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BackgroundReproductive health and Family Planning (FP) services have been of global concern especially in developing countries where fertility rates are high. Traditionally FP services had always targeted females with little or no attention given to males. To ensure equitable distribution of health services, Ministry of Health (MOH), Ghana adopted the Community-Based Health Planning and Services (CHPS) as a nationwide health policy with the aim of reducing obstacles to physical and geographical access to health care delivery including FP services. However, not much is known about the extent to which this policy has contributed to male involvement in FP services. This qualitative descriptive study was therefore designed to explore male involvement in FP services in communities with well functioning CHPS and those with less or no functioning CHPS structures. The study further solicited views of the community on the health status of children.MethodsThis was a qualitative descriptive study and adapted the design of an ongoing study to assess the impact of male involvement in FP referred to as the Navrongo experiment in Northern Ghana. Twelve focus group discussions were held with both male and female community members, six in communities with functional CHPS and six for communities with less/no-functional CHPS. In addition, fifty- nine (59) in-depth interviews were held with Community Health Officers (CHOs), Community Health Volunteers (CHVs) and Health Managers at both the districts and regional levels. The interviews and discussions were tape recorded digitally, transcribed and entered into QSR Nvivo 10© for analysis.ResultsThe results revealed a general high perception of an improved health status of children in the last ten years in the communities. These improvements were attributed to immunization of children, exclusive breastfeeding, health education given to mothers on childcare, growth monitoring of children and accessible health care. Despite these achievements in the health of children, participants reported that malnutrition was still rife in the community. The results also revealed that spousal approval was still relevant for women in the use of contraceptives; however, the matrilineal system appears to give more autonomy to women in decision-making. The CHPS strategy was perceived as very helpful with full community participation at all levels of the implementation process. Males were more involved in FP services in communities with functioning CHPS than those without functioning CHPS.ConclusionThe CHPS strategy has increased access to FP services but spousal consent was very important in the use of FP services. Involving males in reproductive health issues including FP is important to attain reproductive health targets.

BackgroundMale involvement in contraceptive use is increasingly becoming a global reproductive health issue. Vasectomy is one of the two male modern contraceptive methods espoused by the National Family Planning Policy in Ghana. Despite these advocacies, there are reports of low patronage of this method in Ghana. This study adhering to RATS guidelines on qualitative research therefore explored the social and cultural factors that may be affecting the low vasectomy uptake in Southern Ghana.MethodsThe study was conducted in Sefwi Bibiani-Ahwiaso Bekwai (SBAB) District and Komenda-Edina-Eguafo-Abrem (KEEA) Municipal area in the Western and Central regions of Ghana respectively. Twelve Focus Group Discussions were held with both male and female community members. In-depth interviews were also carried out with Community Health Officers (CHOs), Community Health Volunteers (CHVs) and health managers at both the district and regional levels. The discussions and interviews were recorded, transcribed verbatim and analysed using Nvivo 10.ResultsThe study revealed that vasectomy was perceived as an act against God, which was punishable either by death or answerable on judgement day. Vasectomy was also perceived to be a form of castration, which can make men weak and incapable, thereby unable to satisfy their wives sexually, leading to marital conflicts. Women were more concerned about the negative effects of vasectomy on men. Cafalgin and panacin which are locally manufactured analgesics were perceived to have contraceptive abilities and therefore used by men as an alternative to modern contraceptive methods.ConclusionsStigma and the misconceptions in the community may be accounting for the low vasectomy uptake in Ghana despite several advocacy strategies. Women were highly influential in a man's decision on vasectomy. This calls for the need to increase health education to demystify the misconceptions about vasectomy. Vasectomy-related campaign messages should target both men and women.

BackgroundChild marriage remains a challenge in Ghana. Over the years, government and development partners have made various commitments and efforts to curb the phenomenon of child marriage. However, there is little empirical evidence on the predictors, norms and practices surrounding the practice to support their efforts, a gap this study sought to fill.MethodsThe study employed a multiple-method approach to achieve the set objectives. Data from the women’s file of the 2014 Ghana Demographic and Health Survey (GDHS) was used to examine the predictors of child marriage using frequencies and logistic regression methods. Data from Key Informant Interviews (KIIs) and Focus Group Discussions (FGDs) collected in Central and Northern regions of Ghana were used to examine norms and practices surrounding child marriage using thematic analysis.ResultsTwo in ten (20.68%) girls in the quantitative sample married as children. The results revealed that girls who had never attended school compared to those who had ever attended school were more likely to marry as children (OR, 3.01). Compared with girls in the lowest wealth quintile, girls in the middle (OR, 0.59), fourth (OR, 0.37) and highest (OR, 0.32) wealth quintiles were less likely to marry as children. From the qualitative data, the study identified poverty, teenage pregnancy, and cultural norms such as betrothal marriage, exchange of girls for marriage and pressure from significant others as the drivers of child marriage.ConclusionsThe findings show that various socio-economic and cultural factors such as education, teenage pregnancy and poverty influence child marriage. Hence, efforts to curb child marriage should be geared towards retention of girls in school, curbing teenage pregnancy, empowering girls economically, enforcing laws on child marriage in Ghana, as well as designing tailored advocacy programs to educate key stakeholders and adolescent girls on the consequences of child marriage. Additionally, there is the need to address socio-cultural norms/practices to help end child marriage.