Stakeholder perspectives on contextual barriers to the successful implementation of multiple family group therapy in the Lower Manya Krobo District, Ghana: A qualitative study

Objective This study aimed to examine the contextual barriers that may hinder the implementation of multiple family group therapy (MFGT) in Ghana's Lower Manya Krobo District. Design An exploratory, descriptive, qualitative study employing focus group discussions and in-depth interviews. Setting Atua Government Hospital in the Lower Manya Krobo District. Data were collected between February and March 2025. Participants 12 young people living with HIV (YPLHIV; aged 12-22 years), 13 caregivers and five healthcare professionals were selected via purposive sampling. Results Four major themes emerged: (1) resource and logistic constraints, including transportation challenges, programme sustainability concerns and inadequate physical facilities; (2) stigma and confidentiality concerns, encompassing public identification fears and community stigma; (3) implementation challenges, involving attendance reliability and organisational instability; and (4) participation barriers, including group setting anxiety and delayed HIV status disclosure. These barriers spanned multiple domains of the Consolidated Framework for Implementation Research (CFIR), highlighting the complex, multi-level nature of implementation challenges. Conclusion Successful implementation of MFGT for YPLHIV in Ghana requires addressing interrelated barriers across multiple ecological levels simultaneously. These findings largely underscore the importance of exploring the local context for potential barriers to inform the adaptation of evidence-based interventions to accommodate ecological concerns. Trial registration number NCT06701942.