Bhagavathi Veena, Ogum Deda, Agyabeng Kofi, Coker-Appiah Dorcas, Ohemeng Fidelia N A
Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United States of America.
Department of Population, Family & Reproductive Health, School of Public Health, University of Ghana, Legon, Accra, Ghana.
PLoS One. 2025 Aug 11;20(8):e0328298. doi: 10.1371/journal.pone.0328298. eCollection 2025.
Evidence suggests that disaster situations such as the COVID-19 pandemic may affect reproductive intentions. These effects interact with an individual's social context, including socioeconomic status, cultural norms, family size and structure, to shape reproductive intentions. In this paper, we review the COVID-19 lockdowns' effects on reproductive intentions among Ghanaian women living in Accra and Kumasi. A correlational quantitative research design was adopted for the study while data was obtained through a survey of 532 women of reproductive age. Descriptive statistics, bivariate modeling using Chi-square and Fisher's exact tests and multivariate modeling using Firth's logistic regression model were conducted to understand determinants of changing intentions following the COVID-19 lockdowns. In all, 25 women (4.7%) reported changing their intentions. Those who come from Kumasi were more likely to change their intentions (p < 0.001) as were those who reside within their respective metropolis (p < 0.05). Those who had ever been married or cohabitated with a partner (p < 0.01), who have their childrearing decisions made with input from their partner or other family members (p < 0.05), and who were pregnant or expecting to become pregnant before the lockdowns were enforced (p < 0.001) were also more likely to change their minds. Residence in Kumasi (AOR = 4.21, 95%CI 1.41-12.62) and being pregnant or expecting to become pregnant just before lockdown (AOR = 4.29, 95%CI 1.28-14.32) were the strongest predictors for changing of intentions. Overall, reproductive intentions among those surveyed were largely characterized by ambivalence and inconsistency, with the largest groups of people labeling their state prior to COVID-19 lockdowns as "undecided" and their change in state after lockdown also as "undecided." Future work should include more room for ambiguity when characterizing reproductive intentions among Ghanaian women. Incorporating room for ambiguity in characterizing reproductive intentions may improve accuracy in data collection in demographic health research and shift how success is measured in family planning policy. We hope that this shift will promote individualized and person-centered care in the realm of family planning.
有证据表明，诸如新冠疫情这样的灾难情况可能会影响生育意愿。这些影响与个人的社会背景相互作用，包括社会经济地位、文化规范、家庭规模和结构，从而塑造生育意愿。在本文中，我们回顾了新冠疫情封锁措施对居住在阿克拉和库马西的加纳女性生育意愿的影响。本研究采用相关性定量研究设计，同时通过对532名育龄妇女的调查获取数据。进行了描述性统计、使用卡方检验和费舍尔精确检验的双变量建模以及使用菲思逻辑回归模型的多变量建模，以了解新冠疫情封锁措施后生育意愿变化的决定因素。总体而言，25名女性（4.7%）报告称改变了生育意愿。来自库马西的女性更有可能改变生育意愿（p < 0.001），居住在各自大城市内的女性也是如此（p < 0.05）。曾经结婚或与伴侣同居的女性（p < 0.01）、生育决策有伴侣或其他家庭成员参与的女性（p < 0.05）以及在封锁措施实施前已怀孕或预期怀孕的女性（p < 0.001）也更有可能改变主意。居住在库马西（优势比 = 4.21，95%置信区间1.41 - 12.62）以及在封锁前已怀孕或预期怀孕（优势比 = 4.29，95%置信区间1.28 - 14.32）是生育意愿改变的最强预测因素。总体而言，被调查者的生育意愿在很大程度上具有矛盾性和不一致性，最大比例的人群将新冠疫情封锁前的状态标记为“未决定”，封锁后的状态变化也标记为“未决定”。未来的研究在描述加纳女性的生育意愿时应预留更多模糊空间。在描述生育意愿时纳入模糊空间可能会提高人口健康研究中数据收集的准确性，并改变计划生育政策中衡量成功的方式。我们希望这种转变将在计划生育领域促进个性化和以人为主的护理。
