Deconstructing the Barriers to ASRH in Contemporary Ghana
Keywords:
Adolescent, Sexual Reproductive Health, Sexuality, Barriers, STIsAbstract
Adolescent Sexual Reproductive Health (ASRH) is crucial for the physical, emotional, and social well-being of adolescents. The paper aims to identify the barriers to ASRH in Ghana and suggest potential measures to address these challenges. The paper argues that socio-cultural and gender norms that stifle the rights and voices of adolescents, particularly adolescent girls regarding their sexuality, are a significant factor exacerbating other barriers to ASRH in Ghana. These norms perceive adolescents as inexperienced and lacking agency in their sexuality, consequently disregarding their voices. In addition to these norms, other barriers to ASRH in Ghana include inadequate ASRH education within and outside of schools, limited access to ASRH services and products, absence of adolescent-friendly sexual reproductive health services, and the high cost of sexual reproductive health services and contraceptives. These barriers put adolescents at a higher risk of contracting sexually transmitted infections (STIs) such as HIV/AIDS, as well as other problems like unwanted pregnancies and unsafe abortions in Ghana. To address these challenges, the paper suggests several potential measures such as increasing access to affordable SRH services and products, improving ASRH education within schools, creating adolescent-friendly sexual reproductive health services, and promoting gender equality by empowering adolescent girls.
References
Ahinkorah, B. O., Kang, M., Perry, L., & Brooks, F. (2023). Knowledge and awareness of policies and programmes to reduce adolescent pregnancy in Ghana: a qualitative study among key stakeholders. Reproductive Health, 20(1), 143.
Aliyu, T. K., & Aransiola, J. O. (2023). Factors associated with parent-adolescent communication on sexual and reproductive health issues in urban slums of Ibadan, southwest Nigeria. Community Health Equity Research & Policy, 44(1), 3-14.
Akwara, E., Pinchoff, J., Abularrage, T., White, C., & Ngo, T. D. (2023). The Urban Environment and Disparities in Sexual and Reproductive Health Outcomes in the Global South: a Scoping Review. Journal of Urban Health, 1-37.
Aninanya, G.A., Debpuur., C.Y., Awine, T., Williams J.E., Hodgson A, and Howard, N. (2015). “Effects of an adolescent-sexual and reproductive-health intervention on health-service: usage by young-people in Northern-Ghana: A community-randomized-trial”. PLoS ONE 10(4).
Awusabo Asare, K., Biddleman, A., Kumi-Kyeremeh, A., & Patterson, K. (2006). Adolescent sexual & reproductive health in Ghana. Results from 2004-National-Survey of adolescents. Occasional-Report No. 22 New York, Guttmacher-Institute.
Baku,E.A., Adanu, M.K. Richard& Adatara, P. (2017). Socio-cultural factors affecting parent-child communication on sexuality in Accra-Metropolis, Ghana. International Journal of Nursing & Midwifery 1, 2.
Bankole, A., Ahmed, F.H., Neema, S., Quedraogo, C., & Konyan, S. (2007). “Knowledge of correct-condom-use & consistency of use among adolescents in Sub-saharan Africa” African Journal of Reproductive-Health 11(3): 197-220.
Besoain-Saldaña, A., Bustamante-Bravo, J., Rebolledo Sanhueza, J., & Montt-Maray, E. (2023). Experiences, Barriers, and Facilitators to Sexual and Reproductive Health Care Access of People with Sensory Impairments: A Scoping Review. Sexuality and Disability, 41(2), 411-449.
Budu, E., Seidu, A. A., Armah-Ansah, E. K., Frimpong, J. B., Aboagye, R. G., Anin, S. K., ... & Ahinkorah, B. O. (2023). Prevalence and predictors of premarital sexual intercourse among young women in sub-Saharan Africa. Reproductive health, 20(1), 1-11.
Buitrago, D. C. C., & Pimentel, J. (2023). Barriers and facilitators influencing parent–adolescent communication on sexual and reproductive health in Indigenous communities in Latin American countries: protocol for a scoping review. BMJ open, 13(3), e066416.
Chandra-Mouli, V., McCarraher, D., Philips, S, J., Williamson, N. E., Hainsworth, G. (2014). Contraception for adolescents in LMIC-needs; barriers& access. Reproductive-Health 11(1)1-8.
Chilambe, K., Mulubwa, C., Zulu, J. M., & Chavula, M. P. (2023). Experiences of teachers and community-based health workers in addressing adolescents’ sexual reproductive health and rights problems in rural health systems: a case of the RISE project in Zambia. BMC Public Health, 23(1), 335.
Denno, D. M. & Andrea, J. H. (2015). Effective strategies to promote adolescent sexual & and reproductive health services & and to increase demand and community support. Journal of Adolescent-health 56(1) 22-41.
Envuladu, E. A., Massar, K., & de Wit, J. (2023). Healthcare workers’ delivery of adolescent responsive sexual and reproductive healthcare services: an assessment in Plateau state, Nigeria. BMC Women's Health, 23(1), 132.
