Accessibility and Utilization of Family Planning Services in Selected Districts in Central Region of Ghana

ABSTRACT Family planning has been considered to contribute immensely to child survival and reduction in maternal mortality, hence targeted as one of the main reproductive health services in achieving the fifth millennium development goal (MDG 5). The 2011 Multiple Indicator Cluster Survey report indicates that use of modern contraceptives in Central region has improved from 17.0 percent in 2008 to 29 .1 percent in 2011 and subsequently decline of unmet need for contraceptives from 49.7 percent to 22.6 percent for the same years respectively. In spite of this improvement, there is huge variations in utilization of family planning methods especially between districts in the region, particularly in Upper Denkyira East and Mfantsiman, and the causes of this variations are not clearly known. Hence, the main aim of the study is to assess the level of accessibility and utilization of family planning services in the selected districts and factors influencing them. The study design adopted was descriptive cross –sectional, using both quantitative and qualitative approach for data collection. The sample size was 373 women of reproductive age 15 – 49 years. Again, 66 husbands/male partners were also interviewed to solicit for their views about the subject matter. Eight health institutions as well as 22 religious establishments were also interviewed. The study revealed high knowledge level of modern contraceptives among women of reproductive age (93 percent) and men (88 percent) in general. There is little (0.3 percent) difference in contraceptives use between the Upper Denkyira East (25.9 percent) and Mfantsiman (25.6 percent) district. Poor data management in facilities in Upper Denkyira East was accounting for the huge variations. Factors such as proximity to facility or clinic (12.5 percent), privacy and confidentiality at clinic (19.5 percent), wanting to delay pregnancy (49.2 percent) among others motivate use of contraceptives whiles factors such as desire for many children (14.8 percent) , health concerns (9.7 percent) and fear of side effects (7.6 percent) accounted for non-use. Again, social issues such as stigma of use (3.5 percent), husbands/partners opposition (4 percent) and religious prohibition (1.6 percent) among others hinder the use of contraceptives among women. There is good physical accessibility with respect to location of clinic providing family planning services in all study districts. Again financial accessibility to family planning services is good despite unapproved charges for family planning services by health facilities in the study districts. Social accessibility regarding service providers’ attitude, privacy and confidentiality is also good in FP facilities, however social factors such as stigmatization, husband/partner opposition, religious opposition among others hinder access and utilization of contraceptives. To improve on family planning services in the study districts, there is the need for family planning (FP) data collection tools’ training for all FP service providers in the facilities in order to improve on FP data quality. Also, family planning awareness or education should be intensified particularly with respect to health concerns, side effects as well as prices of contraceptives or FP services.

Source: KNUST