The role of community-based health planning and services strategy in involving males in the provision of family planning services: a qualitative study in Southern Ghana

Abstract

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.

Magnitude and trends of inequalities in antenatal care and delivery under skilled care among different socio-demographic groups in Ghana from 1988 – 2008

“…The Community-based Health Planning and Services (CHPS) may be one such contributing factor [62–64]. This is a national health policy initiative adopted in 1999 that aims to reduce geographical barriers making access to health care difficult in Ghana by mainly focusing on deprived rural districts in remote areas.…”

A Comparative Qualitative Study of Misconceptions Associated with Contraceptive Use in Southern and Northern Ghana

“…In effect, women who cannot overcome fear of spousal abandonment or neglect in case of method complications may likely opt not to use contraception until their spouse agrees to it. A recent study in southern Ghana revealed that spousal consent was still very relevant in contraceptive uptake among women (11). Programs should therefore be designed to target men to discredit these misconceptions.…”

“…However, records indicate that Ghana’s current contraceptive acceptance rate is 23%, five percentage points below the expected projection. Several factors may be responsible for Ghana’s inability to achieve this target, notably barriers in contraceptive use that have often been cited as one of the reasons impeding the achievement of fertility regulations (11). Understanding these barriers is important for providing programing guidance on the provision of family planning services.…”

Risk Factors and Barriers to Male Involvement in the Choice of Family Planning Methods in the Buea Health District, South West Region, Cameroon: A Cross-Sectional Study in a Semi-Urban Area

“…This picture is similar to findings in Nigeria, Ghana, Democratic Republic of Congo (DRC) and Ethiopia. 3,4,20,21 Some modern female FP methods are expensive and therefore tend to dissuade men from being involved. Also, since some men are ignorant or do not have adequate information about FP, their involvement is affected to the same extent.…”