title: Determinants of modern family planning use among women of reproductive age in the Nkwanta district of Ghana: a case-control study.
abstract: BACKGROUND
  Average contraceptive prevalence rate in the Nkwanta district of Ghana was estimated to be 6.2% relative to the national average at the time, of 19%. While several efforts had been made to improve family planning in the country, the district still had very low use of modern family planning methods. This study sought to determine the factors that influenced modern family planning use in general and specifically, the factors that determined the consistently low use of modern family planning methods in the district.
  
  
  METHODS
  A case-control study was conducted in the Nkwanta district of Ghana to determine socio-economic, socio-cultural and service delivery factors influencing family planning usage. One hundred and thirty cases and 260 controls made up of women aged 15-49 years were interviewed using structured questionnaires. A logistic regression was fitted.
  
  
  RESULTS
  Awareness and knowledge of modern family planning methods were high among cases and controls (over 90%). Lack of formal education among women, socio-cultural beliefs and spousal communication were found to influence modern family planning use. Furthermore, favourable opening hours of the facilities and distance to health facilities influenced the use of modern contraceptives.
  
  
  CONCLUSIONS
  While modern family planning seemed to be common knowledge among these women, actual use of such contraceptives was limited. There is need to improve use of modern family planning methods in the district. In addition to providing health facilities and consolidating close-to-client service initiatives in the district, policies directed towards improving modern family planning method use need to consider the influence of formal education. Promoting basic education, especially among females, will be a crucial step as the district is faced with high levels of school dropout and illiteracy rates.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Eliason
authors.forename: John K
authors.initials: JK
authors.lastname: Awoonor-Williams
authors.forename: Cecilia
authors.initials: C
authors.lastname: Eliason
authors.forename: Jacob
authors.initials: J
authors.lastname: Novignon
authors.forename: Justice
authors.initials: J
authors.lastname: Nonvignon
authors.affiliation: Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Legon, Ghana. mksaikins@ug.edu.gh.
authors.forename: Moses
authors.initials: M
authors.lastname: Aikins
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D003267:Contraception / Q000379:methods / Q000523:psychology; D003268:Contraception Behavior / Q000523:psychology / Q000706:statistics & numerical data*; D003431:Cross-Cultural Comparison; D005193:Family Planning Services / Q000706:statistics & numerical data*; D005260:Female; D005869:Ghana; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007255:Information Services / Q000706:statistics & numerical data; D008875:Middle Aged; D012959:Socioeconomic Factors; D055815:Young Adult