AN INVESTIGATION OF FACTORS CONTRIBUTING TO LOW UPTAKE OF FAMILY PLANNING SERVICES IN WEST GONJA DISTRICT OF GHANA

Abstract

There is no information or scanty information on the factors associated with utilization of modern family planning methods in the West Gonja District. This study therefore examined the determinants of uptake of family planning services and the barriers in accessing family planning services among urban poor women. A community-based cross-sectional analytical study was conducted. Both quantitative and qualitative methods were used in the data collection.Thesampleincluded15familyplanningserviceproviders,300menintheagegroup of (17 -50) years and 600 women in the reproductive age group of (15 – 49) years. Structured questionnaires were used to interview 600 women while another 300 group of women were engaged in focus group discussions. The study was carried out in 30 communities that were selected using multi-stage cluster sampling method. In each of the study communities, 20 women were interviewed using a structured questionnaire whilst 10 women who were not interviewed with a structured questionnaire were engaged in focus group discussion. There were also 10 men in the focus group discussions in all the thirty communities. Information regarding socio-demographic factors, economic factors, women autonomy, and knowledge of family planning methods, barriers, availability and accessibility of family planning methods were gathered. The contraception prevalence rate (CPR) was 20.3 %. Multiple logistic regression analysis showed that the uptake of modern familyplanning methods was associated with the ability of women to discuss their health issues with service providers (OR = 1.10, 95 %CI: 1.9-2.4,P <0.001),householdwealthindex(OR=2.70,CI:1.7-4.4,P<0.001),number of daughters a woman have (OR= 0.471, 95 % CI: 0.31- 0.72, P <0.001) and maternal autonomy (OR= 1.413, 95 % CI: 1.09 -1.83, P< 0.009). Education level of husbands had a more positive effect on the uptake of family planning services, compared to the education level of their wives. Women’s education, economic and empowerment or autonomy were significant determinants of the uptake of family planning services in the study population. Also, the ability of the woman to discuss her health needs especially her reproductive health issues with a health service provider had a positive influence on the uptake of family planning services. Family planning service providers should freely avail themselves to women and encourage them to feel confident to discuss their health needs with them. Family planning behaviour change communication (BCC) that target both women and men should be strengthened in the district.