Ranked 155 out of 162 in the 2019 Gender Inequality Index, the situation for women and girls in Sierra Leone is among the worst in the world, with the inequalities and vulnerabilities particularly acute for adolescent girls. The issue of adolescent fertility is important for both health and social reasons. Children born to very young mothers are at increased risk of sickness and death.
Teenage mothers are more likely to experience adverse pregnancy outcomes and to be constrained in their ability to pursue educational opportunities than young women who delay childbearing. In Sierra Leone, 21% of women age 15-19 have begun childbearing; 18% have had a live birth, and 4% are pregnant with their first child. 1 Teenagers with a secondary education and those in the highest wealth quintile are less likely to have started childbearing than those with less education and those in the lower quintiles.
Rural teenagers are more likely to start child bearing earlier than urban teenagers, at 29 per cent vs 4 per cent and by district, the proportion of teenagers who have begun childbearing is lowest in Western Area Urban and Falaba (11% each) and highest in Pujehun, Moyamba, and Karene (31% each).