Communique of the National Sample Survey of Fertility and Birth Control (abstract)

The State Family Planning Commission in China surveyed 2,151,212 people, including 459,269 married women aged 15-57 on fertility and birth control, in July, 1988 from 30 provinces and other regions. From 1980- 87 the average total fertility rate was 2.47 vs. 4.01 in the 1970s. Fertility rates in the 80s were 1.33 for cities, 2.43 for towns, and 2.84 for villages. 1st parity births rose from 44.15% to 52.55% from Jan. to July of 1988 and 2nd parity births were about 30%. Women aged 50-57 had an average of 5.27 children while women aged 45-59 had an average of 4.44 children. 71.21% of childbearing-age women use contraception: 10.99% use male sterilization, 38.24% use female sterilization, 41.48% use IUDs, 4.91% oral pills, 2.65% condoms, 0.42% external contraceptives, and 1.32% use other methods. 13.79% of the married, childbearing-age couples have one-child certificates. The population of China as of April 1989 was 1.1 billion. In 1988 the birth rate was 20.78/1000 and the death rate was 6.58/1000.     

Choosing a contraceptive method: why does it matter?

The use of contraceptives varies widely among Asian countries. Based on the most recent survey data available, the rate varies from nearly 8/10 married women aged 15-44 in Taiwan to fewer than 1/10 in Pakistan and Nepal. Women in East Asian countries are most likely to practice contraception, followed by those in Southeast Asia, with lower contraceptive prevalence rates found in South Asia. The rates of some East Asian nations now match those of the US and other developed nations, while in most South Asian nations contraception is spreading slowly. Contraceptive methods in use vary widely by country. The leading method in the greatest number of countries is sterilization, but in most countries several methods are nearly equal in popularity. Only in India is sterilization used by a majority of those people who practice contraception. Japan is the only country in which a majority of contraceptors use condoms, and only in China do 1/2 use IUDs. The choice of a particular contraceptive method is strongly influenced by 1) methods available through family planning programs, or promoted through the use of target systems; 2) religous and cultural factors; 3) concerns about side effects and safety; 4) ease of access to particular methods; 5) the medical profession; and 6) legality--in Japan the pill is illegal. In most countries the type of contraceptive that people prefer has changed since the introduction and promotion of modern methods of contraception. In general, there has been a shift to more effective methods. An increase in female sterilization at the expense of other methods such as the IUD or pill is the most common pattern. In countries where female sterilization is unpopular, use of such modern methods as the pill, IUD, or condom has increased at the expense of traditional methods.     

A survey of China's birth control among women of child-bearing age

To further implement China's family planning policy of "prevention first, birth control first," a study of the current family planning situation was conducted. A survey of the birth control methods employed by women of childbearing age and by men was based on a nationwide randomized sampling of 1/1000. In the different age groups, ranging from 15-49 years old, IUD users accounted for over 50%, tubal sterilization 25%, and vasectomy 10%. The main IUD users were women in the 20-24 age group. Tubal sterilization was more prevalent among the women in the 35-39 age group. The use of oral contraceptives (OCs) was more common among younger women but accounted for less than 10% of the total. The survey was based on the replies to questionnaires from 172,788 married women of childbearing age; 120,022 of them practiced contraceptive methods for a birth control rate of 69.46%. The breakdown was as follows: IUD, 34.84%; tubal sterilization, 17.63%; vasectomy, 6.94%; OCs, 5.86%; condom users, 1.39%; and other methods (including chemical suppositories, rhythm, or safe period method and withdrawal before ejaculation), 2.78%. There was a higher percentage of OC users in urban areas, and a marked preference for IUDs in the rural communities. The rural birth control rate was 68.58%; the urban rate was 74.17%. The use of the IUD has priority in all the areas; its percentage approaches the national average level. The use of vasectomy as a birth control method varies considerably according to area as does the use of OCs, condom, and tubal sterilization. Rural minority groups prefer the IUD and OCs; tubal sterilization, the condom, and vasectomy are preferred by the Han nationality. The birth control rate differed according to the different occoupation groups: 77.85%, workers; 76.01%, farmers; 85.15%, cadres; 59.52%, housewives; and 66.67%, others. The birth control rate was higher among those who received a college education than the illiterates, but statistics did not show a significant difference in the rate of those with a high school education and the illiterates. Mothers of 0-1 children generally preferred OCs; tubal sterilization was preferred by mothers with 2-3 children. The nonusers of contraception accounted for 30.54% among married women of childbearing age. A breakdown gives the following figures: menopause and infertility, 6.17%; divorced and widowed, 1.64%; planned parenthood, 10.51%; nonusers who should have practiced contraception, 12.22%. On a national level, the estimated number of nonusers of contraception among those who should be practicing contraception comes to about 20,000,000 women.     

