Ghana - Demographic and Health Survey 2022

Publication date: 2024

Ghana Demographic and Health Survey 2022 G hana 2022 D em ographic and H ealth S urvey Ghana Demographic and Health Survey 2022 Ghana Statistical Service Accra, Ghana The DHS Program ICF Rockville, Maryland, USA January 2024 The 2022 Ghana Demographic and Health Survey (2022 GDHS) was implemented by the Ghana Statistical Service (GSS). Funding for the 2022 GDHS was provided by the Government of Ghana; the United States Agency for International Development (USAID); the U.S. President’s Malaria Initiative (PMI); the United Nations Population Fund (UNFPA); the United Nations Children’s Fund (UNICEF); the World Bank; the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund); the Korean International Cooperation Agency (KOICA); the World Health Organization (WHO); and the Foreign, Commonwealth and Development Office (UK-FCDO). ICF provided technical assistance through The DHS Program, a USAID-funded project providing support and technical assistance in the implementation of population and health surveys in countries worldwide. Additional information about the 2022 GDHS may be obtained from the Ghana Statistical Service, Head Office, P.O. Box GP 1098, Accra, Ghana; email: info@statsghana.gov.gh. Information about The DHS Program may be obtained from ICF, 530 Gaither Road, Suite 500, Rockville, MD 20850, USA; telephone: +1-301-407-6500; fax: +1-301-407-6501; email: info@DHSprogram.com; internet: www.DHSprogram.com. The contents of this report are the sole responsibility of the GSS and ICF and do not necessarily reflect the views of USAID, the United States Government, or other donor agencies. Recommended citation: Ghana Statistical Service (GSS) and ICF. 2024. Ghana Demographic and Health Survey 2022. Accra, Ghana, and Rockville, Maryland, USA: GSS and ICF. Contents • iii CONTENTS TABLES, FIGURES, AND MAPS . ix FOREWORD . xix ACKNOWLEDGEMENTS . xxi ACRONYMS AND ABBREVIATIONS . xxiii READING AND UNDERSTANDING TABLES FROM THE 2022 GHANA DEMOGRAPHIC AND HEALTH SURVEY (GDHS) . xxv SUSTAINABLE DEVELOPMENT GOAL INDICATORS . xxxiii MAP OF GHANA . xxxvi 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 1.1 Survey Objectives . 1 1.2 Sample Design . 1 1.3 Questionnaires . 2 1.3.1 Household Questionnaire . 2 1.3.2 Woman’s Questionnaire . 3 1.3.3 Man’s Questionnaire . 3 1.3.4 Biomarker Questionnaire . 3 1.3.5 Fieldworker Questionnaire . 3 1.3.6 Finalisation of the Questionnaires . 3 1.4 Anthropometry, Anaemia Testing, and Malaria Testing . 4 1.5 Training of Trainers and Pretest . 5 1.6 Training of Field Staff . 5 1.6.1 Computer-assisted Personal Interviewing (CAPI) Training . 6 1.6.2 Anthropometry Training . 7 1.6.3 Fieldwork Practice . 8 1.7 Fieldwork . 8 1.8 Data Processing . 8 1.8.1 Central Office Training and Secondary Editing . 8 1.8.2 Data Cleaning and Finalisation . 8 1.8.3 Malaria Microscopy . 9 1.9 Response Rates . 9 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 11 2.1 Housing Characteristics . 11 2.1.1 Use of Clean Fuels and Technologies . 12 2.1.2 Cooking . 12 2.1.3 Heating and Lighting . 12 2.1.4 Primary Reliance on Clean Fuels and Technologies . 12 2.2 Household Wealth . 12 2.2.1 Household Durable Goods . 12 2.2.2 Wealth Index . 13 2.3 Household Population and Composition . 13 2.4 Children’s Living Arrangements and Parental Survival . 14 2.5 Birth Registration . 14 2.6 Education . 15 2.6.1 Educational Attainment . 15 2.6.2 Primary and Secondary School Attendance . 15 2.6.3 Participation Rate in Organised Learning among Children Age 5 . 16 iv • Contents 3 CHARACTERISTICS OF RESPONDENTS . 31 3.1 Basic Characteristics of Survey Respondents . 31 3.2 Education and Literacy . 32 3.3 Mass Media Exposure and Internet Usage . 33 3.4 Employment . 34 3.5 Occupation . 34 3.6 Health Insurance Coverage . 35 3.7 Tobacco Use . 36 3.8 Alcohol Consumption . 36 3.9 Place of Birth and Recent Migration . 36 3.9.1 Type of Migration . 37 3.9.2 Reason for Migration . 37 4 MARRIAGE AND SEXUAL ACTIVITY . 67 4.1 Marital Status . 67 4.2 Marriage Registration . 68 4.3 Polygyny . 68 4.4 Age at First Marriage . 69 4.5 Age at First Sexual Intercourse . 69 4.6 Recent Sexual Activity . 70 5 FERTILITY . 81 5.1 Current Fertility . 81 5.2 Children Ever Born and Living . 82 5.3 Birth Intervals . 83 5.4 Insusceptibility to Pregnancy . 83 5.5 Age at First Menstruation . 84 5.6 Arrival of Menopause . 84 5.7 Age at First Birth . 84 5.8 Teenage Pregnancy . 84 5.9 Pregnancy Outcomes and Induced Abortion Rates . 85 6 FERTILITY PREFERENCES . 97 6.1 Desire for Another Child . 97 6.2 Ideal Family Size . 98 6.3 Fertility Planning Status . 99 6.4 Wanted Fertility Rates . 99 7 FAMILY PLANNING . 107 7.1 Contraceptive Knowledge and Use . 108 7.1.1 Contraceptive Knowledge . 108 7.1.2 Contraceptive Prevalence . 108 7.1.3 Timing of Sterilisation . 110 7.1.4 Use of DMPA-SC/Sayana Press . 110 7.1.5 Use of Emergency Contraception . 110 7.1.6 Knowledge of the Fertile Period . 110 7.2 Source of Modern Contraceptive Methods . 111 7.3 Informed Choice . 112 7.4 Discontinuation of Contraceptives . 112 7.5 Demand for Family Planning . 113 7.6 Decision Making about Family Planning . 114 7.7 Pressure to Become Pregnant and Future Use of Contraception . 115 Contents • v 7.8 Exposure to Family Planning Messages . 115 7.9 Contact of Nonusers with Family Planning Providers . 115 8 INFANT AND CHILD MORTALITY . 137 8.1 Infant and Child Mortality . 138 8.2 Perinatal Mortality . 139 8.3 High-risk Fertility Behaviour . 140 9 MATERNAL AND NEWBORN HEALTH CARE. 147 9.1 Antenatal Care Coverage and Content . 147 9.1.1 Skilled Providers . 147 9.1.2 Timing and Number of Antenatal Care Visits . 148 9.2 Components of Antenatal Care . 148 9.2.1 Deworming and Iron-containing Supplementation during Pregnancy . 149 9.2.2 Source of Iron-containing Supplements . 150 9.3 Protection against Neonatal Tetanus . 150 9.4 Delivery Services . 150 9.4.1 Institutional Deliveries . 150 9.4.2 Delivery by Caesarean . 151 9.4.3 Skilled Assistance during Delivery . 151 9.5 Postnatal Care . 153 9.5.1 Postnatal Health Check for Mothers . 153 9.5.2 Postnatal Health Check for Newborns . 153 9.5.3 Postnatal Health Checks for Mothers and Newborns. 154 9.6 Men’s Involvement in Maternal Health Care . 154 9.7 Breast and Cervical Cancer Examinations . 154 9.8 Problems in Accessing Health Care . 155 9.9 Distance and Means of Transport to the Nearest Health Facility . 155 10 CHILD HEALTH . 185 10.1 Child’s Size and Birth Weight . 185 10.2 Vaccination of Children. 186 10.2.1 Vaccination Card Ownership and Availability . 186 10.2.2 Basic Antigen Coverage . 186 10.2.3 National Schedule Coverage . 189 10.3 Symptoms of Acute Respiratory Infection and Care-seeking Behaviour . 190 10.4 Diarrhoeal Disease . 190 10.4.1 Diarrhoea and Care-seeking Behaviour . 190 10.4.2 Feeding Practices . 191 10.4.3 Oral Rehydration Therapy, Zinc, Continued Feeding, and Other Treatments . 191 10.5 Treatment of Childhood Illness . 192 11 NUTRITION OF CHILDREN AND ADULTS . 211 11.1 Nutritional Status of Children . 212 11.2 Growth Monitoring and Promotion . 214 11.3 Infant and Young Child Feeding Practices . 215 11.3.1 Ever Breastfed, Early Initiation of Breastfeeding, and Exclusive Breastfeeding for the First 2 Days after Birth . 215 11.3.2 Exclusive Breastfeeding and Mixed Milk Feeding . 215 11.3.3 Continued Breastfeeding and Bottle Feeding . 216 11.3.4 Introduction of Complementary Foods . 217 vi • Contents 11.3.5 Minimum Dietary Diversity, Minimum Meal Frequency, Minimum Milk Feeding Frequency, Minimum Acceptable Diet, and Egg and/or Flesh Food Consumption . 217 11.3.6 Sweet Beverage Consumption, Unhealthy Food Consumption, and Zero Vegetable or Fruit Consumption among Children . 219 11.3.7 Infant and Young Child Feeding (IYCF) Indicators . 219 11.4 Infant and Young Child Feeding Counselling . 219 11.5 Anaemia Prevalence in Children . 220 11.6 Micronutrient Supplementation and Deworming among Children . 220 11.7 Adults’ Nutritional Status . 221 11.7.1 Nutritional Status of Women . 222 11.7.2 Nutritional Status of Men . 222 11.8 Women’s Dietary Practices . 223 11.9 Anaemia Prevalence in Adults. 224 11.10 Presence of Iodised Salt in Households . 224 12 MALARIA . 251 12.1 Ownership of Insecticide-treated Nets . 251 12.2 Household Access to and Use of ITNs . 252 12.3 Use of ITNs by Children and Pregnant Women . 254 12.4 Reasons Mosquito Nets Were Not Used . 254 12.5 Malaria in Pregnancy . 255 12.6 Case Management of Malaria in Children . 255 12.7 Prevalence of Low Haemoglobin Levels in Children . 257 12.8 Prevalence of Malaria in Children . 257 13 KNOWLEDGE, ATTITUDES, AND BEHAVIOUR RELATED TO HIV AND AIDS . 275 13.1 Knowledge and Attitudes about Medicines to Treat or Prevent HIV . 276 13.2 Discriminatory Attitudes towards People Living with HIV . 276 13.3 Multiple Sexual Partners . 277 13.4 Coverage of HIV Testing Services . 277 13.4.1 HIV Testing of Pregnant Women . 278 13.4.2 Experience with Prior HIV Testing . 278 13.5 Male Circumcision . 278 13.6 Self-reporting of Sexually Transmitted Infections . 279 13.7 Knowledge and Behaviour Related to HIV and AIDS among Young People . 279 13.7.1 Knowledge about HIV Prevention . 279 13.7.2 First Sex . 280 13.7.3 Premarital Sex . 280 13.7.4 Multiple Sexual Partners . 280 13.7.5 Recent HIV Testing . 281 14 HEALTH INSURANCE COVERAGE . 301 14.1 Health Insurance Coverage and National Health Insurance Scheme . 302 14.2 Possession of a Valid NHIS Card . 303 14.3 Access to and Use of Health Services . 303 14.3.1 Health Care Service Utilisation. 303 14.3.2 Out-of-pocket Payments . 303 15 WOMEN’S EMPOWERMENT . 313 15.1 Married Women’s and Men’s Employment . 313 15.2 Control over Women’s Earnings . 314 15.3 Control over Men’s Earnings . 315 Contents • vii 15.4 Women’s and Men’s Ownership of Assets . 315 15.4.1 Ownership of a House or Land and Documentation of Ownership . 315 15.4.2 Ownership and Use of Mobile Phones and Bank Accounts. 316 15.5 Participation in Decision Making . 316 15.6 Attitudes toward Wife Beating . 317 15.7 Negotiating Sexual Relations . 317 15.8 Women’s Participation in Decision Making regarding Sexual and Reproductive Health . 318 16 HOUSEHOLD WATER AND SANITATION . 337 16.1 Drinking Water Sources, Availability, and Treatment . 337 16.1.1 Drinking Water Service Ladder . 338 16.1.2 Person Collecting Drinking Water . 339 16.1.3 Availability of Drinking Water . 340 16.1.4 Treatment of Drinking Water . 340 16.2 Sanitation . 340 16.2.1 Sanitation Service Ladder . 341 16.2.2 Removal and Disposal of Excreta . 341 16.3 Disposal of Children’s Stools . 342 16.4 Handwashing . 342 16.5 Menstrual Hygiene . 343 17 DOMESTIC VIOLENCE . 357 17.1 Measurement of Violence . 358 17.2 Women’s Experience of Physical Violence. 359 17.2.1 Perpetrators of Physical Violence . 359 17.2.2 Experience of Physical Violence during Pregnancy . 359 17.3 Experience of Sexual Violence . 360 17.3.1 Prevalence of Sexual Violence . 360 17.3.2 Perpetrators of Sexual Violence . 360 17.3.3 Experience of Sexual Violence by a Non-intimate Partner . 360 17.4 Experience of Different Forms of Violence . 360 17.5 Forms of Controlling Behaviours and Intimate Partner Violence . 361 17.5.1 Prevalence of Controlling Behaviours and Intimate Partner Violence . 361 17.5.2 Intimate Partner Violence in the Last 12 Months Perpetrated by any Husband/Intimate Partner . 362 17.6 Injuries to Women due to Intimate Partner Violence . 362 17.7 Violence Initiated by Women against Their Husband/Intimate Partner . 363 17.8 Help Seeking among Women Who Have Experienced Violence . 363 REFERENCES. 387 Appendix A SAMPLE DESIGN . 391 A.1 Introduction . 391 A.2 Sampling Frame . 391 A.3 Structure of the Sample and Sampling Procedure . 393 A.4 Selection Probability and Sampling Weights . 395 A.5 Survey Implementation. 396 Appendix B ESTIMATES OF SAMPLING ERRORS . 399 Appendix C DATA QUALITY TABLES . 443 viii • Contents Appendix D PERSONS INVOLVED IN THE 2022 GHANA DEMOGRAPHIC AND HEALTH SURVEY . 465 Appendix E QUESTIONNAIRES . 471 Household . 473 Woman’s . 489 Man’s . 565 Biomarker . 591 Fieldworker . 613 Tables, Figures, and Maps • ix TABLES, FIGURES, AND MAPS 1 INTRODUCTION AND SURVEY METHODOLOGY . 1 Table 1.1 Results of the household and individual interviews . 9 2 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION . 11 Table 2.1 Household characteristics . 17 Table 2.2 Household characteristics: Cooking . 18 Table 2.3 Household characteristics: Heating and lighting . 19 Table 2.4 Primary reliance on clean fuels and technologies . 20 Table 2.5 Household possessions . 21 Table 2.6 Wealth quintiles . 21 Table 2.7 Household population by age, sex, and residence . 22 Table 2.8 Household composition . 23 Table 2.9 Children’s living arrangements and orphanhood . 24 Table 2.10 Birth registration of children under age 5 . 25 Table 2.11.1 Educational attainment of the female household population . 26 Table 2.11.2 Educational attainment of the male household population . 27 Table 2.12 School attendance ratios . 28 Table 2.13 Participation rate in organised learning . 29 Figure 2.1 Household wealth by residence . 13 Figure 2.2 Population pyramid . 14 3 CHARACTERISTICS OF RESPONDENTS . 31 Table 3.1 Background characteristics of respondents . 38 Table 3.2.1 Educational attainment: Women . 39 Table 3.2.2 Educational attainment: Men . 40 Table 3.3.1 Literacy: Women . 41 Table 3.3.2 Literacy: Men . 42 Table 3.4.1 Exposure to mass media: Women . 43 Table 3.4.2 Exposure to mass media: Men . 44 Table 3.5.1 Internet usage: Women . 45 Table 3.5.2 Internet usage: Men . 46 Table 3.6.1 Employment status: Women . 47 Table 3.6.2 Employment status: Men . 48 Table 3.7.1 Occupation: Women . 49 Table 3.7.2 Occupation: Men . 50 Table 3.8.1 Type of employment: Women . 51 Table 3.8.2 Type of employment: Men . 51 Table 3.9.1 Health insurance coverage: Women . 52 Table 3.9.2 Health insurance coverage: Men . 53 Table 3.10.1 Tobacco smoking: Women . 54 Table 3.10.2 Tobacco smoking: Men . 55 Table 3.11 Average number of cigarettes smoked daily: Men . 56 Table 3.12 Smokeless tobacco use and any tobacco use . 56 Table 3.13 Any tobacco use by background characteristics . 57 Table 3.14.1 Alcohol consumption: Women . 58 Table 3.14.2 Alcohol consumption: Men . 59 Table 3.15.1 Usual number of alcoholic drinks consumed: Women . 60 x • Tables, Figures, and Maps Table 3.15.2 Usual number of alcoholic drinks consumed: Men . 61 Table 3.16.1 Place of birth and recent migration: Women . 62 Table 3.16.2 Place of birth and recent migration: Men . 63 Table 3.17 Type of migration . 64 Table 3.18.1 Reason for migration: Women . 65 Table 3.18.2 Reason for migration: Men . 66 Figure 3.1 Education of survey respondents . 32 Figure 3.2 Exposure to mass media . 33 Figure 3.3 Internet usage by sex. 34 Figure 3.4 Employment status by sex . 34 Figure 3.5 Occupation . 35 Figure 3.6 Use of tobacco among women and men . 36 Maps 3.1 and 3.2 Secondary education by region . 33 4 MARRIAGE AND SEXUAL ACTIVITY . 67 Table 4.1 Current marital status . 71 Table 4.2 Marriage registration. 72 Table 4.3.1 Number of women’s co-wives . 73 Table 4.3.2 Number of men’s wives . 74 Table 4.4 Age at first marriage . 75 Table 4.5 Median age at first marriage according to background characteristics . 76 Table 4.6 Age at first sexual intercourse . 77 Table 4.7 Median age at first sexual intercourse according to background characteristics . 78 Table 4.8.1 Recent sexual activity: Women . 79 Table 4.8.2 Recent sexual activity: Men . 80 Figure 4.1 Marital status . 68 Figure 4.2 Trends in polygyny . 69 Figure 4.3 First sex and first marriage by age 18 . 69 Figure 4.4 Trends in early sexual intercourse . 70 5 FERTILITY . 81 Table 5.1 Current fertility . 87 Table 5.2 Fertility by background characteristics . 