Abstract
Context: Estimating demand for contraception from married women only may
misrepresent unmet need for family planning; given that unmarried women, who are often
young, are equally if not more exposed to unwanted pregnancy and have good reasons to
practice contraception. Past studies mainly focused on married women, which limits the
ability to estimate demand among all women; specifically it is unclear if intention to use
contraception among married women predicts use among all women.
Methods: The study site is a rural, marginalized district in northern Ghana, where contraceptive
use is low based on the complex interplay of culture, preferences and contraceptive availability.
The district is a site under demographic surveillance since 1993. Using data collected
longitudinally from 1995 to 2003, this study examines if intention to use contraception
among all women can be used to predict their actual use. The study also describes the main
contraceptive methods used and reasons for non-use in the district. A panel survey was
introduced to monitor changes in fertility and contraceptive use following the introduction
of a community health and family planning intervention project. Data from the 2001 and
2003 panel survey were used for the analysis. The sample consisted of 2827 non-users of
contraception in the baseline year (2001). Logistic regression analysis was used to calculate
the adjusted effect of contraceptive intention on future use.
Results: About two thirds (65%) of the respondents were in a marital union while 23% had
never been married. Among all women, those who expressed the need to use contraception
were more than twice as likely to have used contraception when compared with those
without such intentions (OR 2.04; CI: 1.47; 2.82). Among the married women, those with
intention to use contraception were close to two times as likely to have used contraception
compared to those without (OR 1.88; CI: 1.31; 2.72). The main family planning methods used were injectables (55%) followed by prolonged abstinence (22%) and the pill (10%).
More than half of the women not using a method reported not being at risk as the main
reason for non-use. Results for all women and for married women alone demonstrate that,
in this setting, intention can be used to predict future use.
Conclusion: Stated contraceptive intention is a significant determinant and measure of
future family planning needs when the needs of unmarried women as well as married
women are considered. Unmarried women and not only married women should therefore be
a focus in family planning studies for their intentions count in determining who is in need
of contraception and the nature and scale of that need.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/5014 |
| Date | 09 July 2008 |
| Creators | Joseph, Maurice Mutisya |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | 615580 bytes, application/pdf, application/pdf |
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