Modelling Knowledge, Attitudes and Contraceptive Use Among Adolescents in the Ho Municipality, Ghana

Research evidence indicates that good knowledge, positive attitudes, and regular contraceptive use are linked to a reduction in unintended pregnancies among adolescents worldwide. Despite the high rate of unintended pregnancies in Ghana, particularly in the Volta Region, there is limited information about adolescents' knowledge, attitudes, and contraceptive practices. This study examined the knowledge, attitudes, and contraceptive use among adolescents in the Ho Municipality of Ghana.

This study used a quantitative cross-sectional design, with a convenience sampling method to recruit 841 adolescents in the Ho Municipality. The primary outcome variable was contraceptive use, and the secondary outcome variables-knowledge of and attitude towards contraceptive use-were measured with standardised scales with Cronbach's α reported above the cutoff of 0.7 (contraceptive use: α = 86; Knowledge: α = 0.93; Attitude: α = 0.95). All tests were done using a 5% level of significance in the R statistical package and the SPSS software version 27.

This study found that the prevalence of contraceptive use was comparatively low (48.2%). The multiple logistic regression model indicated that employed participants (aOR = 3.98, 95% CI = 1.51, 11.62, p = 0.007) and older adolescents (aOR=1.44, 95% CI = 1.23, 1.69, p < 0.001) were more likely to use contraceptives compared to their counterparts. Additionally, the analysis showed that adolescents with no formal education (aOR = 4.95, 95% CI = 1.65, 18.56, p = 0.008) were more likely to have positive attitudes than those with tertiary education. The results also revealed that adolescents aged 18 and above (aOR = 4.09, 95% CI = 2.21, 7.66, p < 0.001), those who were employed (aOR = 3.26, 95% CI = 1.32, 8.65, p = 0.013), and those with one child (aOR = 6.29, 95% CI = 1.03, 43.73, p = 0.049) were more likely to have good knowledge compared to their counterparts.

The rate of contraceptive use among the participants was low. Socio-demographic factors such as education, employment status, and age contribute to unequal outcomes in attitude, knowledge, and contraceptive use among adolescents. Health interventions aimed at addressing inequalities in attitudes, knowledge, and contraceptive use among adolescents in the study setting should target socio-demographic factors.