title: Factors influencing the intention of women in rural Ghana to adopt postpartum family planning.
abstract: BACKGROUND
  Uptake of postpartum family planning (PPFP) remains low in sub-Saharan Africa and 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.
  
  
  METHODS
  We conducted a survey among pregnant women attending antenatal clinics in a rural district in Ghana. We used univariate and multivariate logistic regression analysis to explore how knowledge of various family planning (FP) methods, past experience with their use and the acceptability of PPFP to male partners and close relations influenced the intention of pregnant women to adopt PPFP.
  
  
  RESULTS
  We interviewed 1914 pregnant women in four health facilities. About 84% considered PPFP acceptable, and 70% intended to adopt a method. The most preferred methods were injectables (31.5%), exclusive breastfeeding (16.7%), and oral contraceptive pills (14.8%). Women whose first choice of PPFP method were injectables were more likely to be women who had had past experience with its use (O.R = 2.07, 95% C.I. 1.50-2.87). Acceptability of PPFP by the pregnant woman (O.R. = 3.21, 1.64-6.26), perception of partner acceptability (O.R. = 3.20, 1.94-5.48), having had prior experience with the use of injectables (O.R. = 3.72, 2.61-5.30) were the strongest predictors of the intention to adopt PPFP. Conversely women who knew about the diaphragm (O.R. = 0.59, 0.38-0.93) and those who had past experience with IUD use (O.R. = 0.13, 0.05-0.38) were less likely to want to adopt PPFP.
  
  
  CONCLUSIONS
  Acceptability of PPFP to the pregnant woman, male partner approval, and past experience with the use of injectables are important factors in the PPFP decisions of women in this population. Antenatal and early postnatal care need to be adapted to take these factors into consideration.
authors.affiliation: Department of Community Medicine, University of Cape Coast, Cape Coast, Ghana.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Eliason
authors.forename: Frank
authors.initials: F
authors.lastname: Baiden
authors.forename: Gloria
authors.initials: G
authors.lastname: Quansah-Asare
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Graham-Hayfron
authors.forename: Derek
authors.initials: D
authors.lastname: Bonsu
authors.forename: James
authors.initials: J
authors.lastname: Phillips
authors.forename: Kofi
authors.initials: K
authors.lastname: Awusabo-Asare
mesh_terms: D000328:Adult; D003267:Contraception / Q000379:methods / Q000523:psychology*; D005193:Family Planning Services; D005260:Female; D005869:Ghana; D006801:Humans; D033182:Intention; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D049590:Postpartum Period; D011247:Pregnancy; D012747:Sexual Partners / Q000523:psychology; D014930:Women / Q000523:psychology*