The rapid population growth and economic expansion in Ghana over the last decade have made the management of its population increasingly important necessitating detailed confidential studies on use of birth control methods. This paper reports a highly confidential survey-based study undertaken to assess the extent of awareness of and factors influencing the use of birth control methods among 120 women aged between 15 and 49 years, in their reproductive lifespan, at Abokobi, a suburb of Accra, Ghana. The analysis showed that age was the main factor responsible for the general level of awareness of birth control methods. The use of birth control methods was positively related to the level of awareness of birth control methods, being in a current sexual relationship, and the number of children that the woman had. Students were less likely to use birth control methods than non-students suggesting the need for more recognition of abstinence as an alternative birth control method.
During earlier human civilisations, an issue of high value to human societies was the ability to reproduce and to have as many children as possible. The larger the number of children a woman procreates, the greater the level of respect for the individual. In this modern era, many people look beyond subsistence living and prefer a more leisured, relaxed life and hence increasingly fewer societies are holding on to this perspective of life. This has led to an increased demand for scientific means for controlling birth rates. Many people in the modern era, dating from several centuries ago, have had the desire to decide when to have a child and when not to have one. In the modern era giving birth is one of the least motivating factors for people having sex especially for the unmarried who may want to have the pleasure of sex, but not with the intention of giving birth to children [
Contraceptives have been used in several forms for thousands of years throughout human history. A report by the United Nations Department of Economic and Social Affairs in 2011 indicates that the prevalence rate of contraceptive usage in the world increased from an average of 49.2% in 1980 to 62.7% in 2009. Sub-Saharan Africa which recorded an average prevalence rate of 11.2% in 1980 had its prevalence rate increased to 21.8% in 2009 [
A striking importance of birth control is the extent of pressure that large populations exert on economic and social facilities of a country. High levels of population create major limitations and constraints on economic progression and the ability of a country to make the necessary provision for the livelihood improvement of its citizens and the achievement of its national development targets and visions [
These peri-urban and urban areas in Ghana have even much higher population growth rates than the overall population growth rate of the country largely due to increasing rural-urban migration. For example, the Greater Accra region, one of the ten politically-administrative regions of Ghana, which hosts the national capital city, recorded a population of 4,010,054 in 2010, an increase from 491,817 in 1960, 851,614 in 1970, 1,431,099 in 1984, and 2,905,726 in 2000; an eight-fold increase over 50 years from 1960 to 2010, and an annual growth rate of 3.1% between 2000 and 2010 larger than the 2.5% annual growth of the entire population. Of particular importance to this study is that while the population increase in urban areas is in a greater part largely due to migration as compared to natural birth increase, in the agriculturally-dominated peri-urban areas close to the cities, the natural population increase is more dominant than that due to migration [
In Ghana, since political independence on 6 March 1957, various governments have pledged a commitment to improve the quality of life of the people through measures such as the reduction of maternal and infant mortality. The population policy of the country was clearly articulated and documented in 1969 [
The prevalence rate of contraceptive use in Ghana increased from 12.9% in the 1980s to about 24% in 2010 [
Among women and men aged 25 - 29, the median age at first sexual intercourse was 18.3 years and 19.6 years respectively in 2003 [
Better educated women are also thought of having more knowledge of birth control methods and also of ways to obtain them than people who are less educated because of the level of literacy and much more familiarity with modern institutions. For women especially, education has been seen as an important factor that promotes contraceptive usage in many developing countries like Ghana [
While several research studies have been undertaken to assess the awareness and use of birth control methods by various groups of people in Ghana, the link between awareness of birth control methods and their use has not been fully analysed especially for low-income women in the child bearing age group. In particular, a distinction is needed to be made between general awareness of the existence of birth control methods, and specific awareness and information about the desirable attributes of the specific birth methods ideally required by women. Information about the desired attributes of birth control methods that meet the needs of women, especially those from low-income and disadvantaged backgrounds, must ultimately involve confidential personal-based surveys to elicit more accurate preferences of women in order to shape more appropriate policies.
