Trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014

Ebenezer AGBAGLO, Pascal AGBADI, Justice Kanor TETTEH, Edward Kwabena AMEYAW, Collins ADU, Jerry John NUTOR*

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

2 Citations (Scopus)



The past few decades witnessed a considerable decline in total fertility rates globally. However in Ghana, there has been a slight increase in the fertility rate with little understanding of the reason for the increment. To understand this change, it is important to first examine the trend over a considerable period of time while taking into consideration some important inequality dimensions. This informed the need for this present study as we examined the trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014.


Data from the 1993–2014 Ghana Demographic and Health Surveys were used for the study, and we relied on the World Health Organization’s (WHO) Health Equity Assessment Toolkit (HEAT) software for the analysis. The analysis involved disaggregation of TFR by wealth index, education, place of residence and region. This was followed by the estimation of inequality by Difference, Population Attributable Risk, Ratio and Population Attributable Fraction. In the analysis, we set the statistical significance at a 95% confidence interval.


For all surveys, the total fertility rate was consistently highest among the poorest women (7.00, 6.28, 6.77, 6.61 and 6.29 in 1993, 1998, 2003, 2008 and 2014, respectively). The highest total fertility rate was recorded among women with no formal education in all the survey years. For instance, in the 2014 survey, the total fertility rate for women with no formal education was 5.98 and those with secondary/higher had a total fertility rate of 3.40. Women in rural areas had a higher total fertility rate compared to those in urban areas (4.90 vs. 3.40 in 2014). In terms of sub-national regions, the Northern region was the region where women consistently had the highest total fertility rate.


There is a need for a collective effort to design interventions and policies to create awareness among the people of Ghana especially girls and women on the implications of high fertility.

Original languageEnglish
Article number49
Number of pages8
JournalBMC Women's Health
Early online date23 Feb 2022
Publication statusPublished - 23 Feb 2022
Externally publishedYes

Bibliographical note

We would like to extend our gratitude to the DHS program for granting permission for using this data for publication.

© 2022. The Author(s).


  • Demographic and Health Surveys
  • Ghana
  • Global health
  • Inequality
  • Low-middle income countries
  • Total fertility


Dive into the research topics of 'Trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014'. Together they form a unique fingerprint.

Cite this