1.1 Introduction
Contraception refers to the deliberate use of methods, devices, medicines, or practices to prevent pregnancy and, in some cases, protect against sexually transmitted infections (STIs) (World Health Organization [WHO], 2023). Contraceptive methods include modern methods such as condoms, oral contraceptive pills, injectables, implants, intrauterine devices (IUDs), and emergency contraceptives, as well as traditional methods such as withdrawal and periodic abstinence. The use of contraception is recognized globally as an essential component of reproductive health because it enables individuals to make informed decisions regarding childbearing, family planning, and sexual health (UNFPA, 2023). Adolescence is a critical stage of human development characterized by significant physical, psychological, emotional, and social changes. During this period, young people begin to explore relationships and develop attitudes and behaviors related to sexuality and reproductive health.
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the aim and objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Contraceptive use has become an important aspect of reproductive health across the world because it contributes significantly to the prevention of unintended pregnancies, reduction of maternal and infant mortality, and promotion of healthy family planning practices. According to the World Health Organization (WHO, 2023), contraception refers to the use of methods, medicines, devices, or practices that are intended to prevent pregnancy. The availability and utilization of contraceptives have been recognized as essential strategies for improving reproductive health outcomes, particularly among adolescents and young adults who are often exposed to various sexual and reproductive health risks.
Globally, adolescent reproductive health continues to attract considerable attention due to the increasing incidence of teenage pregnancies and sexually transmitted infections among young people. According to the United Nations Population Fund (UNFPA, 2023), adolescents constitute a substantial proportion of the world's population, and many of them face challenges related to reproductive health decision-making. Despite widespread awareness campaigns and educational programs, many adolescents continue to engage in unprotected sexual activities, resulting in unintended pregnancies and associated social and health consequences.
Darroch et al. (2016) reported that millions of adolescents worldwide have unmet needs for contraceptive services due to barriers such as inadequate information, limited access to healthcare facilities, social stigma, and cultural restrictions. The authors further stated that addressing these barriers is essential for improving adolescent reproductive health and promoting informed sexual health choices. According to the World Health Organization (WHO), the inability of adolescents to access and utilize contraceptive services effectively contributes significantly to reproductive health challenges in many countries (World Health Organization, 2023).
In developing countries, the issue of contraceptive use among adolescents is particularly important because of the high prevalence of teenage pregnancies and the limited availability of youth-friendly reproductive health services. According to the United Nations Children's Fund (UNICEF), adolescent girls in developing nations are more likely to experience early pregnancies, which often lead to educational disruption, economic hardship, and adverse health outcomes. The organization stated that effective contraceptive utilization among adolescents remains one of the most reliable approaches for reducing these challenges and improving the well-being of young people (United Nations Children's Fund, 2023).
In sub-Saharan Africa, adolescent contraceptive use remains relatively low despite growing awareness of reproductive health issues. According to the World Bank (2023), many countries within the region continue to experience high rates of adolescent fertility due to social, cultural, economic, and institutional factors that influence contraceptive behavior. Chandra-Mouli et al. (2014) reported that barriers such as misconceptions about contraceptives, fear of side effects, religious beliefs, lack of parental support, and limited access to reproductive health services often discourage adolescents from using contraceptives. The authors asserted that improving access to accurate reproductive health information and adolescent-friendly services is necessary for increasing contraceptive uptake among young people.
Ghana has made significant efforts toward improving reproductive health through various national policies, programs, and interventions. According to the Ghana Health Service (2022), family planning and reproductive health education have been incorporated into national health initiatives to increase awareness and accessibility of contraceptive methods. These initiatives are intended to reduce teenage pregnancies, improve maternal health outcomes, and promote responsible sexual behavior among adolescents. Despite these efforts, adolescent reproductive health challenges remain prevalent in many parts of the country.
Boamah et al. (2014) reported that although many Ghanaian adolescents possess knowledge about contraceptive methods, utilization rates remain lower than expected. The authors stated that knowledge alone does not necessarily translate into contraceptive use because adolescents are influenced by multiple factors, including personal beliefs, social expectations, and environmental conditions. According to the Ghana Statistical Service (2022), teenage pregnancy remains a significant concern in several regions of Ghana, indicating the need for a better understanding of the factors that influence contraceptive behavior among adolescents.
Apanga and Adam (2015) reported that contraceptive use among adolescents in Ghana is influenced by factors such as educational level, religious affiliation, cultural norms, peer influence, accessibility of contraceptive services, and concerns about confidentiality. The authors affirmed that adolescents often face challenges when seeking reproductive health services because they fear negative reactions from parents, teachers, healthcare providers, and members of their communities. Half Assini Senior High School is one of the educational institutions that serve adolescents from diverse social, cultural, and economic backgrounds within the Jomoro Municipality of the Western Region of Ghana. Students in the school are exposed to various influences that may shape their attitudes and behaviors regarding contraceptive use.
This study is set against the backdrop of increasing concerns about adolescent reproductive health, the persistence of teenage pregnancies and sexually transmitted infections among young people, and the need to know the factors that influence contraceptive use among students of Half Assini Senior High School in order to promote informed reproductive health decisions and improve adolescent well-being.
1.3 Statement of Problems
Investigation revealed that contraceptive use among adolescents and young people remains a significant public health concern, particularly in developing countries where rates of unintended pregnancies, unsafe abortions, and sexually transmitted infections continue to pose serious challenges. Adolescents in senior high schools are often at a stage of rapid physical, emotional, and social development, making them vulnerable to engaging in sexual activities that may expose them to reproductive health risks. Although various contraceptive methods are available and information on reproductive health is increasingly disseminated through schools, health facilities, media platforms, and community programs, the utilization of these methods among students remains inconsistent (World Health Organization [WHO], 2023).
