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Determinants of contraceptive use among sexually active unmarried adolescent girls and young women aged 15–24 years in Ghana: a nationally representative cross-sectional study
  1. Felix Boakye Oppong1,
  2. Divine Darlington Logo2,
  3. Senyo Yao Agbedra3,
  4. Anthony Agyapong Adomah1,
  5. Seidu Amenyaglo4,
  6. Kingsley Arhin-Wiredu3,
  7. Samuel Afari-Asiedu5,
  8. Kenneth Ayuurebobi Ae-Ngibise5
  1. 1 Global Statistical Institute, Techiman, Ghana
  2. 2 Research and Development Division, Ghana Health Service, Accra, Ghana
  3. 3 Sunyani Municipal Health Directorate, Ghana Health Service, Sunyani, Ghana
  4. 4 Department of Global and International Health, School of Public Health, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
  5. 5 Kintampo Health Research Centre, Kintampo, Ghana
  1. Correspondence to Felix Boakye Oppong; atomistic4u{at}


Objective There is a decline in contraceptive use among sexually active unmarried young women in Ghana. This study assessed the prevalence of contraceptive knowledge and use, and the determinant of contraceptive use among sexually active unmarried young women in Ghana.

Design This was a nationally representative cross-sectional survey, using data from the 2017 Ghana Maternal Health Survey. Weighted logistic regression was used to assess the association between background and obstetric characteristics of young women and contraceptive use.

Setting Ghana.

Participants A total of 809 sexually active unmarried adolescent girls (15–19 years) and young women (20–24 years).

Primary and secondary outcome measures Knowledge and use of both modern and traditional contraceptive methods.

Results Knowledge of at least one modern and traditional contractive method was 99.8% and 95.0%, respectively. The prevalence of contraceptive use was 43%—with 34% modern and 9% traditional methods. From the unadjusted analyses, age (p=0.002), past pregnancy (p<0.001), abortion in the past 5 years (p=0.007) and history of childbirth (p=0.025) were independently associated with contraceptive use, whereas education (p=0.072), place of residence (p=0.702), household wealth (p=0.836) and age at first sex (p=0.924) were not independently associated with contraceptive use. In the adjusted analysis, contraceptive use was significantly higher among respondents with secondary education compared with those with primary education (OR 2.43, 95% CI 1.31 to 4.49, p=0.017), and was higher among respondents with a history of pregnancy (OR 2.13, 95% CI 1.48 to 3.06, p<0.001).

Conclusion There is a significant gap between knowledge and use of contraceptives among the study population. While intensifying knowledge of adolescents and young women on contraceptives, adolescent-friendly corners should be established at vantage points to increase utilisation and to prevent societal stigma on young women who access contraceptives services.

  • reproductive medicine
  • sexual medicine
  • preventive medicine

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  • Contributors FBO, DDL and KAA-N conceived the idea and conceptualised the study. FBO conducted the data analysis and wrote the first draft. KA-W, AAA and SA contributed significantly to the statistical analyses. SA-A and SYA provided critical contributions to the discussion of the findings of the study. All authors contributed to the study design and review of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Ethics approval This study is based on publicly available DHS data. FBO was granted access to the data by the Demographic and Health Surveys (DHS) Programme, Rockville, Maryland, USA.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available. This study is a secondary data analysis of the 2017 Ghana Maternal Health Survey. The data set is not publicly available but can be requested from the DHS programme on reasonable request.