increase the female risk for HIV and other sexually transmitted infections (STIs) (Raj, 2010). Furthermore, normative pressure persists for girls to marry young due to the fear that they may be 'left behind' otherwise or not marry. Young men are pressured to marry around the age of 22-25 because of gendered norms that they must first secure a job and assets such as a house or car to provide for their family before marrying (National Statistical Committee of the Kyrgyz Republic & UNICEF, 2019). Parents wish to ensure financial stability for their daughters and strengthen their social networks through marriage. This qualitative research was developed and implemented to add to the body of knowledge around the knowledge, attitudes, and experiences of youth in Kyrgyzstan with early marriage. Insights about adolescent knowledge, attitudes, and behaviors regarding early marriage can be leveraged by local nongovernmental organizations to develop programs that empower and protect greater access to education and career opportunities for young women. ## II. LITERATURE REVIEW There are an estimated 650 million child brides (UNFPA, UNICEF & Global Women's Institute, 2019). The causes and drivers of child marriage include lack of economic or educational opportunities, adolescent pregnancy, events causing displacements such as natural disasters or conflict, lack of implementation of laws and policies to prevent early marriage, inaccessibility of sexual and reproductive health services, and gender inequity (UNICEF Regional Office for Europe and Central Asia, 2015). Religious beliefs are also cited as a driving factor for child marriage. It is believed that protecting the "honor" of adolescent girls by ensuring they are virgins upon marriage is culturally important (Kosheleva et al., n.d.). In Kyrgyzstan, traditional and religious practices such as bride kidnapping, bride price, and polygamy occur with limited social protection for young women who become subservient members of their husband's family members (Childress, 2017). Forced early marriage and cohabitation is a crime that carries a prison sentence of up to five years; however, these policies are often not enforced (UNICEF Regional Office for Europe and Central Asia, 2015). The lack of enforcement perpetuates the practice of child marriage and bride kidnapping. A survey of adolescent girls in 2014 revealed that $10.4\%$ had begun childbearing between the ages of 15 and 19, which correlates with the $13.9\%$ prevalence of early marriage in girls aged 15 to 19 (Oxfam Novib, 2014). Another recent survey of adolescent girls in Kyrgyzstan showed that married girls face pressure to start having children as soon as they get married and continue until they give birth to a son, and only $7\%$ of girls between the ages of 15-19 use one or more methods of contraception (UNICEF, 2018). In a qualitative study by UNFPA, nine out of 11 married girls experienced complications during pregnancy, childbirth, or post-partum (Kosheleva et al., n.d.). Despite these health concerns, they were still expected to continue physical labor and household chores and were not provided adequate access to medical care by their in-laws. According to 2018 data from United Nations International Children's Emergency Fund (UNICEF), in Kyrgyzstan, $12.7\%$ of women ages 20-49 got married before 18, and $13.8\%$ of women aged under 24 married through some form of coercion (Childress, 2017). The United Nations also estimates that around 12,000 girls and women are abducted for marriage each year (Doolbekova, 2018). Parents and caregivers arrange early marriages for their girls due to religious views and honor, a desire for financial stability, and the influence of restrictive gender roles (Bouman et al., 2017) (Doolbekova, 2018). Women in Kyrgyzstan have fewer employment opportunities than men due to the restrictive gender norms that uphold early marriage and encourage them to leave school to marry and start a family (Mayoux, 2017). In some rare cases, early pregnancy is a driver of marriage before 18 due to societal norms and expectations (National Statistical Committee of the Kyrgyz Republic & UNICEF, 2019). Despite the legal protections for adolescent girls from early and forced marriage, there are still many barriers to its elimination. Since many early marriages are not registered, girls have few enforceable rights to financial support or property in the case of divorce or abandonment (UNICEF, 2018). In addition, it can be challenging for girls to leave a marriage if they experience abuse because they will be left vulnerable and do not have sufficient education or experience to find work. Another barrier to eliminating early marriage in Kyrgyzstan is early marriage is viewed as a "private matter" by society, making people unwilling to interfere or report suspected cases to law enforcement (UNICEF, 2018). Proposed solutions to end child marriage include the empowerment of girls through formal schooling, information, skills, and social support, mobilization of parents and community members, economic incentives for girls and their families, and enabling a legal framework that prevents early marriage (Malhotra et al., 2011). ## III. THEORETICAL FRAMEWORK This study explores the adolescent's perceptions in Kyrgyzstan about early marriage, gender norms within marriage, and their hopes for changes in the current social paradigm. According to Eco-social Theory (Krieger, 2012), effective public health practice should address and explore the lived realities of individuals facing exploitative practices in their communities. A clear understanding of individual and social factors driving harmful practices like child marriage is essential to developing evidence-based interventions that are relevant across an individual's life; and their historical context. Social norms reflect a complex set of issues that comprise "unwritten rules" that emerge at the nexus of beliefs, perceptions, and behaviors. Harmful practices like child marriage exist due to an intersection of factors. First, it is essential to determine individual values and beliefs. Social norms theory describes three related domains. To be considered normative, a behavior needs to also align with the perceptions about what others do, also known as descriptive norms or normative expectations. If I think child marriage is a common practice, I might support it for fear of being socially ostracized. This perception of prevalence is not enough; norms prosper not just if others do something but also perceptions that I am expected to follow the norms, injunctive norms (empirical expectations). So not only do I think child marriage is a common practice, but I also believe that there is external pressure on me to comply. These two conditions are insufficient; people's behavior is based on their outcome expectations. This third domain of social norms is critical. I may think everyone is engaged in a practice and feels unspoken pressure to follow the norm. It is my expectations of adverse social outcomes for bucking the norm or positive social effects for following the norm that ultimately predicts my behavior. The practice of asking elicitation questions about early marriage directly to adolescents (regarding experiential/instrumental attitudes, injunctive/descriptive norms, perceived control, and self-efficacy) allows us to hear from them directly. Better understanding, the specific social, cultural, and normative experiences of adolescents around child marriage can help develop a critical understanding of this practice from the adolescent's perspective (Glanz et al., 2015). Several factors play a significant role in predicting behavior change among adolescents (Krieger, 2012). These factors are typically categorized by personal, social, or environmental factors influencing behavioral change. Personal factors, or individual factors, include beliefs, knowledge, attitudes, or skills, whereas social factors involve interactions with friends, family, or community. Additionally, environmental factors consist of the physical and emotional environment that affect behavior change (Krieger, 2012). These factors often intersect and impact an individual's confidence to perform a new behavior (self-efficacy), their intention to perform a new behavior, or an individual's perceived behavioral control over performing a new behavior (Krieger, 2012). In situations such as child marriage, where structural inequities are at play, individuals, especially adolescent girls, perceived behavioral control significantly impacts their intentions and behaviors around marriage (Krieger, 2012). Similarly, personal, social, and environmental factors can impact the health outcomes of adolescents. For example, social relationships can positively or negatively affect adolescent health outcomes (Umberson & Montez, 2010). Social relationships that are supportive and come from family, friends, or teachers can reduce stress, improve mental health, and enhance feelings of personal control (Umberson & Montez, 2010). While females have rarely reaped the rewards of social relationships, including marriage, this has not been the case for married, heterosexual men worldwide. Historically, this population has gained more health benefits as they experience fewer costs from child-rearing and are provided the opportunity to balance work and personal demands (Umberson & Montez, 2010). Health recommendations provided by family, health care professionals, or a teacher can help lead to individual behavior change and improved health outcomes (Glanz et al., 2015). At the same time, social support and networks can greatly influence adolescents' behavior change and health outcomes by triggering the decision-making process within this population. ## IV. STUDY DESIGN, TOOLS, AND METHODS This study was conceptualized as a rapid needs assessment of social norms perpetuating child marriage in Kyrgyzstan to support future social and behavior change interventions addressing social norms around this practice. Due to the limitations resulting from the COVID-19 pandemic, this needs assessment was unable to be conducted face-to-face. The research team had to be flexible and gather data by creating a digital diary with a series of prompts for adolescent boys and girls. Because of school closures, the research team collaborated with local NGO partners to identify adolescents between the ages of 14 and 17 to participate in the needs assessment. The sample included six adolescent males and six adolescent females between the ages of 14 and 17. Half of the respondents were from Osh, the second-largest city in Kyrgyzstan, in the country's southern area. The other half of the respondents were from Chuy, a rural region located on the northern border with Kazakhstan. Participants recorded their thoughts and feelings about early marriage over ten days using specific prompts in the diary. These diaries were then uploaded over the Internet, consolidated by local NGO representatives, and shared with the research team. The digital diaries consisted of five core activities, inquiring about their interests and demographic information, personal characteristics, dreams for the future, ideal future partner, life before and after marriage, social support network, and social norms around child marriage in their community. These activities allowed adolescents to share their thoughts freely about norms surrounding marriage and gender in their community while providing crucial data to inform program planning, implementation, and evaluation. Table 1: Description of Tools <table><tr><td>Name of Tool</td><td>Description</td></tr><tr><td>Famous Me</td><td>Participants provided Demographic information including age, gender, residence, level of education, as well as psychographic information such as favorite tv show, favorite film personality, and favorite ice cream flavor. • Participants were also asked to describe themselves using "I am" statements. Research Question: What are the demographic characteristics of a typical adolescent in Kyrgyzstan?