Quantitative sampling procedure.

The number of fishers in Elmina is unknown due to the lack of national statistics on small-scale artisanal fishers. Therefore, the sample size for the quantitative data was calculated using the formula below:

(1)

n = sample size, Z score for 95% confidence interval = 1.96, SD is standard deviation = 0.5, and margin of error = 0.05.

(2)

From the calculation, the sample size was 384. However, the first author conveniently estimated the sample size to be 385. Consequently, a total of 385 fishers were interviewed. With the assistance of the chief fisherman and several contacts within the Elmina fishing community, the first author identified 10 fishers’ associations. These associations represent a variety of groups, including boat owners, male fish traders, female market queens who owned boats and made substantial investments in the fishing business, as well as porters of fish and boat repairers. This diversity underscores the multifaceted nature of the fishing industry in Elmina. After compiling the list of all members from these ten associations, a total of 690 members was identified. A simple random sampling procedure was employed to identify 385 study respondents.

Qualitative sampling procedure.

For the qualitative data, a purposive sampling procedure was used to select fishers and key informants. Thirty (30) key informant interviews (KIIs) were interviewed (See Table 1). Also, two (2) focus group discussions (FGDs) were conducted with ten (10) participants for each group. In total, twenty fishers participated in the FGDs. The FGDs consisted of two groups: male fishers and female fish traders. Participants in groups were chosen from the ten fisher associations, five of which represented male fishers and the other five representing female fish traders. Two fishers from each association were chosen to participate. Participants for the FGD were chosen based on age, residency status, and the ability to offer detailed information about fishing-related activities in Elmina. This approach ensured a diverse group that sufficiently represented a range of experiences essential for the study’s objectives.

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Table 1. Participants of the key informant interviews.

https://doi.org/10.1371/journal.pone.0325440.t001

The study population comprised artisanal marine water fishers aged 18 or older who were actively involved in fishing, fish transport, boat repair, fishing gear sales, and fish trade. The sample size was calculated to ensure accurate proportion estimates while considering financial constraints, survey distribution time, and the undefined number of fishers in the area. Participants, referred to as ‘fishers,’ were involved in diverse fishing-related activities, including fish catching, post-harvest processing (drying, smoking, marketing), equipment maintenance (boat repairs, net mending), and fish portering.

Quantitative data collection.

A semi-structured questionnaire was used to collect data from respondents (S1 Appendix). The semi-structured questionnaire covered various topics, including but not limited to mobility and settlement patterns and HIV risks, HIV and AIDS-related knowledge and attitudes, and risky sexual behaviors. However, the current study concentrated primarily on fisher participation in fish for sex, pregnancy, and birth from FFS relations, as well as associated parenting factors.

Qualitative data collection.

Interview guides were developed to collect data from key informants and FGD participants (S2 Appendix). The interviews and discussions were conducted in both English and the local languages of Fante and Twi. For the KIIs conducted in various administrative offices of the KEEA and NGOs, English was the predominant language used. All two FGDs were conducted in Fante, led by the first author, who is fluent in both Fante and Twi. Interactions with key members of fishers’ associations were also conducted in Fante and Twi. Each KII lasted between 30–45 minutes, while the FGDs ranged from one hour to one and a half hours. The KIIs and FGDs aimed to gather insights on fishing activities, community challenges, and the living conditions of fishers in and around Elmina. Participants were chosen based on their knowledge and ability to provide essential information pertinent to the research questions.

Participation in the study was voluntary, and all participants provided written informed consent prior to being interviewed (S3 Appendix). The study adhered to all ethical guidelines outlined in the Helsinki Declaration. Moreover, this study was reviewed and approved by the Ethics Committee for the Humanities at the University of Ghana (ECH 118/16–17). All data collected from respondents were stored on a password-protected laptop, which can only be accessible by the first author and authorized persons.

Quantitative data analysis.

Descriptive statistics (frequencies and percentages) were used to describe the quantitative data with the aid of the Statistical Package for Social Sciences version 27. We employed descriptive statistics (frequency and percentage) to describe the socio-demographic characteristics of respondents and the frequency of occurrence of FFS related female single parenthood in Elmina. The quantitative data is attached as S4 Appendix.

