Community Mentoring Programs in Sierra Leone Significantly Improve Survival for Pregnant Adolescents and Their Babies

A groundbreaking community-based mentoring initiative in Sierra Leone has demonstrated remarkable success in safeguarding the lives of pregnant adolescents and their infants, while also supporting girls in resuming their education. The pilot program, documented in a recent publication in The Lancet and conducted through collaboration between King's College London and the local NGO Lifeline Nehemiah Projects (LNP), achieved a 48% reduction in maternal and perinatal deaths. This means that for every 18 girls enrolled in the mentoring scheme, one baby's life was saved.

The study involved 673 pregnant girls from twelve communities across five districts in Sierra Leone, running from July 2022 to November 2023. Each girl was paired with a local mentor who provided essential support throughout their pregnancy and postpartum period. These mentors helped the girls access prenatal care, connected them with other pregnant women, facilitated family reunification, and provided financial support for themselves and their babies.

Participants in the program experienced a range of benefits beyond improved health outcomes. Many girls returned to school, engaged in vocational training in fields like plumbing, electrical work, hospitality, and tailoring, or started their own businesses. Since its inception in 2017 with only three mentors and nine mentees, the scheme expanded by 2021 to include 24 mentors and more than 300 girls, with no maternal deaths reported.

The project highlights the potential for scalable, community-led interventions to address complex social and health issues. In 2021, the initiative became part of CRIBS, a global health organization dedicated to reducing maternal mortality and enhancing research capacity in Sierra Leone.

Lead researcher Dr. Cristina Fernandez Turienzo emphasized the importance of local solutions, stating, "This pilot demonstrates how powerful community-led mentoring can be for adolescent mothers and their infants—showing why global health efforts should prioritize locally developed strategies."

The founders of the project, Mrs. Lucy November and Mangenda Kamara, underscored that the scheme’s real impact extends beyond clinical outcomes. It has empowered girls to thrive beyond their pregnancies by providing income support, improving nutritional status, and enabling educational and vocational pursuits. Despite significant progress in reducing maternal mortality—from 1,165 per 100,000 live births in 2013 to 443 in 2020—Sierra Leone remains among the countries with the highest maternal death rates worldwide.

Researchers recommend expanding the program to larger trials to reinforce its benefits and explore possibilities for scaling in other regions, including high-income countries. Professor Jane Sandall from King's College London suggested that the intervention could also benefit marginalized groups in the UK, such as women facing language barriers or healthcare access challenges.

This innovative approach underscores the importance of community-centered strategies in improving health and social outcomes for vulnerable adolescent populations, offering a promising model for similar initiatives globally.