Factors influencing women's decision to adopt family planning methods,a case study of women aged 15-39 years in east akim district.

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Introduction: The single most criti¬cal intervention for safe motherhood is to ensure a skilled attendant for every delivery. Effective dissemination of information and education is vital if women are to enjoy access to available services. Whenever there is suspicion and fear of medical interventions, such as facility delivery, Caesarean section or blood transfusion, introduction of appropriate information, education and communication (IE&C) activities is vital to explain and dispel misconceptions about procedures. Aim: The study aims at assessing the effectiveness of IE&C on prenatal care and skilled delivery in the district. Method: A descriptive cross-sectional survey using questionnaire was conducted among a sample of 400 mothers who have delivered in the Bibiani-Anhwiaso-Bekwai district within the last six months. The questionnaire asked for mothers’ view on how best IE&C activities have helped them in making informed choices during prenatal care and childbirth. Results: Although majority (98.5%) of the mothers attended ANC at least once during their last pregnancy, only 50.50% delivered in health facility. Most (66.7%) of the mothers feared health facility delivery, and 85.5% did not prepare adequately for health facility delivery. Mothers have good knowledge on danger signs of pregnancy, signs of labour and importance of skilled care during pregnancy. Statistically, level of education (OR=0.54(0.37-0.79)) distance to health facility (OR=3.86(.44-6.11)), birth plans (OR=9.44(3.80-23.42)), items required (OR=3.87(2.44-6.13)), transport available at labour (OR=4.81(1.73-13.33)), discussion with male partners on place of delivery (OR=0.33(0.19-0.54)), advice on place of delivery during ANC by health personnel (OR=0.29(0.12-0.69)), and initiating antenatal care within the first three months of pregnancy (OR=1.84(1.22-2.76)) showed significant association with the use of skilled care at delivery even after controlling for confounders. Conclusion: Antenatal care coverage is high but proportion of skilled delivery is far below the ICPD+5 target of 85% skilled delivery by 2010. Mothers in the district have good knowledge on danger signs of pregnancy, signs of labour and importance of prenatal care and skilled delivery. Ignorance and cost of accessing skilled care impede the use of maternal health services. To improve the service, individual counselling of women on health facility delivery, early initiation of antenatal care and individual birth preparedness should be intensify. Male partners and communities should be involved in IE&C on maternal health care
A thesis dissertation submitted to the school of graduate studies, Kwame Nkrumah University of science and Technology in partial fulfilment of the requirements for the degree of master of public health;population and reproductive health,