Family planning (FP) plays a critical role in shaping multiple dimensions of societal progress, including fertility management, poverty alleviation, gender equality, and women’s empowerment. Its significance is underscored by its central role in the attainment of the Sustainable Development Goals (SDGs), particularly targets 3.7 which aims to ensure universal access to sexual and reproductive healthcare services, including family planning, information, and education, and 5.6 which aims to ensure universal access to sexual and reproductive health and reproductive rights, within Goals 3 and 5 respectively.
The impact of family planning on health, education, food security, living standards, income, and overall national development is profound, necessitating its integration across all tiers of developmental policies and planning.
The Evolving Landscape of FP in Ghana
Ghana’s family planning programme has witnessed remarkable advancements since its inception in 1969. Notably, the year 2022 marked a pivotal juncture with the integration of clinical FP services into the National Health Insurance Scheme, marking a significant step towards wider access to FP services. Ghana’s commitment to curbing population growth through education, family planning, and the incorporation of population targets in developmental policies signifies its dedication to achieving a growth rate of 2.2 percent, as outlined in the Coordinated Programme of Economic and Social Development Policies (2017-2024).
Challenges on the Path to Progress
Ghana’s demographic landscape reflects a considerable proportion of youth (15-35) constituting 38.2 percent of the population in 2021. Enabling access to effective FP, particularly for the youth, is crucial to bridging gaps in unmet needs among adolescents, reducing unintended pregnancies, curbing maternal mortality, empowering girls and women to make informed decisions, and reducing the burden on the country’s limited resources to ensure a more equitable distribution of wealth and opportunities, especially for the youth.
However, the path towards comprehensive FP is marred by challenges. Research indicates that emerging adults aged 18 to 24 in Ghana exhibit a propensity to abstain from effective contraceptive methods, use modern contraception inconsistently, discontinue use of effective methods, and face method failure. This trend, especially among young women, is concerning and poses an impediment to achieving the country’s FP targets. Insufficient government investment to procure FP commodities and inequitable distribution of trained healthcare personnel to provide Long-Acting Reversible Contraceptives (LARCs) and implants further limit access to FP services. Statistics from the Ghana Health Service show that donor funding consistently makes up a larger portion (between 85%-90%) of the country’s FP procurements. Given the recent decrease in donor funding, however, the government must take on a more substantial role in FP financing.
Factors Underpinning Challenges
The barriers to FP uptake and usage have been linked to inadequate knowledge about modern contraceptives, misconceptions about side effects, false beliefs about immediate or long-term health issues, and stigmatization of family planning users. Also, Ghana’s traditional gender dynamics further exacerbate the situation by limiting women’s access to resources and agency in decision-making, particularly relating to their sexual and reproductive health. In addition to these challenges is the government’s lack of appreciation of the critical linkages between family planning and Ghana’s socioeconomic development. This is evident in the historically low investment (ranging between 10%-15%) allocated to the procurement of family planning commodities over the years.
Statistical Reality: Unmet Needs for FP
Regrettably, Ghana is currently not on track to meet its FP objectives for 2020-2025 and commitments for FP 2030. The goal of reducing the unmet need for modern contraceptives among women and women in union from 32% in 2018 to 16% by 2025 remains distant, with the 2023 figure standing at 30.2%. Similarly, the objective of increasing demand for modern contraceptives, and consequently increasing the modern contraceptive prevalence rate among currently married women and women in the union from 25% in 2018 to 39% by 2025 and 44.4% by 2030, appears challenged with a rate of 31.2% in 2023.
Family planning’s crucial role in Ghana’s national development is undeniable. By surmounting obstacles through comprehensive strategies, Ghana can lay the foundation for sustainable development, gender equality, and improved quality of life for all its citizens. To effectively navigate challenges and achieve national FP objectives and SDGs, Ghana must adopt a multi-faceted approach:
- Integrated Approach: Family planning should be interwoven into national plans and programmes to solidify its linkage with national development.
- Government Investment: Increased government investment and procurement of contraceptives is paramount and must be a priority. This will reduce reliance on external funding.
- Behaviour Change: The government must develop a targeted social and behavior change communication plan that aims to deliver accurate and consistent information to combat FP misinformation and misconceptions. Likewise, it is crucial to engage men and boys in FP dialogues and decisions to tackle cultural norms and beliefs that hinder FP uptake, unequal access to resources, and underrepresentation of women in decision-making processes. Consistent reproductive health for both in and of school adolescent girls can also foster informed choices and increase uptake of FP services
- Investment in Health workforce and equitable distribution of same: Investments in trained staff are essential for providing quality FP services. Also, an equitable distribution of trained staff will ensure that no one is left behind.
- Community Involvement in FP programme design and implementation: Collaborations with leaders and influencers can help reshape community perceptions.