Contextual versus Compositional effects on cumulative fertility in Ghana – a multilevel analysis

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November, 2015
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Ghana has experienced an unexpectedly rapid fertility decline over the past 30 years, which has not been adequately explained in light of the concurrent persistently low usage of contraception. Factors at both the individual and contextual level have been investigated for their role in the determination of fertility levels and differentials in Ghana however, the relative contributions of the contextual factors compared with the individual factors to variation in fertility has rarely been studied. This study investigated how much of the observed district level fertility differentials are attributable to contextual versus compositional effects using a multilevel framework. Data from the second round of the Performance Monitoring and Accountability 2020 survey were analyzed using a 2-level multilevel framework with individuals as the first level and districts at the second level. Age, education, wealth, marital status, history of family planning use and age at first sex were used as individual-level predictors while urban/rural residence was included as a district-level explanatory variable. Multilevel multivariate regression models with interaction terms included were used to determine how much of the variance was attributable to each level. Age, education, marital status, age at first sex and history of family planning were found to significantly influence cumulative fertility, however, most of the observed effects of these variables were significantly attenuated when age interactions were included in the models. The models also found that only 3-4% of the variance in cumulative fertility could be attributed to contextual effects as opposed to individual effects. Cumulative fertility is primarily determined by individual-level characteristics, and how these characteristics change with age and over time. Thus, policies aimed at fertility regulation should pay particular attention to improving the socio-economic circumstances of women.
A thesis submitted to the Department of Population, Family and Reproductive Health, College of Health Sciences, School of Public Health, in partial fulfillment of the requirements for the award of the degree of Master of Public Health in Population and Reproductive Health,