Navigating Care: Behavioural Determinants of Adolescent Sexual and Reproductive Health Service Delivery in Healthcare Organisations in the Greater Accra Region

Abstract

Over the years, Ghana’s growing cultural and patient diversity has become increasingly evident in healthcare facilities, raising important concerns about how provider behaviours shape service delivery and health outcomes. However, little is known about how healthcare professionals’ behaviours influence service delivery within multicultural healthcare settings. This study explored the behavioural determinants shaping healthcare professionals’ (HCPs’) delivery of adolescent sexual and reproductive health services (ASRHs) within healthcare organisations in the Greater Accra Region. The study employed a qualitative descriptive design, using two complementary theoretical frameworks; COM-B and Campinha-Bacote’s models to understand the behaviours of the service providers. The study focused on HCPs delivering adolescent sexual and reproductive health services (ASRHs) to migrant adolescents in selected facilities in Greater Accra Region. Convenience sampling was used to recruit 10 HCPs after saturation was reached. Data were collected through (4) in-depth interviews (IDIs), (4) key informant interviews (KIIs), and 6 in the FGD, some HCPs participated in more than one data collection method.  The study found that HCPs had limited confidence and cultural competence to effectively address cultural and communication barriers during service delivery. These challenges hindered discussions on sensitive topics such as family planning and safe abortion, resulting in reliance on untrained interpreters and inadequate community outreach services. The study concludes that limited confidence and capability among HCPs led to sub-optimal care, undermining ASRH service delivery within multicultural healthcare organisations. The study informs organisational policies and workforce practices that strengthen behavioural competencies among HCPs and enhance the quality of care in culturally diverse...