Correlates of Mistimed Pregnancy and Unmet Need for Family Planning among Women of Reproductive Age in Sandema, Ghana

Background: Globally, an estimated 80 million unintended pregnancies comprising both mistimed and unwanted pregnancies are recorded yearly. Yet only half of the women at risk of mistimed pregnancy use contraceptives. In developing countries, over 100 million females have unmet need, and national surveys in Ghana indicate 23% unmet need rate. Methods: Using a cross-sectional community-based approach, a sample size of 300 women of reproductive age were selected using multi-step cluster sampling techniques. The study was quantitative, using structured interviewer-administered questionnaires. Results: Two-third (66%) of the women in reproductive age still had unmet need, 71% were currently pregnant, and more than a third (36%) confirmed ever having a mistimed pregnancy. Fifty-three percent (53%) of the women confirmed never communicating with their partners on family planning issues, a little below half (45%) took their own health care decisions. Seventy nine percent (79%) ever received family planning services from a health professional. Factors related to unmet needs included mistimed pregnancy, level of education, preferred birth/pregnancy interval, communication between partners and the autonomy to spend self-earnings. Conclusion: Considering that high rates of unmet need results in mistimed pregnancy, improved policies around the influence of unmet need on mistimed pregnancies are needed.

From talk to action:Developing a model to foster effective integration of traditional medicine into the Ghanaian healthcare system

This research assessed the experience of stakeholders and the efficacy of integrating traditional medicine into the Ghanaian health system using the Ashanti Region as the focal point.Elements of an integrative healthcare delivery model including philosophies/values,structure,process and outcome were used to conduct a quality assessment of the integrated health system in Ghana.Each element clearly showed that Ghana is currently not running a coordinated health practice model,thus making it a tolerant,rather than an inclusive,health system.Therefore,the primary purpose of this research is to discuss the development of a new and appropriately customised model that could enhance the practice of integrated healthcare in Ghana.The model we present has flexibility and far-reaching applicability in other African countries because such countries share similar socio-cultural and economic characteristics.As such,governments and health practitioners could adapt this model to improve the practice of integrated healthcare in their specific settings.Hospital administrators and health system researchers could also adapt the model to investigate or to monitor the progress and efficacy of integrated healthcare practices within their settings.This might help to understand the relationships between the integration of traditional medicine and health outcomes for a given population.

Views of health service providers on obstacles to tuberculosis control in Ghana

Background:Although Ghana does not fall into the category of those countries which have a high burden of tuberculosis(TB),the disease does present considerable economic and health limitations to individuals infected with,and affected by,the disease,as well as to the health system in general.Despite this fact,insufficient studies have been done on the key barriers to controlling the disease.This paper presents results from an exploratory study on the constraints of controlling TB in Ghana based on the opinions of health service providers.Methods:In-depth interviews were conducted with frontline health workers involved in TB control in the country.Participants were purposively selected from a pool of national and regional,and district and facility level coordinators of the National Tuberculosis Control Programme(NTP).One key informant was also selected from an international non-governmental organisation(NGO)involved in TB-related activities in Ghana.Observations were utilised to complement the study.Data were analysed inductively.Results:Respondents identified the following as being constraints to TB control:clinical complication,bottlenecks in funding administration,quality of physical infrastructure,competition for attention and funding,unsatisfactory coordination between TB and HIV control programmes,a poor public-private partnership,and weak monitoring and evaluation of interventions.Conclusions:This paper provides evidence of some key barriers to TB control.The barriers,as reported,were generally health system-based.Although this list of barriers is not exhaustive,it would be useful to take them into account when planning for TB control,thus adopting a more rounded approach to TB management in the country.As well as that,further studies should be done to explore patients’views on health service-related barriers to TB control.

Contraceptive Use in Ghana: What about Women Empowerment?

Introduction: Although contraceptive usage appears to be increasing in Ghana, 30 and 42 percent of married and unmarried women respectively still have unmet need for family planning services partly due to their inability to exercise their basic rights on fertility issues. Meanwhile, expanding freedom of choice and actions to shape women’s life is critical to how women can be autonomous about issues surrounding their fertility. On this premise, this study aimed at investigating empowerment status and usage of contraceptives among women in the reproductive age in Ghana. Methods: The study made use of the 2014 Ghana Demographic and health survey with a sample size of 9396. The outcome variable was contraceptive use whilst the main independent variable was women empowerment (measured by ability to decide on a woman’s own healthcare, large household purchases and visiting family members). Both bivariate and multivariate binary logistic regressions were carried out generating odd ratios to explore the association at 95% confidence interval. Results: The results indicated that women who were not deciding alone on their own healthcare were less probable to use contraceptives (OR = 0.92, CI = 0.80 - 1.07) as well as those who were not deciding alone on large household purchases (OR = 0.96, CI = 0.82 - 1.11) and visiting family members (OR = 0.63, CI = 0.93 - 1.25) at the bivariate level. However, at the multivariate level, higher likelihoods of contraceptive use were found among those who were not deciding alone on health (OR = 1.26, CI = 1.18 - 1.68), large household purchases (OR = 1.30, CI = 1.08 - 1.55) and visiting family members (OR = 1.32, CI = 1.12 - 1.57). Conclusion: This has inspired the need to intensify women empowerment interventions through mass media and all possible avenues in order to enhance reproductive health.