Predictors Of Modern Contraceptive Use In Ghana, 1998-2008

Abstract

Background: Contraception is an effective means of reducing fertility and improving women’s health. Family planning services became available to Ghanaians over five decades ago. One of the aims was to increase prevalence of modern contraceptive use to 28% by 2010 and to 50% by 2020 but the contraceptive prevalence has been low. Only 23% of Ghanaian women are using modern methods as at 2012 while unmet need for contraception stands at 34%. Studies have been done to determine the predictors of modern contraceptive use in Ghana, however not much has been explored to determine the changes in the predictors over time. Knowing the predictors of modern contraceptive use, and the changes in the predictors over time will help managers of family planning programmes to appropriately focus interventions for improved outcomes and hence increase prevalence of current use. Objectives: To determine the socio-demographic factors that predict modern contraceptive use and changes in the predictors between 1998 and 2008 using Ghana Demographic and Health Survey data. Methods: Secondary data from the Ghana Demographic and Health and Surveys conducted in 1998, 2003 and 2008 were analyzed. Chi square test was used to determine association between demographic characteristics and current use of modern methods, while logistic regression techniques were used to determine variables that best predict contraceptive use. Results: The results showed that discussion of family planning among partners, husband’s approval of family planning, formal education at secondary and higher level and parity were significant predictors of Ghanaian women currently using modern contraceptives. In 1998 and 2003 women who discussed family planning with their partners frequently were more likely to use contraceptives compared with their counterparts who had never had such discussions (OR: 5 6.7 95% CI: 4.42 -10.22) and (OR:4.8 95% CI:3.59-6.47) respectively. Likewise, husband’s approval of family planning was associated with contraceptive use in 1998 and 2003; also educational status increased the likelihood of contraceptive use from 2003 and 2008. Parity of four or more children increased the likelihood of contraceptive use in all surveys. There were changes in the predictors of modern contraception between 1998 and 2008. Age and fertility preference which were not predictors in 1998 and 2003 predicted modern contraceptive use in 2008 except for age group 45-49 years. Place of residence and marital status which were predictors in 1998 no longer predicted modern contraceptive use in 2003 and 2008. Educational status which was not a predictor in 1998 predicted modern contraceptive use in 2003 and 2008. The income level of Ghanaian women did not predict modern contraceptive use except in 2008 when women in the richer quintile only were more likely to use modern methods compared to their poorer and richer counterparts. Conclusion: Discussion of family planning among partners, husband’s approval of family planning, formal education at secondary and higher level and parity were significant predictors of modern contraceptive use in Ghana. There were changes in the predictors for the surveys as well as the relative strengths of the predictors. The Strongest predictor was discussion of family planning among partners followed by husband’s approval of family planning, parity and educational status. Recommendation: Family planning programmes should include education on how partners initiate and sustain discussions about modern contraceptive use. Female education at least up to high school level should be given priority by the government. Family planning programmes at all levels should involve men.