Abstract
BackgroundThe past few decades witnessed a considerable decline in total fertility rates globally. However in Ghana, there has been a slight increase in the fertility rate with little understanding of the reason for the increment. To understand this change, it is important to first examine the trend over a considerable period of time while taking into consideration some important inequality dimensions. This informed the need for this present study as we examined the trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014.MethodsData from the 1993–2014 Ghana Demographic and Health Surveys were used for the study, and we relied on the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software for the analysis. The analysis involved disaggregation of TFR by wealth index, education, place of residence and region. This was followed by the estimation of inequality by Difference, Population Attributable Risk, Ratio and Population Attributable Fraction. In the analysis, we set the statistical significance at a 95% confidence interval.ResultsFor all surveys, the total fertility rate was consistently highest among the poorest women (7.00, 6.28, 6.77, 6.61 and 6.29 in 1993, 1998, 2003, 2008 and 2014, respectively). The highest total fertility rate was recorded among women with no formal education in all the survey years. For instance, in the 2014 survey, the total fertility rate for women with no formal education was 5.98 and those with secondary/higher had a total fertility rate of 3.40. Women in rural areas had a higher total fertility rate compared to those in urban areas (4.90 vs. 3.40 in 2014). In terms of sub-national regions, the Northern region was the region where women consistently had the highest total fertility rate.ConclusionThere is a need for a collective effort to design interventions and policies to create awareness among the people of Ghana especially girls and women on the implications of high fertility.
Highlights
The past few decades witnessed a considerable decline in total fertility rates over the world
Throughout the surveys, there was a disparity in total fertility rate (TFR) across the four inequality dimensions
TFR was consistently highest among the poorest women (7.00, 6.28, 6.77, 6.61 and 6.29 in 1993, 1998, 2003, 2008 and 2014, respectively), compared to the richest women (3.50, 2.45, 2.72, 2.45 and 2.85 in 1993, 1998, 2003, 2008 and 2014, respectively)
Summary
The past few decades witnessed a considerable decline in total fertility rates over the world. Agbaglo et al BMC Women’s Health (2022) 22:49 in 1950 to 4.62 births per woman in 2019, TFR of Asia and Latin America declined sharply from 5.83 and 5.83 births per woman in 1950 to 2.15 and 2.04 births per woman in 2019 respectively [3, 4] This is critical, given the alarming impacts of uncontrolled rapid population growth on the wellbeing of nations [5]. In Ghana, there has been a slight increase in the fertility rate with little understanding of the reason for the increment To understand this change, it is important to first examine the trend over a considerable period of time while taking into consideration some important inequality dimensions. This informed the need for this present study as we examined the trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014
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