Enhancing contraceptive use: assessment of determinants of contraceptive use among rural women in Nor thern Ghana

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Contraceptive use prevalence among women in the Upper East region is low as 12% (GSS et al., 2004). The study therefore sought to assess the determinants that influence the use of contraceptives and identified those that are significant among rural women. The study was a quantitative cross sectional study conducted in the Builsa district in the Upper East Region. Three hundred and four women aged 15-49 years and 110 married men were interviewed. A multi-stage cluster sampling was used. A sub-district was randomly selected and the communities in it were randomly selected and all females of the reproductive age and their spouses were interviewed. Contraceptive use prevalence was 17.6% among the women. The mean age at first marriage was 19.6 and 22.9 years for female and males respectively. Women who married at 30 years and above were 2.7 times more likely to use contraceptives as compared to those who married at 15-19 years [OR=2.7, (95% CI: 1.2, 5.9), p<0.OlJ. Women who were Christians were twice more likely to use contraceptives when compared to women who practiced traditional religion [OR=2.0, (95 % CI: 1.01, 4.2), p<O.O35J. Spousal communication on fertility and family planning enhances contraceptive use. This was evident in the survey, which showed that women who discussed the number of children they would like to have in their reproductive lifetime were three times more likely to use a contraceptive method as compared to women who did not discuss this issue with spouses/partners [OR=3.l7, (95% CI: 1.64, 6.13), p<O.OOI j, whilst women who discussed family planning issues with their husband/partners were six times more likely to use a contraceptive method as compared to those who did not discuss with their spouses/partners on family planning [ 0R6.44, (95% CI: 3.02, 13.75), p=O.OOJ. Only eight percent of contraceptive users said they had the information of the FP methods they were using from peers. However, women who said they were members of any social organization/association were two times more likely to use contraception than those who did not belong to organization [0R=2.0, (95% CI: 1.02, 3.9), p<O.042]. Household health decision-making was also found to have an impact on contraceptive use. Women who take their own health decision were 8.8 times more likely to use contraceptives as compared to those family members make decision for [0R8.8, (95% CI: 1.06, 72.79]. The public health units in all the sub-district provide FP services. The CHPS centres have made FP services more accessible to the women in the communities. The communities rely mostly on the health workers for FP services. There is therefore the need for Non-Governmental Organizations (NGOs) to supplement the efforts of the DHMT in the provision of reproductive health, especially FP services.
A thesis submitted to the School of Graduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi in partial fulfilment of the requirements for the award of MPh degree in Population and Reproductive Health, 2005