A groundbreaking community-based mentoring initiative tailored for pregnant adolescent girls in Sierra Leone has demonstrated remarkable success in saving lives and enabling young mothers to resume their education and vocational pursuits. This innovative program, known as 2YoungLives, was recently evaluated in a pilot trial that revealed a dramatic reduction in combined maternal and perinatal mortality rates. The findings, published in The Lancet and spearheaded by King’s College London researchers in partnership with the local NGO Lifeline Nehemiah Projects (LNP), underscore the transformative power of localized, culturally attuned health interventions in low-resource settings.
The pilot study, conducted between July 2022 and November 2023, enrolled 673 pregnant adolescents across twelve communities spanning five districts in Sierra Leone. Participants were assigned dedicated local mentors who provided continuous, hands-on support throughout pregnancy and the postpartum period. These mentors played a pivotal role not only in medical and psychosocial support, but also in mitigating the severe stigma and familial alienation commonly experienced by pregnant teenagers in these regions. By serving as advocates and navigators within fragmented healthcare and social systems, mentors facilitated access to antenatal care, fostered peer connections among expectant young mothers, and encouraged family reunification when possible.
Results from the trial revealed a nearly 50% decrease in the combined rate of maternal and perinatal deaths when compared to historical data. Statistically, this equates to one saved infant life for every eighteen girls mentored, a substantial impact given Sierra Leone’s historically high maternal mortality ratio (MMR). Notably, the MMR in Sierra Leone, though reduced from 1,165 deaths per 100,000 live births in 2013 to 443 in 2020, remains one of the highest globally. Interventions such as 2YoungLives therefore offer critical pathways to further reduce these grim statistics by addressing multifaceted barriers at both medical and community levels.
Beyond clinical outcomes, the program has seen impressive social ramifications. Participating girls have been empowered to return to formal education or engage in skill-building vocational training programs in trades such as plumbing, electrical installation, hospitality, and tailoring. This dual focus on health and education underscores the holistic nature of the initiative, recognizing that breaking cycles of poverty and social exclusion requires supportive structures that extend well beyond pregnancy and childbirth.
Since its inception in 2017, the 2YoungLives program has demonstrated scalability and adaptability. Initially starting with just three mentors and nine girls, the scheme expanded to encompass 24 mentors by 2021, having supported over 300 adolescent mothers without any maternal deaths recorded in that year. Its integration in 2021 into the larger CRIBS project, a global health consortium funded by the National Institute for Health and Care Research (NIHR), highlights the growing recognition of community-centered, research-driven strategies in tackling maternal health crises in sub-Saharan Africa.
The local leadership and development of the mentoring scheme are central to its success and sustainability. Dr. Cristina Fernandez Turienzo, the lead author of the trial publication and Senior Research Fellow at King’s College London, emphasized the crucial role of community-driven approaches in addressing complex health challenges. She remarked that the program exemplifies why global health research must prioritize locally derived solutions tailored to specific sociocultural contexts in order to be effective.
Lifeline Nehemiah Projects founders Lucy November and Mangenda Kamara further stress that the numbers alone do not capture the full scope of the social transformation enabled by the intervention. The incorporation of a business start-up fund within the program has allowed young mothers to generate sustainable incomes, which in turn has improved nutrition during pregnancy and provided financial stability for their newborns. This economic empowerment facet has been instrumental in helping girls gain autonomy and resilience, crucial elements for long-term wellbeing.
In Sierra Leone, adolescent pregnancy is often accompanied by profound stigma and social alienation, leading to a cascade of negative outcomes including family abandonment and school dropout. By pairing pregnant girls with empathetic mentors from their own communities, the 2YoungLives program mitigates these adverse social determinants of health. Mentors act as social linchpins, encouraging continuity in education and vocational engagement, thereby interrupting the entrenched patterns of poverty and disenfranchisement faced by young mothers.
The intervention’s effects extend beyond Sierra Leone’s borders. Researchers advocate for larger-scale trials to evaluate the replicability and efficacy of this mentoring model across diverse geographic and socioeconomic contexts, including in high-income countries where marginalized groups face barriers to adequate maternal healthcare. Professor Jane Sandall CBE, Professor of Social Science and Women’s Health at King’s College London, noted that the program’s approaches could be adapted to support communities with limited access to health services, including migrant or non-English speaking women in the UK.
From a technical perspective, the mentoring scheme integrates psychosocial support with practical guidance on navigating antenatal and postnatal care pathways. Mentors are trained to identify warning signs of obstetric complications and facilitate timely referrals to healthcare providers, directly addressing critical gaps in maternal health systems. This proactive engagement forms a crucial intermediary layer between overstretched clinical resources and vulnerable adolescent populations, enhancing early detection and intervention for potential pregnancy-related complications.
Moreover, the study’s methodology involved rigorous monitoring and evaluation, with systematic data collection on maternal and perinatal outcomes, educational continuation, and economic activities post-birth. This comprehensive data framework has allowed researchers to quantify not only survival metrics but also the broader socio-economic benefits, providing a compelling case for policymakers and global health stakeholders to integrate similar community-led models into maternal health strategies.
In conclusion, the 2YoungLives pilot trial represents a paradigm shift in maternal health interventions for adolescent populations in resource-limited settings. By centering local leadership, community engagement, and multidisciplinary support, the program achieved substantial reductions in mortality while fostering pathways for young mothers to rebuild their futures through education and economic empowerment. This evidence positions localized mentoring schemes as critical tools in the global fight against maternal and neonatal mortality and underscores the urgency of scaling such initiatives within Sierra Leone and beyond.
Subject of Research: People
Article Publication Date: 18-Jun-2025
Web References:
https://cribs-i.org/
References:
Pilot trial published in The Lancet led by King’s College London and Lifeline Nehemiah Projects (LNP)
Keywords:
Pregnancy, Mentoring
