Publications Summary


Document Type
Qualitative Research Studies
Publication Topic(s)
Youth
Country(s)
Ghana
Survey
Ghana DHS, 2022
Language
English
Recommended Citation
MacQuarrie, Kerry LD, Sara Riese, Jeffrey Edmeades, Peter Takyi Peprah, Priscilla Opoku, Nana Akosua Owusu-Ansah, Emmanuel Boateng, Afra Adomako Kwabiah, Martin Wiredu Agyekum, Frank Kyei-Arthur, and Jones Apawu. 2024. Agency, Consent, and Coercion: Young People’s Experiences of First Sex in Ashanti and Northern Regions, Ghana. DHS Qualitative Research Studies No. 24. Rockville, Maryland, USA: ICF.
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Publication Date
February 2024
Publication ID
QRS24

Abstract:

The establishment of romantic and sexual relationships is a key component of the transition from adolescence to adulthood across the world. This is a time of both great excitement and vulnerability for youth, as they have less experience with relationships and how to protect themselves from poor outcomes. This is also a time when many are especially vulnerable to being pressured or forced into starting their sexual lives earlier than they would choose and where patterns of behavior, including for things like couple communication and decision-making or contraceptive use, are established. This point in the life course is very important, potentially influencing the rest of the lives of young women and men. However, significant gaps remain in the field’s understanding of this period of life, including how young people enter into intimate relationships, what influences the decisions young people make about starting their sexual lives, and how much coercion is involved in those decisions. As a result, researchers, policymakers and programmers are often forced to make assumptions about what the needs of youth are at this point and how to best meet them. This study aims to address some of these gaps through using a mixed-method approach to explore the context around the first time youth had sex in the Ashanti and Northern regions of Ghana. Ghana is in many ways an ideal setting in which to explore these questions, with a youthful age structure, considerable diversity, and rapidly changing patterns in the ages and types of relationships where first sex takes place. Qualitative data were collected in the two regions from 154 young women and men who had completed the main Ghana Demographic and Health Survey (GDHS) and met the following criteria: - Age 15–29 (with a greater focus on collecting data from those aged 15–24) - Reported having first sex before age 18 (women) and 20 (men) - Consented to be reinterviewed for the study during the main GDHS The study focused on three main themes related to the first sexual experience of young women and men in these two regions: - What types of relationships were youth in when they experienced first sexual intercourse? - How much coercion did youth experience around having sex for the first time? - How prepared were youth for the initiation of sex? The key findings from the study included: - The type of relationship that youth were in when they first had sex plays a major role in how that experience took place - Open and clear communication between couples about sex and contraception is generally very low prior to the first sexual encounter - Detailed and correct knowledge about sexual and reproductive health (SRH) is very low - Youth generally have limited understanding of sexual and reproductive health rights (SRHR) and the role of consent within relationships, especially marriage - Gender norms play a major role in limiting communication and decision-making about sex and contraception, particularly for women - Coercion at low or moderate levels around first sex was almost universal for women and forced sex was relatively common. These findings show that for many of the young women and men in this study, the initiation of sexual activity took place in ways that were neither safe nor healthy. Most youth did not take the decision to start having sex lightly but lacked the capacity, skills and knowledge required to minimize the risk of poor outcomes. There is, thus, a clear need for programming that builds on prior efforts by the Ghanian government to provide youth with a comprehensive education that will better prepare them for establishing health relationships within which they may or may not become sexually active. This programming should aim to build knowledge about sexual and reproductive health rights (SRHR), gender roles, and the life skills required to ensure healthy, safe and respectful relationships, while also acknowledging that many young people will become sexually active, including within marriage. All efforts should be made to build this capacity before youth are likely to become sexually active so they can make fully informed decisions and effectively protect themselves from poor outcomes, such as unintended pregnancies and sexually transmitted infections. The Government of Ghana has made the health and productivity of youth a priority and in many ways it is in a good position to address these concerns. However, full success cannot be achieved without taking a realistic approach to youth sexual behavior and working to ensure that the SRHR needs of youth are met.

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