Objective:

Access to family planning service is a known factor which influence contraceptive uptake in Ghana. However, uptake rate in Ghana still remains low despite introduction of several strategies to address this access problem by stakeholders. Currently accessing majority of family planning (FP) services in Ghana remains free. 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 in accessing family planning services in Ghana

Methods:

A cross-sectional design involving quantitative methods were employed to recruit 1194 clients who accessed family planning services in 336 primary health facilities, selected through a two-stage sampling. A smartphone-based questionnaire was administered to participants. Descriptive statistics were used to estimate the cost, using STATA 13.

Results:

The average age of the women was 29 ± 6.87. Most women had basic education. The sources of payment for FP services were self-finance, family and sponsorship. The average direct cost of accessing FP services was GHS 7.90 [US$ 1.76]. The cost of FP services was highest for consultation GHS 7.50 [US$ 1.67], Laboratory test/x-ray GHS 6.03[US$ 1.34], Transportation GHS GHS5.50 [US$ 1.22], Contraceptive GHS 4.73 [US$ 1.05] and Client records Card GHS 3.30[US$ 0.73]. The cost of FP services was higher for clients visiting private facilities, tertiary level as well as those in urban centers. Clients on average spent 54.21 minutes traveling at a distance of 3.49 kilometers and wait averagely 18.11minutes for each visit.

Conclusion: Government stakeholders are encouraged to revise the existing maternal health policies, as well as increase the list of FP services within the exemption package of the NHIS policy.