Adolescent pregnancy is a significant health and social challenge in sub-Saharan Africa. The region has the highest adolescent fertility rate—over a quarter of adolescents begin childbearing before the age of 18 years compared to 13% globally. Early childbearing puts adolescents on a trajectory of poor health and social outcomes. Adolescent mothers are at higher risk for morbidity and mortality than women who give birth in their 20s. Their children are also at higher risk for poor health and social outcomes.
The high burden of adolescent pregnancy in the region has led (understandably) to a focus on interventions and programs to delay sexual activity and childbearing. One consequence of the emphasis on pregnancy prevention is a limited focus on research to understand the experiences of pregnant and parenting adolescents in sub-Saharan Africa or to develop and test appropriate interventions to improve health and social outcomes for these adolescents and their children.
To draw attention to the relatively small, but growing, body of research focused on pregnant and parenting adolescents in the region, we recently co-edited a special collection of the Reproductive Health journal that brings together a set of nine articles that report on research on pregnant and parenting adolescents in sub-Saharan Africa. Four key issues emerge from this body of work.
First, the research underscores the need to integrate pregnancy prevention and interventions to support adolescents who become parents. As described by Chamdimba and her colleagues, who draw on data from pregnant and parenting adolescents in Malawi, as well as their parents or guardians, girls’ vulnerability to early pregnancy stems from multiple factors. These factors include adolescents’ limited knowledge, their restricted access to contraceptives, poverty, and sexual violence. However, parents often blame adolescents for being stubborn and ignoring guidance about the value of abstinence. Blaming pregnant adolescents for their “deviance” is also reported by Alex-Ojei and her colleagues in their article, which reports on data from Nigeria. Unfortunately, as highlighted by Adedini and Omisakin, once girls become pregnant, they are at significant risk for repeat pregnancy because they often do not use contraceptives or discontinue use.
Second, the research documents a significant burden of intimate partner violence among pregnant and parenting adolescents, with younger adolescents and those who engage in transactional sex being at higher risk for violence. Gebrekristos’ and colleagues’ study points to the strong association between intimate partner violence during pregnancy and the risk for postpartum depression among adolescent mothers in South Africa.
Third, pregnant and parenting adolescents, particularly those who are unmarried, face high levels of stigma from the community, as well as providers. As highlighted by Undie and Birungi, these adolescents and their parents may live with deep psychological trauma. For some girls, the psychological trauma arises from the sexual violence that led to their pregnancies. For parents, the disappointment, anger and hurt experienced when they learn of their daughter’s pregnancy can lead to psychological trauma that can result in them forcing their daughters to leave home. Ajayi and colleagues also highlight the association between probable depression and paternity denial, as well as the lack of parental support among pregnant and parenting girls in Burkina Faso and Malawi. Taken together, the findings around the interpersonal violence, stigma, and psychological trauma faced by adolescent parents and their own parents highlights the need for violence prevention and mental health interventions targeting them.
Fourth, living in poverty may increase the risk for adolescent pregnancy. However, pregnancy may also exacerbate adolescents’ vulnerability to poverty, because adolescent parents are largely financially dependent on their families, but may be expelled from the family home following their pregnancies. Their exclusion from schooling further increases their socioeconomic precarity as they are denied the opportunity to gain critical skills.
Moving forward, increased investment in research on this sub-population is critical given evidence showing that research on pregnant and parenting adolescents in sub-Saharan Africa is skewed towards a few countries and, with few exceptions, is primarily observational research. Yet, research on this sub-population is needed to inform context-relevant interventions to support them and their families such as the PROMOTE Project being piloted in Burkina Faso and Malawi. The PROMOTE project seeks to test three interventions targeting adolescent mothers: cash transfers conditioned on schooling, childcare support and life skills training.
Follow the Topic
-
Reproductive Health
This journal focuses on all aspects of human reproduction, including adolescent health, female fertility, contraception, and maternal health and all articles are open access.
Related Collections
With Collections, you can get published faster and increase your visibility.