The main objective of the study was to assess the extent of awareness and use of birth control methods by potentially child-bearing women between 15 to 49 years in Abokobi, a peri-urban, low-income area of Accra. The rest of the paper is organised as follows: the next section focuses on the review of relevant literature review followed by the presentation of the methodology. The results of the study are discussed in the fourth section. The conclusions and recommendations follow.
Birth control is the planned control of the birth rate by methods that prevent the conception of individuals [
Birth control methods are categorized into three groups based on their effectiveness and the nature of the products. These three groups are 1) long-acting contraceptive methods involving invasive procedures inside the human body such as surgery or implants which are reversible or non-reversible, 2) hormonal methods which are less invasive and have medium contraceptive impact, and 3) barriers and natural methods [
The Cambridge Dictionary of the English language defines awareness as knowledge that something exists; or an understanding of a situation or subject based on the available information and experience. Basic information that a product exists is at the lower end of an awareness continuum scale for a product; at the higher end of the awareness continuum scale is high level of familiarity of the product including its prior use. Awareness of birth control methods is therefore the logical first step necessary for their use by women. Since intensity of awareness is related to the available information and experience, the extent of use of birth control methods is also dependent on the intensity of awareness of these methods.
Birth control methods play a crucial role in population management, poverty alleviation, and human development. Effective birth control methods have a wide range of benefits. These benefits include increased maternal and child survival, improved nutrition, better educational prospects, increased possibility of girls and women getting into places of authority both at home and in society, and the prevention of sexually-transmitted infections [
Awareness of birth control methods especially contraceptives is high in Ghana. The 2003 Ghana Demographic and Health Survey (GDHS) confirmed this assertion by reporting that about 98 percent of women and about 99% of men had heard of at least one modern method of contraception. In the 2008 GDHS about 17% of married women used a modern method of family planning with an additional 7% using a traditional method. Injectable (6%) was the most frequently used method. This was followed by the pill; it was recorded that 5% of married women aged 15 to 49 years used this product in 2008 [
In a survey conducted among teenage pregnant women in Nigeria, there was a high level of general awareness as high as 91.7% among the women. This result showed the explorative instincts of youth hence their high level of awareness on birth control methods. From the study, the male condom and the combined oral pill ranked highest in terms of awareness. Despite the high level of general awareness of birth control methods, the use of more complicated methods was rare. The majority of youth who were aware of birth control methods received information from friends [
There was a low level of patronage of contraceptives in city slums in Kenya. This was possibly be due to the fact that residents lived in poor conditions with low level of education and therefore did not appreciate contraceptive usage as compared to those who are were rich and well educated [
Religious beliefs have also been found as major factor that influences people’s use of birth control methods. Fundamentalist adherents of some religions believe that child birth is a natural process ordained by God and therefore should not be hindered by any means. These fundamentalist believers are less likely to use contraceptives as established in some parts of Nigeria [
Birth control methods or contraceptives are essentially products desired by people to use for particular purposes. From an economics viewpoint, any product demanded by people can be considered as a mix of desirable attri- butes or characteristics. It is the attributes of the product that the consumers demand [
Affordability is important as enhanced family planning services targeted at low-income and rural people need to incorporate this attribute for sustainable use of these services [
The unit of analysis for the research study was females between the ages of 15 and 49 years at Abokobi, the capital town of the Ga East Municipal Assembly in the Greater Accra region of Ghana. The survey focussed geographically on the Abokobi township and involved the use of residential houses as the means through which the females could be contacted as these houses provided evidence of residential status of the respondents. Further given that the Government authorities do not have detailed information about people living in the area, the use of houses is the appropriate tool as these authorities, such as the local government District Assembly, has information on the number of houses in Abokobi Township. The survey of houses at Abokobi involved the scientific sampling procedures using the multi-stage cluster sampling procedures as used in Ghanaian and overseas contexts [
The sampling procedures were based on selecting an optimal size of 101 houses out of the total 404 houses in Abokobi as at the time of the survey. The desired maximum sampling error was 10%. The minimum optimal size (n) of 101 was chosen based on a formula given as n = N/1 + N(e)2 where N is the total number of households and e is the margin of error (assumed to be 10% for this study) [
The survey was conducted over a period of five months from February to June 2014. A scientific calculator was employed using random sampling to choose randomly houses located in the eight different clusters. The houses in the clusters were numbered sequentially for easy tracking to avoid duplication. All women between the ages of 15 to 49 who were located in the randomly selected houses and were willing to participate in the study were interviewed. In two of the 101 houses, the contacted women were very busy with commitments and declined to be interviewed. Thus the 120 women interviewed came from 99 houses; 78 women came from single-household houses, and the remaining 42 women were from 21 houses that contained at least two households. The interviews were conducted based on ethical guidelines involving voluntary participation and clearly- expressed consent, and undertaken in the appropriate local Ghanaian language understood by the respondent.
