{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:02:16Z","timestamp":1787022136731,"version":"build-2736575974"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T00:00:00Z","timestamp":1702512000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a significant literature describing the link between parity and contraceptive use. However, there is limited knowledge about the disaggregation by parity of the type of contraceptives. In this study, we describe the use of contraceptives by parity among women of reproductive age in Ghana, focusing on use of highly effective methods (injection, pill, intrauterine device, implant, and sterilization).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the 2017 Ghana Maternal Health Survey, a nationally-representative cross-sectional household survey, we describe contraceptive method use by number of living children among sexually active women of reproductive age. We then estimated predictors of use of highly effective contraception in a multilevel logistic regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most women in this survey are not using any method of contraception, although this varies by whether or not they have begun childbearing. Contraceptive method use varies by number of living children. Before having children, natural (periodic abstinence and withdrawal) and episodic (condoms) methods dominate. Once a woman has one living child, method preference changes to injectables and implants. Factors associated with using a highly effective method of contraception are: having &gt;3 children, being in a relationship, having had an abortion, being younger than age 30, and having had sexual intercourse within days of answering the survey (p &lt; .001 for all).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this analysis, the number of living children a woman has, her age, and timing of last intercourse are the most significant predictors of using a highly effective method of contraception. However, the majority of participants in this study report not using any method of contraception to avoid unwanted pregnancies. Future research that attempts to unpack the disconnect between not wanting to become pregnant and not using contraception is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0295815","type":"journal-article","created":{"date-parts":[[2023,12,14]],"date-time":"2023-12-14T13:48:20Z","timestamp":1702561700000},"page":"e0295815","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Contraceptive use by number of living children in Ghana: Evidence from the 2017 maternal health survey"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1539-5397","authenticated-orcid":true,"given":"Sarah","family":"Compton","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Nakua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5796-157X","authenticated-orcid":true,"given":"Cheryl","family":"Moyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Dzomeku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Treleaven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Easmon","family":"Otupiri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jody","family":"Lori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,12,14]]},"reference":[{"issue":"1","key":"pone.0295815.ref001","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1055\/s-0034-1395272","article-title":"Global fertility and population trends.","volume":"33","author":"J. Bongaarts","year":"2015","journal-title":"Semin Reprod Med"},{"issue":"S1","key":"pone.0295815.ref002","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1111\/j.1728-4457.2016.00164.x","article-title":"Africa\u2019s Unique Fertility Transition.","volume":"43","author":"J. Bongaarts","year":"2017","journal-title":"Popul Dev Rev."},{"issue":"26","key":"pone.0295815.ref003","first-page":"737","article-title":"Slowdowns of fertility decline.","volume":"46","author":"M Grimm","year":"2022","journal-title":"Demogr Res."},{"issue":"3","key":"pone.0295815.ref004","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1111\/sifp.12098","article-title":"Stalls in Fertility Transitions in sub-Saharan Africa: Revisiting the Evidence.","volume":"50","author":"B. Schoumaker","year":"2019","journal-title":"Stud Fam Plann."},{"issue":"1","key":"pone.0295815.ref005","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1080\/10130950.2018.1438962","article-title":"African women\u2019s sexual and reproductive health and rights: The revised Maputo Plan of Action pushes for upscaled delivery.","volume":"32","author":"BM Munyati","year":"2018","journal-title":"Agenda."},{"issue":"7","key":"pone.0295815.ref006","doi-asserted-by":"crossref","first-page":"e904","DOI":"10.1016\/S2214-109X(19)30200-1","article-title":"Trends in contraceptive prevalence rates in sub-Saharan Africa since the 2012 London Summit on Family Planning: results from repeated cross-sectional surveys","volume":"7","author":"S Ahmed","year":"2019","journal-title":"Lancet Glob Health"},{"issue":"10099","key":"pone.0295815.ref007","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/S0140-6736(17)32294-8","article-title":"WHO Working Group for Operationalizing Sexual Health. Detangling and detailing sexual health in the SDG era","volume":"390","author":"R Stephenson","year":"2017","journal-title":"Lancet"},{"issue":"2","key":"pone.0295815.ref008","doi-asserted-by":"crossref","first-page":"e1003026","DOI":"10.1371\/journal.pmed.1003026","article-title":"Estimating progress towards meeting women\u2019s contraceptive needs in 185 countries: A Bayesian hierarchical modelling study.","volume":"17","author":"V Kantorova","year":"2020","journal-title":"PLoS Med."},{"key":"pone.0295815.ref009","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.srhc.2019.06.002","article-title":"Prevalence and predictors of contraceptive use among women of reproductive age in 17 sub-Saharan African countries: A large population-based study.","volume":"21","author":"DM Ba","year":"2019","journal-title":"Sex Reprod Healthc"},{"key":"pone.0295815.ref010","volume-title":"Ghana Demographic and Health Survey 2014.","author":"Ghana Statistical Service (GSS), Ghana Health 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information and services.","volume":"41","author":"A Bankole","year":"2010","journal-title":"Stud Fam Plann"},{"key":"pone.0295815.ref017","author":"Ghana Statistical Service (GSS), Ghana Health Service (GHS), ICF","year":"2016","journal-title":"Ghana Malaria Indicator Survey"},{"key":"pone.0295815.ref018","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12978-015-0017-8","article-title":"Spatial and socio-demographic determinants of contraceptive use in the Upper East region of Ghana.","volume":"12","author":"FS Achana","year":"2015","journal-title":"Reprod Health."},{"key":"pone.0295815.ref019","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/s40834-018-0066-9","article-title":"Postpartum fertility behaviours and contraceptive use among women in rural Ghana.","volume":"3","author":"SK Eliason","year":"2018","journal-title":"Contracept Reprod Med"},{"key":"pone.0295815.ref020","author":"Ghana Statistical Service (GSS), Ghana Health Service (GHS), 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