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 socioeconomicrelated
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.