Department of Biological Sciences
Permanent URI for this collectionhttps://dspace.njala.edu.sl/handle/20.500.144402/136
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Item Early sexual debut among adolescent girls and young women in Sierra Leone: A multilevel analysis of prevalence and predictors(BioMed Central, 2024-11-12) Osborne, AugustusBACKGROUND: Early sexual debut among young women is associated with adverse sexual and reproductive health outcomes, including unintended pregnancies and sexually transmitted infections. Despite its negative impact, there is limited research on this issue in Sierra Leone. This study aims to address this gap by examining the prevalence of early sexual debut and its associated factors among adolescent girls and young women aged 15-24 years in Sierra Leone. METHODS: Data from the 2019 Sierra Leone Demographic and Health Survey was used for the study. Provincial variations in the proportion of early sexual debut were visualised using a spatial map. A mixed-effect multilevel binary logistic regression analysis was performed to examine the factors associated with early sexual debut. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI) and intraclass correlation coefficients. RESULTS: The prevalence of early sexual debut was 26.1% \[24.3, 28.0\]. Adolescent girls and young women aged 20-24 were less likely to engage in early sexual debut \[aOR = 0.52; 95% CI: 0.41, 0.65\] than those aged 15-19. The odds of early sexual debut was lower among adolescent girls and young women with secondary/higher education \[aOR = 0.62; 95% CI: 0.45, 0.85\] compared to those with no education. Adolescent girls and young women who used the internet in the last 12 months \[aOR = 0.50; 95% CI: 0.34, 0.73\] and those who belonged to the Fullah ethnic group \[aOR = 0.25; 95% CI: 0.07, 0.85\] were less likely to engage in early sexual debut relative to those who did not use the internet and those belonging to the Creole ethnic group respectively. Adolescent girls and young women who intend to use contraceptives \[aOR = 0.60; 95% CI: 0.46, 0.77\] and those who do not intend to use contraceptives \[aOR = 0.65; 95% CI: 0.49, 0.88\] were less likely to engage in early sexual debut than those who were using contraceptives. Conversely, adolescent girls and young women who were working \[aOR = 1.41; 95% CI: 1.12, 1.77\] had higher odds for early sexual debut than those not working. The odds of early sexual debut were higher among adolescent girls and young women who were married/cohabiting \[aOR = 1.72; 95% CI: 1.32, 2.22\] and previously married \[aOR = 3.26; 95% CI: 1.61, 6.56\] than those who were never married. Adolescent girls and young women living in the North Western area \[aOR = 1.81; 95% CI: 1.05, 3.13\] had higher odds for early sexual debut than those living in the Eastern province. CONCLUSION: Early sexual debut is prevalent among adolescent girls and young women in Sierra Leone. Age, education, internet use, ethnicity, contraceptive use intention, marital status, employment status, and province of residence were the factors associated with early sexual debut. The study underscores the need for policymakers, government, and non-governmental organisations to design and implement comprehensive and multifaceted interventions to promote informed decision-making and reproductive health among adolescent girls and young women in Sierra Leone.Item Provincial distribution of unintended pregnancy and its associated factors in Sierra Leone(BioMed Central, 2025-01-02) Osborne, AugustusBACKGROUND: Unintended pregnancy is a significant public health concern in Sierra Leone, with far-reaching consequences for both mothers and children. This issue impacts individual well-being, strains healthcare systems, and hinders socioeconomic development. This study examined the prevalence and factors associated with unintended pregnancy in Sierra Leone. METHODS: Data from the 2019 Sierra Leone Demographic and Health Survey was used for the study. Provincial variations in the prevalence of unintended pregnancy was presented using a spatial map. A mixed-effect multilevel binary logistic regression models was fitted to examine the factors associated with unintended pregnancy. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI) and intra-cluster correlation coefficients. RESULTS: In Sierra Leone, the national prevalence of unintended pregnancy was 16.4% in 2019. Women aged 20-49 exhibit lower odds of unintended pregnancy compared to those aged 15-19, with the lowest odds found among those aged 30-34. Factors associated with decreased odds include being employed, married or cohabiting, and belonging to the Fullah tribe, while living in various provinces outside the Western area also correlates with lower odds. Conversely, women with secondary education, listened to the radio, those with more children (5+), contraceptive users, larger household sizes (six or more), and those in the middle wealth index had increased odds of unintended pregnancies. CONCLUSION: The results from Sierra Leone indicate that various socio-economic and demographic factors significantly influence the prevalence of unintended pregnancies, suggesting critical areas for intervention. For women in the 20-49 age group, the lower odds of unintended pregnancies compared to younger women suggest that targeted educational and health initiatives could further enhance their reproductive health outcomes. The protective factors associated with employment, marital status, and tribal affiliation highlight the importance of promoting stable family structures and economic opportunities. Also, women living in the Eastern, Northwestern, Northern, and Southern provinces, the results imply a need for province-specific interventions. These areas may require tailored outreach programs that address cultural and socio-economic barriers to contraceptive use and reproductive health education. The increased odds linked to secondary education, listening to radio, those with more children, contraceptive users, and larger household sizes suggest that educational initiatives should also address family planning and reproductive health. A focused approach that considers the unique needs of these women could lead to more effective strategies in reducing unintended pregnancies in Sierra Leone.Item A study of vulnerable student populations, exclusion and marginalization in Sierra Leonean secondary schools: a social justice theory analysis(BioMed Central, 2025-03-18) Osborne, AugustusBACKGROUND: Sierra Leone faces challenges in ensuring equitable and inclusive education for all its citizens. Certain groups, including pregnant students, student mothers, students with disabilities, economically disadvantaged students, and those without family support, are particularly vulnerable to exclusion and marginalisation. These groups are identified as vulnerable based on criteria established by organisations such as the World Health Organisation and the United Nations Educational, Scientific and Cultural Organization, which highlight the interplay between health, socio-economic status, and access to education. This study explores the extent of exclusion and marginalisation experienced by these vulnerable groups within Sierra Leonean educational institutions. METHODS: Between November and December 2023, a participatory study design was utilised, employing purposive sampling to gather diverse perspectives from 127 key informant interviews with 366 participants, including teachers, parents, students with disabilities, pregnant students, students who are mothers, and economically disadvantaged students across 11 schools in six districts in Sierra Leone. The analysis was performed manually using Microsoft Word, with four researchers responsible for organising, coding, and identifying patterns and themes within the dataset. RESULTS: Pregnant students are often stigmatized, being perceived as immoral and a negative influence on their peers. This stigma results in social isolation, bullying, and derogatory comments from both peers, and at times, teachers. Students with disabilities frequently experience bullying and social exclusion; however, there are also positive examples of peer support that facilitate their inclusion in schools and the broader community. Economically disadvantaged students are often subjected to bullying and discrimination based on their socioeconomic status, which contributes to feelings of self-isolation, reduced self-esteem, and low participation in school activities. CONCLUSION: Our study revealed that pregnant students, students with disabilities, economically disadvantaged students, and those lacking family support face stigma, social isolation, and limited access to education in Sierra Leone. These challenges are deeply rooted in societal attitudes, parental expectations, and inadequate support from teachers. To address these systemic issues, policymakers and educators should adopt comprehensive strategies, including evidence-based community awareness campaigns to challenge harmful societal attitudes, the promotion of inclusive education practices through clear and targeted policies, and the establishment of robust support services within schools. Such measures are essential to create an equitable and inclusive educational environment for all students.