The final questionnaire was developed after the pilot survey and it consisted of six main sections. Section A of the questionnaire captured general information on population and birth control methods in the Municipality. This section elicited the perceptions of respondents on birth control to control population. Section B dealt with the awareness of the different birth control methods. Section C focused on the use of birth control methods by the respondents. Section D requested details of the use and non-use of birth control methods. Section E elicited data relating to current use of birth control methods. Section F, the last component, asked questions related to the socioeconomic characteristics of the respondents including age, income level, education and marital status.
The summary of the literature review suggests that in generality the use of birth control methods by adult women is dependent on the intensity of awareness of these products, and the attributes that are embodied in them. Other socio-economic factors such as age, education, employment, status, location and religiosity exert important influences on the use of birth control methods. A certain minimum amount of awareness about a birth control method is necessary before a woman can use the method. Hence, we use the generalisation of the Tobit model [
For the generalized Tobit model, in the first stage, a Probit equation model was used to estimate the likelihood of a woman using birth control methods. This first stage was dependent on the second stage model which was a multiple regression model dealing with factors influencing the level of general awareness of recognized birth control methods. It is postulated that the likelihood of using birth control methods was dependent on the level of awareness of birth control methods. The first-stage probit model is described in Equation (1).
where EVERUSEBCM was a dummy variable with 1 representing women who had ever used birth control methods (BCM) including those currently using BCM, and zero otherwise;
CSEXRELA was a dummy variable with 1 representing those who had current sexual relationships at the time of the survey and zero otherwise;
AWARENESS2 was the score of importance of awareness of the seven major birth control methods actually used by the respondents. These were 1) dual protection with the male wearing condom, 2) rhythm or calendar method, 3) withdrawal before ejaculation, 4) illegal abortion, 5) female pill, 6) injectable medicine and 7) emergency contraception. The scoring index was based on the zero to five Likert-type scale of awareness with 5 presenting the highest value of importance and zero representing complete lack of awareness;
EDU was the number of years of formal educational attainment of the respondent;
NCHILD was the number of children produced by the respondent;
STUDENT was a dummy variable with 1 representing respondents who were students at the time of the study and zero otherwise; and V1 was the equation error term.
The second-stage awareness of birth control methods model is described in Equation (2).
where AWARENESS1 was the average level of importance of awareness of the identified 18 birth control methods except the traditional abstinence method (used by 12 respondents). The scoring index was based on the zero to five Likert-type scale of awareness with 5 presenting the highest value of importance and zero representing complete lack of awareness;
AGE is the age of the woman respondents; and V2 is the equation error term.
