Child survival in Ghana : current determinants and relationships with fertility behaviour

Nyarko, Philomena Efua (1999) Child survival in Ghana : current determinants and relationships with fertility behaviour. University of Southampton, Doctoral Thesis.

Abstract

This thesis focuses on a comprehensive study of the current determinants of under five mortality by drawing on data from the 1993 Ghana Demographic and Health Survey. The existence of death clustering among siblings or children within the same community is explored.

The findings suggest that the significant correlates of under five mortality include biodemo graphic, socio-economic, environmental and health care factors such as the length of the preceding birth interval, the survival status of the previous child, birth order and the sex of the child, maternal age, region and place of residence, exposure to the mass media, socio-economic status of the household, source of water supply, flooring material, and immunization status of both mothers and children. The results also demonstrate that clustering of child deaths exists in Ghana but this effect is masked because of the inclusion of the survival status of the previous sibling. The study further provides evidence to suggest that a child's death increases the pace of subsequent childbearing, implying that reducing mortality can lower fertility. The analyses also suggest that, contrary to previous findings, there is some degree of son preference in Ghana. Previous family size and composition, on the other hand, have no direct links with under five mortality. The apparent effect of family size is the result of socioeconomic differences among households. Finally, succeeding birth intervals affect mortality much more than preceding birth intervals but a child whose inter-birth intervals are both short suffers the greatest risk because of the additive effect.

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