Reproductive change in Ghana : evidence from two national surveys
Creators: name: Amenuvegbe, Benjamin E
Publisher: name: The Australian National University
Year: 1994
Subjects: subject: Fertility, Human Ghana
subject: Birth intervals Ghana

description: This analysis examines various aspects of human reproductive change based on the Ghana Fertility Survey (GFS) and the Ghana Demographic and Health Survey (GDHS). It compares the data on transition to parenthood, birth spacing and durations of breastfeeding, postpartum amenorrhoea and abstinence and the factors influencing them. The study also dealt with the use of modem contraception as well as the relationship between the survival status of a child and the time to the next birth. The consistency in the measurement of selected variables in both surveys was also examined. There was considerable agreement in the measurement of birth intervals and the effects of factors affecting them. Consistency has been demonstrated in the measurement of the second, fifth and sixth birth intervals and also in the effect of selected independent variables examined in the two surveys. Age at first marriage, first birth and the first birth interval do not appear to be comparable in the two surveys; this is also the case with the third and the fourth birth intervals. This finding is not surprising because of problems of measurement of marriage data in Africa which result from the fact that it is often a process rather than an event at a point in time. The finding of inconsistency of measurement of age at marriage and the first birth interval implies that these data may not be pooled from the GFS and the GDHS to obtain a larger and possibly more stable series; also it is necessary to exercise caution in interpreting observed differences when such data are compared for the GFS and GDHS. On the other hand the consistency found shows reliability of the data though at aggregate level, and thus considerably increases our confidence in the comparative results. The study found general stability in the pace and quantum of fertility. The overall distribution of the second birth interval is only marginally different for the two surveys; first, third and fourth interval distributions are not significantly different between surveys. The distribution of the second to the fourth intervals are fairly symmetrical though the younger cohorts appear to show slightly longer delays for these births. Age at first marriage and age at first birth also appear to be generally stable within and between surveys though small increases are observed for later periods and younger cohorts. The only significant differential for age at first birth is education: women with 11 or more years had higher ages at first birth in both surveys. Median durations of breastfeeding and postpartum sexual abstinence either are stable or have increased slightly between the GFS and GDHS. A positive relationship is found between birth interval length and breastfeeding duration and also between fertility on the one hand and amenorrhoea and abstinence on the other indicating the importance of these postpartum factors for fertility. Median durations of postpartum amenorrhoea are found to generally exceed those of postpartum sexual abstinence. This suggests that amenorrhoea is more important for birth spacing than sexual abstinence among the respondents. Since failure time data from large-scale surveys are usually heavily tied, the grouped proportional hazard model is applied to determine important factors influencing age at first birth, birth intervals as well as breastfeeding and postpartum amenorrhoea and abstinence. Ethnicity, place of residence and education are found to be significantly related to breastfeeding and postpartum sexual abstinence in both surveys. Finally, the analysis showed a positive relationship between breastfeeding and birth interval length which indicates the contraceptive effect of breastfeeding, and implies that the long periods of breastfeeding in Ghana are advantageous not only for the sake of infants' health but also for birth spacing. Since effective contraceptive use is low, and the women tend to bear children throughout the reproductive life-span, long breastfeeding durations are important for fertility reduction. This analysis concludes that there is only a weak evidence for reproductive change. Few and generally weak differentials were observed within and across surveys. Also, lack of significant association between postpartum variables and age and parity indicates stability of fertility decline. Except for the weak evidence mainly associated with recent periods and also younger cohorts, the pace and quantity of fertility appear to be stable.