Trend Analysis of Family Planning Methods in Ghana: Use, Limitations, and Recommendations Natalie Cline Meriame Filali Marybec Griffin-Tomas Anita Rohira May 6, 2008

EngenderHealth Family Planning Project Main Contact Kerry Bruce, Senior Technical Officer Defining the Project A trend analysis of family planning methods in Ghana Qualitative approach Anthropological and sociological overview Focus: use, limitations, and recommendations

EngenderHealth Background Founded in 1943, to provide quality care in reproductive health services: Clinic-based and client-centered services Advocates for tubal ligation and vasectomy on a voluntary basis. The organization advocates for reproductive care Dissemination of knowledge Providing counseling services Designing curricula Training medical teams

Purpose of Project The objectives of this study are the following: Regional overview of organizations working in country Identify key challenges that limit the use of family planning methods Develop recommendations for future family planning programs

Methodology Four research themes: Regional Family Planning Programs Gender Relations Culture and Fertility Unmet Need, Demand, Provider Behavior, and Distribution

Unmet Need for Family Planning in West Africa % Married Women of Reproductive Age USAID Survey, 2005

Desire to Limit Fertility Based on Marriage Type Ghana Demographic and Health Survey, % Couples Preferring Cessation

Trends in Total Fertility Rate Total Births Per Woman Ghana Demographic and Health Survey,

Unmet Need for Family Planning and Contraception % Married Women with Demand for FP Govindasamy and Boadi, 2000

Research Process Literature review: Six documents provided by EngenderHealth Individual research on respective topics Conference calls: To client liaison, Kerry Bruce Discussed project direction Framing Documents: Terms of Reference Timeline for Deliverables

Project Process: The Beginning Individual process: Contacted organizations and authors for documents Researched respective topics Developed content for the document Group process: Discussed timeline and development Provided feedback, encouragement, and criticisms Continually debated relevance of points to overall project goal

Project Process: Obstacles Access to client: No face to face time with client Liaison not based in NY and frequently out of the country Unclear goals and objectives: Ambiguous project goal Lack of cohesive project design Communication: Effective communication between group members and remote client Filtering information back to group

Project Process: Obstacles Preliminary draft due date: Unexpectedly moved up by nearly six weeks Shortened schedule proved to be challenging Further due date issues: No firm date for presentation Schedule subject to arrival of Ghana team Access to information: Uneven coverage of topics Inconsistency of data

Project Process: Deliverables Presentation: Presented findings to EngenderHealth staff Fielded questions from the Ghana team Document: Forty page document to be distributed to the Ghana field team Potential to be passed on to USAID

Project Process: Successes Project completion: Executed the project objectives Worked within the established timeframe Development of skills: Familiarity with consultant environment and language Easy-going yet professional and reliable attitude

Project Process: Reflections Criticisms Slow start: Lost two weeks of work due to delays in project assignments Additional week lost due to delay in initial contact with client Presentation let-down: Led to believe there would be a larger audience Lack of dialogue from the field and headquarters Document’s relevance in question: No feedback after initial draft No future recommendations for how the document would be implemented

Project Process: Reflections Positives Individual: Enhanced research and analytical skills Learned to work effectively within a team Effectively communicated issues within the group Group: A positive group work experience Gained confidence in terms of research skills Gained some leadership skills Learned to create work within a client-driven process and generate client-centered deliverables