Factors Influencing Contraceptives Use among Female Migrants in Ghanaian Cities, A case of Kayeyei in the Kumasi Metropolis

Abstract

Historically, women in Africa have long been known to transport agricultural produce, firewood, and pots of water by way of the head for domestic use. This culture has been transformed into feminised unskilled labour termed Kayayei in Ghanaian cities as a fallout from poor education outcomes and its attendant lack of sustainable jobs in the rural areas. Kayayei is used in Ghana to refer to young female migrants between the ages of 8-35 years from the poverty endemic areas of northern Ghana engaging in head porterage business in the cities as a means of survival. The increasing incidence of kayaye and its attendant social, health and economic problems have attracted media and research commentary in Ghana in recent times. This study investigates contraceptive use among kayayei in the Kumasi metropolis of Ghana to inform strategies to improve the reproductive health of the low-income group. The study uses a mixed-method design. A structured survey questionnaire was administered to 121 kayayei. Further, 44 participants were selected from the 121 kayeyei to participate in focus group discussions (FGD). These were complemented with individual interviews of a pharmacist, a chemist shop attendants, and a drug peddler [unlicensed medicine walker]. Statistical Package for Social Sciences (SPSS) was used to analyse the quantitative data from the survey questionnaire, while descriptive coding was used to analyse the qualitative data from FGDs, interviews and field observation. The findings revealed that male partners’ approval was the major determinant of contraceptive use among the participating migrant female head porters. Some 90% of women who were less likely to use contraceptives are those who never discuss or get approval from their partners. Oral contraceptives, intrauterine devices (IUD) and condoms were the most used contraceptive among the kayayei. Participants’ choice of contraceptives was influenced by affordability, accessibility and their perceptions about contraceptive security. The study also identified that side effects from the use of contraceptives, including inconveniences on menstruation, weight gain, and weight loss, were a set of factors that demotivate contraceptives use among the research participants. The study also identified that, although culture has a significant influence on contraceptive use in Africa generally, in the case of migrant young women who have escaped from the cultural scrutiny of their home communities, their sexual partners, rather than culture, have a significant influence on their contraceptives use. The study, therefore, recommends an aggressive public education campaign on contraceptives use targeting both kayayei and their sexual partners in Ghanaian cities, while family planning services are accessible and affordable to this low-income group.