Trends and determinants of socioeconomic inequalities in sexual and reproductive health among women in Ghana

Abstract

Purpose This study aims to estimate the degree and nature of socioeconomic-related inequalities in sexual and reproductive health in Ghana and further assesses causes of these inequalities using decomposition technique. The authors assess the contribution of personal characteristics of the woman including access to health information and health seeking behaviours, household and locational characteristics to inequalities in sexual and reproductive health in Ghana. The study uses data from the three rounds of the Ghana Demographic and Health Survey conducted in 2003, 2008 and 2014. Design/methodology/approach Two indicators – use of modern contraceptives and intention to use modern contraceptives – are used to measure sexual and reproductive health of sexually active women. A wealth index, based on household ownership of assets, consumer goods and living conditions, is used as a measure of socioeconomic status. The paper estimates a concentration index to the relationship between cumulative health and socioeconomic rank. Paper procedures to apply decomposition techniques to determine the causes of socioeconomic inequalities in health based on a linear health regression model. Findings The study finds evidence of varying degrees of socioeconomic-related inequalities in sexual and reproductive health indicators. Specifically, the study finds that whilst use of modern contraceptives was concentrated among women in households with high socioeconomic status in 2003 and 2008, modern contraceptive use was prevalent among women in low socioeconomic status households in 2014. Equally, the study finds significant pro-poor inequalities in the intentions to use modern contraceptives in 2003 and 2014. The degree of socioeconomic inequalities in the intentions to use modern contraceptives increased between 2003 and 2014. Originality/value There is the lack of evidence on the degree, nature and causes of socioeconomic-related inequalities, which in tend impedes the design and implementation of sexual and reproductive health policies targeted at vulnerable and under-served populations. In addition, there is the need to study inequalities in health over time to monitor progress of health delivery systems towards equitable and universal coverage and understand the evolution of the determinants.

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

“…Although the fertility rates of most high-income countries are declining, the programs and interventions seem not to be working in many SSA countries as the rate of fertility is either stable, reducing at a slower pace, or is on the rise [8,[10][11][12]. For example, In Ghana it is reported that the TFR has been fluctuating over 2 decades [13,14]. Despite the introduction of many government policies, programs and interventions such as the 2004 National Population Policy, Ghana Population and AIDS project (1996)(1997)(1998)(1999)(2000), 2002 Free Compulsory Universal Basic Education (FCUBE) Contraceptive Social Marketing project (1987)(1988)(1989)(1990), Ghana Family Planning and Health Programme (1990Programme ( -1996 and Free Senior High School programs, TFR has not seen major declines and it remains unclear the trend over the past few years.…”

Unveiling the influence of reproductive health on poverty: a cross-sectional study in Magwi County, South Sudan

“…Skilled birth attendance rates vary across countries, with some regions experiencing low rates [6] . Postnatal care utilization is also variable, with some studies reporting low rates of utilization [7,8] .…”

Hubungan Paritas dan Karakteristik Individu terhadap Pemakaian Alat Kontrasepsi diantara Wanita Usia Subur di Provinsi Jawa Timur Tahun 2017

“…Hasil ini sejalan dengan penelitian di Ghana. Penelitian tersebut menginformasikan bahwa wanita usia subur di Ghana yang memiliki status sosioekonomi lebih baik memiliki kemungkinan yang lebih tinggi untuk menggunakan alat kontrasepsi, terutama jenis alat kontrasepsi modern (Agyire-Tettey et al, 2019). Penelitian sebelumnya di Indonesia menemukan informasi yang sejalan.…”