Fertility among women in Ghana: Do child mortality and education matter?

Abstract

BackgroundChild mortality and fertility are crucial in determining the growth of a country's population and have implications for public health and family planning interventions. An understanding of the effect of child mortality and education on fertility would be relevant to direct policies towards fertility reduction in Ghana. ObjectiveThe study examined the effect of child mortality and education on fertility in Ghana. MethodThe study used data from the 2014 Ghana Demographic and Health Survey (GDHS), using a sample of 4938 women who have ever given birth to at least one or more children. An instrumental variable Poisson generalized method of moments estimator was used in estimating the model. This helped in dealing with the eminent endogeneity among our key variables of interest. ResultsThe results show that the experience of child mortality contributes to the high fertility rate in Ghana, while education leads to a reduction in fertility. The results suggest that women who have experienced the death of a child or live in a cluster with high mortality ratio tend to have higher fertility in line with the replacement effect, whereas women facing a high risk of child mortality are inclined to high fertility through the hoarding effect. The results further show that women with higher average years of education have a lower fertility rate. Additionally, the negative interactive terms suggest that the effect of child mortality on fertility depends on the woman's education. Women with a higher level of education, have lower fertility even in an environment marked with high child mortality. ConclusionThe results affirm that a high rate of child mortality increases fertility in Ghana through both the replacement and hoarding effects. Besides, the education of the woman leads to fertility reduction. Our findings imply that while efforts are made to reduce fertility in Ghana, policy should emphasize public education on the adverse consequences of higher fertility while prioritizing measures aimed at reducing child mortality or the risk of child mortality in Ghana. Besides, increasing access to education for women will also contribute to the reduction in fertility in Ghana. The focus of such education should complement and consolidate already existing efforts that aim to reduce child mortality such as the Sustainable Development Goals.