</td></tr><tr><td>Dream Tool</td><td>Participants drew and then described Their dreams for the future and then explained their drawing describing observations about family, education, profession, hobbies, and their future spouse. • Follow-up questions about the age at which they would like to start a family and how many children they would like to have were included in this tool. Research Question: What hopes do young people in Kyrgyzstan have for their futures?</td></tr><tr><td>Perfect Life Companion Tool</td><td>Participants described: • How and where they will meet their future spouse. • The qualities and characteristics of their ideal partner. • How they would like to be treated by their spouse. • The type of housework their partner will contribute. • How they would like to spend time with their spouse. Research Question: How do ideal perceptions of marriage differ between adolescent boys and adolescent girls in Kyrgyzstan?</td></tr><tr><td>Life Before and After Marriage Tool</td><td>Participants described: • The typical lives of women in their village before and after marriage in terms of how she should behave, what she will do around the house, and what she should be doing. • Why a woman would want to get married and why a woman would not want to get married. • The benefits and consequences of getting married along with the benefits and consequences of not getting married. Research Question: What are the outcome expectations that adolescents hold around the social benefits and negative consequences of child marriage?</td></tr><tr><td>Know, Feel, Do</td><td>Participants described: • Their opinions about what they know, how they feel, and what they can do about early marriage. • Their perceptions about what others in their village know, how they feel, and what they can do about early marriage. Research Question: What are the current social norms around early marriage in Kyrgyzstan?</td></tr></table> ## V. DATA CODING PROCEDURE AND ANALYSIS Data from the Famous Me, Dream Tool, Ideal Partner, Life Before and After Marriage, and Know, Feel, Do activities were analyzed using a grounded theory approach involving thematic analysis to reveal social norms around child marriage in Kyrgyzstan. These codes were designed to uncover ideas, assumptions, and conceptualizations of early marriage shared by adolescents. The information was organized by theme in matrices and annotated with memos. Exemplar quotes were selected to represent major qualitative themes (such as dreams for the future, gender expectations in marriage, the role of parents/caregivers in early marriage, and fears/anxieties regarding early marriage). The analysis was disaggregated by gender to highlight differences between adolescent boys and girls in their feelings about early marriage in their communities. ## VI. RESULTS Famous Me is an activity designed to allow participants to share information about themselves and develop rapport with the interviewers. This tool collected basic demographic data about participants such as age, gender, residence, level of education, and psychographic information such as favorite tv shows, favorite film personality, and favorite ice cream flavor. The favorite ice cream flavor prompt was used to engage adolescents. This tool also asked them to use "I am" statements to describe themselves. The most common adjectives used by male respondents to describe themselves were sporty, sociable, brave, responsible, studious, smart, honest, calm, funny, and shy. Female respondents used adjectives such as obedient, responsible, diligent, positive, sociable, inquisitive, industrious, smart, good, kind, and a good student. The Dream tool is a visual and narrative activity that asks participants to draw their dreams for the future and then explain their drawings describing observations about family, education, profession, hobbies, and their future spouse. A follow-up question inquired about at what age they would like to start a family and how many children they would like to have. An analysis of the dream tool revealed that $83\%$ of participants discussed future career aspirations, $58.3\%$ spoke about their family, $50\%$ mentioned their educational goals, $41.7\%$ discussed their hobbies, $41.7\%$ mentioned travel aspirations, and just $33.3\%$ talked about marriage in describing their dreams for the future. Male participants described additional goals for the future, such as building their dream home, living with their parents or grandparents, owning a car, being a musician, having money, winning an Olympic gold medal, competing in tennis and football tournaments, playing chess, attending university, and having an attentive and obedient wife who will do household chores. One boy said he hopes to "win an Olympic gold medal in Greco-Roman wrestling, visit and tour the U.S., become a surgeon, go to the final football championship, play in chess competitions and a concert, play tennis, and have happiness." On average, both boys and girls identified their ideal age of marriage to be between 24-25 years and their perfect number of children to be between three and