Examining the relationships between contraception and fertility rate in Ghana: Evidence from the 1988 to 2014 Ghana Demographic and Health Surveys

Abstract

Background: There have been some discrepancies between Contraceptive Prevalence Rate (CPR) and Total Fertility Rate (TFR) in Ghana over the years which we examined in this study. Methods: We adopted a repeated cross-sectional study design to examine the relationship between Ghana's CPR and TFR using data from 1988 to 2014 Ghana Demographic and Health Surveys (GDHS). Results: Our findings show that TFR declined from 6.4 to 4.2 births per woman between 1988 and 2014. Bivariate models fitted revealed that between 1988 and 2014, women using contraceptives had higher prospects of bearing more children than women not using contraceptives. This manifested in 1988 (IRR=1.16, 95% CI=1.11, 1.22) and 2014 (IRR=1.20, 95% CI=1.12, 1.29). The multivariable Poisson regression models also showed the same patterns in all the surveys including the 1988 GDHS (IRR=1.12, 95% CI=1.09,1.19) and 2014 (1RR=1.13,95% CI=1.09,1.17). Contrary to earlier studies reports, and common perceptions held by stakeholders in family planning that there is an inverse relationship between CPR and TFR in Ghana, we did not find any such inverse relationship between CPR and TFR in Ghana during the period under review. Conclusions: Based on our findings we believe, contraception alone does not guarantee low fertility in Ghana, hence we recommend a qualitative study to further investigate the plausible factors behind our results/observations from this current study to inform policy and program decisions.