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Reproductive Health
July 2021

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

Sarah Keogh
Easmon Otupiri,Kwame Nkrumah University of Science and Technology
Philicia Castillo,Guttmacher Institute
Naomi Li,Guttmacher Institute
Joana Apenkwa,Kwame Nkrumah University Of Science and Technology
Chelsea Polis,Guttmacher Institute
The time is now. Will you stand up for reproductive health and rights?
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First published online: July 18, 2021 DOI: https://doi.org/https://doi.org/10.1186/s12978-021-01189-6

Background

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-tablet.

Full article available at Reproductive Health
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Research Article

Use of Fertility Awareness-Based Methods for Pregnancy Prevention Among Ghanaian Women: A Nationally Representative Cross-Sectional Survey

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Hormonal contraceptive use in Ghana: the role of method attributes and side effects in method choice and continuation

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Prevalence and Correlates of Perceived Infertility in Ghana

Studies in Family Planning

Topic

Global

  • Abortion
  • Contraception
  • Pregnancy
  • Teens

Geography

  • Global
  • Africa: Ghana

Tags

birth control, adolescents
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