four. This same boy went on to say, "I would like to start a family at 26 and have two children, one son, and one daughter." Both male and female participants identified a slight preference for sons over daughters. One girl said, "I would like to start a family around 26-27 years of age and have five children: three sons and two daughters." Boys identified preferred occupations such as a businessman, pilot, chef, surgeon, doctor, and farmer. Girls, on the other hand, identified dream professions as becoming lawyers, pediatricians, or journalists. Additional dreams that female participants described include defending girls' rights, owning a car, playing basketball, blogging, making video content for social media, having money, making their parents and husband proud, owning a dog, attending university, and having happiness and protection. While male participants wanted to go to the United States and Moscow, Russia, the female participants dreamt of traveling to Korea, Mecca, the United Arab Emirates, and Paris. Table 2: Dream Tool <table><tr><td colspan="2">Dream Tool</td></tr><tr><td>Gender</td><td>Quote</td></tr><tr><td>Male</td><td>"I hope to win an Olympic gold medal in Greco-Roman wrestling, visit and tour the U.S., become a surgeon, go to the final football championship, play in chess competitions and in a concert, play tennis, and have happiness."</td></tr><tr><td>Male</td><td>"I would like to start a family at 26 and have two children, one son and one daughter."</td></tr><tr><td>Female</td><td>"I would like to start a family around 26-27 years of age and have five children, three sons and two daughters."</td></tr></table> The Perfect Life Companion tool asked participants to discuss how and where they will meet their future spouse, the qualities and characteristics of their ideal partner, how they would like to be treated by their spouse, the type of housework their partner will contribute, and how they would like to spend time together. All female participants said they would like to meet their future spouse themselves either at work, university, or by chance. One girl said, "I told my mother that if they decided to marry me off, I would run away from home." On the other hand, half of the male respondents said their parents would find a wife for them. Girls hoped their future partner would be purposeful, humble, attentive, neat, patient, courageous, educated, respectful, honest, caring, generous, and kind. In contrast, boys hoped their spouse would be smart, well-mannered, faithful, loving, beautiful, approved by their parents, kind, faithful, sincere, educated, obedient, honest, quiet, friendly, and calm. Female participants identified the household expectations of their future partner to include sharing advice, discussing issues, helping raise children, making money, working, offering advice, and repairing household items/appliances. One female participant said, "I want him to treat me with care and not forbid me to go for a walk in the park or a movie with girlfriends. He does not forbid me from making my dreams come true." Male participants said they expect their future partners to do household chores, clean, entertain guests, cook, wash, raise children, tend to the garden, and milk cows. One male participant said, "She has to respect me, obey me, know her limits. She must understand and know that I want my own family to be like the family of my parents, with the same rules and order. I want her to stay at home raising her children. If she wants to work, then I will allow her to do that after, once the children have grown up." Boys said they would like to spend leisure time with their spouse by traveling, resting, going on a walk in the park or the capital, going to the zoo, watching movies at the cinema, spending time with their parents and children, going to a café, the theater, and the ballet. Girls said they would like to cook and eat delicious food with their spouse, discuss home renovations together, attend the same university, work together, listen to music, spend time in nature, go for walks, travel, watch movies and television and eat in restaurants. Table 3: Perfect Life Companion Tool <table><tr><td colspan="2">Perfect Life Companion Tool</td></tr><tr><td>Gender</td><td>Quote</td></tr><tr><td>Female</td><td>"I told my mother that if they decided to marry me off, I would run away from home."</td></tr><tr><td>Female</td><td>"I want him to treat me with care and not forbid me to go for a walk in the park or a movie with girlfriends. He does not forbid me from making my dreams come true."</td></tr></table> The Life Before and After Marriage tool asked participants to describe the typical lives of women in their communities before and after marriage regarding how they should behave, what they will do around the house, and what they should be doing before marriage. The tool then asked participants to describe why a woman would want to get married and why a woman would not want to get married. Finally, it asked them to describe the benefits and consequences of getting married and the benefits and consequences of not getting married. Adolescent boys and girls shared similar responses about how girls should behave, what girls should do around the house, and what they should be doing before marriage. Both groups primarily responded that girls should take on antiquated gender roles and perform activities such as cooking, cleaning, and obeying their family members before marriage. For example, one boy said, "Girls should be modestly obeying her parents, help her mother with household chores, clean around the house, cook and read books conducive to the development and enrichment of worldviews." Likewise, one girl responded, "Girls should