Population and Reproductive Health Division, School of Public Health, University of Port Harcourt, Choba, Nigeria.
Department of Community Health, College of Health, Yamfo, Ghana.
Int Health. 2024 Jan 2;16(1):61-67. doi: 10.1093/inthealth/ihad019.
Family planning is essential in promoting the well-being of women and their families and communities and ensuring quality of care in contraceptive use. This study sought to assess the trend and inequalities in the demand for family planning satisfied (DFPS) in Ghana from 1993 to 2014.
The World Health Organization's Health Equity Assessment Toolkit was employed to analyse the data. We disaggregated DFPS by five equity stratifiers: age, economic status, education, residence and region. Inequality was measured using difference (D), population attributable risk (PAR), ratio (R) and population attributable fraction (PAF).
The study showed an increment in DFPS from 17.8% to 38.7% between 1993 and 2014. With respect to age, we noted substantial inequality in 2003 (D=21.9 [95% confidence interval {CI} 15.2 to 28.7]), 1993 (D=4.8 [95% CI -1.8 to 11.4]) and 2014 (D=15 [95% CI 3 to 26.9]). The greatest economic inequality occurred in 1993 (PAF=69.7 [95% CI 50.8 to 88.6]; D=20.1 [95% CI 14.8 to 25.4]). Regarding education, significant inequality existed in 1993 (PAF=112 [95% CI 100.8 to 123.2]; D=29.7 [95% CI 21.9 to 37.4]). Ashanti and the Upper West regions reported significant inequalities (PAF=55.6 [95% CI 33.1 to 78.2]; D=16.1 [95% CI 8.9 to 23.3]).
There are age-, education-, wealth-, residence- and region-related inequalities with respect to DFPS. Policymakers will have to prioritize the needs of women with no formal or low educational attainment in order to improve DFPS coverage. Special attention needs to be given to adolescent girls since they suffer greater inequalities than adult women.
计划生育对于促进妇女及其家庭和社区的福祉以及确保避孕使用的护理质量至关重要。本研究旨在评估 1993 年至 2014 年期间加纳计划生育需求满足情况（DFPS）的趋势和不平等现象。
采用世界卫生组织卫生公平评估工具包对数据进行分析。我们按五个公平分层因素对 DFPS 进行分类：年龄、经济状况、教育、居住地和地区。使用差异（D）、人群归因风险（PAR）、比（R）和人群归因分数（PAF）衡量不平等程度。
研究表明，1993 年至 2014 年间，DFPS 从 17.8%增长到 38.7%。就年龄而言，我们注意到 2003 年（D=21.9[95%置信区间{CI}15.2 至 28.7]）、1993 年（D=4.8[95%CI-1.8 至 11.4]）和 2014 年（D=15[95%CI3 至 26.9]）存在明显的不平等。1993 年经济不平等程度最大（PAF=69.7[95%CI50.8 至 88.6]；D=20.1[95%CI14.8 至 25.4]）。就教育而言，1993 年存在显著不平等（PAF=112[95%CI100.8 至 123.2]；D=29.7[95%CI21.9 至 37.4]）。阿散蒂和上西部地区报告存在显著不平等（PAF=55.6[95%CI33.1 至 78.2]；D=16.1[95%CI8.9 至 23.3]）。
DFPS 与年龄、教育、财富、居住地和地区有关。决策者将不得不优先考虑没有正规或低教育程度的妇女的需求，以提高 DFPS 的覆盖率。需要特别关注少女，因为她们比成年妇女遭受更大的不平等。
