Barriers to accessing contraceptive services for adolescents in Sub-Saharan Africa: a scoping review

Adolescents in Sub-Saharan Africa (SSA) continue to face significant barriers to accessing contraceptive services, despite global and regional commitments to improve sexual and reproductive health (SRH) outcomes. This scoping review synthesises current evidence on the barriers adolescents encounter when seeking contraceptive services across SSA. Following the Arksey and O'Malley framework and the Joanna Briggs Institute guidelines, a comprehensive literature search of peer-reviewed and grey literature published between January 2010 and January 2025 across multiple databases was conducted. A total of 30 studies met the inclusion criteria. Thematic synthesis revealed five major categories of barriers: individual-level [limited knowledge, fear of side effects, misconceptions], sociocultural [stigma, religious beliefs, parental disapproval], economic [cost of services and transportation], health system-related [provider attitudes, confidentiality concerns, facility accessibility], and policy/legal [age restrictions, mandatory parental consent, poor coordination among agencies]. The findings highlight how these multi-level barriers intersect to impede adolescents' access to contraception, contributing to high rates of early pregnancy, unsafe abortion, and sexually transmitted infections. Notably, research gaps remain regarding marginalised groups such as LGBTQ+ youth and adolescents with disabilities. The review emphasises the need for adolescent-centred policy reforms, improved provider training, expanded community engagement, and equitable financing mechanisms to support adolescent access to contraception. These findings can inform strategies for achieving the Sustainable Development Goals (SDGs) related to health and gender equality in Sub-Saharan Africa.