87 Table 5.3 Trends in age-specific fertility rates . 88 Table 5.4 Children ever born and living . 88 Table 5.5 Birth intervals . 89 Table 5.6 Postpartum amenorrhoea, abstinence, and insusceptibility. 90 Table 5.7 Median duration of amenorrhoea, postpartum abstinence, and postpartum insusceptibility . 91 Table 5.8 Age at first menstruation . 91 Table 5.9 Menopause . 92 Table 5.10 Age at first birth . 92 Table 5.11 Median age at first birth . 93 Table 5.12 Teenage pregnancy . 94 Table 5.13 Sexual and reproductive health behaviours before age 15 . 94 Table 5.14 Pregnancy outcome by background characteristics . 95 Table 5.15 Induced abortion rates . 96 Figure 5.1 Trends in age-specific fertility . 82 Tables, Figures, and Maps • xi Map 5.1 Fertility by region . 82 Map 5.2 Teenage pregnancy by region . 85 6 FERTILITY PREFERENCES . 97 Table 6.1 Fertility preferences according to number of living children . 101 Table 6.2.1 Desire to limit childbearing: Women . 102 Table 6.2.2 Desire to limit childbearing: Men . 103 Table 6.3 Ideal number of children according to number of living children . 104 Table 6.4 Mean ideal number of children according to background characteristics . 105 Table 6.5 Fertility planning status . 106 Table 6.6 Wanted fertility rates . 106 Figure 6.1 Desire to limit childbearing by number of living children . 98 Figure 6.2 Trends in desire to limit childbearing . 98 Figure 6.3 Ideal family size . 99 Figure 6.4 Fertility planning status . 99 Figure 6.5 Trends in wanted and actual fertility . 100 7 FAMILY PLANNING . 107 Table 7.1 Knowledge of contraceptive methods . 117 Table 7.2 Knowledge of contraceptive methods according to background characteristics . 118 Table 7.3.1 Current use of contraception according to age. 119 Table 7.3.2 Current use of male condoms among men according to age . 120 Table 7.4 Current use of contraception according to background characteristics. 121 Table 7.5 Timing of sterilisation . 121 Table 7.6 Use of DMPA-SC/Sayana Press . 122 Table 7.7 Use of emergency contraception . 123 Table 7.8 Knowledge of fertile period . 123 Table 7.9 Knowledge of fertile period by age . 124 Table 7.10 Source of modern contraceptive methods . 124 Table 7.11 Use of social marketing brand pills and condoms . 125 Table 7.12 Informed choice . 126 Table 7.13 Twelve-month contraceptive discontinuation rates . 127 Table 7.14 Reasons for discontinuation . 127 Table 7.15.1 Need and demand for family planning among currently married women . 128 Table 7.15.2 Need and demand for family planning among all women and among sexually active unmarried women . 129 Table 7.16 Decision making about family planning . 131 Table 7.17 Decision making about family planning by background characteristics. 132 Table 7.18 Pressure to become pregnant . 133 Table 7.19 Future use of contraception . 134 Table 7.20.1 Exposure to family planning messages: Women . 134 Table 7.20.2 Exposure to family planning messages: Men . 135 Table 7.21 Contact of nonusers with family planning providers . 136 Figure 7.1 Contraceptive use . 108 Figure 7.2 Trends in contraceptive use . 109 Figure 7.3 Source of modern contraceptive methods . 111 Figure 7.4 Contraceptive discontinuation rates . 113 Figure 7.5 Trends in demand for family planning among currently married women and sexually active unmarried women . 114 xii • Tables, Figures, and Maps Maps 7.1a and 7.1b Contraceptive use by region . 109 Map 7.2 Unmet need by region . 114 8 INFANT AND CHILD MORTALITY . 137 Table 8.1 Early childhood mortality rates . 142 Table 8.2 Five-year early childhood mortality rates according to background characteristics . 142 Table 8.3 Ten-year early childhood mortality rates according to additional characteristics . 143 Table 8.4 Perinatal mortality . 144 Table 8.5 High-risk fertility behaviour . 145 Figure 8.1 Trends in early childhood mortality rates . 138 Figure 8.2 Under-5 mortality by mother’s education . 139 Figure 8.3 Perinatal mortality by mother’s education . 140 Map 8.1 Under-5 mortality by region . 139 9 MATERNAL AND NEWBORN HEALTH CARE. 147 Table 9.1 Antenatal care . 157 Table 9.2 Number of antenatal care visits and timing of first visit . 158 Table 9.3.1 Components of antenatal care among women receiving ANC . 160 Table 9.3.2 Components of antenatal care among all women . 162 Table 9.4 Deworming and iron-containing supplementation during pregnancy . 164 Table 9.5 Source of iron-containing supplements . 166 Table 9.6 Tetanus toxoid injections . 167 Table 9.7 Place of delivery . 168 Table 9.8 Caesarean section . 169 Table 9.9 Assistance during delivery . 170 Table 9.10 Duration of stay in health facility after birth. 172 Table 9.11 Timing of first postnatal check for the mother . 173 Table 9.12 Type of provider of first postnatal check for the mother . 175 Table 9.13 Content of postnatal care for the mother . 176 Table 9.14 Timing of first postnatal check for the newborn . 177 Table 9.15 Type of provider of first postnatal check for the newborn. 178 Table 9.16 Content of postnatal care for newborns . 179 Table 9.17 Postnatal checks for mothers and newborns . 180 Table 9.18 Men’s involvement in maternal health care . 181 Table 9.19 Examinations for breast and cervical cancer. 182 Table 9.20 Problems in accessing health care. 183 Table 9.21 Distance from health care . 184 Figure 9.1 Trends in antenatal care coverage . 148 Figure 9.2 Components of antenatal care . 149 Figure 9.3 Trends in antenatal care coverage . 149 Figure 9.4 Health facility births by education . 151 Figure 9.5 Trends in place of birth . 151 Figure 9.6 Caesarean section by birth outcome . 151 Figure 9.7 Assistance during delivery . 152 Figure 9.8 Skilled assistance at delivery by birth order . 152 Figure 9.9 Trends in assistance during delivery . 152 Tables, Figures, and Maps • xiii Figure 9.10 Postnatal care by place of delivery . 153 Figure 9.11 Breast and cervical cancer exams by household wealth . 154 10 CHILD HEALTH . 185 Table 10.1 Child’s size and weight at birth . 194 Table 10.2 Possession and observation of vaccination cards . 196 Table 10.3 Vaccinations by source of information . 197 Table 10.4 Vaccinations by background characteristics . 198 Table 10.5 Source of vaccinations . 200 Table 10.6 Children with symptoms of ARI and care seeking for symptoms of ARI . 201 Table 10.7 Source of advice or treatment for children with symptoms of ARI . 202 Table 10.8 Children with fever and care seeking for fever . 203 Table 10.9 Children with diarrhoea and care seeking for diarrhoea . 204 Table 10.10 Feeding practices during diarrhoea . 205 Table 10.11 Oral rehydration salts, zinc, continued feeding, and other treatments for diarrhoea . 207 Table 10.12 Source of advice or treatment for children with diarrhoea . 209 Figure 10.1 Childhood vaccinations. 187 Figure 10.2 Trends in childhood vaccinations . 188 Figure 10.3 Diarrhoea prevalence by age . 190 Figure 10.4 Feeding practices during diarrhoea . 191 Figure 10.5 Treatment of diarrhoea. 192 Figure 10.6 Symptoms of childhood illness and care seeking . 192 Map 10.1 Vaccination coverage by region. 188 11 NUTRITION OF CHILDREN AND ADULTS . 211 Table 11.1 Nutritional status of children . 226 Table 11.2 Child growth monitoring . 228 Table 11.3 Early breastfeeding . 229 Table 11.4 Breastfeeding status according to age . 231 Table 11.5 Infant feeding practices by age . 232 Table 11.6 Liquids consumed by children in the day or night preceding the interview . 233 Table 11.7 Foods consumed by children in the day or night preceding the interview . 234 Table 11.8 Minimum dietary diversity, minimum meal frequency, and minimum acceptable diet among children . 235 Table 11.9 Egg and/or flesh food consumption and unhealthy feeding practices among children age 6–23 months . 237 Table 11.11 Infant and young child feeding counselling . 239 Table 11.12 Prevalence of anaemia in children . 240 Table 11.13 Micronutrient supplementation and deworming among children . 241 Table 11.14.1 Nutritional status of women age 20–49 . 242 Table 11.14.2 Nutritional status of adolescent women age 15–19 . 243 Table 11.14.3 Nutritional status of men age 20–49 . 244 Table 11.14.4 Nutritional status of adolescent men age 15–19 . 245 Table 11.15 Foods and liquids consumed by women in the day or night preceding the interview . 246 Table 11.16 Minimum dietary diversity and unhealthy food and beverage consumption among women . 248 Table 11.17 Prevalence of anaemia in women . 249 Table 11.18 Presence of iodised salt in household . 250 xiv • Tables, Figures, and Maps Figure 11.1 Trends in child growth measures . 213 Figure 11.2 Trends in stunting . 213 Figure 11.3 Infant feeding practices by age . 216 Figure 11.4 IYCF indicators on minimum acceptable diet by breastfeeding status . 218 Figure 11.5 Unhealthy feeding practices among children age 6–23 months by residence . 219 Figure 11.6 Trends in childhood anaemia . 220 Figure 11.7 Anaemia in pregnant and nonpregnant women . 224 Map 11.1 Stunting in children by region . 214 12 MALARIA . 251 Table 12.1 Household possession of mosquito nets . 260 Table 12.2 Source of mosquito nets . 261 Table 12.3 Access to an insecticide-treated net (ITN) . 262 Table 12.4 Use of mosquito nets by persons in the household . 263 Table 12.5 Use of existing ITNs . 264 Table 12.6 Use of mosquito nets by children. 265 Table 12.7 Use of mosquito nets by pregnant women . 266 Table 12.8 Main reason mosquito net was not used the night before the survey . 267 Table 12.9 Use of intermittent preventive treatment (IPTp) by women during pregnancy . 268 Table 12.10 Children with fever and care seeking, prompt treatment, and diagnosis . 269 Table 12.11 Source of advice or treatment for children with fever . 270 Table 12.12 Type of antimalarial drugs used . 271 Table 12.13 Coverage of testing for anaemia and malaria in children . 272 Table 12.14 Haemoglobin <8.0 g/dl in children . 273 Table 12.15 Prevalence of malaria in children . 274 Figure 12.1 Trends in household ownership of ITNs . 252 Figure 12.2 Source of ITNs . 252 Figure 12.3 Trends in ITN access and use . 253 Figure 12.4 Trends in ITN use . 254 Figure 12.5 Trends in IPTp use by pregnant women . 255 Figure 12.6 Trends in ACT use by children with fever . 256 Figure 12.7 Trends in malaria prevalence among children . 258 Map 12.1 ITN access by region . 254 Map 12.2 Prevalence of malaria in children by region . 258 13 KNOWLEDGE, ATTITUDES, AND BEHAVIOUR RELATED TO HIV AND AIDS . 275 Table 13.1 Knowledge of and attitudes about medicines to treat HIV or prevent HIV transmission . 282 Table 13.2 Discriminatory attitudes towards people living with HIV . 283 Table 13.3.1 Multiple sexual partners and higher-risk sexual intercourse in the last 12 months: Women . 285 Table 13.3.2 Multiple sexual partners and higher-risk sexual intercourse in the last 12 months: Men . 287 Table 13.4 Pregnant women tested for HIV . 289 Table 13.5.1 Coverage of prior HIV testing: Women . 290 Table 13.5.2 Coverage of prior HIV testing: Men . 291 Table 13.6 Number of times tested for HIV in lifetime . 292 Table 13.7 Knowledge and coverage of self-testing for HIV . 292 Tables, Figures, and Maps • xv Table 13.8 Male circumcision . 293 Table 13.9 Self-reported prevalence of sexually transmitted infections (STIs) and STI symptoms . 294 Table 13.10.1 Knowledge about HIV prevention among young people: Women . 296 Table 13.10.2 Knowledge about HIV prevention among young people: Men . 297 Table 13.11 Age at first sexual intercourse among young people . 298 Table 13.12 Premarital sexual intercourse among young people . 298 Table 13.13.1 Multiple sexual partners and higher-risk sexual intercourse in the last 12 months among young people: Women . 299 Table 13.13.2 Multiple sexual partners and higher-risk sexual intercourse in the last 12 months among young people: Men . 300 Table 13.14 Recent HIV tests among young people . 300 Figure 13.1 Knowledge of medicines to treat HIV or prevent HIV transmission . 276 Figure 13.2 Trends in knowledge of mother-to-child transmission (MTCT) . 276 Figure 13.3 Discriminatory attitudes towards people living with HIV by age . 277 Figure 13.4 Sex and condom use with noncohabiting partners . 277 Figure 13.5 Trends in HIV testing during pregnancy . 278 Figure 13.6 HIV testing. 278 Figure 13.7 Trends in HIV testing . 278 Figure 13.8 Knowledge about HIV prevention among young people . 280 Figure 13.9 Trends in age at first sex . 280 Figure 13.10 Recent HIV testing among young people . 281 14 HEALTH INSURANCE COVERAGE . 301 Table 14.1.1 Health insurance coverage: Women . 304 Table 14.1.2 Health insurance coverage: Men . 305 Table 14.2 Reasons for dropping NHIS coverage . 306 Table 14.3.1 National Health Insurance Scheme: Women . 306 Table 14.3.2 National Health Insurance Scheme: Men . 307 Table 14.4.1 Access to and utilization of health services: Women . 308 Table 14.4.1a Utilisation of health services and type of payment: Women . 309 Table 14.4.2 Access to and utilisation of health services: Men . 310 Table 14.4.2a Utilisation of health services and type of payment: Men . 311 Figure 14.1 Trends in NHIS coverage . 302 Figure 14.2 Reasons for dropping NHIS coverage . 302 15 WOMEN’S EMPOWERMENT . 313 Table 15.1 Employment and cash earnings of currently married women and men . 319 Table 15.2.1 Control over women’s cash earnings and relative magnitude of women’s cash earnings . 320 Table 15.2.2 Control over men’s cash earnings . 321 Table 15.3.1 House and land ownership: Women . 322 Table 15.3.2 House and land ownership: Men. 322 Table 15.4.1 House ownership and documentation of ownership: Women. 323 Table 15.4.2 House ownership and documentation of ownership: Men . 324 Table 15.5.1 Land ownership and documentation of ownership: Women. 325 Table 15.5.2 Land ownership and documentation of ownership: Men . 326 Table 15.6.1 Ownership and use of mobile phones and bank accounts: Women . 327 Table 15.6.2 Ownership and use of mobile phones and bank accounts: Men . 328 Table 15.7 Participation in decision making . 329 Table 15.8.1 Women’s participation in decision making by background characteristics . 330 xvi • Tables, Figures, and Maps Table 15.8.2 Men’s participation in decision making by background characteristics . 331 Table 15.9.1 Attitude toward wife beating: Women . 332 Table 15.9.2 Attitude toward wife beating: Men . 333 Table 15.10 Attitudes toward negotiating safer sexual relations with husband . 334 Table 15.11 Ability to negotiate sexual relations with husband . 335 Table 15.12 Women’s participation in decision making regarding sexual and reproductive health . 336 Figure 15.1 Control over women’s earnings . 314 Figure 15.2 Trends in control over earnings . 314 Figure 15.3 Control over men’s earnings . 315 Figure 15.4 Ownership of assets . 316 Figure 15.5 Women’s participation in decision making . 317 Figure 15.6 Attitudes towards wife beating . 317 16 HOUSEHOLD WATER AND SANITATION . 337 Table 16.1 Household drinking water . 344 Table 16.2 Drinking water service ladder . 345 Table 16.3 Person collecting drinking water . 346 Table 16.4 Availability of sufficient drinking water . 347 Table 16.5 Treatment of household drinking water . 348 Table 16.6 Household sanitation facilities . 349 Table 16.7 Sanitation service ladder . 350 Table 16.8 Emptying and removal of waste from on-site sanitation facilities . 351 Table 16.9 Management of household excreta . 352 Table 16.10 Disposal of children’s stools . 353 Table 16.11 Handwashing . 354 Table 16.12 Menstrual hygiene . 355 Figure 16.1 Household population drinking water service . 338 Figure 16.2 Person collecting drinking water . 339 Figure 16.3 Household population sanitation service . 341 Figure 16.4 Appropriate management of household excreta . 342 Map 16.1 At least basic drinking water service by region . 339 17 DOMESTIC VIOLENCE . 