On November 6, 2015, the world celebrated the news that the deadly Ebola outbreak in Sierra Leone was over, after reaching 42 days with no new reported cases. This was an historic victory for the government and people of Sierra Leone.

Another public health victory was also recently recognized in Sierra Leone in support of the Millennium Development Goals: since 1990, the rate of maternal deaths in the country has been cut in half.

Despite these efforts, the country is still struggling to overcome an ongoing massive public health challenge that has not made the headlines.  As recently as 2013, Sierra Leone had the world’s highest rate of mortality among children under the age of five (at 182 child deaths per 1,000 live births).  Undernutrition is a major contributor to child mortality in the country, and also undermines longer-term health and development among children.

Undernutrition is caused by a combination of immediate causes—such as a lack of available nutritious food and/or  illness and disease—and underlying factors, such as poverty, lack of access to health care and information, and poor knowledge and practices regarding hygiene and feeding.  In Sierra Leone, 12.9 percent of children are underweight, 28.8 percent are physically stunted (not growing to normal height), and 4.7  are severely malnourished.

Poor households—and children of mothers who lack access to education—are at particularly high risk of undernutrition. Information also suggests that teenage mothers are more likely to have poor care practices that can contribute to undernutrition.

Even though prior to the Ebola outbreak on May 26th, 2014,  teenage  pregnancy accounted for 34 percent of all pregnancies in Sierra Leone, until recently, there was very little evidence on the care and feeding practices of teen mothers.

In partnership with the Ministry of Health  and two other international organizations (Save the Children and Concern Worldwide), Action Against Hunger recently completed a study to better understand the health risks associated with teen pregnancy.

Our study revealed that teenage mothers experience significant stigma, social rejection, isolation, and a correlation with high dropout rates from schools. Our work also showed that teen mothers experience a lack of sufficient income, and inadequate knowledge regarding infant and child nutrition. In fact, the majority of mothers in the study reported that they had fed their children with water or other food when they were younger than six months of age. One mother said, “After one month, I had to give my baby warm water because I didn’t have enough food, so he wasn’t satisfied.”

Read the full report here to find out what we learned about how to improve the health of Sierra Leone’s teen mothers and their babies.