Liberia has an alarming high rate of teenage pregnancy. It’s estimated that on average 3 in 10 Liberian girls are pregnant before the age of 18. The rate of pregnancy among adolescent girls aged 15-19 in rural areas is almost double that in urban areas – 42% and 24% respectively.
During a field trip to Margibi Country in north-east Liberia, I met with health staff and administrators from a government-run clinic to discuss adolescent reproductive health as part of my work to support fundraising for Save the Children’s health programme in Liberia.
We quickly moved on to a very heated and animated discussion as the nurses, doctors and administrators present identified early marriage and/or early sexual debut as a leading cause of teenage pregnancy. Poverty, traditional cultural practices, lack of enforcement of existing laws outlawing marriage under the age of 18 and poor awareness of sexual and reproductive health among young people were also all cited by those present as key factors leading to the high rate of pregnancy among adolescent girls. Physical and sexual abuse in the home was also mentioned as a factor that forced young girls to leave home, thus increasing their vulnerability.
Growing number of abortions
The incidence of teenage pregnancy in Liberia is a major cause of concern. Many of the teenage mothers are between 12-14 years old and are at risk for numerous complications associated with pregnancy. The increasing number of illegal and unsafe abortions adds another horrific dimension to this complex situation.
Most teen pregnancies are unwanted
The health needs of adolescents are not being met. Adolescents are more likely to engage in unprotected sex, which can result in pregnancy or sexually-transmitted infections (STIs) including HIV. Most adolescent pregnancies are unwanted and are more likely to end in induced unsafe abortions. The attitudes of parents and that of service providers in the public sector who are not willing to provide services to teenagers compounds their plight.
Although there is a National Reproductive Health Policy, it does not adequately address issues related to adolescent reproductive health. Adolescent sexual and reproductive health services are currently only being provided by a few international non-governmental organisations including Save the Children.
Adolescent sexual and reproductive health services (SRH) that address sensitive issues need to involve adolescents, adults, parents and the larger community to gain support and to be sustainable. Lack of accurate information and the judgemental attitudes of health providers are often identified by young people as obstacles that stop them from using the services. Health providers need to be trained to deliver confidential and accurate services in a setting that will encourage young people to use them.
It’s also very important to raise awareness on the impact of traditional belief systems, such as sande bush, or the sexual rite of passage — a ritual that initiates a child to become sexually active — on the sexual health and well-being of adolescent girls and boys.
Equally important is the need for advocacy so that those in positions of power protect the health and rights of young people by enforcing laws that prohibit under-age marriage.