Citation: Ahinkorah BO, Perry L, Brooks F, Kang M. Barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy in Ghana: an exploratory qualitative study. BMJ Open 2022; 12:e060576. doi: 10.1136/bmjopen-2021-060576 


This study explored the perceived barriers and facilitators regarding the implementation of policies and programmes aimed at reducing adolescent pregnancy among health and education professionals (‘professionals’), grassroots workers and adolescent girls in Ghana.

Design and setting

We employed an exploratory qualitative study design involving interviews with professionals, grassroots workers and adolescent girls in the Central Region of Ghana.


This study involved 15 professionals employed in government or non-governmental organisations, 15 grassroots workers and 51 pregnant/parenting and non-pregnant adolescent girls.

Data analysis

Thematic analysis was conducted deductively using the ecological framework for understanding effective implementation.


Eighteen themes mapped to the five domains of the ecological framework emerged. Perceived barriers included gender inequality, family poverty, stigma, community support for early childbearing and cohabitation, inadequate data systems, lack of collaboration between stakeholders and lack of political will. Effective implementation of community by-laws, youth involvement, use of available data, and collaboration and effective coordination between stakeholders were the perceived facilitators.


Political leaders and community members should be actively engaged in the implementation of adolescent sexual and reproductive health policies and programmes. Gender empowerment programmes such as education and training of adolescent girls should be implemented and strengthened at both the community and national levels. Community members should be sensitised on the negative effects of norms that support child marriage, gender-based violence and early childbearing.

About The Authors


Bright Opoku Ahinkorah

Bright Opoku Ahinkorah is a PhD student at the University of Technology Sydney. His doctoral thesis ...

  Associate Professor  

Melissa Kang is an Associate Professor in Public Health at the University of Technology Sydney, and ...


Lin Perry is Professor of Nursing Research and Practice Development with the University of Technolog...


WH&Y Chief Investigator Professor Fiona Brooks passed away on 13 January 2023, after a short ill...