OBJECTIVES : Access to family planning service is a known factor which influence contraceptive uptake. However, uptake rate in Ghana still remains low despite introduction of several strategies that sought to address access problem by stakeholders. Currently, accessing majority of family planning (FP) services remains free in Ghana. Yet, a large number of women are unable to access these services due to unofficial payment and under carpet cost they incur in seeking these services. This study therefore sought to report the hidden cost a woman incurs in accessing family planning services in Ghana.

METHODS : A cross-sectional design, involving quantitative methods were used to recruit 1194 clients who accessed family planning services in 335 primary health facilities selected through a two-stage sampling. A smartphone-based questionnaire was administered to participants. Descriptive statistics were employed to estimate the cost, using STATA 13.

RESULTS : The average age of the respondents was 29±6.87, with most of them married (58.04%). Fifty-three percent had basic education and seventy-three percent lived in urban centers. Forty-seven percent accessed FP facilities by walking. Majority (88.36%) of the respondents confirmed making monetary payments at the FP service delivery centers through either self (56.78%) or family (1.34%) sponsorship. A total cost of GHS 8733.36 (US$ 1785.96) was incurred by respondents, whiles 75% spent GHS 9 (US$ 1.84) on each visit. Fifty percent of the clients pays GHS 3.00 (US$ 0.61), GHS 10 (US$ 2.04), GHS 5.00 (US$ 1.02) for folder, consultation and lab investigation respectively. Client pays GHS 2.00 (US$ 0.41) for contraceptive supplied at facility and GHS 6.00 (US$ 1.23) for those purchase outside on a visit

CONCLUSIONS : There is an increase cost burden among clients accessing family planning services in primary health facilities in Ghana. Stakeholders are encouraged to expand the fee waiver policies to cover other services that are not free aside the commodities