do household chores, babysit children, not get an education." Adolescent girls responded with more comprehensive answers relating to how a girl should be and what they should be doing. For instance, one girl mentioned, "Girls should be modest and fun and thinking about their future work." Adolescent boys and girls also responded with similar answers about how girls should behave, what girls should do around the house and what they should be doing after marriage. Responses from adolescent boys touched upon areas relating to household chores, taking care of and respecting their husbands and other family members, child-rearing, faithfulness, and obedience. One boy said, "A girl after marriage should be obedient, respect her husband's relatives, do "women chores" around the house, and love their children."Adolescent girls shared similar responses while adding that girls after marriage should be polite, non-emotional, well-groomed, support their family, and be silent and humble. For example, one girl mentioned, "After marriage, a girl should speak politely to the husband's parents and relatives." Additionally, the Life Before and After Marriage tool asked participants to elaborate on why a woman would or would not want to get married. When asked why women want to get married, boys responded with answers relating to bearing children, pleasing their parents and relatives, financial senses, feelings of loneliness and independence, subjective norms, and media portrayals. One boy said, "Women want to get married so that they have independence and the money of the husband. Also, it is written on the Internet and on TV, and in all families, they think so. They see it in the village." Girls replied with identical answers; however, some girls mentioned that girls are expected to marry to have children. One girl said, "Loneliness is only good for Allah and no one else," while another girl responded with, "Women and girls were hammered into the head that they should continue their birth, they should have children and bring them up." The participants were then asked explain why women would not want to get married. Boys responded with answers such as the ability to work, freedom and independence, study and attend university, inability to find their ideal life partner, financial reasons, and control and abuse of women. One boy said, "They want to get an education. To be independent. Perhaps they were once offended by men, or they saw men behaving as husbands, beating their wives, behaving dishonestly." Girls replied with answers relating to having the opportunity to work and study, inability to find an ideal life partner, a lack of desire to perform household chores, feelings of being afraid, dislike of children, the work that goes into being married and being a wife, restrictions that come with marriage, and the betrayal that can result from marriage. One girl responded that when you are married, "There are a lot of prohibitions, you can't speak. Children take a lot of time, the husband controls, and giving birth is hard and painful. There will be no freedom. All relatives and communities will control your actions." In addition, another girl said, "Some are afraid to get married because some families treat their daughters-in-law as slaves. They do not give freedom and do not consider her opinion." Adolescents also reflected on the benefits and consequences of marriage for women. Boys identified the benefits of marriage for women, including having children, building a family, having a life partner, becoming a mother, and gaining respect in society. For instance, one boy responded by saying, "The benefits to marriage for women is that they get to create a family, become a mother, and build a family life." Likewise, boys identified the consequences of marriage for women as societal repercussions in the case of divorce, dislike of the husband or his relatives, abuse from a spouse, and the expectation that hobbies will end. One boy said, "The consequences of marriage for women are that they could endure screaming and beatings from their husband." Additionally, male participants identified the benefits of not getting married for women as having the freedom to pursue work and university, autonomy, spending time with relatives, economic freedom, and having options for potential spouses. One boy said, "The benefits of not getting married for women are that they get to have a profession and more time to spend with their parents." In contrast, they identified the consequences of not getting married for women as childlessness, financial difficulties, societal repercussions, and loneliness. In particular, one boy replied, "The consequences of not getting married for women is that they will be alone." Girls identified the benefits of marriage for women as happiness, spouse support, having a family and a home, becoming a mother, and having love. A participant responded, "The benefits of marriage for women is that they get to learn to appreciate their husband and have a home. They get to learn to raise children, and everyone will know she is married."They identified the consequences of marriage for women as family quarrels, child-rearing, issues with the husband and his relatives, inability to pursue work or studies, and potential divorce. One girl said, "If a woman is divorced, her children are taken away. If a woman returns home after divorce, she is married a second time as a second wife. Or she is married to a man much older than her without even asking her consent." Female participants said the benefits of not getting married for women are freedom, the ability to study and live for themselves, the ability to pursue a career, fulfill dreams, and the ability to help their