Abstract
BACKGROUND: High fertility rates and low infant mortality hurt maternal and child health and increase child dependency ratios, leading to poor economic development, low standards of living and low educational attainment. Despite efforts over the years, Ghana's fertility rates have declined at a rate lower than the global average. Using the multi-indicator cluster survey (MICS) data, we analysed the factors associated with three fertility dimensions: parity, high fertility and the desire for more children in Ghana. OBJECTIVE: The study aimed to investigate the factors associated with parity, high fertility and the desire for another child in Ghana. DESIGN: The MICS are cross-sectional, nationally representative surveys that employ a multi-stage, stratified cluster sampling approach to select sample units. METHODS: The data for this study were obtained from the 2017 to 2018 Multiple Indicator Cluster Survey (MICS) conducted in Ghana. Three outcome variables - parity, high fertility and the desire for another child - were defined. The explanatory variables consisted of respondents' sociodemographic and economic variables. The sample consisted of 11,228 women. We employed descriptive statistics, logistic regression and the generalised Poisson regression for the data analysis. RESULTS: Factors that are negatively associated with parity and high fertility include higher educational level, frequency of watching television, being insured and computer use. Residing in an urban location, being older, being in a higher wealth quintile (compared to the poorest) and the frequency of listening to the radio are all positively related to parity and being in a high-fertility zone. Women who have attained a higher level than middle/JHS, the older ones and those who are insured tend to desire another child. CONCLUSION: The study found that educational level, media (television) exposure, insurance uptake and computer use are associated with a lower likelihood of having fewer children, while being in a union, residing in an urban location, being older, having higher wealth and exposure to radio are associated with parity and being in a high-fertility zone. Our study contributes to a deeper understanding of the drivers of fertility and the desire for more children in the context of low- and middle-income countries.