A new review of research from across sub-Saharan Africa found that inadequate access to food is linked to depression, suicide attempts, HIV vulnerabilities, and poorer sexual and reproductive health outcomes among adolescent mothers.
The findings, published in the journal PLOS ONE, suggest that food insecurity is not only a nutrition issue but also a critical health and equity challenge, highlighting the importance of placing adolescent girls becoming mothers at the center of policies and programs designed to improve food security, health, and social equity across sub-Saharan Africa.
"Food insecurity among adolescent mothers is not simply about hunger," says lead author Suliat Fehintola Akinwande, PhD Candidate at the Factor-Inwentash Faculty of Social Work, University of Toronto, and lead author of the study. "Our review shows how poverty, disrupted education, stigma, and limited livelihood opportunities combine to create a cycle of disadvantage that affects both young mothers and their children,"
The University of Toronto researchers conducted a scoping review examining the drivers, coping strategies, and health impacts of food insecurity among adolescent mothers aged 10 to 19 years in sub-Saharan Africa. Their review synthesized evidence from 16 studies conducted across seven countries and identified important gaps in research and policy.
Poverty was the most consistently reported driver of food insecurity. School dropout, limited employment opportunities, low literacy, and financial hardship frequently left adolescent mothers struggling to secure adequate food for themselves and their children.
Researchers also identified social and ecological factors contributing to food insecurity. Stigma surrounding adolescent pregnancy often led to rejection by family and community members, reducing access to social support. In some communities, environmental challenges such as infertile land, poor infrastructure, and declining agricultural productivity further limited access to food.
To cope with food shortages, adolescent mothers often relied on informal work, farming, social support networks, borrowing food, and reducing meal sizes. However, the review also found that severe food insecurity sometimes forced young mothers to adopt high-risk survival strategies.
"Many adolescent mothers demonstrate remarkable resilience in the face of enormous challenges. However, the evidence shows that some are forced into difficult choices simply to meet basic needs, underscoring the urgent need for stronger social and economic supports," says Kehinde Akinwande, co-author of the study.
The review further revealed strong links between food insecurity and poor mental health. Multiple studies found that food-insecure adolescent mothers were more likely to experience depression, while others reported associations with suicidal thoughts and suicide attempts.
"One of the most concerning findings was the consistent relationship between food insecurity and mental health challenges," says senior author Dr. Carmen Logie, Professor at the Factor-Inwentash Faculty of Social Work, and Canada Research Chair in Social and Environmental Justice for Global Health Equity. "Addressing hunger may also help reduce depression, psychological distress, and other mental health burdens experienced by adolescent mothers."
Food insecurity was also associated with adverse sexual and reproductive health outcomes. Studies found links between food insecurity and transactional sex, age-disparate relationships, substance-influenced sex, HIV vulnerabilities, and difficulties adhering to antiretroviral treatment among adolescent mothers living with HIV.
The authors call for expanded investments in food assistance programs, school re-entry initiatives, livelihood training, mental health services, and adolescent-friendly healthcare. They also emphasize the need for more research to better understand food insecurity among adolescent mothers and develop evidence-based solutions that break intergenerational cycles of disadvantage.
Adolescent mothers often become parents within circumstances they did not fully choose or control, say the researchers. Across sub-Saharan Africa, factors such as poverty, child marriage, unintended pregnancies, gender inequities, disrupted education, and limited access to healthcare can shape the transition to motherhood. As the study showed, these same structural challenges frequently influence whether young mothers have access to adequate food, social support, and economic opportunities for themselves and their children.
