Background and Rationale  

Adolescent girls in Sierra Leone continue to face significant barriers to exercising their sexual and reproductive health and rights, including limited access to quality health services, harmful social norms, gender inequality, and low decision-making power over their own bodies and futures. These challenges are particularly acute for vulnerable groups such as very young adolescents, married adolescent girls, and adolescent mothers.

The Foundations Project was established to address these barriers by empowering adolescent girls to make informed decisions about their sexual and reproductive health, improving the social environment that influences these decisions, and strengthening institutions to deliver accountable, gender-responsive health services.

Project Goal 

To increase decision-making by adolescent girls on their sexual and reproductive health rights and use of quality sexual and reproductive health services.

Objectives

The project focuses on three key objectives. First, to empower adolescent girls to exercise their sexual and reproductive health rights and make informed choices. Second, to improve social norms and community support for adolescent sexual and reproductive health and gender equality. Third, to strengthen health systems and institutions to provide accessible, accountable, and high-quality sexual and reproductive health services.

Target Beneficiaries  

The project reaches more than 149,000 adolescent girls and boys, over 50,000 parents and caregivers, and 500 health workers across 40 communities in all 15 chiefdoms of Kailahun District. Special attention is given to very young adolescents, older adolescent girls, married adolescents, and adolescent mothers.

Key Interventions  

The project strengthens adolescent sexual and reproductive health through a combination of community engagement, health system strengthening, and adolescent empowerment. It supports adolescent girls with information, skills, and opportunities to make informed decisions about their health and wellbeing.

The project has renovated and equipped 15 health facilities to improve the quality of maternal, newborn, child, and reproductive health services. It also builds the capacity of health workers through training in areas such as postpartum family planning, clinical waste management, data management, and supportive supervision.

At community level, the project supports Women and Girls Groups, Real Fathers Groups, Adolescent App Champions, and community taskforces that promote dialogue, challenge harmful norms, and encourage positive behaviours related to adolescent health and gender equality.

Expected Results  

The project is expected to increase the ability of adolescent girls to make informed decisions about their sexual and reproductive health, improve access to quality health services, strengthen community support for gender equality, and enhance the capacity of health systems to deliver responsive and accountable services.

Approach  

The project adopts a rights-based and gender-transformative approach that combines adolescent empowerment, community mobilization, and health system strengthening. By working with adolescents, families, communities, and government institutions, it promotes sustainable improvements in sexual and reproductive health outcomes.

Monitoring and Evaluation  

The project uses continuous monitoring and learning systems to track progress, measure outcomes, and generate evidence for improved programming. Regular data collection, community feedback, and collaboration with health authorities support accountability and learning throughout implementation.

Partnerships  

The project is implemented through a consortium comprising Save the Children International, the International Rescue Committee, Planned Parenthood Association of Sierra Leone, Ndomakeh Foundation, and the Ministry of Health and Sanitation.

Sustainability  

The project strengthens local institutions, health systems, and community structures to ensure long-term impact. By building local capacity and promoting community ownership, it supports sustained improvements in adolescent sexual and reproductive health and rights beyond the project period.