Demand for family planning satisfied by modern methods in Ghana: trends and inequalities (2013-2022).

BACKGROUND

In Ghana, while coverage of demand for family planning satisfied by modern methods (mDFPS) has increased, substantial inequalities persist across demographic and geographic factors. This study aims to assess mDFPS trends from 2013 to 2022, with a focus on inequalities related to residence, education, and wealth, and identifying the determinants of mDFPS.

METHODS

Using data from Performance Monitoring Action (PMA) (2013-2017) and Ghana Demographic and Health Survey (DHS) (2022), an evaluation of the trends of demand for family planning satisfied by modern methods (mDFPS) was assessed from 2013 to 2022 with the corresponding annual average rate of change. Absolute complex measures of inequalities (SII and WMADM) were used to identify wealth, education and regional related inequalities in mDFPS coverage. A binary logistic regression was used to assess factors influencing mDFPS.

FINDINGS

The coverage of women with a demand for family planning satisfied with modern methods increased from 33.0% to 49.5% between 2013 to 2022. An overall 3.8% annual increase in mDFPS was observed from 2013 to 2022. A decreasing trend in wealth, education and regional inequalities were observed over the years. However, women with no education and those from the Northern region of Ghana have consistently had the lowest mDFPS coverage over the years, and they continue to lag. Women aged 20-35 have a 28% increase in odds [95%CI:1.01-1.63; p = 0.038] of family planning satisfaction by modern methods compared to those aged 15-19. Mothers currently working have a 27% increased odds of family planning satisfaction by modern methods compared to those who are not working [95%CI: 1.07-1.51; P = 0.007]. Furthermore, women who are married or co-habiting have a 33% decrease in odds of family planning satisfaction by modern methods compared to those who are single [95%CI: 0.56-0.84; P < 0.001].

CONCLUSION

Reductions in educational and wealth-related inequalities in mDFPS coverage have been observed over time; however, persistent challenges emphasize the need for targeted interventions. Prioritizing equitable access for poorer, less educated women and addressing regional disparities, particularly in the Northern region of Ghana, are crucial to achieving inclusive family planning services.