New survey finds fertility decline in India

A brief indication was provided of demography, fertility, and contraceptive usage and knowledge based on the recent 1992/93 Indian National Family Health Survey. The sample included 88,562 households and 89,777 ever married women aged 13-49 years in 24 states and the National Capital Territory of Delhi. About 38% of household members were aged under 15 years. The sex ratio was 944 females to 100 males. 54% aged over 5 years were currently married; 10% were widowed, divorced, or separated. 43% were literate and 9% had secondary or higher education: 67% for females in cities and 34% in rural areas. Female literacy was 82% in Kerala but under 30% in Rajasthan, Bihar, Uttar Pradesh, and Madhya Pradesh. During 1990-92, the crude birth rate was 28.9 per 1000 population. Total fertility was 3.4 for women aged 15-49 years: 3.7 in rural and 2.7 in urban areas. 31% of parents had been sterilized. 26% desired no more children. Only 6% of women with four or more children desired another child. 99% of urban and 95% of rural respondents had knowledge of at least one modern or traditional method. Female and male sterilization were the most well-known modern methods. 47% of women had ever used contraception: 42% with a modern method and 12% with a traditional method. 41% were current users of family planning: 36% with a modern and 4% with a traditional method (45% in urban and 33% in rural areas with a modern method). The highest contraceptive use was in Kerala, Himachal Pradesh, Maharashtra, and Punjab states and Delhi (over 50%). The two most populous states, Uttar Pradesh and Bihar, had the lowest rates, which were under 25%; other low usage was in Assam and several small northeastern states. 75% of all female modern contraceptive use was female sterilization. 12% in urban and 3% in rural areas used a modern spacing method. Use increased with increased educational level. Rural sources of supply emphasized public facilities: sterilization and IUDs.     

Fertility regulation technology: status and prospects

The current status of and prospects for contraceptive methods is reviewed. Regulations governing the development, safety, and effectiveness of contraceptive methods are discussed, as well as the nature of the female and male reproductive system. Methods reviewed include coitus interruptus, the condom, spermicidal contraceptive agents, postcoital douching, the vaginal diaphragm, male and female sterilization, the rhythm method, oral contraceptives, IUDs, induced abortion, progesterone-releasing IUDs, postcoital estrogens, abortifacient agents (prostaglandins), immunization against human chorionic gonadotropin (HCG), pharmacologic suppression of the corpus luteum, long-acting injections of Depo-Provera, implantation of capsules containing norgestrel, the intravaginal ring, intracervical devices, release of contraceptive steroids through an arm bracelet, and male contraceptive agents. New areas of contraceptive research include influencing the release of luteininzing hormone-releasing hormone, 'turning-off' corpus luteum function in early pregnancy by competitors for HCG, affecting sperm or ovarian membranes to prevent fertilization, and interferring with sperm and egg development.     

Use of contraceptives by Chinese women

In April 1985 the State Statistical Bureau of China conducted a fertility sampling survey in the provinces of Hebei and Shaanxi, and Shanghai municipality covering a population of 93,000,000. The target group was married women under 50 whose knowledge and use of contraceptives are the main content of this survey. The IUD has been used by 62% in Hebei, 61% in Shaanxi, and 55% in Shanghai, and is most popular with women over 30 who have had at least 1 child. Married women who have used the pill make up 33% in Shanghai, 14% in Hebei, and 7% in Shaanxi. Female and male sterilization are used by women who have had more than 2 children (15.7% in Shanghai, 40% in Hebei, and 28% in Shannxi). 70-80% have used contraception of some type, reflecting the success of the family planning program.     

