FEMALE ADOLESCENT SEXUALITY, CONTRACEPTIVE USE AND REPRODUCTIVE HEALTH IN THE CENTRAL REGION OF GHANA: A CASE STUDY OF CAPE COAST AND MANKRONG

ABSTRACT The study on Adolescent Sexuality, Contraceptive Use and Reproductive Health was undertaken as part of the ongoing effort at understanding some o f the problems that confront adolescents in Ghana, With a general objective o f examining the magnitude of reproductive health-related problems pertaining to adolescent sexuality and contraceptive use, the study used a sample of 1,828 female adolescents aged 12-24 years (1,503 from Cape Coast and 325 from Mankrong) in the Central Region of Ghana as a case study. This was with the primary purpose of comparing the situation in an urban vis-a-vis a rural area. The two study areas are far apart: Cape Coast at the coast while Mankrong is located in the interior o f the Central Region. It uses simple techniques including cross-tabulations as well as multiple regression analysis to examine quantitative and qualitative data collected from structured questionnaire and focus group discussions held separately among male and female adolescents and adults in Cape Coast and Mankrong. Among other things, the study found that the proportion o f adolescents ever having sex increased with higher age of the adolescent with higher proportion having sex in Mankrong compared to Cape Coast. The mean age at first sex was, however, almost the same at 16.9 years in Cape Coast and 17 years in Mankrong. Mean age at first sex also increased with higher age of adolescents, implying plausibly of a declining age at first sex at the two study areas. Furthermore, there were suggestions to indicate that females become sexually active earlier than their male counterparts on account of the fact that at first sex most females were much younger than their male partners at the time. However, it was deduced that due to the fact that first sex usually may occur with persons who may be sexually moreexperienced and older, it may not always be easy to determine whether or not it is the female who enters into sex earlier if one depended on responses exclusively from the male or female. Generally, the adolescents did not approve o f pre-marital sex but gave the indication of the possibility to indulge in it for financial reasons. What people approve of may thus, be different from what they may practise depending on the issues at stake. Peer pressure and lack of knowledge were the main reasons that provided grounds for a large proportion of the adolescents entering into sex for the first time. Again, although most of the adolescents did not approve o f abortion, the report on abortion among them showed a possibility of an underestimation, suggesting a situation of a much higher abortion rate among the sexually active adolescents than was reported. Abortion rates were found to be higher in Cape Coast relative to Mankrong. Also important was the finding that adolescents who used contraception at first sex had a higher age at pregnancy. Similarly, adolescents who practised contraception had a relatively lower number o f children ever bom in contrast with those who did not practise contraception at first sex. There was also a lower number of children ever bom with higher education of the woman. Results from the multiple regression analysis confirmed most o f the observations made in the cross-tabulations. These included a declining age at first sex at 100 per cent level of confidence. Besides, financial considerations were found to contribute more to the reduction of an adolescent’s age at first sexual activity.