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.

Abstract

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.