Factors Influencing Contraceptives Use among Female Migrants in Ghanaian Cities, A case of Kayeyei in the Kumasi Metropolis
Abstract
Historically, women in Africa have long been known to transport agricultural produce, firewood, and pots of water by way of the head for domestic use. This culture has been transformed into feminised unskilled labour termed Kayayei in Ghanaian cities as a fallout from poor education outcomes and its attendant lack of sustainable jobs in the rural areas. Kayayei is used in Ghana to refer to young female migrants between the ages of 8-35 years from the poverty endemic areas of northern Ghana engaging in head porterage business in the cities as a means of survival. The increasing incidence of kayaye and its attendant social, health and economic problems have attracted media and research commentary in Ghana in recent times. This study investigates contraceptive use among kayayei in the Kumasi metropolis of Ghana to inform strategies to improve the reproductive health of the low-income group. The study uses a mixed-method design. A structured survey questionnaire was administered to 121 kayayei. Further, 44 participants were selected from the 121 kayeyei to participate in focus group discussions (FGD). These were complemented with individual interviews of a pharmacist, a chemist shop attendants, and a drug peddler [unlicensed medicine walker]. Statistical Package for Social Sciences (SPSS) was used to analyse the quantitative data from the survey questionnaire, while descriptive coding was used to analyse the qualitative data from FGDs, interviews and field observation. The findings revealed that male partners’ approval was the major determinant of contraceptive use among the participating migrant female head porters. Some 90% of women who were less likely to use contraceptives are those who never discuss or get approval from their partners. Oral contraceptives, intrauterine devices (IUD) and condoms were the most used contraceptive among the kayayei. Participants’ choice of contraceptives was influenced by affordability, accessibility and their perceptions about contraceptive security. The study also identified that side effects from the use of contraceptives, including inconveniences on menstruation, weight gain, and weight loss, were a set of factors that demotivate contraceptives use among the research participants. The study also identified that, although culture has a significant influence on contraceptive use in Africa generally, in the case of migrant young women who have escaped from the cultural scrutiny of their home communities, their sexual partners, rather than culture, have a significant influence on their contraceptives use. The study, therefore, recommends an aggressive public education campaign on contraceptives use targeting both kayayei and their sexual partners in Ghanaian cities, while family planning services are accessible and affordable to this low-income group.
https://doi.org/10.26803/ijhss.13.2.8
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Adanu, R. M. K., Seffah, J. D., Hill, A. G., Darko, R., Duda, R. B., & Anafi, J. K. (2009). Contraceptive use by women in Accra, Ghana: results from the 2003 Accra Women’s Health Survey: original research article. African Journal of Reproductive Health, 13(1), 123–133.
Addai, I. (1999). Does religion matter in contraceptive use among Ghanaian women? Review of Religious Research, 40(3), 259-277.
Adepoju, A. (2010). Migration in West Africa. Development, 46(3), 37-41.
Agarwal, S., Attah, M., Apt, N., Grieco, M., Kwakye, E. A., & Turner, J. (1997). Bearing the weight: the kayayoo, Ghana’s working girl child. International Social Work, 40(3), 245-263.
Agyei, Y. A., Kumi, E., & Yeboah, T. (2016). Is it better to be a kayayei than to be unemployed: reflecting on the role of head portering in Ghana’s informal economy. Geojournal, 81(2), 293-318.
Ahenkan, V. (2017). Determinants of modern contraceptive use among migrant female head porters in Asokore-Mampong Municipality [Doctoral dissertation].
Amoako-Mensah, T., Anlimachie, A. M., Adu, B. S., & Elorm, E. A. (2019). Out-migration and the Double Jeopardy of rurality in Ghana. An integrated approach to rural development. European Journal of Geography, 10(1), 50-67
Anarfi, J. K. (2003). The role of local herbs in the recent fertility decline in Ghana; contraceptives and abortifacients. The socio-cultural and political aspect of abortion. Westport, Connecticut: Praeger
Anlimachie, M. A. (2016). Achieving Equity in Basic Education in Ghana; Contexts and Strategies. [Masters of Philosophy Thesis, University of Oslo].
Anlimachie, M. A. (2019). Enacting Relevant Basic Education to Bridge the Rural-Urban Inequality in Ghana; The Prospects and Approaches for Investigating Rural Educational Realities. International Journal of Humanities and Social Sciences, 11(1), 42-58.
