Adolescent Sexual and reproductive health services availability assessment
Table 4 reveals that in the Ga East district, about 94% of PHC facilities have AHS available. However, we observed significant variation in the specific types of AHS provided: only 31% of facilities offer HIV services, 69% provide family planning, 56% furnish contraceptive pills, 56% deliver IUCD services, and 56% supply male condoms.
In Shai Osudoku district, adolescent health services were available in 100% of the PHC facilities. There was variation in specific health service availability including HIV services (65%), family planning (94%), contraceptive pills (88%), IUCD services (65%), and male condom (88%). In Ningo Prampram, 89% of facilities offer adolescent health services. HIV and family planning services was available for 79% of facilities. About 21% provide contraceptive pills, 16% offer IUCD provisions, and 21% had male condoms available. La Nkwantanang district had the lowest adolescent service availability across facilities (47%). Of these facilities that offered adolescent services, 53% had HIV services available, 47% had family planning, 67% had contraceptive pills, 67% had IUCD services and 67% had male condoms available. Ga East and Shai Osudoku districts stand out for their higher availability of Adolescent Sexual and Reproductive Health (ASRH) services, with all services offered in 5 and 11 facilities, respectively. In contrast, Ningo Prampram and La Nkwantanang districts face more significant challenges, with all services available in only 3 and 7 facilities, respectively. However, a consistent theme across all districts is the relative accessibility of contraceptive supplies, including pills, IUCDs, and male condoms. Notably, Ga East and Shai Osudoku maintain this availability in over half of their facilities, and La Nkwantanang notably offers these supplies in 10 out of its 15 facilities, highlighting a focused effort to ensure contraceptive access amid the broader context of ASRH service provision disparities.
Tables 4. ASRH availability by District
| Ga East (16) | Shai Osudoku (17) | Ningo Prampram (19) | La Nkwantanang (15) |
Adolescent health services | 94% (15) | 100% (17) | 89% (17) | 47% (7) |
HIV services | 31% (5) | 65% (11) | 79% (15) | 53% (8) |
Family Planning | 69% (11) | 94% (16) | 79% (15) | 47% (7) |
Contraceptive Pills | 56% (9) | 88% (15) | 21% (4) | 67% (10) |
IUCD Provisions | 56% (9) | 65% (11) | 16% (3) | 67% (10) |
Male Condoms | 56% (9) | 88% (15) | 21% (4) | 67% (10) |
All Selected ASRH services | 31% (5) | 65% (11) | 16% (3) | 47% (7) |
Source: Authors’ computation from field data |
Table 5 presents evidence on service availability by facility types. In general, adolescent health services were available in 100% of CHPS facilities, 88% of health centres and 69% of clinics. HIV services were available in 73% of CHPS compounds, 63% of health centres and 62% of clinics. Family planning services was also available in CHPS compounds (100%), health centres (76%) and clinics (51%). Availability of contraceptive pills and IUCD was similar across all three facility types with health centres having the highest (59%) followed by CHPS compounds (57%) and clinics (44%). Male condoms were also available in health centres (94%), CHPS (90%) and clinics (79%). CHPS facilities stand out in ASRH service provision, with all services offered in 12 of 21 facilities, and complete AHS availability. In contrast, Health Centres face obstacles, providing a full-service range in only 10 of 17 facilities, with two lacking AHS services entirely. Clinics encounter more severe challenges, offering complete services in 13 of 29 facilities, with 9 completely devoid of AHS.
Table 5
ASRH availability by facility type
|
CHPS
(21)
|
Health Centres
(17)
|
Clinics
(29)
|
Adolescent Health Services
|
100% (21)
|
88% (15)
|
69% (20)
|
HIV Services
|
71% (15)
|
63% (10)
|
62% (18)
|
Family Planning
|
100% (21)
|
76% (13)
|
51% (15)
|
Contraceptive Pills
|
57% (12)
|
59% (10)
|
44% (13)
|
IUCD Provisions
|
57% (12)
|
59% (10)
|
44% (13)
|
Male Condoms
|
90% (19)
|
94% (16)
|
79% (23)
|
All Selected ASRH services
|
57% (12)
|
59% (10)
|
44% (13)
|
Source: Authors’ computation from field data
|
Table 6 presents the availability of adolescent health services by location (urban and rural). In urban areas, 72% of facilities offered adolescent health services, while 100% of rural facilities provided these services. The availability of other services in urban areas was as follows: HIV services (51%), family planning (59%), contraceptive pills (51%), IUCD provisions (51%), and male condoms (87%). In rural areas, the availability of other services was HIV services (68%), family planning (93%), contraceptive pills (54%), IUCD provisions (50%), and male condoms (93%). The results indicate a higher availability of adolescent health services and related services in rural areas compared to urban areas.
Regarding the availability of ASRH services, both urban and rural areas show more than 50% coverage, with all selected ASRH services being offered in 20 urban facilities and 15 rural facilities. Remarkably, all facilities in rural settings provide AHS, highlighting a gap in urban areas where 11 facilities lack AHS provision. When it comes to the accessibility of contraceptive supplies—such as pills, IUCDs, and male condoms—both urban and rural localities exhibit a moderate performance, with both settings offering a full range of contraceptive services in the same number of facilities (20 urban and 15 rural).
