A Qualitative Exploration of Factors Explaining Non-Uptake of Hormonal Contraceptives Among Adolescent Girls in Rural Ghana: The Adolescent Girls’ Perspective

Abstract

Background

Adolescent pregnancy remains a public health concern globally. The use of hormonal contraceptive methods are proven ways of preventing pregnancies and in turn unsafe abortions. However, research shows that use of hormonal contraceptive methods is rather low among African adolescent girls, of which Ghana is no exception.

Objective

This manuscript uses the socio-ecological model to guide our understanding of the factors associated with non-use of hormonal contraceptives among adolescent girls in Ghana.

Methods

An explorative study was done using qualitative data collection methods. Two focus group discussions and sixteen in-depth interviews were conducted among adolescent girls aged 15–19 years (N = 38) in the Kintampo area of Ghana to determine factors affecting uptake of hormonal contraceptives.

Results

Adolescents showed a lack of in-depth knowledge related to the different hormonal contraceptive types. Negative attitudes towards adolescent hormonal contraceptive use, fear of real and perceived side effects of hormonal contraceptives, lack of self-efficacy to use contraceptives, fear of disclosure of use and fear of societal stigma related to sexual intercourse and its related issues among adolescents may explain why adolescent girls in this context do not use hormonal contraceptive methods.

Conclusion

To promote hormonal contraceptives among adolescent girls, a combination of multifaceted social-psychological, personal and community level interventions are needed.

Keywords:

• hormonal contraceptives
• adolescents
• Ghana
• behavioral determinants
• pregnancy prevention
• qualitative research

Data Sharing Statement

Data supporting the results reported in this manuscript is available upon request. Interested persons may contact the corresponding author.

Ethics Approval and Informed Consent

Ethical approvals were obtained from the Kintampo Health Research Centre Institutional Ethics Review Committee (FWA number 00011103) and the Ethical Review Committee, Psychology and Neuroscience at Maastricht University (Reference number ECP_04_09_2012_S23). Also, permission was sought from the management of the youth facilities and schools where participants were recruited. We explained to the prospective study participants during recruitment that data collection would be anonymous and that participation was voluntary. We also explained that participants had the right to decline participation or withdraw their consent at any stage of the study, or decline to answer any question they did not feel comfortable about and that one was free to stop the interview without having to offer any explanation. Finally, the prospective participants were assured of strict confidentiality regarding information collected; that only aggregated data will be made available as part of scientific and public dissemination. Written informed consent was obtained from the [individual(s) and/or minor(s)’ legal guardian/next of kin] for the publication of aggregated study results and any potentially identifiable images or data included in this article.

Acknowledgment

Our deep appreciation goes to all the adolescents who consented to participate in our study. We also thank teachers and school heads who gave us permission to their school and access to the adolescent girls. We thank the managers of the adolescent health centers where we worked. We are grateful to the management of Kintampo Health Research Centre and Maastricht University for their support for this work. We are extremely grateful to Ms. Awurabena Quayeba Dadzie for her immense support with data collection.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

All authors declare no conflict of interests, be it financial or otherwise in this work.