Contraception within the context of adolescents’ sexual and reproductive lives: country profile: Sierra Leone

Sierra Leone Contraception within the context of adolescents’ sexual and reproductive lives: Country profile SOCIO-DEMOGRAPHIC CHARACTERISTICS Both Sexes Female Male 10-19 years 10-14 years 15-19 years 10-14 years 15-19 years Total population of adolescents (millions)1 (2020) 1.9 0.5 0.4 0.5 0.4 % of total population that are adolescents1 (2020) 23.4 12.4 10.9 12.5 11.0 % of adolescents that live in rural areas2 (2014) 55.2 52.9 56.2 56.8 54.8 % of total rural population that are adolescents2 (2014) 21.2 10.7 9.8 12.0 10.0 % of total urban population that are adolescents2 (2014) 26.0 14.9 12.0 13.2 11.9 % national monetary child poverty3 (2017) No data Completion rate for lower secondary school4 (2017) Female 42.0 Male 47.1 Completion rate for upper secondary school4 (2017) Female 14.8 Male 24.6 Out of school rate4 (2018) Female 58.8 Male 57.3 CHILD MARRIAGE/UNION STATUS5 (2016-17) Female Male Adolescents, 15-19, who are married/ in union (%) 15.3 1.6 % married/in union before age 15 (aged 20-24) 12.9 2.8 % married/in union before age 18 (aged 20-24) 29.9 6.5 SEXUAL ACTIVITY6 (2013) Female Male 10-14 years 15-19 years 10-14 years 15-19 years % of adolescents engaged in pre-coital physical behavior No data No data No data No data % of adolescents that ever- had sex No data 64.5 No data 44.4 % of adolescents having had sex by age 15 No data 19.3 No data 10.4 % of adolescents sexually active in the last month No data 33.5 No data 20.2 FEMALE GENITAL MUTILATION5 (2016-17) 10-14 years 15-19 years % of girls who have undergone female genital mutilation/cutting No data 64.3 GENDER-BASED VIOLENCE % of girls who report experiencing6 (2013): 10-14 years 15-19 years Physical violence in the last 12 months No data 26.1 Sexual violence in the last 12 months No data 2.7 % of adolescents (aged 15-19) who think a husband is justified in hitting or beating his wife in certain circumstances5 (2016-17) Female Male 43.9 28.6 CHILDBEARING % of adolescent girls who have begun childbearing5 (2019) 10-14 years No data 15-19 years 21.3 % of women (aged 20-24) who gave birth before 18 years5 (2017) 30.6 Number of births per 1,000 girls, 15-197 (2019) 99.8 % of adolescent girls (aged 15-19) with live births who received antenatal care (ANC4+ visits)5 (2019) 81.6 % of births among girls (aged 15-19) attended by skilled health personnel5 (2016-17) 81.4 ABORTION 10-14 years 15-19 years Abortion rate per 1,000 girls No data No data FERTILITY INTENTIONS & CONTRACEPTIVE USE5,8 (2013) % of most recent pregnancies experienced by adolescent girls aged 15-19, including current pregnancies by planning status6 (2013) Married/ In union Unmarried/ not in union Last pregnancy wanted (<2 years) 76.9 40.8 Last pregnancy wanted later (>=2 years) 22.0 58.4 Last pregnancy not wanted at all 1.1 0.8 % of adolescent girls (aged 15-19) with an unmet need for modern methods of contraception9(2019) * 28.0 36.3* % of sexually active unmarried adolescent girls (aged 15-19) who currently use at least one method of modern contraception6 (2013) 53.9 Current use and non-use of contraception, 15-19 years 8 (2013) Contraceptive method mix, 15-19 years 8 (2013) Main sources of contraception, 15-19 years 8 (2013) Main reasons for not intending to use contraception, 15-19 years 8 (2013) 92.2 7.8 0.0 56.0 42.0 2.1 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Not using Modern method Traditional In Union Not in Union 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% In Union Not in Union Other Lactational amenorrhea (lam) Implants/norplant Condom Injectables IUD Pill 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Not in Union In Union Other Friend/relative Pharmacy/Shop Private hospital/clinic/mobile clinic Public mobile clinic Family planning clinic Government 46.0% 8.2% 5.4% 6.2% 5.5% 4.7% Not having sex Breastfeeding Infrequent sex Fear of side effects Other Not married Not in Union 57.7% 8.6% 6.8% 3.3% 2.6% Breastfeeding Not having sex Respondent opposed Knows no method Fear of side effects In Union WHO/SRH/20.24 © World Health Organization 2020. 