{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T20:42:52Z","timestamp":1792701772411,"version":"4.5.0"},"reference-count":43,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Modern contraceptive use remains a major public health priority in Ghana, yet geographic inequalities and contextual determinants of utilization among ever sexually active women are not fully understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to examine the prevalence, spatial distribution, and determinants of modern contraceptive use among ever sexually active Ghanaian women using data from the 2022 Ghana Demographic and Health Survey (GDHS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cross-sectional study design with multilevel and spatial analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The study included 10,415 ever sexually active women aged 15\u201349 years from the 2022 GDHS. Descriptive statistics and Pearson\u2019s chi-square tests were performed. Multilevel mixed-effects logistic regression models were fitted to identify individual- and community-level factors associated with modern contraceptive use. Spatial analyses, including Global Moran\u2019s I, Local Moran\u2019s I, and Getis-Ord Gi\n                      <jats:sup>*<\/jats:sup>\n                      hotspot analysis, were conducted to assess geographic clustering and spatial patterns. Adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were reported.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The prevalence of modern contraceptive use among women with a history of sexual intercourse was 31.4% (95% CI: 30.1\u201332.7). Modern contraceptive use demonstrated significant spatial clustering across Ghana (Global Moran\u2019s I = 0.218, p = 0.036). Western North emerged as a significant hotspot, whereas Northern and Savannah regions were identified as cold spots of low utilization. Women aged 40\u201349 years (aOR = 0.55; 95% CI: 0.42\u20130.73), Muslims (aOR = 0.73; 95% CI: 0.58\u20130.90), breastfeeding women (aOR = 0.77; 95% CI: 0.63\u20130.94), and women currently abstaining from sex (aOR = 0.12; 95% CI: 0.09\u20130.17) had lower odds of using modern contraceptives. Conversely, HIV testing history, recent births, exposure to family planning media messages, and larger household size were associated with higher odds of utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Modern contraceptive use among ever sexually active Ghanaian women remains relatively low and spatially clustered. Targeted, culturally sensitive, and geographically focused reproductive health interventions are needed to address regional inequalities and improve contraceptive uptake in Ghana.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057261500722","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:03:57Z","timestamp":1792443837000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Spatial patterns and multilevel analysis of modern contraceptive utilization among ever sexually active ghanaian women: Evidence from the 2022 Ghana demographic and Health Survey"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1859-2620","authenticated-orcid":false,"given":"Julius Kwabena","family":"Karikari","sequence":"first","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheneil","family":"Agyemang","sequence":"additional","affiliation":[{"name":"University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sulemana Baba","family":"Abdulai","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7682-766X","authenticated-orcid":false,"given":"Emmanuel","family":"Konadu","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mercy","family":"Addae","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muftawu Mohammed","family":"Saani","sequence":"additional","affiliation":[{"name":"Nursing and Midwifery Training College"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivetta","family":"Dela Alomenu","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obed Kwabena","family":"Offe Amponsah","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2321-387X","authenticated-orcid":false,"given":"Douglas Aninng","family":"Opoku","sequence":"additional","affiliation":[{"name":"Kwame Nkrumah University of Science and Technology"},{"name":"University of Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,19]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssmph.2020.100554"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12905-018-0634-9"},{"key":"e_1_3_7_4_2","doi-asserted-by":"crossref","first-page":"e0230139","DOI":"10.1371\/journal.pone.0230139","article-title":"Spatial variations and socioeconomic determinants of modern contraceptive use in Ghana: A Bayesian multilevel analysis","volume":"15","author":"Nyarko SH","year":"2020","unstructured":"Nyarko SH. 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