357 Table 17.1 Experience of physical violence by any perpetrator . 365 Table 17.2 Persons committing physical violence . 366 Table 17.3 Experience of physical violence during pregnancy . 367 Table 17.4 Experience of sexual violence by any perpetrator . 369 Table 17.5 Persons committing sexual violence . 370 Table 17.6 Experience of sexual violence by any non-intimate partner . 371 Table 17.7 Age at first experience of sexual violence . 372 Table 17.8 Experience of different forms of violence . 372 Table 17.9 Forms of controlling behaviours and intimate partner violence . 373 Table 17.10 Controlling behaviours of husband/intimate partner by background characteristics . 374 Table 17.11 Intimate partner violence by background characteristics . 376 Table 17.12 Intimate partner violence by husband’s/intimate partner’s characteristics and women’s empowerment indicators . 378 Table 17.13 Violence by any husband or intimate partner in the last 12 months . 379 Table 17.14 Injuries to women due to intimate partner violence . 380 Tables, Figures, and Maps • xvii Table 17.15 Violence by women against their husband/intimate partner by women’s background characteristics . 381 Table 17.16 Violence by women against their husband/intimate partner by husband’s/intimate partner’s characteristics and women’s empowerment indicators. 383 Table 17.17 Help seeking to stop violence . 384 Table 17.18 Sources for help to stop the violence . 385 Figure 17.1 Women’s experience of physical violence by marital status . 359 Figure 17.2 Women’s experience of sexual violence by marital status . 360 Figure 17.3 Forms of controlling behaviours . 361 Figure 17.4 Intimate partner violence by husband’s/intimate partner’s alcohol consumption . 362 Figure 17.5 Help seeking by type of violence experienced. 363 Appendix A SAMPLE DESIGN . 391 Table A.1 Distribution of the household population by region and type of residence . 392 Table A.2 Distribution of residential households by region and type of residence . 392 Table A.3 Distribution of enumeration areas and their average size in number of households . 393 Table A.4 Sample allocation of clusters and households by region and type of residence . 394 Table A.5 Sample allocation of expected numbers of interviews with women and men by region and type of residence . 395 Table A.6 Sample implementation: Women . 397 Table A.7 Sample implementation: Men . 398 Appendix B ESTIMATES OF SAMPLING ERRORS . 399 Table B.1 List of selected variables for sampling errors, Ghana DHS 2022 . 401 Table B.2 Sampling errors: Total sample, Ghana DHS 2022 . 404 Table B.3 Sampling errors: Urban sample, Ghana DHS 2022 . 406 Table B.4 Sampling errors: Rural sample, Ghana DHS 2022 . 408 Table B.5 Sampling errors: Western sample, Ghana DHS 2022 . 410 Table B.6 Sampling errors: Central sample, Ghana DHS 2022 . 412 Table B.7 Sampling errors: Greater Accra sample, Ghana DHS 2022 . 414 Table B.8 Sampling errors: Volta sample, Ghana DHS 2022 . 416 Table B.9 Sampling errors: Eastern sample, Ghana DHS 2022 . 418 Table B.10 Sampling errors: Ashanti sample, Ghana DHS 2022 . 420 Table B.11 Sampling errors: Western North sample, Ghana DHS 2022. 422 Table B.12 Sampling errors: Ahafo sample, Ghana DHS 2022 . 424 Table B.13 Sampling errors: Bono sample, Ghana DHS 2022 . 426 Table B.14 Sampling errors: Bono East sample, Ghana DHS 2022 . 428 Table B.15 Sampling errors: Oti sample, Ghana DHS 2022 . 430 Table B.16 Sampling errors: Northern sample, Ghana DHS 2022 . 432 Table B.17 Sampling errors: Savannah sample, Ghana DHS 2022 . 434 Table B.18 Sampling errors: North East sample, Ghana DHS 2022 . 436 Table B.19 Sampling errors: Upper East sample, Ghana DHS 2022 . 438 Table B.20 Sampling errors: Upper West sample, Ghana DHS 2022 . 440 Appendix C DATA QUALITY TABLES . 443 Table C.2.1 Age distribution of eligible and interviewed women . 444 Table C.2.2 Age distribution of eligible and interviewed men . 444 Table C.3 Age displacement at ages 14/15 . 445 xviii • Tables, Figures, and Maps Table C.4 Age displacement at ages 49/50 . 446 Table C.5 Pregnancy outcomes by years preceding the survey . 447 Table C.6 Completeness of reporting . 448 Table C.7 Standardisation exercise results from anthropometry training. 449 Table C.8 Height and weight data completeness and quality for children . 451 Table C.9 Height measurements from random subsample of measured children . 454 Table C.10 Interference in height and weight measurements of children . 455 Table C.11 Interference in height and weight measurements of women and men . 457 Table C.12 Heaping in anthropometric measurements for children (digit preference) . 458 Table C.13 Observation of mosquito nets . 459 Table C.14 Observation of handwashing facility . 460 Table C.15 School attendance by single year of age . 461 Table C.16 Vaccination cards photographed . 462 Table C.17 Number of enumeration areas completed by month and region . 463 Table C.18 Positive rapid diagnostic test (RDT) results by month and region . 463 Table C.18a Positive rapid diagnostic test (RDT) results by month and region (unweighted) . 464 Table C.19 Concordance and discordance between RDT and microscopy results . 464 Foreword • xix FOREWORD Demographic and Health Surveys are population-based surveys that are essential to monitor progress in service utilisation and management of health-related issues to inform decision making. The 2022 Ghana Demographic and Health Survey (2022 GDHS) is the seventh in the series of DHS surveys conducted by the Ghana Statistical Service (GSS) in collaboration with the Ministry of Health/Ghana Health Service (MoH/GHS) and other stakeholders, with funding from the United States Agency for International Development (USAID) and other partners. The survey provides national estimates of demographic and health indicators that are comparable to data collected in the six previous DHS surveys and similar surveys in other developing countries. The information gathered will add to the large database of population-based indicators for Ghana. Data were collected from a nationally representative sample of approximately 18,540 households from all 16 regions in Ghana. The survey interviewed 17,933 households, 15,014 women of reproductive age (age 15 to 49), and 7,044 men age 15 to 59. In addition, 4,935 children age 0–5 were measured for anthropometry, and children age 6–59 months were tested for malaria using malaria rapid diagnostic tests (RDTs) and microscopy. The report provides information on fertility, fertility preferences, family planning practices, childhood mortality, maternal and child health, nutrition, knowledge of HIV prevention methods, violence against women, women’s empowerment, health insurance, water, sanitation, menstrual hygiene, malaria prevalence, marriage and sexual activity, and other health issues. These data are disaggregated by region, type of locality, and selected demographic characteristics including sex, age, education, and wealth. These indicators are essential for policy planning, programme planning, and monitoring and evaluation of population and health programmes, including those related to the Health Sector Medium-Term Development Plan 2022–2025, the Sustainable Development Goals (SDGs), and other national and international agendas. The findings from this report will support the design, implementation, monitoring, and evaluation of policies and programmes to improve health care in general as well as reproductive, maternal, and child health in particular. Findings from the Key Indicators Report (KIR) of the 2022 GDHS were released on 5 June 2023 during the 2023 Annual Health Summit hosted by the Ministry of Health. This was a source of information for programme managers on performance, monitoring, and evaluation of programme interventions. Professor Samuel Kobina Annim Government Statistician Ghana Statistical Service Acknowledgements • xxi ACKNOWLEDGEMENTS The Ghana Statistical Service (GSS) acknowledges the Ghana Health Service Ethical Review Committee for the ethical clearance that allowed performance of anaemia and malaria testing. The GSS is indebted to its development partners, including the United States Agency for International Development; the World Bank; the United Nations Population Fund; the World Health Organization; the Foreign, Commonwealth and Development Office; the United Nations Children’s Fund; the Korean International Cooperation Agency; the Global Fund to Fight AIDS, Tuberculosis and Malaria; and the Government of Ghana, for funding the survey. The Service wishes to express its deepest gratitude to the Ministry of Health, the Ghana Health Service, and the National Malaria Control Programme for their valuable partnership and for providing artemisinin- based combination therapy (ACT) and COVID-19 personal protective equipment used in both training and fieldwork. The immense contribution of the National Public Health Reference Laboratory cannot go unacknowledged, especially during the training of field personnel, field supervision, and microscopy reading of malaria slides to determine malaria parasite infections. The GSS is also indebted to the Noguchi Memorial Institute for Medical Research for conducting external quality assurance of the microscopy readings of the malaria slides. The Service appreciates the technical support provided by ICF through The Demographic and Health Surveys Program throughout the survey period. Special admiration goes to the Steering and Technical Advisory Committee members and the Project Implementation Team for their invaluable contributions to and oversight of the implementation of the survey. To the media, we say thank you for publicising the survey and sensitising the public during the period of data collection and dissemination of the Key Indicators Report. We appreciate the cooperation of all respondents during the data collection, the field officers who committed themselves to the collection of quality data, and other survey personnel whose contribution made the entire exercise a reality. Acronyms and Abbreviations • xxiii ACRONYMS AND ABBREVIATIONS ACT artemisinin-based combination therapy AIDS acquired immunodeficiency syndrome ANC antenatal care ARI acute respiratory infection BCG bacille Calmette-Guérin BMI body mass index CAPI computer-assisted personal interviewing CBR crude birth rate CDC U.S. Centers for Disease Control and Prevention CHPS community-based health planning and services COVID coronavirus disease DEFT design effect DHS Demographic and Health Survey DMPA-SC subcutaneous depot medroxyprogesterone acetate DPT diphtheria, pertussis, and tetanus EA enumeration area ERC Ethical Review Committee FDA Food and Drugs Authority GAR gross attendance ratio GDHS Ghana Demographic and Health Survey GFR general fertility rate GHPC Ghana Housing and Population Census GHS Ghana Health Service GMIS Ghana Malaria Indicator Survey GPI gender parity index GPS Global Positioning System GSS Ghana Statistical Service HepB hepatitis B Hib Haemophilus influenzae type B HIV human immunodeficiency virus HPV human papillomavirus IPTp intermittent preventive treatment during pregnancy IPV inactivated poliomyelitis vaccine IRB Institutional Review Board ITN insecticide-treated net IUD intrauterine contraceptive device IYCF infant and young child feeding JMP Joint Monitoring Programme for Water Supply, Sanitation and Hygiene KIR Key Indicators Report KMC kangaroo mother care xxiv • Acronyms and Abbreviations LAM lactational amenorrhoea method LLIN long-lasting insecticidal net LPG liquified petroleum gas MMR measles, mumps, and rubella MR measles-rubella MTCT mother-to-child transmission MUAC mid-upper-arm circumference NAR net attendance ratio NGO nongovernmental organisation NHIA National Health Insurance Authority NHIS National Health Insurance Scheme NMEP National Malaria Elimination Programme OOP out-of-pocket payment OPV oral polio vaccine ORS oral rehydration salts ORT oral rehydration therapy PCV pneumococcal conjugate vaccine PHC Population and Housing Census PMI U.S. President’s Malaria Initiative PNC postnatal care PSU primary sampling unit RDT rapid diagnostic test RHF recommended homemade fluids RV rotavirus vaccine SD standard deviation SDG Sustainable Development Goal SDM standard days method SP sulfadoxine-pyrimethamine STI sexually transmitted infection TFR total fertility rate UNFPA United Nations Population Fund UNICEF United Nations Children’s Fund USAID United States Agency for International Development WHO World Health Organization Reading and Understanding Tables from the 2022 GDHS • xxv READING AND UNDERSTANDING TABLES FROM THE 2022 GHANA DEMOGRAPHIC AND HEALTH SURVEY (GDHS) the 2022 Ghana DHS final report is based on approximately 200 tables of data. For quick reference, they are located at the end of each chapter and can be accessed through links in the pertinent text (electronic version). Additionally, this more reader-friendly version features about 90 figures that clearly highlight trends, subnational patterns, and background characteristics. Large, colourful maps display breakdowns for the regions in Ghana. The text has been simplified to highlight key points in bullets and to clearly identify indicator definitions in boxes. While the text and figures featured in each chapter highlight some of the most important findings from the tables, not every finding can be discussed or displayed graphically. For this reason, GDHS data users should be comfortable reading and interpreting tables. The following pages provide an introduction to the organization of GDHS tables and the presentation of background characteristics, along with a brief summary of sampling and understanding denominators. In addition, this section provides some exercises for users as they practice their new skills in interpreting GDHS tables. T xxvi • Reading and Understanding Tables from the 2022 GDHS Example 1: Exposure to mass media: Women A Question Asked of All Survey Respondents Table 3.4.1 Exposure to mass media: Women Percentage of women age 15–49 who are exposed to specific media on a weekly basis, according to background characteristics, Ghana DHS 2022 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of women Age 15–19 5.0 61.9 34.7 1.9 29.1 2,682 20–24 3.8 60.4 38.5 1.7 28.0 2,695 25–29 3.8 66.8 41.1 2.3 23.8 2,340 30–34 3.9 65.7 44.7 2.5 24.5 2,252 35–39 2.2 62.7 47.4 1.4 25.7 2,059 40–44 2.8 59.0 48.9 2.1 28.4 1,675 45–49 2.6 48.8 46.8 1.9 34.6 1,312 Residence Urban 5.0 73.0 45.3 2.8 19.1 8,557 Rural 1.7 46.4 38.3 0.9 38.3 6,457 Region Western 3.5 69.3 51.2 1.7 19.3 955 Central 5.3 73.5 46.0 2.1 17.7 1,703 Greater Accra 7.6 82.8 47.6 4.7 13.4 2,327 Volta 4.1 56.8 50.3 2.8 27.0 713 Eastern 3.0 71.3 47.6 1.8 17.9 1,220 Ashanti 1.8 62.4 47.6 1.0 24.0 2,928 Western North 3.4 57.6 38.3 1.5 28.4 411 Ahafo 1.1 43.5 33.4 1.0 39.7 317 Bono 1.8 61.4 40.2 0.9 27.5 567 Bono East 3.7 51.8 32.3 1.9 37.3 676 Oti 2.2 53.0 44.3 1.1 30.0 403 Northern 1.8 41.0 19.1 1.0 53.8 1,149 Savannah 1.0 37.9 30.0 0.6 44.7 319 North East 1.3 38.7 28.6 0.7 45.3 290 Upper East 3.5 30.8 36.2 1.7 49.4 640 Upper West 1.8 29.3 29.2 1.0 53.1 398 Education No education 0.2 33.1 29.2 0.1 52.2 2,411 Primary 0.7 54.7 38.0 0.1 32.6 2,071 Secondary 3.4 67.8 45.3 1.8 21.7 8,999 More than secondary 14.0 79.4 50.8 8.3 14.0 1,533 Wealth quintile Lowest 1.1 15.5 31.0 0.5 61.9 2,447 Second 1.8 46.7 36.7 0.5 38.1 2,712 Middle 1.4 67.4 40.3 0.7 22.8 3,121 Fourth 4.1 78.7 47.7 2.5 14.9 3,379 Highest 8.5 84.6 51.4 4.9 10.2 3,355 Total 3.6 61.6 42.3 2.0 27.3 15,014 Step 1: Read the title and subtitle, highlighted in orange in the table above. They tell you the topic and the specific population group being described. In this case, the table is about women age 15–49 and their exposure to different types of media. All eligible female respondents age 15–49 were asked these questions. Step 2: Scan the column headings—highlighted in green in Example 1. They describe how the information is categorized. In this table, the first three columns of data show different types of media that women access at least once a week. The fourth column shows women who access all three types of media, while the fifth column shows women who do not access any of the three types of media on a weekly basis. The last column lists the number of women age 15–49 interviewed in the survey. Step 3: Scan the row headings—the first vertical column highlighted in blue in Example 1. These show the different ways the data are divided into categories based on population characteristics. In this case, the table presents women’s exposure to media by age, urban-rural residence, region, level of education, and wealth quintile. Most of the tables in the GDHS report will be divided into these same categories. 