Too young to die, too silenced to love: Sexual and reproductive health of young adults receiving palliative and end-of-life care in Ghana

英年早逝,无暇感受爱:加纳接受临终关怀和安宁疗护的年轻人的性与生殖健康

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Abstract

Young adults living with chronic noncommunicable diseases (NCDs) in Ghana face unique challenges that extend beyond physical and psychosocial suffering to include unmet sexual and reproductive health (SRH) needs. Yet, SRH remains a neglected aspect of palliative and end-of-life (EoL) care in the country. This article explores why SRH needs are rarely discussed in palliative and EoL care settings. It also examines the factors contributing to the high-unmet need for SRH needs, the repercussions, and possible actions that can be implemented to elevate SRH as a core dimension of palliative and EoL care service provision in the Ghanaian/African setting. The article argues that false assumptions, cultural barriers, policy gaps, and inadequate training contribute to the neglect of SRH in palliative and EoL care settings. The article identifies the following as strategies to surmount the identified barriers: integrating SRH as a core component of palliative care education in Ghana, developing a guideline or a protocol for assessing and handling SRH needs of young adults living with chronic NCDs, and adopting a person-centred approach when communicating about SRH matters. The article further highlights the potential of adopting the PLISSIT model as a practical framework to facilitate sensitive, structured discussions on sexuality in palliative settings.

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