Sex negotiation skills of in-school, young adolescent girls in Effiduasi, Sekyere-East District, Ashanti Region, Ghana

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November, 2015
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Adolescents who have gone through comprehensive sex education which includes sex refusal and negotiation skills are not likely to experience a pregnancy compared with those who are educated on abstinence only. It is important for adolescents who are not ready for sex to practise refusal skills and well-practised skills can be used automatically, without requiring a lot of thinking. The skills help adolescents to personalize sexual issues, which result in significant delays in the onset and the practice of safe sexual intercourse. The issues of adolescent sexual activity and reproduction are increasing in Africa. In Ghana, adolescent sexuality is of concern because some sections of the adult population do not endorse contraceptive use among sexually active adolescents. The Sekyere-East District in the Ashanti Region, has been recording increasing numbers of teenage pregnancies. By the year 2012, Effiduase sub-district recorded the highest teenage pregnancy of 31.9%, Nyanfa and Asokore sub-districts also recorded 9.7% and 8.9% respectively. This study sought to find out from in-school young adolescent girls, aged 10-14 years in Effiduasi, in the Sekyere East District, what sex negotiation skills they practise as well as the factors that influence their sexual choices. The study employed a descriptive cross-sectional design. Self-administered questionnaire was developed and used for respondents. Four hundred and fifty (450) study participants were selected by Probability Proportional to Size (PPS) from all the basic schools in Effiduasi. In this study, the worrisome figures that highlighted the importance of sex knowledge are that the mean age at which respondents first had sex was 11.77 years. Sex knowledge is the availability of a knowledge transfer mechanism from a passive to an active form that allows girls to personalize sexual issues and develop specific sex negotiation skills. Except in the case of rape, it can be deduced from the responses in this study that unwanted sex and reproduction as teenagers are largely attributable to the feelings and opinions that they hold about sex. The study also observed that self-esteem is an important reason and a key determinant for sex negotiation and sex refusal which delay first sexual intercourse and thus postpones pregnancy until the right time. Although, the mean age of having sex was 11.77 years, most of which cases was defilement, the study indicates self-esteem as one of the determinants for a strong level of sex refusal and sex negotiation skills among the participants. It is recommended that sex education begin very early in a girl‘s life, starting from the home where parents and guardians develop firstly, a loving atmosphere and secondly, honest and clear communication with their daughters about sex and sex negotiation skills. Effective policies on sex education and sex negotiation skills specifically tailored for young adolescents are either not available or hard to find. Such policies should be in place for educational institutions, non-governmental and religious organisations to implement in their various jurisdictions. The phrase ‘catch them young‘ is very relevant in the case of young adolescents.
A thesis submitted to the Department of Population, Family and Reproductive Health, School of Public Health, College of Health Sciences in partial fulfilment of the requirements for the Degree of Master of Public Health (MPH) in Population, Family and Reproductive Health,