depending on the circumstances. It seems possible that a girl may refer to herself as married 

during a long term relationship, as was the case in some of these interviews.  In addition, once 

one is married, either legally or by common law, it cannot be assumed that the nuclear, single 

family dwelling, or the pooling of resources is the arrangement into which families settle either 

currently or historically in Ghana. Thus the definition of who is and who is not married and what 

a  broken home  or a single parent family is, must be measured carefully according to local 

practices, and these may vary from region to region.     

Furthermore, the differences between the findings of this study of adolescent abortion 

and of the studies conducted among other groups, such as street youth or middle class youth, 

suggest that examining the data at the aggregate level masks differences that are important for 

program planning and implementation. Standardizing approaches instead of adapting them to 

specific groups can lead to programs that do not address the health behavior of the adolescent 

group the program is designed to change. For example, the assumption that girls are promiscuous 

or that boyfriends lack interest or responsibility in deciding whether to terminate a pregnancy can 

lead to alienation of the target group.  Girls may reject health messages about sexual behavior 

that do not seem to apply to them.  Or, important players in the decisionmaking process about 

how to handle an unintended pregnancy, such as boyfriends, may be ignored by programs. 

Based on these findings, the following recommendations were developed by an 

interdisciplinary group organized by NPC and the USAID mission in Ghana. 

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