Understanding U.S. fertility: findings from the National Survey of Family Growth,Cycle III

The 1st overview of findings from Cycle III of the National Survey of Family Growth, the latest of 7 such surveys of US fertility since 1955 and the 1st to cover all women of childbearing age in the conterminous US is presented. Interviews between August 1982 and February 1983 with 7969 women, representative of 54 million women aged 15-44, reveal that sterilization is now the leading contraceptive method in the US, used by 33% of all contraceptors in 1982 (22%, female sterilization; 11% male sterilization), followed by the pill (29%), condom (12%), diaphragm (8%), and IUD (7%). Linked to this is the continuing decline in unwanted births since the baby boom peak in 1957, which accounted for nearly 1/2 of the drop between 1973 and 1982 in ever-married women's children ever born, from 2.2 to 1.9/woman. However, births conceived sooner than planned increased slightly among younger married women, probably due to the large drop in pill use since 1973 and increased use of the less effective diaphragm and condom among couples still intending to have more children. Black women are now more likely than white women to use the most effective female methods: female sterilization, pill, and IUD. Only 45% of women aged 15-44 in 1982 had used a contraceptive method at 1st intercourse. 4 out of 5 women married for the 1st time between 1975 and 1982 had intercourse before marriage. However, premarital sexual activity may be leveling off among white teenagers after a steep rise since the early 1970s and declining moderately among black teenagers. 16% of 1st marriages among ever-married women aged 15-44 in 1982 had been dissoved within 5 years, mostly by divorce or separation. 59% of black women with children in 1982 had their 1st birth before marriage, compared to 11% of white mothers. The proportion of babies who were breastfed more than doubled between 1970-71 and 1980-81, from 24 to 53%.     

The trends of contraceptives of people in Shanghai since early 1980s

Shanghai has had the lowest fertility rate in China for many years. Shanghai had a negative rate of natural growth during 1990-95. During 1980-93, fertility dropped continuously. In 1982, contraceptive use among married women included 29.47% using IUDs, 29.33% using oral pills, 23.44% using female sterilization, and 10.48% using condoms. Contraceptive prevalence declined slightly from 98.6% in 1982 to 92.29% in 1993. By 1993, method use changed. Oral pill and female sterilization use declined to 8.04% and 7.22%, respectively, among married women of reproductive age. IUD use increased dramatically to 72.2% in 1993. Condom use declined to 8.83% of total users. Despite reduced contraceptive prevalence, the birth rate declined from 18.51/1000 population in 1982 to 6.50/1000 population in 1993. The proportion of women accepting the one-child certificate increased from 53.32% of all married women of reproductive age in 1984 to 70.13% in 1993. The shift use of contraceptive methods means reliance on long-term reversible methods.     

Communique of the State Family Planning Commission on a nationwide fertility sampling survey of every person per thousand

In 1982, the Chinese State Family Planning Commission conducted a nationwide fertility survey of 1 person/1000 in 28 provinces, municipalities, and autonomous regions. 815 sample units were selected and 310,462 women aged 15-67 were interviewed, 99.9% of those identified. 252,094 (24.77%) were of childbearing age (15-49) with 24.76% 15-19 years old. Among women of fertile age, 31.46% were unmarried, 64.53% were married to their 1st husbands, 2.89% were remarried, .19% were divorced, and .94% were widowed. Average age of 1st marriage increased from 18.4 in the 1940s to 22.8 in 1981. Total fertility rate dropped from 5.44 in the 1940s to 2.63 in 1981. In 1981, the birth rate was 85/1000 women of fertile age. Fertility was much higher among minority nationalities. 118 million of China's 170 million married couples of reproductive age (69.46%) use birth control at present; 50.2% use the IUD, 25.4% tubal ligation, 10.0% vasectomy, 8.2% oral contraceptives, and 2.0% condoms. About 21 million married women should have begun using contraception but have not. 14 million or 42.3% of 33 million 1 child couples have pledged to have only 1 child. If the fertility level of 1981 is maintained and the average woman continues to have 2.63 children, 2.91 in rural areas, China's population will reach 1.2 billion by 1993 and will exceed 1.3 billion by 2000. The Central Committee has a target population of 1.2 billion by 2000.     

Community-based contraceptive distribution: a Korean success story

The results of a community-based contraceptive distribution program using village women canvassers in Cheju Island province, Korea, are evaluated. This rural province had the highest fertility and lowest contraceptive use before the project began. After pre-testing in another area, township-level family planning field workers recruited 365 new female canvassers per 150 women at risk of pregnancy, compared to 10,000-25,000 per worker in the previous scheme. The canvassers were to contact every household, offering them pills or condoms, or vouchers for an IUD or sterilization from the clinic. The former target system, which in reality had limited the numbers of acceptors, was suspended, necessitating an increase in budget outlays for family planning in Cheju province. By 1985 the contraceptive prevalence had doubled, and fertility fell 40.1 and 32.4% in the 2 Cheju counties. Costs per couple-year for the Cheju program were lower than those in other areas. The results of this project suggested that increasing the number of community workers or canvassers in rural areas helps reduce barriers to the use of contraceptives.     