The above two equations (Equation (1) and Equation (2)) were connected by estimating a correlation (ρ) between their error terms, V1 and V2. The two equations were jointly estimated using the SAMPSEL command based on the Time Series Processor (TSP) software [
The study identified 18 specific methods of birth control as follows: 1) Male condom, 2) Illegal abortion, 3) Female condom, 4) Injectable medicine, 5) Rhythm or calendar method, 6) Female pill, 7) Legal abortion, 8) Withdrawal before ejaculation, 9) Implant, 10) Emergency contraception pill, 11) Female sterilization, 12) Traditional herbs,
Item/group | Percentage (%) |
---|---|
Age group 15 - 20 21 - 25 26 - 30 31 - 35 36 - 40 41 - 45 46 - 49 | 19.9 26.6 15.0 18.4 9.1 6.7 4.2 |
Marital status Single Married Informal unions Divorced Widowed Separated | 45.8 35.0 9.2 5.8 3.3 0.8 |
Educational level No formal education Primary school Junior high school Some senior high school Completed senior high school Technical college/school Diploma Higher National Diploma Bachelor degree Other certificate | 4.2 7.6 49.2 11.9 6.8 1.7 4.2 5.9 5.1 3.4 |
Occupation Self-employed/own business Others such as student Private sector employee Unemployed Government sector employee Artisan Farmer | 42.0 19.3 14.3 13.4 8.4 1.7 0.8 |
Item | Mean | Standard deviation |
---|---|---|
Age (years) | 28.3 | 9.3 |
Total personal income of respondents per month, Ghana Cedis (GH₵) | 700.0 | 8.3 |
Total household income of respondents per month (GH₵) | 1650.0 | 8.0 |
Number of people in the household | 5.0 | 3.0 |
Number of children | 1.5 | 1.9 |
Number of male children including living and those dead | 0.8 | 1.2 |
Number of female children including living and those dead | 0.7 | 1.0 |
13) Intra-uterine device (IUD), 14) Foaming tablet, 15) Men taking drugs to prevent pregnancy, 16) Male sterilization, 17) Breastfeeding method and 18) Traditional Ghanaian birth control method based on planned abstinence of the woman from her partner/spouse, for a few months and up to one year or more, after delivery of a baby.
No. | Method | No. | Average score of importance | Standard deviation of score | Coefficient of variation |
---|---|---|---|---|---|
1. | Male condom | 120 | 4.85 | 0.806 | 0.166 |
2. | Illegal abortion | 120 | 4.77 | 0.837 | 0.175 |
3. | Female condom | 120 | 4.58 | 1.275 | 0.278 |
4. | Injectable medicine | 120 | 4.46 | 1.334 | 0.299 |
5. | Rhythm or calendar | 120 | 4.43 | 1.493 | 0.337 |
6. | Female pill | 120 | 4.30 | 1.510 | 0.351 |
7. | Legal abortion | 120 | 4.22 | 1.711 | 0.405 |
8. | Withdrawal before ejaculation | 120 | 3.94 | 1.972 | 0.501 |
9. | Implant | 120 | 3.86 | 1.984 | 0.514 |
10. | Emergency contraception pill | 120 | 3.76 | 2.080 | 0.554 |
11. | Female sterilization | 120 | 3.40 | 2.243 | 0.660 |
12. | Traditional herbs | 120 | 3.17 | 2.349 | 0.741 |
13. | IUD/coil/diaphragm | 120 | 3.01 | 2.310 | 0.767 |
14. | Foaming tablet | 120 | 2.75 | 2.359 | 0.858 |
15. | Men taking drugs to prevent pregnancy | 120 | 2.52 | 2.394 | 0.950 |
16. | Male sterilization | 120 | 2.08 | 2.407 | 1.157 |
17. | Breastfeeding method | 120 | 2.07 | 2.354 | 1.137 |
18 | Traditional birth control based on planned abstinence from husband | 120 | 0.18 | 0.907 | 5.039 |
Notes: The scoring is based on 5 denoting that item is very high level of awareness, 4 represented high level of awareness, 3 indicated moderate level of awareness, 2 represented low level of awareness, 1 represented very low level of awareness and 0 represented total lack of awareness of the particular birth control method. The coefficient of variation is the standard deviation divided by the mean score.
6) female pill and 7) legal abortion. All these seven methods were ranked above 4.0 in terms of the awareness intensity index, in the high awareness range.
The next six most familiar methods, in the moderate to high awareness range from 3.0 to 4.0, were 8) withdrawal before ejaculation method, 9) implant, 10) emergency contraception pill, 11) female sterilization, 12) traditional herbs and 13) IUD. The birth control methods considered to be lowly important in terms of level of awareness were 14) foaming tablet, 15) men taking drugs to prevent pregnancy, 16) male sterilization, 17) breastfeeding method, and 18) traditional birth control involving planned abstinence of the woman from her husband, which was known by only 12 women (10% of the sample).