1 2 3 4 5 Reading and Understanding Tables from the 2022 GDHS • xxvii Step 4: Look at the row at the bottom of the table highlighted in pink. These percentages represent the totals of all women age 15–49 and their weekly access to different types of media. In this case, 3.6% of women age 15–49 read a newspaper at least once a week, 61.6% watch television at least weekly, and 42.3% listen to the radio on a weekly basis.* Step 5: To find out what percentage of women in rural areas listen to the radio at least once a week, draw two imaginary lines, as shown on the table. This shows that 38.3% of women age 15–49 in rural areas listen to the radio at least once a week. By looking at patterns by background characteristics, we can see how exposure to mass media varies across Ghana. Mass media are often used to communicate health messages. Knowing how mass media exposure varies among different groups can help programme planners and policymakers determine how to most effectively reach their target populations. *For the purpose of this document data are presented exactly as they appear in the table, including decimal places. However, the text in the remainder of this report rounds data to the nearest whole percentage point. Practice: Use the table in Example 1 to answer the following questions: a) What percentage of women in Ghana do not access any of the three media at least once a week? b) Which age group of women is most likely to watch television at least once a week? c) Compare women by urban-rural residence—which group is more likely to read a newspaper at least once a week? d) What are the lowest and the highest percentages (range) of women who access none of the three media at least once a week by region? e) Is there a clear pattern in weekly exposure to newspapers by educational level? f) Is there a clear pattern in weekly exposure to television by wealth quintile? Answers: a) 27.3%. b) Women age 25–29: 66.8% of women in this age group watch television at least once a week. c) 5.0% of women in urban areas read a newspaper at least once a week, as compared with 1.7% of women in rural areas. d) The percentage of women who access none of the three media ranges from a low of 13.4% in Greater Accra to a high of 53.8% in Northern. e) Yes. By educational level, the percentage of women who read a newspaper at least once a week ranges from a low of 0.2% among those with no education to a high of 14.0% among those with a secondary education or higher. f) Yes. By wealth quintile, the percentage of women who watch television at least once a week increases as wealth increases: 15.5% of women in the lowest wealth quintile watch television at least once a week, compared with 84.6% of women in the highest wealth quintile. xxviii • Reading and Understanding Tables from the 2022 GDHS Example 2: Children with symptoms of ARI and care seeking for symptoms of ARI A Question Asked of a Subgroup of Survey Respondents Table 10.6 Children with symptoms of ARI and care seeking for symptoms of ARI Among children under age 5, percentage who had symptoms of acute respiratory infection (ARI) in the 2 weeks preceding the survey, and among children with symptoms of ARI in the 2 weeks preceding the survey, percentage for whom advice or treatment was sought, according to background characteristics, Ghana DHS 2022 Among children under age 5: Among children under age 5 with symptoms of ARI: Background characteristic Percentage with symptoms of ARI1 Number of children Percentage for whom advice or treatment was sought2 Percentage for whom advice or treatment was sought the same or next day2 Number of children Age in months <6 1.4 850 * * 12 6–11 1.6 868 * * 14 12–23 2.8 1,823 61.6 28.2 50 24–35 2.6 1,546 64.4 20.1 40 36–47 1.9 1,632 (46.0) (25.4) 31 48–59 2.1 1,596 (37.9) (10.7) 34 Sex Male 2.4 4,240 58.2 20.3 100 Female 2.0 4,075 48.9 22.8 81 Mother’s smoking status Smokes cigarettes/tobacco 1.5 78 * * 1 Does not smoke 2.2 8,237 53.8 21.5 180 Cooking fuels and technologies Clean fuel and technology3 1.4 1,774 * * 25 Solid fuel4 2.4 6,522 57.5 23.0 156 No food cooked in household * 18 * * 0 Residence Urban 1.5 4,048 44.6 19.5 62 Rural 2.8 4,267 59.0 22.4 119 Region Western 1.9 515 * * 10 Central 3.1 841 * * 26 Greater Accra 0.9 1,057 * * 9 Volta 4.5 313 * * 14 Eastern 1.0 611 * * 6 Ashanti 1.4 1,495 * * 21 Western North 2.0 222 * * 5 Ahafo 3.4 186 * * 6 Bono 1.0 277 * * 3 Bono East 2.7 437 * * 12 Oti 1.7 276 * * 5 Northern 4.1 923 (70.8) (22.4) 38 Savannah 2.4 247 * * 6 North East 5.3 267 (54.7) (15.9) 14 Upper East 1.3 406 * * 5 Upper West 0.7 242 * * 2 Mother’s education No education 3.6 1,922 60.2 22.5 69 Primary 2.6 1,250 (56.5) (30.3) 33 Secondary 1.7 4,348 44.6 16.0 74 More than secondary 0.7 794 * * 5 Wealth quintile Lowest 3.1 1,966 60.8 20.1 62 Second 3.0 1,690 66.8 30.7 50 Middle 1.2 1,614 * * 19 Fourth 2.1 1,584 (38.7) (15.9) 33 Highest 1.2 1,460 * * 17 Total 2.2 8,315 54.1 21.4 181 Note: Figures in parentheses are based on 25–49 unweighted cases. An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. NGO = nongovernmental organisation 1 Symptoms of ARI include short, rapid breathing that is chest-related and/or difficult breathing that is chest-related. 2 Includes advice or treatment from the following sources: public sector, private medical sector, NGO medical sector, shop, market, and medicines peddler. Excludes advice or treatment from a traditional practitioner. 3 Includes stoves/cookers using electricity, liquefied petroleum gas (LPG)/natural gas/biogas, solar, and alcohol/ethanol 4 Includes coal/lignite, charcoal, wood, straw/shrubs/grass, agricultural crops, animal dung/waste, processed biomass (pellets) or woodchips, garbage/plastic, and sawdust 1 2 3 4 a b Reading and Understanding Tables from the 2022 GDHS • xxix Step 1: Read the title and subtitle. In this case, the table is about two separate groups of children: all children under age 5 (a) and children under age 5 with symptoms of acute respiratory infection (ARI) in the 2 weeks before the survey (b). Step 2: Identify the two panels. First, identify the columns that refer to all children under age 5 (a), and then isolate the columns that refer only to children under age 5 with symptoms of ARI in the 2 weeks before the survey (b). Step 3: Look at the first panel. What percentage of children under age 5 had symptoms of ARI in the 2 weeks before the survey? It is 2.2%. Now look at the second panel. How many children under age 5 had symptoms of ARI in the 2 weeks before the survey? It’s 181, or 2.2% of the 8,315 children under age 5 (with rounding). The second panel is a subset of the first panel. Step 4: Only 2.2% of children under age 5 had symptoms of ARI in the 2 weeks before the survey. Once these children are further divided into the background characteristic categories, there may be too few cases for the percentages to be reliable.  What percentage of children under age 5 with symptoms of ARI in the 2 weeks before the survey from Northern were taken for advice or treatment? 70.8%. This percentage is in parentheses because there are between 25 and 49 children (unweighted) in this category. Readers should use this number with caution—it may not be reliable. (For more information on weighted and unweighted numbers, see Example 3.)  What percentage of children under age 5 with symptoms of ARI in the 2 weeks before the survey whose mothers have a secondary education or higher were taken for advice or treatment? There is no number in this cell—only an asterisk. This is because there are fewer than 25 unweighted cases. Results for this group are not reported. The subgroup is too small, and therefore the data are not reliable. Note: When parentheses or asterisks are used in a table, the explanation will be noted under the table. If there are no parentheses or asterisks in a table, you can proceed with confidence that enough cases were included in all categories that the data are reliable. xxx • Reading and Understanding Tables from the 2022 GDHS Example 3: Understanding Sampling Weights in GDHS Tables A sample is a group of people who have been selected for a survey. In the GDHS, the sample is designed to represent the national population age 15–49. In addition to national data, most countries want to collect and report data on smaller geographical or administrative areas. However, doing so requires a large enough sample size in each area. For the 2022 GDHS, the survey sample is representative at the national and regional levels and for urban and rural areas. To generate statistics that are representative of the country as a whole and the 16 regions, the number of women surveyed in each region should contribute to the size of the total (national) sample in proportion to size of the region. However, if some regions have small populations, then a sample allocated in proportion to each region’s population may not include sufficient women from each region for analysis. To solve this problem, regions with small populations are oversampled. For example, let’s say that you have enough money to interview 15,014 women and want to produce results that are representative of Ghana as a whole and its regions (as in Table 3.1). However, the total population of Ghana is not evenly distributed among the regions: some regions, such as Ashanti, are heavily populated while others, such as North East, are not. Thus, North East must be oversampled. A sampling statistician determines how many women should be interviewed in each region in order to get reliable statistics. The blue column (1) in the table above shows the actual number of women interviewed in each region. Within the regions, the number of women interviewed ranges from 792 in Western North to 1,169 in Northern. The number of interviews is sufficient to get reliable results in each region. With this distribution of interviews, some regions are overrepresented and some regions are underrepresented. For example, the population in Ashanti is 19.5% of the population in Ghana, while North East’s population contributes only 1.9% of the country’s population. But as the blue column shows, the number of women interviewed in Ashanti accounts for only about 7.5% of the total sample of women interviewed (1,131/15,014) and the number of women interviewed in North East accounts for 6.4% of the total sample of women interviewed (963/15,014). This unweighted distribution of women does not accurately represent the population. In order to get statistics that are representative of Ghana, the distribution of the women in the sample needs to be weighted (or mathematically adjusted) such that it resembles the true distribution in the country. Women from a small region, like North East, should contribute only a small amount to the national total. Women from a large region, like Ashanti, should contribute much more. Therefore, DHS statisticians mathematically calculate a “weight” that is used to adjust the number of women from each region so that each region’s contribution to the total is proportional to the actual population of the region. The numbers in the purple column (2) represent the “weighted” values. The weighted values can be smaller or larger than the unweighted values at the regional level. The total national sample size of 15,014 women has not changed after weighting, but the distribution of the women in the regions has been changed to represent their contribution to the total population size. How do statisticians weight each category? They take into account the probability that a woman was selected in the sample. If you were to compare the green column (3) to the actual population distribution of Ghana, you would see that women in each region are contributing to the total sample with the same Table 3.1 Background characteristics of respondents Percent distribution of women age 15–49 by selected background characteristics, Ghana DHS 2022 Women Background characteristic Weighted percent Weighted number Unweighted number Region Western 6.4 955 797 Central 11.3 1,703 979 Greater Accra 15.5 2,327 969 Volta 4.7 713 837 Eastern 8.1 1,220 854 Ashanti 19.5 2,928 1,131 Western North 2.7 411 792 Ahafo 2.1 317 849 Bono 3.8 567 835 Bono East 4.5 676 974 Oti 2.7 403 921 Northern 7.7 1,149 1,169 Savannah 2.1 319 999 North East 1.9 290 963 Upper East 4.3 640 987 Upper West 2.7 398 958 Total 15–49 100.0 15,014 15,014 1 2 3 Reading and Understanding Tables from the 2022 GDHS • xxxi weight that they contribute to the population of the country. The weighted number of women in the survey now accurately represents the proportion of women who live in Ashanti and the proportion of women who live in North East. With sampling and weighting, it is possible to interview enough women to provide reliable statistics at national and regional levels. In general, only the weighted numbers are shown in each of the GDHS tables, so don’t be surprised if these numbers seem low: they may actually represent a larger number of women interviewed. Sustainable Development Goal Indicators • xxxiii SUSTAINABLE DEVELOPMENT GOAL INDICATORS Sustainable Development Goal Indicators, Ghana DHS 2022 Residence Total DHS table number Indicator Urban Rural 1. No poverty 1.4.1 Proportion of population living in households with access to basic services a) Access to basic drinking water services 94.9 71.6 83.8 16.2 b) Access to basic sanitation services 33.5 14.2 24.3 16.7 c) Access to basic hygiene services 52.8 33.3 43.5 16.11 d) Access to electricity1 94.6 68.1 82.0 2.3 e) Access to clean fuels and technologies2 37.8 7.9 23.6 2.4 Sex 2. Zero hunger Male Female Total 2.2.1 Prevalence of stunting among children under 5 years of age 19.4 15.3 17.4 11.1 2.2.2 Prevalence of malnutrition among children under 5 years of age 8.7 7.1 7.9 11.1 a) Prevalence of wasting among children under 5 years of age 6.7 5.2 6.0 11.1 b) Prevalence of overweight among children under 5 years of age 2.0 1.9 2.0 11.1 2.2.3 Prevalence of anaemia in women age 15 to 49 years, by pregnancy status a) Prevalence of anaemia in non-pregnant women age 15 to 49 years na 40.4 na 11.17.1 b) Prevalence of anaemia in pregnant women age 15 to 49 years na 51.4 na 11.17.1 3. Good health and well-being 3.1.2 Proportion of births attended by skilled health personnel na na 87.6 9.9 3.2.1 Under-5 mortality rate3 43.0 36.0 40.0 8.1 and 8.2 3.2.2 Neonatal mortality rate3 20.0 14.0 17.0 8.1 and 8.2 3.7.1 Proportion of women of reproductive age (aged 15–49 years) who have their need for family planning satisfied with modern methods na 49.5 na 7.15.2 3.7.2 Adolescent birth rates per 1,000 women na na na a) Girls aged 10–14 years4 na 2.0 na 5.1 b) Women aged 15–19 years5 na 63.0 na 5.1 3.a.1 Age-standardized prevalence of current tobacco use among persons aged 15 years and older6 5.3 1.0 3.2a 3.12 3.b.1 Proportion of the target population covered by all vaccines included in their national programme a) Coverage of DPT containing vaccine (3rd dose)7 89.8 88.2 89.0 10.4 b) Coverage of measles containing vaccine (2nd dose)8 74.6 70.4 72.5 10.4 c) Coverage of pneumococcal conjugate vaccine (last dose in schedule)9 90.0 86.4 88.2 10.4 4. Quality education 4.2.1 Participation rate in organized learning (one year before the official primary entry age) 89.0 87.8 88.4 2.13 5. Gender equality 5.2.1 Proportion of ever-partnered women and girls aged 15 years and older subjected to physical, sexual or psychological violence by a current or former intimate partner in the previous 12 months10,11 a) Physical violence na 9.8 na 17.13 b) Sexual violence na 6.1 na 17.13 c) Psychological violence na 25.5 na 17.13 5.3.1 Proportion of women aged 20–24 years who were married or in a union before age 15 and before age 18 na na na a) before age 15 na 3.3 na 4.4 b) before age 18 2.4 16.1 na 4.4 5.6.1 Proportion of women aged 15–49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care12 na 51.7 na 15.12 5.b.1 Proportion of individuals who own a mobile telephone13 87.5 79.6 83.6a 15.6.1 and 15.6.2 Residence 6. Clean water and sanitation Urban Rural Total 6.1.1 Proportion of population using safely managed drinking water services a) Proportion with basic drinking water services 94.9 71.6 83.8 16.2 b) Proportion with water available when needed 80.2 81.7 80.9 16.4 6.2.1 Proportion of population using (a) safely managed sanitation services and (b) hand-washing facility with soap and water a) Proportion using basic sanitation service 33.5 14.2 24.3 16.7 b) Proportion in which excreta are safely disposed of in situ or treated off site 73.2 42.2 58.4 16.9 c) Proportion using a hand-washing facility with soap and water 52.8 33.3 43.5 16.11 d) Proportion using open defecation 11.7 38.8 24.6 16.6 Continued. xxxiv • Sustainable Development Goal Indicators Sustainable Development Goal Indicators—Continued Sex DHS table number 7. Partnerships for the goals Male Female Total 7.1.1 Proportion of individuals using the internet14 61.6 43.3 54.5a 3.5.1 and 3.5.2 na = not applicable 1 Persons living in households that report the primary source of lighting is electricity 2 Persons living in households that report no cooking, no space heating, or no lighting are not excluded from the numerator. 