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For more information, please contact: Department of Sexual and Reproductive Health and Research; E-mail: srhavp@who.int Website: www.who.int/health- topics/adolescent-health/ HIV/AIDS, SEXUALLY TRANSMITTED INFECTIONS (STIs) AND HUMAN PAPILLOMA VIRUS (HPV) Female Male 10-19 years 10-14 years 15-19 years 10-19 years 10-14 years 15-19 years Number of adolescents living with HIV10 (2020) 4,700 1,400 3,300 3,200 1,400 1,800 Number of new HIV infections among adolescents per year10 (2020) 750 No data 750 <500 No data <500 % of adolescents with comprehensive knowledge about AIDS9 (2019) No data No data 22.2 No data No data 26.5 % prevalence of sexually transmitted infections among adolescents 6(2013) No data No data 21.3 No data No data 13.4 % of sexually active adolescents who had an HIV test in the last 12 months and received the results5 (2016-17) No data No data 7.9 No data No data 3.7 % of girls, 15 or older, who have completed the full three dose vaccination schedule for HPV No data No data No data No data No data No data MENSTRUAL HEALTH 10-14 years 15-19 years % of adolescent girls who were aware of menstruation before the onset of their first menstruation No data No data % of adolescent girls who did not participate in social activities, school, or work due to their last menstruation in the last 12 months5 (2016-17) No data 23.3 DATA SOURCES 1. World Population Prospects, 2019 Revision. Population data. United Nations Department of Economic and Social Affairs, Population Division. Available from: https://esa.un.org/unpd/wpp/Download/Standard/Population/ [Accessed 17th October, 2019]. 2. United Nations. World Urbanization Prospects, the 2014 Revision. New York: United Nations; Department of Economic and Social Affairs, Population Division; 2014. 3. Keeley B, Little C. The State of the World’s Children 2017: Children in a Digital World. UNICEF: New York; 2017. 4. UNESCO Institute of Statistics. UIS Statistics. Available from: http://data.uis.unesco.org [Accessed 23rd September 2019]. 5. Statistics Sierra Leone-SSL and UNICEF. Sierra Leone Multiple Indicator Clustery Survey 2016-17. New York: UNICEF: 2017. *Unmet need for modern methods of contraception for girls not married/in union is for the proportion that are sexually active in the last month. 6. Statistics Sierra Leone- SSL and ICF International. Sierra Leone Demographic and Health Survey 2013. Freetown, Sierra Leone: SSL and ICF International: 2014. 7. United Nations Department of Economic and Social Affairs, Population Division. World Population Prospects. Fertility data- 2020-2025. Available from: https://population.un.org/wpp/Download/Standard/Fertility/ [Accessed 30th October 2019]. 8. Statistics Sierra Leone- SSL and ICF International. Sierra Leone Demographic and Health Survey 2013/ SLIR61FL.DTA. Freetown, Sierra Leone: SSL and ICF International: 2014. 9. Statistics Sierra Leone (Stats SL) and ICF. Sierra Leone Demographic and Health Survey 2019: Key Indicators. Freetown, Sierra Leone, and Rockville, Maryland, USA: Stats SL and ICF; 2019 10. UNAIDS. Trends of new HIV infections. Available from: http://aidsinfo.unaids.org [Accessed 9th October 2020].