Family planning (FP) programs in Ghana have long been shaped by donor-driven priorities and global indicator frameworks that do not always reflect local needs or support national autonomy. This study examines how FP indicators, within donor-influenced systems, create challenges for Ghana’s family planning policy landscape. Using a multi-phase qualitative design, the research draws on a comparative case study of Ghana, Kenya, and Nigeria; an inductively developed analytical framework; a scoping literature review; and stakeholder consultations with representatives from government, donor, and nongovernmental sectors.
Findings identify five core challenges, categorized as structural, context-specific, or overlapping, reflecting the multilevel forces shaping FP policy implementation. The study also identifies ten potential solutions from comparable contexts, including regional coordination platforms and rights-based measurement approaches, and assesses their feasibility through stakeholder consultations.
These findings contribute to growing scholarship on decolonizing global health metrics and offer a practical framework for policymakers seeking to strengthen domestic ownership, improve data systems, and center autonomy in Ghana’s family planning system.