1993 年至 2014 年加纳不同不平等维度的总生育率趋势。
Trends in total fertility rate in Ghana by different inequality dimensions from 1993 to 2014.
机构信息
Department of English, University of Cape Coast, Cape Coast, Ghana.
Department of Nursing, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
出版信息
BMC Womens Health. 2022 Feb 23;22(1):49. doi: 10.1186/s12905-022-01629-w.
BACKGROUND
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.
METHODS
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.
RESULTS
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.
CONCLUSION
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.
背景
在过去的几十年中，全球的总和生育率大幅下降。然而，在加纳，生育率略有上升，但人们对这种增长的原因知之甚少。为了了解这种变化，首先重要的是在考虑到一些重要的不平等维度的情况下，检查相当长一段时间内的趋势。这就是为什么我们需要进行本研究，我们通过不同的不平等维度检查了 1993 年至 2014 年期间加纳的总和生育率趋势。
方法
本研究使用了 1993-2014 年加纳人口与健康调查的数据，并依靠世界卫生组织（WHO）的卫生公平评估工具包（HEAT）软件进行分析。分析按财富指数、教育程度、居住地和地区对总和生育率进行了分解。然后，我们使用差异、人群归因风险、比值和人群归因分数来估计不平等。在分析中，我们将统计显著性设定在 95%置信区间内。
结果
在所有调查中，最贫穷的妇女的总和生育率一直最高（1993 年、1998 年、2003 年、2008 年和 2014 年分别为 7.00、6.28、6.77、6.61 和 6.29）。在所有调查年份中，没有正规教育的妇女的总和生育率最高。例如，在 2014 年的调查中，没有正规教育的妇女的总和生育率为 5.98，而接受过中等/高等教育的妇女的总和生育率为 3.40。农村地区的妇女总和生育率高于城市地区（2014 年为 4.90 比 3.40）。在次国家地区方面，北方地区是妇女总和生育率一直最高的地区。
结论
需要共同努力，设计干预措施和政策，让加纳人民，特别是女孩和妇女，认识到高生育率的影响。
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