Teenage Pregnancy in Rural West Bengal: Reasons for Persistence, Risk Factors, and Programmatic Pathways to Reduction — A Comprehensive Review

Background: Teenage pregnancy remains a pressing public health, gender‑equity, and development challenge in pockets of rural West Bengal despite broad declines at the national level. This review synthesizes quantitative and qualitative evidence on trends, drivers, health risks, and programmatic solutions tailored to rural West Bengal. Methods: We conducted a narrative review of national and state surveys (NFHS‑4 and NFHS‑5), state programme reports, and peer‑reviewed studies, prioritising West Bengal–specific evidence and India‑validated interventions. Findings: NFHS‑4 (2015–16) reported that 18% of West Bengal girls aged 15–19 had begun childbearing, while NFHS‑5 (2019–21) reports ~16%—with notable district heterogeneity and hotspots like Purba Bardhaman (≈21.9%) [1–3]. Persistent structural drivers include child marriage (≈>40% of women aged 20–24 married <18 years), incomplete secondary schooling, poverty, social norms, and limited adolescent‑friendly SRH services; service‑level gaps persist despite 505 Adolescent Friendly Health Clinics (AFHCs) and 461 counsellors statewide as of 2019 [4–6]. Adolescent pregnancy increases risks of eclampsia, infections, preterm birth, and low birth weight, with compounding burdens of anaemia and undernutrition [7–10]. Evidence‑backed approaches include keeping girls in school via conditional cash transfers (e.g., Kanyashree) with documented reductions in under‑age marriage and school dropout; strengthening RKSK/AFHCs and supply of modern contraception; comprehensive sexuality education (CSE); community norm change; and targeted interventions in high‑burden districts [4–6,11–17]. Conclusion: In rural West Bengal, a multi‑sector plan that integrates education retention (Kanyashree), rights‑based CSE, adolescent‑friendly contraceptive access, and strong enforcement/clarification of laws on child marriage—implemented through district‑level action plans—offers the most credible pathway to reducing teenage pregnancy while protecting adolescents’ rights [4–6,11–19].