Esantsi, S.F., Asare Quansah, JG. Kufour, E.O., Tapsoba, P., & Birungi, H. (2015). Understanding reproductive-health needs of adolescents in selected slums in Ghana: a public-health assessment. National Population-Council.
Garbarino, J., (1985). Adolescent-development-An ecological-perspective. Columbus: OH, Charles E. Merrill.
Ghana AIDS Commission. (2014). Country AIDS-Response Progress-Report. Accra. GAC.
Ghana National-Population-Council (2001). Ghana adolescent-reproductive-health policy. GNPC.
Ghana Statistical-Service (GSS) (2009). Macro 1. Ghana-demographic& health-survey. Accra. GSS & ICF-Macro Survey.
Giri, S. (2022). Awareness of Uterine Prolapse among Women in Birendranagar’s Reproductive Age Group, Surkhet, Nepal. Inverge Journal of Social Sciences, 1(2), 49-69.
GSS (2014). Ghana-demographic & health-survey. Accra. GSS & ICF-Macro-Survey. GSS & ICF-Macro Survey.
Guiella, G., & Woog, V. (2006). Sante sexuelle et reproductive-des-adolescents au Burkina-Fasso: Resultats d’une enquete nationale en 2004. Occasional-Report No. 21 New York, Guttmacher-Institute.
Guttmacher-Institute (2013). Abortion in Ghana. Guttmacher-Institute.
Hirose, N., Sanmei, C., Okamoto, M., Madeni, F. E., Madeni, N., Teshima, A., & Shimpuku, Y. (2023). Associated factors for multidimensional attitudes and behaviors of reproductive health toward pregnancy among early and late adolescents in Tanzania: a cross-sectional study. Reproductive Health, 20(1), 44.
Ibitoye, M., Sommer, M., Davidson, L. L., & Sandfort, T. G. (2023). Exploring the effect of early menarche on sexual violence among adolescent girls and young women in southeastern Ghana: a longitudinal mediation analysis. Sexual and reproductive health matters, 31(1), 2244271.
Jarvis, K., Richter, S., Adjorlolo, S., Swab, M., Tenkorang, E., Mao, Y., ... & Petrucka, P. (2023). Interventions impacting the accessibility of sexual reproductive health services for head porters in sub-Saharan Africa-A scoping review protocol. Plos one, 18(8), e0289564.
Kamangu, A. A., John, M. R., & Nyakoki, S. J. (2017). Barriers to parent-child communication on sexual and reproductive health issues in East Africa: A review of qualitative research in four countries. Journal of African Studies and Development, 9(4), 45-50.
Khalid, B., Zia urRehman, M., & Asghar, R. J. (2016). How to Augment Task and Contextual Performance through Employee Engagement. IBT Journal of Business Studies (JBS), 2(2).
Kirby, D. B., Laris, B. A. & Rolleri, L. (2007). Sex & HIV/AIDS education-program: Their impacts on sexual behaviors of young people throughout the World. Journal of Adolescent-Health 40(3):206-217.
Kyiilleh, J.M., Taboong, P.T. & Konlaan, B. (2018). Adolescents reproductive-health-knowledge-choices and factors affecting reproductive health-choices: a qualitative study in the West Gonja District in Northern region, Ghana. BMC Int. Health& Human-Rights.18 (1)6.
Lau, P. L., Nandy, M., & Chakraborty, S. (2023, January). Accelerating UN sustainable development goals with ai-driven technologies: A systematic literature review of women’s healthcare. Healthcare, 11, 3. MDPI.
Mohammed, S. (2023). Analysis of national and subnational prevalence of adolescent pregnancy and changes in the associated sexual behaviours and sociodemographic determinants across three decades in Ghana, 1988–2019. BMJ open, 13(3), e068117.
Morris, J. L., & Rushwan, H. (2015). Adolescent sexual and reproductive health: The global challenges. International Journal of Gynecology & Obstetrics, 131, S40-S42.
Munthari, A., Zulu, E.M. & Madise, N. (2006). Adolescent sexual& reproductive-health in Malawi-Results from 2004-National-Survey of Adolescents. Occasional-Report No. 24. New-York, Guttmacher-Institute.
Mushtaque, T., Tunio, M. N., ur Rehman, Z., & Asif, M. (2021). INFLUENCE OF ADMINISTRATIVE EXPERTISE OF HUMAN RESOURCE PRACTITIONERS ON THE JOB PERFORMANCE: MEDIATING ROLE OF ACHIEVEMENT MOTIVATION. International Journal of Management (IJM), 12(4).
National Research-Council& Institute of Medicine (2005). “Growing-up global: the transition to adulthood in developing countries”. (Ed) Lloyd, C.B. Washington DC: NRCIM-Academic Press.
