‘I used to cry a lot every night’

In Sierra Leone, one of the world’s least developed countries, the socio-economic and political context
has impacted adversely on the maternal health and wellbeing of women and girls. In the southern region of Bo, where this study took place, the devastating impact of Sierra Leone’s decade-long civil war is
particularly pronounced. Poverty has intensified and become pervasive. Opportunities for education
and employment are limited. Most households rely on farming for their primary source of income, and
many are forced to supplement this with wood selling, small-scale petty trading, and vegetable gardening. Women and girls in Sierra Leone face multiple forms of discrimination and disadvantages
in many areas of their lives. This is especially true for women living in rural areas, who are at most risk of obstetric fistula.