ABSTRACT
Background and Aims: Female head-porters are a cohort of women who have migrated from their rural communities into commercial cities in search of better economic opportunities. These young women are vulnerable to untoward reproductive experiences. The study assesses the reproductive experiences of women and the factors influencing contraceptive use among them. Methods: A cross-sectional study was conducted from January to May 2021 in the Kumasi Metropolis (n = 280). The study included 280 female head-porters within the reproductive age of 15-49 years. Convenience sampling and consecutive recruitment were used to obtain the needed sample size. All statistical significance was declared at a p-value of <0.05. Results: Forty-two percent of respondents had a history of contraceptive use (all modern or artificial contraception). The study found gravidity (p < 0.0001), parity (p < 0.0001), number of sexual partners post-migration (p = 0.008), and age of first sex (p = 0.033) to be associated with contraceptive use among female head-porters. Conclusion: Fourteen percent had experienced sexual exploitation post-migration, the first sexual encounter of one-third of participants were nonconsensual, 19% had sex at or before 16 years, and 72% were aware of contraception. Reproductive experiences such as gravidity and sexual debut (age at first sex) have a significant influence on the use of contraception.
ABSTRACT
OBJECTIVES: Unintended pregnancy presents a crisis situation with limited options for resolution. Abortion appears to be a commonly chosen option but is stigmatized in many societies including Ghana. Keeping a child from an unintended pregnancy is also unsuitable for many people. Carrying through with the pregnancy and placing the child up for adoption is a potential management option but there is scanty literature on how viable this option is to women globally including Ghana. The study sought to assess acceptability of this option and its barriers and facilitators in Ghana. METHODS: This study was a part of a bigger analytical cross-sectional study on unintended pregnancy in Kumasi conducted in three centres from January to April 2014. Exit interviews were conducted for 461 consenting women to capture data on demography, reproductive profile and acceptability of giving up a child from an unintended pregnancy for adoption. Frequencies, proportions and means were computed and presented in tables. RESULTS: Over 85% of respondents would not give up their children for adoption as a way to manage their unintended pregnancy, whereas about 6% were undecided. A need for the child to grow up in a two-parent home was considered more important than the financial security of the adoptive parents while disappointment from family and friends came up as marked barrier to adoption. CONCLUSIONS: Keeping a pregnancy and placing the child up for adoption is presently not ideal for managing an unintended pregnancy crisis. More education is needed to increase awareness of adoption as an option in resolving this crisis while continued efforts are made at primary prevention through using contraceptives. The complex adoption process must be made friendly for women with unintended pregnancies who neither desire parenting nor abortion.
ABSTRACT
BACKGROUND: Pregnancy crisis mismanagement has contributed to maternal deaths and illnesses globally and in Ghana due to absence/inadequate pregnancy options counselling for clients to make informed decisions. This study examines options counselling for abortion seekers in health facilities in Ghana. METHODS: Analytical cross-sectional study design was done in selected specialised public and NGO health facilities within Kumasi Metropolis of Ghana, using self-administered structured questionnaires for data collection from 1st January to 30th April, 2014. Participants were 442 women with unintended pregnancies seeking abortion services. Data was analysed using Epi-Info (7.1.1.14) and STATA 12 to generate descriptive statistics, Pearson chi-square and multivariable logistic regressions. The Kwame Nkrumah University of Science and Technology approved the study. RESULTS: Respondents had divergent reproductive and socio-demographic profiles. Majority (about 58%) of them had been pregnant more than twice, but about 53% of this population had no biological children. (Although about 90% of respondents held perceptions that the index and previous pregnancies were mistimed/unintended, the majority (72%) had no induced abortion history. Induced abortion (208, 49%) and parenting (216, 51%) were mentioned as the only available options to unintended pregnancy in hospitals. Exposure to options counselling was observed to be significantly associated with parity (P = < 0.001), gestational age (P = < 0.001), previous induced abortions (P = < 0.001), perception of pregnancy at conception (P = < 0.001) and level of education (P = 0.002). The logistic regression analysis also shows that higher education has statistically significant effect on being exposed to options counselling (P = < 0.001). Majority of respondents (95%) were not aware that giving a child up for adoption is an option to abortion in Ghana. CONCLUSIONS: Pregnancy options counselling remains a major challenge in comprehensive abortion care in Ghana. Although higher educational attainments significantly exposes women to options counselling for informed decisions, the less educated are disadvantaged in this regard. Further research on type and depth of counselling services provided to pregnant women in health facilities is required to inform health policy and program decisions.
Subject(s)
Abortion, Induced , Counseling , Parenting , Pregnancy, Unplanned , Adoption , Cross-Sectional Studies , Decision Making , Educational Status , Female , Gestational Age , Ghana , Hospitals, Public , Humans , Parity , Pregnancy , Reproductive Health Services , Surveys and Questionnaires , Young AdultABSTRACT
BACKGROUND: The World Health Organization (WHO) recommends the use of Insecticide Treated Bed-Nets and Intermittent Preventive Treatment (IPT) with Sulphadoxine-Pyrimethamine (SP) as interventions in curbing malaria during pregnancy. However, increasing evidence shows a gap in coverage where not all pregnant women receive the recommended SP dose. This study evaluated the factors influencing uptake of IPTp-SP among pregnant women in Kumasi, Ghana. METHODOLOGY: This cross-sectional study was conducted among 280 pregnant women attending the Kwame Nkrumah University of Science and Technology Hospital in Kumasi, Ghana. Validated structured questionnaires were administered to obtain sociodemographic, medical/reproductive information, and IPTp-SP uptake among participants. Statistical analyses were performed using IBM SPSS 25.0 statistics. RESULTS: The mean age of respondents was 29.7±4.9 years. Of the 280 women interviewed, 74.6% attended the antenatal care (ANC) clinic at least four times with only 31.8% completing the recommended doses. Tertiary education [aOR=3.15, 95% CI (0.94 -10.97), and p=0.042] and ≥ 4 ANC visits [aOR=24.6, 95% CI (5.87-103.07), p<0.0001] had statistically significant higher odds of completing the recommended IPTp-SP dose. However, participants employed by the formal sector [aOR=0.28, 95% CI (0.09 - 0.79), p=0.016] and participants with more than four children [aOR=0.14, 95% CI (0.03 - 0.63), and p=0.011] had statistically significant lower odds of completing the recommended IPT dose. CONCLUSION: ANC attendance is critical in IPTp uptake. The results emphasize the need for the Health Policy Makers in Kumasi to encourage pregnant women, especially women working in the formal sector and women having more than four children to patronize ANC attendance to ensure high coverage of the recommended IPTp dose.
