Healthcare workers experiences in providing comprehensive abortion care to adolescents in the Eastern region of Ghana: A qualitative study

Globally, less safe or least safe abortion among adolescents remains a public health concern. In Ghana, complications from less safe and least safe abortions result in approximately 43,000 facility-based post-abortion care cases annually, contributing significantly to the overall burden of maternal morbidity and mortality. Healthcare workers play a critical role in delivering comprehensive abortion care (CAC) services to address the challenges of less safe and least safe abortion. At the same, there is scanty literature in Ghana on the experiences of these healthcare workers. This study explored the experiences of healthcare workers in providing CAC to adolescents in the New Juaben Municipality in Eastern Region, Ghana. A phenomenological qualitative study was conducted. Data were collected from November 2022 to January 2023 among 12 healthcare providers. Prior to data collection, ethical approval was obtained from the Ghana Health Service (GHS) Ethics Review Committee (GHS-ERC: 039/11/22). Participants who had provided CAC services for at least 6 months were purposively sampled. In-depth interviews were conducted and audio-recorded with permission from participants. The interviews were transcribed verbatim and inductive thematic analysis was done using ATLAS. ti. Results were presented using quotes. Three main themes emerged, namely desire to minimize harm, attitudes and beliefs toward CAC provision for adolescents, and stigma and psychosocial impacts of providing CAC services. First, providers offered CAC to adolescents to reduce maternal morbidity and mortality, viewing their work as life-saving and a way to prevent less safe and least safe abortions and promote contraceptive use. Second, providers’ attitudes and beliefs were shaped by professional duty, personal discomfort, religious and moral dilemmas, and empathy for adolescents’ vulnerability. Third, stigma and psychosocial impacts influenced their experiences. Many faced judgments from colleagues and society, leading to emotional distress and, in some cases, psychological trauma. The experiences of healthcare providers in delivering CAC to adolescents in the New Juaben Municipality reflect a complex interplay of professional responsibilities/ obligations, national health policy requirements, personal and religious beliefs, and societal stigma. Addressing these challenges requires coordinated and targeted interventions. These include institutionalizing values clarification and attitude transformation (VCAT) training, integrating cultural competence into provider education, and ensuring legal and ethical accountability that emphasizes patient safety over personal beliefs. Structured mentorship and peer support programs are also essential to reduce emotional burden and sustain provider motivation. Expanding task sharing to include other trained cadres can enhance service continuity and retention. Finally, strengthening public education on safe abortion care is critical to destigmatizing CAC and fostering an environment where providers can deliver adolescent-centered care effectively.