Exploring Service Providers’ Perspectives On Facilitators And Barriers To Contraceptive Uptake Among Women: Implications For Policy Reform In Ghana

Abstract

Objective Healthcare providers play essential roles in delivering contraceptive and family planning services globally. In Ghana, previous research on contraceptive uptake among women has predominantly focused on clients in rural populations, leaving urban contexts and the perception of healthcare providers relatively underexplored. This study investigated the beliefs of service providers–physicians, midwives, and nurses regarding contraceptive uptake among women in Ghana. Method We performed a qualitative exploratory study involving twenty-eight in-depth interviews with family planning service providers in the Greater Accra Region of Ghana. Participants were purposively selected from two large district hospitals in Ghana’s most populous region. The interviews were audio-recorded and transcribed following data saturation. The transcribed data were analyzed thematically and systematically categorized to identify themes and subthemes based on Anderson’s Model of Health Service Utilization. Results Our study found four themes and eleven subthemes. The first theme, predisposing factors, included three subthemes: knowledge and education, peer influence, and availability and accessibility. The second theme, need factors, comprised two subthemes: desired child spacing and psychological considerations. The third theme, enabling factors, comprised two subthemes: the capacity of service providers and systemic support. The fourth theme, barriers to contraceptive uptake, included four subthemes: partner dispute, misconceptions, economic restraints, and side effects. Conclusion From the perspective of service providers, the uptake of contraceptives is shaped by a mix of predisposing, need, enabling, and contextual barriers. Factors like knowledge, education, peer influence, and accessibility influence awareness and the willingness to use contraceptives. Additionally, factors related to need, such as desired child spacing and psychological considerations, indicate women’s reproductive goals and readiness. Factors like provider capacity and systemic support boost confidence and improve service delivery. Barriers such as partner disagreement, misconceptions, economic challenges, and side effects hinder uptake. Enhancing provider training, broadening health coverage, and fostering community education can lead to more equitable contraceptive use among women.