Facilitators and Barriers to the Use of Sexual and Reproductive Health Services among Adolescents in a Rural Ghanaian District

Using the Andersen and Newman model, we explored the facilitators and barriers to the use of sexual and reproductive health (S&RH) services by in-school adolescents in Ghana. Thematic analysis of interviews revealed that parental support and a good peer network predispose adolescents to use S&RH services, while religious prejudice predisposes adolescents not to use S&RH services. Adolescent-friendly social clubs, S&RH corners, and well-trained health workers enable S&RH service use while parental disapproval, poor health workers' attitudes, and inconvenience of health facilities inhibit S&RH service use. Adolescents' perceptions of the severity of S&RH conditions create the need for S&RH care, while societal perception of sexual pleasure and perceived side effects of S&RH services are need-based barriers to the use of S&RH services. We recommend that adolescent-focused S&RH interventions should build the competence of health workers, promote religious and community tolerance, and strengthen family relationships that facilitate parent-child S&RH communication.