Department of Biological Sciences
Permanent URI for this collectionhttps://dspace.njala.edu.sl/handle/20.500.144402/136
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Item 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(BioMed Central, 2024-07-11) Osborne, AugustusBACKGROUND: 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. METHODS: 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). RESULTS: 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 \[aOR = 0.08, 95% CI = 0.02, 0.40\]. CONCLUSION: 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.Item Prevalence and factors associated with unintended pregnancy among women in Ghana(BioMed Central, 2025-07-04) Osborne, AugustusBACKGROUND: Unintended pregnancy remains a major public health concern, particularly in low-and middle-income countries. It poses significant challenges to both maternal and child health. It is associated with adverse outcomes such as unsafe abortions, delayed initiation of antenatal care, low birth weight, and poor developmental outcomes in children. This study examined the prevalence and factors associated with unintended pregnancy among women in Ghana. METHODS: Data from the 2022 Ghana Demographic and Health Survey was used for the study. Regional variations in the prevalence of unintended pregnancy were presented using a spatial map. A mixed-effect multilevel binary logistic regression models were fitted to examine the factors associated with unintended pregnancy using a four-modelled approach. The results were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI) and intra-cluster correlation coefficients. RESULTS: The prevalence of unintended pregnancy in Ghana was 38.9% \[37.0, 40.8\]. Women aged 20–49 had lower odds for unintended pregnancy than those aged 15–19, with the lowest odds among those aged 40–44 \[aOR = 0.07; 95% CI: 0.03, 0.13\]. Women who were Muslims \[aOR = 0.69; 95% CI: 0.49, 0.98\] had lower odds of unintended pregnancy than those who were Christians. Women who were Mande by tribe \[aOR = 0.40; 95% CI: 0.18, 0.87\] had lower odds of unintended pregnancy than those who were Akan by tribe. The likelihood of unintended pregnancy was lower among women from the richest households \[aOR = 0.46; 95% CI: 0.26, 0.80\] compared to those from the poorest quintile households. Women residing in the Northern \[aOR = 0.49; 95% CI: 0.25, 0.94\] and North East \[aOR = 0.37; 95% CI: 0.19, 0.73\] regions were less likely to have unintended pregnancy relative to those from the Western Region. Women with primary \[aOR = 1.41; 95% CI: 1.05, 1.90\] and secondary \[aOR = 1.46; 95% CI: 1.09, 1.97\] education were more likely to have unintended pregnancy than those with no education. Women with 3–4 \[aOR = 2.02; 95% CI: 1.48, 2.77\] and 5 + children \[aOR = 4.34; 95% CI: 2.79, 6.74\] had higher odds of unintended pregnancy than those with 1–2 children. Women with six or more in household size \[aOR = 1.53; 95% CI: 1.20, 1.94\] had higher odds of unintended pregnancy than those with five and below. Women with females as household heads \[aOR = 1.47; 95% CI: 1.15, 1.87\] were more likely to have unintended pregnancy compared to those with males as household heads. Women living in the Central, Greater Accra, Volta, Eastern, Ashanti, Western North and Oti regions had higher odds of unintended pregnancy than those living in the Western region, with the highest odds among those residing in the Central region \[aOR = 7.08; 95% CI: 3.99, 12.57\]. CONCLUSION: Unintended pregnancy is prevalent among women in Ghana, with variations across the regions. Factors such as women's age, education, parity, religion, ethnicity, household size, sex of household head, wealth index, and region were associated with unintended pregnancy. To effectively reduce unintended pregnancies in Ghana, the Ministry of Health should consider restructuring existing sexual and reproductive health programmes and use these findings to inform the design of targeted, evidence-based interventions aimed at preventing unintended pregnancies among women.