Prevalence and factors associated with unintended pregnancy among women in Ghana.

backgroundUnintended pregnancy remains a major public health concern, particularly in low-and middle-income countries. It poses significant challenges to both maternal and child health. It is associated with adverse outcomes such as unsafe abortions, delayed initiation of antenatal care, low birth weight, and poor developmental outcomes in children. This study examined the prevalence and factors associated with unintended pregnancy among women in Ghana.

methodsData from the 2022 Ghana Demographic and Health Survey was used for the study. Regional variations in the prevalence of unintended pregnancy were presented using a spatial map. A mixed-effect multilevel binary logistic regression models were fitted to examine the factors associated with unintended pregnancy using a four-modelled approach. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI) and intra-cluster correlation coefficients.

resultsThe prevalence of unintended pregnancy in Ghana was 38.9% [37.0, 40.8]. Women aged 20–49 had lower odds for unintended pregnancy than those aged 15–19, with the lowest odds among those aged 40–44 [aOR = 0.07; 95% CI: 0.03, 0.13]. Women who were Muslims [aOR = 0.69; 95% CI: 0.49, 0.98] had lower odds of unintended pregnancy than those who were Christians. Women who were Mande by tribe [aOR = 0.40; 95% CI: 0.18, 0.87] had lower odds of unintended pregnancy than those who were Akan by tribe. The likelihood of unintended pregnancy was lower among women from the richest households [aOR = 0.46; 95% CI: 0.26, 0.80] compared to those from the poorest quintile households. Women residing in the Northern [aOR = 0.49; 95% CI: 0.25, 0.94] and North East [aOR = 0.37; 95% CI: 0.19, 0.73] regions were less likely to have unintended pregnancy relative to those from the Western Region. Women with primary [aOR = 1.41; 95% CI: 1.05, 1.90] and secondary [aOR = 1.46; 95% CI: 1.09, 1.97] education were more likely to have unintended pregnancy than those with no education. Women with 3–4 [aOR = 2.02; 95% CI: 1.48, 2.77] and 5 + children [aOR = 4.34; 95% CI: 2.79, 6.74] had higher odds of unintended pregnancy than those with 1–2 children. Women with six or more in household size [aOR = 1.53; 95% CI: 1.20, 1.94] had higher odds of unintended pregnancy than those with five and below. Women with females as household heads [aOR = 1.47; 95% CI: 1.15, 1.87] were more likely to have unintended pregnancy compared to those with males as household heads. Women living in the Central, Greater Accra, Volta, Eastern, Ashanti, Western North and Oti regions had higher odds of unintended pregnancy than those living in the Western region, with the highest odds among those residing in the Central region [aOR = 7.08; 95% CI: 3.99, 12.57].

conclusionUnintended pregnancy is prevalent among women in Ghana, with variations across the regions. Factors such as women's age, education, parity, religion, ethnicity, household size, sex of household head, wealth index, and region were associated with unintended pregnancy. To effectively reduce unintended pregnancies in Ghana, the Ministry of Health should consider restructuring existing sexual and reproductive health programmes and use these findings to inform the design of targeted, evidence-based interventions aimed at preventing unintended pregnancies among women.