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

BMC Public Health - Tập 18 - Trang 1-8 - 2017
Caroline Wuni1, Cornelius A. Turpin2,3, Edward T. Dassah2,4
1Metropolitan Health Directorate, Kumasi, Ghana
2Department of Obstetrics and Gynaecology, Komfo Anokye Teaching Hospital, Kumasi, Ghana
3School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
4School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

Tóm tắt

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. 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 (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. 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. 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.

Tài liệu tham khảo

Starbird E, Norton M, Marcus R. Investing in family planning: key to achieving the sustainable development goals. Glob Health Sci Pract. 2016;4(2):191–210. Moore Z, Pfitzer A, Gubin R, Charurat E, Elliott L, Croft T. Missed opportunities for family planning: an analysis of pregnancy risk and contraceptive method use among postpartum women in 21 low- and middle-income countries. Contraception. 2015;92(1):31–9. Borda MR, Winfrey W, McKaig C. Return to sexual activity and modern family planning use in the extended postpartum period: an analysis of findings from seventeen countries. Afr J Reprod Health. 2010;14(4 Spec no.):72-79. Do M, Hotchkiss D. Relationships between antenatal and postnatal care and post-partum modern contraceptive use: evidence from population surveys in Kenya and Zambia. BMC Health Serv Res. 2013;13:6. Ghana Statistical Service (GSS), Ghana Health Service (GHS), ICF International. Ghana demographic and health survey 2014. Rockville, Maryland, USA.: GSS, GHS, ICF International; 2015. Eliason S, Baiden F, Quansah-Asare G, Graham-Hayfron Y, Bonsu D, Phillips J, Awusabo-Asare K. Factors influencing the intention of women in rural Ghana to adopt postpartum family planning. Reprod Health. 2013;10:34. Morhe E, Dalton V. Contraceptive uptake among referred postpartum women in Komfo Anokye Teaching Hospital Ghana. Paper presented at the International Conference on Family Planning (ICFP): November 12-15, 2013; Addis Ababa, Ethiopia. Addis Ababa: ICFP; 2013. Sunyani Municipal Health Directorate. 2013 Annual Report. Sunyani: Ghana Health Service; 2014. Ekabua JE, Ekabua KJ, Odusolu P, Iklaki CU, Agan TU, Etokidem KJ. Factors associated with contraceptive use and initiation of coital activity after childbirth. Open Access J Contracept. 2010;1:85–91. Zou G. A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol. 2004;159(7):702–6. Adanikin AI, Onwudiegwu U, Loto OM. Influence of multiple antenatal counselling sessions on modern contraceptive uptake in Nigeria. Eur J Contracept Reprod Health Care. 2013;18(5):381–7. Bawah AA. Spousal communication and family planning behavior in Navrongo: a longitudinal assessment. Stud Fam Plan. 2002;33(2):185–94. Sileo KM, Wanyenze RK, Lule H, Kiene SM. Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda. Int J Public Health. 2015;60(8):987–97. Lagro M, Liche A, Mumba T, Ntebeka R, van Roosmalen J. Postpartum care attendance at a rural district hospital in Zambia. Trop Dr. 2006;36(4):205–8. Dulli LS, Eichleay M, Rademacher K, Sortijas S, Nsengiyumva T. Meeting postpartum Women's family planning needs through integrated family planning and immunization services: results of a cluster-randomized controlled trial in Rwanda. Glob Health Sci Pract. 2016;4(1):73–86. High-Impact Practices in Family Planning. Family planning and immunization integration: reaching postpartum women with family planning services. Washington, DC: USAID; 2013. Lopez LM, Grey TW, Hiller JE, Chen M. Education for contraceptive use by women after childbirth. Cochrane Database Syst Rev. 2015;(7). doi:10.1002/14651858.CD001863. Vance G, Janowitz B, Chen M, Boyer B, Kasonde P, Asare G, Kafulubiti B, Stanback J. Integrating family planning messages into immunization services: a cluster-randomized trial in Ghana and Zambia. Health Policy Plan. 2014;29(3):359–66. Shattuck D, Kerner B, Gilles K, Hartmann M, Ng'ombe T, Guest G. Encouraging contraceptive uptake by motivating men to communicate about family planning: the Malawi male motivator project. Am J Public Health. 2011;101(6):1089–95. Ezeanolue EE, Iwelunmor J, Asaolu I, Obiefune MC, Ezeanolue CO, Osuji A, Ogidi AG, Hunt AT, Patel D, Yang W, et al. Impact of male partner's awareness and support for contraceptives on female intent to use contraceptives in southeast Nigeria. BMC Public Health. 2015;15:879.