BackgroundThe use of contraception among women aged 35 to 49 years is imperative due to the risk of unplanned pregnancy and poor obstetric outcomes. However, the use of contraceptives in this age group has been reported to be low. In Ghana, studies are limited that determine factors influencing contraception among women in this age group, in particular the influence of husbands. This study aims to ascertain factors that influence contraception among women aged 35 to 49 years and their male partners. ObjectivesThe objective of the study was to describe factors that influence contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District of Ghana.MethodsA total of 44 informants participated in the study. In-depth interviews were conducted remotely for 22 women, 15 male partners of women interviewed, and seven family planning service providers. 21 informants participated in four focus group discussions organized. A simple thematic analysis was undertaken. ResultsFactors that influenced the use of contraceptives were achieved desired family size, counselling by health professionals, experience and/or fear of side effects, health reasons and influence of male partner. Barriers to using modern contraceptives included religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, and the belief that contraceptive use is a matter for women. ConclusionsThis study described factors that influence contraception among women 35 to 49 years and their male partners. All informants used some form of contraception. Strengthening male involvement in family planning activities and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives.

Background Fertility declines with age, but it remains important to protect women from unplanned pregnancies throughout their reproductive lives. The objective of this study was to describe factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in Gomoa West District of Ghana. Methods In-depth interviews were conducted remotely for 22 women, 15 male partners of the women interviewed and seven family planning (FP) providers. In all, a total of 44 participants took part in the study. Seven refusals were recorded, four females and three males. Four focus group discussions were organized for 21 participants who took part in the in-depth interviews. Data collected were transcribed and coded after exporting to Nvivo12 qualitative analysis software. Thematic analysis was undertaken using an abductive approach. Results Factors that influenced the use of modern contraceptives included: achieved desired family size, providing for the family, counselling by health professionals, influence of the male partner, and health reasons. Barriers cited included: religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, declining fertility, and the belief that contraceptive use is a matter for women. Within the study group, roughly half of women used modern contraceptives, while the majority of male partners were non-users. Conclusion Contraception among women aged 35 to 49 years and their male partners is influenced by several factors such as achieved desired family size, influence of the male partner, rumors or misconceptions, and declining fertility. Strengthening male involvement in family planning activities and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives.

Background:Patient non-attendance for outpatient appointments is increasingly becoming more important in an era where resources have to be used in the most cost effective way. The Leicestershire region of the United Kingdom has a very diverse multi-ethnic population of just over 1 million people. Across 3 large hospital sites the University Hospitals of Leicester, United Kingdom caters for the rheumatology needs of this diverse population.Objectives:The aim of our observational study was to identify the patient characteristics of the non-attenders and investigate if ethnicity and socioeconomic class contribute to the non-attendance rate.Methods:The study was based on patient appointments scheduled at a busy rheumatology outpatient clinic across three large hospital sites from January 2017 to June 2017. Extensive data on various outcomes such as cancellation on the part of the patients and non-attendance from the patients without giving formal notice were collected from the main electronic administrative systems of three hospitals in the region. The data for the appointment characteristics were also collected. Logistic regression was used for statistical analysis.ResultsOf the 22,011 appointments scheduled over the study period. The non-attendance rate of 3.5% was recorded for this study period without the patients giving notice. The age range of the study population was 16 to 95 years. The median age was 50 years. Majority (24%) of non-attenders were in the 45–54 year age bracket. The 85–95 year age group had the lowest non-attendance rate at 2%. When the data was analysed for ethnicity, the percentage of patients who did not attend in the black Asian and minority ethnic group (BAME) was 44%. Only 33% of the study population were recorded on the hospital database as employed. The reminder included retirees (29%), students (4%) whilst the remaining 34% were either unemployed or we had no formal recording of their employment status.Conclusions:The cost implications of missed appointments is so significant that even small percentage reductions in non-attendance rates could lead to significant savings. Various studies have identified many contributory factors such as age and ease of access to hospital facilities.Few studies have looked at the role of ethnicity and socioeconomic class. From our data there was a significant (P value <0.05) difference between the employed and unemployed group. The working class group also had a significant non-attendance rate which suggests that more can be done at looking at the appointment scheduling by the health service provider.Patient factors are likely to play a role in the BAME group not attending hospital appointments. The existing letter and text reminder service might need to explore several language options as this may play a contributory role in non-attendance rates. Addressing these issues may go a long way in ensuring that existing resources are not wasted due to non-attendance.References1. Ellis AD, et al. Demographic and practice factors predicting repeated non-attendanc...

Background: The use of contraception among women aged 35 to 49 years is imperative due to the risk of unplanned pregnancy and poor obstetric outcomes. However, the use of contraceptives in this age group has been reported to be low. In Ghana, studies are limited that determine factors influencing contraception among women in this age group, in particular the influence of husbands. This study aims to ascertain factors that influence contraception among women aged 35 to 49 years and their male partners. Objectives: The objective of the study was to describe factors that influence modern contraceptive use among women aged 35 to 49 years and their male partners in the Gomoa West District of Ghana. Methods: A total of 44 informants participated in the study. In-depth interviews were conducted remotely for 22 women, 15 male partners of women interviewed, and seven family planning service providers. Twenty-one informants participated in four focus group discussions organized. A simple thematic analysis was undertaken. Results: Factors that influenced the use of modern contraceptives were achieved desired family size, counselling by health professionals, health reasons, and influence of male partner. Barriers to using modern contraceptives included religious or socio-cultural reasons, experience or fear of side effects, rumors or misconceptions, and the belief that contraceptive use is a matter for women. Conclusions: This study described factors that influence contraception among women 35 to 49 years and their male partners. All informants used some form of contraception, although traditional contraceptive method users (TCMUs) did not consider traditional contraceptive methods (TCMs) as a form of contraception. Education on effective TCMs as an alternative for non-users of modern contraceptive methods (MCMs) is needed. Strengthening male involvement in family planning and health educational activities could alleviate fear and reduce misconceptions about using modern contraceptives.