Bridging the Gap Between Awareness and Use: Adolescent Contraceptive Practices and Associated Barriers among Final Year Students in a Ghanaian Senior High School

Abstract Background Majority of adolescent births occur in the 15–19-year age group. Contraceptive use plays a crucial role in preventing unintended pregnancies, reducing adolescent birth rates, and improving reproductive health outcomes. Despite increasing awareness, contraceptive uptake among adolescents remains low in many settings, particularly in sub-Saharan Africa. This study assessed the knowledge, attitudes, and practices regarding contraception among adolescents at Tarkwa Senior High School in Ghana. Method A cross-sectional study was conducted among final-year students at Tarkwa Senior High School. Eligible final-year students were recruited through simple random sampling. A structured self-administered questionnaire was used to collect data on students’ sociodemographic characteristics, knowledge, attitudes, and use of contraceptives. The data was analyzed using SPSS version-27. Descriptive and inferential statistics were determined and p-value below 0.05 considered statistically significant. Results While all respondents (100%) had heard of contraception, only 2.9% had ever used a contraceptive method. The primary sources of information on contraception were teachers (52.4%), friends (21.4%), and health workers (10.7%). Pills (44.7%) and condoms (32.0%) were the most well-known contraceptive methods. However, misconceptions about contraceptives were common, with 24.3% of respondents believing that contraceptive use leads to promiscuity. The major barriers to contraceptive use included fear of side effects (62.1%), religious beliefs (20.4%), and partner or family opposition (7.8%). Conclusion Although adolescents at Tarkwa Senior High School exhibited high awareness of contraception, actual usage was remarkably low due to misconceptions, sociocultural barriers, and concerns about side effects. This highlights the need for comprehensive, adolescent-friendly reproductive health education and policies that ensure easier access to contraceptive services.