Qualitative data analysis.

The qualitative data was analyzed following Braun and Clarke’s reflexive thematic analysis (RTA)   six distinct phases [33] . The RTA framework allows for an interpretation of the collected data while acknowledging the subjectivity of the researchers’ perspectives. We captured, transcribed, and classified our data based on relevant issues identified in the study. To familiarize ourselves with the data, we carefully read the transcripts of respondents. To enhance the study, we produced narrative descriptions that illustrated the connections within the data, quoting statements from focus group discussions (FGDs) and key informant interviews (KIIs) in specific contexts.

The data analysis was conducted collaboratively by both authors, with the first author focusing primarily on the qualitative data and the second author handling the quantitative data. The themes for thematic analysis centered on the frequency of FFS-related female single parenting, the drivers of single parenthood in FFS relationships, and the effects of single female parenting.

Since this study used a convergent parallel mixed-methods design, we merged the quantitative and qualitative findings to compare them. The qualitative data is attached as S5 Appendix.

Uncertain paternity resulting from multiple sexual partners.

The FGDs and KIIs revealed that some women who had children with fishers after engaging in FFS become single parents when they were unable to confirm the father of their children due to having multiple FFS partners. Some participants narrated the following to support the theme:

Some women who may have had multiple sexual partners and are unsure of the father’s identity by the time they get pregnant. Consequently, they may choose to assume full responsibility for the child without considering the father’s identity. (KII 1, Municipal Health Directorate)

I find it difficult to comprehend the girls’ actions. How can one woman have three or more boyfriends in this small town? This is why many of them do not know the fathers of their children. All they care about is having sexual relations with fishermen after their expedition, a time when they have a lot of money to spend on women. (FGD 1, Female fisher)

Male partners’ denial of paternity due to suspicions of promiscuity.

Interviews with key informants and FGD participants revealed that some male FFS partners deny paternity of their children on suspicion of their FFS partners’ promiscuity, leading to single female parenting. Some participants shared the following insights:

Many women in the fishing community are unmarried and have no marital commitments, allowing them to have as many partners as they desire despite societal disapproval of such behavior. Due to this, some male fishers are aware that their partners have other partners and yet engage in sexual relations with them for sexual gratification. However, when unfortunate and unexpected pregnancies occur, some male fishers deny responsibility, accuse the women of being promiscuous, and urge them to blame their other boyfriends for the pregnancy. This often leads to single female parenting as the males refuse to take responsibility for the pregnancy and the child that comes out of it. (FGD 2, Male fisher)

My boyfriend accused me of having another man several times, which led to a lack of trust in our relationship. Since then, he has not provided for me and the child. Because he has neglected his responsibilities, I am raising my child alone, even though he knows they look alike and that he is his. (FGD 3, Female fisher)

Single parenting is very common in the community. Through radio and community awareness campaigns, we provide advice on protective measures, yet only a small number of individuals heed our guidance. No matter what you tell them, many fishermen refuse to use condoms. Additionally, male fishermen often have multiple female partners, and some fish traders will engage in sexual relations with them if they have access. When these women become pregnant, the men often claim they bear no responsibility. (KII 2, Community-Based Organisation).

Transient fishers who become untraceable sexual partners.

The KIIs also found that some FFS men are migrants who have brief sexual encounters, move, and sometimes never return to the community of the sexual encounter, leaving them untraceable if a woman becomes pregnant. Consequently, these women become single parents. A key informant had this to say:

In this community, most fishermen are migrants from other villages. They merely trade fish and leave the community. After exchanging FFS with the women, they go before the women get pregnant. Occasionally, authorities track down some of the migrant fishers and establish settlements. However, many never return and may not even know they have children in the fishing community they had the sexual encounter. (KII 2, Department of Fisheries).

Neglect of children by fathers engaged in multiple partnerships.