Anlimachie, M. A., & Avoada, C. (2020). Socio-economic impact of closing the rural-urban gap in pre-tertiary education in Ghana: context and strategies. International Journal of Educational Development, 77(102236), 1-12. https://doi.org/10.1016/j.ijedudev.2020.10
Aransiola, J. O., Akinyemi, A. I., & Fatusi, A. O. (2014). Women’s perceptions and reflections of male partners and couple dynamics in family planning adoption in selected urban slums in Nigeria: a qualitative exploration. BMC Public Health, 14(1), 869.
Asbell, B. (1995). The Pill: A Biography of the Drug That Changed the World.
Awumbila, M., & Ardayfio-Schandorrf, E. (2008). Gendered poverty, migration, and livelihood strategies of female porters in Accra, Ghana. Norsk Geografisk Tidsskrift-Norwegian Journal of Geography, 62(3), 171-179.
Baah-Ennumh, T. Y., & Adom-Asamoah, G. (2012). The Role of Market Women in The Informal Urban Economy in Kumasi. Journal of Science and Technology (Ghana), 32(2), 56-67.
Bakewell, O., & De Haas, H. (2007). African Migrations: Continuities, Discontinuities And Recent Transformations. In P. Chabal, U. Engel & L. de Haan (Eds.), African Alternatives (pp. 95-117). Brill.
Barfai, G. (2000). Emergency Contraception in Clinical Practice: Global Perspectives.
Bonifacio, G. T. (Ed). (2012). Feminism and Migration: Cross-Cultural Engagements (vol. 1). Springer Science & Business Media.
Bourdieu, P. (1986). The forms of capital. In J. Richardson (Ed.), Handbook of theory and research for the sociology of education (pp. 241-258). New York: Greenwood Press.
Brucker, C., & Lipford, G.B. (1995). The human sperm acrosome reaction: physiology and Regulatory Mechanisms. An update. Human Reproductive Update, 1(1), 51–62.
Burrell, G., & Gareth, M. (1992). Sociological Paradigms and Organisational Analysis. Part I – In Search of a Framework. Burlington, MA: Ashgate.
Carter, E., Rose, P., Sabates, R., & Akyeampong, K. (2020). Trapped in low performance? Tracking the learning trajectory of disadvantaged girls and boys in the Complementary Basic Education programme in Ghana. International Journal of Educational Research, 100, 101541.
Creswell, J. W. (2021). Educational Research: Planning, Conducting, and Evaluating Quantitative and Qualitative Research (6th edn.). United Kingdom: Pearson Education Limited.
Creswell, J. W., & Plano Clark, V. L. (2011). Designing and conducting mixed methods research (2nd ed.). Los Angeles: SAGE Publications.
Castles, S., & Miller, M. J. (1993). The age of migration: International population movements in the modern world. Basingstoke: Macmillan.
Cheng, K.-W. (2011). The effect of contraceptive knowledge on fertility: The roles of mass media and social networks. Journal of Family and Economic Issues, 32(2), 257–267.
Chipeta, E. K., Chimwaza, W., & Kalilani-Phiri, L. (2010). Contraceptive Knowledge, Beliefs and Attitudes in Rural Malawi: Misinformation, Misbeliefs and Misperceptions. Malawi Medical Journal, 22(2), 38–41.
Cleland, J., Bernstein, S., Ezeh, A., Faundes, A., & Glasier, A. (2006). Family planning: the unfinished agenda. Lancet, 368(9549), 1810–1827.
Creinin, M. D. (1997). A Reassessment of The Efficacy of The Yuzpe Regimeno Emergency Contraception. Human Reproduction, 12(3), 496–498.
Croce, M. (2015). The Habitus and the Critique of the Present: A Wittgensteinian Reading of Bourdieu's Social Theory. Sociological Theory, 33(4), 327-346. https://doi.org/10.1177/0735275115617801
d'Arcangues, C. (2007). Worldwide use of intrauterine devices for contraception. Contraception, 75(6), S2-S7.
