Document Type

Working Paper

Publication Date



This study reports on a primarily qualitative investigation of adolescent reproductive behavior in the Kassena-Nankana District, a rural isolated area in northern Ghana, where traditional patterns of marriage, family formation, and social organization persist. The study is based on in-depth interviews and focus groups with adolescents, parents, chiefs and traditional leaders, teachers, youth leaders, and health workers, supplemented by quantitative data from the 1996 wave of a panel survey of reproductive-aged women conducted by the Navrongo Health Research Centre. The social environment faced by adolescent boys and girls in the Kassena-Nankana District and its links to reproductive behavior are described. The principal question is whether even in this remote, rural area, the environment has been altered in ways that have undermined traditional sexual and reproductive patterns. The survey data indicate a considerable increase in educational attainment among younger women. In addition, it appears that the incidence of early marriage has begun to decline. The qualitative data suggest that social institutions, systems, and practices such as female circumcision, which previously structured the lives of adolescent boys and girls, have eroded, leading to an apparent increase in premarital sexual activity. The implications of these developments for adolescent health and well-being in the District are discussed.