Contraception Method Preferences Among Women in Two Ghanaian Cities

Background: While availability of women’s preferred methods is an important indicator of quality of family planning services, the preferences Ghanaian women hold around contraceptive methods are largely unknown. Methods: We conducted a facility-based survey in five family planning clinics in Ghana’s two largest cities. Women were interviewed before and after their family planning counseling session. In the pre-visit interview, women were asked both the method they most preferred, as well as method characteristics which appealed to them. In the post-visit interview, they were asked which method they were leaving with, if they received the method they most preferred, and how satisfied they were to be leaving with their method. A series of bivariate logistic regressions were performed to assess factors associated with certain method preference and adoption. Results: A total of 337 women were interviewed and able to be linked pre- and post-visit. Most of the participants (54.1%, n=482) stated a preference for a long acting reversible contraceptive (LARC) method (either an implant (40.7%, n=137) or an IUD (13.4%, n=45)), while a sizable minority of the participants stated a preference for an injectable (32.3%, n=109). Only 5% (n=17) participants said they did not know which method they preferred. In bivariate logistic regression analysis, older and married women and those with higher education were more likely to want the IUD, while unmarried and younger women preferred the injection. Women who wanted a method that would protect them for multiple years showed preference for the IUD and the implant, while women who wanted pregnancy protection for a few months and those who did not want a method which requires a visit to the clinic to stop using preferred the injection. Conclusion: Our study participants were most likely to want, and receive, a LARC method, mainly the implant. These participants have strong preferences, which are generally being met. Further work should investigate whether women who receive their preferred method are more likely to continue using the method than those who do not.