FREETOWN, September 22 (IPS) – Eunice Dumbuya, a young activist in Freetown, Sierra Leone, still remembers being called promiscuous after getting a contraceptive implant a few years ago. She knew the risks of an unplanned pregnancy in her conservative country, so she made a choice.
“I had to go with my aunt to the hospital for contraceptives because my mom was very strict,” she explained. “My aunt was the one who supported me. Using contraceptives boosted my self-confidence,” Eunice shared.
In Sierra Leone, many people see sex outside marriage as a taboo, while childbirth within marriage is viewed as a blessing. As a result, using contraceptives can attract harsh judgment.
“Some people, once they see the [contraceptive] implant under your skin, assume you are promiscuous,” Eunice said. “If you’re a teenager, it’s worse. People think you’re doing something inappropriate for your age just because you are on contraceptives.
Cultural and Religious Barriers
Family planning remains a key issue shaping the lives of women and men in Sierra Leone. According to the 2019 Sierra Leone Demographic and Health Survey[1], the contraceptive prevalence rate is 24 percent for all women, 21 percent for married women, and 53 percent for sexually active unmarried women.
Despite rising use, many women still face major barriers. Fayia Foray, the Integrated Marketing Officer at Marie Stopes Sierra Leone, a Non-Governmental Organization providing Family Planning, and Sexual Reproductive Health Services in Sierra Leone, pointed to cultural stigma, discrimination, and religious beliefs as major challenges.
“It is important that married women use contraceptives to space births, regain their health, and support their families through work,” he said. “Young people use it to delay childbirth, focus on education or skills, and plan for the future. Nationally, it empowers youths to become productive, contributing to the country’s development.”
However, opposition from religious leaders makes family planning hard to promote. “There are still communities where religious leaders preach against the use of family planning, which severely limits its acceptance and use,” Foray added.
This resistance often trickles down to families, especially those with strict religious beliefs. Mariatu Sankoh, a university student, recalled how difficult it was to seek contraception. “I can’t confront my parents to tell them I want to take contraceptives, because I know I would receive the beating of my life, something I’ve never experienced before,” she said. “So, I had to take matters into my own hands because I don’t want to get pregnant.” She added that the first time she went to the hospital for contraception, she had to go with a friend’s aunt to avoid suspicion.
Foray also mentioned that some people falsely believe contraceptives cause infertility, and others exaggerate side effects.
“All medications have side effects, and family planning is no exception,” he said. “Despite the side effects, the benefits of using family planning far outweigh the risks.”
Controlling Women’s Choices
In Sierra Leone, stigma around contraceptives is often rooted in gender-based violence[2] and attempts to control women’s bodies. These issues remain widespread. Around 62 percent of women[3] aged 15 to 49 have experienced physical or sexual violence. And 61 percent of ever-married women have suffered abuse from their partners, whether physical, sexual, or emotional.
Experts say that stigma around contraception goes beyond family planning. It is tied to the way society treats women’s independence.
“In our African society, when a young girl uses implants, she is often judged harshly,” said Rebecca Kamara, who remembers facing stigma herself.
“That was one of the major challenges I faced. Even partners can be unsupportive. Some prefer you use emergency pills, which come with serious side effects. When I started using contraceptives, I was still studying. I didn’t want an unplanned pregnancy to disrupt my education,” she explained.
“I was looked at in a very demeaning way when I started using implants at an early age,” says Isha Sesay, a young, unmarried woman. “Some family members and neighbors whispered behind my back that I had multiple partners, that’s why I was using it.”
Like Isha, many young women in Sierra Leone face stigma from family, friends, and neighbors for choosing to protect themselves.
Some men still believe that only women with multiple sexual partners use contraceptives.
“If I am the only one you are sleeping with, you can’t stress yourself out to use it. I can’t date a woman who uses contraceptives. They are the ones you should be afraid of as a man,” said Francis Kanu.
Michael Sahr Kendor, a married man, shares a similar view. “I can understand a teenager using contraceptives, but I don’t see the reason for adult women to use contraceptives,” he said.
Progress?
In Sierra Leone, efforts are being made[4] to promote family planning and expand access to reproductive health services. The country is part of the FP2030 initiative[5], a global partnership working to ensure that all women and girls have access to modern contraception by 2030.
The United Nations Population Fund has stepped up efforts and is supplying contraceptives used in the public sector, but despite this, it says, stigma around contraceptive[6] use remains a challenge.
Adama*, a visually impaired woman, shared how health workers still discriminate against people with disabilities who try to use contraceptives.
“At one time, when I went to a pharmacy to purchase an emergency pill, the pharmacist, while handing me the prescription, told me to inform the person who sent me to eat well before taking it,” she said. The comment made her feel terrible because the pharmacist assumed she couldn’t be the user.
Marie Kamara, another woman living with a disability, said she simply cannot afford contraceptives.
“I have never used family planning. I know I’m not financially strong, so contraceptives are obviously not an option for me. I can barely afford basic needs like feeding, so thinking about contraceptives and how to maintain them isn’t even realistic.”
Courage in the Face of Stigma
Eunice in Freetown regrets that the stigma around contraceptives is getting worse. Still, she believes women must be brave and make their own choices.
“Societal pressure has driven many girls to remove the implant or switch to less visible methods. Even though the stigma affected me, I didn’t remove it because I knew I couldn’t let people’s opinions determine my choices. Sometimes, you just can’t escape the stigmatization,” she said.
Note: Adama’s name was changed because she wanted anonymity.
IPS UN Bureau Report
© Inter Press Service (20250922051511) — All Rights Reserved. Original source: Inter Press Service[7]
References
- ^ 2019 Sierra Leone Demographic and Health Survey (archpublichealth.biomedcentral.com)
- ^ gender-based violence (sierraleone.unfpa.org)
- ^ Around 62 percent of women (sierraleone.unfpa.org)
- ^ efforts are being made (awokonewspapersl.com)
- ^ FP2030 initiative (www.fp2030.org)
- ^ stigma around contraceptive (sierraleone.unfpa.org)
- ^ Original source: Inter Press Service (www.ipsnews.net)
- ^ How Stigma Undermines Contraceptive Use Among Women in Sierra Leone (www.globalissues.org)
- ^ 30 Years advancing gender equality: Achievements, setbacks, and the road ahead (www.globalissues.org)
- ^ UN, AU and EU leaders pledge joint push for peace and development in Africa (www.globalissues.org)
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- ^ 146 Land and Environmental Defenders Killed or Disappeared in 2024 (www.globalissues.org)
- ^ Frontline of a Planetary Emergency: Africa Demands Climate Justice and Action (www.globalissues.org)
- ^ How Stigma Undermines Contraceptive Use Among Women in Sierra Leone (www.globalissues.org)