Faith, Social Protection, and Reproductive Health among Kayayei in Old Fadama

Menstrual Stigma and Fertility Awareness in Context

Abstract

This article examines how religiosity shapes reproductive health knowledge, menstrual stigma, and contraceptive decision-making among ‘kayayei’ (female head porters) in Old Fadama, Accra. A cross-sectional survey of 342 participants, paired with qualitative narratives, indicates that religious norms of impurity and silence constrain menstrual hygiene practices, fertility awareness, and condom use in this informal settlement. Nearly half of respondents reported no knowledge of proper menstrual hygiene, and 70 percent had never heard of condoms. Qualitative accounts describe how faith-mediated taboos exclude menstruating girls from communal spaces and suppress open discussion of reproductive health. Comparison with a school-based study in the Kpando Municipality shows that structured education can counteract these norms. The article argues that social protection and reproductive health interventions must engage faith-based actors as partners (not as obstacles) to reach marginalised young women outside formal education systems.