Dalaba, M. A., Stone, A. E., Krumholz, A. R., Oduro, A. R., Phillips, J. F., & Adongo, P. B. (2016). A qualitative analysis of the effect of a community-based primary health care programme on reproductive preferences and contraceptive use among the Kassena-Nankana of northern Ghana. BMC Health Services Research, 16(1), 1-8.
Darroch, J. E., Sedgh, G., & Ball, H. (2011). Contraceptive Technologies: Responding to Women’ s Needs. Guttmacher Institute.
DeJonge, C. U. (1998). An Update On Human Fertilization. Seminars in Reproductive Medicine 16(3), 209–217.
Eliason, S., Baiden, F., Quansah-Asare, G., Graham-Hayfron, Y., Bonsu, D., Phillips, J., & Awusabo-Asare, K. (2013). Factors influencing the intention of women in rural Ghana to adopt postpartum family planning.
Ezeh, A. C. (1997). Polygyny and Reproductive Behavior in Sub-Saharan Africa: A Contextual Analysis. Demography, 34(3), 355-368.
Fentiman, A, Hall, A., & Bundy, D (1999). School Enrolment Patterns in Rural Ghana: A comparative study of the impact of location, gender, age and health on children's access to basic schooling. Comparative Education, 35(3), 331-349.
Foster, D. G., Bley, J., Mikanda, J., Induni, M., Arons, A., Baumrind, N., & Stewart, F. (2004). Contraceptive Use and Risk Of Unintended Pregnancy in California. Contraception, 70(1), 31–39.
Frost, J. J., & Darroch, J. E. (2008). Factors associated with Contraceptive Choice and Inconsistent Method Use, United States, 2004. Perspectives on Sexual and Reproductive Health, 40(2), 94–104.
Frost, J. J., Singh, S., & Finer, L. B. (2007). Factors associated with contraceptive use and nonuse, United States, 2004. Perspectives on Sexual and Reproductive Health, 39(2), 90–99.
Ghana Statistical Service [GSS]. (2012). Population and Housing Census. 2010. Assembly Press Accra.
GSS.(2008). Ghana Demographic and Health Survey 2008.
GSS. (2012). Population Census Report. Accra. Ghana Statistical Service.
GSS, Ghana Health Service (GHS), & ICF Macro. (2015). Ghana Demographic and Health Survey 2014: Key Indicators. Accra, Ghana.
Ghana Statistical Service [GSS]. (2021). Preliminary Report, Population and Housing Census 2021. GSS, Accra.
Glasier, A. (1997). Emergency Postcoital Contraception. New England Journal of Medicine, 337(15), 1058–1064.
Häggström-Nordin, E., Hanson, U., & Tyden, T. (2002). Sex behavior among high school students in Sweden: improvement in contraceptive use over time. Journal of Adolescent Health, 30, 288–295.
Hannaford, P. C. (1995). Combined oral contraceptives: do we know all their effects? Contraception, 51(6), 325-327.
Harper, C. C., Blum, M., Thiel de Bocanegra, H., Darney, P. D., Speidel, J. J., Policar, M., & Drey, E. A. (2008). Challenges in translating evidence to practice: The provision of intrauterine contraception. Obstetrics & Gynecology, 111, 1359-1369.
Hart, C. (1998). Doing a literature review: Releasing the social science research imagination. London, UK: Sage Publications.
Hatcher, R. A., Trussell, J., Nelson, A. L., Cates, W., Stewart, F. H., & Kowal, D. (2007). Contraceptive Technology (19th ed.). New York, NY: Ardent Media, Inc.
ICF International. (2012). Measure DHS STAT compiler. http://www.statcompiler.com
IOM. (2014). Migration Initiatives 2014: Health of Migrants. IOM, Geneva.
Kongnyuy, E. J., Ngassa, P., Fomulu, N., Wiysonge, C. S., Kouam, L., & Doh, A. S. (2007). A survey of knowledge, attitudes, and practice of emergency contraceptives among university students in Cameroon. BMC Emergency Medicine, 7(1), 7.
Kuyini, A. B., Abukari, A., Mohammed, A. K., & Powell, H. O. (2020).Narratives of internal migration experiences, health/well-being issues among females working as head-porters (Kayayei) in Ghana. International Journal of Migration, Health and Social Care, 16(4), 511-525. https://doi.org/10.1108/IJMHSC-07-2020-0068
Lattof, S. R. (2018). Health insurance and care-seeking behaviours of female migrants in Accra, Ghana. Health Policy and Planning, 33(4), 505-515.
