Individual and community-level factors associated with ovulatory cycle knowledge among women in Ghana: a multilevel analysis of recent demographic and health survey data.

Abstract

Background: Knowledge of the ovulatory cycle plays a crucial role in reducing the incidence of unintended pregnancies and promoting women's reproductive health. However, there exists a paucity of research on the determinants associated with ovulatory cycle knowledge specifically within the context of Ghana. Therefore, the objective of this study was to investigate the individual and community-level factors that influence knowledge of the ovulatory cycle among women of reproductive age in Ghana.

Methods: The study utilized data from the 2022 Ghana Demographic and Health Survey, which included a representative sample of 6,839 women of reproductive age. Using a multilevel logistic regression model, the study aimed to identify factors influencing knowledge of the ovulatory cycle. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were employed to assess the associations between explanatory variables and knowledge of the ovulatory cycle. Statistical significance was determined at a p-value threshold of less than 0.05. All data analyses were performed using STATA version 17 software.

Results: The prevalence of knowledge regarding the ovulatory cycle among Ghanaian women was 42.3% (95% CI: 41.1-43.5%). In the multivariable mixed-effects logistic regression model, factors associated with knowledge of the ovulatory cycle included women aged 30-39 (AOR: 1.62, 95% CI: 1.54-2.73) and 40-49 (AOR: 1.51, 95% CI: 1.39-1.66), women's educational attainment (AOR: 1.62, 95% CI: 1.55-2.59), household wealth index (AOR: 1.51, 95% CI: 1.10-2.25), and partner's education level (AOR: 1.59, 95% CI: 1.20-2.11). Additionally, community-level factors such as community level literacy (AOR: 4.5, 95% CI: 2.22-9.25), and residing in the Eastern (AOR: 0.36, 95% CI: 0.19-0.68) and Oti (AOR: 0.26, 95% CI: 0.13-0.53) regions were significantly associated with knowledge of the ovulatory cycle.

Conclusion: The prevalence of ovulatory cycle knowledge among Ghanaian women was low, with significant determinants including age, women's education, wealth, partner's education, community literacy rates, and regional disparities. These findings highlight the importance of targeted educational interventions to improve reproductive health literacy, especially in underserved communities and regions with lower educational attainment in Ghana.