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Cost Analysis – Measuring the economic burden of adolescent sexual and reproductive health, Ghana

This study examines the effects of SRH on adolescents’ human capital development, in order to understand the magnitude of the burden of poor adolescent sexual and reproductive health service delivery in Ghana and provide a strong evidence base for future advocacy for increased funding in the sector.

There is ample theoretical basis for interrogation of the impact of current levels of adolescent sexual and reproductive health service delivery in Ghana on health, educational and labour market participation outcomes, and the economic burden to the country associated therewith. There is, currently, however, no evidence in the literature on the magnitude of this economic burden. Moreover, there is little evidence of how gender, socio-economic status and other demographic factors may contribute to the manifestation of these effects. This study, therefore, aims to fill these gaps in the literature, by examining these effects of SRH on adolescents’ human capital development, in order to understand the magnitude of the burden of poor adolescent sexual and reproductive health service delivery in Ghana, and provide a strong evidence base for future advocacy for increased funding in the sector. This study will use a combination of data on adolescent sexual and reproductive health services, practices, outcomes, budgeting and financing in Ghana to examine the current provision adolescent sexual and reproductive health in Ghana, and the economic and health burdens that accrue as a result thereof. Specifically, the study will answer the following research questions:

  • What is the nature of the adolescent sexual and reproductive health sector in Ghana, and to what extent is this sector prioritized in Ghana’s development agenda, policy and programming documents, and health sector strategic objectives?
  • What is the current provision of adolescent sexual and reproductive health services in Ghana, and what is the financing landscape?
  • What is the current status of adolescent sexual and reproductive health service provision and outcomes in terms of efficiency and equity of services and outcomes?
  • How have these outcomes manifested as negative health impacts, and how, in turn, have these impacts been realized as economic burdens?
  • What is the total size of these burdens, and how are they broken down by: (i) pathway/mechanism; and by (ii) type of cost (e.g., health, employment, educational outcomes)
  • What other burdens and/or outcomes, if any, have an impact upon adolescents in Ghana but could not be adequately monetised (e.g., due to incomplete data required to monetise costs)
  • To what extent, and how, do various socio-demographic factors contribute to the manifestation of the effects?
    • Does poor sexual and reproductive health have a larger impact on outcomes for girls than it does for boys in Ghana?
    • Does poor sexual and reproductive health have a larger impact on outcomes for adolescents from lower income families?
    • Does poor sexual and reproductive health have a larger impact on outcomes for rural adolescents compared to those residing in urban areas?
    • Are younger adolescents (i.e., aged 10-14 years) affected differently than older adolescents (i.e., aged 15-19 years)?
  • Based on ‘what works’ in similar LMICs:
    • How does the Government of Ghana’s current expenditure compare to comparable countries?
    • What recommendations could be made to improve outcomes for girls and boys, and reduce the economic burden of adolescent sexual and reproductive health in Ghana?

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