Birth control method | First most important source of information | Second most important source of information | Third most important source of information |
---|---|---|---|
Implants | Hospitals and clinics (64.6%) | Peers and friends (24.2%) | Television advertisements (19.2%) |
IUD | Hospitals and clinics (57.5%) | Television advertisements (26.4%) | Peers and friends (23.0%) |
Female sterilisation | Hospitals and clinics (48.8%) | Peers and friends (23.8%) | Sex education in schools (17.9%) |
Illegal abortion | Peers and friends (61.8%) | Sex education in schools (15.3%) | Radio (11.7%) |
Legal abortion | Peers and friends (44.3%) | Hospitals and clinics (25.2%) | Special television programmes (15.0%) |
Note: The figures in parentheses are the proportions of respondents using that information source.
Birth control method | First most important source of information | Second most important source of information | Third most important source of information |
---|---|---|---|
Injectable medicine | Hospitals and clinics (60.5%) | Television advertisements (36.8%) | Peers and friends (21.1%) |
Female pill | Television advertisements (55.3%) | Hospitals and clinics (48.2%) | Peers and friends (34.2%) |
Emergency contraceptive pill | Peers and friends (36.5%) | Hospitals and clinics (35.5%) | Television advertisements (32.3%) |
Traditional herbs | Peers and friends (54.2%) | Parents, carers and older relatives (20.9%) | Sex education in schools (9.8%) |
Men taking hormonal and related medicine to prevent pregnancy. | Peers and friends (70.2%) | Radio (21.0%) | Sex education in schools (7.5%) |
Note: The figures in parentheses are the proportions of respondents using that information source.
As reported in
Forty out of the 120 respondents indicated that they had never used any of the 18 birth control methods that involved sexual intercourse with a partner (see
Birth control method | First most important source of information | Second most important source of information | Third most important source of information |
---|---|---|---|
Male condom | Television advertisements (71.4%) | Radio (48.2%) | Peers and friends (43.8%) |
Female condom | Television advertisements (47.3%) | Hospitals and clinics (42.9%) | Peers and friends (31.2%) |
Breastfeeding | Hospitals and clinics (55.0%) | Sex education in schools (18.3%) | Television advertisements (15.0%) |
Foaming tablets | Hospitals and clinics (38.5%) | Peers and friends (31.8%) | Television advertisements (22.5%) |
Rhythm | Peers and friends (51.3%) | Sex education in schools (30.7%) | Hospitals and clinics (23.2%) |
Withdrawal before ejaculation | Peers and friends (69.6%) | Sex education in schools (18.5%) | Hospitals and clinics (7.7%) |
Traditional method based on the planned abstinence with the woman staying away from partner for a period of time | Peers and friends (53.7%) | Parents, carers and older relatives (35.9%) | Hospitals and clinics (18.0%) |
Note: The figures in parentheses are the proportions of respondents using that information source.
No. | Birth control method | Current use that is within 12 months preceding the survey (%) | Used in the past meaning more than one year preceding the survey (%) |
---|---|---|---|
1. | Rhythm or calendar method | 42.5 | 10.8 |
2. | Withdrawal before ejaculation | 41.3 | 11.1 |
3. | Dual protection with use of male condom | 21.7 | 30.5 |
4. | Injectable method | 9.5 | 8.5 |
5. | Female pill | 7.2 | 17.1 |
6. | Emergency contraception pill | 7.2 | 6.0 |
7. | Lactational amenorrhea method/ breastfeeding method | 7.2 | 4.8 |
8. | Female condom | 4.8 | 2.4 |
9. | Implant | 4.8 | 0.0 |
10. | IUD/coil/diaphragm | 2.4 | 0.0 |
11. | Illegal abortion | 1.2 | 18.1 |
12. | Foaming tablet | 1.2 | 4.8 |
13 | Traditional herbs | 1.2 | 2.4 |
14. | Legal abortion | 1.2 | 0.0 |
15. | Traditional birth control based on planned abstinence from husband | 0.0 | 2.4 |
16. | Female sterilisation | 0.0 | 0.0 |
17. | Men taking hormonal and related medicine to prevent pregnancy | 0.0 | 0.0 |
18. | Male sterilisation | 0.0 | 0.0 |
As reported in the literature review, the choice of a birth control method, similar to other consumer products, is influenced greatly by the attributes embodied in the birth control method in line with the Lancaster demand theory. The survey elicited information from the 84 current and past users of various birth control methods on the key attributes that influenced their decision to choose and use specific methods. The attributes elicited included affordability and price, availability of product locally, low travel costs to pharmacy or clinic, access to adequate information about product, ease of inserting item into body, comfort in having item inside body, reliability in preventing pregnancy, safety in terms of minimal side effects, acceptance by male partner or spouse, peer influence and confidentiality and no embarrassment to either male or female partner in using the product.
