The Determinants of Contraceptive Use-Dynamics in Kassena-Nankana District of Northern Ghana

John E. Williams, Navrongo Health Research Centre
Elizabeth F. Jackson, Population Council
Isaac Akumah, Navrongo Health Research Centre
James F. Phillips, Population Council

Since 1994, the Navrongo Health Research Centre has conducted longitudinal registration of the dynamics of contraceptive use among women served by the Community Health and Family Planning Project, a factorial experiment assessing the determinants of reproductive change in a Sahelian population of northern Ghana. The CHFP examines the fertility impact of two experimental arms of activities: i) marshalling traditional social institutions for community leadership and participation in program operations; and ii) reorienting the Ministry of Health clinical care system to community-based services. Four cells are implied, since arms are launched independently, jointly, and not at all. This paper uses discrete-time hazard regression to examine the impact of experimental exposure on contraceptive use dynamics, controlling for other covariate effects. Results suggest that contrasting continuity of use explains observed cell differences in program fertility impact. Furthermore, use of contraception is fragile in all cells and minor disruptions in services produce pronounced disjunctures.