The setting is the serene, sprawling village called Fiankoma, located in the newly created Amansie Central District of the Ashanti Region.
I found myself in the community one fine Saturday morning in the company of a a friend who is a health worker in the district.

As we entered the village, we realized that majority of the inhabitants were at a church service. What was significant, though, was that a good number of the women were sitting outside the church and all of them were nursing babies.
A couple of the men, who seemed to be among the leaders of the church, sat a few metres away, deeply engaged in a discussion.
A soon as we sighted them, my friend, who commonly known to most of the women started walking towards them for a chat.

During the interaction, I was attracted by the smile of a beautiful baby who was sitting on the lap of its mother and I drew closer to hold her little hands and return the smile.
Just then, the mother softly asked, ‘’are you also a nurse? Can you help me with any family planning method?’’
I did not tell her that I was not a nurse but rather asked why she sounded so desperate to practise family planning and why she did not direct the question at my friend who is a health worker.
‘’Auntie, I am only 26 and I already have four children. I get pregnant so easily that I am afraid I will get pregnant soon. I need help,‘’ she said.

Moved by her outburst, I beckoned my friend to draw closer to us and listen to the lady’s story. Our interaction attracted the other who immediately reiterated their colleague’s request for urgent family planning services.
Abena Gyamfiwaa, one of the women said ”Look at me. I am 39 years and I have seven children. I am already tired but here we have no access to family planning.”

Many of the mothers told similar stories, with a number of them talking at the same time. They were joined by more women who, though were in the church, had heard our discussions and came out to participate.
The discussions created some noise and the pastor had to come out to implore the women to be quite.
But the women, who were bent on carrying their message across, paid little attention to him.
Almost all of them recounted stories of how they were unable to control their birth and the impact it was having on their lives.

Interestingly, the men who had been talking nearby found themselves drawn into the conversation and also echoed the sentiment of the women. They appealed to as (thinking that I was also a health worker )to do what we could do to help their wives.

The large number of children delivered by their wives was compromising the quality care they were able to give the children, they declared.
“Indeed, you have  to come and give our women a talk on how to plan their families”, one of the men said .
The people of Fiankoma are mostly farmers and majority of the women engage in petty trading.
The inhabitants explained that their inability to secure regular family planning services was because the main health service facility in the area was a catholic institution which, as a policy, did not provide modern contraception services.
Unfortunately, the GHANA HEALTH SERVICE does not have a strong presence in the area. Until recently when the new district was created, the district was administered from Bekwai and GHS workers conducted periodic out reach services in the area.

Even during that period, the health workers were accommodated in shed on the premises of the catholic hospital and; therefore had difficulty in openly providing family planning services, my friend explained.
She assured the women a few permanent health staff had been posted to the new district to provide comprehensive health care to the people.

The pioneer health workers in Amansie Central, led by the District Director, Madam Agnes Adu, have indicated their preparedness to address the reproductive health needs of the women. Just two weeks old the District Health Management Team has already drawn up a programme to reach out to the women in the district with modern contraception and health education messages.

Madam Adu, who acknowledged that the task was daunting because the new health team did not have office and staff accommodation or the required number, emphasized that her team will soon get to work with the few  resources they had because of gravity of the situation. She said since they took up office they had received maximum co-operation from government authorities in the area and noted that with such co-operations, they were sure meeting their objectives.

For me, the experience with the women in Fiankoma really improved my understanding of what statisticians mean when they say that Ghana has one of the highest unmet needs for family planning.
According to the Ghana Demographic and Health Survey (GDHS) 2003, only 19% of currently married women in Ghana use modern method of family planning. From the GDHS findings, unmet need has remained unchanged in the 5 year period, 1998-2003.

The benefits of family planning actually extend beyond slowing the pace of population growth. By using contraception, women can avoid the high risk of poorly –timed pregnancies that jeopardize their health and that of their children.
It is worthy of note that in spite of this, the issue of leadership, both at the highest level and at the regional and district level, to give visibility and enhance support to the national family planning programme is still not receiving the priority it deserves.

In fact, the government’s new policy initiative to implement a National Health Insurance Scheme excludes coverage for family planning services.