As indicated in
No. | Attribute | No. | Average score of importance | Standard deviation of score | Coefficient of variation |
---|---|---|---|---|---|
1 | Access to adequate information about product | 47 | 4.85 | 0.625 | 0.129 |
2 | Low travel costs to pharmacy or clinic | 47 | 4.79 | 0.778 | 0.162 |
3 | Acceptance by male partner or spouse | 48 | 4.75 | 0.863 | 0.182 |
4 | Ease of inserting item into body | 42 | 4.74 | 0.828 | 0.175 |
5 | Reliability in preventing pregnancy | 49 | 4.71 | 0.707 | 0.150 |
6 | Availability of product locally | 47 | 4.70 | 0.998 | 0.212 |
7 | Confidentiality and no embarrassment | 44 | 4.66 | 1.099 | 0.236 |
8 | Safety in terms of minimal side effects | 48 | 4.54 | 1.254 | 0.276 |
9 | Comfort in having item inside body | 43 | 4.33 | 1.410 | 0.326 |
10 | Affordability and price | 47 | 3.30 | 1.876 | 0.568 |
Notes: A score of 5 indicates “very high level of importance”, 4 is “high level of importance”, 3 is “moderately important”, 2 is “low level of importance” and 1 “very low level of importance.
No. | Attribute | No. | Average score of importance | Standard deviation of score | Coefficient of variation |
---|---|---|---|---|---|
1 | Access to adequate information about product | 40 | 4.95 | 0.221 | 0.045 |
2 | Confidentiality and no embarrassment | 41 | 4.90 | 0.490 | 0.100 |
3 | Safety in terms of minimal side effects | 44 | 4.73 | 1.020 | 0.216 |
4 | Acceptance by male partner or spouse | 42 | 4.43 | 1.417 | 0.320 |
5 | Reliability in preventing pregnancy | 45 | 4.36 | 1.246 | 0.286 |
6 | Affordability and price | 39 | 3.97 | 1.724 | 0.434 |
Notes: A score of 5 indicates “very high level of importance”, 4 is “high level of importance”, 3 is “moderately important”, 2 is “low level of importance” and 1 “very low level of importance.
No. | Attribute | No. | Average score of importance | Standard deviation of score | Coefficient of variation |
---|---|---|---|---|---|
1 | Access to adequate information about product | 24 | 5.00 | 0.000 | 0.000 |
2 | Safety in terms of minimal side effects | 33 | 4.85 | 0.712 | 0.147 |
3 | Confidentiality and no embarrassment | 32 | 4.84 | 0.723 | 0.149 |
4 | Acceptance by male partner or spouse | 33 | 4.82 | 0.727 | 0.151 |
5 | Reliability in preventing pregnancy | 32 | 4.66 | 0.827 | 0.177 |
6 | Affordability and price | 29 | 3.72 | 1.869 | 0.502 |
Notes: A score of 5 indicates “very high level of importance”, 4 is “high level of importance”, 3 is “moderately important”, 2 is “low level of importance” and 1 “very low level of importance.
