What Factors Predict Use of Contraceptives in Ghana?

Background and purpose: Most studies have focused on establishing predictors of contraceptive use in developed countries, but not much has been done in Africa,  specifically in Ghana, where contraceptive use rate has  declined from 19% to 17% in 2003 (Ghana, DHS report 2008). Despite efforts by the government to reduce population growth and the fertility rate, the country has experienced a decline in contraceptive usage that affects the fertility rate of the country. In this regard, this study sought to understand the predicting factors that contribute to contraceptive use in Ghana.

Methods: This study used the Ghana Demographic and Health Survey dataset from 2008. It is a national representative data set. The Ghana Demographic and Health Survey is a household survey conducted primarily by the Ghana Statistical Service and the Noguchi Memorial Institute for Medical Research (Nketiah-Amponsah et al 2012). It used a multistage, stratified probability sample of eligible women aged 15-49 years. It interviewed a total 11,778 households (Ghana DHS, 2008). A total of 4,916 women aged 15-49 and 6,141 men aged 15-59 were interviewed over a period of 3 months (Ghana DHS, 2008). From this sample, women who were sexually active at the time of interview were selected.

Results:  Logistic regression used 11,748 women out of a total sample of 11,888 to predict contraceptive use. The model was significant with a Wald chi-square of 1099.04 (p<0.05). The C statistics of 0.72 showed that the model has good classification. To ensure the model’s goodness of fit, Hosmer and Lemeshow was requested and was insignificant, p=.19, implying that the model is good for predicting contraceptive use in Ghana.  A diagnostic test was conducted to ensure that the predictors had no issues with multicollinearity. The highest VIF was 3 and the lowest was .33, indicating that the model had no issues with multicollinearity. Findings from the study showed that women who had at least completed primary school education were 77% more likely to use contraceptives than women with no educational status, controlling for other variables. Those who had completed secondary and higher education were 2.10 times more likely to use contraceptives than women with no level of education. Also, poor women were 44% less likely to use contraceptives compared to those in the rich category. The odds for women living in the Greater Accra region using contraceptives were 2.13 times higher than women living in the Northern Region. As the number of children increased by 1 the odds for using contraceptive increased by 13%.

Conclusion:  These results imply that there is the need for a comprehensive approach to increase primary school enrollment and ensure retention in school, especially in rural areas. In addition, the government should make efforts to increase the availability of contraceptives and subsidize the cost of contraceptives for low income earners, especially those located in the Northern, Upper West, and the Upper East Region.