Contents 

Page 

Acknowledgments....................................................................................................................... vii 

Summary ...................................................................................................................................... ix 

Map of the Ga Mashi Community of Central Accra.................................................................. xiv 

1 Introduction........................................................................................................................1 

1.1 

Purpose of the Study and Study Questions ............................................................3 

 1.2 

Background ............................................................................................................3 

2 

Methods and Research Process..........................................................................................7 

 2.1 

Study 

Methods .......................................................................................................7 

 2.2 

Case 

Studies 

........................................................................................................7 

2.3 

Teachers and School Personnel .............................................................................8 

 2.4 

Health 

Care 

Providers ............................................................................................8 

 2.5 

Informed 

Consent...................................................................................................8 

 2.6 

Staff 

Recruitment ...................................................................................................9 

 2.7 

Research 

Schedule .................................................................................................9 

  2.7.1 

Phase 

One...................................................................................................9 

  2.7.2 

Phase 

Two..................................................................................................9 

  2.7.3 

Phase 

Three..............................................................................................10 

2.8 

Demographic Characteristics of Case Study Participants....................................10 

3 

Growing Up: Work, Aspirations, Dating, and Sex ..........................................................13 

3.1 

School, Work, and Aspirations ............................................................................13 

3.2 

Boyfriends, Dating, and Sex ................................................................................15 

3.3 

Common Sense in Dating and Girls' Reports of Parental Supervision ...............16 

 3.4 

First 

Sex ...............................................................................................................19 

4 

Knowledge About the Body, Menstruation, Sex and Contraception, and  

Pregnancy Intentions and Strategies for Preventing Pregnancy ......................................23 

 4.1 

First 

Menstruation................................................................................................23 

4.2 

Learning about Sex and Related Topics from Teachers ......................................24 

 4.3 

Fertile 

Period........................................................................................................25 

4.4 

Pregnancy Intended or Unintended?....................................................................26 

4.5 

Using Periodic Abstinence...................................................................................26 

4.6 

Using Modern Contraception: Understanding and Practice ................................27 

iii