A population and public health expert, Dr John K. Ganle, has called on the government and donor agencies to increase the supply of free or subsidised family planning (FP) or contraceptive commodities and services to public health facilities especially in urban slums in Ghana.
This, he believes, will help to increase access and adoption of FP or contraceptive commodities by the sexually active residents in slum communities.
He said poor access to FP or contraceptive services in Ghana’s urban slums could negatively affect overall sustainable urban development in cities such as Accra.
Dr. Ganle, who is also a Senior Lecturer at the School of Population, Family and Reproductive Health (PFRH), University of Ghana, in a presentation on a study conducted by the Department on Thursday, June 29, 2023, explained that the high fertility in urban slums in Accra could increase population growth, expand demand for urban and municipal services, and increase environment population.
“Not only can this result in poor health outcomes for slum communities but also it could exacerbate inequalities and potentially hinder efforts to attain both universal FP coverage and sustainable urban development as envisaged under SDG 2,” he pointed out.
The study, titled “Achieving universal access to family planning: Preferences for contraceptive delivery models in Ghana’s informal settlements,” which was funded by a fellowship from the International Union for the Scientific Study of Population (IUSSP) as part of Bill & Melinda Gates Foundation grant, aimed at supporting research and policy engagement on fertility and family planning in urban development, had an overall objective to identify low-cost and acceptable interventions or models for delivering quality family planning and contraceptive services to slum dwellers in Accra.
The study sampled a total of 1,083 sexually active girls and women aged 15-49 years in four informal settlements in Accra, namely Nima, Old Fadama, Agbogbloshie and Chorkor between May 2021 and October 2021.
In his presentation, Dr Ganle further called on the Ministry of Health (MoH) and the Ghana Health Service (GHS) to take deliberate steps to support and strengthen the private sector to reduce the cost of FP or contraceptive commodities and services in informal settlements to enable residents in such locations to benefit from such services.
He said the study found out that only 19.6 per cent of women in informal settlements in Accra are currently using modern contraception, adding that majority of the women, about 78.4 per cent in Accra’s slums who ever used a contraception used an emergency contraceptive pill.
He pointed out that majority of women in Accra’s informal settlements, about 57 per cent preferred government or donors supplying free or subsidised FP or contraceptive commodities and services in public health facilities.
The reason, Dr. Ganle explained, many women in Accra’s slum perceived the quality of family planning services in private health facilities to be very high as compared to the public health facilities.
He disclosed that although awareness about contraception among women in informal settlements was high as compared to the awareness of the general population, adoption was quite low.
He said the study also discovered that many residents in urban slums, particularly in Accra did not like the long-acting FP methods or contraceptives.
That, Dr. Ganle added, majority of the women in slum communities who used contraception used an emergency contraceptive pill, particularly Postinor-2, Lydia Post Pill, NorLevo, and Pregnon.
He further indicated that majority of those using FP or contraceptives in urban slums in Accra accessed such services through the over-the-counter medicine sellers.
Call to action
In his recommendations, Dr. Ganle, who is also the Principal Investigator of the study, urged the MoH and GHS to improve the quality of FP and contraceptive services provided in public health facilities.
Additionally, he urged the Health Ministry and GHS to collaborate with the private sector to reduce the cost of FP and contraceptive services offered by private providers in urban slums.
This, he noted, could include persuading private providers to enroll under the National Health Insurance Scheme (NHIS), a situation he observed, will reduce the high out-of-pocket payment women in informal settlement face when accessing services from private providers.