In Kono district where I work, and across Sierra Leone, we have a teenage pregnancy epidemic. This is not just a problem of unprotected sex between teenagers, but of older men impregnating teenage girls. Sierra Leone has among the highest teenage pregnancy rates in the world. The National Strategy for the Reduction of Adolescent Pregnancy reports that 30 per cent of all pregnancies occur among teenage girls. Over 30 per cent of girls said their partner was more than ten years older than them.
Sierra Leone has long had a teen pregnancy problem but the rate is rising. During the Ebola outbreak when schools were closed for a long time, UNICEF reports that 14,000 teenage girls became pregnant and 11,000 of these were in school before the outbreak. Sierra Leone does not let visibly pregnant girls stay in school and pregnancy is one of the most common reasons for girls to drop out of education.
Many of the girls and young women like 13-year-old Sia tell a similar story: they live in vulnerable households, are rejected after becoming pregnant, and excluded from their regular schooling. According to the Status of Youth Report for 2014 and 2015, early pregnancies are also linked with “premature delivery, stillbirth, foetal distress as a result of the high incidence of obstructed labor resulting in fistulas, birth asphyxia, low birth weight, and miscarriage”. Babies born to teen mothers are far more likely to die than those born to older women and it is therefore not surprising that Sierra Leone is among the countries with the highest maternal mortality rates in the world.
One major problem is that there is no longer reproductive health education in Sierra Leone’s schools. I remember when I was in secondary school, we had a subject called Family Planning Education (FPE) where we were taught about sexuality and contraception. FPE helped us understand about the risks of having sex at an early age and the benefits of using contraception. I don’t understand why the subject was removed from the curriculum.
The use of modern contraceptives is very low in Sierra Leone. An official survey conducted in 2010 reported only 5 per cent of girls aged 15-19 were using any contraceptives, yet 24.5 per cent of girls under 15 years of age had already started having sex. Girls report that access to contraceptives is limited and they fear the stigma attached to attending adolescent clinics at primary health care facilities. A solution may be to offer contraceptives in schools. We know from studies elsewhere that access to contraceptives has led to a decline in teenage pregnancies in the US, UK and other countries.
The government now agrees that the situation is urgent and is hampering our development potential. The First Lady has taken a lead in addressing this problem, speaking out on early marriage and the problems associated with teenage pregnancy.