Risk and protective factors for intention of contraception use among women in Ghana

The use of various forms of contraception in Ghana gained prominence after the government resorted to investing more in family planning programs when maternal mortality was declared an emergency in the country. In Ghana, the intention to use and actual usage of contraceptives is influenced by many factors, which may lead to non-usage or discontinuation. This quantitative study was conducted to determine risk and protective factors impacting on the intention and usage of contraceptives. Survey data from the Ghana 2014 Demographic and Health Survey (DHS) (n = 9396) was used. A sub-sample of 7661 women in their reproductive age were included in this study, who reported being sexually active within the last year. Logistic regression analyses were conducted to test the association between a broad range of risk and protective factors including religion, early sexual intercourse, frequency of sex, number of lifetime sexual partners with intention to use contraception. We controlled for income, educational attainment, and age. Overall (n = 3661; 47.8%) reported no intention of contraception use. Logistic regression analysis revealed that no formal education (OR = 1.49; 95% CI, 1.29-1.72; p < 0.001), and primary school as highest educational level (OR = 1.19; 95% CI, 1.04-1.25; p < 0.001), Islamic religion (OR = 0.73; 95% CI, 0.59-0.90; p < 0.001), not currently employed (OR = 1.50; 95% CI, 1.34-1.69; p < 0.001), husband opposing contraception use (OR = 2.19; 95% CI, 1.42-3.46; p < 0.001), and currently pregnant (OR = 1.30; 95% CI, 1.09-1.54; p < 0.001) were also positively associated with no intention of use. Engaging religious leaders for advocacy in the community was identified as an approach to address barriers and increase awareness on contraceptive use. Targeted family planning programs should intensify public education on safe sex behaviors.