273.
Of particular concern to the GoSL is the high and increasing early fertility rate among
girl-children under the age of 18 years. In 2008 the fertility rate among girls aged
15-19 years was 146 per 1,000 live births and this increased to 155 per 1,000 in 2013
(Statistics Sierra Leone & MoHS, 2009) (Statistics Sierra Leone, 2014). As is evident
from the table below, in 2010, 32 percent of girls between the ages of 15 and 19 years
had begun childbearing, 26 percent had given birth before the age of 19 years, and 7
percent had given birth before the age of 15 years. This is of particular concern given
the close link between poor health and other development outcomes for both the young
mother and her infant including the lack of educational opportunities to young women,
risks to women’s health and fertility, and children being born into homes that are
not ready for them. 40 percent of maternal deaths are the result of teen pregnancies
(Statistics Sierra Leone and UNICEF, 2011) and it is the 3rd most common reason for
girls dropping out of school. The phenomenon is more common in rural areas and
is driven by a combination of factors, including low rates of use of contraception,
poverty, low education levels, and harmful traditional and social norms and practices
such as early marriage, transactional sex and peer pressure (Government of Sierra
Leone, 2013). In 2010, 16 percent of girls were married before the age of 15 years and
50 percent before the age of 18 years, and 25 percent had started engaging in sexual
intercourse before the age of 15 years (Statistics Sierra Leone and UNICEF, 2011).
Use of contraception amongst young women is very low. It is 8 percent amongst girls
aged 15-19 years, although this has increased substantially from 1 percent in 2008
(Statistics Sierra Leone & MoHS, 2009) (Statistics Sierra Leone, 2014).
Table 2: Percentage of girls aged 15-18 who had a live birth, 2010
Region
East
North
South
West
District
Kailahun
Kenema
Kono
Bombali
Kambia
Koiadugu
Port Loko
Tonkolili
Bo
Bothe
Moyamba
Pujehun
Western Rural
Western Urban
Area
Urban
Rural
Education
None
Primary
Secondary +
Wealth index Poorest
quintiles
Second
Middle
Fourth
Richest
Total
Number of women age 15-19 who …
are pregnant
had a live
have had a
have begun
with first
birth before
live birth
childbearing
child
age 15
29.2
5.7
35.0
7.9
30.7
6.8
37.5
7.6
29.6
7.6
37.2
10.0
13.7
2.7
16.4
3.1
31.4
7.7
39.1
9.7
28.3
5.8
34.1
5.7
27.5
2.6
30.1
9.1
28.6
4.5
33.1
6.5
34.5
8.3
42.8
11.2
28.3
4.2
32.5
7.6
30.9
12.2
43.0
5.5
32.2
2.1
34.3
10.0
24.8
7.7
32.5
7.9
34.9
5.3
40.2
7.4
30.2
9.4
39.6
15.7
36.0
7.9
43.9
13.0
25.7
5.2
30.9
5.0
11.9
2.3
14.2
2.9
20.6
2.5
23.1
4.5
30.6
8.3
38.9
9.2
47.4
10.1
57.5
18.4
23.2
7.0
30.2
5.6
18.2
3.4
21.6
2.9
38.1
9.3
47.4
13.2
30.0
7.7
37.8
11.0
34.4
7.2
41.6
7.2
25.6
5.0
30.7
6.6
14.6
2.9
17.4
2.9
26.4
5.8
32.2
7.2
Number
of women
age 15-19
616
828
544
562
220
251
145
239
125
88
236
141
258
101
86
99
74
488
1,083
1,466
616
555
1,378
367
388
448
595
752
2,549
% of women age
Number
20-24 who had a live of women
birth before age 18 age 20-24
40.5
43.5
42.8
19.6
40.2
40.6
41.0
39.3
41.3
37.2
44.5
51.2
35.9
47.4
44.3
54.4
36.5
17.4
27.4
44.6
52.8
35.8
17.9
50.3
42.0
47.2
41.6
18.2
38.1
557
772
485
429
200
235
142
197
87
92
211
185
223
96
80
86
50
379
854
1,409
1,151
311
802
398
393
394
489
589
2,263
Source: MICS 2010
7. Health and Welfare
75