parents. One respondent said, "The benefit of not getting married for women is that her dreams will come true." Participants said the consequences of not getting married for women are living with their parents, being childless, and not having someone to take care of them in old age. One respondent said if she does not get married, her "parents can scold, constantly reminding her that she made the wrong decision at the time, that she did not listen to them." Another girl said, "Even if she is financially independent, she will still be told that she was not married because she has flaws. If she refuses to marry, she will be left alone, and people will condemn her." Table 4: Life Before and After Marriage Tool <table><tr><td colspan="4">Life Before Marriage and After Marriage Tool</td></tr><tr><td colspan="4">Life Before Marriage</td></tr><tr><td colspan="4">How Should A Women Behave, What A Women should Do, What Should A Women Be Doing</td></tr><tr><td colspan="2">Male Adolescents</td><td colspan="2">Female Adolescents</td></tr><tr><td colspan="2" rowspan="2">"Girls should be modestly obeying her parents, help her mother on household chores, clean around the house, cook and read books conducive to the development and enrichment of worldviews."</td><td colspan="2">"Girls should do household chores, babysit children, not get an education."</td></tr><tr><td colspan="2">"Girls should be modest and fun and thinking about the future."</td></tr><tr><td colspan="4">Life After Marriage</td></tr><tr><td colspan="4">How Should A Women Behave, What A Women should Do, What Should A Women Be Doing</td></tr><tr><td colspan="2">Male Adolescents</td><td colspan="2">Female Adolescents</td></tr><tr><td colspan="2">"A girl after marriage should be obedient, respect her husband's relatives, do "women chores" around the house, and love their children."</td><td colspan="2">"After marriage, a girl should speak politely by the husband's parents and relatives."</td></tr><tr><td colspan="4">Life Before and After Marriage</td></tr><tr><td colspan="4">Why A Women Would Want To Get Married</td></tr><tr><td colspan="2">Males</td><td colspan="2">Females</td></tr><tr><td>Reason</td><td>Quote</td><td>Reason</td><td>Quote</td></tr><tr><td rowspan="2">Independence and Financial Reasons</td><td rowspan="2">"Women want to get married because so that they have independence and the money of the husband. Also, it is written on the Internet and on TV and in all families they think so. They see it in the village."</td><td>Loneliness</td><td>"Loneliness is only good for Allah and no one else"</td></tr><tr><td>Child Baring and Expectations</td><td>"Women and girls were hammered into the head that they should continue their birth, they should have children and bring them up."</td></tr><tr><td colspan="4">Why A Women Would Not Want To Get Married</td></tr><tr><td colspan="2">Males</td><td colspan="2">Females</td></tr><tr><td>Reason</td><td>Quote</td><td>Reason</td><td>Quote</td></tr><tr><td rowspan="2">Ability to Attend University/Control and Abuse of Women</td><td rowspan="2">"They want to get an education. To be independent. Perhaps they were once offended by men or they saw men behaving as husbands, beating their wives, behaving dishonestly."</td><td>Restrictions, Lack of Freedom, Control over Women, and Feelings of being Afraid</td><td>"There are a lot of prohibitions, you can't speak. Children take a lot of time, the husband controls, and giving birth is hard and painful. There will be no freedom. All relatives and communities will control your actions."</td></tr><tr><td>Lack of Desire to Perform Household Chores, Lack of</td><td>"Some are afraid to get married because some families treat their</td></tr><tr><td></td><td></td><td>Freedom, and Feelings of being Afraid</td><td>daughters-in-law as slaves. They do not give freedom and do not consider her opinion."</td></tr><tr><td colspan="4">Benefits of Getting Married</td></tr><tr><td colspan="2">Females</td><td colspan="2">Males</td></tr><tr><td colspan="2">"The benefits of marriage for women is that they go to learn to appreciate their husband and have a home. They get to learn to raise children and everyone will know she is married."</td><td colspan="2">"The benefits to marriage for women is that they get to create a family, become a mother, and build a family life."</td></tr><tr><td colspan="4">Consequences of Getting Married</td></tr><tr><td colspan="2">Females</td><td colspan="2">Males</td></tr><tr><td colspan="2">"If a woman is divorced, her children are taken away. If a woman returns home after divorce, she is married a second time as a second wife. Or she is married to a man much older than her without even asking her consent."</td><td colspan="2">"The consequences of marriage for women are that they could endure screaming and beatings from their husband."</td></tr><tr><td colspan="4">Benefits of Not Getting Married</td></tr><tr><td colspan="2">Females</td><td colspan="2">Males</td></tr><tr><td colspan="2">"The benefits of not getting married for women is that her dreams will come true."</td><td colspan="2">"The benefits of not getting married for women are that they get to have a profession and more time to spend with their parents."</td></tr><tr><td colspan="4">Consequences of Not Getting Married</td></tr><tr><td colspan="2">Females</td><td colspan="2">Males</td></tr><tr><td colspan="2">"parents can scold, constantly reminding her that she made the wrong decision at the time, that she did not listen to them."</td><td colspan="2">"The consequences of not marrying for women is that they will be alone."