No. | Attribute | No. | Average score of importance | Standard deviation of score | Coefficient of variation |
---|---|---|---|---|---|
1 | Reliability in ending pregnancy | 18 | 4.61 | 1.145 | 0.248 |
2 | Access to adequate information about product | 18 | 4.39 | 1.335 | 0.304 |
3 | Confidentiality and no embarrassment | 18 | 4.00 | 1.715 | 0.429 |
4 | Acceptance by male partner or spouse | 18 | 3.89 | 1.844 | 0.474 |
5 | Safety in terms of minimal side effects | 18 | 3.83 | 1.757 | 0.459 |
6 | Availability of product locally | 18 | 3.56 | 1.688 | 0.474 |
7 | Comfort in having item inside body | 17 | 2.53 | 1.940 | 0.767 |
8 | Low travel costs to pharmacy or clinic or hospital | 17 | 2.47 | 1.940 | 0.785 |
9 | Ease of inserting item into body | 15 | 2.13 | 1.807 | 0.848 |
10 | Affordability and price | 18 | 1.89 | 1.711 | 0.905 |
Note: A score of 5 indicates “very high level of importance”, 4 is “high level of importance”, 3 is “moderately important”, 2 is “low level of importance” and 1 “very low level of importance.
No. | Attribute | No. | Average score of importance | Standard deviation of score | Coefficient of variation |
---|---|---|---|---|---|
1 | Access to adequate information about product | 17 | 4.94 | 0.243 | 0.049 |
2 | Reliability in preventing pregnancy | 20 | 4.75 | 0.786 | 0.165 |
3 | Ease of inserting item into body | 13 | 4.69 | 1.109 | 0.236 |
4 | Low travel costs to pharmacy or clinic | 18 | 4.67 | 0.840 | 0.180 |
5 | Availability of product locally | 18 | 4.61 | 0.778 | 0.169 |
6 | Comfort in having item inside body | 14 | 4.57 | 1.158 | 0.253 |
7 | Confidentiality and no embarrassment | 16 | 4.19 | 1.601 | 0.382 |
8 | Safety in terms of minimal side effects | 18 | 3.72 | 1.406 | 0.378 |
9 | Affordability and price | 18 | 3.56 | 1.886 | 0.530 |
10 | Acceptance by male partner or spouse | 17 | 3.00 | 1.904 | 0.635 |
Notes: A score of 5 indicates “very high level of importance”, 4 is “high level of importance”, 3 is “moderately important”, 2 is “low level of importance” and 1 “very low level of importance.
No. | Attribute | No. | Average score of importance | Standard deviation of score | Coefficient of variation |
---|---|---|---|---|---|
1 | Access to adequate information about product | 16 | 4.69 | 0.793 | 0.169 |
2 | Availability of product locally | 16 | 4.69 | 1.014 | 0.216 |
3 | Reliability in preventing pregnancy | 16 | 4.69 | 1.014 | 0.216 |
4 | Low travel costs to pharmacy or clinic | 16 | 4.56 | 1.094 | 0.240 |
5 | Confidentiality and no embarrassment | 17 | 4.53 | 0.943 | 0.208 |
6 | Ease of inserting item into body | 15 | 4.40 | 1.183 | 0.269 |
7 | Safety in terms of minimal side effects | 16 | 4.19 | 1.424 | 0.340 |
8 | Acceptance by male partner or spouse | 16 | 4.19 | 1.601 | 0.382 |
9 | Comfort in having item inside body | 15 | 3.93 | 1.710 | 0.435 |
10 | Affordability and price | 15 | 3.33 | 1.839 | 0.552 |
Note: A score of 5 indicates “very high level of importance”, 4 is “high level of importance”, 3 is “moderately important”, 2 is “low level of importance” and 1 “very low level of importance.
