Contraceptive and abortion practices of young Ghanaian women aged 15-24: evidence from a nationally representative survey

Access to adolescent sexual and reproductive health services in Accra, Ghana: An exploratory qualitative study

Nearly 31% of the Ghanaian population are adolescents, and these populations persistently face high rates of teenage pregnancies and unsafe abortions. This is despite sexual and reproductive health (SRH) being taught in the school curriculum. In this qualitative study, we explore the factors affecting adolescents' access to, and experiences of, SRH services in Accra, Ghana. We conducted 12 focus group discussions (FGDs) with adolescents and 13 key informant interviews (KIs) in Ghana. The FGDs were conducted with school-going and out-of-school adolescents. KIIs were conducted with various stakeholders working with adolescents or in SRH services. All interviews were conducted in English, audio recorded and transcribed verbatim. We applied the Dahlgren-Whitehead Rainbow model of health determinants and used a thematic analysis. Eight themes were identified, across micro, meso and macro levels, that influence adolescents' SRH access and experience in Accra. These included: family, social networks, the role of schools, health providers and services, the policy landscape, gender norms, cultural norms, and poverty. The findings highlight several factors that influence adolescents' access to appropriate SRH services in this context and demonstrate the need for a multisectoral effort to address structural factors such as harmful gender norms and persistent poverty.

Comparing the reasons for contraceptive discontinuation between parenting adolescents and young women in sub-Saharan Africa: a multilevel analysis

BACKGROUND

Adolescent sexual and reproductive health remains a major public health and development issue of global importance. Given that adolescents and young people are heterogenous groups in terms of many characteristics, this study expands the literature by comparing the reasons for contraceptive discontinuation between parenting adolescents (aged 15-19) and parenting young women (aged 20-24) in sub-Saharan Africa (SSA).

METHODS

Data for the study came from Demographic and Health Surveys of 22 SSA countries. The outcome variable was reasons for discontinuation. We performed multilevel binary logistic regression on analytic samples comprising 1485 parenting adolescents and 10,287 parenting young women across the selected SSA countries.

RESULTS

Findings show that the proportion of respondents who used modern contraceptives was lower among parenting adolescents (35%) relative to their 20-24-year-old counterparts (43%). Higher percentages of parenting adolescents than young women discontinued contraceptives because of reasons such as pregnancy or method failure (i.e., 9.9% and 8.17% accordingly), husband disapproval, access or availability issues, wanting more effective methods, and inconvenience in using methods. The multilevel analysis further highlighted disparities between parenting adolescents and parenting young women who discontinued contraceptives. For instance, parenting young women had 30% lower odds of discontinuing contraceptives due to pregnancy or method failure than parenting adolescents.

CONCLUSION

The study established disparities in the reasons for contraceptive discontinuation between parenting adolescents and parenting young women, with adolescents demonstrating greater vulnerabilities and higher risks. Considerable attention must be given to parenting adolescents in the efforts to achieve equity goals such as the Sustainable Development Goals and universal health coverage in SSA.

The Effects of Pregnancy: A Systematic Review of Adolescent Pregnancy in Ghana, Liberia, and Nigeria

There is a high incidence of adolescent pregnancy in West Africa. The objective of this study is to highlight the health impacts of adolescent pregnancy through a systematic review. A search was conducted in the electronic databases of Google, Google Scholar, SCOPUS, EBSCO, CINAHL, Web of Science, African Journals Online (AJOL), and the Demographic Health Surveys (DHS) Program. The study found anemia, complications of pregnancy, obstetric and gynecological risks, unsafe abortions, and psychological effects to adversely impact the health of adolescent girls in Ghana, Liberia, and Nigeria. Pregnancy could be deleterious to the health and well-being of adolescent girls in various forms. In addition, adolescent pregnancy could expose adolescent girls to gender-based violence, exclusions, and inequities, be detrimental to upholding women's sexual and reproductive health rights, and could also have implications for Sustainable Development Goal 3. Targeted interventions to prevent pregnancy in young women and mitigate these effects by stakeholders are encouraged.