SHAPE - Sexual and reproductive Health Access and Promotion of Empowerment

In 2019, 21% of teenage girls in Sierra Leone had a child or were pregnant, and 82% of these pregnancies were unwanted (DHS 2016).
In 2019, Sierra Leone had 717 maternal deaths per 100,000 births, one of the highest rates in the world. An estimated 40% of these maternal deaths occur in adolescent girls, with obstetric complications representing the 1st cause of death in this population (DHS 2019).
Early pregnancy exposes adolescent girls to high risks of obstetric complications and maternal mortality, as well as stigmatisation and social and family rejection.
Gender-based violence (GBV) affects 53% of women over the age of 15 in Sierra Leone, increasing the risk of early pregnancy.
Excision is still common, affecting around 90% of women.
Shortcomings in the training of carers, the organisation of healthcare structures and the lack of referral systems complicate care provision.
Policies exist, such as the national strategy to reduce teenage pregnancies, but they are not sufficiently implemented.
Social norms and the domination of the medical establishment limit the autonomy of adolescent girls and young women in managing their own health.


Project duration	2,5 years (March 2025 – December 2027)
partners	CaWEC (Community Action for the Welfare of Children)Ministry of Health, in particular the reproduction and child health department (RCHD)The national secretariat for the reduction of teenage pregnanciesThe unit responsible for quality of care Teams from the Western Area Urban (WAU) and Western Area Rural (WAR) health districts
Beneficiaries	Direct beneficiaries : In total, more than 200 people will benefit directly from the project. 30 health professionals in 8 health centres trained and coached in technical skills and knowledge of DSSRs. 80 mother leaders and 46 community health workers trained. 8 tutors identified and trained. 8 members of the OSC CAWeC trained. 50 members of health facility management committees trained. 10 representatives of the supervisory teams from the health districts. 15 representatives from the RCH, NSRTP and quality of care unit involved. Indirect beneficiaries : 50,000 young people (men and women) in the intervention zones and, more specifically, 2,000 adolescents and young women/men aged between 10 and 24 receiving SRH consultations in the targeted health facilities. 9,000 pregnant women in supported health centres, including 800 teenagers and young women aged 10-24 giving birth in supported health centres.
Source of financing	AFD
Country of intervention	Sierra Leone

To help reduce maternal and neonatal mortality and morbidity in two districts of Sierra Leone.

R1: Adolescents and young people in the target areas have improved their knowledge and skills in SRH and gender equity.
R2: The supply of SRH care and services is better adapted to the needs of young people and of higher quality in the project areas.
R3: The tools developed, the knowledge generated and the good practices identified are shared with national, regional and EU stakeholders.

Solthis Therapeutic Solidarity and Initiatives for Health