Urban-rural differences in caregivers’ willingness to support adolescent girls’ contraceptive use in Ghana: a comparative study

Adolescent pregnancy remains a critical public health challenge in Ghana, accounting for a significant proportion of unintended pregnancies, unsafe abortions, and adverse health outcomes. This study explored urban-rural differences in caregivers' willingness to support adolescent girls' contraceptive use, focusing on Awutu Senya East (urban) and Jaman North (rural) districts. A cross-sectional comparative design was employed, involving 366 caregivers. Data were collected using structured surveys and analyzed through descriptive, comparative, and modified Poisson regression techniques. Findings revealed that 68% of caregivers expressed willingness to support adolescent contraceptive use, with higher support in rural areas (76.2%) than in urban areas (63.5%). Key factors influencing caregiver willingness included gender, residential setting, and income level. Female caregivers and those in rural settings demonstrated greater support, while cultural beliefs significantly shaped attitudes toward contraceptive use. Caregivers cited pregnancy prevention, STI reduction, and health improvement as primary motivations for support, while concerns about promiscuity, infertility, and cultural or religious objections were common barriers. The study highlights the importance of addressing socio-cultural misconceptions, enhancing caregiver knowledge, and fostering supportive attitudes through targeted interventions. This study recommends community-based education, affordable contraception policies, and integrated family planning initiatives to enhance caregiver support and improve adolescent reproductive health outcomes.