</td></tr></table> The Know, Feel, Do tool asked participants to describe the social norms surrounding child marriage by having them give their opinions about what they know, how they feel, what they can do about early marriage, and their perceptions about what others in their community know, how they feel, and what they can do about early marriage. The male respondents said they know that there are early marriages, that parents give their daughters to rich grooms, that the law prohibits early marriage, early marriage causes high mortality, a girl is not ready to become a wife and mother at 15-16 years old, and that girls will not be able to provide for the upbringing of their children without an education. Girls said they know that early marriage breaks people's lives, the consequences are harmful, they will become a mom early, it is harmful to health, girls can die during childbirth, they are not yet formed as a person, their interest in life will be lost, and that there are laws against early marriage with administrative fines. One girl responded, "Many regret that girls are married early." In response to the social norms around child marriage, boys said, "That everyone knows and sees it. Many do not know the laws or understand the negative consequences of early marriage or early marriage is not the norm in their village". They responded, "That others feel a sense of pity and have different opinions that they cannot answer on their behalf. People don't talk about their feelings regarding child marriage because they often feel indifferent." Boys went on to say that people would not meddle or say anything if they disagreed with an early marriage and have seen parents or others arranging an early marriage for their daughter, who was a minor. One boy said, "The community should intervene if they see a mistake. Early marriage is a mistake." Girls said that others know about early marriage, some pretend they are indifferent, and others know the law prohibits early marriage. However, they still create families at an early age. For example, low-income families form early marriages for religious purposes. One girl said, "My mom does not know, but I know she got married early. Then she married my father. All teenagers think marriage is bad and the consequences are negative. Girls think about it more. Boys don't even think about the future; they are not being stolen or married." Female participants said, "That other people don't feel anything, they don't care about early marriage, that their mom says to take your time with marriage, that people are indifferent or don't react, that others view it as a normal phenomenon and feel regret." Girls said that some people are taking legal action, that teachers say it is forbidden to get married early and girls should be educated first, and that there are no early marriages in their village, so no one pays attention to it. One respondent said, "Our neighbor got married last year; she was 15 years old. Everyone was happy." Another girl said, "At 18 years old, girls are looking for a partner. If they cannot find one after 25 years, they are left alone." Table 5: Know, Feel Do Tool <table><tr><td colspan="2">Know, Feel Do Tool</td></tr><tr><td>Gender</td><td>Quote</td></tr><tr><td>Female</td><td>"Many regret that girls are married early."</td></tr><tr><td>Male</td><td>"The community should intervene if they see a mistake. Early marriage is a mistake."</td></tr><tr><td>Female</td><td>"My mom does not know, but I know she got married early. Then she married my father. All teenagers think marriage is bad and the consequences are negative. Girls think about it more. Boys don&#x27;t even think about the future, they are not being stolen or married."</td></tr><tr><td>Female</td><td>"Our neighbor got married last year, she was 15 years old. Everyone was happy."</td></tr><tr><td>Female</td><td>"At 18 years old, girls are looking for a partner. If they cannot find one after 25 years, they are left alone."</td></tr></table> ## VII. DISCUSSION Data collected from the digital diaries revealed several significant themes, including lack of autonomy in decision-making, desire for freedom; future fears and hopes; gender inequities, social norms supportive of child marriage, and different expectations for married women compared to married men. Findings from the Know, Feel, Do tool concluded that parents and guardians were perceived as the decision-makers in early marriage, leaving both young women and men with limited autonomy in selecting both when they would marry and who their spouse would be. One boy said, "No one listens to me when there are adults involved." Another boy said, "If my parents had chosen my wife of 15 or 16 years and her parents would not mind, then I would have been silent and would live with it. Our parents decide everything." The dream tool disclosed the strong desires of adolescents for achieving their personal, professional, and academic goals. It conceded that early marriage remains a barrier for young women to achieve these goals. Both boys and girls expressed pity and concern for adolescents undergoing early marriage. One girl said, "I feel sorry for the girls. I think it's wild. It's not a deliberate act. I don't condone it. If the girls are firm and if they have a purpose, it's very difficult to get them married." The Life Before and After Marriage tool uncovered the difference in domestic roles and expectations of marriage between men and women. Young women are expected to bear children, perform household duties, and respect and obey their husbands and relatives. In contrast, young men are expected to find work, lead a marriage, and follow his aspirations. Furthermore, the characteristics of a future spouse and their household responsibilities revealed in the Perfect Life Companion tool demonstrated gendered viewpoints of the roles of