Durban, South Africa — In rural Rwanda, a girl’s first period signals womanhood, but too often steals her education and future. This is the devastating toll of Africa’s adolescent pregnancy crisis.
In Africa, nearly one in five teenage girls becomes pregnant before they turn 19, a staggering statistic that continues to threaten millions of lives, education, and health. A disturbing rise in teenage pregnancy, child marriage, gender-based violence, and HIV infections among adolescent girls has become one of Africa’s most urgent public health concerns, demanding collective and immediate action. Sub-Saharan Africa has the highest rate, accounting for approximately 90% of adolescent births in low- and middle-income countries. Half of these pregnancies are unplanned, pushing girls into cycles of poverty and stigma. The consequences are severe: school dropout, limited economic opportunity, and lifelong vulnerability.
According to the Center for Reproductive Rights, pregnant girls often face social backlash, including discrimination, stigma, and rejection from their families and communities. In many cases, the stigma they experience prevents them from seeking medical or legal assistance, which places them at risk.
They are children raising children.
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Isaie Nshimiyimana, a public health worker, has been studying these realities closely. His mission: find out why.
His abstract, “Factors Associated with Adolescent Pregnancy among Girls Aged Between 15 and 19 Years in Muhanga District, Rwanda,” was accepted for presentation at the 2025 Conference on Public Health in Africa (CPHIA). It seeks to answer an urgent question: What is driving this trend, and how can we stop it?
Nshimiyimana said that teenage pregnancy remains especially urgent in rural areas like Muhanga District, where early pregnancies push girls out of school and into poverty cycles. According to him, cultural taboos, a lack of sexuality education, and economic challenges impede prevention efforts.
“Adolescent pregnancy remains a pressing public health and social issue in Rwanda. According to my recent study in Muhanga District, 10.7% of girls aged 15–19 had experienced pregnancy, roughly double the national average of 5% reported in the 2020 Demographic and Health Survey,” he said. “Although the rate has slightly declined from 12% in 2020, the persistence of this problem highlights ongoing vulnerabilities in education, family structures, and reproductive health education.”
He said that talking about it now is crucial because teenage pregnancy not only threatens girls’ health and education but also perpetuates cycles of poverty and gender inequality. It’s also a timely discussion as Rwanda continues to pursue national strategies on youth empowerment and health equity, he said.
The Rwandan government has made significant advances in gender equality and reproductive health, focusing on the empowerment of women and improving access to education. According to UNESCO, Rwanda places a high priority on ensuring the health and well-being of its youth as a means of ensuring their future success. Despite progress, challenges such as teenage pregnancies, HIV infections, and gender-based violence persist, often due to limited access to accurate SRH information and services. Education and community engagement are essential in addressing these issues.
Nshimiyimana said his motivation to study the problem stemmed from Muhanga District’s consistently reported one of the highest adolescent pregnancy rates in the Southern Province. As a public health professional, he wanted to understand why this was happening in a district that otherwise performs well in education and development. Most studies examined national trends, but little insight was provided at the community level. He aimed to provide evidence that could guide district-level interventions and help policymakers strengthen preventive strategies.
Key findings
Nshimiyimana said that the study revealed that education level, family structure, financial dependence, peer pressure, and access to sexual and reproductive health (SRH) education were the strongest predictors of adolescent pregnancy. Girls not in school or only at the primary level were over 23 times more likely to become pregnant than those in secondary school. Adolescents living in households headed by non-parental figures faced a fourfold increase in pregnancy risk, while those supported financially by people other than their parents were nearly four times more vulnerable. On the other hand, receiving SRH education reduced pregnancy risk by 80%.
“The most surprising finding,” he said, “was that overall family income did not significantly influence pregnancy risk; instead, who provided the support and how family relationships functioned mattered more.”
He said that one major challenge is the stigma surrounding discussions of sexuality and reproductive health, both at home and in schools.
Many adolescents lack access to accurate SRH information, and open communication between parents and children on these issues remains limited, mostly related to our culture. Poverty and gender norms also push some girls toward relationships that offer financial or emotional support but expose them to early pregnancy. Furthermore, once a girl becomes pregnant, returning to school is still difficult due to social stigma, childcare burdens, and lack of institutional support.
According to Nshimiyimana, stable home environments are essential for the protection of adolescents. “Girls living with non-parental guardians may experience weaker emotional supervision, reduced communication, or even neglect, factors that can make them more vulnerable to exploitation or risky behavior,” he said. “It shows that, beyond economic factors, social connectedness and parental guidance are key protective elements. Strengthening family-based interventions and mentorship programs could greatly reduce these risks.”
Teenage pregnancy has also been linked to mental health issues, including anxiety, depression, and social isolation.
He said that teen mothers often experience anxiety, depression, stigma, and social isolation. The disruption of education and early motherhood responsibilities adds emotional and financial stress, sometimes leading to long-term psychological distress. According to him, addressing these effects requires integrating psychosocial support into health and education systems, such as counseling services in schools and community health centers, peer support groups, and programs to help young mothers reintegrate into society.
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To the global health community, Nshimiyimana’s message is clear: adolescent pregnancy is not only a health issue but a symptom of social and structural inequalities.
Multi-layered approaches combining education, economic empowerment, and community-based interventions should be adopted by the global community, he said. According to Nshimiyimana, programs should focus on empowering adolescents and strengthening their families, as well as ensuring that SRH services are accessible and youth-friendly. Solutions must be culturally sensitive and grounded in local communities; what works in one region may not work in another.
However, Nshimiyimana is optimistic because Rwanda has demonstrated strong political will and community-based structures that can mobilize change quickly.
The inclusion of SRH education in schools, youth-friendly health services, and growing public dialogue are positive steps. “Young people themselves are central to the solution through peer education, advocacy, and innovation; they are increasingly shaping conversations about health and gender equality,” he said. “Empowering them as change agents gives me confidence that we can significantly reduce adolescent pregnancies in the years ahead.”
allAfrica is a media partner of the CPHIA 2025.
