Effect of one-to-one versus group counseling on uptake of postpartum contraception in selected hospitals in Ghana: A prospective cohort study

Int J Gynaecol Obstet. 2023 Jun;161(3):794-802. doi: 10.1002/ijgo.14654. Epub 2023 Jan 26.

Abstract

Objective: To compare the effect of one provider to one client counseling and one provider to a group client counseling on the uptake of postpartum contraception.

Methods: This was a hospital-based prospective cohort study among women attending a postpartum clinic at Korle-Bu Teaching Hospital and Greater Accra Regional Hospital. Postpartum mothers were recruited daily from April 1, 2017 to November 28, 2017. Mothers from this cohort that used a contraceptive method within a year postpartum were determined at 3, 6, 9, and 12 months after recruitment. A P value of less than 0.05 was considered statistically significant for all analyses.

Results: Of 982 women surveyed, contraceptive uptake among women who received one-to-one counseling was 306/600 (51.0%) and that for women who received group counseling was 48/382 (12.6%) (P < 0.001). Factors associated with contraceptive uptake during postpartum period were: one-to-one counseling (adjusted odds ratio [aOR] 7.05, 95% confidence interval [CI] 4.94-10.07), mothers' age (aOR 0.95, 95% CI 0.91-0.98), being single (aOR 0.54, 95% CI 0.35-0.85), cohabiting (aOR 0.39, 95% CI 0.22-0.69), and previous use of contraception (aOR 1.55, 95% CI 1.12-2.15).

Conclusion: One-to-one counseling was associated with a significantly greater uptake of contraception during the postpartum period compared with group counseling. Other factors associated with uptake were age, marital status, and history of contraceptive use.

Keywords: contraceptives; counseling; family planning; group; one-to-one; postpartum.

MeSH terms

  • Contraception Behavior
  • Contraception* / methods
  • Contraceptive Agents
  • Counseling
  • Family Planning Services* / methods
  • Female
  • Ghana
  • Hospitals
  • Humans
  • Postpartum Period
  • Prospective Studies

Substances

  • Contraceptive Agents