A report on adolescents' sexual reproductive health in Ghana has revealed that they do not use contraceptives to prevent pregnancy or Sexually Transmitted Infections, (STIs) because of lack of knowledge.

Ironically, there have been mass media education and school based programmes on sexual and reproductive health in Ghana for over two decades.

The depth of their knowledge is said to be inadequate even as majority of them are afraid to get pregnant.

Among adolescents aged 15-19, only 28% of females and 21% of males had detailed knowledge about pregnancy prevention; awareness of a woman's fertile period, ability to reject several popular misconceptions about pregnancy and familiarity with at least one modern method of contraception.

Among 12-14 years olds, only 12% of females and 6% of males had this level of knowledge.

The report said adolescents in general expressed little confidence that they could properly use the male condom which is the most common method of protection in this age group.

Between 15-19 year olds, only 29% of males said they were 'very confident' that they knew how to use a condom correctly, while just 31% females said they were very confident that they could get a male partner to use a condom.

Almost half of 15-19 year olds 46% of males and 48% of females admitted that they were not at all confident about using a male condom.

A 2004 research revealed that although about two-thirds of 15-19-year-olds (female and male) approve of family planning, most sexually active teenagers in Ghana do not use contraceptives. Among sexually active adolescents in this age-group, 80% of females and 63% of males do not use any modern method.

The report entitled, "Protecting the Next Generation in Ghana: New Evidence on Adolescent Sexual and Reproductive Health Needs", presents findings from a new body of research on adolescent sexual and reproductive health in Ghana.

It is part of a larger project, designed to contribute to the global fight against the growing HIV/AIDs epidemic among adolescents and conducted in Ghana, Burkina Faso, Malawi and Uganda, entitled "Protecting the Next Generation: Understanding HIV Risk among Youth."

Other findings emphasize that adolescents have received little information about using contraceptives and so have misconceptions about them. 31% of both males and females did not know that condoms should be used only once.

29% of females and 39% of males in this age group believed that using a condom was a sign that one did not trust one's partner. In the 2004 National Survey of Adolescents, over 90% of respondents reported that they had heard of at least one modern contraceptive method.

The best known methods were the male condom; familiar to 88% of females and 91% males, the female condom: 70% of females and 73% of males, the injectable: 57% of females and 56% of males and the pill: 53% of both females and males.

According to the report, adolescents have fair knowledge about HIV/AIDS and other STIs. This influences their decision about the use of contraceptive, particularly the condom.

The report cautions that when STIs are left untreated, they can have significant negative consequences, including infertility and increased susceptibility to HIV.

The World Health Organisation, (WHO) in a review of prevention interventions for young people in developing countries concluded that there was strong evidence to recommend curriculum-based interventions led by adults.

Family life education was introduced in Ghana on a pilot basis during the 1970s and implemented nationwide in 1987 at the basic and secondary school levels as part of the new educational system's social studies curriculum.

The report gives evidence that adolescents want sexual and reproductive education to be available in school. In the 2004 National Survey of adolescents, 91% females and 89% of males aged 12-19 who had ever attended school agreed to the importance of family life education to be taught in schools.

About two thirds thought such education does not encourage adolescents to have sex. However, there seem to be a gap between national sex education policies and their implementation.

"Protecting the Next Generation in Ghana" report recommends comprehensive and accurate information about sexual and reproductive health issues to increase adolescents' knowledge and counter their misconceptions. This will help adolescents safeguard and improve their health.

According to the report although knowledge does not guarantee that adolescents will change their sexual behaviour, it can empower them to make informed decisions about their reproductive health and may increase the odds that they will choose to protect themselves from unintended pregnancy and HIV/AIDs.

If possible, it suggests that interventions should expand access to comprehensive sexual and reproductive health information, including material on puberty, pregnancy, contraception and abstinence.

However, it is important to ensure that adolescents who are not in school also have access to comprehensive sexual and reproductive health education.