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

2. 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

3. 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

4. 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

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

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

7. Desire to Limit Fertility Based on Marriage Type Ghana Demographic and Health Survey, 1998 - 2003 % Couples Preferring Cessation

8. Trends in Total Fertility Rate Total Births Per Woman Ghana Demographic and Health Survey, 1998 - 2003

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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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

17. 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