Why Ghanaian Women Are Not Using Contraception

Michelle J. Hindin, Johns Hopkins Bloomberg School of Public Health
Laura McGough, Independent Consultant
Richard M. K. Adanu, University of Ghana

Between the 2003 and 2008 Demographic and Health Surveys, Ghana's TFR declined from 4.4 to 4.0, while modern contraceptive use also declined-- 19% to 17% among married women. We explore reasons why women are not using modern contraceptive methods. We conducted 16 focus groups among 89 women recruited from three wards at Legon University Hospital, Acrra: maternity, child welfare, and the student clinic. We used vignette-based methods to elicit women’s responses to why women are not using contraception. In general, women who had never used contraception were fearful of methods based on hearsay or second-hand information. A leading concern with modern contraception was menstrual irregularity, particularly for hormonal methods. Hearsay about side effects, including concern about "fibroids" and "tumors" is also common. Targeted programmatic efforts are needed, including increased media attention to side effects and provider training to ensure that women know what to expect when using modern contraceptive methods.