men and women that are highly consistent with social norms and societal expectations in Kyrgyzstan, with more boys than girls reporting their appreciation of the status quo, related to gender and social norms. Information from this study has implications for future theory, program development, implementation, and monitoring and evaluating the effectiveness. ### a) Implications for Theory The collected information provided insights into the determinants of child marriage by using elements of eco-social theory and exploring the lived realities of individuals that could potentially face harmful practices in their communities. Overall the results show that child marriage exists within a complex web of individual and social factors. Self and normative expectations of gender roles were evident, with boys and girls tacitly agreeing with gender discriminatory norms, indicating that adolescents know about the harmful impacts of child marriage and generally hold opposing views on the subject. When asked questions in the context of their own lives, adolescents provided answers that suggest that theories of social norms can be applied to interventions designed to end child marriage. ### b) Implications for Program Implementation Although further validation is needed, these results have implications for developing and implementing future prevention programs. While recognizing family and community dynamics at play, traditional gendered attitudes about the other sex among boys and girls need to be challenged. School-based interventions designed to focus on social and emotional learning skills would help in influencing the next generation of adults in Kyrgyzstan. In addition, adolescents know the negative impacts of child marriage and express opposition to the practice. However, the data shows a lack of critical thinking and negational skills to communicate these attitudes and values properly. As a result, future interventions should teach adolescents how to talk and what to say to their parents while empowering young women and men to express their voices and challenge social norms that continue to uphold gender inequity. Young men who appeared to be more conservative than girls in their gender role attitudes should be involved in these interventions to shift their perceptions of gender roles and support them in developing healthy behaviors in relationships. Furthermore, the results showcased the need for improving parent-child communication. It is possible to hypothesize that parents have similar reservations about talking with their children. The lack of communication between parents and children needs to be addressed by creating interventions designed for parents and adolescents to foster honest and open communication between parents and their children. Interventions that spark a dialogue about the causes, drivers, harms, and solutions for child marriage in Kyrgyzstan will help families, as well as communities, to explore social norms that perpetuate gender inequality. These conversations should include key stakeholders such as adolescent girls and boys, parents, religious leaders, policymakers, health care workers, and teachers. ### c) Implications for Research and Evaluation The present needs assessment data by no means replaces a theory-defined and evidence-based situation and causal assessment. Instead, this research delves deep into adolescents' knowledge, attitudes, and behaviors around child marriage norms using an innovative diary prompt. Lasting change requires addressing structural determinants like support for girls' access to education and career development. Hence addressing child marriage in Kyrgyzstan requires concerted action at all levels of the social-ecological model. We can further recommend that different diary-based activities can be used to study and compare youth populations and regularly monitor to what extent a given intervention is proving successful to plan for scale-up and which intervention approaches need to be reviewed, revised, and adapted to local contexts. ## VIII. LIMITATIONS The small sample makes it impossible to draw generalizations from the data. Threats to validity in this study include potential mistranslations or misinterpretations based on the Russian to English translation of the data. The translated data may have lost some of the cultural nuances in translation. Additionally, the need to change the data collection processes due to travel restrictions during the COVID-19 pandemic resulted in inadequate training for NGO staff explaining the activity to the adolescents. The long-distance nature of this project also limits the understanding of the cultural context of the researchers. It is also possible that the participant's responses were influenced by response bias due to the sensitive nature of the questions regarding gender and marriage. Despite these limitations, this small needs assessment does provide rich data to help design and implement future multilevel interventions to address the issue of child marriage by tackling social and gender norms. ### ACKNOWLEDGMENTS Thank you to our colleagues from UNICEF Kyrgyzstan and to all the young people who shared their thoughts, dreams, and experiences with us through participating in this study. List of Abbreviations C4D: Communication for Development UNFPA: United Nation's Fund for Population Activities UNICEF: United Nations International Children's Emergency Fund Funding Source: This work was supported through an institutional contract in Communication for Development (C4D) capacity building on changing social norms supporting child marriage. By UNICEF, Kyrgyzstan to Drexel University under contract #42106677.

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