Determinants of family plannig choices in the Tamale Metropolis of Northern Region, Ghana

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BACKGROUND The Tamale Metropolis records one of the highest fertility rates in Ghana estimated at 7.0. It has an estimated population of 366,535. Women in reproductive age constitute about 24% of the population. Contraceptive acceptance rate is reported as 21% by the Metropolitan Health Directorate (MHD). The knowledge of determinants of family planning choices will help policy makers and service providers to come out with interventions that will improve utilization of effective family planning methods in the metropolis. OBJECTIVE To determine family planning choices and their determinants in the Tamale Metropolis. METHODS The study is a cross-sectional analytical study, conducted from July – September 2008 in the Tamale Metropolis. Primary data was obtained from respondents using interviewer administered questionnaires. In-depth interviews of service providers were carried out using interview guides and observation at family planning service delivery points. Secondary data was obtained by reviewing family planning data for the metropolis from the MHD. Study Population- women and men in the reproductive age group (15 to 49 years) in a stable relationship and couples of reproductive age in the Metropolis. Multi stage sampling was used. Random sampling of communities followed by random sampling of households, and then random sampling of individual respondents. Purposive sampling of service providers was done. Random sampling of private pharmacists and dispensary technicians was also done. Data was entered in access software and exported to Stata for analysis. RESULTS A total of 405 people (161 males and 244 females) were interviewed. Mean age of respondents was 27.9. Mean parity was 2. About 40.5% of respondents had at least primary education. The contraceptive acceptance rate was 39%. The most preferred methods were male condoms 56.6%, pills 15.7% and injectables 10.7%. The factors that were significantly associated with non utilization of contraceptive methods include; Islamic religion, lack of formal education, less than 20 years of age and married couples. Christian religion and formal education are positively associated with use of family planning services. Only three centers in the metropolis provides the full range of contraceptive methods including IUD insertion, implants and sterilization (mainly BTL). There was lack of privacy in most family planning service points. The rural areas are poorly covered. CONCLUSION The FP acceptance rate in the metropolis is higher than the metropolitan average but is still on the low side. The predominant contraceptive method of choice was the condom which has a lower effectiveness than most of the other modern contraceptive methods. The prominent determinants of choice of method were education, perceptions about safety, effectiveness and low side effects profile. There is therefore the need to intensify public education on the efficacy and safety of contraceptive methods so as to enhance utilization. FP services should be organized adequately to cover the rural areas and to provide ample privacy.
A thesis submitted to the school of graduate studies, Kwame Nkrumah University of Science and technology, Kumasi in partial fulfilment of the requirements for the award of MPH degree in Population and Reproductive Health.