Exploring Knowledge, Availability, Accessibility, and Utilization of Emergency Contraception in Ghana: A Scoping Review

In Ghana, emergency contraception (EC) was initially introduced in the form of combined oral contraceptive pills and has since expanded to include progestin-only formulations and other methods. Despite these advances, unintended pregnancy rates remain high, suggesting limited use of post-coital contraceptive methods. We undertook this scoping review to understand what is known about EC in Ghana, with a focus on knowledge, availability and accessibility, and utilization. We used an established framework to identify, chart, and summarize relevant source materials. We identified 57 source materials for inclusion in our review. We found that most EC research focuses on specific sub-populations, including students, urban dwellers, and unmarried women. Knowledge of EC varies but is almost exclusively centered on progestin-only emergency contraceptive pills (ECPs), and information appears to be sourced from both formal and peer-based channels. While progestin-only ECPs are available, geographic barriers to access persist. Some Ghanaians use progestin-only ECPs as their only ongoing method of pregnancy prevention, while others use them alongside traditional and modern methods. Although several EC modalities are available in Ghana, knowledge and use are almost exclusively related to progestin-only ECPs. Most studies have been conducted with students, urban populations, and unmarried women. Research documenting women's lived experiences with seeking and obtaining all modalities of EC, identifying ways to increase awareness about a range of methods, and understanding the experiences of those who use progestin-only ECPs as their primary pregnancy prevention strategy appears warranted.