Factors influencing the uptake of family planning services in the Talensi district, Ghana

  • Pan African Medical Journal, Volume 20, Year 2015

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Study Justification:
The study aimed to investigate the factors influencing the decision of women in fertility age to use family planning services in the Talensi district, Ghana. This is important because although family planning services have been found to reduce unintended pregnancies and maternal and child mortality, their usage remains low in developing countries. Understanding the factors that influence the uptake of family planning services can help inform interventions and policies to increase their usage and improve reproductive health outcomes.
Highlights:
– The study was conducted in the Talensi district, one of thirteen districts in the Upper East Region of Ghana.
– A cross-sectional quantitative survey was conducted between January and May 2014.
– Questionnaires were administered to women aged 15-49 years in households in the eight sub-districts of the Talensi district.
– A sample size of 280 women was recruited using systematic random sampling technique.
– The study found that factors such as marital status, age, religion, parity, and educational level influenced the uptake of family planning services.
– The study also identified reasons that motivated women to access family planning services and reasons that discouraged women from using the service.
Recommendations:
Based on the findings of the study, the following recommendations can be made:
1. Increase awareness and education about family planning services, targeting different age groups, religious communities, and educational levels.
2. Strengthen family planning services in the Talensi district by ensuring availability and accessibility of a variety of contraceptive methods.
3. Address cultural and social barriers that discourage women from using family planning services, such as misconceptions and negative attitudes towards contraception.
4. Collaborate with community leaders and volunteers to promote family planning services and address community-specific challenges.
5. Conduct further research to explore the specific reasons behind low uptake of family planning services in the Talensi district and develop targeted interventions.
Key Role Players:
1. Researchers: Conduct further research, analyze data, and disseminate findings.
2. Community Volunteers: Assist researchers in recruiting participants and obtaining permission from community leaders.
3. Community Leaders: Provide permission for research and support the promotion of family planning services.
4. Health Care Facilities: Offer free family planning services and ensure availability of a variety of contraceptive methods.
5. Policy Makers: Use the study findings to inform policies and interventions to increase the uptake of family planning services.
Cost Items for Planning Recommendations:
1. Awareness and Education Campaigns: Printing and distribution of educational materials, organizing community workshops, and hiring educators.
2. Strengthening Family Planning Services: Procurement of contraceptive methods, training of healthcare providers, and infrastructure improvements.
3. Cultural and Social Barriers: Sensitization programs, community engagement activities, and development of culturally appropriate messaging.
4. Research and Analysis: Funding for further research, data collection, and analysis.
5. Collaboration and Coordination: Meetings and workshops with key stakeholders, transportation costs, and communication expenses.

The strength of evidence for this abstract is 7 out of 10.
The evidence in the abstract is relatively strong, but there are some areas for improvement. The study design is clearly described as a cross-sectional quantitative survey, and the sample size calculation is provided. The study population is also clearly defined. However, there is limited information on the data collection methods and analysis techniques used. Additionally, while the study was approved by an ethics committee and written consent was obtained, there is no mention of any measures taken to ensure data quality or validity. To improve the evidence, it would be helpful to provide more details on the data collection methods, including how the questionnaires were administered and any measures taken to ensure data quality. It would also be beneficial to provide information on the statistical analysis techniques used and any steps taken to ensure the validity of the findings.

Introduction: usage of family planning services in developing countries have been found to avert unintended pregnancies, reduce maternal and child mortality, however, it’s usage still remains low. Hence, the objective of this study was to investigate the factors that influence the decision of women in fertility age to go for family planning services.