3 Expressed in term of deaths per 1,000 live births in the 5 years before the survey 4 Equivalent to the age-specific fertility rate for girls age 10–14 for the 3-year period preceding the survey, expressed in terms of births per 1,000 girls age 10–14 5 Equivalent to the age-specific fertility rate for women age 15–19 for the 3-year period preceding the survey, expressed in terms of births per 1,000 women age 15–19 6 Data are not age-standardized and are available for women and men age 15–49 only. 7 The percentage of children age 12–23 months who received three doses of DPT-HepB-Hib vaccine 8 The percentage of children age 24–35 months who received two doses of measles-rubella vaccine 9 The percentage of children age 12–23 months who received three doses of pneumococcal vaccine 10 Data are available for women age 15–49 who have ever been in union only. 11 In the DHS, psychological violence is termed emotional violence. 12 Data are available for currently married women only. 13 Data are available for women and men age 15–49 only. 14 Data are available for women and men age 15–49 who have used the internet in the last 12 months. a The total is calculated as the simple arithmetic mean of the percentages in the columns for males and females. xxxvi • Map of Ghana Introduction and Survey Methodology • 1 INTRODUCTION AND SURVEY METHODOLOGY 1 he 2022 Ghana Demographic and Health Survey (GDHS) was implemented by the Ghana Statistical Service (GSS). Data collection took place from 17 October 2022 to 14 January 2023. ICF provided technical assistance through The Demographic and Health Surveys (DHS) Program, which is funded by the United States Agency for International Development (USAID) and the U.S. President’s Malaria Initiative (PMI) and offers financial support and technical assistance for population and health surveys in countries worldwide. Other agencies and organisations that facilitated the successful implementation of the survey through technical or financial support were the Government of Ghana; the United Nations Population Fund (UNFPA); the United Nations Children’s Fund (UNICEF); the World Bank; the Global Fund to Fight AIDS, Tuberculosis and Malaria (the Global Fund); the Korean International Cooperation Agency (KOICA); the World Health Organization (WHO); and the Foreign, Commonwealth and Development Office (UK/FCDO). 1.1 SURVEY OBJECTIVES The primary objective of the 2022 GDHS is to provide up-to-date estimates of basic demographic and health indicators. Specifically, the GDHS collected information on:  Fertility levels and preferences, contraceptive use, antenatal and delivery care, maternal and child health, childhood mortality, childhood immunisation, breastfeeding and young child feeding practices, women’s dietary diversity, violence against women, gender, nutritional status of adults and children, awareness regarding HIV/AIDS and other sexually transmitted infections, tobacco use, and other indicators relevant for the Sustainable Development Goals  Haemoglobin levels of women and children  Prevalence of malaria parasitaemia (rapid diagnostic testing and thick slides for malaria parasitaemia in the field and microscopy in the lab) among children age 6–59 months  Use of treated mosquito nets  Use of antimalarial drugs for treatment of fever among children under age 5 The information collected through the 2022 GDHS is intended to assist policymakers and programme managers in designing and evaluating programmes and strategies for improving the health of the country’s population. 1.2 SAMPLE DESIGN To achieve the objectives of the 2022 GDHS, a stratified representative sample of 18,450 households was selected in 618 clusters, which resulted in 15,014 interviewed women age 15–49 and 7,044 interviewed men age 15–59 (in one of every two households selected). The sampling frame used for the 2022 GDHS is the updated frame prepared by the GSS based on the 2021 Population and Housing Census.1 The sampling procedure used in the 2022 GDHS was stratified two-stage cluster sampling, designed to yield representative results at the national level, for urban and rural areas, and for each of the country’s 16 regions for most DHS indicators. In the first stage, 618 target clusters were selected from the sampling frame using a probability proportional to size strategy for urban and rural 1 The updated sampling frame was prepared by the GSS. T 2 • Introduction and Survey Methodology areas in each region. Then the number of targeted clusters were selected with equal probability systematic random sampling of the clusters selected in the first phase for urban and rural areas. In the second stage, after selection of the clusters, a household listing and map updating operation was carried out in all of the selected clusters to develop a list of households for each cluster. This list served as a sampling frame for selection of the household sample. The GSS organised a 5-day training course on listing procedures for listers and mappers with support from ICF. The listers and mappers were organised into 25 teams consisting of one lister and one mapper per team. The teams spent 2 months completing the listing operation. In addition to listing the households, the listers collected the geographical coordinates of each household using GPS dongles provided by ICF and in accordance with the instructions in the DHS listing manual. The household listing was carried out using tablet computers, with software provided by The DHS Program. A fixed number of 30 households in each cluster were randomly selected from the list for interviews. Prior to training, the listing manual, adequate copies of all maps, listing forms, tablet computers, and GPS dongles were made available for use by the field staff. Each team worked in an average of 24–25 clusters. The GSS provided all of the logistical arrangements for the listing staff, including planning for deployment to the various regions, distributing field supplies, and arranging for the distribution of allowances and salaries during training and fieldwork. To ensure a smooth field operation and an accurate and complete listing, four GSS personnel (three master trainers and a project coordinator) and 16 regional statisticians visited the team regularly to monitor data quality. The survey director and two deputies visited some of the teams. Data processing supervisors assigned to support the household listing on the tablets served as team backstops. When the field teams needed support from the local government, they contacted the regional officers. Upon completion of the listing operation, the GSS verified that the results were complete and accurate and entered households into the household selection spreadsheet provided by the ICF sampling specialist for automatic selection of households for the main fieldwork. The spreadsheet, together with census maps, the listing database, and maps from field staff, facilitated the identification of households to be interviewed. 1.3 QUESTIONNAIRES Four questionnaires were used in the 2022 GDHS: the Household Questionnaire, the Woman’s Questionnaire, the Man’s Questionnaire, and the Biomarker Questionnaire. The questionnaires, based on The DHS Program’s model questionnaires, were adapted to reflect the population and health issues relevant to Ghana. In addition, a self-administered Fieldworker Questionnaire collected information about the survey’s fieldworkers. The GSS organised a questionnaire design workshop with support from ICF and obtained input from government and development partners expected to use the resulting data. The DHS Program optional modules on domestic violence, malaria, and social and behaviour change communication were incorporated into the Woman’s Questionnaire. ICF provided technical assistance in adapting the modules to the questionnaires. 1.3.1 Household Questionnaire The Household Questionnaire was used to collect indicators for the household and to list all members of the household. The respondent for this questionnaire was (1) the head of the household or (2) any adult living in the household. The questionnaire collected basic information on each household member (sex, age, marital status, education, orphanhood), information on household characteristics (source of drinking water, type of toilet facility, number of rooms for sleeping, type of cooking stove, household possessions, availability of electricity, means of transportation), and information on ownership and use of mosquito nets. Salt used for cooking by the household was tested for the presence of iodine. Introduction and Survey Methodology • 3 1.3.2 Woman’s Questionnaire The Woman’s Questionnaire was used to collect information on adult women (for example, contraceptive use, antenatal care, and pregnancy history2) and on children (for example, child health, vaccination coverage, breastfeeding, and infant and young child feeding practices). All women age 15–49 identified as household residents or as visitors who stayed in the household the night before the survey were interviewed. Because of the sensitivity of some questions, only female interviewers administered the Woman’s Questionnaire. Women were asked questions on the following topics:  Background characteristics (including age, education, and access to media)  Reproduction (including pregnancy history and number of children)  Family planning (including knowledge and use of contraception and sources of contraceptive methods)  Maternal and newborn health care, child immunisation, and child health and nutrition  Marriage and sexual activity  Fertility preferences  Husbands’ background characteristics and women’s work  HIV/AIDS and other sexually transmitted infections  Other health issues (including alcohol consumption and smoking)  Domestic violence 1.3.3 Man’s Questionnaire The Man’s Questionnaire collected much of the same information as the Woman’s Questionnaire but was shorter because it did not contain a detailed reproductive history or questions on maternal and child health. 1.3.4 Biomarker Questionnaire The Biomarker Questionnaire was used to record anthropometric measurements and the results of anaemia and malaria testing. In 50% of households, all children under age 5, all eligible women age 15–49, and all eligible men age 15–59 were weighed and measured to assess their nutritional status. A blood test was performed with eligible children age 6–59 months and eligible women age 15–49 to estimate the prevalence of anaemia. Children age 6–59 months were eligible for malaria testing with rapid diagnostic tests (RDTs) and slide preparation for laboratory microscopy. Informed consent and test outcomes were recorded in the questionnaire. 1.3.5 Fieldworker Questionnaire The Fieldworker Questionnaire was used to collect background information on the persons collecting data in the field, including team supervisors, interviewers, and biomarker technicians. 1.3.6 Finalisation of the Questionnaires ICF’s data processing specialist checked all questionnaires for internal coherence. The English versions of the questionnaires were translated into four local languages: Twi, Ga, Dagbeni, and Ewe. Back translations into English were done by people other than the initial translators to verify the accuracy of the translations. 2 The pregnancy history provided information for calculation of infant and child mortality. It was also used to calculate fertility rates. 4 • Introduction and Survey Methodology All problems arising in the translations were resolved before the scheduled training of trainers and the pretest. After finalisation of the questionnaires, ICF staff in collaboration with GSS staff developed the interviewer and supervisor/editor manuals and fieldwork control forms to be used to track the progress of the survey. The manuals provided instructions to the interviewers and supervisors/editors on how to do their jobs, explained the purpose behind various questions and sections of the questionnaires, and assisted the trainers in conducting the pretest and main survey training. The GSS submitted the survey protocol to the Ethical Review Committee (ERC) of the Ghana Health Service to ensure that the survey procedures were in accordance with Ghana’s ethical research standards. The ERC granted ethical clearance for the survey. ICF submitted the GDHS survey protocol to the ICF Institutional Review Board (IRB) to obtain ethical clearance and ensure that the survey procedures were in accordance with U.S. and international ethical research standards. The IRB provided ethical clearance for the survey. Tablet computers were used for data collection by the fieldworkers. The tablet computers were equipped with Bluetooth® technology to enable remote electronic transfer of files, such as assignments from the team supervisor to the interviewers, individual questionnaires to survey team members, and completed questionnaires from interviewers to team supervisors. The computer-assisted personal interviewing (CAPI) data collection system used in the GDHS was developed by The DHS Program with the mobile version of CSPro. The CSPro software was developed jointly by the U.S. Census Bureau, Serpro S.A., and The DHS Program. 