Factors Influencing the Willingness of Pregnant Women in Rural Ghana to Adopt Postpartum Family Planning

Author(s): Eliason S, Baiden F, Graham-Hayfron Y, Bonsu, D, Phillips J, Awusabo-Asare K

Year:

Abstract:

Uptake of postpartum family planning (PPFP) remains very low in sub-Saharan Africa. Very little is known about how pregnant women arrive at their decisions to adopt PPFP. This information is needed to guide the development of interventions to promote PPFP.

 

Method

We conducted a survey among pregnant women attending antenatal clinics in a rural district in southern Ghana to identify determinants of their willingness to adopt PPFP. We used univariate and multivariate analysis to explore predictors of the willingness to adopt PPFP.

 

Results

We interviewed 1914 pregnant women attending antenatal clinics in four health facilities. About 84% considered PPFP acceptable, and 70% expressed a willingness to adopt a method after delivery. The most preferred methods of PPFP were the injectables (31.5%), exclusive breastfeeding (16.7%), and oral contraceptive pills (14.8%). The perception of partner acceptability (O.R.=5.29, 3.23-8.38), acceptability of PPFP by the pregnant woman (O.R.=3.54, 1.65-7.60), having had prior experience with the use of injectables (O.R.=3.06, 1.71-5.47) and carrying an either unwanted or unexpected pregnancy (O.R.=1.50, 1.11-2.02) were independent predictors of a pregnant woman’s willingness to adopt PPFP. Conversely, women who had heard of the diaphragm (O.R.=0.48, 0.30-0.76) were less likely to want to adopt PPFP.

 

Conclusion

Male partner approval, acceptability of PPFP by the pregnant woman, past experience with the use of injectables, and the circumstances under which the current pregnancy occurred are the major determinants of the willingness of a pregnant woman to adopt PPFP. Procedures adopted at antenatal and early postnatal clinics should take these determinants into consideration.