Predictors of Postpartum Family Planning Uptake: Understanding Provider and Potential Family Planning User Behaviour in the Wa Municipality of the Upper West Region, Ghana

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Postpartum family planning uptake is known to have the potential to significantly reduce unintended pregnancies and maternal deaths especially worldwide with Ghana not an exception. The aim of this study was to assess the effects of socio-demographic characteristics of postpartum women on postpartum family planning (PPFP), factors that influence postpartum fertility preference, compare current FP practices among immediate and extended postpartum women and determine the effects service-related factors have on PPFP in the Wa municipality. The study was conducted from July to November, 2012. METHODS The study involved a cross-sectional survey of 518 randomly sampled postpartum women aged 15 – 49 years and 10 service providers. Data were captured through person -to - person interviews with questionnaires. RESULTS Two hundred and ninety one postpartum women (67.7%) accepted FP method within the first year postpartum. Postpartum acceptance of FP was significantly associated with parity (p=0.001) but not with level of education (p=0.72), religion (p=0.06), discussion number of children with partner (p=0.06) and Postpartum women with higher education (AOR=0.46; 95%, CI=0.20-1.05), Muslims (AOR=0.35; 95%, CI=0.9-1.29), women who discussed number of children with partner (AOR=0.56; 95%, CI=0.28-1.10) were more likely to refuse contraception while postpartum women with 3-6 children (AOR=5.9; 95%, CI=1.30-27.55) were more likely to use contraception. CONCLUSION The study highlights the importance of developing interventions on client-provider interactions postpartum to increase more effective contraceptive methods use. Early provider contact with postpartum women has shown a greater opportunity of increased contraception. RECOMMENDATION Family planning service providers should focus specifically on immediate postpartum contraception by providing education on fertility return behaviours, benefits of breastfeeding in preventing unintended pregnancies within the first six months postpartum and initiation of contraception before the return of menses or resumption of sexual activity as conception could precede return of menses after delivery.
A Thesis Submitted to the Department of Community Health, Kwame Nkrumah University of Science and Technology in partial fulfilment of the requirements for the Degree of Master of Public Health, 2014