1.4 ANTHROPOMETRY, ANAEMIA TESTING, AND MALARIA TESTING The 2022 GDHS biomarkers included anthropometric measurements, anaemia testing, and malaria testing. Biomarker data were collected in half of the households selected for the men’s survey. Anthropometry: Height and weight measurements were carried out for eligible women age 15–49 and children age 0–59 months. Similarly, anaemia testing was carried out for eligible women age 15–49, men age 15–59, and children age 6–59 months. Weight measurements were taken using SECA 874U scales with a digital display. Height was measured using a ShorrBoard® measuring board. Children younger than age 24 months were measured lying down (recumbent length), while older children and adults were measured standing (height). To assess the precision of measurements, one child per cluster was randomly selected to be measured a second time. The DHS Program defines a difference of less than 1 centimetre between the two height measurements as an acceptable level of precision. Children with a z score of less than −3 or more than 3 for height-for-age, weight-for-height, or weight-for-age were flagged and measured a second time. The remeasurement of flagged cases was performed to ensure accurate reporting of height. Following remeasurement, parents of children identified as having severe acute malnutrition (a weight-for-height z score of less than −3) were provided a referral form and instructed to take the child to a local health facility. Anaemia: Blood specimens for anaemia testing were collected from women age 15–49 who consented to be tested. Blood specimens were also collected from children age 6–59 months whose parents or guardians had given consent to the testing. Blood samples were drawn from a drop of blood taken from a finger prick (or a heel prick in the case of children age 6–11 months) and collected in a microcuvette. Haemoglobin analysis was carried out on-site using a battery-operated portable HemoCue® 201+ device. Results were provided verbally and in writing. Parents or guardians of children with a haemoglobin level below 8 g/dl Introduction and Survey Methodology • 5 were provided with a referral and instructed to take the child to a health facility for follow-up care. Likewise, adults were referred for follow-up care if their haemoglobin level was below 8 g/dl. Malaria: Children age 6–59 months were tested for malaria using Abbott Bioline, a rapid diagnostic test. Testing was performed using 5 µl of blood from the same finger or heel prick used for anaemia testing. Results were available in 15 minutes and given to the child’s parent/responsible adult. Children who tested positive for malaria by RDT were referred to a health facility or offered a full course of treatment if they fulfilled the following conditions: they were not severely anaemic, they had no other symptom of severe malaria, they had not been on any treatment for malaria in the last 2 weeks, and their parent/responsible adult accepted the medication. All treatment was administered according to Ghana’s national malaria treatment guidelines. A blood sample was also collected on a microscope slide and used to prepare thick blood smears in the field. All of the blood smears were sent to the National Public Health and Reference Laboratory (NPHRL) in Accra. Using the Malaria Data Entry and Testing System (MADETS), 10% of the smears were randomly selected and sent to the Noguchi Memorial Institute for Medical Research (NMIMR) for external quality control. 1.5 TRAINING OF TRAINERS AND PRETEST Twenty-seven individuals (17 supervisors/interviewers and 10 biomarker technicians) took part in the pretest training for the 2022 GDHS over a 4-week period from 27 June to 21 July 2022. The first 2 weeks featured classroom training focused on questionnaire content. Participants initially practised using paper questionnaires, and then they were trained on the CAPI system from 11–19 July 2022. Staff from The DHS Program and consultants co-facilitated the training with GSS personnel. The training consisted of classroom lectures and discussions, mock interviews, and interview practice in English and in local languages. Tests and quizzes were given throughout the training to monitor progress and identify gaps in understanding. Four guest lecturers gave presentations on mosquito net programmes and malaria treatment, family planning methods, immunisation, and HIV/AIDS. Biomarker technician training was held 4–19 July 2022. Ten participants (six female and four male) and two biomarker coordinators (both male) were trained on the paper Biomarker Questionnaire and on biomarker collection procedures. The training utilised a variety of learning tools such as formal lectures on the technical aspects of biomarker collection, instruction on how to fill out the questionnaires, informal discussions using case scenarios, videos to demonstrate the process of biomarker collection, demonstrations using adults, and hands-on practice with children and adults. In addition to the training, the biomarker technicians participated in anthropometry standardisation exercises on 13 July (with adults) and 14 July (with children). On 16 July 2022, children and mothers came to the venue and biomarker technicians practised the entire biomarker collection procedure from start to finish. After the practice there was group discussion, and feedback was provided to the technicians. In addition, interviewers and biomarker technicians conducted field practice to solidify the skills learned during the pretest training and to provide a simulated fieldwork experience to test the survey materials. Four teams composed of one supervisor, two female interviewers, one male interviewer, and two biomarker technicians practised data collection in three local communities in both urban and rural areas. Each team was assigned a cluster, returning to that same cluster each day. Teams were expected to complete interviews with 16 households, half of which were selected for the Man’s Questionnaire and biomarkers. Feedback was provided to individuals and teams during this exercise and during the daily debriefs. 1.6 TRAINING OF FIELD STAFF The 2022 GDHS training was sequential, beginning with questionnaire training followed by CAPI training. Questionnaire training was initiated on 11 September 2022 and completed on 24 September. A total of 168 candidates participated in the main survey training: 42 team supervisors (31 male and 11 female), 84 6 • Introduction and Survey Methodology female interviewers, and 42 male interviewers. A larger number of participants than needed was recruited and trained, enabling the GSS to select the best candidates at the end of the training and keep the others as backup fieldworkers. All candidates participated in the questionnaire training. Twenty-seven GSS trainers/coordinators and a DHS staff person conducted the training. The participants were recruited from regions across the country and were required to speak at least one of the five languages used in the 2022 GDHS interviews. The training was conducted in English and focused on the four main questionnaires (Household Questionnaire, Woman’s Questionnaire, Man’s Questionnaire, and Biomarker Questionnaire). The training included practice in local languages other than English along with discussions of the different sections and modules of the questionnaires, mock interviews, role plays, group work, presentations, and in-class practice sessions. The training also included training on selection of different subsamples and on the eligibility criteria for different survey components and modules. A design diagram and several examples were used to demonstrate how households are selected and how eligible respondents are identified. In addition, examples were provided on how to record correct information during data collection. Mock interviews were organised at the end of the training. Each trainee completed three Household Questionnaires and three individual questionnaires. Data collected during the practice exercises were used in later training sessions to test the CAPI programmes and to practise collecting data on the tablets. Guest lecturers from the Ghana Health Service (GHS), the Ghana AIDS Commission, the National Malaria Control Programme and U.S. President’s Malaria Initiative (PMI) visited the training sessions and conducted presentations. 1.6.1 Computer-assisted Personal Interviewing (CAPI) Training From 20 to 24 September 2022, DHS staff conducted a training of trainers for 12 GSS and GHS coordinator/trainers (eight male and four female). Nine of the trainers had attended the pretest training in July 2022. The training was aimed at providing trainers with the competencies necessary to assist the DHS staff in the main CAPI training and equipping them with the skills to monitor and resolve issues during the main fieldwork. Topics included understanding the sampling design and subsamples, the 2022 GDHS directory structure, the key application files, an overview of interviewers’ and supervisors’ menus and applications, and the utilities required for data preparation and transfers. For practice purposes, the 12 trainers were grouped in two field teams (four persons per team). Each team practised in a cluster of six households. At the end of the training, trainers were divided into three groups, with each group responsible for training one of the three classrooms. DHS and GSS staff prepared a schedule for the three groups of trainers. DHS staff and the GSS trainers conducted the CAPI training from 26 September to 7 October. A total of 168 participants were organised into 42 teams of four (one supervisor, two female interviewers, and one male interviewer) divided into three classrooms. Training focused on a series of presentations on the CAPI system, tablet basics, interviewer menus, supervisor menus, household assignments, data transfers, the Biomarker Questionnaire, selection of children for remeasurement, and troubleshooting error and warning messages. During in-classroom practice sessions, hypothetical clusters were created. Each cluster had six households and was assigned to a team. Under the supervision of DHS staff, the trainers led these sessions and made several presentations on topics such as data collection system features, different scenarios and potential technical issues that might encountered during fieldwork, and ways of resolving these issues. By the end of the training, all teams were able to successfully close many of their clusters, and supervisors had learned how to use an internet connection to access SyncCloud for the purposes of sending data to the central office and receiving updates to the CAPI system. Introduction and Survey Methodology • 7 1.6.2 Anthropometry Training The 2022 GDHS included the following biomarkers: anthropometry, anaemia testing, malaria rapid diagnostic testing, and thick smear preparation for malaria microscopy. During the pretest, 10 biomarker technicians were recruited to be trainers for this component. In this main training, 77 biomarker trainees (40 male and 37 female) joined the biomarker training. Biomarker training was led by a DHS staff person and supported by two consultants. The 10 biomarker technicians who successfully participated in the pretest were the biomarker trainers in breakout sessions during classroom practice and during the 3-day field practice when they monitored biomarker collection. The training started on 19 September 2022 and ended on 14 October with the conclusion of field practice, debriefing, and distribution of biomarker supplies to the various teams. Following a general introduction to the survey, participants were given an overview of the biomarkers to be collected in the 2022 GDHS. This was followed by an exhaustive 2 days of training on the Biomarker Questionnaire and related documents, including the informational pamphlet, severe anaemia and malaria referral forms, and wasting referral form. The training on the Biomarker Questionnaire and the collection of blood to test for malaria and anaemia and prepare thick blood smears included:  Lectures on the technical components  Videos illustrating the protocol and hands-on practice sessions focusing on respondent eligibility criteria and obtaining informed consent from parents or responsible adults to conduct anaemia and malaria testing with eligible children  Procedures for recording data in the Biomarker Questionnaire and reporting forms  Proper blood collection procedures  Details on anaemia and malaria testing, including appropriate reporting of test results  Procedures for filling out field forms In each session ICF staff and other trainers used the integrated training approach, which included presentations and discussions of technical content from the biomarker manual and hands-on practical demonstrations followed by hands-on practice by participants. Over 200 children were brought to the training venue by their parents or guardians during class training. The in-class training included practice on testing children who were brought to the training venue. In addition to in-class training, participants visited communities and clinics where they practised the biomarker test protocol with eligible children whose parents or guardians consented to anaemia and malaria testing. Training on anthropometry included measurement of the weight and height of children using SECA 874U scales with a digital display and ShorrBoard® measuring boards. Biomarker technicians received anthropometry training during 6 days of classroom practice, 2 days of community and clinic visits, and 3 days of field practice. Before starting field practice, eight anthropometry standardisation exercises and one restandardisation exercise were conducted. All 77 biomarker technicians were standardised as measurers. For each standardisation exercise, 10 stations were laid out. The stations were assigned numbers from one to 10, and children’s numbers corresponded to the number of the station to which they were assigned. Depending on their age, children were measured standing or lying down. The height/length of each child was measured by DHS staff twice. Thereafter, each pair (measurer and assistant) measured every child once and recorded the measured values in the standardisation form designed for that purpose. This first round of measurements was collected by the DHS trainers, after which a second form was given and the 8 • Introduction and Survey Methodology measurements were repeated for every child. Results of the first and second rounds of measurements by both the trainers and trainees were entered into an Excel sheet and evaluated for accuracy and precision. Accuracy was evaluated by comparing the average value of each trainee’s measurement with that of the DHS staff. Precision was determined by comparing the difference between each participant’s first and second measurements of the same child. A technical error of measurement was used to determine whether a trainee passed the standardisation exercise. All 77 technicians who took part in the standardisation exercise passed during their first or second attempt. On 13 October 2022, in a joint session of interviewers and biomarker technicians, there was a discussion of the measures The DHS Program has taken to improve data quality, including remeasurement procedures in anthropometry and use of checklists to monitor data collection for anthropometry, anaemia, and malaria testing. 1.6.3 Fieldwork Practice Fieldwork practice was implemented from 12–14 October 2022 after the classroom training and on-site practice. The fieldwork exercise allowed the participants to practise the functionality of the CAPI system and the biomarkers. Each team was assigned a cluster of 20 households. These clusters were selected from actual 2021 Ghana Housing and Population Census (GHPC) enumeration areas (EAs). Fieldwork practice is helpful as it allows teams to proceed through the entire process, from household assignment to closing a cluster successfully and working through the most common error messages that can prevent closing a cluster. Together, these are the most important aspects of fieldwork practice, and they were accomplished by all of the teams. Data from the 42 clusters were sent to the central office via SyncCloud. 