Adolescent sexuality and reproductive health in Ghana: Some results from a survey of Cape Coast And Mankrong
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2007
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Population, Health and Development in Ghana: Attaining the Millennium Development Goals
Abstract
4 Chapter Adolescent Sexuality and Reproductive Health in Ghana: Some Results from a Survey of Cape Coast and Mankrong Stephen O. Kwankye Introduction Adolescent sexuality and reproductive health issues are increasingly becoming of concern in many sub-Saharan African countries. This is especially the case when viewed in the context of the HIV/AIDS pandemic, a situation , which puts many young persons particularly females at risk. This constitutes a serious problem considering that most of these sexual activities are taking place outside wedlock and without contraception. As a result, teenage pregnancies and their accompanying child delinquency and poor development of female adolescent victims are unfolding problems that Ghana will have to contend with for a long time. One fundamental barrier that has worked seriously against policies that have aimed at addressing adolescent sexuality problems in Ghana has been the sociocultural environment within which the interventions are being evolved and or implemented. In Ghana, it is felt in many circles that it is culturally unwelcome to discuss sexual issues with adolescents. Again, sections of the society and even some family planning service providers frown upon the provision of family planning services to these youngsters. For example, according to the 1994 Situation Analysis of Family Planning Service Delivery Points in Ghana, 40% of service providers expressed their unwillingness to provide family planning services such as intra-uterine device (IUD) and injectables to unmarried adolescents and 25% of them would not administer the pill under the same conditions (Ghana Statistical Service, 1994). Such an unfriendly socio-cultural environment has often overtly or covertly not permitted open and frank discussions regarding issues of sexuality and reproductive health particularly among adolescents. Thus, as a result of their engagement in unprotected sex, the chances of further enhancement of their socio-economic development are often and largely foreclosed due to unplanned pregnancies and, or sexually transmitted infections (STIs) including HIV/AIDS. In Ghana, the three Demographic and Health Survey reports of 1993, 1998 and 2003 have indicated that overall a little more than one in every 10 female adolescents of 15-19 years have begun childbearing at a time they are expected to be in school (GSS and MI, 1994; 1999; 2004). The conditions are again made fertile for criminal abortion to thrive in Ghana. Data are not readily available on abortion in Ghana, but in a society where adolescents are largely indulging in sex with little or no family planning practices, the probability exists for pregnant adolescents who still want to continue their education to resort to induced, and unsafe abortion which is likely to contribute to high maternal mortality ratios in Ghana. Data on reported AIDS cases in Ghana suggest that a higher proportion of HIV contraction takes place during adolescent ages of 15-19 years. For example, available data on reported AIDS cases by age indicate that for both males and females, almost 75% of the cases were reported among persons aged 20-39 years and 4% among ado54 POPULATION, HEALTH AND DEVELOPMENT lescents aged 15-19 years. The inference is that considering that the incubation period of the disease ranges between 5 and 12 years or more, it is possible that many of the reported cases in the age group 20-39 must have been contracted within adolescent ages. Adolescent childbearing rates in Ghana have been found to be highest in the Central Region in 1993 (33.3%) and 2003 (34.1%) (see GDHS reports of 1993 and 2003). At the same time, the region has been shown to have one of the highest levels of poverty in the country in 1998/1999 (Government of Ghana/UNFPA, 2004). Linked to the high sexual activity among young women is their low contraceptive use. For example, current contraceptive use for modern methods in 1993 was 5.0% and 8.3% among women of 15-19 and 20-24 years respectively compared to 9.3% among all women in Ghana (Ghana Statistical Service, 1994). The corresponding figures for 1998 were 4.8% and 10.4% among women of 15-19 and 20-24 years respectively as against 10.7% among all women in Ghana. In 2003, modern contraceptive use was 6.4% and 15.4% among married females of 15-19 and 20-24 years respectively compared to 20.7% among all women in the country. The implication is that low contraceptive use among adolescent and young women may foreclose education and employment opportunities to many of them as they expose themselves to risks of unplanned...