Sexuality education, condoms and contradictions: The views of educators and students in Ghana

Background: Condom education campaigns that aim to prevent early and unintended pregnancies can be undermined by local gender norms, religious edicts and ineffective sexuality education policies. In some schools in Ghana, both condom education and abstinence only education run concurrently. Methods: This study explored community attitudes towards condom education in a context of competing messages about sexuality education. The study adopted a qualitative case study approach involving three schools in the Komenda-Edina-Eguafo-Abrem Municipality of the Central Region of Ghana. Data were collected from in-depth interviews with pupils and educators. They were analysed by (1) template analysis and (2) using the Health Promoting Schools framework, which emphasises links between schools and communities in sexuality education programming. Findings: In the case study schools, condom education was implemented alongside abstinence education through partnerships between schools and the local community. Attitudes varied in the community – with some members rejecting condom education, while others encouraged their daughters into consensual relationships and contraception. The (Methodist) church locally also rejected condom education. The interplay between poverty and gender power relations puts young women at a disadvantage in decision-making about sex, including condom use. Simultaneously, cultural taboos and religious norms limit condom use and place 11- to 15-year-olds at risk of early and unintended pregnancy. Conclusion: Future policy must account for local gender norms, poverty and gender power relations, alongside prevailing religious beliefs that affect sexual health interventions. Unlike the current fragmented picture, a coherent sexuality education framework could effectively address these local factors, leading to better outcomes for sexuality and condom education programmes, with health and educational benefits for young people.