Peck, K. E., Bassani, D., Camara, S. M., Domingues, M. R., Sentell, T., Velez, M. P., & Pirkle, C. M. (2023). Adolescent childbirth and mobility disability among women ages 15–49: an analysis of population health surveys from 14 low-income and middle-income countries. BMJ open, 13(7), e072535.
Qi, W., Li, H., Lian, Q., Zuo, X., Yu, C., Lou, C., & Tu, X. (2023). Knowledge level and access barriers related to sexual and reproductive health information among youth with disabilities in China: a cross-sectional study. Reproductive Health, 20(1), 1-11.
Rice, M. (2000). Adolescent sexual & reproductive health. Reproductive-Biomedicine Web paper, 3, 78-86.
Sadeghi, M., Jamshidimanesh, M., & Alimoradi, Z. (2023). Predictors of sexual and reproductive health self-care based on demographic factors in adolescent girls. International Journal of Adolescent Medicine and Health, (0).
Sawadogo, P. M., Sia, D., Onadja, Y., Beogo, I., Sangli, G., Sawadogo, N., ... & Tchouaket Nguemeleu, E. (2023). Barriers and facilitators of access to sexual and reproductive health services among migrant, internally displaced, asylum seeking and refugee women: A scoping review. Plos one, 18(9), e0291486.
Shariati, M., Babazadeh, R., Mousavi, S. A., & Najmabadi, K. M. (2014). Iranian adolescent girls’ barriers in accessing sexual and reproductive health information and services: a qualitative study. Journal of Family Planning and Reproductive Health Care, 40(4), 270-275.
Sidamo, N. B., Kerbo, A. A., Gidebo, K. D., & Wado, Y. D. (2023). Socio-Ecological Analysis of Barriers to Access and Utilization of Adolescent Sexual and Reproductive Health Services in Sub-Saharan Africa: A Qualitative Systematic Review. Open Access Journal of Contraception, 103-118.
Sidze-Estelle M., Larsoux, S., Speizer, I.S., Faye, C. M., Mutua, M. M. & Badji, F. (2014). Young women’s access to and use of contraceptives: the role of providers-restrictions in Urban-Senegal. Int. Perfect Sex-Reproductive Health, 40 (4), 176-183.
SIECUS (2010). A portrait of sexuality-education & abstinence-only until marriage-program in US-Overview of fiscal-year 2010 edition. www.siecus.org (Accessed on 08 Sep. 2023).
Singh, N. S., DeJong, J., Popple, K., Undie, C. C., El Masri, R., Bakesiima, R., ... & Blanchet, K. (2023). Adolescent wellbeing in humanitarian and fragile settings: moving beyond rhetoric. BMJ, 380.
Svanemyr, J., A. Amin, O.J., Robles & Greene, M.E (2015). “Creating an enabling-environment for adolescent-sexual& reproductive health: a framework& promising approaches”. Journal of Adolescent-Health, 56(7-14).
Thatte, N., Bingenheimer, J.B., Ndiaye, K. & Rimal, R.N. (2016). Unpacking barriers to reproductive-health-services in Ghana: HIV-STIs-testing, abortion& contraception. African Journal of Reproductive Health, 20(2)53-61.
Thakuri, K. S. (2022). Awareness about Patient Rights Available to Patients Entrant in Nepalgunj Medical College of Nepalgunj, Banke. Inverge Journal of Social Sciences, 1(2), 36-48.
UNAIDS (2010). Report on the global AIDS epidemic. Geneva, UNAIDS.
UNAIDS (2008). AIDS epidemic update. Geneva, UNAIDS.
UNFPA (2018). Adolescents & youth-demographics: A brief overview. http://www.unfpa.org/resources/adolescent-and-youthdemograpphics-abrief-overview. (Accessed on 07 Sep. 2023).
Van Belle, S., Abejirinde, I. O., Sennyonjo, A., Srinivas, P. N., Hebbar, P., & Marchal, B. (2023). How to develop a realist programme theory using Margaret Archer’s structure–agency–culture framework: The case of adolescent accountability for sexual and reproductive health in urban resource-constrained settings. Evaluation, 29(3), 259-275.
WHO (2001). The second decade is improving adolescent health& and development. Geneva. WHO.
WHO/UNESCO (2000). Adolescent sexual & reproductive-health: addressing the gender-perspective. Technical Advisory-Program, Occasional-Paper Series. No. 2. Geneva, WHO.
WHO (2000). Young people’s health: A challenge for society report. Group on young people and health for all by year 2000. Technical-report series. No. 731. Geneva, WHO.
WHO (2003). Guidelines on research on reproductive health involving adolescents. Geneva, WHO.
World Bank Group (2018). The challenge of reducing poverty. World Bank. http://www.worldbank.org/poverty/reduction.html. (Accessed on 06 Sep. 2023).
Zegeye, B., Idriss-Wheeler, D., Oladimeji, O., & Yaya, S. (2023). Exploring health insurance and knowledge of the ovulatory cycle: evidence from Demographic and Health Surveys of 29 countries in Sub-Saharan Africa. Reproductive Health, 20(1), 129.
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