Abstract:
Background: The uptake of modern family planning (FP) methods remains a major challenge in sub-Saharan Africa. Current use of modern contraceptive methods in Ghana stand as 22%. This is in spite of considerable public education and investment in the provision of services. The Upper Wes Region of Ghana has some of the worst indicators of FP uptake in the country. It has been postulated that this may be due to the highly patriarchal social system. An improved understanding of male attitude towards family planning in the Region will help in the design of interventions targeted at improving male acceptability and overall increased FP uptake.
Methods: This is a cross-sectional study that employed a questionnaire administered to taxi drivers (an entirely male-dominated vocation) in four communities in Wa, the regional capital. The questionnaire enquired into socio-demographic background, knowledge of family planning methods and attitudes towards their use. Questionnaires were administered by trained fieldworkers at various taxi stations in the communities. Descriptive analysis compared findings in the present survey with the findings in a similar study in Wa in 2013 that used the same instrument and interviewed 250 respondents. Bivariate and multivariate analysis explored the association between the socio-demographic background of respondents, attitudes towards FP and respondents’ willingness of to pay for FP services.
Results: Four hundred and ten male taxi drivers were interviewed. The median age was 34 (interquartile range 28-42) years. Only 12.1% of respondents had been schooling beyond high school. The majority (59.7%) were Muslims and of the Waali and Dagarti tribes (91.5%). About 62.1% of respondents approved of FP use (82.4% in the 2013 survey). More than half (61.2%) of respondents indicated a willingness to pay the cost of FP services to their partners. The independent predictors of this willingness were: Approval of FP (Odds Ratio OR= 6.77 95% Confidence
Interval-CI 3.73-12.28), past experience with couple counseling (OR= 4.20, 95% CI 1.35 - 13.09), believing that wife access to family planning will make her unfaithful (OR= 0.27, 95% CI 0.13 – 0.57), being Waali/Dagarti (OR= 0.81, 95% CI 0.02 – 0.32) and having more than one wife (OR= 0.18, 95% CI 0.06 – 0.51).
Conclusion: There has been reduction the number of men indicating FP approval since 2013. Male attitudes towards FP are rooted within levels of FP education, ethnicity and fear of spousal infidelity. A multidimensional approach is needed to overcome male apprehensions towards spousal adoption of FP in this community.