Self-efficacy for Modern Contraceptive Use Among Senior High School Female Day Students in a Peri-urban Area in Ghana

Abstract

Introduction

Promoting modern contraceptive use among adolescents in low- and middle-income countries is essential to address high rates of unintended pregnancies, unsafe abortions, and sexually transmitted infections. Perceived self-efficacy is a key determinant of contraceptive behavior among adolescents. This study assessed the prevalence of modern contraceptive use, perceived self-efficacy, and associated factors among adolescent girls in the Techiman North District, Ghana.

Methods

A cross-sectional quantitative study design was employed involving 228 senior high school (SHS) female day students selected through proportionate stratified random sampling. A pretested, self-administered questionnaire was used, and data were analyzed using Statistical Package for Social Sciences (SPSS) version 23. Descriptive statistics, binary, and multiple linear regression analyses were conducted with significance set at p < .05.

Results

The mean age of participants was 18.3 years (standard deviation [SD] ± 2.59), and the mean age at sexual debut was 16.3 years (SD ± 1.9). Lifetime and current contraceptive use prevalence were 27% (n = 61) and 16% (n = 36), respectively. Additionally, 35.5% reported penetrative vaginal intercourse in the past 12 months. Participants in SHS 2 were 0.15 times (adjusted odds ratio [AOR] = 0.147; 95% confidence interval [CI] = 0.046–0.466; p = .001) and 0.14 times (AOR = 0.139; 95% CI = 0.036–0.544; p = .005) less likely to use modern contraceptives compared to those in SHS 1. Conversely, those in SHSs 2 and 3 were 8 times (AOR = 8.09; 95% CI = 3.444–19.022; p = .000) and 7 times (AOR = 7.15; 95% CI = 2.641–19.377; p = .000) more likely to have high perceived self-efficacy. Cohabiting participants were twice as likely to have high perceived self-efficacy than singles (AOR = 2.48; 95% CI = 2.453–170.929; p = .005).

Conclusion

Comprehensive, empowerment-focused sexual and reproductive health education is urgently needed to increase contraceptive use.