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

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          Abstract

          Background

          Family 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.

          Methods

          We 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 (χ 2) 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.

          Results

          A 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.

          Conclusion

          Effective counselling on family planning during antenatal and child welfare clinics, and encouraging spousal communication on contraception are likely to increase contraceptive use after delivery.

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          Most cited references 12

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          Encouraging contraceptive uptake by motivating men to communicate about family planning: the Malawi Male Motivator project.

           Dominick Shattuck (corresponding) ,  Brad Kerner,  Kate Gilles (2011)
          We examined the effect of a peer-delivered educational intervention, the Malawi Male Motivator intervention, on couples' contraceptive uptake. We based the intervention design on the information-motivation-behavioral skills (IMB) model. In 2008 we recruited 400 men from Malawi's Mangochi province who reported not using any method of contraception. We randomized them into an intervention arm and a control arm, and administered surveys on contraceptive use at baseline and after the intervention. We also conducted in-depth interviews with a subset of intervention participants. After the intervention, contraceptive use increased significantly within both arms (P < .01), and this increase was significantly greater in the intervention arm than it was in the control arm (P < .01). Quantitative and qualitative data indicated that increased ease and frequency of communication within couples were the only significant predictors of uptake (P < .01). Our findings indicate that men facilitated contraceptive use for their partners. Although the IMB model does not fully explain our findings, our results show that the intervention's content and its training in communication skills are essential mechanisms for successfully enabling men to help couples use a contraceptive.
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            Spousal communication and family planning behavior in Navrongo: a longitudinal assessment.

             Ayaga A Bawah (2002)
            The poor performance of most family planning programs in the 1980s, especially in sub-Saharan Africa, generated concern among researchers and led to a quest for explanations. In most countries, the alienation of men from participation in these programs was subsequently identified as one of the major causes, a finding that led researchers to redirect their attention to couples instead of individuals as the focus of such programs. Lack of spousal communication about family planning was identified as one reason for the low level of contraceptive use among women. Subsequent research has persistently demonstrated a positive relationship between spousal communication and contraceptive use. Most prior studies on this topic have been based on cross-sectional data, so that whether the identified relationships are causal remains unclear. Does communication, in fact, predict contraceptive use, or does the use of contraceptives generate communication among couples? This study addresses the question of causality by using longitudinal data from the Navrongo Health Research Centre panel survey. Results from both cross-sectional and longitudinal analysis demonstrate that spousal communication does, indeed, predict contraceptive behavior, even when other factors are controlled.
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              Ghana Demographic and Health Survey 2014

              (2015)
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                Author and article information

                Contributors
                caroline.wuni@yahoo.com
                corneliusturpin@yahoo.co.uk
                +233244623287 , edidassah@yahoo.com
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                1 August 2017
                1 August 2017
                2018
                : 18
                Affiliations
                [1 ]Metropolitan Health Directorate, Kumasi, Ghana
                [2 ]ISNI 0000 0004 0466 0719, GRID grid.415450.1, Department of Obstetrics and Gynaecology, , Komfo Anokye Teaching Hospital, ; P. O. Box KS 1934, Kumasi, Ghana
                [3 ]ISNI 0000000109466120, GRID grid.9829.a, , School of Medical Sciences, Kwame Nkrumah University of Science and Technology, ; Kumasi, Ghana
                [4 ]ISNI 0000000109466120, GRID grid.9829.a, , School of Public Health, Kwame Nkrumah University of Science and Technology, ; Kumasi, Ghana
                Article
                4641
                10.1186/s12889-017-4641-9
                5539629
                28764670
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                Funding
                Funded by: Not applicable
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

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