article · Sexual & Reproductive Healthcare
A cross-sectional survey of 613 in-school adolescents across 15 basic schools in Ghana assessed their functional literacy regarding written information on abstinence and condom use. Nearly half of the participants, 48.6 percent, demonstrated inadequate functional literacy, while 31.0 percent had marginal literacy and 20.4 percent had adequate literacy. Several factors influenced comprehension. Older adolescents aged 16 to 18 years had lower odds of higher literacy compared to those aged 10 to 12 years. Conversely, students in Grade 8 showed higher odds of literacy than those in Grade 7. Engagement with digital media also yielded distinct patterns: following trending celebrity news was linked to higher literacy, whereas seeking reproduction-related information online was associated with lower literacy. Overall sexual and reproductive health knowledge strongly correlated with higher literacy levels.
Sexual risk-reduction guidance can only protect young people if they can comprehend written health messaging. With almost half of the surveyed adolescents exhibiting inadequate functional literacy, standard educational materials may fail to communicate risks effectively. Recognising how age, school grade, and online media consumption influence understanding allows educators and public health organisations to design clearer, literacy-appropriate reproductive health resources.
The abstract does not indicate a commercialisation pathway, as it represents observational research aimed at educational and public health policy. However, the findings provide baseline evidence that educational content creators, health communication designers, and digital platform developers could use to produce literacy-appropriate sexual health materials. Any direct intervention or application based on these insights remains at an early developmental stage.
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OBJECTIVE: Adolescents' ability to understand written sexual risk-reduction information is an important component of sexual and reproductive health (SRH) literacy. This study assessed functional literacy related to abstinence and condom-use information among basic school adolescents in Ghana, and identified associated factors. METHODS: A cross-sectional survey was conducted among 613 adolescents from 15 basic schools using multistage and convenience sampling. Data were collected using self-administered questionnaires and analysed using descriptive statistics, bivariate analysis, and ordinal logistic regression with cluster-robust standard errors at the school level. RESULTS: 48.6% of adolescents had inadequate functional literacy, 31.0% had marginal literacy, and 20.4% had adequate literacy. Adolescents aged 16-18 years had lower odds of higher literacy than those aged 10-12 years (AOR = 0.196; 95% CI: 0.064-0.601; p = 0.004), whereas Grade 8 students had higher odds than Grade 7 students (AOR = 2.256; 95% CI: 1.534-3.317; p < 0.001). Following trending celebrity news was associated with higher literacy (AOR = 1.688; 95% CI: 1.090-2.614; p = 0.019), whereas accessing reproduction-related information online was associated with lower literacy (AOR = 0.531; 95% CI: 0.299-0.943; p = 0.031). High SRH knowledge was also associated with higher literacy (AOR = 2.532; 95% CI: 1.707-3.756; p = 0.001). CONCLUSION: Functional literacy related to abstinence and condom-use information was associated with age, grade level, digital information-seeking, and SRH knowledge. Age-appropriate and literacy-conscious SRH education delivered through accessible and contextually relevant information channels may strengthen adolescents' comprehension of sexual risk-reduction information.
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DOI: 10.1016/j.srhc.2026.101266
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