Determinants of contraceptive use among female adolescents in the Shai-Osudoku District of Ghana

Adolescent contraceptive use is vital for preventing unintended pregnancies, reducing maternal morbidity, and supporting educational and socioeconomic opportunities among young girls. This study determined the prevalence of contraceptive use and examined factors associated with its use among female adolescents in the Shai-Osudoku District of Ghana. A community-based cross-sectional study was conducted among 389 adolescents aged 10–19 years in the Shai-Osudoku District. A modified Expanded Programme on Immunization (EPI) multi-stage cluster sampling technique was used to select adolescents for the study. Data were collected using a structured questionnaire via KoboCollect and analysed using STATA version 17. Chi-square and multivariable binary logistic regression analyses were performed at the 0.05 significance level. Overall, 76.9% of adolescents were currently using at least one modern contraceptive method. Among them, 54.2% demonstrated good knowledge (mean score 59.1%), and 50.9% held a positive attitude (mean score 64.9%) toward contraceptive use. In adjusted multivariable binary logistic regression, adolescents with Junior High School education had higher odds of use compared to those with no formal or primary education [aOR = 2.64 (95% CI: 1.21–5.78), p = 0.015]. Working adolescents were approximately six times more likely to use contraceptives than students [aOR = 6.10 (95% CI: 2.17–17.15), p = 0.001], and unemployed adolescents had approximately four times higher odds [aOR = 3.70 (95% CI: 1.15–11.90), p = 0.028]. Adolescents with good knowledge had significantly higher odds of contraceptive use compared to those with poor knowledge [aOR = 2.89 (95% CI: 1.60–5.22), p < 0.001]. Contraceptive use was high in the Shai-Osudoku District and was independently associated with Junior High School education, non-student occupational status, and good contraceptive knowledge, while attitude was not independently associated with use after adjustment. These findings suggest that advancing education, supporting out-of-school adolescents, and strengthening comprehensive knowledge programmes may improve contraceptive use in similar settings. Longitudinal research is needed to clarify causal pathways and evaluate targeted interventions.