While Ghana has made striking gains in enabling its women to use family planning to reduce family size—the total fertility rate shifted from 7.0 to 4.2 children per woman from the 1970s to the 2010s—the Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP) studies found that educated women in Ghana are achieving their fertility goals by limited use of highly effective contraceptive methods. Their fertility regulation strategies involve contraceptive method mosaics that have not been captured by the DHS. This evidence summary aggregates research from the STEP UP Research Programme Consortium along with other related evidence to explore this question of how educated women in Ghana are able to control their fertility. Recommendations include focusing efforts on ensuring that family planning providers explain effects and side effects of contraceptives, integrating effective use of coital and traditional methods into family planning programs, and suggesting that stable couples use a more effective contraceptive regimen, as well as providing abortion services as allowed by law.
Machiyama, Kazuyo, Cicely Marston, Nancy Termini LaChance, Terence Adda-Balinia, and Placide Tapsoba. 2018. "How are educated women in Ghana regulating fertility without high levels of modern contraceptive use?" STEP UP Evidence Summary, June. Accra: LSHTM and Population Council.
Strengthening Evidence for Programming on Unintended Pregnancy (STEP UP)