In Ghana, adolescent reproductive health continues to attract attention due to concerns about teenage pregnancy and its associated consequences. Teenage pregnancy is linked to school dropout, reduced educational attainment, economic hardship, and adverse health outcomes for both mothers and their children. While efforts have been made by government agencies, non-governmental organizations, and health professionals to promote contraceptive awareness and accessibility, many adolescents still do not use contraceptives effectively or consistently (Ghana Health Service, 2022).
Furthermore, some adolescents who possess adequate knowledge about contraceptives may still avoid using them due to fear of being judged by family members, teachers, healthcare providers, or members of their communities. Others may face challenges related to availability, affordability, confidentiality, or concerns about possible side effects. These barriers may discourage students from seeking contraceptive services even when they recognize the need for protection against unintended pregnancy and sexually transmitted infections (United Nations Population Fund [UNFPA], 2023). It is against this backdrop that this study seeks to investigate the determinants of contraceptive use among students of Half Assini Senior High School.
1.4 Aim and Objectives of Study
The aim of this study is to investigate the determinants of contraceptive use among students of Half Assini Senior High School. In achieving this aim, the following specific objectives were laid out as follows:
- To determine the level of knowledge of students regarding contraceptive methods.
- To examine students' attitudes toward contraceptive use.
- To assess the influence of socio-cultural factors on contraceptive utilization among students.
- To determine the accessibility of contraceptive services among students.
- To identify the barriers affecting contraceptive use among students.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level of knowledge of students regarding contraceptive methods?
- What are the attitudes of students toward contraceptive use?
- How do socio-cultural factors influence contraceptive utilization among students?
- How accessible are contraceptive services to students?
- What barriers affect contraceptive use among students?
1.6 Research Hypotheses
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between students' knowledge of contraceptive methods and contraceptive use among students of Half Assini Senior High School.
- H1: There is a significant relationship between students' knowledge of contraceptive methods and contraceptive use among students of Half Assini Senior High School.
Hypothesis Two
- H0: There is no significant relationship between students' attitudes toward contraceptives and contraceptive use among students of Half Assini Senior High School.
- H1: There is a significant relationship between students' attitudes toward contraceptives and contraceptive use among students of Half Assini Senior High School.
Hypothesis Three
- H0: Socio-cultural factors have no significant influence on contraceptive use among students of Half Assini Senior High School.
- H1: Socio-cultural factors have a significant influence on contraceptive use among students of Half Assini Senior High School.
Hypothesis Four
- H0: Accessibility to contraceptive services has no significant influence on contraceptive use among students of Half Assini Senior High School.
- H1: Accessibility to contraceptive services has a significant influence on contraceptive use among students of Half Assini Senior High School.
Hypothesis Five
- H0: Barriers to contraceptive use have no significant effect on contraceptive utilization among students of Half Assini Senior High School.
- H1: Barriers to contraceptive use have a significant effect on contraceptive utilization among students of Half Assini Senior High School.
1.7 Significance of Study
It is believed that at the completion of the study, the findings will provide factual information on factors influencing contraceptive use among students of Half Assini Senior High School. Also, the research will contribute to existing literature on adolescent reproductive health and contraceptive utilization.
Furthermore, the outcome of this study will provide evidence for reproductive health planning and intervention programs. It will also support the development of effective contraceptive education initiatives in schools.
Lastly, the result obtained from this study will serve as a basis for future academic research on adolescent reproductive health.
1.8 Scope and Limitations of the Study
The scope of this research is focused on the determinants of contraceptive use among students. The respondents are limited to students of Half Assini Senior High School in Ghana. The study does not include students from other schools or adolescents outside the school environment.
In terms of geographical scope, the research is conducted within Half Assini Senior High School. However, supporting literature may be drawn from studies conducted in similar educational and institutional settings within the study area.
1.9 Definition of Terms
Contraception:
Contraception refers to the deliberate use of methods, devices, medicines, or practices to prevent pregnancy and, in some cases, reduce the risk of sexually transmitted infections (WHO, 2023).
Contraceptive Use:
Contraceptive use refers to the utilization of any approved contraceptive method by an individual to prevent unintended pregnancy during sexual activity (UNFPA, 2023).
Determinants:
Determinants are factors or conditions that influence an individual's behavior, decision, or outcome regarding a particular issue (Creswell & Creswell, 2018).
Students:
Students refer to individuals enrolled in an educational institution for the purpose of acquiring knowledge, skills, and academic qualifications.
Adolescents:
Adolescents are individuals between the ages of 10 and 19 years who experience physical, emotional, psychological, and social development during the transition from childhood to adulthood (WHO, 2023).
Knowledge of Contraceptives:
Knowledge of contraceptives refers to the level of awareness and understanding students possess regarding contraceptive methods, benefits, risks, and availability.
Attitude:
Attitude refers to an individual's feelings, perceptions, beliefs, and disposition toward a particular subject, which may influence behavior and decision-making (Ajzen, 2020).
Socio-cultural Factors:
Socio-cultural factors refer to social norms, cultural beliefs, religious values, traditions, and community expectations that influence individual behavior and choices.
Accessibility:
Accessibility refers to the ease with which students are able to obtain contraceptive information, counseling, and services when needed.
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