Study finds rise in mental health conditions among pregnant adolescents.

Poverty, Social stigma, isolation, and lack of systemic support are driving more pregnant adolescent girls in Kenya and Mozambique to mental health conditions, a new study finds.

The study done by the Aga Khan University, a center of excellence in women and child health in East Africa, revealed that adolescent girls have increased vulnerability to mental health conditions, with an estimated prevalence of 55.8 percent during the perinatal period, compared to 28.4 percent among the general population.

The study conducted in Kenya and Mozambique involved 159 participants, including adolescent girls aged 15 to 19, young women who had experienced pregnancy during adolescence, partners, family members, health workers and community influencers.

In Kenya, the study was conducted in Kilifi County, where 12.5 percent of adolescent girls experience pregnancy, more than twice the national figure of 5.7 percent.

Aga Khan University, Centre of Excellence in Women and Child Health Study coordinator Margrette  Hanselmann says the research was conducted in two faces between 2020 and 2024 in Rabai and Kaloleni sub counties.

‘’1 out of 3 adolescents usually experiences a mental disorder during pregnancy and earlier after birth. We went to the targeted persons and asked them what the challenges were using different methods and what was important to them at that particular time.’’ Said Margrette.

The Study coordinator further says that apart from the pregnant adolescent, the study also included young mothers with a child who is under one year and understand the challenges they went through.

Among the adolescent girls who participated in Kenya, 85 percent were in their first pregnancy, while in Mozambique, all 20 adolescent girls who participated were in their first pregnancy.

In Kenya, 22.9 percent of adolescent girls are married before their 18th birthday, and the study noted that many of the marriages happen because of pregnancy.

‘’We come to realise that a lot of girls dropped out of school because of stigma at school and at home from relatives and some parents. Many were married off to the people who impregnated them.’’ Said Margrette, adding that apart from lacking financial support to take care of themselves and the child, most girls receive violence from their partners and parents of the partners.

 Only 26 percent of girls in Kenya and 13 percent of girls in Mozambique complete secondary school. However, school attendance falls even further after pregnancy. Among the adolescent girls interviewed, only one percent in Kenya and Mozambique were still attending school.

In addition, the study found that stigma and discrimination from students and school staff, caregiving responsibilities, and lack of money for school fees all contributed to girls dropping out.

Rabai Sub County counseling psychologist Racheal Charo says Early, unintended pregnancy can add stress to the normal physiological and behavioral changes during the perinatal period.

 Racheal, who worked with the adolescent mothers during the study period, says that some of the girls experienced poor antenatal service provision, blatant social and gender discrimination, violence, and stigma, exacerbating their mental conditions.

The mental health services that are available for adults may not be able to help pregnant adolescents and young women. Although adolescent pregnancy remains relatively common in Kilifi, Racheal says it continues to be viewed through a moral rather than a health or social lens.

"The participants described experiencing stigma from family and community members, who often interpreted pregnancy as evidence of irresponsibility, promiscuity, or failure rather than recognising the complex drivers such as poverty, limited access to sexual and reproductive health information, gender inequality, school dropout, sexual coercion, and limited economic opportunities," Said Racheal.

In Kenya, priority targets from the Mental Health Action Plan 2021–2025 include the establishment of mental health promotion and prevention programmes, increasing the integration of mental health care within maternal and child health, and establishing peer support group.

In Kenya, there are 15•32 mental health professionals for every 1000 people, while in Mozambique, this number drops to 1•37 for 2829  people.

To address the lack of human resources for mental health, both governments have expanded mental health professionals to include new cadres.

The study further showed that support means far more than financial assistance. Adolescents described meaningful support as having trusted people who listened without judgment, offered emotional reassurance, respected confidentiality, and helped them navigate pregnancy and early motherhood.

Prof Tatiana Salisbury of King's College London said practical support includes accompaniment to antenatal clinics, help with transport and nutrition, childcare after delivery, continuation of education, and guidance on infant care.

"The mentor mother model highlighted that adolescents particularly valued peer support from women with lived experience who could normalise their experiences, reduce feelings of isolation, and provide accurate information. Therefore, effective support is emotional, informational, practical, and social rather than purely material," she said.

In addition, the study found that poverty within  adolescent households contributed to early marriage and shaped girls' experiences of pregnancy. Financial instability affected their ability to plan for the future, attend care, buy food, and provide basic items for their babies.

"We lack food at home. On lucky mornings, we get porridge. We sometimes don't get it, even my baby misses so he starts crying. "said one of the adolescents participant involved in the study.

For Prof Tatiana, this is why mental health support cannot be separated from the conditions in which young mothers live.

She says that while mental health interventions can improve coping, resilience and help-seeking, their effectiveness is limited when underlying socioeconomic challenges remain unresolved.

"Many adolescents linked persistent stress, anxiety, and depressive symptoms to food insecurity, unemployment, unstable housing, inability to provide for their babies, and dependence on unsupportive partners or families," she says.

The researchers are now calling for psychological support for pregnant and parenting adolescents to be integrated with broader social protection, including education re-entry opportunities, livelihood programs, economic empowerment, and stronger referral systems.

In addition, health providers noted that the lack of a clear referral pathway for mental health made it difficult to provide targeted support during pregnancy and after birth.

Lack of sexual and reproductive health education for adolescents due to resistance within communities was also highlighted as a major challenge to equipping adolescents with knowledge about what happens to their bodies during pregnancy and childbirth.