This was a cross-sectional quantitative survey which was conducted between January and May, 2014. Questionnaires were administered to women aged 15-49years in households in the eight (8) sub-districts of the Talensi district. The Talensi district is one of thirteen districts in the Upper East Region of Ghana. The district has a total of population of 84,712 with a population of 19,738 of the women in fertility age (15-49years) with most inhabitants of the district being peasant farmers [12]. The district has eighteen (18) health care facilities which comprise of health centres, clinics and Community-based Health Planning and Services (CHPS) compounds of which sixteen (16) of the facilities offer free family planning services. Some of the family planning methods that are currently being offered include; Jadelle, Norplant, Condoms, Depo-provera, combined oral contraceptive pills etc [12]. A sample size of 280 was derived using sample size formula for a single population. The assumptions made were using a 95% confidence interval, 5% margin of error and 23.3% national expected proportion of uptake of family planning service among Women In Fertility Age (WIFA). n= Z2P (1-P)/(d)2 Where n is the required sample size, P= 23.3% (0.233), Z= 1.96 and d= 5% (0.05). n= (1.96)2 (0.233 × 0.767)/(0.05)2 =275 which is 280 (to the nearest tenth). A total of 280 of women aged 15-49years were recruited for the study using systematic random sampling technique. The 280 participants recruited were from households in the 8 sub-districts that make up the Talensi district (35 households from each sub-district) with one participant from each household. The 280 participants were recruited by the researchers themselves with the help of a community volunteer from each sub-district. The community volunteer helped researchers to approach community leaders to inform them about the purpose of the study and to obtain permission from them to recruit and interview potential participants as this is standard community entry protocol for conducting research within local community context in Ghana [13]. The presence of community volunteers in the team may have influenced the high response rate of 100% as they are highly respected with good knowledge of local residents. All households were numbered and a sampling interval, n=5 was used to select the first household. Subsequent selection of every 5th household then followed in same direction. Using this technique about 284 households was selected but 4 households were dropped because no one was available at the house to be recruited at the time of the survey. The questionnaires were structured with closed ended pre-coded questions and administered to participants by the Researchers. The questionnaires were divided into four parts. The first part was the socio-demographics whilst the second part was the awareness and usage of family planning services. The third part of the questionnaire provided various reasons that motivated women to access family planning services and the fourth part provided various reasons that discouraged women from using the service. The questionnaires were administered in a language that participants were comfortable to respond. The questionnaires were first piloted on ten (10) participants in the Nabdam district, a neighbouring district which shares border with the Talensi district. Piloting of the questions was done to ensure that the questions were more refined for participants to respond without difficulties [14]. All data were entered into SPSS version 21.0 and analyzed. The P-value of 0.05 was taken for statistical significance. The association between the binary outcome, usage of family planning services (yes or no) with independent categorical variables such as marital status, age, religion, parity and educational level were investigated using chi-squared test. Binary logistic regression model with the outcome, those who had used family planning services was used to investigate the influence of independent variables such marital status, age, religion, parity and educational level on the uptake of family planning services. Descriptive summary statistics was also used to report various reasons that motivated respondents to go for family planning services as well as reasons why some respondents did not use the service in the district. This study was approved by the Ethics committee board of the Catholic University college of Ghana and the Talensi district health directorate. Written consent was obtained from participants and for participants who were within the ages of 15-17years written consent was obtained from their guardians on behalf of them. All participants who consented to take part in the survey were well informed about the purpose of the study and why they were being asked to participate. They were also informed that participation was voluntary and they had the right to withdraw from the study even after they had participated.

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Based on the provided description, here are some potential innovations that could improve access to maternal health:

1. Mobile health (mHealth) interventions: Develop mobile applications or text messaging services to provide information and reminders about family planning services, prenatal care, and postnatal care. This can help increase awareness and encourage women to seek appropriate healthcare services.

2. Community-based health workers: Train and deploy community health workers to provide education, counseling, and support for family planning services. These workers can reach remote areas and provide personalized care, addressing any concerns or misconceptions that women may have.

3. Telemedicine: Implement telemedicine services to connect women in rural areas with healthcare providers. This can enable remote consultations, diagnosis, and treatment, reducing the need for women to travel long distances for healthcare services.

4. Public-private partnerships: Collaborate with private healthcare providers to expand access to family planning services. This can involve subsidizing or providing free services at private clinics or pharmacies, increasing the availability and affordability of contraceptives.

5. Health education campaigns: Conduct targeted health education campaigns to raise awareness about the benefits of family planning services and address cultural or religious barriers. These campaigns can be conducted through various channels, such as radio, television, community meetings, and social media.

6. Integration of services: Integrate family planning services with other healthcare services, such as antenatal care and immunization programs. This can ensure that women have access to comprehensive care and increase the likelihood of utilizing family planning services.

7. Improving infrastructure: Invest in improving healthcare infrastructure, including the availability of well-equipped health facilities and transportation systems. This can reduce barriers to accessing maternal health services, particularly in remote areas.

8. Financial incentives: Provide financial incentives, such as conditional cash transfers or vouchers, to encourage women to seek and utilize family planning services. This can help overcome financial barriers and increase the uptake of services.

9. Quality improvement initiatives: Implement quality improvement initiatives to enhance the delivery of maternal health services. This can involve training healthcare providers, improving the availability of essential supplies and equipment, and ensuring respectful and patient-centered care.

10. Research and data-driven approaches: Conduct further research to identify specific barriers and challenges to accessing family planning services in the Talensi district. Use data to inform evidence-based interventions and monitor the impact of implemented innovations.

