Use of any contraceptive method among women in rural communities in the eastern region of Ghana: a cross-sectional study.

BACKGROUND: In Ghana, there is an increase in contraceptive use for traditional and modern methods in rural areas. This study seeks to examine the prevalence and determinants of current use of any contraceptive method among women of reproductive age in the rural Eastern Region of Ghana. METHODS: A community-based cross-sectional study was conducted among women of reproductive age in the rural Eastern region of Ghana. A structured questionnaire was used to interview women in rural Lower Manya and Upper Manya Krobo districts of Eastern region who were selected using a simple random sampling technique. The data were analysed using Stata version 16. A Binary logistic regression was used to examine the determinants of current use of any contraceptive use (traditional and modern methods). RESULTS: The prevalence of contraceptive use was 27.8%. In the adjusted analysis of binary logistic regression, contraceptive use was significantly lower (aOR = 0.24; 95%CI = 0.10-0.56; p = 0.001) among respondents aged 41-49 years compared to those aged 18-35 years. Contraceptive use was significantly lower among migrants (aOR:0.53; 95%CI:0.28-0.99; p = 0.048) compared with non-migrant. CONCLUSION: The prevalence of any contraceptive use among rural women was low. Government and other stakeholders need to create awareness about contraception in the rural areas of Eastern region of Ghana and that would help increase contraceptive methods utilization. In addition, family planning programs should target migrants to design an intervention to increase contraceptive use in rural areas.

Multiple sexual partnership among adolescent boys and young men in Ghana: analysis of the 2003-2014 Ghana Demographic and Health Survey.

BACKGROUND: Multiple sexual partnership (MSP) is a major cause of HIV/AIDS epidemic and unplanned pregnancies in sub-Saharan Africa. We investigate how individual, household, interpersonal, community and structural factors correlate with multiple sexual partnership of adolescent boys and young men in Ghana. METHODS: We pooled secondary data from the 2003, 2008 and 2014 Ghana Demographic and Health Surveys (GDHS). Analytic sample of 1422 males aged 15-24 years who are sexually active and never married were used for the study. The outcome variable for the study was two or more sexual partners in the last 12 months preceding the survey. Five models were fitted using multilevel mixed effects logistic regression to identify predictors of multiple sexual partners. Results were presented using adjusted odds ratios (ORadj) with its corresponding 95% confidence interval. RESULTS: The pooled data prevalence of multiple sexual partnership was 28.1%, with 18.7%, 30.0% and 33.3% of adolescent boys and young men involved in multiple sexual partnerships in 2003, 2008 and 2014, respectively. Results of the study showed that young men aged 20-24 years [ORadj = 1.39, 95% CI = 1.01-1.91], being from household with richest wealth index [ORadj = 1.76, 95% CI = 1.01-3.06] and those with secondary/higher education [ORadj = 2.94, 95% CI = 1.44-6.06] were more likely to have multiple sexual partners. On the other hand, those who delayed their first sex [ORadj = 0.45, 95% CI = 0.29-0.70] and those currently using modern contraceptive methods [ORadj = 0.37, 95% CI = 0.28-0.50] were less likely to have multiple sexual partners. CONCLUSION: The findings provide support for the social ecological argument that sexual health behaviours are influenced by individual, interpersonal, community and contextual characteristics. Future policies and interventions seeking to address the increasing prevalence of multiple sexual partnerships among adolescent boys and young men should take into consideration family planning programmes and sexual education in affluent communities, secondary and higher institutions.

Utilization of abortion services from an unsafe provider and associated factors among women with history of induced abortion in Ghana.

BACKGROUND: In sub-Saharan Africa (SSA), numerous studies have examined women's choice of abortion methods and services using hospital-based data, community-based surveys and nationally representative data. Little research focuses on the factors influencing a woman's choice of abortion provider. This study sought to identify factors that are associated with why a woman seeks abortion care services from an unsafe provider in Ghana. METHODS: We used nationally representative data of women from the 2017 Ghana Maternal Health Survey (GMHS). Data analysis was restricted to women aged 15-49 with a recent history of induced abortion. Analyses focused on a weighted sample of 1,880. Descriptive analysis and the chi-square test were used to examine the proportion of women utilizing abortion services from unsafe providers. Factors hypothesized to affect the utilization of abortion services from unsafe providers were examined using both bivariable and multivariable logistic regression analyses. RESULTS: The proportion of survey respondents who reported that they utilize abortion service from unsafe providers were 57.5%. After adjusting for confounders, those who have knowledge of abortion legality [aOR: 0.381 (0.271-0.541)] and those who have attained secondary or higher education [aOR: 0.613 (0.411-0.914)] were less likely to use abortion services from unsafe providers. On the other hand, women belonging to the Ewe ethnic group [aOR: 0.696 (0.508-0.953)], those residing in the middle belt zone [aOR: 1.743 (1.113-2.728)], younger women aged 15-29 years [aOR: 2.037 (1.234-3.362)] were more likely to use abortion services from unsafe abortion providers. CONCLUSIONS: This research suggests that increasing the knowledge of women on the legal status of abortion through public education and encouraging more women to pursue secondary or higher education can contribute to reducing the use of abortion services from unsafe providers. These interventions should be targeted among younger women and those who reside in the middle belt zones of Ghana.