Determinants

Studies identify some key determinants of teenage pregnancy:

Early Marriage: Data from the 2010 MICS have indicated relatively high levels of early marriage, and the onset of early sexual intercourse, amongst teenage girls. The data show that amongst women aged 15 to 49 years, who were married or in consensual union, 16% were married before age 15 years, and 50% before age 18 years. In addition, 24.5% of women aged 15 to 19 years started sexual intercourse before age 15 years.

Low Contraceptive Rate: The use of modern contraception is restricted to a small proportion of the female population of childbearing ages. In fact, the SLDHS 2008 shows a very low contraceptive rate of 1.2% for ages 15-19. MICS 2010 data also show that amongst women aged 15 to 49 years, who are married or living with a man, 94.7% of those aged 15 to 19 years, and 90.4% of those aged 20 to 24 years, are not using any method of contraception.The importance of social norms is also visible in regard to contraceptives — in Sierra Leone, it is not a social norm to use them and there is peer pressure against using them.

The use of modern contraception is restricted to a small proportion of the female population of childbearing ages. In fact, the SLDHS 2008 shows a very low contraceptive rate of 1.2% for ages 15-19.

Limited coordinated effort: Few elements have been documented in Sierra Leone on the real impact of teenage pregnancy on the health of the girls, on their sexual and reproductive behavior, on their level of educational attainment, and on their current or prospective socio-economic status. As a result, there have been so far limited coordinated and focused efforts, at national level, to devise programmes that would reduce the incidence of teenage pregnancy, or help to reintegrate teenage mothers back into the productive socio- economic system, either by continuing their education, or skills training, or accessing opportunities for employment, and income generation.

Social Norms: Strong emphasis must be put on social norms, which are key drivers of Teenage Pregnancy. Often, girls view it as normal – even expected and desirable – that they become pregnant at an early age. The fact that many girls decide at an early age that they want to have a baby is itself an indication of a social norm.

Social norms are key drivers of Teenage Pregnancy

Peer-pressure: This in general plays a central role. Bullying, teasing and name-calling are worldwide problems, which especially happen in schools. Interviews with teenagers reveal that the teasing begins with simple things such as the lack of lunch food and ragged school clothing. Teenagers who are sexually abstaining are also ostracized for their choice. They are made to feel inferior, like a person who is unaware of the real world. Based on these interviews, the UNICEF Teenage Pregnancy Document (2010) identifies the peer-pressure cycle as a key determinant for adolescents, particularly young girls, to enter into unsafe behaviors, including substance abuse and unprotected sex.

Poverty: Analysis of SLDHS 2008 and MICS 2010 shows a strong relationship between poverty and teenage pregnancy with teenage girls in the poorest quintile being 3 times more likely to have a child before age 18 years compared to girls in the wealthiest quintile. Parents of most low-income families, who are unable to support their children’s basic needs, are faced with a choice between nutrition, health and education. Research shows that a certain value is given to girl-child education, but that both the cost and the mistrust in the education system are clear barriers for parents to send their girls to school. Parents do not see quick returns from education, whereas children (especially girls) can contribute to the family’s financial income through petty trading, and family labor as well as through transactional sex, bride price and other economic benefits from early marriage.

The change in power structure within the family completely alters when adolescents begin earning money and providing for the needs of the family members. The constant inability to meet basic needs is one critical motive, which pushes children to find ways of acquiring money. Often, this leads to unwanted and unplanned pregnancies. (UNICEF, 2010).

Lack of positive parenting: In general, it is observed that the relationship between parents and children plays a central role in social behavior. Lack of communication, and supervision as well as low positive parenting, contribute to early sexual activity. Parents as well as other members of the community can strongly influence the choices made by young people. The absence of positive role models in families or within the community make it difficult for adolescents and young people to identify and adopt safe/positive behavior.

Lack of communication, and supervision as well as low positive parenting, contribute to early sexual activity and teenage pregnancy.

Harmful practices: Aside from early marriage, which was already mentioned, some harmful practices, such as transactional sex are seen to be acceptable to gain social and economic status. Sexual abuse must also be mentioned as a determinant: ethnographic data (Wessels, 2011) indicate that a significant number of older men coerce girls into having sex and that condoms are very seldom used in such violations.