It is important to note that the specific context and needs of the Talensi district should be taken into consideration when implementing these innovations.
AI Innovations Description
Based on the provided description, the following recommendation can be developed into an innovation to improve access to maternal health:

1. Increase awareness and education: Develop and implement comprehensive awareness campaigns to educate women and communities about the importance of maternal health and family planning services. This can include using various communication channels such as radio, television, social media, and community outreach programs to reach a wider audience.

2. Improve access to family planning services: Strengthen the existing healthcare infrastructure by increasing the number of health facilities that offer free family planning services. This can be achieved by partnering with local organizations, NGOs, and government agencies to provide funding and resources for the expansion of healthcare facilities in the Talensi district.

3. Address cultural and religious barriers: Conduct culturally sensitive and religiously appropriate educational programs to address misconceptions and myths surrounding family planning services. Engage community leaders, religious leaders, and traditional birth attendants to promote the benefits of family planning and maternal health.

4. Enhance healthcare provider training: Provide comprehensive training to healthcare providers on family planning counseling and services. This can include training on effective communication, counseling techniques, and the provision of a wide range of family planning methods to meet the diverse needs of women in the Talensi district.

5. Strengthen community support systems: Establish support groups and networks for women and families to share experiences, provide emotional support, and promote the use of family planning services. These support systems can also serve as platforms for disseminating accurate information and addressing any concerns or barriers to accessing maternal health services.

6. Monitor and evaluate progress: Implement a robust monitoring and evaluation system to track the progress of the implemented recommendations. This can include regular data collection, analysis, and reporting to identify areas of improvement and ensure the effectiveness of the interventions.

By implementing these recommendations, it is expected that access to maternal health services, including family planning, will be improved in the Talensi district, ultimately leading to a reduction in maternal and child mortality rates.
AI Innovations Methodology
Based on the provided description, here are some potential recommendations to improve access to maternal health:

1. Increase awareness: Implement targeted awareness campaigns to educate women and communities about the importance of maternal health and the available services. This can be done through community outreach programs, radio broadcasts, and informational materials.

2. Improve accessibility: Enhance the availability and accessibility of maternal health services by increasing the number of healthcare facilities, especially in rural areas. This can be achieved by establishing mobile clinics or community-based health centers.

3. Strengthen healthcare workforce: Invest in training and capacity building for healthcare providers to ensure they have the necessary skills and knowledge to provide quality maternal health services. This can include training on antenatal care, safe delivery practices, and postnatal care.

4. Address cultural and social barriers: Identify and address cultural and social barriers that prevent women from accessing maternal health services. This can involve engaging community leaders, religious leaders, and traditional birth attendants to promote the importance of maternal health and encourage women to seek care.

To simulate the impact of these recommendations on improving access to maternal health, a methodology could include the following steps:

1. Define indicators: Identify key indicators to measure the impact of the recommendations, such as the number of women accessing maternal health services, the reduction in maternal and child mortality rates, and the increase in contraceptive use.

2. Collect baseline data: Gather baseline data on the current state of maternal health access, including the number of healthcare facilities, the availability of services, and the utilization rates.

3. Implement interventions: Implement the recommended interventions, such as awareness campaigns, infrastructure improvements, and healthcare workforce training.

4. Monitor and evaluate: Continuously monitor and evaluate the progress of the interventions by collecting data on the indicators identified in step 1. This can be done through surveys, interviews, and data analysis.

5. Analyze the data: Analyze the collected data to assess the impact of the interventions on improving access to maternal health. This can involve comparing the baseline data with the post-intervention data to identify any changes or improvements.

6. Adjust and refine: Based on the findings from the data analysis, make any necessary adjustments or refinements to the interventions to further enhance their effectiveness.

7. Repeat the process: Continuously repeat the process of monitoring, evaluating, and adjusting the interventions to ensure sustained improvements in access to maternal health.

By following this methodology, it will be possible to simulate the impact of the recommendations on improving access to maternal health and make informed decisions on how to further enhance maternal health services.


Statistics:
Citations: 76
Identifiers:
DOI: 10.11604/pamj.2015.20.10.5301
ISSN: 19378688
Research Areas:
Community Interventions, Health System and Policy, Maternal Access, Maternal and Child Health, Quality of Care, Sexual and Reproductive Health, Social Determinants
Study Countries:
Ghana
Study Design:
Cross Sectional Study
Study Approach:
Quantitative
Participants Gender:
Female
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