Pregnancy Planning And Associated Factors Among Reproductive-Aged Women In Urban Slums In Accra
Date
2022-03
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Publisher
University Of Ghana
Abstract
Background: Unintended pregnancy is one of the major public health issues globally. Around 44% of all pregnancies worldwide are unintended, with 74 million in low- and middle-income countries. In sub-Saharan Africa, about 29.1% of all pregnancies are unintended, with 35.8% in Ghana. It has been estimated that about 37.9% (5.4 million) of urban residents in Ghana live in slums with most of the slums in Accra. While previous studies have highlighted many aspects of the reproductive health situation of women in urban slums, pregnancy planning in urban slums in Ghana has received little attention in the literature. This study aimed to fill this gap by examining pregnancy planning and its related variables among reproductive-aged women living in urban slums in Accra, Ghana.
Methods: The data used for this study are part of a larger mixed method cross-sectional study conducted to examine contraceptive use behaviours and identify challenges to contraceptive use as well as potential low-cost interventions in urban slums in Ghana. The secondary data used for the analysis in this study covered a total sample of 541 reproductive-aged women in two large urban slums in Accra - Agblobloshie and Old Fadama. Descriptive, bivariate, and logistic regression analysis techniques were used to analyze the data.
Results: Results indicated that 65.9% (357) of the respondents who have ever been pregnant did not plan their first pregnancy whilst 54.9% (297) did not plan their most recent pregnancy. After adjusting for potential covariates, only one variable (monthly expenditure) remained significantly associated with the planning of the most recent pregnancy. In general, increasing monthly expenditure positively predicted the planning of the most recent pregnancy. Specifically, those who spent between GHC 500 and 1000 had higher odds of planning their most recent pregnancy (AOR=6.97, 95%CI: 6.90, 10.80; p<0.01) compared to those who spent less than GHC500. Similarly, the odds of planning the most recent pregnancy were over 13 times higher for those who spent between GHC 1001 and 1500 a month (AOR 13.19; 95%CI: 5.41-32.11; p=0.01) compared to those who spent less than GHC 500 a month.
Conclusions: The prevalence of unplanned pregnancy is high in urban slums in Ghana. Targeted community-level education on the benefits of family planning and how to prevent unplanned pregnancies are urgently needed in slum communities where this study was conducted. There is also a need for policymakers to make a continuous effort to improve the economic and/ or purchasing power situation of women and girls in urban slums to address the negative ripple effect of poverty on unwanted pregnancy, unsafe abortion, maternal mortality and the economy as a whole.
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Keywords
Pregnancy Planning, Urban Slums, Accra, Reproductive-Aged Women