Healthcare system indicators associated with modern contraceptive use in Ghana, Kenya, and Nigeria: evidence from the Performance Monitoring and Accountability 2020 data

Abstract

Background: Public health literature is replete with evidence on individual and interpersonal indicators of modern contraceptive use. There is, however, limited knowledge regarding healthcare system indicators of modern contraceptive use. This study assessed how the healthcare system influences use of modern contraceptive among women in Ghana, Kenya, and two large population states in Nigeria. Methods: This study used data from Phase 1 of the Performance Monitoring and Accountability 2020. The analytical sample was limited to women with a need for contraception, defined as women of reproductive age (15 to 49 years) who wish to delay or limit childbirth. Therefore, this analysis consisted of 1066, 1285, and 1955 women from Nigeria, Ghana, and Kenya respectively. Indicators of healthcare assessed include user-fees, visit by health worker, type of health facility, multiple perinatal services, adolescent reproductive healthcare, density of healthcare workers, and regularity of contraceptive services. All analyses were conducted with SAS (9.4), with statistical significance set at p < 5%. Results: The prevalence of modern contraceptive was 22.7, 33.2, and 68.9% in Nigeria, Ghana, and Kenya respectively. The odds of modern contraceptive use were higher among Nigerian women who lived within areas that provide adolescent reproductive healthcare (OR = 2.05; 95% C.I. = 1.05-3.99) and Kenyan women residing in locales with polyclinic or hospitals (OR = 1.91; 1.27-2.88). Also, the odds of contraceptive use were higher among Kenyan women who lived in areas with user-fee for contraceptive services (OR = 1.40; 1.07-1.85), but lower among Ghanaian women residing in such areas (OR = 0.46; 0.23-0.92). Lastly, the odds of modern contraceptive use were higher among women visited by a health-worker visit among women in Ghana (OR = 1.63; 1.11-2.42) and Nigeria (OR = 2.97; 1.56-5.67) than those without a visit. Conclusion: This study found an association between country-specific indicators of healthcare and modern contraceptive use. Evidence from this study can inform policy makers, health workers, and healthcare organizations on specific healthcare factors to target in meeting the need for contraception in Ghana, Kenya, and Nigeria.

Predictors of modern contraceptive usage among sexually active rural women in Ethiopia: A multi-level analysis

“…The independent was selected by reviews of previous literature [10][11][12][13][14][15][16][17][18][19][20][21]. The independent variables included in the study were the wealth index, educational level of the mother, educational level of husband, age of women, occupation of women, religion, age at first birth, contraceptive use, number of living children, birth in the last three years, marital status, occupation of husband, terminated pregnancy, the region they live in, and access to mass-media.…”

“…The use of modern contraceptives has slightly increased worldwide, from 54% in 1990 to 57.4% in 2015. It goes from 23.6 to 28.5% in Africa [17].…”

“…In Ethiopia, studies were conducted to identify predictors of modern contraceptive use among sexually active women [10][11][12][13][14][15][16][17][18][19][20]. Those studies were done by using an ordinary regression model.…”

Assessing the Current States of Logistics Management and Training on Family Planning Services in Nigerian Healthcare Facilities

“…This is not a good report for primary health facilities because they are closer to the grassroots people and the first point of call for FP and other medical services. The implication of this is the poor FP services, regular stockouts, and low uptake of contractive in rural areas of the country [19,[29][30][31][32][33]. The few facilities that had trained staff on FP commodities logistics did not have sufficient trained staff with an average of 1-2 and 3-4 trained personnel in both primary and secondary healthcare facilities respectively.…”

The Role of Structural and Process Quality of Family Planning Care in Modern Contraceptive Use in Indonesia: A Multilevel Analysis

“…The ndings further disclosed that proportion of community members had been visited by community health worker was positively associated with modern contraceptive utilization. This could be contributed by information, education, and communication (IEC) delivered by community health volunteer that may in uence woman's decision making process to use modern FP method (49)(50)(51). This nding suggests community outreach / social mobilizer programs as an essential strategy to enhance modern contraceptive prevalence.…”