Despite the fall in fertility, unmet need for family planning in Ghana has declined only modestly
from 50 percent in 1988 to 42 percent in 2008. The relative contribution to unmet need of lack of
access to methods has diminished but attitudinal resistance has grown. In 2008, 45 percent of
women with unmet need had no apparent problems of access or attitude, a third had access but an
unfavourable attitude and 23 percent had no access. The mention of health concerns as a reason
for non-use has increased substantially since 1988 and is now the dominant reason. In recent
surveys, the second most commonly mentioned reason was infrequent sex. An enduring
resistance to hormonal methods, much of it based on experience of side effects during prior
episodes of use, may lead many Ghanaian women, particularly in urban areas, to use periodic
abstinence or reduced coital frequency as an alternative means of reducing pregnancy-risk.
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