An evaluation of the current state of sexual and reproductive health and rights of women in Ghana

Abstract

Objective: To provide a current account of women’s sexual and reproductive health and rights (SRHR) in Ghana (West Africa), a priority area in achieving the World Health Organization’s Millennium Development Goals.

Method: The study was observational. Three-hundred ninety Ghanaian women attending cervical cancer screening were surveyed about their SRHR. The data were analyzed with chi-squared test (p ≤ 0.05, two-sided).

Results: 22.1% had a life-time history of non-consensual sexual experience and 55.4% a previous history of abortion, mostly using services of a registered clinic (68.5%). Experience of sexual violence increased life-time risk of abortion (p = 0.018). The overall use of contraceptives was high (>60%); however, condom use during sexual intercourse with a new partner was low (23%), even among the highly educated women (32.7%) and women who stated to have received information on the risks and benefits of condom use (26.0%). Although condom use among the highly educated women was low, it was still 2 times higher than among the lower educated women, 15.7% (p < 0.001). There was also less condom use among the women with multiple sexual partners compared to single-partnered women (p = 0.001).

Conclusion: More than a decade after the inception of the Millennium Development Goals, there is still work to be done in Ghana, especially on education and sexual violence.

• Abortion
• Africa
• contraceptive use
• Ghana
• observational study
• sexual and reproductive health and rights
• unwanted sexual experience
• WHO’s millennium development goals

Acknowledgements

The authors will like to thank SOS Children’s Villages and its staff in Ghana for helping administer the survey.

Declaration of interest

The authors report no declaration of interest.

Current knowledge on this subject

• Due to unmet need for contraceptives, 40% of pregnancies in Ghana are unwanted.

• Majority of the abortions performed in Ghana are unsafe, resulting in many deaths.

• Sexual coercion is a problem in Ghanaian communities.

What this study adds

• It revealed that education is paramount for the realization of the Millennium Development Goals (MDGs).

• The rate of unsafe sexual practice (lower condom use) and sexual coercion remain high.

• Sexual violence increased women’s life-time risk of having an abortion.

• In Ghana, a history of sexual violence may not influence a woman’s choice of whether or not to use contraceptives or barrier protection.

• Life-time history of contraceptive use in Ghana is high, but most stop using it along the way due to range of reasons.

• The majority of the abortions undergone by the women in the survey were rendered by registered clinics.