Patterns of Birth and Family Planning Acceptor Rates in Ghana: An Ecological Study.

Despite a reported decline in Ghana's birth rate (BR), the pattern of ecological percent decrease in BR as corresponding to the percent increase in family planning acceptor rate (FPAR) in Ghana is not clear. This study explicitly explored and compared the pattern of birth and FPAR in Ghana from 2004-2015. National FPAR and BR data were retrieved from Ghana Health Service and World Bank. A time- trend descriptive analysis was performed via tableau software. Additionally, a segmented regression was applied to inferentially identify where statistically significant log-linear distinct segments exist in the trends. All segmented-related analysis was performed using joinpoint trend analysis software. Whereas, the highest decline in BR was observed from 2013-2015 (-1.4%), the highest increase in FPAR was rather observed from 2004-2008 (7.4%). Unexpectedly, from 2008-2013, a much higher decrease in FPAR (-5.8%) also yielded a moderate decline in BR (-0.7%). FPAR over the eleven years (2004-2015) increased by 1.1% whereas BR declined by -0.7%. BR in Ghana continues to be on a moderate declining trend. However, the decline was uninterrupted by an increase or decrease in FPAR. For a further decrease in Ghana's birth rate, a multifaceted approach is needed, not only focusing on increasing FPAR but also targeting adherence to FP control methods.