Gender differences in knowledge and attitudes toward modern and traditional methods of child spacing in Malawi

This paper examines male-female differences in knowledge and attitudes towards traditional and modern methods of child spacing in Malawi, based on the survey on traditional methods of child spacing in Malawi which was conducted in 1988. The results show that most people in Malawi are knowledgeable about both traditional and modern methods of child spacing. In general more men than women report knowledge and practice of traditional methods. For modern methods, however, females are more knowledgeable than males of all the specific methods, with the exception of condoms. The greater knowledge by women of female-based modern contraceptives appears to be a manifestation of the exclusion of males from the family planning program. The high rates of knowledge do not translate into equivalent high rates of utilization for both modern and traditional methods of contraception. The study further demonstrates that, while women are involved in making decisions to use contraception, the proportion of men initiating such decisions is greater than that of women. This finding calls for family planning planners to think seriously about revising their target population to include men.     

Birth control techniques in China

This article describes the major birth control techniques in use in China, based on data from a contraceptive prevalence study conducted in September, 1982. 118 million of the 170 million married women of child bearing age use birth control. IUD insertion accounts for 50.2% of birth control methods used, tubal ligation accounts for 25.4%, vas deferens ligation 10.0% oral contraceptives (OCs) 8.2%, and condoms 2.0%. A table of clinical data on 9 China made IUDs reveals that pregnancy rates range from 0 (V Cu-300 model) to 5.83% (mixed ring model). A method of IUD insertion immediately after delivery has been researched and adopted, using a silastic Delta IUD with barium added to reduce the high postpartum expulsion rate. fixing the IUD by sutures during Cesarean section has also been developed. Electronmicroscopic studies of the endometrium of women who have used a stainless steel IUD for more than 20 years showes no tendency towards malignancy, nor negative effects on the endocrine functions of the ovaries. 28 million Chinese women have accepted sterilization as of June, 1982. Local anesthesia and the use of acupuncture have reduced complications due to general anesthesia seen previously. Sterilization by means of chemically induced adhesion of Fallopian tube tissue has also been performed successfully; however, this method makes later anastomosis difficult, and is not suitable for young women with only 1 child. Fallopian tube occlusion by means of a silver clip has been performed in 1,128 cases, with a pregnancy rate of only .85%. 10.62 million men have accepted sterilization. While most of the procedures are val ligations, 300,000 men have been sterilized by direct injection of an adhesive agent throuh the skin of the scrotum. No increase in auto immune or vascular disease has been found. 3 low-dose OCs, used since 1969, have proven to be reliable and freer of side effects than higher-dose compounds. In addition, longterm OCs containing quinestrol have been used since 1969 with a success rate of 98.3% women-year. These pills are taken 1x monthly. R and D priority will be given be given to monthly injectable contraceptives; megestrol and norethindrone are the compounds most preferable. In trials so far, the effective rate has been 99.9% with mild side effects. Gossypol, a male contraceptive, has shown an antifertility effect in 99% of 8000 cases studied; however, hypokalemia and irreversibility of spermatogenesis were reported in some cases. Vacuum suction is the most common method for abortion, but Radix Trichosanthis and lilac daphne terpine, traditional abortifacients, anre acceptable for 1st trimester abortions. Prostaglandins are also used.     

Are young cohorts of women delaying first birth in Mexico?

In the last decades, female permanent sterilisation became the most used method of contraception in Mexico. During this time, the demand for pills, condoms and other short-term contraceptives fell consistently. The shift in the demand for contraceptives raises concerns among demographers that the timing of children may remain unchanged regardless of observed reductions in period fertility rates. This paper assesses such ideas in the context of the timing of a first child using duration models as the main analysis tool. Findings suggest that young cohorts of women are effectively delaying first birth relative to the experience of older generations.