Adolescent Sexual and Reproductive Health, Agency, and Protection
Adolescence is a critical period for reproductive health, wellbeing, and future life opportunities. Yet adolescents often face significant barriers to accurate information, protective services, bodily autonomy, and confidential, youth-friendly care. This Collection seeks to highlight research on adolescent reproductive health, agency, and protection, particularly in settings where gender inequality, poverty, stigma, restrictive norms, harmful practices, limited health system capacity, and intersecting forms of exclusion shape young people's reproductive choices, safety, and outcomes.
Progress in adolescent sexual and reproductive health has been driven by investments in comprehensive sexuality education, youth-friendly services, prevention of child marriage and female genital cutting, and gender-transformative programming. However, major challenges persist, including adolescent pregnancy, interpersonal violence (intimate partner violence, dating violence, family violence, sexual coercion, and peer violence), unmet need for services, school dropout, harmful practices, and limited autonomy in decision-making. Adolescents affected by displacement, disability, poverty, humanitarian crises, migration, ethnic minority status, or social marginalization may face compounding and intersecting risks that require tailored, context-sensitive, inclusive, and equity-oriented responses.
A growing body of evidence emphasizes the importance of adolescent agency, empowerment, and resilience as both outcomes and protective factors. Interventions that adopt gender-transformative approaches, utilize social and behavior change communication, address intersecting inequalities, and actively engage young people in design and implementation show promise in shifting harmful norms and improving health outcomes. Continued research is needed to understand how different intervention modalities affect adolescent reproductive health, safety, and empowerment across diverse contexts and among adolescents who are often underserved or excluded from mainstream services.
Future studies may evaluate multi-component interventions that integrate education, health services, community engagement, legal protection, economic strengthening, and social norm change. Evidence generated with meaningful adolescent participation and grounded in local realities will be essential to design services and programs that are acceptable, inclusive, effective, and sustainable.
In this Collection, we invite submissions covering a range of topics, including but not limited to:
Reproductive Health and Services
- Adolescent pregnancy prevention, care, support, and social consequences
- Access to contraception, counselling, and youth-friendly reproductive health services
- Comprehensive sexuality education and school-based reproductive health interventions
- Menstrual health, school participation, and adolescent wellbeing
Harmful Practices and Violence
- Female genital cutting/mutilation: prevalence, consequences, prevention, and support for affected adolescents
- Child marriage prevention and response
- Interpersonal violence, including intimate partner violence, family violence, sexual coercion, and peer violence
- Linkages between violence, harmful practices, and reproductive health outcomes
Agency, Empowerment, and Resilience
- Adolescent agency, decision-making, and reproductive autonomy
- Resilience, coping strategies, and protective factors among adolescents facing adversity
- Gender-transformative interventions and approaches
- Social and behavior change communication strategies targeting adolescents, families, and communities
Intervention Research and Implementation
- Multi-component and integrated intervention models
- Community-based, school-based, health facility-based, and digital interventions
- Intervention effectiveness across different contexts and populations, including adolescents living with disabilities, migrants, ethnic minorities, and other socially marginalized groups
- Implementation science and scale-up of evidence-based programs
Equity and Context
- Adolescent reproductive health in humanitarian, displacement, migrant, and low-resource settings
- Intersecting vulnerabilities: disability, poverty, migration status, ethnic minority status, social marginalization, and other forms of exclusion
- Participatory and adolescent-centered research methodologies, including inclusive approaches that meaningfully engage adolescents from socially marginalized populations
This Collection supports and amplifies research related to SDG 3, Good Health and Well-Being and SDG 5, Achieve gender equality and empower all women and girls.
All submissions in this Collection undergo the journal’s standard peer review process. Similarly, all manuscripts authored by a Guest Editor(s) will be handled by the Editor-in-Chief. As an open access publication, this journal levies an article processing fee. We recognize that many key stakeholders may not have access to such resources and are committed to supporting participation in this issue wherever resources are a barrier. For more information about what support may be available, please visit OA funding and support, or email OAfundingpolicy@springernature.com or the Editor-in-Chief.
Publishing Model: Open Access
Deadline: Apr 30, 2027
Please sign in or register for FREE
If you are a registered user on Research Communities by Springer Nature, please sign in