title: Reproductive health decision making among Ghanaian women.
abstract: BACKGROUND
  Women's reproductive health decision-making and choices, including engaging in sexual intercourse and condom use, are essential for good reproductive health. However, issues concerning sexual intercourse and condom use are shrouded in secrecy in many sub-Saharan African countries. This study investigates factors that affect decision making on engaging in sexual intercourse and use of condom among women aged 15-49.
  
  
  METHODS
  A nationally representative sample (N = 3124) data collected in the 2008 Ghana Demographic and Health Survey was used. Multivariate logistic regression was used to study the association between women's economic and socio-demographic characteristics and their decision making on engaging in sexual intercourse and use of condom.
  
  
  RESULTS
  One out of five women reported that they could not refuse their partners' request for sexual intercourse while one out of four indicated that they could not demand the use of condoms by their partners. Women aged 35-49 were more likely to make decision on engaging in sexual intercourse (OR = 1.35) compared to those aged 15-24. Furthermore, the higher a woman's education, the more likely that she would make decision regarding condom use. Also, if a woman had primary (OR = 1.37) or secondary (OR = 1.55) education, she is more likely to make decision regarding engaging in sexual intercourse compared to a woman who had no formal education. Compared to women in the Greater Accra region (the capital city region), women in the Western region (OR = 2.10), Central region (OR = 2.35), Brong Ahafo (OR = 1.70), Upper East (OR = 7.71) and Upper West (OR = 3.56) were more likely to make decision regarding the use of condom. Women who were in the richest, rich and middle wealth index categories were more likely to make decision regarding engaging in sexual intercourse as well as condom use compared to the poorest.
  
  
  CONCLUSIONS
  Interventions and policies geared at empowering women to take charge of their reproductive health should focus particularly on women from less wealthy backgrounds and those with low educational attainments.
authors.affiliation: Department of Population and Health, University of Cape Coast, Private Mail Bag, University Post Office, Cape Coast, Ghana. eugenedarteh@gmail.com.
authors.forename: Eugene Kofuor Maafo
authors.initials: EK
authors.lastname: Darteh
authors.forename: David Teye
authors.initials: DT
authors.lastname: Doku
authors.forename: Kobina
authors.initials: K
authors.lastname: Esia-Donkoh
mesh_terms: D000293:Adolescent; D000328:Adult; D017280:Condoms / Q000706:statistics & numerical data; D003657:Decision Making; D004522:Educational Status; D005260:Female; D005869:Ghana; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D060728:Reproductive Health; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors