BACKGROUND:
Family planning (FP) is a critical public health intervention that enables women to control their reproductive health, yet its utilisation remains suboptimal in the Western North Region, with a 26.5% acceptor rate in 2023, far below the national target of 44.4%. This study examines the factors influencing FP utilisation among women of reproductive age (15–49 years) in the region.

METHODS:
A cross-sectional survey was conducted among 508 reproductive-age women selected through cluster and systematic sampling across nine districts. Data were collected using a structured questionnaire and analysed using descriptive statistics, chi-square tests, and multivariate logistic regression in Stata 17. The Health Belief Model guided the assessment of behavioural determinants.

RESULTS:
The contraceptive prevalence rate was 43.7%, with emergency contraceptives (29.7%) being the most used method. Key predictors of FP use included being aged 25–34 (AOR = 4.05, 95% CI: 1.52–10.81), cohabiting (AOR = 8.26, 95% CI: 1.51–45.18), autonomous decision-making (AOR = 3.11, 95% CI: 1.34–7.20), and prior FP discussions (AOR = 3.59, 95% CI: 1.61–7.96). Fear of side effects (48.6%) and health concerns (19.9%) were major barriers. Approachable healthcare providers significantly increased uptake (OR = 0.26, p< 0.001). Awareness was high (89%), with friends/family (52.1%) and health facilities (49.3%) as primary information sources.

CONCLUSIONS:
This study reveals that the modern contraceptive utilisation is lower than the national target. Factors such as marital and educational status, provider-client relationships and women's autonomous decision-making significantly influence family planning utilisation in the Western North Region of Ghana. The findings highlight the need for client-centred approaches that improve service quality, address misconceptions, and empower women.