A Qualitative Study on Youth and Healthcare Provider Perspectives on Youth Access to Sexual and Reproductive Health Services in Northern Ghana: Implications for a Peer-Led Intervention.
Outcomes: Sexual and Reproductive Health
View SourceKey Social Norms Take-aways Social and gender norms substantially shape young people’s access to sexual and reproductive health services in northern Ghana. Expectations of abstinence before marriage, religious discouragement, and stigma linking contraceptive use with promiscuity create fear of judgment and discourage care-seeking. Young women face particularly strong social consequences because of gendered expectations surrounding sexuality and reproductive decision-making. However, growing acceptance of delayed childbearing, particularly among more educated community members, suggests that norms are shifting. The authors emphasize that improving services alone is insufficient; interventions should also reduce stigma, address gender and power dynamics, and support reproductive autonomy.
Objectives This formative study explored the sexual and reproductive health needs, preferences, and expectations of adolescents and young adults in northern Ghana to inform the co-design of a peer-led counseling program.
Methods Researchers conducted semi-structured interviews with 27 young people aged 15–24 and 22 healthcare providers. Thematic analysis combined inductive theme development with mapping to the Capability-Opportunity-Motivation-Behavior framework. Social norms were explored qualitatively through community stigma and moral expectations, religious and cultural norms, parental judgment, peer and partner influence, gender norms, and perceived social acceptance of contraception.
Results Youth faced misinformation, logistical and privacy barriers, and stigma around service use. Community norms often framed adolescent contraception as immoral or indicative of premarital sex. Parents and elders were frequently perceived as judgmental, while peers and partners could either support or discourage contraception. Participants also described increasing acceptance of delaying pregnancy, especially among more educated groups. Although youth expressed strong motivation to protect their education and reproductive autonomy, stigma, misinformation, privacy concerns, and fear of side effects constrained service use.
Conclusions Youth service use is shaped by interacting informational, social, and structural barriers rather than lack of motivation. Peer-led counseling may address misinformation and interpersonal barriers, but sustained improvements also require youth-friendly care, better accessibility and confidentiality, community stigma reduction, and efforts to address inequitable gender norms.
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