1.7 FIELDWORK The main fieldwork for the 2022 GDHS took place between 17 October 2022 and 14 January 2023. There were 37 teams, each including a team supervisor, two female interviewers, one male interviewer, and two biomarker technicians. The GSS coordinators created a WhatsApp group for all fieldworkers to post questions and issues that arose during data collection. For quality assurance, field monitoring was conducted throughout the period of data collection. DHS staff participated in fieldwork monitoring in the Accra, Central, Western, and Northern regions during the first 2 weeks. They continued to monitor field data collection via SyncCloud toward the end of fieldwork. Data were transmitted by every team to the central office daily, and field check tables were always available for review by DHS staff in SyncCloud. DHS staff reviewed the field check tables periodically, communicated their observations with the GSS coordinators to evaluate data quality and the performance of each team, and explained how to improve the quality of fieldwork. 1.8 DATA PROCESSING 1.8.1 Central Office Training and Secondary Editing DHS staff installed all central office programmes, data structure checks, secondary editing, and field check tables from 17–20 October 2022. Central office training was implemented using the practice data to test the central office system and field check tables. Seven GSS staff members (four male and three female) were trained on the functionality of the central office menu, including accepting clusters from the field, data editing procedures, and producing reports to monitor fieldwork. 1.8.2 Data Cleaning and Finalisation From 27 February to 17 March, DHS staff visited the Ghana Statistical Service office in Accra to work with the GSS central office staff on finishing the secondary editing and to clean and finalise all data received from the 618 clusters. Introduction and Survey Methodology • 9 1.8.3 Malaria Microscopy The National Public Health and Reference Laboratory received blood slides from the field and started malaria microscopy reading at the beginning of the third week of fieldwork. Ten percent of the blood slides were randomly selected and subsequently sent to Noguchi Laboratory for the external quality control checks. Microscopy at NPHRL was completed on 6 February 2023, and external quality control procedures at Noguchi Laboratory were completed on 20 February. 1.9 RESPONSE RATES Table 1.1 shows the response rates for the 2022 GDHS. A total of 18,540 households were selected for the GDHS sample, of which 18,065 were found to be occupied. Of the occupied households, 17,933 were successfully interviewed, yielding a response rate of 99%. In the interviewed households, 15,317 women age 15–49 were identified as eligible for individual interviews. Interviews were completed with 15,014 women, yielding a response rate of 98%. In the subsample of households selected for the male survey, 7,263 men age 15–59 were identified as eligible for individual interviews and 7,044 were successfully interviewed. Table 1.1 Results of the household and individual interviews Number of households, number of interviews, and response rates, according to residence (unweighted), Ghana DHS 2022 Residence Total Result Urban Rural Household interviews Households selected 9,120 9,420 18,540 Households occupied 8,869 9,196 18,065 Households interviewed 8,795 9,138 17,933 Household response rate1 99.2 99.4 99.3 Interviews with women age 15–49 Number of eligible women 7,502 7,815 15,317 Number of eligible women interviewed 7,362 7,652 15,014 Eligible women response rate2 98.1 97.9 98.0 Household interviews in subsample Households selected 4,560 4,709 9,269 Households occupied 4,442 4,595 9,037 Households interviewed 4,400 4,568 8,968 Household response rate in subsample1 99.1 99.4 99.2 Interviews with men age 15–59 Number of eligible men 3,369 3,894 7,263 Number of eligible men interviewed 3,251 3,793 7,044 Eligible men response rate2 96.5 97.4 97.0 1 Households interviewed/households occupied 2 Respondents interviewed/eligible respondents Housing Characteristics and Household Population • 11 HOUSING CHARACTERISTICS AND HOUSEHOLD POPULATION 2 Key Findings ▪ Electricity: 85% of households have electricity. ▪ Clean fuels and technologies: 29% of households use clean fuels and technologies for cooking. ▪ Household composition: 40% of the household population is under age 15. ▪ Birth registration: 75% of children under age 5 had their births registered. ▪ Early childhood education: 67% of children age 5 (1 year younger than the official primary school entry age) attend an early childhood education programme, and 21% attend primary school. nformation on the socioeconomic characteristics of the household population in the 2022 GDHS provides a context for interpreting demographic and health indicators and furnishes an approximate indication of the representativeness of the survey. The information also sheds light on the living conditions of the population. This chapter presents information on housing characteristics and household possessions, use of clean fuels and technologies (related to cooking, heating, and lighting), wealth, household population and composition, children’s living arrangements and orphanhood, birth registration, educational attainment, and school attendance. 2.1 HOUSING CHARACTERISTICS The survey collected data on access to electricity, flooring materials, number of rooms used for sleeping, and frequency of smoking in the home. Overall, 85% of households in Ghana have electricity. The most common flooring materials are cement (61% of households) and ceramic tiles (17% of households). More than half of households have only one room for sleeping (55%); 27% have two rooms and 19% have three or more rooms. In 6% of households, someone smokes inside the house on a daily basis, and in 5% of households someone smokes inside on a weekly basis (Table 2.1). I 12 • Housing Characteristics and Household Population 2.1.1 Use of Clean Fuels and Technologies Primary reliance on clean fuels and technologies The percentage of the population using clean fuels and technologies for cooking, heating, and lighting, where each component is defined as follows: Clean cooking fuels and technologies Includes stoves/cookers using electricity, liquefied petroleum gas (LPG)/natural gas/biogas, solar, and alcohol/ethanol Clean heating fuels and technologies Includes central heating, electricity, LPG/natural gas/biogas, solar air heaters, and alcohol/ethanol Clean lighting fuels and technologies Includes electricity, solar lanterns, battery-powered or rechargeable flashlights/torches/lanterns, and biogas lamps Sample: Households and de jure population 2.1.2 Cooking Cooking is one of the major activities of most households. It contributes to energy consumption and, depending on the fuel type and cooking technology used, places the household at risk of exposure to smoke and injury due to accidental fire. In Ghana, 31% of households cook inside the home, 21% in a separate building, and 43% outdoors (in the open). Twenty-nine percent of Ghanaian households use clean fuels and technologies for cooking, primarily LPG/natural gas stoves (28%). Among households that rely on other fuels and technologies, the most common technologies are three-stone stoves/open fires (35%) and traditional solid fuel stoves (26%). The most common traditional solid fuel stoves used are stoves without chimneys (22%) (Table 2.2). 2.1.3 Heating and Lighting In Ghana, space heating is uncommon among households; only 3% of households use one or more forms of heating technologies. Charcoal and wood are the most common fuels (2%) used for space heating (Table 2.3). Ninety-nine percent of households use clean fuels and technologies for lighting; electricity is the most common clean fuel/technology used for lighting (84%). 2.1.4 Primary Reliance on Clean Fuels and Technologies Twenty-three percent of the household population primarily relies on clean fuels and technologies for cooking, while 77% primarily relies on solid fuels. Use of solid fuels is predominant (93%) in the rural household population (Table 2.4). 2.2 HOUSEHOLD WEALTH 2.2.1 Household Durable Goods Possession of household durable goods is a useful indicator of household socioeconomic status. Ninety- four percent of households own a mobile phone, 53% own a radio, and 66% own a television. Forty-two percent of households own a refrigerator, with the percentage being more than twice as high in urban households as in rural households (56% versus 22%). Bicycles are the most commonly owned means of transport among Ghanaian households (20%), followed by motorcycles/scooters (18%). One in 10 households (10%) own a car or truck. One-third of households own agricultural land, with rural households Housing Characteristics and Household Population • 13 more likely to own land (57%) than urban households (21%). Thirty-five percent of households possess farm animals (55% in rural areas and 20% in urban areas) (Table 2.5). 2.2.2 Wealth Index Wealth index Households are given scores based on the number and kinds of consumer goods they own, ranging from a television to a bicycle or car, and housing characteristics such as source of drinking water, toilet facilities, and flooring materials. These scores are derived using principal component analysis. National wealth quintiles are compiled by assigning the household score to each usual (de jure) household member, ranking each person in the household population by her or his score, and then dividing the distribution into five equal categories, each comprising 20% of the population. Sample: Households Table 2.6 shows the distribution of the de jure household population by wealth quintile, according to place of residence and region. Eighty-six percent of urban residents are distributed among the top three quintiles, as compared with just 32% of rural residents (Figure 2.1). At the regional level, 49% of the population in Greater Accra falls in the highest wealth quintile, as compared with only 1% of the population in North East, 2% in Savannah, and 3% in Oti. More than half of the population in the North East, Upper East, Savannah, and Upper West regions falls in the lowest wealth quintile (64%, 57%, 55%, and 52%, respectively) (Table 2.6). 2.3 HOUSEHOLD POPULATION AND COMPOSITION Household A person or group of related or unrelated persons who live together in the same dwelling unit(s), who acknowledge one adult male or female as the head of the household, who share the same housekeeping arrangements, and who are considered a single unit. De facto population All persons who stayed in the selected households the night before the interview (whether usual residents or visitors). De jure population All persons who are usual residents of the selected households, whether or not they stayed in the household the night before the interview. How data are calculated All tables are based on the de facto population unless otherwise specified. Figure 2.1 Household wealth by residence 3 3811 30 23 17 30 9 33 5 Urban Rural Percent distribution of de jure population by wealth quintiles Highest Fourth Middle Second Lowest 14 • Housing Characteristics and Household Population A total of 63,247 individuals stayed overnight in the 17,933 households interviewed in the 2022 GDHS. Forty-eight percent (29,948) of these individuals were male and 52% (33,299) were female (Table 2.7), yielding a sex ratio of 90 males per 100 females. The population pyramid in Figure 2.2 illustrates the distribution of the de facto population by 5-year age groups and sex. Children under age 15 account for 40% of the population, while individuals age 65 and older make up only 6%. Most households in Ghana are male- headed (63%). The average household consists of 3.5 usual members; rural households are on average larger than urban households (4.0 and 3.2 persons per household, respectively) (Table 2.8). 2.4 CHILDREN’S LIVING ARRANGEMENTS AND PARENTAL SURVIVAL Orphan A child with one or both parents who are dead. Sample: Children under age 18 The definition of orphanhood can vary, but in the 2022 GDHS it refers to the population of children age 0– 17 with one or both parents dead. Table 2.9 shows that 51% of children under age 18 live with both of their biological parents, 16% do not live with a biological parent, and 8% are orphans. 2.5 BIRTH REGISTRATION Registered birth Child has a birth certificate or child does not have a birth certificate, but the birth is registered with the civil authorities. Sample: De jure children under age 5 Table 2.10 presents information on the percentage of children under age 5 who have a birth certificate and the percentage who do not have a birth certificate but whose birth has been registered with the civil authorities. Overall, 75% of children under age 5 had their births registered with the civil authorities (61% with a birth certificate and 13% without a birth certificate). Figure 2.2 Population pyramid 8 6 4 2 0 2 4 6 8 <5 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80+ Age Percent distribution of the household population Male Female 268 4 Housing Characteristics and Household Population • 15 2.6 EDUCATION 2.6.1 Educational Attainment Median educational attainment Half of the population has completed less than the median number of years of schooling, and half of the population has completed more than the median number of years of schooling. Sample: De facto household population age 6 and older Table 2.11.1 presents information on educational attainment among the female de facto household population age 6 and over. Overall, 24% of female household members age 6 years and over have no education, 26% have attended some primary school, 4% have completed primary school but advanced no further, 33% have attended some secondary school, 8% have completed secondary school but advanced no further, and 6% have attained some education after secondary school. Female household members in the highest wealth quintile (21%) are much more likely than those in the lowest quintile (less than 1%) to have attained more than a secondary education. Seventeen percent of male household members age 6 and over have no education, 26% have attended some primary school, 4% have completed primary school but advanced no further, 33% have attended some secondary school, 11% have completed secondary school but advanced no further, and 10% have attained some education after secondary school (Table 2.11.2). Male household members have completed a median of 6.3 years of schooling, 1.2 years more than female household members (5.1 years). 2.6.2 Primary and Secondary School Attendance Net attendance ratio (NAR) Percentage of the school-age population that attends primary or secondary school. Sample: Children age 7–12 for primary school NAR and children age 13–18 for secondary school NAR Gross attendance ratio (GAR) The total number of children attending primary school divided by the official primary school-age population and the total number of children attending secondary school divided by the official secondary school-age population. Sample: Children age 7–12 for primary school GAR and children age 13–18 for secondary school GAR School attendance ratios are shown in Table 2.12. The net attendance ratio (NAR) in primary school for both girls and boys is 82%. The NAR drops in secondary school: 55% of girls and 56% of boys attend secondary school. The gross attendance ratio (GAR) for primary school is 108 for girls and 109 for boys; the GAR for secondary school is 75 for girls and 71 for boys (Table 2.12). Gender parity index (GPI) The ratio of female to male students attending primary school and the ratio of female to male students attending secondary school. The index reflects the magnitude of the gender gap. Sample: Primary school students and secondary school students The gender parity index (GPI) for the NAR at the primary school level is 1.00, indicating that in primary school there are the same number of female and male students. At the secondary school level, the GPI for 16 • Housing Characteristics and Household Population the NAR is 0.98, indicating that there are slightly more males than females attending secondary school (Table 2.12). 