Can LARC Fulfill Its Potential to Reduce U.S. Women’s Unintended Pregnancy Risk? Examining Women’s Contraception and Childbearing in the Year Before Initiating LARC

Long-acting reversible contraceptives (LARCs) have received increased attention in recent decades for their potential to reduce the high level of unintended pregnancy. We know little about women’s contraceptive use and (unintended) childbearing prior to LARC initiation, even though it provides vital context to considering the extent to which increased LARC use could be expected to reduce the U.S. unintended pregnancy rate. Data from 849 women who initiated LARC in the 2–3 years prior to the 2006–2015 cycles of the National Survey of Family Growth were analyzed to describe U.S. women’s contraceptive use and (unintended) childbearing in the year before initiating LARC. Results show that more than half of women (55.4%) who initiated LARC did so within a year of giving birth, with 47.3% of these births resulting from an unintended pregnancy. Among women without a recent birth, 5.0% had last relied on sterilization, 54.7% had last used a moderately-effective method, 34.7% had last used a less-effective method, and 5.6% had not used contraception in the year prior to initiating LARC. These findings advance understanding of the extent to which increased LARC use could be expected to reduce the unintended pregnancy rate. Women initiating LARC after a recent birth are selective of those at high risk of unintended pregnancy. In contrast, the majority of LARC initiators without a recent birth last relied on a moderately-effective method or sterilization—a pattern that could reduce LARC’s impact on the unintended pregnancy rate.

     

Fertility decline in Bangladesh: an emerging family planning success story

Bangladesh has a population of 115 million people, and the economic growth rate of 3.7% during the 1980s was undermined by rapid population growth. The annual population growth rate was 3% in the 1960s and early 1970s, 2.5% between 1981-91 decreasing to 2.3% in 1991. The average of number of children is 4.6/woman compared with 7 in the 1960s. Infant mortality dropped from 150/1000 births in 1976 to 118/1000 in 1991. Life expectancy rose from 47 to 54 years. The 1991 Contraceptive Prevalence Survey showed that 39.9% of married women under 50 use contraceptives in 1991 vs. 18.6% in 1981. The use of modern methods increased from 10.9% in 1981 to 31.2% in 1991, while traditional methods rose from 7.7% to 8.7%. Sterilization was most prevalent in 1981. 29,000 female family planning (FP) workers were aggressively engaged in dispensing FP services in 1990. The Social Marketing Company sells pills, condoms, and oral rehydration salts through 130,000 retail outlets. The 1989 Contraceptive Prevalence Survey showed that 40% of pill and condom users obtained them from this network, and 95.4% of women knew about 4 methods of contraception. In 1990 there were 120 private organizations providing contraceptive services. Some of the components of the government FP program include field worker distribution door-to-door of injectable contraceptives (50% injectable usage rate in the Matlab project); recordkeeping activities; a satellite clinic network with access to contraceptive services; and decentralization through the Upazila (subdistrict) approach. The logistics system of FP has improved the warehousing, transportation, and management information system. Foreign aid (mainly USAID) financing of contraceptives helped avert 14.4 million births between 1974-90. The increase of contraceptive prevalence to 50% by 1997 would avert another 21.9 million births during 1991-96 (replacement fertility requires 70% prevalence.     

Fertility in black Africa

The number of children per woman is between 6 and 7 children in Black Africa. Infertility and poor fertility existing in certain regions of Africa only appear in results concerning central Africa. 6-10% of births occur in women between the ages of 40 and 50. It must be noted that the goal of the majority of societies in Black Africa is to have numerous descendants. Factors of fertility in Africa examined are: precocious marriage, a long period of exposure to the risk of pregnancy, birth spacing and pathological infertility. The paper also discusses modern contraception and birth control, the improvement of sanitation conditions as part of the battle against infertility and infant mortality, combating infertility, decreasing infant mortality and governmental attitudes toward fertility control. Despite the efforts of several private and governmental agencies to promote family planning, progress in Africa has been modest. In the majority of Black African countries, women do not have access to contraception. In rural areas, the absence of an administrative infrastructure prevents diffusion of information and access to contraception. Improving general health conditions has 2 consequences on fertility: it reduces infertility due to diseases that cause sterility and it reduces infant mortality which affects birth intervals. So far birth control has only been successful among the very educated women. However, a great potential for more users exists.     

