Contraceptive use by women in Accra, Ghana: results from the 2003 Accra Women's Health Survey.
ABSTRACT The study was to determine the predictors of use of modern contraception among women in Accra, Ghana. Data were collected by trained interviewers using questionnaires. Complete data for 2199 women were analysed using Stata 8.2. The study showed that educational status was the most significant predictor of contraceptive use. Women with no formal education had a 48% reduction in the odds of having ever used contraception and a 66% reduction in the odds of currently using contraception. Regular use of health facilities did not affect contraceptive use. Female education should continue to be a priority of the Ghanaian government. Education about family planning and the effects of having large families should be integrated into the school curriculum. Ghanaian health workers need to be active in promoting the use of modern contraceptive methods.
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ABSTRACT: BACKGROUND: In most resource poor countries, particularly sub-Saharan Africa, modern contraceptive use and prevalence is unusually low and fertility is very high resulting in rapid population growth and high maternal mortality and morbidity. Current evidence shows slow progress in expanding the use of contraceptives by women of low socioeconomic status and insufficient financial commitment to family planning programs. We examined gaps and trends in modern contraceptive use and fertility within different socio-demographic subgroups in Ghana between 1988 and 2008. METHODS: We constructed a database using the Women's Questionnaire from the Ghana Demographic and Health Survey (GDHS) 1988, 1993, 1998, 2003 and 2008. We applied regression-based Total Attributable Fraction (TAF); we also calculated the Relative and Slope Indices of Inequality (RII and SII) to complement the TAF in our investigation. RESULTS: Equality in use of modern contraceptives increased from 1988 to 2008. In contrast, inequality in fertility rate increased from 1988 to 2008. It was also found that rural--urban residence gap in the use of modern contraceptive methods had almost disappeared in 2008, while education and income related inequalities remained. CONCLUSIONS: One obvious observation is that the discrepancy between equality in use of contraceptives and equality in fertility must be addressed in a future revision of policies related to family planning. Otherwise this could be a major obstacle for attaining further progress in achieving the Millennium Development Goal (MDG) 5. More research into the causes of the unfortunate discrepancy is urgently needed. There still exist significant education and income related inequalities in both parameters that need appropriate action.International Journal for Equity in Health 05/2013; 12(1):37. DOI:10.1186/1475-9276-12-37 · 1.71 Impact Factor
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ABSTRACT: Pervasive gendered inequities and norms regarding the subordination of women give Ghanaian men disproportionately more power than women, particularly in relation to sex. We hypothesize that lack of sexual empowerment may pose an important barrier to reproductive health and adoption of family planning methods. Using the 2008 Ghana Demographic Health Survey, we examine the association between women's sexual empowerment and contraceptive use in Ghana among nonpregnant married and partnered women not desiring to conceive in the next three months. Increasing levels of sexual empowerment are found to be associated with use of contraceptives, even after adjusting for demographic predictors of contraceptive use. This association is moderated by wealth. Formal education, increasing wealth, and being in an unmarried partnership are associated with contraceptive use, whereas women who identify as being Muslim are less likely to use contraceptives than those who identify as being Christian. These findings suggest that to achieve universal access to reproductive health services, gendered disparities in sexual empowerment, particularly among economically disadvantaged women, need to be better addressed.Studies in Family Planning 09/2012; 43(3):201-12. DOI:10.1111/j.1728-4465.2012.00318.x · 1.28 Impact Factor
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ABSTRACT: To describe sexual and reproductive health among women in Accra and explore the burden of sexual and reproductive ill health among this urban population. Cross-sectional study. We analysed data from the WHSA-II (n=2814), a cross-sectional household survey on women's health, and supplemental data from an in-depth survey (n=400), focus groups discussions (n=22) and in-depth interviews (n=20) conducted among a sub-sample of women which focused specifically on reproductive health issues. Modern contraceptive use was uncommon. More than one third of women reported ever using abstinence; condoms, injectables and the pill were the most commonly reported modern methods ever used. The total fertility rate among this sample of women was just 2.5 births. We found a considerable burden of sexual and reproductive ill health; one in ten women reported menstrual irregularities and almost one quarter of women reported symptoms of a Sexually Transmitted Infection (STI) or Reproductive Tract Infection (RTI) in the past 6 months. Focus group results and in-depth interviews reveal misperceptions about contraception side-effects and a lack of information. In urban Ghana, modern contraceptive use is low and a significant proportion of women experience reproductive ill health (defined here as menstrual irregularity or RTI, UTI, STI symptoms). Increased access to information, products and services about for preventive care and contraception could improve reproductive health. More research on healthy sexuality and the impact of reproductive ill health on sexual experience is needed.Ghana medical journal 06/2012; 46(2):58-65.