Under-15s and sex: Ghana must talk, not look away

“One out of 10 adolescent girls and one out of seven adolescent boys engage in sexual intercourse before the age of 15.”

That single line from the Ghana Health Service at last Wednesday’s Adolescent Sexual Reproductive Health Summit in Accra should stop every policymaker, parent and teacher in their tracks.

This is not about morality debates. It is about facts, health and the future of a country where over 70 per cent of people are under 35.

When children under 15 are having sex, and half of them do it without any contraception, we have a public health emergency hiding in plain sight.

Dr Chris Opoku Fofie, Deputy Director of Family Health at Ghana Health Service (GHS), laid out the reality:  Unmet need for family planning among sexually active adolescents: 51 per cent — more than half want contraception but are not getting it.  

Adolescent pregnancies have stagnated around 10 per cent for years.

Each year, adolescents make up 10 per cent of antenatal registrants.  

The most worrying trend? Emergency contraception use has doubled among adolescent girls in the Greater Accra and Ashanti regions.

That sounds like progress until you hear the next line: adolescents are choosing emergency pills instead of condoms. 

Emergency contraception prevents pregnancy, not HIV and other STIs.

Replacing condoms with “Plan B” is trading one risk for another. Abstinence is a valid message.

But when one in 10 girls and one in seven boys under 15 are already sexually active, “just say no” alone leaves them unprotected.

It is like teaching road safety by saying “don’t cross the road” while children are already on the highway.

They need information, skills and access to services to avoid pregnancy, HIV and the dropout that follows.

The GHS is right: with 76 per cent of secondary school-age adolescents enrolled in school, classrooms are our most powerful platform.

That is where knowledge, values and life skills can be built. Ignoring reality in the name of policy purity costs our children their  future.

A teenage pregnancy often means a girl drops out. A new HIV infection at 16 means a lifetime of treatment, stigma and lost productivity.

The National Population Council ( NPC) is right - teenage pregnancy and new HIV infections are direct barriers to Ghana’s development.

We cannot talk about “demographic dividend” while a tenth of our girls are pregnant in their teens, and half of sexually active adolescents use no contraceptives.

There must be honest, age-appropriate comprehensive sexuality education.

Abstinence should be taught, but so should facts about puberty, consent, contraception, STIs and healthy relationships.Knowledge does not push children into sex.

It protects those who are already at risk.

Teachers need training and policy backing to have these conversations without fear.

Clinics and pharmacies must be spaces where a 15-year-old can ask questions without shame or judgment.

Youth corners, peer educators and confidential counselling work.

GHS, NPC and partners must scale what already works in pilot districts.

Prioritise condoms alongside emergency contraception.

Emergency contraception has a role, but the message must be clear: it is a backup, not a plan.

Dual protection — condoms for STIs + another method for pregnancy — must be the standard. 

Boys need to be in this conversation too, since one in seven are  sexually active under 15.

Parents, communities, faith leaders must join in. Schools cannot do this alone. Parents need tools to talk to their children early, before age 15. 

Communities must protect children from abuse and exploitation, which also drive early sex.

Faith leaders can frame sexual health within values of dignity and responsibility. 

GHS must work with NPC, the government, civil society and communities.

That partnership must move from  conferences to classrooms, clinics and homes.

We have two options. We can keep avoiding the topic until another 8,800 schoolgirl pregnancies show up next year.

Or we can accept that Ghanaian adolescents are growing up in a complex world and equip them with truth, skills and services.

Future generations will not judge us by the policies we avoided.

They will judge us by the children we protected. Ten per cent is not just a statistic.

It is thousands of girls and boys whose lives hang in the balance.

Let the Accra summit be the moment we stopped whispering and started acting.

Our young people are Ghana’s dividend.

Let us invest in their health now, so that they can build the Ghana we all want later.