Identifying promising or priority effective adolescent, sexual and reproductive health interventions in Ghana: what frameworks should guide the selection of interventions?
Achala D, Fenny A, Atim C, Ataguba J • Reproductive health • 2025
Identifying effective priority interventions for addressing the SRH needs of adolescents is a consultative process facilitated by proven and valid frameworks adapted to align with specific country contexts, with four top interventions identified for Ghana: adolescent health clubs, girls' empowerment through comprehensive sexuality education, national capacity-building for integrated family planning and maternal health services, and eHealth/digital health programmes.
Key Findings
Results
Four priority ASRH interventions were identified and validated by stakeholders as most effective or promising for addressing adolescent sexual and reproductive health needs in Ghana.
The four interventions are: adolescent health clubs programmes, girls' empowerment programmes through comprehensive sexuality education, national capacity-building programmes to deliver high-quality integrated family planning and comprehensive maternal health services, and electronic health (eHealth)/digital health programmes.
These four were selected from a broader list of seven priority interventions that were ranked and validated by stakeholders.
The identification was consistent with findings in the broader literature on ASRH interventions.
Methods
A qualitative descriptive methodology combining literature review and stakeholder engagement was used to list, rank, and validate ASRH interventions.
The study combined literature review with stakeholder engagement processes.
The framework used was adapted from an established framework designed by the West African Health Organization (WAHO).
The stakeholder engagement process facilitated the listing, ranking, and validation of interventions.
The framework was adapted to align with the specific country context of Ghana.
Background
Limited access to ASRH services increases adolescents' risk of multiple poor health outcomes in Ghana and across Africa.
Identified poor health outcomes include unintended pregnancies, high adolescent birth rate, poor birth outcomes, high maternal and neonatal mortalities, and high exposure to sexually transmitted infections.
Barriers to ASRH services include inadequate funding of interventions, cultural barriers and norms, lack of education, and inadequate supplies of ASRH services and commodities.
The need to expand ASRH services is described as more urgent in Africa compared to other regions, given its youthful population and unmet ASRH needs.
Background
Gains from investments in ASRH interventions following the implementation of the Millennium Development Goals highlight the importance of identifying and prioritising adequate funding for effective ASRH interventions.
The paper situates ASRH within the universal health coverage (UHC) agenda of the sustainable development goals (SDGs).
The study's broader aim is to accelerate progress towards UHC in Ghana through identification of priority ASRH interventions.
Prior MDG-era investments are cited as evidence for the value of continued prioritization of ASRH funding.
Conclusions
The process of identifying effective priority ASRH interventions requires a consultative approach using proven frameworks adapted to specific country contexts.
The WAHO framework was adapted through a stakeholder engagement process to fit the Ghanaian context.
Stakeholder engagement ensured local validation of the ranked interventions.
The authors conclude that framework adaptation to country context is essential for identifying locally appropriate priority interventions.
What This Means
This research suggests that four specific health programs are the most promising for improving sexual and reproductive health among teenagers and young people in Ghana. These are: health clubs for adolescents in schools or communities, programs that empower girls through comprehensive sex education, national efforts to build healthcare workers' capacity to deliver integrated family planning and maternal health services, and the use of digital or electronic health tools. These four were chosen from a longer list of seven candidate interventions through a process that combined reviewing scientific literature with consulting a range of stakeholders familiar with Ghana's health system and social context.
This research suggests that the barriers preventing young people in Ghana and across Africa from accessing sexual and reproductive health services are multiple and interconnected, including insufficient funding, cultural norms, lack of education, and shortages of supplies and trained providers. These gaps contribute to serious health problems such as unintended pregnancies, high rates of teen births, maternal and infant deaths, and sexually transmitted infections. The study used an established framework from the West African Health Organization, adapted to fit Ghana's specific situation, to systematically identify which interventions should receive priority attention and investment.
This research suggests that the process of deciding which health interventions to prioritize cannot be done in isolation — it requires structured, consultative methods that bring together evidence from research and the knowledge of local stakeholders. The findings have practical implications for policymakers and health planners in Ghana and similar settings, pointing toward specific, validated programs that could be scaled up or strengthened to better meet the sexual and reproductive health needs of adolescents and advance progress toward universal health coverage.
Achala D, Fenny A, Atim C, Ataguba J. (2025). Identifying promising or priority effective adolescent, sexual and reproductive health interventions in Ghana: what frameworks should guide the selection of interventions?. Reproductive health. https://doi.org/10.1186/s12978-025-01989-0