Reproductive Health Awareness and Literacy Among Basic School Pupils in Ghana: Health Belief Model

Amidst the COVID-19 pandemic, adolescents within the Ghanaian societies were found not reporting to schools due to high incidence of pregnancies and childhood marriages, as reported by the 2020 monitoring report on Ghana's COVID-19 Back to School Campaign, ActionAid Ghana, and the Africa Education Watch. The Ghana Health Service revealed that as of March 2022, 109,888 adolescent girls were pregnant due to the lockdown of schools, causing an inexplicable disruption of education. This happens because of adolescents’ inadequate knowledge of their reproductive health well-being. As a result, adolescent reproductive health vulnerabilities need to be tackled from a multi-dimensional point. This research sought to address adolescents' reproductive health knowledge (cognitive dimension), sources of reproductive health information (socio-cultural dimension) and methods of promoting reproductive health awareness (interventional dimension). The Health Belief Model underpinned this study to assess literacy and awareness among adolescents. Participants acknowledged the possession of knowledge on activities that make them vulnerable to reproductive health risks, contraceptive usage, sexually transmitted infections, and the consequences of having multiple sex partners. The study revealed that participants' dominant sources of reproductive health information emanated from four different sources (their home, peers, internet sources, and the school). Participants' literacy and awareness of their reproductive health choices and issues contradict the underlying assumptions of the health belief model. Specifically, adolescents' perception of threats as a signal towards the adaptation of positive, healthy reproductive behaviour (perceived susceptibility), the extent of vulnerability leading to avoidance of unprotected sex and having multiple sexual partners (perceived severity) did not motivate them to adopt healthy reproductive health behaviours and choices. This contradiction arises as peer acceptance, social group affiliation, gaining social recognition and adhering to the current trend of youth exuberance were the desires of most adolescents, thereby preventing adolescents from putting a stop to their risky reproductive healthy behaviours.