Rethinking: Timely Access to Comprehensive Sexual and Reproductive Health Education within the Context of Seasonal Migration in the Urban Slum of the Greater Accra Region, Ghana-A Qualitative Exploratory Design.

Publisher: BioMed Central Country of Publication: England NLM ID: 101224380 Publication Model: Electronic Cited Medium: Internet ISSN: 1742-4755 (Electronic) Linking ISSN: 17424755 NLM ISO Abbreviation: Reprod Health Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2004-

Transients and Migrants*/psychology ; Reproductive Health*/education ; Sex Education* ; Sexual Health*/education ; Health Services Accessibility*; Humans ; Adolescent ; Female ; Ghana ; Qualitative Research ; Poverty Areas ; Male ; Sexual Behavior ; Urban Population ; Health Knowledge, Attitudes, Practice ; Seasons

Competing Interests: Declarations. Ethics approval and consent to participate: Ghana Health Service Ethics Review Committee (clearance number: GHS-ERC 016/04/22). Competing interests: The authors declare no competing interests.
Background: Although comprehensive sexuality education (CSE) is widely recognised as a key strategy for improving adolescent sexual and reproductive health and rights, significant gaps remain in its implementation, especially among out-of-school migrant adolescents affected by seasonal internal migration. This study sought to explore the experiences of this subgroup in accessing timely and comprehensive sexual and reproductive health education within the context of seasonal migration in the urban slums of the Greater Accra Region.
Methods: The study adopted a qualitative exploratory design, guided by the socioecological model of health behavior. Urban slum communities relevant to the study were identified via criterion purposive sampling. The study was then publicised, and participants were recruited through formal and informal social networks, including youth groups. A total of 15 (fifteen) migrant adolescents were selected via convenience sampling, with the final sample size reached by data saturation. To gain a broader perspective, the study also included migrant peers and gatekeepers. Data collection involved 10 (ten) in-depth interviews (IDIs) with migrant adolescents, two (2) focus group discussions (FGDs), two (2) key informant interviews (KIIs) with peer network leaders, and one interview with a migrant gatekeeper.
Results: Migrant adolescents face limited access to SRH education because of their absence in communities, resulting in a lack of confidence in SRH decision-making, leading to low confidence in SRH decision-making. Peer networks influence SRH choices, often reinforcing reliance on informal health providers for sexual information and addressing cultural barriers. Community outreach programs primarily target young mothers attending child welfare clinics rather than targeting wider community migrant adolescents.
Conclusions: The paper concludes that migrants' mobility hinders access to SRH education, resulting in poor SRH knowledge and decision-making. This study underscores the need to address individual-, interpersonal-, and community-level factors. Seasonal migration should be acknowledged as a key social determinant of health and incorporated into national sexual and reproductive health (SRH) policies.
(© 2025. The Author(s).)

Med Teach. 2020 Aug;42(8):846-854. (PMID: 32356468)
J Sex Med. 2014 Mar;11(3):630-41. (PMID: 24418498)
J Adolesc Health. 2016 Oct;59(4S):S11-S28. (PMID: 27664592)
Nurse Res. 2006;13(3):7-21. (PMID: 16594366)
Am J Public Health. 2004 Dec;94(12):2051-3. (PMID: 15569948)
Adm Policy Ment Health. 2015 Sep;42(5):533-44. (PMID: 24193818)
Niger Postgrad Med J. 2014 Jun;21(2):122-7. (PMID: 25126865)
J Adolesc Health. 2015 Jan;56(1 Suppl):S15-21. (PMID: 25528976)
J Adolesc Health. 2019 Dec;65(6S):S41-S50. (PMID: 31761003)
Health Soc Care Community. 2022 Nov;30(6):e4375-e4383. (PMID: 35620865)
Health Educ Q. 1988 Winter;15(4):351-77. (PMID: 3068205)
Health Serv Res. 1999 Dec;34(5 Pt 2):1189-208. (PMID: 10591279)

Keywords: Comprehensive sexuality health education; Out-of-school adolescents; Seasonal migration; Sexual and reproductive health; Urban slum
Local Abstract: [plain-language-summary] Efforts to provide comprehensive sexuality education to out-of-school children have rarely focused on seasonal internal migrant adolescent young people who move between their rural communities and the city in the Greater Accra Region, Ghana. To understand how their patterns of mobility hinder access to sexuality education, the researchers conducted interviews and group discussions with 15 migrant adolescents, peer leaders, and community gatekeepers. They reported that frequent movement prevents these adolescents from accessing SRH education. Many are unaware of where to find accurate information or support and often rely on peers or informal health providers who may not have the right knowledge. Most existing health education efforts target young mothers at clinics, leaving out other adolescents. The study recommends that policies consider the challenges posed by mobility on adolescents’ access to SRH education. It also calls for inclusive strategies that reach all adolescents, not just those who attend child welfare clinics.

Date Created: 20250801 Date Completed: 20250801 Latest Revision: 20250803

20250803

PMC12315291

10.1186/s12978-025-02094-y

40745550