Three papers on side effects and modern contraceptive use among women in Ghana

Abstract

This thesis investigates the issue of side effects and how they may act as a barrier to
the use of modern contraceptive methods among women in Ghana. Three papers are
presented each addressing the issue using different sources of data and different
methodologies. The disparate nature of the data sources and techniques used
provides each paper with its own perspective on the research question and each
paper gives a unique insight into the topic.

The aim of the first paper is to use a qualitative focus group methodology to explore
in-depth the way individuals perceive information about family planning. The study
seeks to better define what is meant by the term fear of side effect in this particular
social context and to determine on what information and from what sources is this
fear constructed. Overall the findings of this study show that fear of side effects does
act as a significant barrier to the use of temporary methods and these fears result
mainly from a large amount of negative information regarding side effects being
passed through the social network. However the events being recounted cannot be
dismissed as myth or rumour as they are most often based in real experiences.

The second paper uses monthly data on contraceptive use and the experience of side
effects from the calendar section of a longitudinal survey of women in Southern
Ghana. Using life tables and a multi-level logistic discrete-time hazards model this
study analyses contraceptive discontinuation and how it relates to the concurrent
self-reported experience of side effects. The results show that experiencing side
effects is associated with a higher probability of discontinuation of the method and
that counselling from health workers is extremely important in minimizing
discontinuation rates.

The third paper uses a sub-sample of women who are not current contraceptive
users from the 2003 GDHS. The study uses multiple logistic regression to determine
the association between exposure to family planning information, through mass
media and interpersonal channels, and the probability that a respondent will cite fear
of side effects as their main reason for not intending to use a contraceptive method in
the future. The results show that the only family planning communication variable
which does have a significant effect is receiving a message from a health worker
which increases the odds of fear of side effects being the main reason for not
intending to use a method in the future. Overall the socio-economic characteristics of
those not intending to use a method in the future due to a fear of side effects is more
similar to current users than to those who are not intending to use in the future for
other reasons.

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Identifiers

ORCID for Zoe Matthews: orcid.org/0000-0003-1533-6618

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