Munika Mohammed sits in the clinic waiting room, breastfeeding her seven-month-old son.
Though the 28-year-old works at Tamale's newest family planning clinic, she still had to beg her husband to let her take contraceptives.
"I waited for a day when he was very happy," she says. "It was difficult to convince him ... but he realized that family planning isn't something that would (prevent me from having another child)."
The Marie Stopes International clinic is the only family planning clinic in Ghana's northern region. The U.K.-based NGO has clinics in Accra and Kumasi but a location in Tamale was long overdue, says Kenneth Danuo, the clinic's behaviour change communications coordinator.
"Tamale has a very high fertility rate (and) maternal deaths have also increased in this part of Ghana," he says.
According to the 2008 Ghana Demographics Health Survey, the northen region's fertility rate is 6.8. This means women of child-bearing age have an average of 6.8 children in their lifetime compared to the national average of four children per women of child-bearing age.
Mohammed's approach to contraception is typical for the region, says Danuo.
"The fear of the women is that (their) husbands, for all kinds of reasons, will not want (them) to ... take family planning methods."
The main reason husbands deny their wives birth control are the misconceptions that they will never be able to conceive again, says Danuo.
Data from a recent presentation by the region's Family Planning Services shows married women decline taking contraception for many reasons.
Marie Stopes International clinic is 200 metres away from Tamale's Central Mosque. Strong Islamic beliefs in the region are also hindering contraceptive use, says Danuo.
Birth control injections like Depo-Provera are popular, because they prevent pregnancy for up to three months, says Danuo. Women can secretly get the shot and avoid telling their husband they are on birth control.
It's Mohammed's job to teach woman about the different types birth control. She reassures them that their periods won't stop and that they will be able to conceive again.
"Women are coming one-by-one and they don't know what method to choose, but after counselling...they (go) for the injectables," she says.
Like family planning services offered by Ghana Health Services, contraceptives at Marie Stopes are heavily subsidized. Both Marie Stopes and GHS charge 0.50 GHC ($0.25 Cdn) for an injection of Devo-Provera.
Mohammed's son, Muhaison, coos as she bounces him on her lap. Mohammed plans to have more children, but on her own schedule.
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