When knowledge of modern contraceptives does not lead to uptake: a mixed method study among early adolescents in Koforidua Municipality, Ghana

The use of modern contraceptives by adolescents remains a major challenge despite the implementation of several policies and initiatives to improve their availability and accessibility in Ghana. This study explored early adolescents’ knowledge and uptake of contraceptives in Koforidua, Ghana. This was a cross-sectional study that employed a mixed-method approach and included an in-depth interview. Three hundred and seventy-three early adolescents aged 11 and 15 years were surveyed for the study. Knowledge of contraceptives was measured at a binary level, with “Yes” indicating high knowledge and “No” indicating lack of knowledge. In-depth interviews were conducted among ten participants. The quantitative data was processed using SPSS version 25 and has been analysed using discriptive and inferential statistics. Binary logistic regression and multilevel regression analysis has ben conducted to establish independent predictors of modern contraceptive knowledge by early adolescents with p<0.05 considered statistically significant.The qualitative data has been informed by a thematic analysis. The mean age of early adolescents was 13.6 years. A total of 17(9.2%) had a history of ever using at least one form of modern contraceptive. The low uptake was justified by the view that using modern forms of contraceptives is against God's will (46.0%). Early adolescents had a fair knowledge of modern contraceptives (49.3%), with school being the primary source of information. Early adolescents aged [12 years (AOR = 15.602 (95.0% CI 1.869–130.212), 14 years (AOR = 2.541 (95.0% CI 1.405–4.596), and 15 years (AOR = 1.679 (95.0% CI 1.018–2.768)] are more likely to have increased knowledge of modern contraceptives compared to those age 11 years. On the adjusted level, early adolescents whose mothers are formal sector workers [(AOR = 3.091 (95.0% CI 1.240–7.706)] are three times more likely to know about modern contraceptives compared to those whose mothers are not working. This finding indicates a significant gap between contraceptive knowledge and use among early adolescents which must be addressed through targeted interventions for early adolescents.