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Abstract：
BACKGROUND: High completed fertility among married and cohabiting women has profound consequences, including straining resources, increasing healthcare challenges, and contributing to educational and gender inequalities. This study examined the factors associated with high completed fertility among married and cohabiting women aged 40-49 years in Ghana.
METHODS: Data for the study was sourced from the 2022 Ghana Demographic and Health Survey (GDHS). A spatial map was used to present the women\'s geographic variations in high completed fertility. A mixed-effect multilevel binary logistic regression analysis was performed to identify the factors associated with high completed fertility. The findings were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI).
RESULTS: The national proportion of high completed fertility among married and cohabiting women aged 40-49 years in Ghana was 52.0% [48.8, 55.2]. Women who were Ga/Dangme/Ewe by tribe [aOR = 2.32, 95% CI = 1.06, 5.08] had higher odds of high completed fertility than Akans. Women who indicated 6 + as their ideal number of children had a higher [aOR = 5.60, 95% CI = 2.90, 10.82] likelihood of high completed fertility compared to those whose ideal number of children was 0-3. Those who were using contraceptives at the time of the survey had a higher [aOR = 2.31, 95% CI = 1.17, 4.55] likelihood of high completed fertility compared to those who were not using contraceptives. Women with secondary/higher education [aOR = 0.32, 95% CI = 0.17, 0.58] had lower odds of high completed fertility than those without no formal education. Women with females as household heads [aOR = 0.56, 95% CI = 0.33, 0.95] had lower odds of high completed fertility than males. Women in Volta, Western North, Ahafo, and Bono regions had lower odds of high completed fertility compared to those living in the Northeast region, with the lowest odds among those living in the Volta region [aOR = 0.08, 95% CI = 0.02, 0.40].
CONCLUSIONS: High completed fertility is prevalent in Ghana, with more than half of married and cohabiting women having at least five or more children. The government and policymakers in Ghana should promote education for women, increase culturally sensitive family planning programs, increase access to family planning resources, address ideal family size preferences, and improve understanding of contraceptive use.
METHODS: Data for the study was sourced from the 2022 Ghana Demographic and Health Survey (GDHS). A spatial map was used to present the women\'s geographic variations in high completed fertility. A mixed-effect multilevel binary logistic regression analysis was performed to identify the factors associated with high completed fertility. The findings were presented as adjusted odds ratios (aOR) with a 95% confidence interval (CI).
RESULTS: The national proportion of high completed fertility among married and cohabiting women aged 40-49 years in Ghana was 52.0% [48.8, 55.2]. Women who were Ga/Dangme/Ewe by tribe [aOR = 2.32, 95% CI = 1.06, 5.08] had higher odds of high completed fertility than Akans. Women who indicated 6 + as their ideal number of children had a higher [aOR = 5.60, 95% CI = 2.90, 10.82] likelihood of high completed fertility compared to those whose ideal number of children was 0-3. Those who were using contraceptives at the time of the survey had a higher [aOR = 2.31, 95% CI = 1.17, 4.55] likelihood of high completed fertility compared to those who were not using contraceptives. Women with secondary/higher education [aOR = 0.32, 95% CI = 0.17, 0.58] had lower odds of high completed fertility than those without no formal education. Women with females as household heads [aOR = 0.56, 95% CI = 0.33, 0.95] had lower odds of high completed fertility than males. Women in Volta, Western North, Ahafo, and Bono regions had lower odds of high completed fertility compared to those living in the Northeast region, with the lowest odds among those living in the Volta region [aOR = 0.08, 95% CI = 0.02, 0.40].
CONCLUSIONS: High completed fertility is prevalent in Ghana, with more than half of married and cohabiting women having at least five or more children. The government and policymakers in Ghana should promote education for women, increase culturally sensitive family planning programs, increase access to family planning resources, address ideal family size preferences, and improve understanding of contraceptive use.
摘要：
背景：已婚和同居妇女的高生育率具有深远的影响，包括资源紧张，不断增加的医疗保健挑战，促进教育和性别不平等。这项研究调查了加纳40-49岁已婚和同居妇女中与高生育率相关的因素。
方法：研究数据来自2022年加纳人口与健康调查（GDHS）。使用空间地图来显示妇女在高完成生育率方面的地理变化。进行了混合效应多水平二元逻辑回归分析，以确定与高完成生育率相关的因素。研究结果以调整后的比值比（aOR）表示，置信区间为95％（CI）。
结果：加纳40-49岁已婚和同居妇女中完成生育率高的国家比例为52.0%[48.8,55.2]。按部落划分为Ga/Dangme/Ewe的女性[aOR=2.32，95％CI=1.06，5.08]的完成生育率高的可能性高于Akans。与理想子女数为0-3的女性相比，以6+为理想子女数的女性具有更高的[aOR=5.60，95％CI=2.90，10.82]高完成生育能力的可能性。与未使用避孕药具的人相比，在调查时使用避孕药具的人具有更高的[aOR=2.31，95％CI=1.17，4.55]完成生育率高的可能性。受过中等/高等教育的女性[aOR=0.32，95％CI=0.17，0.58]的完成生育率高的可能性低于没有正规教育的女性。以女性为户主[aOR=0.56，95％CI=0.33，0.95]的女性完成生育率高的几率低于男性。Volta的女人,西部北部,Ahafo,与东北地区相比，博诺地区的高生育率几率较低，在生活在沃尔特地区的人群中几率最低[aOR=0.08，95%CI=0.02，0.40]。
结论：高完成生育率在加纳很普遍，超过一半的已婚和同居妇女有至少五个或更多的孩子。加纳政府和决策者应促进妇女教育，增加对文化敏感的计划生育计划，增加获得计划生育资源的机会，解决理想的家庭大小偏好，提高对避孕药具使用的认识。
方法：研究数据来自2022年加纳人口与健康调查（GDHS）。使用空间地图来显示妇女在高完成生育率方面的地理变化。进行了混合效应多水平二元逻辑回归分析，以确定与高完成生育率相关的因素。研究结果以调整后的比值比（aOR）表示，置信区间为95％（CI）。
结果：加纳40-49岁已婚和同居妇女中完成生育率高的国家比例为52.0%[48.8,55.2]。按部落划分为Ga/Dangme/Ewe的女性[aOR=2.32，95％CI=1.06，5.08]的完成生育率高的可能性高于Akans。与理想子女数为0-3的女性相比，以6+为理想子女数的女性具有更高的[aOR=5.60，95％CI=2.90，10.82]高完成生育能力的可能性。与未使用避孕药具的人相比，在调查时使用避孕药具的人具有更高的[aOR=2.31，95％CI=1.17，4.55]完成生育率高的可能性。受过中等/高等教育的女性[aOR=0.32，95％CI=0.17，0.58]的完成生育率高的可能性低于没有正规教育的女性。以女性为户主[aOR=0.56，95％CI=0.33，0.95]的女性完成生育率高的几率低于男性。Volta的女人,西部北部,Ahafo,与东北地区相比，博诺地区的高生育率几率较低，在生活在沃尔特地区的人群中几率最低[aOR=0.08，95%CI=0.02，0.40]。
结论：高完成生育率在加纳很普遍，超过一半的已婚和同居妇女有至少五个或更多的孩子。加纳政府和决策者应促进妇女教育，增加对文化敏感的计划生育计划，增加获得计划生育资源的机会，解决理想的家庭大小偏好，提高对避孕药具使用的认识。
