Though contraceptive knowledge has become widespread among Female Adolescents in Ghana, its use has persistently remained low for which the Central Region is no exception. Several studies have shown no evidence of empirical study conducted on Adolescents knowledge, Access and Usage of contraceptives among female adolescents in the Cape Coast Metropolis. To fill this literature gap, this study assessed the Adolescents knowledge level of contraceptive usage, the availability and accessibility of contraceptive, the rate of contraceptive usage, and the barriers to contraceptive use, using 150 adolescents in three selected schools in the study area. The descriptive study style was employed using structured questionnaire which was self-administered. Frequencies and percentages of data were displayed using tables, non-parametric equivalent of the One-way ANOVA and the Kruskal-Wallis method of data analysis. Findings from the study revealed that, knowledge on contraceptives was universal with almost every respondent being knowledgeable in the variables provided. Principally most respondents knew the pharmacy as the only sales point or source for contraceptives. A low prevalence rate of contraceptive use was also revealed. Aside from that, results from both culture and religion clearly showed that, both were not in support of contraceptive use for adolescents. The study therefore recommends the need to improve awareness among the study population.

Background to the Study
Adolescent as defined by the World Health Organization (WHO) (2018), is any young person between the ages of 10 and 19. The period through which this young person progresses is known as the period of adolescence. This phase of life stretches between childhood and adulthood (Sawyer, Azzopardi, Wickremarathn & Patton, 2018). Biologically, Sharp (2018), described this period as a span of time starting with puberty and concluding with maturity. Furthermore, the period may be classified into three stages of development thus, early 10 to 15 years, middle 14 to 17 years and late 16 to 19 years (WHO, 2010).

According to Freud (1925), a whole lot of challenges take place during this period, which the adolescent has to make adjustments to. According to him, these challenges have got to do with the self-image where there is the appearance of pubic hair in sexes, the development of breasts in females, and the first signs of beard in males. This may be seen as challenges in the sense that, whether the adolescent likes it or not, he or she would have to live with these physical appearances though out his or her life time.

Likewise, Hall (1916), also pointed out that, adolescence is a time of “storm and stress” during which the individual is thrown about by opposites such as action versus inaction, excitement versus calm, elation versus depression, self-confidence versus doubts about self-esteem, and the need for authority versus the need to rebel against authority.

Erikson (1959) also added on that, the adolescent at this stage also establishes a sense of personal identity and avoid the dangers of role diffusion and identity confusion. Razak (2016), described this phase as a period characterized by increased exploration and exposure to risk-taking behaviours, including unsafe sex. In recent years, adolescents have started to mature earlier than before, which results in a number of negative implications, particularly affecting their reproductive abilities and sexual health (Skrzeczkowska, Heimrath, Surdyka & Zalewski, 2016).

Both the rates of sexually transmitted infectioins and the number of unplanned or undesired pregnancies in adolescents/young adults is on the rise (Skrzeczkowska et al., 2016), which calls for the need for preventing such phenomena. Again Razak (2016), observes that, globally most adolescents become sexually active before their 20th birthday, and in Sub-Saharan Africa, 75% of adolescents report having had sex by age 20.

Green and Merrick (2015), also submit that, about 1 in 6 people globally are adolescents. This equals 1.2 billion people between the ages of 10 and 19. Amongst these more than 46,000 adolescent girls give birth each day (Green & Merrick, 2015). High birth rates according to Maclean (2016), may not only affect maternal and child mortality but frustrates governments in the provision of social and health services to communities such as the provision of national health insurance scheme which provides assistance to health charges.

In a study, Maclean (2016), reported the great benefits of investing in family planning, these included reduced poverty levels, improvement in maternal and child survival, and women’s participation in the labor market. However, over 200 million girls in developing countries have an unmet need for family planning despite a global call for promotion of and investment into family planning (Maclean, 2016).

Yidana, Ziblim, Azongo, Yakubu and Abass (2015), concluded that, most sexually active adolescent girls in developing countries do not use contraceptive. This may result in many negative social and health outcomes, including elevated maternal and newborn death rates, abortion and abortion-related complications (Green & Merrick, 2015). Recent data from several countries in sub-Saharan Africa show that only a third of unmarried, sexually active girls 15 to 19 years old are using contraception, with most of the others indicating an unmet need for methods to delay or space pregnancy (Green & Merrick, 2015).

Contraceptives refer to any family planning method used to prevent a pregnancy. This is achievable by interfering with the normal process of ovulation, fertilization, and implantation (Deri, 2016). Finding an effective method that everyone can easily access has been a major hurdle. This challenge exists primarily because of the push-pull forces of various contextual factors which can be socio-demographic, cultural, economic, and religious or even psychological (Deri, 2016).

Yidana et al., (2015), argue that, the sexual and reproductive health of adolescents is a pressing concern because the world has a larger population of adolescents now than ever before. This group of people, have been seen to be sexually active and in need of information about sexual health and access to contraceptive products and services (Guttmacher Institute, 2015). Most of them in their bid to solicit information from various sources often miss it by getting exposed to inaccurate or incomplete information (Yidana et al., 2015).

Furthermore, Feleke, Koye, Demssie and Mengesha (2013), in their study, submitted that, contraceptive use among married women who are 15–19 years old was only 17 percent, while the use among unmarried sexually active adolescents, is believed to be even lower. Irrespective of the consequences likely to occur, these teenage girls unfortunately run or get themselves into unintended pregnancies which further ruin their lives. Feleke et al., (2013), further revealed that the risk of dying from complications related to pregnancy or childbirth is two times higher for those aged 15–19 than for women in their mid-twenties.

An estimated, 225 million women in developing countries would like to delay or stop childbearing but are not using any method of contraception (Endriyas, 2017). The worldwide rate of unintended pregnancy in 2012 was 53 per 1,000 women aged 15–44 with the highest regional rate in Africa. Avoiding barriers to the use of contraceptive methods could avert 54 million unintended pregnancies, 79,000 maternal deaths and one million infant deaths each year (Endriyas, 2017).

According to Herbert (2015), a number of influences such as stereotypes, stigma, misconceptions and fear limit uptake of contraception. Attitude of the service providers are seen as one of the most common barriers to young people’s use of contraceptives. Notwithstanding, Schuler, Rottach and Mukiri (2011), also found that, sexual jealousy discouraged contraceptive use, as men worried that women’s use of contraception might allow them to be promiscuous and unfaithful without fear of conceiving.

In Sub-Sahara Africa, 20% to 30% of partners and significant others oppose contraceptives use (Clottey, 2012). In that case, they do not encourage their adolescents to use contraceptives. It is a taboo in Ghana for adolescents to talk about sexual issues let alone contraceptives. Some communities do not openly discuss contraceptives, due to strong cultural and religious beliefs, hence usage appear to be low and adolescents get exposed to the increased risk of unwanted or unintended pregnancies (Clottey, 2012). Furthermore, over 50% of women in Africa are poor and illiterate, thus not knowledgeable in the correct use of contraceptives, hence the low use (Clottey, 2012).

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