In Elmina, some male fishers follow a cultural norm of having multiple wives and additional FFS partners, leading to large families that are difficult to support. The male fishers often struggle to provide for all their children, including those from FFS relationships. Consequently, female FFS partners are left to care for their children independently. A key informant reported the following:

In some FFS relationships, women transition into the role of a wife without any formal marriage rites. Often, a woman is simply considered a wife by virtue of entering a sexual relationship with a man, which creates an informal partnership. This lack of formal commitment can complicate family dynamics and frequently leads to single parenting among women involved in FFS relationships. Many fishermen in these situations have multiple children across different households, making it difficult for them to provide adequate care for each one. (KII 2, Community-Based Organisation).

Paternal absence.

Key informants explained that children born out of FFS relationships often grow up without knowing their fathers, leaving them with fragmented family identities and limited guidance, especially in fishing communities. A key informant from the Fisheries Department reported that:

Many children in Elmina are unaware of their parents’ identities. If you go to the town right now and talk to many of them, they will tell you that they do not have fathers. While this may be disheartening, it is a reality within the fishing community. (KII 2, Department of Fisheries)

Women who have sex with fishers and cannot determine the paternity of their children or identify their fathers are unable to tell their children who their fathers are, leaving these children to grow up without knowledge of who their fathers are. Many such children are found in fishing communities. (KII 5, Community Member)

Maternal burden.

Both the male and female FGD participants highlighted that women who gave birth as a result of FFS relationships face the challenges of pregnancy and childcare alone, often without support, which restricts their ability to provide adequate care for their children and themselves. Participants expressed the following:

Most women involved in FFS relationships who become pregnant are often unable to locate their fathers or face rejection from them. As a result, they are left to manage their pregnancies and childcare alone, making it extremely challenging to provide adequate care for themselves and their children. (FGD 6, Female fisher)

Often, they (women) do not listen when you advise them, and when the men (fishers) refuse their pregnancies, then they rush to Social Welfare to complain. There are instances where we can invite some of the men to make settlements, but in many cases, we are unable to trace the men. As a result, the women struggle to support themselves, with their already impoverished family members unable to assist them. (FGD 7, Male fisher)

Also, KEEA officials elaborated that children frequently end up with grandparents as mothers struggle to cope, leading to inconsistent care and early self-supporting behaviors. Two officials shared the following:

With fathers denying paternity and abandoning their children, these children frequently end up living with their grandparents. Mothers grappling with anger and hardship may struggle to care for them effectively. Consequently, children born into FFS relationships face significant challenges, including inadequate parental care and early sexual relationships as a means of self-support. (KII 10, KEEA official)

Regrettably, when fathers fail to identify or accept responsibility for their children’s upbringing, their mothers also experience emotional disengagement from the children because of the father’s actions, leading to inadequate care. Frequently, grandparents take care of the children, but due to their age and insufficient income, they often struggle to provide adequate support. (KII 9, KEEA official)

Intergenerational cycle of FFS relationships.

During the FGDs, it emerged that daughters born out of FFS relationships may repeat similar behavior. Such children may also engage in FFS relationships when they grow up, which perpetuates the vicious cycle of FFS relationships and its adverse effects. Some participants explained this situation:

Some girls involved in FFS relationships within the community are daughters of women who have previously engaged in FFS. Often, these girls do not know their fathers and lack parental guidance. This lack of guidance allows them to act freely, usually associating with male fishers and engaging in similar relationships. (FGD 8, Female fisher).

Honestly, parents who had their children through FFS relationships naturally put serious impediments in their lives. Since these births typically stem from a lack of love, the children often feel burdened and learn that their parents do not care about them. In extreme cases, these children may rebel by engaging in risky sexual lifestyles such as FFS and commercial sex work. (FGD 9, Male fisher).

Child developmental challenges.

Interviews with key informants noted that the absence of a father figure creates emotional and social obstacles, hindering children’s identity formation and sense of belonging as they grow up. This consequently affects their development, especially their social and emotional development. A key informant indicated that:

Children from FFS relationships who grow up without a paternal figure are often raised by their mothers or grandparents. The absence of a father figure can lead to emotional and social challenges as they navigate their formative years. Without the guidance and support typically provided by a father, these children may struggle to develop a sense of identity and belonging within their communities. (KII 1, Community-Based Organisation)