The evolution of family planning in an African city: Ibadan, Nigeria

Summary Data drawn from a 1973 probability sample of 6,606 Yoruba females, 15-59 years of age in Ibadan City, Nigeria, are employed to analyse changing family planning practice over time. Usage and method rates are calculated for broad age groups from 1930 to 1973. Contraceptive practice is shown to have increased rapidly during the 1960s and early 1970s, from a very low initial base with a doubling period for the proportion of contraceptors of about four years, so that by 1973 one-sixth of the women had practised contraception and one-ninth were currently doing so. The major determinant of contraceptive practice is education. Oral contraceptives and IUDs account for an ever larger proportion of all contraception over time and together made up over 50 per cent by 1973. The Ibadan data give strong support to a suggestion emanating from scattered findings elsewhere that there is a special pattern of sub-Saharan contraceptive use: it begins with use in pre-marital and extra-marital relationships; then is increasingly employed as a substitute for post-marital sexual abstinence, and only later becomes the means for limiting the size of the family. Hence, the success of a family planning programme is indicated by rising average parity among the acceptors. Most couples in Ibadan will probably be practising contraception at some time in the 1980s, but even then such rates will probably still be low in rural areas.     

Problems of abortion in Britain - Aberdeen, a case study

Summary This paper reports on nearly all pregnancies occurring in the City of Aberdeen in the years 1961-74 (births, and therapeutic and spontaneous abortions) and on male and female sterilization and the use of contraception. The collection of these data for a defined community was made possible through the coordinated and comprehensive maternity and contraceptive services. Several important innovations made during the years included the introduction of oral contraception and the inter-uterine device, laparoscopic sterilization and vasectomy. The Abortion Act 1969 came into force and at different times the Local Authority Family Planning Clinic made many changes including the removal of charges and of the need for referral. The pattern of outcome differs for legitimate and illegitimate pregnancies, which are considered separately. Over half of all first pregnancies now occur before marriage and their outcome in women in different occupational groups is discussed. Oral contraception is favoured for postponing or spacing pregnancies, but when it comes to limitation of family size, couples have increasingly requested sterilization. Nevertheless there has been a ten-fold increase in the proportion of pregnancies being terminated. Aberdeen's birth rate is now below replacement level but the real objective 'every pregnancy a wanted pregnancy' is far from being achieved in either married or unmarried women.     

Trends in reproductive behavior among young single women in Colombia and Peru: 1985–1999

Using "calendar" data for single women aged 15-24 from successive Demographic and Health Surveys (DHS) conducted in Colombia and Peru during the 1990s, we document trends, year by year, in sexual activity, the use of contraceptives, and subsequent reproductive outcomes. We provide evidence of the important and hitherto largely untapped potential of DHS calendar data to draw complete sexual and reproductive profiles when data from various surveys are integrated. Over the period 1985-1999, young single women in both Colombia and Peru became sexually active at younger ages. The use of contraceptives, especially the use of condoms, increased but did not fully offset the rise in sexual activity, and thus the incidence of premarital conceptions rose among young single women. In both countries, sharp declines occurred in the proportion of premaritally conceived births that were reported as being wanted.     

Workshop on long-term contraceptives

The National Population Council Secretariat (NPCS) of Ghana held a three-day workshop on long-term contraceptives in 1996 in collaboration with the Ministry of Health, the Association of Voluntary Surgical Contraception, and the Johns Hopkins Population Communication Services. The session was funded by USAID. The executive director of NPCS, Dr. Richard Turkson, said that the slow rate of contraceptive acceptance was an obstacle to population control despite political concern that rapid population growth exerted an adverse impact on the economy. Only 10% of married women were using long-term or permanent methods of contraception. The hope was voiced that the participants would devise practical and cost-effective education, information, and communication (IEC) strategies to boost the demand for long-term contraceptive methods among sexually active people in Ghana. It was essential that these strategies and activities were based on a realist assessment of the demographic and social situation of the country. The examination of case studies in cultures similar to Ghana would also offer valuable lessons. The factors that hinder the acceptance of long-term methods include misconceptions, myths, and false rumors rooted in a general lack of knowledge among the people. Participants were urged to come up with strategies to counter these problems, and service providers were encouraged to improve their knowledge about contraceptive methods and counseling skills. Male involvement in contraception was also advocated. Statistics show that most Ghanians practicing contraception were using short-term methods such as foaming tablets, pills, and condoms. However, it is necessary to shift to long-term methods such as injectables, implants, and sterilization in order to achieve significant reductions in fertility.