Table 6
ASRH service availability by Location
| Urban (39) | Rural (28) |
Adolescent Health Services | 72% (28) | 100% (28) |
HIV Services | 51% (20) | 68% (19) |
Family Planning | 59% (23) | 93% (26) |
Contraceptive Pills | 51% (20) | 54% (15) |
IUCD Provisions | 51% (20) | 54% (15) |
Male Condoms | 87% (34) | 93% (26) |
All Selected ASRH services | 51% (20) | 54% (15) |
Source: Authors’ computation from field data |
Table 7 presents the availability of adolescent health services and related services by operating authority (government and private facilities). In government facilities, 100% offered adolescent health services, while 73% of private facilities provided these services. A breakdown of service availability in government facilities include HIV services (70%), family planning (100%), contraceptive pills (66%), IUCD provisions (73%), and male condoms (37%). In private facilities, the breakdown includes HIV services (49%), family planning (51%), contraceptive pills (46%), IUCD provisions (49%), and male condoms (65%).
Table 7
ASRH service availability by Operating Authority
| Government (30) | Private (37) | |
Adolescent Health Services | 100% (30) | 73% (27) |
HIV Services | 70% (21) | 49% (19) |
Family Planning | 100% (30) | 51% (18) |
Contraceptive Pills | 66% (20) | 46% (17) |
IUCD Provisions | 73% (22) | 49% (18) |
Male Condoms | 37%(11) | 65%(24) |
All Selected ASRH services | 70%(21) | 46%(17) |
Source: Authors’ Computation |
Regarding the availability of ASRH services, both government and private run-facilities show some disparities in coverage, with all selected ASRH services being offered in 11 government facilities and 17 private facilities. Remarkably, all government facilities provide AHS, highlighting a gap in privately operated where 10 facilities lack AHS provision.
Adolescent sexual and reproductive health service readiness assessment
Table 8 presents the findings on the readiness of ASRH services across various districts. In Ga East, the study found that 6% of facilities had service guidelines, 31% had at least one staff member trained in AHS, 25% had FP staff with appropriate training, and 94% were equipped with male condoms at the day of the survey. In Shai Osudoku, a higher level of readiness was observed: 24% of facilities had service guidelines, 76% had staff trained in AHS, the same percentage had trained FP staff in AHS, and all facilities were stocked with male condoms, highlighting their preparedness in offering preventive services. In Ningo Prampram, the readiness assessment revealed that 42% of facilities had service guidelines, an equal percentage had trained AHS staff, 53% had trained FP staff in AHS, and all facilities were stocked with male condoms. Lastly, in La Nkwantanang, the assessment showed 20% of facilities with service guidelines, only 7% had trained AHS staff, the same low percentage for trained FP staff in AHS, and 67% were equipped with male condoms.
Table 8
ASRH service readiness by District
| Ga East (16) | Shai Osudoku (17) | Ningo Prampram (19) | La Nkwantanang (15) |
Service Guidelines | 6% (1) | 24% (4) | 42% (8) | 20% (3) |
Trained Staff | 31% (5) | 76% (13) | 42% (8) | 7% (1) |
Trained FP staff | 25% (4) | 76% (13) | 53% (10) | 7% (1) |
Male Condoms | 94% (15) | 100% (17) | 100% (19) | 67% (10) |
Source: Authors’ Computation |
The assessment of ASRH service readiness across different types of health facilities revealed varying levels of preparedness. For CHPS facilities, 38% of them had service guidelines, 71% of their staff were trained in AHS, 71% had FP staff with relevant ASRH training, and 90% were stocked with male condoms. Clinics, on the other hand, showed lower readiness levels, with only 12% having service guidelines, 15% having trained staff, 12% with trained family planning staff, and 77% equipped with male condoms. Health centres presented a moderate level of readiness, with 24% having service guidelines, 47% of the staff trained in adolescent health, an equal percentage having trained family planning staff, and 94% equipped with male condoms.
Table 9
ASRH readiness by facility type
| CHPS (21) | Health Centre (17) | Clinics (29) |
Service Guidelines | 38% (8) | 24% (4) | 14% (4) |
Trained Staff | 71% (15) | 47% (8) | 14% (4) |
Trained FP staff | 71% (15) | 47% (8) | 14% (4) |
Male Condoms | 90% (19) | 94% (16) | 100% (29) |
Source: Authors’ Computation |
Table 9 highlights the readiness of adolescent services by location, distinguishing between urban and rural areas. In urban locations, 21% of facilities had service guidelines, 23% of the facilities had staff trained in adolescent health services, 21% had family planning staff with the necessary training, and 87% were equipped with male condoms. Rural areas showed a higher level of readiness, with 29% of facilities possessing service guidelines, 46% having trained staff, 64% with trained family planning staff, and 93% equipped with male condoms.
Table 10
ASRH service readiness by Location
|
Urban
(39)
|
Rural
(28)
|
Service Guidelines
|
21% (8)
|
29% (8)
|
Trained Staff
Trained FP staff
Male Condoms
|
23% (9)
21% (8)
87% (34)
|
46% (13)
64% (18)
93% (26)
|
Source: Authors’ Computation
|
Table 10 provides an overview of adolescent service readiness based on the operating authority of the facilities. Among public facilities, there was a 37% readiness with service guidelines, 77% of the staff were trained in adolescent health, another 77% had family planning staff with appropriate training, and 37% were equipped with male condoms. In comparison, private facilities exhibited lower readiness levels: 14% had service guidelines, 11% had trained staff, 8% had trained family planning staff, and 65% had male condoms in stock.
Table 10
ASRH service readiness by Operating Authority
| Public (30) | Private (37) | |
Service Guidelines | 37% (11) | 14% (5) |
Trained Staff | 77% (23) | 11% (4) |
Trained FP staff | 77% (23) | 8% (3) |
Male Condoms | 37% (11) | 65% (24) |
Source: Authors’ Computation |