Socioeconomic and geographical inequalities in adolescent fertility rates in Sierra Leone, 2008–2019

Our study found a positive decline in AFR across socioeconomic and geographic groups in Sierra Leone, but significant inequalities remain. Economic status and education are key drivers, with the poorest quintile consistently showing higher AFR. Although AFR declined among girls across all levels of education over time, it increased between 2008 and 2019 for those with primary and higher education. Rural areas had a higher AFR than urban ones, though with less national impact. Policymakers should focus on improving economic opportunities, enhancing quality education, and expanding access to family planning services to reduce adolescent pregnancy and address socioeconomic and educational inequalities.