Determinants of Modern Contraceptive Use among Young Women in Ghana

Abstract

Background: Unintended pregnancy among young women is a major challenge that hinders attainment of optimal reproductive health. Little is known about contraceptives young women use and factors that influence their use. Knowledge on the determinants of modern contraceptive use among young women in Ghana is essential for intervention programmes targeted at improving young women’s reproductive health. Objective: To examine the use of modern contraceptives and its determinants among young women in Ghana. Methods: An analysis of data from 2017 Ghana Maternal Health Survey (GMHS) involving 4,267 sexually active young women aged 15–24 years and were not pregnant during the survey. Pearson’s chi-square test of association and logistic regression were used to examine the determinants of modern contraceptive use among study participants. Results: Overall prevalence of modern contraceptive use was 27.6% among the study participants; 20% among females aged 15-19 years and 31.4% among 20-24 years. The male condom was the most widely known modern contraceptive (97.4%), followed by injectable (93.7%) and implants (90.3%); male sterilisation was the least known modern contraceptive (34.7%). The injectable was the widely used modern contraception method (25.8%), followed by implant, male condom, and pills. Multiple logistic regression analysis showed the following factors as significant determinants of modern contraceptive use among young women in Ghana: age (aOR = 1.46, 95% CI = 1.23- 1.74, p<0.001); being formerly married (aOR = 1.79, 95% CI = 1.21-2.65, p=0.004) or cohabiting (aOR = 1.34, 95% CI = 1.09-1.63, p=0.005); primary education (aOR = 1.35, 95% CI = 1.02-1.80, p=0.038), JHS education (aOR = 1.44, 95% CI = 1.11-1.86, p=0.006), secondary or SHS education (aOR = 1.50, 95% CI = 1.19-2.07, p=0.001) and higher than SHS education (aOR = 2.14, 95% CI = 1.45-3.15, p<0.001); ever had an abortion (aOR = 1.92, 95% CI = 1.57-2.33, p<0.001); ever given birth (aOR = 1.60, 95% CI = 1.33-1.93, p<0.001); watching television (aOR = 1.24, 95% CI = 1.04-1.48, p=0.014); and residing in Brong Ahafo (aOR = 2.00, 95% CI =1.42-2.83, p<0.001), Ashanti (aOR = 1.56, 95% CI = 1.11-2.19, p=0.010), Upper East (aOR = 1.94, 95% CI =1.35-2.78, p<0.001) and Upper West (aOR = 1.72, 95% CI =1.20-2.46, p=0.003) regions. Conclusion: The group of young women involved in this study seem to have good knowledge of contraception methods. Modern contraceptive prevalence observed in this study is higher than the national modern contraceptive prevalence with regional variations. Promotion of effective counselling on contraception during antenatal, child welfare clinics, and when women visit health facilities for abortion services will greatly influence the use of contraception. This will help reduce cases of unintended pregnancies and some pregnancy-related complications as a result of unsafe induced abortions. There is the need for intensified education on contraceptive use, expansion of sexual and reproductive health programmes for young people, as well as targeting specific groups for effectiveness.