Attitudes of Gatekeepers Towards Adolescent Sexual and Reproductive Health in Ghana

Akwasi Kumi-Kyereme, Kofi Awusabo-Asare, Eugene Kofuor Maafo Darteh


Adults constitute gatekeepers on adolescent sexual and reproductive health (ASRH). This qualitative paper discusses the views of adults on ASRH problems and challenges based on 60 in-depth interviews conducted among adults in Ghana in 2005. Adults were purposively selected based on their roles as parents, teachers, health care providers and community leaders. The major ASRH problems mentioned were teenage pregnancy and HIV/AIDS. The results indicated a number of challenges confronting ASRH promotion including resistance from parents, attitudes of adolescents, communication gap between adults and adolescents and attitudes of health care providers. Among health workers three broad categories were identified: those who were helpful, judgmental and dictators. Some adults supported services for young people while others did not. Some served as mediators and assisted to ‘solve’ ASRH problems, which occurred in their communities. It is argued that exploring the views of adults about their fears and concerns will contribute to the development of strategies and programmes which will help to improve ASRH. (Afr J Reprod Health 2014; 18[3]: 142-153)


Keywords: Adolescents, Adults, Gatekeepers, Ghana, Adolescent Sexual and Reproductive Health 



Les adultes constituent les gardiens sur la santé sexuelle et de la reproduction des adolescents (SSRA). Ce document qualitatif examine les points de vue des adultes sur les problèmes et les défis de la SSR en se basant  sur 60 entrevues en profondeur menées auprès des adultes au Ghana en 2005. Les adultes ont été intentionnellement sélectionnés en fonction de leur rôle de parents,  d’enseignants, de fournisseurs de soins de santé et de dirigeants communautaires. Les principaux problèmes de la SSR mentionnés  étaient la grossesse chez les adolescentes et le VIH / SIDA. Les résultats ont indiqué un certain nombre de défis auxquels est confrontée la promotion SSRA y compris la résistance des parents, les attitudes des adolescents, le manque de communication entre les adultes et les adolescents et les attitudes des fournisseurs de soins de santé. Parmi le personnel  de  santé, trois grandes catégories ont été identifiées: ceux qui étaient utiles, de jugement et de dictateurs. Certains adultes ont appuyé les services  pour les jeunes tandis que d'autres n'ont pas. Certains ont servi en tant que médiateurs et ont aidé à «résoudre» les problèmes de la SSR, qui ont eu lieu dans leurs communautés. L’on affirme  que l'exploration des points de vue des adultes sur leurs craintes et préoccupations contribuera à l'élaboration de stratégies et de programmes qui contribueront à améliorer SSRA. (Afr J Reprod Health 2014; 18[3]: 142-153)


Mots-clés: adolescents, portiers adultes,  Ghana, santé sexuelle et de la reproduction des adolescents  

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Population Reference Bureau (PRB). The world’s youth 2013 data sheet. Washington DC: PRB, 2013.

Ghana Statistical Service (GSS), Ministry of Health (MOH) and Macro International (MI). Ghana demographic and health survey 2008, Calverton: Maryland GSS and MI, 2009.

Awusabo-Asare K, Biddlecom A, Kumi-Kyereme A and Patterson K. Adolescent Sexual and reproductive health in Ghana: Results from the 2004 national survey of adolescents, Occasional Report, No. 22 New York: Guttmacher Institute, 2006.

Nabila JS. Urbanization in Ghana. Accra: Population Impact Project (PIP), 1988.

Ghana Statistical Service (GSS) and ORC Macro. Ghana demographic and health survey 1998. Accra: GSS, ORC Macro, 1999.

Darteh, EKM and Nnorom CPN. Sexual behaviour and condom use among adolescents living in poor areas in Brong Ahafo, Ghana. Journal of Alternative Perspectives in the Social Sciences 2012; 4(3): 61839.

Henry R and Fayorsey C. Coping with pregnancy: Experiences of adolescents in Ga Mashi, Accra. Calverton MD: ORC Macro. 2002.

Bronferbrenner U. The ecology of human development. Cambridge MA: Harvard University Press, 1979.

Inter-Agency Working Group on the Role of Community Involvement in Adolescent Sexual and Reproductive Health. Community pathways to improved adolescent sexual and reproductive health: A conceptual framework and suggested outcome indicators. Washington DC: Inter-Agency Working Group on the Role of Community Involvement in Adolescent Sexual and Reproductive Health, 2007.

Mehra S, Savithri R and Coutinho L. Sexual behaviour among unmarried adolescents in Delhi, India: Opportunities despite parental controls. New Delhi:

World Health Organization. Key issues in the implementation of programmes for adolescent sexual and reproductive health. Geneva: World Health Organization, 2004.

Kumi-Kyereme A, Awusabo-Asare K, Biddlecom A and Tanle A. Influence of social connectedness, communication and monitoring on adolescent sexual activity in Ghana. African Journal of Reproductive Health 2007; 11(3): 133-47.

Qualitative evidence from Ghana. Occasional Report, No. 30 New York: Guttmacher Institute, 2007.

Wight D, Williamson L and Henderson M. Parental influences on young people’s sexual behavior: A longitudinal analysis. Journal of Adolescence 2006; 29:473-94.

Lewin K. Frontiers in group dynamics. Human Relations 1947; 1(2): 145.

Ghana Statistical Service. 2010 Population and housing census: National analytical report. Accra: Ghana Statistical Service, 2013.

Ghana Statistical Service. Poverty in Ghana in the 1990s. Accra: Ghana Statistical Service, 2000.

Kudolo P, Kavi E and Abdul-Rahman A. Baseline survey on adolescent sexual and reproductive health in the operational area of ten ACDEP - Member primary health care programmes in Northern and Upper East regions, Ghana, 2008.

Iyaniwura C A. Attitude of teachers to school based adolescent reproductive health interventions. Journal of Community Medicine & Primary Health Care. 2004; 16(1): 4-9.

Nutan PJ, Gupta SD and Singh LP. Meeting reproductive and sexual health needs of adolescents: A strategic approach for Rajasthan, India, IIHMR Working Paper No.4 (n.d.).

Speizer IS, Mullen SA and Amégee K. Gender differences in adult perspectives on adolescent reproductive behaviours: evidence from Lomé, Togo. Inter Fam Plann Persp 2001; 27.

Mturi A. Parents' attitudes to adolescent sexual behaviour in Lesotho. African Journal of Reproductive Health 2003; 7(2): 25-33.

Baldo M, Aggleton P and Slutkin G. Does sex education lead to earlier or increased sexual activity in youth? Poster presentation at the Ninth International Conference on AIDS, Berlin, Germany, Global Programmeon AIDS/WHO, 1993.

Awusabo-Asare K, Bankole A and Kumi-Kyereme A. Views of adults on adolescent sexual and reproductive health: Qualitative evidence from Ghana, Occasional Report, No. 30 New York: Guttmacher Institute, 2008. MAMTA-Health Institute for Mother and Child, 2002. Adolescents’ sexual and reproductive health:

Kumi-Kyereme A, Awusabo-Asare K and Biddlecom A.

Tilahun M, Mengistie B, Egata G and Reda AA. Health workers' attitudes toward sexual and reproductive health services for unmarried adolescents in Ethiopia. Reproductive Health 2012; 9:19.

Erulkar AS, Onoka CJ and Phiri A. What is youth friendly? Adolescent preferences for reproductive health services in Kenya and Zimbabwe. African Journal of Adolescent Health 2005; 9(3): 51-58.


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