Abstract
BackgroundAverage contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district.MethodsA case–control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15–49 years were interviewed using structured questionnaires. A logistic regression was fitted.ResultsAwareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives.ConclusionWhile modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.
Highlights
Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%
Health workers were the main source of family planning information in the district for both cases and controls, followed by friends and relatives and by radio
In addition to providing health facilities and consolidating the community based health planning and services (CHPS) initiative in the district, policies directed towards improving modern family planning method use need to consider raising the levels of formal education
Summary
Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. Uptake of modern family planning (FP) methods remains low in Sub-Saharan Africa (SSA) including Ghana. This may be associated with high incidence of unintended pregnancies, unsafe abortions, and maternal deaths [1,2]. Evidence from Bangladesh shows that long-term investment in an integrated family planning and maternal and child health (FPMCH) programme contributed to improved economic security for families, households, and communities through larger incomes, greater accumulation of wealth, and higher levels of education [8]. If individuals and couples, especially in the developing world, planned their pregnancies and families, with improved use of contraception, they are more likely to have fewer and healthier children which will reduce the socio-economic burden on them and allow more investment in each child’s care and education, helping to break the cycle of poverty
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