The MICS Survey: What the Children’s Numbers Tell Us About Sierra Leone

Why this survey carries weight

A MICS is nationally representative, publicly available, and built to a method that lets Sierra Leone be compared with itself over time and with its neighbours. That makes it useful well beyond statisticians. A councillor can use it to argue that a particular district is being shortchanged. A budget committee can use it to move money toward the places where children are most at risk. A court hearing a case about systemic neglect can treat it as reliable proof of a pattern rather than an anecdote.

Its authority comes from its method, and its method is what lets an advocate say, with evidence behind them, that a problem is national and measurable.

Survival and the earliest years

Under-five mortality has come down a long way from the levels of the 1990s and 2000s, but Sierra Leone still loses children at a rate among the highest in West Africa. The most recent United Nations estimates, from the Inter-agency Group for Child Mortality Estimation, put under-five deaths at roughly 100 per 1,000 live births, and a growing share of those deaths now happen in the first month of life.

That shift matters for policy. When newborn deaths dominate, the answer is not simply more clinic visits but better care at the moment of birth and in the hours after it: trained hands, working equipment, and a referral that arrives in time. The survey also shows how thin early support is. Few young children attend any organised early learning, stimulation at home is uneven, and many households have no books or play materials for a small child at all.

Growth, and the inequality hidden inside a good average

The most encouraging finding is the steady retreat of stunting, the low height-for-age that signals long-term deprivation. MICS 2017 recorded stunting at about 26 per cent nationally, and later nutrition data suggest continued improvement in many districts, with the national figure still near 26 per cent by 2021.

The problem is what that national number conceals. A child in the poorest rural households, or one whose mother had little schooling, is far more likely to be stunted than the average suggests, and several districts still sit above 30 per cent. Acute malnutrition, or wasting, is lower in ordinary times, in the range of 4 to 6 per cent, but it can climb quickly during floods, outbreaks or price shocks.

The lesson for anyone writing a budget or a statute is that averages hide the children who need help most. Targets and allocations have to be set district by district, so that resources follow need rather than being spread in equal, and therefore unequal, shares.

The everyday harms: discipline, labour and marriage

Some of the survey’s hardest numbers are about how children are treated. Around 87 per cent of children aged 1 to 14 had experienced violent discipline, physical punishment or psychological aggression, in the previous month. Close to two in five children aged 5 to 17 were engaged in child labour, with the poorest and most rural households most exposed. Roughly three in ten women aged 20 to 24 had married before turning 18, and about one in five girls aged 15 to 19 had already begun childbearing. Female genital cutting remains common among adolescent girls.

These are not separate problems. Early marriage, interrupted schooling, early pregnancy and cutting travel together, and they fall hardest on girls who are already poor. This is the ground on which the Prohibition of Child Marriage Act 2024, signed into law on 2 July 2024, will be tested. That Act sets the age of marriage at 18 with no exceptions, carries penalties of up to fifteen years imprisonment, fines, or both, and voids marriages involving children. Whether it changes lives depends on enforcement, on keeping girls in school, and on social protection for the families who now marry daughters early out of poverty.

Ten findings worth keeping

1. Birth registration is high in the aggregate, at about 81 per cent of children under five, but far fewer hold an actual certificate, around 53 per cent. Recognition and documentation are not the same thing, and the gap is fixable.
2. Violent discipline reaches roughly 87 per cent of children aged 1 to 14 in a given month, which makes it a norm rather than an exception.
3. Child labour affects close to 39 per cent of children aged 5 to 17, concentrated in the poorest and most rural homes.
4. Only about half of children aged 3 to 4 are developmentally on track across the survey’s core domains, and stimulation at home follows the household’s wealth.
5. Around 30 per cent of women aged 20 to 24 married before 18, and about one in five girls aged 15 to 19 have begun childbearing. The 2024 child marriage law now speaks directly to this.
6. Female genital cutting remains common among adolescents and calls for protection, education and health responses together, not a single measure.
7. Stunting has fallen to roughly 26 per cent nationally, but with districts above 30 per cent, progress is real and geographically uneven.
8. Access to information is sharply unequal. Mobile phones are widespread, but home internet and computers are rare and concentrated in wealthier urban households, which shapes who can learn and who can reach services.
9. Under-five mortality, near 100 per 1,000, is still among the region’s highest, and newborn deaths are a rising share of it.
10. The single most useful move in law and budgeting is to pair a clear prohibition, of child marriage or of a harmful practice, with money and district-level targets. A ban without a budget changes little.

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