While the use of modern family planning methods has increased in Ghana over the past decade, a new study published in BMC Public Health reveals that women who are poorer, less educated, or living in the Northern region continue to face substantial barriers to access. The research, coauthored by Cauane Blumenberg from the International Center for Equity in Health (ICEH), shows that the demand for family planning satisfied by modern methods (mDFPS) rose from 33% in 2013 to 49.5% in 2022—but progress has not been equal.

"Our findings show two simultaneous realities," explains Blumenberg. "On one hand, Ghana should be commended for achieving nearly 50% coverage of demand for family planning satisfied. On the other, we're seeing that the most vulnerable populations - particularly poor, rural women in the North - aren't benefiting equally from this progress."

The article emerged as a product of the Countdown to 2030 Fellowship Program, through which Blumenberg co-mentored lead author Akua Amponsaa Obeng alongside experts from the African Population and Health Research Center (APHRC) and the University of Southampton. The program supports early-career African researchers to develop and publish analyses on reproductive, maternal, newborn, child and adolescent health and nutrition (RMNCAH+N), fostering research capacity across the continent. 

The authors analyzed nationally representative data from the Performance Monitoring for Action (PMA) surveys and the Demographic and Health Survey (DHS), using both trend and inequality measures. Although there was a steady 3.8% average annual increase in mDFPS coverage, inequalities by education, wealth, and geographic location remain entrenched.

Key findings reveal that a worrying 3.8 percentage point gap persists between women with higher education and those with no formal schooling. Women residing in the Northern region consistently had the lowest levels of mDFPS across all survey years, while those from wealthier households showed significantly better access.

Sociodemographic factors such as marital status, age, and employment status also influenced access. Interestingly, married or cohabiting women were 33% less likely to have their family planning needs met compared to single women, pointing to the impact of gender norms and relationship dynamics. Women aged 20–35 and those who were employed had higher odds of using modern contraceptive methods.

"Our study suggests we need to move beyond one-size-fits-all approaches," notes Blumenberg. He added: "Targeted interventions must focus on reaching the most marginalized women—particularly those who are poor, uneducated, or living in underserved regions.”

The authors recommend expanding community-based services, investing in adolescent and female education, and developing culturally-sensitive family planning programs to ensure equitable access to family planning.

Read the full article: BMC Public Health