A cross-sectional study of knowledge and practices related to sexual and reproductive health among adolescents in 'unrestricted environments' in Ghana: A policy implementation context view

Background: Sexual and reproductive health (SRH) is key to the growth and development of adolescents. Inadequate information exposes adolescents to some challenges. This becomes more pronounced as they move from restricted unrestricted environments such as pertains universities where there is virtually no control. It is importantto assess their knowledge of issues related to adolescent sexual and reproductive health (ASRH) needs and how that knowledge influences their sexual practices. Objective: To assess the knowledge and practice of adolescents in public universities across Ghana on their SRH needs. Study Participants: 672 adolescents from the three selected public institutions who met the inclusion criteria and consented to the study. Study Setting: The Study Setting was the University of Professional Studies Accra (UPSA); Kwame Nkrumah University of Science and Technology (KNUST), Kumasi; and the University for Development Studies (UDS) in Tamale, all in Ghana. Study Design: A cross-sectional study of adolescents in public universities across Ghana. Results: The study found that over 80% of university respondentshad high knowledge of ASRH issues. However, more than two-thirds (67%) of the respondents indicated that they had no knowledge that sexually transmitted infections (STIs) could be transmitted through unprotected sex. Regarding their sexual practices, the study found that 70% of the respondents were sexually active however, the prevalence of contraceptive use among them was extremely low (7%). Conclusion: A high level of knowledge on SRH issues among a large proportion of sexually active adolescents does not correspond to levels of practising safe sex making themsusceptible to STIsand unplanned pregnancies. Knowledge was thus disproportionally associated with safe sexual practices among adolescents in the unrestricted environments surveyed. Implementing behavioural change interventions through sexual education and improved access to ASRH services could improve the situation. These findings are thus relevant for SRH policy reforms and implementation programmes.