Sierra Leone’s Ministry of Health and its International partners are making strides to its long-driven clamour to achieve sexual reproductive health for its women and girls. While the efforts are being applauded by many women, rights activists, and civil societies, believe there is still a long road for Sierra Leone to achieve increased access to high-quality and youth-friendly reproductive health services for marginalized adolescent girls, including those at risk of Teenage Pregnancy.
Sierra Leone’s largest family planning organisation Marie Stops International defines ‘sexual and reproductive health’ as a person’s right to a healthy body; the autonomy, education and healthcare to freely decide who to have sex with; and the knowledge and healthcare products to avoid sexually transmitted infections or unintended pregnancy. Sexual health is an integral part of overall health and well-being, ensuring people can have pleasurable and safe sexual experiences, free of coercion, discrimination or health risks.
According to the United Nation Commission on population, deprivation of access to education on sexual and reproductive health and rights results in a range of harmful practices — such as early and child marriages, unwanted pregnancies and high levels of gender-based violence.
The challenges of women in Sierra Leone accessing sexual and reproductive health are enormous, including sexual and domestic violence, access to health care, education, and finances. The maternal mortality rate in Sierra Leone is among the highest in the world with close to 1000 mothers dying in every 100,000 live births.
On the 12th March, 2024 the human Rights commission of Sierra Leone [HRCSL], Spearheaded by its Executive Secretary, Mr. Joseph Kamara also launched a series of strategic engagement with key stakeholders to ganer support for an imminent Public Enquiry aimed at addressing the critical issue of Maternal Mortality in the country. The commencement of the engagement with key stakeholders is to galvanize support in pursuit of human Rights and health care advancement in the country.
According to UNFPA, The country’s high teenage pregnancy and HIV/STI infection rates could be attributable to the high rates of unprotected sex. The median age at first birth in Sierra Leone among women 25-49 is 19.5 years and 21% of women age 15-19 have begun child bearing. The proportion of teenagers who have begun child bearing increases rapidly with age from 4% at 15 years to 45% at 19 years with rural (29%) teenagers more likely to start child bearing earlier than urban teenagers (14%).
The risk of dying from pregnancy-related complications is much higher for adolescents than for older women. Youth fertility is important for both health and social reasons. Teenage mothers are more likely to experience adverse pregnancy outcomes and they are constrained in their ability to pursue educational opportunities after child bearing at an early age. Many efforts are ongoing to address the above-mentioned issues, including the advancement of in and out-of-school comprehensive sexuality education but the country is still not out of the woods.
The UNFPA Country Representative to Sierra Leone, Nadia Rasheed says her Organization has distributed eight million six hundred thousand (8.6M) condoms in 2023 in the country.
She made this statement to journalists at a news conference ahead of the International Condom Day slated for Wednesday 14th February 2024. She disclosed that they partnered with the Ministry of Health and partners for the distribution of three million five hundred thousand United States dollars (US$3.5M) worth of contraceptives in 2023.
She affirmed that UNFPA is proud to collaborate with the Government and partners to address issues related to condom use. She pointed out that condom use in the country is low as 6% of women and 21% of men use condoms which she noted is a concern.
Madam Nadia further revealed that there is a high rate of adolescent pregnancy and STI because people are not using condoms. She called on the people of Sierra Leone to destigmatize condom use stating that they must work together to increase access to information about health.
Director General of the National Aids Secretariat, Abdul Rahman Sesay says condom use is a critical health element in the country. He emphasized that there are lots of barriers to Condom use, stressing that there is a need to break them.
This is a common challenge facing developing countries and Sierra Leone is not an exception.
16-yr-old Mary Walker, of Kroobay community is one of many who have become victims of Teenage Pregnancy due to lack of knowledge about sexual reproductive education. Walker got impregnated as a result of having an unprotected sex with a man for financial gains without knowing the implications. This pregnancy has affected her education and forced her to drop out of school. It has really been a difficult situation for her family, and this has caused her mental health issues. She wants to be productive and contribute to society positively.
“I used to hawk goods for my elder Sister. I got pregnant as a result of pressure to refund monies that were normally missing from the business she gave me to sell. She used to insist that l should return her money at all cost even if it cost me to do Prostitution. That is how I got involved with the man that impregnated me.
I was not feeling good when I learnt that I was Pregnant. I never knew the implications of my action were until when I started feeling frequent dizziness. My elder sister took me to the hospital for medical examination and I was confirmed pregnant by a doctor.
I took my family to the man that is responsible for the Pregnancy who later came with money to and accepts that he will take responsibility. They agreed and choose to settle the matter at home.
The Pregnancy affected my life disrupted my education. Currently, I am not doing anything for a living. The man that impregnated me is the one supporting my family and I with basic stipends.
I have learnt that teenage Pregnancy can disrupt the education of the girl child and there are many health implications for young girls during Pregnancy.
My advice for young school going girls is for them to focus on their education and distance themselves from casual sex because they’re still young, “ Walker narrated her plight.
Kroobay is one of the largest slums in Freetown. It lies in the heart of the Capital, Freetown with a Population of over 15,000 residents. Mary’s situation is common in this Community due to Poverty and access to sexual reproductive education.
Sierra Leone is amongst the low human development countries in the world according to the just-released United Nations Development Program (UNDP) 2023-24 Human Development Index.
The country is ranked 184th out of 193 countries with a Human Development Index score of 0.458 in 2022, down from the 0.477 score in 2021 when the country was ranked 181 out of 195 countries (report.hdr.undp.org).
The Human Development Index is a summary measure for assessing average achievement in three basic dimensions of human development: a long and healthy life, access to knowledge, and a decent standard of living.