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|Title: ||Contraceptive and abortion practices of young Ghanaian women aged 15–24: evidence from a nationally representative survey|
|Authors: ||Keogh, Sarah C.|
Castillo, Philicia W.
Li, Naomi W.
Polis, Chelsea B.
|Issue Date: ||Jul-2021|
|Publisher: ||Reproductive Health|
|Citation: ||Reproductive Health, 18(1)|
|Abstract: ||Young Ghanaian women experience high rates of unmet need for contraception and unintended
pregnancy, and face unique barriers to accessing sexual and reproductive health services. This study provides a comprehensive
national analysis of young women’s contraceptive and abortion practices and needs.
Methods: In 2018, we conducted a nationally representative survey of women aged 15–49, including 1039 women
aged 15–24. We used descriptive statistics, multivariable logistic and multinomial regression to compare young versus
older (25–49 year-old) women’s preferred contraceptive attributes, reasons for discontinuing contraception, quality of
counseling, use of Primolut N-tablet, method choice correlates, and friends’ and partners’ influence. We also examined
youth’s self-reported abortion incidence, abortion methods, post-abortion care, and barriers to safe abortion.
Results: Among Ghanaian 15–24 year-olds who had ever had sex, one-third (32%) were using contraception.
Compared to older women, they had higher desires to avoid pregnancy, lower ever use of contraception, more
intermittent sexual activity, and were more likely to report pregnancies as unintended and to have recently ended
a pregnancy. Young contraceptors most commonly used condoms (22%), injectables (21%), withdrawal (20%) or
implants (20%); and were more likely than older women to use condoms, withdrawal, emergency contraception, and
N-tablet. They valued methods for effectiveness (70%), no risk of harming health (31%) nor future fertility (26%), ease
of use (20%), and no effect on menstruation (19%). Infrequent sex accounted for over half of youth contraceptive discontinuation.
Relative to older women, young women’s social networks were more influential on contraceptive use.
The annual self-reported abortion rate among young women was 30 per thousand. Over half of young women used
abortion methods obtained from non-formal providers. Among the third of young women who experienced abortion
complications, 40% did not access treatment.
Conclusions: Young people’s intermittent sexual activity, desire for methods that do not harm their health, access
barriers and provider bias, likely contribute to their greater use of coital-dependent methods. Providers should be
equipped to provide confidential, non-discriminatory counseling addressing concerns about infertility, side effects
and alternative methods. Use of social networks can be leveraged to educate around issues like safe abortion and
correct use of N-table|
|Description: ||This article is published by Reprod Health and is also available at https://doi.org/10.1186/s12978-021-01189-6|
|Appears in Collections:||College of Health Sciences|
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