Determinants of contraceptive use and future contraceptive intentions of women attending child welfare clinics in urban Ghana

Abstract

BackgroundFamily planning is an integral component of maternal and child health services in Ghana. Although knowledge on contraception is universal and most women attend maternal and child health services, contraceptive use remains low among women after delivery. This study aimed to determine factors influencing current use and future contraceptive intentions of women who were attending child welfare clinics within 2 years of delivery in Sunyani Municipality, Ghana.MethodsWe conducted an analytical cross-sectional study among mothers in six selected health care facilities. Data was collected on their socio-demographic characteristics, reproductive and contraceptive experiences and future contraceptive intentions. Categorical variables were compared using the chi-squared (χ2) test. Factors associated with current use and future contraceptive intentions were determined using Poisson regression with a robust error variance to estimate crude and adjusted relative risks (RRs) with 95% confidence intervals (CIs). P < 0.1 was considered statistically significant.ResultsA total of 590 women were recruited into the study. Overall, 50.2% of the women were using contraception, 30.7% modern and 19.5% traditional methods. Compared to previous use, more women were using and would prefer the more effective contraceptive methods in future. Significant factors associated with current contraceptive use were, level of education (p = 0.02), discussing family planning during antenatal care (adjusted RR, 1.28; 95% CI, 1.07-1.53), or with one’s partner (adjusted RR, 1.22; 95% CI, 1.01-1.47) and previous contraceptive use (adjusted RR, 1.91; 95% CI, 1.56-2.33). Family planning discussions during child welfare clinic (adjusted RR, 1.12; 95% CI, 0.99-1.26) or with one’s spouse (adjusted RR, 1.20; 95% CI, 1.08-1.34), desire to space children (adjusted RR, 1.35; 95% CI, 1.17-1.55), previous (adjusted RR, 1.15; 95% CI, 1.05-1.27) and current (adjusted RR, 1.11; 95% CI, 1.01-1.22) contraceptive use were predictive of clients’ intention to adopt family planning in the future.ConclusionEffective counselling on family planning during antenatal and child welfare clinics, and encouraging spousal communication on contraception are likely to increase contraceptive use after delivery.

Factors associated with contraceptive use among young women in Malawi: analysis of the 2015–16 Malawi demographic and health survey data

“…Therefore, there is a need for collaborated efforts by government and its partners to make contraceptives affordable to all women. Our finding is consistent with studies done in other countries which also reported that women who were working were more likely to use contraceptive [ 29 – 31 ].…”

Associations of spousal communication with contraceptive method use among adolescent wives and their husbands in Niger

“…An important finding is that only about one-fourth of adolescent wives in our sample reported ever having discussed contraception with their husbands and one-fifth of husbands reported these discussions, a prevalence lower than found in relevant recent studies in sub-Saharan Africa [ 22 , 30 – 32 ]. While research has shown that Nigerien women have in recent times exercised some amount of agency in FP [ 7 ], significant and persistent gender inequality [ 33 ] may bolster traditional gender roles, playing a large part in determining engagement in communication behaviors.…”

Provision of family planning vouchers and early initiation of postpartum contraceptive use among women living with HIV in southwestern Uganda: A randomized controlled trial

“…The benefit of a voucher in facilitating early initiation of family planning in this trial was seen across all subgroups. Effect sizes, however, appeared bigger in certain subgroups, for example, women subscribing to a non-Catholic religion, those with parity more than 3, women aged 30 years and above, women who attended at least 4 prenatal visits, women with improved household income, and women with a previous history of modern family planning Family planning voucher and early initiation of postpartum contraceptive use use, which corroborates prior work demonstrating higher rates in use of contraception among such populations [49][50][51][52][53][54]. This may also be corroborated with observed reduction in reported fertility aspirations among the same postpartum WLWH with increasing age, parity, and previous use of modern family planning methods [9].…”