No. | Attribute | No. | Average score of importance | Standard deviation of score | Coefficient of variation |
---|---|---|---|---|---|
1 | Reliability in preventing pregnancy | 13 | 5.00 | 0.000 | 0.000 |
2 | Access to adequate information about product | 13 | 4.92 | 0.277 | 0.056 |
3 | Ease of inserting item into body | 11 | 4.64 | 0.924 | 0.199 |
4 | Low travel costs to pharmacy or clinic | 12 | 4.50 | 1.243 | 0.276 |
5 | Availability of product locally | 13 | 4.46 | 1.198 | 0.269 |
6 | Affordability and price | 12 | 4.42 | 1.379 | 0.312 |
7 | Confidentiality and no embarrassment | 12 | 4.33 | 1.073 | 0.248 |
8 | Safety in terms of minimal side effects | 12 | 4.25 | 1.422 | 0.335 |
9 | Comfort in having item inside body | 12 | 4.17 | 1.528 | 0.366 |
10 | Acceptance by male partner or spouse | 13 | 3.77 | 1.691 | 0.449 |
Notes: A score of 5 indicates “very high level of importance”, 4 is “high level of importance”, 3 is “moderately important”, 2 is “low level of importance” and 1 “very low level of importance.
spouse, was ranked highly but was not the most important attribute for any of the seven birth control methods. This attribute was also ranked the lowest for the female pill and emergency contraception pill. This result suggested that power relationship between the woman and her male partner or spouse was not the most important factor influencing the choice of contraceptives by the woman. For all seven birth control methods, the relatively moderate ranking assigned to affordability and price attribute reflected the subsidisation of contraceptives which made them relatively affordable to the population.
Explanatory variable | Parameter estimate (B) | Student t value | Probability level of significance |
---|---|---|---|
CONSTANT | −4.934 | −10.544 | 0.000* |
AWARENESS2 | 1.001 | 9.817 | 0.000* |
CSEXRELA | 0.305 | 9.813 | 0.000* |
NCHILD | 0.174 | 9.816 | 0.000* |
EDU | 0.050 | 1.153 | 0.249 |
STUDENT | −0.095 | −9.601 | 0.000* |
Explanatory variable | Parameter estimate (B) | Student t value | Probability level of significance |
---|---|---|---|
CONSTANT | 3.861 | 18.265 | 0.000* |
AGE | 0.011 | 342.601 | 0.000* |
EDU | 0.001 | 0.032 | 0.974 |
SIGMA | 0.904 | 9.818 | 0.000* |
Notes: The sample size available for the analysis was 110 due to missing values for some variables. *Parameter was statistically significant at the 5% confidence level used for the study.
The general awareness of birth control methods regression analysis indicated that increasing age of the woman led to increased general awareness of birth control methods as shown by another study [
The study reported in this paper was a highly-confidential survey undertaken to assess the awareness of and factors influencing the use of birth control methods among 120 women aged between 15 and 49 years, in their reproductive lifespan. The results of the analysis indicated that all the 120 women respondents were aware of at least one birth control method. Altogether, 18 birth control methods were identified. Increasing age was the main factor responsible for the general level of awareness of birth control methods. Use of birth control methods was significantly and positively related to the level of awareness of birth control methods, being in a current sexual relationship, and the number of children that the woman had.
Students were less likely to use birth control methods than non-students suggesting recognition of temporary abstinence from sex as alternative birth control method. However, the relatively low awareness of birth control methods exhibited by relatively younger women suggested the need of government and non-governmental organisations to establish and/or expand programmes related to sex education and family planning for younger women through outreach programmes in churches, schools and community-operated social centres and institutions such as the local government offices. Community sensitization programmes should be persistently undertaken to clear misconceptions on birth control methods especially on the female condom. The low level of awareness of the traditional Ghanaian method of abstinence from husband/partner for several months after delivery of baby by women should be tackled through the provision of more information on this method by hospitals and clinics to pregnant and nursing mothers and those who attend pre-natal counselling sessions at urban and peri-urban health centres. Finally, future studies on the use of contraceptives in Ghana need to analyse in more detail the influence of career choices made by women on the use of contraceptives as undertaken elsewhere in the world [
Kwabena AsomaninAnaman,Joana Okailey AkuOkai, (2016) Extent of Awareness of Birth Control Methods and Their Use by Women in a Peri-Urban Area of Accra, Ghana. Modern Economy,07,39-54. doi: 10.4236/me.2016.71005