Title: Trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014
Version: 2 Date: 09 Oct 2021
Reviewer's report:
1. I don’t think the background under Abstract provides convincing justification for the work.
2. In the 1st paragraph of the Introduction, before you jump to the conclusion that the fertility
rate in SSA has been reducing at a slower rate, it will be good to provide some trend statistics.
While the authors later indicate the trend in TFR in SSA (p.5), it will be important to compare
the TFR trend for the same period in other parts of the world in order for readers to appreciate
the differences
3. Still under the section on Introduction where the authors indicate the relationship between
rapid population growth and pressure on social amenities, unemployment, etc., There should be
a caveat! e.g., Look at the Chinese case
So, it is rapid population growth that is not accompanied with growth in economic activities,
infrastructure, etc.
***Of course, you can argue the case of pressure on non-renewable resources
4. The actual research problem from Ghana’s perspective is not very clear.
Apart from where the authors indicate the GDHS’ assertion that there has been a slight increase
in fertility rate (in one sentence), it does not provide enough grounds for a study on fertility trend
in Ghana by different inequality dimension.
Authors need to discuss Ghana’s fertility rates from historical/existing studies perspective(s)
and policies implemented over the period. First, it is important readers understand the nature of
fertility rate in Ghana over the years and if there is a course for worry.  Then, authors can argue
for why there is the need to study the trends by different inequality measures.
5. Under the section on "Measure of Inequality", it is important to cite other studies that have used
similar measures for TFR; and while you think this is the best way to measure TFR. Then, regards
the socio-economic variables, authors need to spend a bit more time to explain the variables.
e.g., how is the place of residence categorized into rural or urban? In the GLSS data, it is clear
that the Ghana Statistical Service categorise a place as rural if the population is below 5000.
What does the principal component analysis technique in computing the wealth index take into
consideration? – e.g., using the housing and household characteristics such as …..
***The point is, it is important for authors to demonstrate high level of understanding of these
variables being used***
6. Under the section on "Data analysis", authors have to briefly explain the various inequality
measures before stating how they computed them.
7. Before presenting the results, I suggest authors first present the summary statistics of all the
variables used across the various rounds of the GDHS datasets. Also, presenting a correlation
matrix will be useful. If for instance, education or (and) wealth is highly correlated with place
of residence. Then, you are basically discussing almost the same women across the different
characteristics.
Then, discussing the result in the fertility trends in "percentage change" quickly brings readers
attention to magnitude of issue being reported.
8. Under "Magnitude of TFR based on summary measures", authors need to discuss what
these estimates mean, how they compare, implications, etc., For example, what does it mean to
have significant wealth-related inequality and education-related inequality in the same period?
Perhaps, an indication of high correlation between these characteristics. It is not clear how the
authors compare the trend in the results among the 4 dimensions used. Do they corroborate each
other or not? In either case, what does it mean?
Is it possible to create some form of index of the variables and use to calculate the inequality
in TFR? That may provide useful information.
9. In the 1st paragraph under the section on "Discussion", the authors note that “The present
study also revealed disparities in total fertility rate for all the four indicators across the period
under focus”. It is important to specifically note and explain these disparities. What are the
implications?
In the 2nd paragraph, authors note high TFR among the poorest and report of similar finding in
studies in Europe and North America.
Apart from not giving any plausible reason(s), I don’t think the comparison is appropriate.
Europe and America are totally different contexts. I suggest authors relate to countries in SSA
or other lower-middle income countries that share Ghana’s characteristics. Again, when making
such comparisons, it will be more insightful to compare the absolute values of the TFR. For
instance, in country A, TFR may be higher among the poorest but the rates may range between
3-4 while in Ghana, you are looking at 6-7.
Is TFR higher among the poorest because of high cost of preventive methods or lack of
information or lack of bargaining power within households or gender sensitive social norms or
high child mortality rates (for which people hedge by giving birth to more children)?
*** as much as possible draw these potential explanations from the data you used and then,
corroborate them with some exiting studies. I do not think it is enough to simply state what
other people have found in their studies when you don't find plausible reasons from the data
you used***.
10. Under "Strength and Limitations", I don’t think you can simply generalise the findings when
there are no signs of application of any weight(s) in your estimation.
11. Finally, under "Conclusion", apart from the fact that the findings are expected, I disagree
with the “policy” inference made from the study. Rather,  interventions to control fertility level/
rate should involve both men and women. Even that, based on your results of higher TFR among
the uneducated and rural women, it makes policies targeted at men even more important because
typically, these women have almost no outside option and hence low bargaining power within
the household which may have implications on decisions on their health and even the number
of children to have.