Mills, C. (2008). Reproduction and Transformation of Inequalities in Schooling: The Transformative Potential of the Theoretical Constructs of Bourdieu. British Journal of Sociology of Education, 29(1), 79-89. http://doi.org/10.1080/01425690701737481
National Research Council. (1993). Factors affecting contraceptive use in Sub-Saharan Africa. National Academies.
Njogu, W. (1991). Trend and determinant of contraceptive use in Kenya. Demography, 28(1), 83-99.
Nukunya, G. (2016). Tradition and Change in Ghana, An Introduction to Sociology (2nd edn). Accra, Ghana: Universities Press.
Obasohan, P. E. (2015). Religion, ethnicity and contraceptive use among reproductive age women in Nigeria. International Journal of MCH and AIDS, 3(1), 63.
Opare, J. A. (2003). Kayayei: the women head porters of Southern Ghana. Journal of Social Development in Africa, 18(2).
Palamuleni, M. E. (2013). Socio-economic and demographic factors affecting contraceptive use in Malawi: original research article. African Journal of Reproductive Health, 17(3), 91–104
Population Council. (2015). Low Use and High Discontinuation of Modern Contraceptives in Pakistan: Reasons and Policy Recommendations. Islamabad, Pakistan.
Prata, N., Bell, S., Fraser, A., Carvalho, A., & Neves, I. (2017). Partner support for family planning and modern contraceptive use in Luanda, Angola. African Journal of Reproductive Health, 21(1), 35-48
Rosenberg, M.J., Waugh, M.S., & Long, S. (1995). Unintended pregnancies and use, misuse, and discontinuation of oral contraceptives. Journal of Reproductive Medicine, 40(5), 355-360.
Sedgh, G., Hussain, R., Bankole, A., & Singh, S. (2007). Women with an unmet need for contraception in developing countries and their reasons for not using a method. Alan Guttmacher Institute.
Swadener, E., Kabiru, M., & Njenga, A. (1997). Does The Village Still Raise The Child? A Collaborative Study Of Changing Child-Rearing And Community Mobilization In Kenya. Early Education And Development, 8, 285-306.
Tomasevski, K. (2005). Human Rights and Poverty Reduction Girls’. education through a human rights lens: What can be done differently, what can be made better. http://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/4349.pdf
Trussell, J., Ellertson, C., Stewart, F., Koenig, J., Raymond, E.G., & Shochet, T. (2001). Emergency Contraception: A Cost-Effective Approach to Preventing Unintended Pregnancy. Seminars in Reproductive Medicine, 19(4), 323–330.
Trussell, J., Sturgen, K., Strickler, J., & Dominik, R. (1994). Comparative contraceptive efficacy of the female condom and other barrier methods. Family Planning Perspectives, 26(2), 66-72.
Tumlinson, K., Speizer, I. S., Davis, J. T., Fotso, J. C., Kuria, P., & Archer, L. H. (2013). Partner communication, discordant fertility goals, and contraceptive use in urban Kenya. African Journal of Reproductive Health, 17(3), 79-90.
Udry, J. R., Clark, L. T., Chase, C. L., & Levy, M. (1972). Can mass media advertising increase contraceptive use? Family Planning Perspectives, 4(3), 37-44.
Upson, K., Reed, S. D., Prager, S. W., & Schiff, M. A. (2010). Factors associated with contraceptive nonuse among US women ages 35–44 years at risk of unwanted pregnancy. Contraception, 81(5), 427–434.
World Health Organisation [WHO] (1998). Task Force on Postovulatory Methods of Fertility Regulation. A randomised trial of levonorgestrel versus the Yuzpe regimen of combined oral contraceptives for emergency contraception. Lancet, 353, 429–433.
WHO/UNICEF/UNFPA/World Bank. (2010), Trends in maternal mortality: 1990 to 2008. Estimates developed by WHO, UNICEF, UNFPA, and the World Bank. Geneva, World Health Organization.
WHO. (2010). Update on family planning in Sub-Saharan Africa. In Repositioning Family Planning. Guideline for Advocacy Action (pp, 1-8), Geneva, World Health Organization.
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