Spatial distribution and factors associated with high completed fertility among women aged 40–49 years in Ghana: evidence from the 2022 Ghana Demographic Health Survey

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Reproductive Health Pub Date : 2024-07-11 DOI:10.1186/s12978-024-01845-7

Augustus Osborne, Camilla Bangura, Richard Gyan Aboagye, Florence Gyembuzie Wongnaah, Abdul-Aziz Seidu, Bright Opoku Ahinkorah

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Abstract

High completed fertility among married and cohabiting women has profound consequences, including straining resources, increasing healthcare challenges, and contributing to educational and gender inequalities. This study examined the factors associated with high completed fertility among married and cohabiting women aged 40–49 years in Ghana. Data for the study was sourced from the 2022 Ghana Demographic and Health Survey (GDHS). A spatial map was used to present the women's geographic variations in high completed fertility. A mixed-effect multilevel binary logistic regression analysis was performed to identify the factors associated with high completed fertility. The findings were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI). The national proportion of high completed fertility among married and cohabiting women aged 40–49 years in Ghana was 52.0% [48.8, 55.2]. Women who were Ga/Dangme/Ewe by tribe [aOR = 2.32, 95% CI = 1.06, 5.08] had higher odds of high completed fertility than Akans. Women who indicated 6 + as their ideal number of children had a higher [aOR = 5.60, 95% CI = 2.90, 10.82] likelihood of high completed fertility compared to those whose ideal number of children was 0–3. Those who were using contraceptives at the time of the survey had a higher [aOR = 2.31, 95% CI = 1.17, 4.55] likelihood of high completed fertility compared to those who were not using contraceptives. Women with secondary/higher education [aOR = 0.32, 95% CI = 0.17, 0.58] had lower odds of high completed fertility than those without no formal education. Women with females as household heads [aOR = 0.56, 95% CI = 0.33, 0.95] had lower odds of high completed fertility than males. Women in Volta, Western North, Ahafo, and Bono regions had lower odds of high completed fertility compared to those living in the Northeast region, with the lowest odds among those living in the Volta region [aOR = 0.08, 95% CI = 0.02, 0.40]. High completed fertility is prevalent in Ghana, with more than half of married and cohabiting women having at least five or more children. The government and policymakers in Ghana should promote education for women, increase culturally sensitive family planning programs, increase access to family planning resources, address ideal family size preferences, and improve understanding of contraceptive use.

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加纳 40-49 岁妇女高完成生育率的空间分布和相关因素：来自 2022 年加纳人口健康调查的证据

已婚和同居妇女的高完成生育率具有深远的影响，包括造成资源紧张、增加医疗保健方面的挑战以及加剧教育和性别不平等。本研究探讨了加纳 40-49 岁已婚和同居妇女高完成生育率的相关因素。研究数据来自 2022 年加纳人口与健康调查（GDHS）。研究使用空间地图来呈现妇女在高完成生育率方面的地域差异。为确定与高完成生育率相关的因素，进行了混合效应多层次二元逻辑回归分析。分析结果以调整后的几率比（aOR）和 95% 的置信区间（CI）表示。加纳全国 40-49 岁已婚和同居妇女的高完成生育率比例为 52.0% [48.8, 55.2]。与阿坎人相比，嘎/当梅/埃维部落妇女[aOR = 2.32, 95% CI = 1.06, 5.08]的高完成生育率几率更高。与理想子女数为 0-3 个的妇女相比，理想子女数为 6 个以上的妇女完成高生育率的几率更高[aOR = 5.60，95% CI = 2.90，10.82]。与未使用避孕药具的妇女相比，调查时正在使用避孕药具的妇女有更高的[aOR = 2.31, 95% CI = 1.17, 4.55]完成高生育率的可能性。受过中等/高等教育的妇女[aOR = 0.32, 95% CI = 0.17, 0.58]比未受过正规教育的妇女有更低的高完成生育率。户主为女性的妇女 [aOR = 0.56，95% CI = 0.33，0.95] 的高完成生育率几率低于男性。与生活在东北部地区的妇女相比，生活在沃尔特、西北部、阿哈福和博诺地区的妇女的高完成生育率几率较低，其中生活在沃尔特地区的妇女的几率最低[aOR = 0.08，95% CI = 0.02，0.40]。加纳的高完成生育率非常普遍，一半以上的已婚和同居妇女至少有五个或五个以上的孩子。加纳政府和决策者应促进对妇女的教育，增加对文化敏感的计划生育项目，增加计划生育资源的获取途径，解决理想家庭规模偏好问题，并提高对避孕药具使用的认识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Reproductive Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.00

自引率

5.90%

发文量

220

审稿时长

>12 weeks

期刊介绍： Reproductive Health focuses on all aspects of human reproduction. The journal includes sections dedicated to adolescent health, female fertility and midwifery and all content is open access. Reproductive health is defined as a state of physical, mental, and social well-being in all matters relating to the reproductive system, at all stages of life. Good reproductive health implies that people are able to have a satisfying and safe sex life, the capability to reproduce and the freedom to decide if, when, and how often to do so. Men and women should be informed about and have access to safe, effective, affordable, and acceptable methods of family planning of their choice, and the right to appropriate health-care services that enable women to safely go through pregnancy and childbirth.