A recently completed research project funded by the Center for Global Health Equity at the University of Michigan has taken important steps toward understanding the "know-do" gap in postpartum contraceptive use among Ghanaian women. Spanning from April 2022 to October 2024, this collaborative effort brought together investigators Sarah Compton, PhD, MPH (Medicine/Obstetrics & Gynecology), Cheryl Moyer, PhD, MPH (Medicine/Learning Health Sciences), Emily Treleavan, PhD, MPH (ISR) and Jody Lori, PhD (Nursing) from the University of Michigan, in partnership with the Kwame Nkrumah University of Science and Technology in Ghana.
With the primary objective of identifying interventions that enable Ghanaian women to realize their fertility goals, the project concentrated on understanding the decision-making process surrounding family planning in the postpartum period. Qualitative interviews involving 48 postpartum women, conducted during visits for child immunization services, highlighted significant demand-side barriers to contraception adoption, despite an awareness of available methods and government subsidies.
An unexpected outcome of the study was the discovery that participants' reluctance to adopt postpartum contraception stemmed primarily from demand-side concerns—like fear of side effects—rather than supply-side issues, like limited access to different methods of contraception. While the pilot project did not yield immediate health improvements, it laid the foundation for a continuum of interventions aimed at enhancing postpartum contraceptive decision making. By focusing on qualitative insights, the findings can inform future intervention that genuinely resonate with women's lived experiences, contrasting previous strategies that relied heavily on quantitative data without significant changes in contraception uptake.
With the completion of this initial project, the research team is planning further studies to expand on their findings and explore how the tool can enhance clinician-patient conversations about contraception. The results of this center-funded project played a crucial role in strengthening the evidence base for the team's application for an R01 grant submission to the Eunice Kennedy Shriver National Institute of Child Health and Human Development—a prestigious research project grant from the National Institutes of Health. The insights gathered from the qualitative inquiry not only identified key barriers to postpartum contraceptive use, but also provided valuable feedback on a contraceptive decision-support tool. This robust foundation of data significantly improved the application's competitiveness, leading to the R01 grant being scored favorably for funding.
The Center for Global Health Equity takes pride in supporting early and mid-career researchers as they endeavor to build a comprehensive evidence base and work toward a healthier global community. By funding innovative projects like this one, the center fosters groundbreaking research that addresses pressing health challenges, paving the way for impactful solutions and sustainable improvements in health outcomes worldwide.
