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Exploring the influence of psychosociocultural factors on substance use among adolescent expectant mothers in Bolgatanga municipality: a qualitative study

Por: Abagye · N. · Daliri · D. B. · Deegbe · D. A. · Adjorlolo · S. · Afaya · A.
Background

Substance use among adolescent expectant mothers is a significant public health concern due to its adverse effects on both maternal and fetal health. Despite this, there is limited evidence regarding the patterns and factors influencing substance use among pregnant adolescents in Ghana.

Objective

This study aimed to explore the psycho-social and cultural factors that influence substance use among adolescent expectant mothers attending the antenatal clinic at the Upper East Regional Hospital in the Bolgatanga municipality.

Design

A qualitative, descriptive exploratory design was employed. 17 adolescent expectant mothers were purposively recruited and interviewed using a researcher-developed semistructured guide. Interviews were audio-recorded, transcribed verbatim and analysed using a six-step thematic analysis guided by a deductive approach. The study was underpinned by the socioecological model, which allowed for the exploration of knowledge, social and cultural factors influencing substance use during pregnancy.

Setting and participants

The study was conducted at the antenatal clinic of the Upper East Regional Hospital in Bolgatanga and involved adolescent expectant mothers attending the clinic.

Results

Analysis revealed three major themes: knowledge of substance use, social factors and cultural factors influencing substance use. Participants demonstrated understanding of substance use, including its definition, causes and potential consequences. Social influences, particularly peer pressure and family dynamics, were reported as motivating factors for substance use. Cultural factors, including local beliefs, practices and community attitudes, also played a significant role in shaping substance use behaviours among these adolescents.

Conclusion

The findings indicate that while adolescent expectant mothers possess knowledge about the risks and consequences of substance use during pregnancy, many continue to engage in such behaviours. Peer and family influences, alongside cultural beliefs and community attitudes, were identified as key drivers of substance use. These results highlight the need for targeted, culturally sensitive substance use education and intervention programmes within antenatal clinics and the broader community to support adolescent mothers in reducing substance use during pregnancy.

Stakeholder perspectives on contextual barriers to the successful implementation of multiple family group therapy in the Lower Manya Krobo District, Ghana: a qualitative study

Por: Boakye · D. S. · Adjorlolo · S.
Objective

This study aimed to examine the contextual barriers that may hinder the implementation of multiple family group therapy (MFGT) in Ghana’s Lower Manya Krobo District.

Design

An exploratory, descriptive, qualitative study employing focus group discussions and in-depth interviews.

Setting

Atua Government Hospital in the Lower Manya Krobo District. Data were collected between February and March 2025.

Participants

12 young people living with HIV (YPLHIV; aged 12–22 years), 13 caregivers and five healthcare professionals were selected via purposive sampling.

Results

Four major themes emerged: (1) resource and logistic constraints, including transportation challenges, programme sustainability concerns and inadequate physical facilities; (2) stigma and confidentiality concerns, encompassing public identification fears and community stigma; (3) implementation challenges, involving attendance reliability and organisational instability; and (4) participation barriers, including group setting anxiety and delayed HIV status disclosure. These barriers spanned multiple domains of the Consolidated Framework for Implementation Research (CFIR), highlighting the complex, multi-level nature of implementation challenges.

Conclusion

Successful implementation of MFGT for YPLHIV in Ghana requires addressing interrelated barriers across multiple ecological levels simultaneously. These findings largely underscore the importance of exploring the local context for potential barriers to inform the adaptation of evidence-based interventions to accommodate ecological concerns.

Trial registration number

NCT06701942.

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