Concerns about signi cant increases in Sierra Leone’s already high rates of teenage pregnancy during the Ebola crisis have led to redoubled efforts amongst policy-makers and development practitioners to address this problem. The startling health and educational impacts on teenage girls (twice as many mothers aged 15-19 die in childbirth compared to those aged over 20, while teen pregnancy is one of the leading causes of school dropouts) underline the importance of these efforts. With the Government of Sierra Leone’s 2013 National Strategy for the Reduction of Teenage Pregnancy formally expired as of the end of 2015, and development of a renewed National Strategy under way, it is a timely moment to re ect on current efforts and how they can be strengthened.

This report builds on earlier research that outlined the nature of the problem of teenage pregnancy and reflected on the scope (and gaps) of common donor- supported intervention types (Denney et al., 2015). For this report, we visited the project sites of nine NGOs with programming on this issue across six districts in order to explore how programmes played out on the ground. We conducted 49 interviews and 32 focus group discussions with teenage girls and boys, parents of teenagers, chiefs, women’s and youth leaders, NGO workers, school teachers, Peripheral Health Unit (PHU) staff and Family Support Unit (FSU) officers in the Sierra Leone Police.
The findings aim to provide a broad set of reflections on current programming approaches – what is missing, what some of the challenges of implementation are, and whether the underlying logic implicit in programme approaches makes sense. Drawing from these findings, we make six recommendations aimed at strengthening existing efforts to reduce teenage pregnancy. The overall message is that programming to reduce teenage pregnancy should shift towards a focus on changing the context in which girls are getting pregnant, rather than focusing on changing the behaviour and decisions of girls

• Summary of Sierra Leone description of Husband Schools & impact on men & boys behavior