Effects of a Sexual and Reproductive Health Intervention on Adolescent Service Usage in Northern Ghana: Results of a Community-Randomized Trial

Gifty Apiung, Navrongo Health Research Centre
Cornelius Y. Debpuur, Navrongo Health Research Centre
Abraham Hodgson, Ghana Health Service
Natasha Howard, London School of Hygiene and Tropical Medicine (LSHTM)

The objective of this community-randomized trial was to assess if exposure to a community intervention increased adolescents sexual and reproductive health service usage in north-eastern Ghana. Twenty-six communities were randomly allocated to the intervention consisting of a school-based curriculum, out-of-school youth activities, and health worker outreach, (n=13); and comparison consisting of youth-friendly health service provision only (n=13). The main outcome measures were usage of services for pregnancy or sexually-transmitted infections (STIs) and HIV in the past year. Service usage data was collected at baseline and three years after the intervention started from 2,664 adolescents aged 15-17 years in the trial cohort. Exposure was associated with over twice the odds of using STI services (OR 2.40), 91% greater odds of using delivery services (OR 1.91), and 58% greater odds of using antenatal services (OR 1.58). Although overall usage remained low, these increases were encouraging.