Boys aged 15 to 19 in Saboro, Upper East Region, were reportedly denied condoms by service providers because they were considered too young to be sexually active, highlighting persistent barriers young people face in accessing sexual and reproductive health services.
The finding is contained in the endline evaluation of the five-year Sexual Health and Reproductive Education (SHARE) Project, which found that significant improvements in adolescents’ sexual and reproductive health and rights (SRHR) knowledge and confidence did not translate into a statistically significant increase in their use of services.
The reported experience in Saboro provides one of the clearest examples of the gap between equipping adolescents with SRHR knowledge and ensuring they can access services when they attempt to act on that knowledge.
The evaluation found statistically significant improvements in adolescents’ SRHR knowledge in intervention areas, while young people also reported greater confidence in their ability to seek information and services.
However, reported use of SRH services declined at endline, although intervention areas continued to record higher levels of service use than comparison areas. The difference between the two was not statistically significant.
The evaluation identified privacy and confidentiality concerns, embarrassment, financial difficulties, waiting times and limited availability of adolescent-friendly services among the barriers discouraging young people from seeking care.
Some adolescents also reported encountering attitudes and restrictions from service providers that made accessing services difficult.
Misinformation about contraception was another challenge identified by the evaluation.
Some adolescents and caregivers reportedly believed that using family planning methods before having a first child could result in permanent infertility.
The findings indicate that improved knowledge alone may not be enough to overcome the social, cultural and institutional barriers influencing adolescent health-seeking behaviour.
The SHARE Project was implemented by a consortium led by Right To Play, in partnership with FAWE Ghana, WaterAid Ghana and FHI 360, with funding from Global Affairs Canada.
In Ghana, the project was implemented from 2021 to 2026 in the Bongo District, Builsa North Municipality, Kassena-Nankana Municipality and Kassena-Nankana West District.
It targeted young people aged 10 to 24 and worked through schools, communities, health facilities and government structures to improve access to accurate SRHR information and responsive services.
The endline evaluation, conducted between March and May 2026, gathered evidence from 1,240 adolescents and young people, 351 teachers, 356 caregivers and stakeholders, as well as health facilities.
Speaking during a regional dissemination of the findings, SHARE Project Officer at Right To Play Evans Gariba said the evaluation provides important lessons for future adolescent SRHR interventions.
Schools record gains
The school environment emerged as one of the strongest areas of progress under the project.
The evaluation found that 95% of teachers surveyed had received training from SHARE or its partners, while 91% were aware of national reproductive health education guidelines.
Another 84% reported being much more comfortable teaching reproductive health education.
Teachers, however, identified practical challenges that could undermine those gains.
About 87% reported inadequate teaching and learning materials, while 58% said they did not have sufficient time to deliver reproductive health education.
The evaluation also found increased participation by girls in SRHR advocacy activities in intervention areas, including peer mobilisation, community mobilisation, school governance and action research.
There was also a statistically significant improvement in autonomous SRHR decision-making among women aged 15 to 24 who were married, cohabiting or in relationships and sexually experienced.
Qualitative evidence pointed to increased confidence, voice and boundary-setting among some young women.
However, the evaluation found that most girls still did not participate in advocacy or social action activities, suggesting that opportunities created for adolescent participation had yet to reach the majority.
Family support for adolescents seeking SRH information and services also improved.
The evaluation found that adolescents sometimes returned home with SRHR information that conflicted with cultural, religious or parental expectations, highlighting the importance of continued engagement with parents and caregivers.
Gaps remain at health facilities
SHARE also worked to improve the quality and adolescent-friendliness of health facilities.
Facilities that received infrastructure support generally recorded stronger readiness indicators than those that did not.
However, gaps remained in waste management, standard operating procedures, supervision and the maintenance of adolescent-friendly services.
The findings identified privacy, confidentiality, respectful treatment and age-appropriate services as critical factors in whether young people seek and return for care.
With the project reaching the end of its five-year implementation period, attention has shifted to sustaining the gains.
The Ghana Education Service in the Upper East Region says it plans to use technology to maintain engagement with teachers and monitor the continuation of SHARE-supported activities in schools.
Deputy Regional Director of Education John Ankoh said teacher mentors would be engaged through regular online meetings.
“Once in a month, our mentors in the various schools in the various locations will be met on Zoom to find out what they have been doing thereafter,” he said.
District education officials, including girl-child and training officers, will also engage the mentors to assess progress.
“So, it is not ending here,” Mr. Ankoh said.
He said the project had significantly improved adolescents’ understanding of sexual and reproductive health and rights.
“The data shared with us points to a success story in helping adolescents and members of the community to know their sexual reproductive rights and education issues,” he said.
He added that improved knowledge could contribute to preventing sexually transmitted infections and teenage pregnancies.
The evaluation, however, warned that the gains made under SHARE could weaken without continued institutional support.
It identified funding gaps, staff transfers, inadequate refresher training, supervision challenges and infrastructure maintenance among the risks to sustainability.
The evaluators recommended integrating effective SHARE interventions into routine education and health plans and budgets, continuing engagement with adolescents and providing refresher training for teachers and health workers.
They also called for stronger community accountability mechanisms and clearer SRHR education content across schools, health facilities and communities.
The experience reported by the boys in Saboro underscores one of the central challenges identified by the evaluation: improving what young people know about their sexual and reproductive health must be matched by services that allow them to act on that knowledge without stigma or unnecessary barriers.
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