Question

fertilty preference in ghana.

Answer 1

Unmet need is a central concept in family planning research and a key indicator for gauging the demand for contraception and for measuring the success of programs and policies. At its most basic level, unmet need reflects an apparent discrepancy between women’s stated reproductive preferences and behavior. In surveys some women respond they want to space or limit births, but they are not using any method to prevent pregnancy. These respondents are considered to have unmet need for family planning, and are at risk of unintended pregnancy. Unintended pregnancies frequently lead to unsafe abortions or maternal complications and place the health of mothers and children at risk

Ghana had recorded one of the highest levels of unmet need for family planning among married women on the African continent, at 36 percent in 2008. Family planning use had declined slightly among married women, from 25 percent in 2003 to 24 percent in 2008. Meanwhile, Ghana’s Total Fertility Rate (TFR) in 2008 was among the lowest in West Africa, at 4.0 births per woman. Unmet need is typically only measured among currently married women, but the focus of this study is currently married and sexually active women combined, as both groups of women are at risk of unwanted pregnancies. Nationwide, 29 percent of married and sexually active unmarried women in Ghana had an unmet need for family planning as measured by data from the 2014 GDHS (Ghana Demographic and Health Survey).

Ghana’s attainment of regionally low fertility despite modest levels of family planning use has been a demographic puzzle for nearly two decades. Abortion is legal in Ghana and has been hypothesized as a reason for lower-than-expected fertility; but evidence has been inconclusive. It may be that high levels of unmet need in Ghana partly reflected women’s growing tendency to articulate a need for spacing or limiting births. During early stages of the demographic transition, the percentage of women with unmet need can increase even as demand for family planning is being satisfied simply due to women’s increased interest in reducing fertility.

Ghana has a relatively strong family planning program. The contraceptive method mix is diverse. Injectables, the pill, and implants are the most common methods, followed by the rhythm method. Women can obtain contraception from public and private sources. Family planning is inexpensive but not free. Ghana does experience occasional contraceptive supply issues and there are some limits to the method mix offered. Social marketing campaigns have proven successful but some very remote areas of the country remain a few hours’ distance from the nearest clinic. Even so, in surveys women rarely cite access and cost as reasons for non-use of family planning.

By 2014 the TFR increased slightly, to 4.2 births per woman. The 2014 GDHS also found an increase in modern contraceptive prevalence since 2008 (from 17 to 22 percent) and a decline in unmet need (from 36 to 30 percent) among married women ages 15–49. This brings the country on par with levels of unmet need in neighboring West African countries, but still high in a global perspective.

Perceptions about side effects and attitudinal factors pose a challenge to increased family planning use in Ghana