Utilization of Contraceptives among Serving Military Women in the Greater Accra Region of Ghana

Abstract

Background: There is ongoing annual increase in the proportion of women in the military globally and Ghana is no exception with women making up 14% of the military population in the Greater Accra Region. Military women work in male-dominated environment and often wish to reduce disparities in physical capabilities with their male counterparts to the barest minimum. Female military personnel are disadvantaged compared to their male counterparts mainly due to their reproductive role and its associated risks. For instance, compared to military men, military women are withdrawn from participation in peacekeeping duties and standard military courses due to pregnancy. This affects the carrier progression and welfare of military women and negatively affect available troop numbers for deployment. The biggest threat to female troops and the major reason for their repatriation to their home countries during combat and peacekeeping operations was pregnancy. Pregnancy in military operational area can consume medical and evacuation resources and reduce the available military strength. Yet, most studies show half of all pregnancies are unplanned. This calls for increased urgency in the adoption and implementation of female reproductive health policies. Evidence shows that contraception is an essential tool to reduce unplanned pregnancies and improve, promote and maintain female sexual and reproductive health. Objective: To investigate contraceptive utilization among military women in the Greater Accra Region of Ghana. Method: A community-based quantitative cross-sectional design was adopted for the study. A two-stage cluster sampling technique was used to select 453 military women across the various military locations in the Greater Accra Region. A structured interview-administered questionnaire was used to collect data electronically using Kobo Collection Toolbox. The data was exported to Microsoft Excel (Version 2016), where the data was cleaned and further exported to Stata software version 15.0 for statistical analysis. Univariate analysis was used to describe the variables. Bivariate analysis using Chi-square technique was performed to test the associations between independent variables and contraceptive utilization. Multiple logistic regression analysis was also carried out 00 the individual, sociocultural and health system factors. Crude and adjusted odds ratios and their 95% confidence intervals were used to assess the strength of association. Statistical significance was accepted at p≤0.05. Results: The results show that the proportion of military women who were using contraceptives (all methods) in the Greater Accra Region of Ghana was 45 %. Further, the proportion of military women who were using modem methods was 31.8% while 13.2% used traditional methods. The proportion of military women who had adequate knowledge on contraceptive methods was 90.9%. The Arm of service (AOR= 1.90; 95% CI-1.06-3.29), number of deliveries (AOR= 2.38; 95% CI=1.I8 - 3.47), contraceptive availability (AOR= 0.32; 95% Cl=0.19-0.54), partner's approval (AOR= 0.34; 95% CI-O.22-0.52) and knowledge (AOR=2.2; 950% CI=1.1 1-5.20) were found to be significantly associated with utilization of contraceptives. Conclusion: This study found that the proportion of military women who currently used contraceptives was high when compared to the Greater Accra Regional and the national average. Military women's awareness and knowledge of contraceptives was very high but this did not necessarily translate into significant usage due to fear of side effects, religious prohibition and husband's disapproval. Therefore, partners of military women and religious leaders should be included in contraceptive education programmes and discussions. Majority of military women were using the less effective, short-acting reversible modem contraceptives such as the Pill and Condoms rather than the more effective, long-acting reversible contraceptives and permanent methods. Nearly half of military women had never received contraceptive education since being recruited or commissioned into the Ghana Armed Forces. Additionally, Air force Military Women had much higher contraceptive utilization compared to their Army counterparts.