Socioeconomic determinants of use and choice of modern contraceptive methods in Ghana

Abstract

Background The slow pace of fertility decline in Africa relative to other parts of the world has important implications for the region’s economic development. Modern contraceptive use is seen as important population control and family planning strategy by governments worldwide. This paper examines the socioeconomic determinants of modern contraceptive use and choice among Ghanaian men and women. Methods We use the most recent and nationally representative Ghana Demographic and Health Survey conducted in 2014. The analysis is observational, with no causal implications. Bivariate and multivariate methods are used to analyse the data. We first use logistic regression to explore the correlates of modern contraceptive use among Ghanaian men and women. Second, we explore the socioeconomic factors influencing the choice of modern contraceptive methods among contraceptive users using multinomial logistic regression. We classify the modern methods of contraception into three groups: long-acting reversible contraceptives (LARC), short-acting contraceptives (SAC), and permanent contraceptives. Results Marital status proves to be the most significant predictor for both men and women, with women in monogamous unions having a greater propensity to use modern methods of contraception (OR = 1.4, p < 0.00). We also find that different factors affect the use and choice of modern methods of contraception among men and women in Ghana. Muslim men had a higher likelihood than Catholics to choose the permanent (sterilisation) method (OR = 11.9, p < 0.05), while their female counterparts were 0.25 times less likely to choose sterilisation over SAC (p < 0.05). Moreover, women who ever tested for HIV had higher use of LAC than the SAC ((RRR = 1.6, p < 0.01). The modern contraceptive users (women) with at most basic education were more likely than those with tertiary education to choose LAC over SAC. Finally, rural women with health insurance were 0.75 times (p < 0.01) less likely to use modern methods of contraception. Conclusions The paper reiterates the need to intensify and sustain public health education on the health benefits of using modern methods of contraception among the adult population. The paper suggests that including family planning services on Ghana’s national health insurance benefits package is commendable. It can promote modern contraceptive use and curtail unwarranted population growth.

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“…Enormous studies done in sub-Saharan Africa have found a strong positive effect of wealth index on mFP use [29][30][31][32][33][34][35][36]. Such findings show how financial constraint could have role in reducing mFP usage among poor women.…”

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“…The decision to use contraception is influenced by a complex interplay of factors involving women and their partners, including individual-level factors (such as women's age, education, and employment) and household-level factors (such as partner's education, occupation, number of children ever born, and wealth quintile) [9][10][11][12][13][14][15][16][17][18]. Community-(such as place of residence and region) and healthcare facility-level factors (such as the availability of contraceptives at the healthcare facility) and cultural factors can also influence this decision [9][10][11][12][13][14][15][16][17][18][19]. For example, in societies with a strong cultural preference for male children, couples with only daughters are less likely to use contraception than those with at least one son [20][21][22][23][24].…”

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