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77 Genus 1 (2021)

handle is hein.journals/genus77 and id is 1 raw text is: Biney et al. Genus (2021) 77:1 https://doi.org/1 0.1186/s41118-020-00110-6 Genus SR A LA R Te A Being ready, willing and able: understanding the dynamics of family planning decision-making through community-based group discussions in the Northern Region, Ghana Adriana A. E. Biney , Kalifa J. Wright2, Mawuli K. Kushitorl, Elizabeth F. Jackson2, James F. Phillips2, John Koku Awoonor-Williams3 and Ayaga A. Bawahl * Correspondence: abiney@ug.edu. gh 'Regonal Institute for Population Studies (RIPS), U nversity of Ghana, P. O. Box LG 96, Legon, Accra, Ghana Fu st of author nformation s available at the end of the article © The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which Springer Open permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Abstract Regional contraceptive use differentials are pronounced in Ghana, with the lowest levels occurring in the Northern Region. Community-based health services, intended to promote maternal and child health and family planning use, may have failed to address this problem. This paper presents an analysis of qualitative data on community perspectives on family planning readiness, willingness, and ability compiled in the course of 20 focus group discussions with residents (mothers and fathers of children under five, young boys and girls, and community elders) of two communities each in two Northern Region districts that were either equipped with or lacking direct access to community health services. The study districts are localities where contraceptive use is uncommon and fertility is exceptionally high. Results suggest that direct access to community services has had no impact on contraceptive attitudes or practice. Widespread method knowledge is often offset by side-effect misperceptions. Social constraints are prominent owing to opposition from men. Findings attest to the need to improve the provision of contraceptive information and expand method choice options. Because societal acceptance and access in this patriarchal setting is critical to use, frontline worker deployment should prioritize strategies for outreach to men and community groups with prominent attention to social mobilization themes and strategies that support family planning. Keywords: Family planning, Community-based primary health care, Fertility decline, Rural Ghana

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