2.6.3 Participation Rate in Organised Learning among Children Age 5 Participation rate in organised learning: adjusted net attendance ratio (NAR) The percentage of children 1 year younger than the official primary school entry age (at the beginning of the school year) who are attending an early childhood education programme or primary school. The ratio is termed adjusted since it includes children in primary school. Sample: Children age 5 at the beginning of the school year Early childhood education prepares children for primary school and provides for their physical, social, emotional, and intellectual needs in order to build a broad and solid foundation for their well-being. Sixty- seven percent of children age 5 (1 year younger than the official primary school entry age) are enrolled in an early childhood education programme, and 21% attend primary school (Table 2.13). However, 12% do not attend either an early childhood education programme or primary education. LIST OF TABLES For more information on household population and housing characteristics, see the following tables: ▪ Table 2.1 Household characteristics ▪ Table 2.2 Household characteristics: Cooking ▪ Table 2.3 Household characteristics: Heating and lighting ▪ Table 2.4 Primary reliance on clean fuels and technologies ▪ Table 2.5 Household possessions ▪ Table 2.6 Wealth quintiles ▪ Table 2.7 Household population by age, sex, and residence ▪ Table 2.8 Household composition ▪ Table 2.9 Children’s living arrangements and orphanhood ▪ Table 2.10 Birth registration of children under age 5 ▪ Table 2.11.1 Educational attainment of the female household population ▪ Table 2.11.2 Educational attainment of the male household population ▪ Table 2.12 School attendance ratios ▪ Table 2.13 Participation rate in organised learning Housing Characteristics and Household Population • 17 Table 2.1 Household characteristics Percent distribution of households and de jure population by housing characteristics and percent distribution by frequency of smoking in the home, according to residence, Ghana DHS 2022 Households Population Characteristic Urban Rural Total Urban Rural Total Electricity Yes 95.0 71.6 85.1 95.2 69.3 82.9 No 5.0 28.4 14.9 4.8 30.7 17.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 Flooring material Earth/sand 4.0 12.9 7.8 4.5 13.3 8.7 Dung 0.0 0.5 0.2 0.0 0.6 0.3 Wood/planks 0.5 0.0 0.3 0.4 0.0 0.2 Palm/bamboo 0.0 0.0 0.0 0.0 0.1 0.0 Parquet or polished wood 0.3 0.1 0.2 0.2 0.1 0.1 Vinyl or asphalt strips 0.0 0.1 0.1 0.0 0.1 0.0 Ceramic tiles 24.9 6.5 17.1 25.4 5.6 16.0 Cement 54.6 69.1 60.8 56.7 71.7 63.8 Woolen carpet/synthetic carpet 8.0 4.1 6.4 6.3 3.3 4.9 Linoleum/rubber carpet 7.7 6.6 7.2 6.5 5.3 5.9 Total 100.0 100.0 100.0 100.0 100.0 100.0 Rooms used for sleeping One 57.2 50.8 54.5 42.4 34.5 38.6 Two 27.0 27.1 27.0 32.8 30.9 31.9 Three or more 15.9 22.1 18.5 24.8 34.7 29.5 Total 100.0 100.0 100.0 100.0 100.0 100.0 Frequency of smoking in the home Daily 4.8 6.6 5.6 5.0 8.3 6.6 Weekly 4.8 4.8 4.8 4.8 5.1 5.0 Monthly 1.2 1.3 1.2 1.6 1.4 1.5 Less than once a month 0.8 1.2 1.0 0.8 1.4 1.1 Never 88.4 86.0 87.4 87.7 83.8 85.8 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of households/population 10,320 7,613 17,933 33,294 30,317 63,611 18 • Housing Characteristics and Household Population Table 2.2 Household characteristics: Cooking Percent distribution of households and de jure population by place for cooking, cooking technology, and cooking fuel, according to residence, Ghana DHS 2022 Households Population Characteristic Urban Rural Total Urban Rural Total Place for cooking In the house 39.9 19.8 31.4 39.3 19.1 29.7 Separate room/kitchen 30.4 13.4 23.2 31.2 13.2 22.7 No separate room/kitchen 9.6 6.4 8.2 8.0 5.9 7.0 In a separate building 15.9 28.6 21.3 16.3 28.7 22.2 Outdoors 39.7 48.5 43.4 42.9 51.1 46.8 Other 0.1 0.1 0.1 0.1 0.1 0.1 No food cooked in household 4.4 3.1 3.8 1.5 1.0 1.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 Main cooking technology Clean fuels and technologies 41.7 11.2 28.7 36.4 7.1 22.4 Electric stove 1.2 0.6 0.9 1.0 0.4 0.8 Solar cooker 0.0 0.0 0.0 0.0 0.0 0.0 LPG/natural gas stove 40.3 10.5 27.7 35.2 6.6 21.5 Piped natural gas stove 0.1 0.0 0.0 0.1 0.0 0.1 Biogas stove 0.1 0.1 0.1 0.1 0.0 0.1 Other fuels and technologies 53.9 85.8 67.4 62.0 91.9 76.3 Manufactured solid fuel stove 8.5 4.7 6.9 9.0 4.1 6.7 With a chimney 1.5 0.4 1.1 1.6 0.3 1.0 Without a chimney 7.0 4.3 5.8 7.4 3.8 5.7 Traditional solid fuel stove 30.7 19.6 26.0 33.2 17.5 25.7 With a chimney 5.2 2.5 4.1 6.0 1.9 4.0 Without a chimney 25.5 17.1 21.9 27.2 15.6 21.7 Three-stone stove/open fire 14.7 61.5 34.6 19.9 70.2 43.9 No food cooked in household 4.4 3.1 3.8 1.5 1.0 1.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 Cooking fuel Clean fuels and technologies1 41.7 11.2 28.7 36.4 7.1 22.4 Solid fuels for cooking 53.9 85.8 67.4 62.0 91.9 76.2 Coal/lignite 0.1 0.1 0.1 0.1 0.0 0.0 Charcoal 38.9 18.8 30.4 41.3 15.7 29.1 Wood 14.8 65.9 36.5 20.5 75.0 46.5 Straw/shrubs/grass 0.1 0.8 0.4 0.1 0.9 0.5 Agricultural crop 0.0 0.2 0.1 0.0 0.2 0.1 Animal dung/waste 0.0 0.0 0.0 0.0 0.0 0.0 Processed biomass (pellets) or woodchips 0.0 0.0 0.0 0.0 0.0 0.0 Garbage/plastic 0.0 0.0 0.0 0.0 0.0 0.0 Sawdust 0.0 0.0 0.0 0.0 0.0 0.0 Other fuels 0.0 0.0 0.0 0.0 0.0 0.0 Gasoline/diesel 0.0 0.0 0.0 0.0 0.0 0.0 Kerosene/paraffin 0.0 0.0 0.0 0.0 0.0 0.0 Other 0.0 0.0 0.0 0.0 0.0 0.0 No food cooked in household 4.4 3.1 3.8 1.5 1.0 1.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of households/population 10,320 7,613 17,933 33,294 30,317 63,611 LPG = liquefied petroleum gas 1 Includes stoves/cookers using electricity, LPG/natural gas/biogas, solar, and alcohol/ethanol Housing Characteristics and Household Population • 19 Table 2.3 Household characteristics: Heating and lighting Percent distribution of households and de jure population by heating technology, heating fuel, and main lighting fuel or technology, according to residence, Ghana DHS 2022 Households Population Characteristic Urban Rural Total Urban Rural Total Heating technology Central heating 0.0 0.0 0.0 0.0 0.0 0.0 Manufactured space heater 0.0 0.0 0.0 0.1 0.0 0.0 Without a chimney 0.0 0.0 0.0 0.1 0.0 0.0 Traditional space heater 0.0 0.0 0.0 0.0 0.0 0.0 With a chimney 0.0 0.0 0.0 0.0 0.0 0.0 Without a chimney 0.0 0.0 0.0 0.0 0.0 0.0 Manufactured cookstove 0.1 0.1 0.1 0.1 0.1 0.1 With a chimney 0.0 0.0 0.0 0.0 0.0 0.0 Without a chimney 0.1 0.1 0.1 0.1 0.1 0.1 Traditional cookstove 0.6 1.8 1.1 0.9 2.3 1.6 With a chimney 0.1 0.2 0.2 0.3 0.2 0.3 Without a chimney 0.5 1.6 0.9 0.6 2.1 1.3 Three-stone stove/open fire 0.3 1.7 0.9 0.4 2.1 1.2 No heating in household 99.0 96.4 97.9 98.5 95.5 97.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 Heating fuel Clean fuels and technologies1 0.2 0.1 0.1 0.2 0.1 0.1 Central heating 0.0 0.0 0.0 0.0 0.0 0.0 Electricity 0.1 0.0 0.1 0.2 0.1 0.1 LPG/cooking gas 0.0 0.0 0.0 0.0 0.0 0.0 Alcohol/ethanol 0.0 0.0 0.0 0.0 0.0 0.0 Coal/lignite 0.0 0.0 0.0 0.0 0.0 0.0 Charcoal 0.7 1.7 1.1 1.0 2.3 1.6 Wood 0.2 1.7 0.8 0.2 2.0 1.1 Straw/shrubs/grass 0.0 0.1 0.0 0.0 0.1 0.1 Agricultural crop 0.0 0.0 0.0 0.0 0.0 0.0 Animal dung/waste 0.0 0.0 0.0 0.0 0.0 0.0 No heating in household 99.0 96.4 97.9 98.5 95.5 97.1 Total 100.0 100.0 100.0 100.0 100.0 100.0 Main lighting fuel or technology Clean fuels and technologies 99.0 98.8 98.9 98.9 99.1 99.0 Electricity 94.5 70.3 84.2 94.6 68.1 82.0 Solar lantern 0.2 8.3 3.6 0.3 10.2 5.0 Rechargeable flashlight/torch/lantern 1.5 7.1 3.9 1.3 7.4 4.2 Battery-powered flashlight/torch/lantern 2.8 13.2 7.2 2.8 13.4 7.8 Gasoline lamp 0.0 0.0 0.0 0.0 0.0 0.0 Kerosene/paraffin lamp 0.1 0.1 0.1 0.2 0.1 0.1 Charcoal 0.2 0.1 0.2 0.3 0.0 0.2 Wood 0.0 0.2 0.1 0.1 0.1 0.1 Straw/shrubs/grass 0.0 0.0 0.0 0.1 0.0 0.0 Agricultural crop 0.1 0.1 0.1 0.1 0.0 0.1 Oil lamp 0.1 0.0 0.1 0.1 0.0 0.1 Candle 0.1 0.1 0.1 0.1 0.1 0.1 Other fuel 0.0 0.1 0.0 0.0 0.1 0.0 No lighting in household 0.3 0.5 0.4 0.2 0.3 0.3 Total 100.0 100.0 100.0 100.0 100.0 100.0 Number of households/population 10,320 7,613 17,933 33,294 30,317 63,611 LPG = liquefied petroleum gas 1 Includes central heating, electricity, LPG/natural gas/biogas, solar air heater, and alcohol/ethanol 20 • Housing Characteristics and Household Population Table 2.4 Primary reliance on clean fuels and technologies Percentage of de jure population relying on clean fuels and technologies for cooking, percentage relying on solid fuels for cooking, percentage relying on clean fuels and technologies for space heating, percentage relying on clean fuels and technologies for lighting, and percentage relying on clean fuels and technologies for cooking, space heating, and lighting, according to background characteristics, Ghana DHS 2022 Background characteristic Primary reliance on clean fuels and technologies for cooking1 Primary reliance on solid fuels for cooking2 Number of persons in households that reported cooking Primary reliance on clean fuels and technologies for space heating3 Number of persons in households that reported use of space heating Primary reliance on clean fuels and technologies for lighting4 Number of persons in households that reported use of lighting Primary reliance on clean fuels and technologies for cooking, space heating, and lighting5 Number of persons Residence Urban 37.0 63.0 32,781 14.7 487 99.1 33,217 37.8 33,294 Rural 7.2 92.8 30,009 1.4 1,372 99.5 30,218 7.9 30,317 Region Western 29.7 70.2 3,882 0.0 23 100.0 3,940 30.9 3,944 Central 21.2 78.8 6,878 3.6 61 99.8 6,954 22.1 6,957 Greater Accra 56.8 43.2 9,090 60.7 9 98.8 9,190 57.3 9,217 Volta 22.5 77.5 2,884 23.8 9 99.0 2,895 23.0 2,902 Eastern 21.9 78.0 5,182 10.1 35 99.6 5,203 22.6 5,234 Ashanti 26.5 73.5 11,613 55.8 78 99.3 11,798 27.9 11,844 Western North 9.5 90.5 1,752 2.7 47 99.3 1,772 10.7 1,775 Ahafo 7.9 92.1 1,379 6.9 64 99.1 1,394 9.0 1,397 Bono 13.5 86.5 2,207 0.0 60 99.8 2,259 15.5 2,262 Bono East 6.7 93.3 2,795 1.1 303 99.1 2,826 7.4 2,831 Oti 4.7 95.3 1,929 13.8 71 99.4 1,936 4.7 1,937 Northern 7.9 92.1 5,452 0.1 623 98.8 5,472 8.2 5,493 Savannah 1.4 98.6 1,567 0.0 154 99.7 1,585 2.5 1,586 North East 2.0 97.9 1,546 4.7 86 99.4 1,548 2.3 1,552 Upper East 8.3 91.6 2,880 2.9 111 99.2 2,898 8.6 2,904 Upper West 3.3 96.7 1,753 5.9 125 99.4 1,765 4.2 1,774 Wealth quintile Lowest 0.5 99.5 12,646 1.3 1,386 98.7 12,650 0.7 12,721 Second 1.3 98.7 12,568 12.1 358 98.5 12,650 2.4 12,725 Middle 4.7 95.2 12,428 3.1 78 99.5 12,689 6.8 12,719 Fourth 28.5 71.5 12,478 71.0 29 99.9 12,726 29.8 12,726 Highest 78.3 21.7 12,670 100.0 8 99.9 12,719 78.2 12,719 Total 22.7 77.2 62,790 4.9 1,859 99.3 63,435 23.6 63,611 LPG = liquefied petroleum gas 1 Includes stoves/cookers using electricity, LPG/natural gas/biogas, solar, and alcohol/ethanol 2 Includes coal/lignite, charcoal, wood, straw/shrubs/grass, agricultural crops, animal dung/waste, processed biomass (pellets) or woodchips, garbage/plastic, and sawdust 3 Includes central heating, electricity, LPG/natural gas/biogas, solar air heater, and alcohol/ethanol 4 Includes electricity, solar lantern, rechargeable flashlight/torch/lantern, battery-powered flashlight/torch/lantern, and biogas lamp 5 In order to calculate SDG indicator 7.1.2, persons living in households that report no cooking, no space heating, or no lighting are included in the numerator. Housing Characteristics and Household Population • 21 Table 2.5 Household possessions Percentage of households possessing various household effects, means of transportation, agricultural land, and livestock/farm animals, according to residence, Ghana DHS 2022 Residence Total Possession Urban Rural Household effects Radio 56.9 48.0 53.1 Television 79.9 47.8 66.3 Mobile phone 96.9 90.2 94.0 Non-mobile telephone 1.5 0.5 1.1 Computer 22.8 6.5 15.9 Refrigerator 56.3 22.4 41.9 Freezer 19.9 7.9 14.8 Generator 2.6 1.0 1.9 Washing machine 5.9 1.2 3.9 Camera 2.4 0.7 1.7 Video/DVD/VCD 12.7 5.4 9.6 Sewing machine 15.9 14.2 15.2 Means of transportation Bicycle 15.9 25.9 20.2 Animal-drawn cart 0.3 1.4 0.7 Motorcycle/scooter 14.9 22.8 18.2 Car/truck 14.2 4.8 10.2 Boat with a motor 0.3 1.4 0.8 Ownership of agricultural land 20.7 56.7 36.0 Ownership of farm animals1 20.2 54.8 34.9 Number of households 10,320 7,613 17,933 1 Cows, bulls, other cattle, horses, donkeys, mules, goats, sheep, chickens, or other poultry Table 2.6 Wealth quintiles Percent distribution of the de jure population by wealth quintiles and the Gini coefficient, according to residence and region, Ghana DHS 2022 Wealth quintile Total Number of persons Gini coefficient1 Residence/region Lowest Second Middle Fourth Highest Residence Urban 3.4 10.9 22.7 29.7 33.3 100.0 33,294 0.16 Rural 38.2 30.0 17.0 9.3 5.4 100.0 30,317 0.32 Region Western 9.0 16.2 20.3 24.6 29.8 100.0 3,944 0.23 Central 9.1 19.1 27.1 27.7 17.0 100.0 6,957 0.23 Greater Accra 2.4 4.1 13.3 31.0 49.1 100.0 9,217 0.12 Volta 13.9 26.8 25.9 17.8 15.7 100.0 2,902 0.27 Eastern 8.2 20.7 27.6 25.8 17.6 100.0 5,234 0.22 Ashanti 8.7 19.7 23.0 23.2 25.5 100.0 11,844 0.25 Western North 20.3 29.5 28.7 14.8 6.7 100.0 1,775 0.30 Ahafo 38.5 23.6 19.6 13.4 4.8 100.0 1,397 0.35 Bono 14.0 25.3 27.3 19.1 14.3 100.0 2,262 0.26 Bono East 35.5 23.9 21.6 12.8 6.2 100.0 2,831 0.35 Oti 30.2 39.9 19.7 7.5 2.7 100.0 1,937 0.28 Northern 43.6 25.8 14.2 9.4 7.1 100.0 5,493 0.36 Savannah 55.2 28.0 10.1 5.0 1.7 100.0 1,586 0.35 North East 64.1 24.5 7.5 2.5 1.3 100.0 1,552 0.30 Upper East 57.0 20.1 9.8 7.7 5.4 100.0 2,904 0.37 Upper West 52.0 27.2 8.5 6.3 5.9 100.0 1,774 0.30 Total 20.0 20.0 20.0 20.0 20.0 100.0 63,611 0.27 1 The Gini coefficient indicates the level of concentration of wealth, with 0 representing an equal wealth distribution and 1 representing a totally unequal distribution. 22 • Housing Characteristics and Household Population Table 2.7 Household population by age, sex, and residence Percent distributions of the de facto household population by various age groups and percentage of the de facto household population age 10–19, according to sex and residence, Ghana DHS 2022 Urban Rural Male Female Total Age Male Female Total Male Female Total <5 13.4 11.6 12.5 15.5 13.9 14.7 14.4 12.7 13.5 5–9 13.8 11.9 12.8 15.4 14.1 14.7 14.6 12.9 13.7 10–14 12.7 11.9 12.3 14.5 13.5 14.0 13.6 12.6 13.1 15–19 9.1 8.3 8.7 10.1 7.7 8.8 9.6 8.0 8.7 20–24 7.9 8.4 8.2 6.7 7.3 7.0 7.3 7.9 7.6 25–29 7.0 7.6 7.4 5.6 6.1 5.9 6.4 6.9 6.7 30–34 6.7 6.9 6.8 5.3 6.2 5.7 6.0 6.6 6.3 35–39 6.0 6.7 6.4 4.7 5.2 5.0 5.4 6.0 5.7 40–44 5.6 5.1 5.3 4.2 4.7 4.4 4.9 4.9 4.9 45–49 4.2 4.1 4.1 3.7 3.5 3.6 4.0 3.8 3.9 50–54 3.1 5.6 4.4 3.0 5.1 4.1 3.1 5.3 4.3 55–59 2.5 3.2 2.9 2.5 3.5 3.0 2.5 3.3 2.9 60–64 2.9 2.7 2.8 3.3 2.8 3.0 3.1 2.8 2.9 65–69 1.9 2.2 2.1 2.1 1.8 1.9 2.0 2.0 2.0 70–74 1.4 1.3 1.3 1.3 1.5 1.4 1.4 1.4 1.4 75–79 0.6 1.0 0.8 1.0 1.3 1.2 0.8 1.1 1.0 80+ 0.8 1.5 1.2 1.2 1.8 1.5 1.0 1.7 1.3 Don’t know/missing 0.0 0.1 0.1 0.0 0.0 0.0 0.0 0.1 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Dependency age groups 0–14 40.0 35.3 37.5 45.4 41.5 43.4 42.6 38.2 40.3 15–64 55.2 58.7 57.1 48.9 52.1 50.5 52.1 55.6 54.0 65+ 4.8 5.9 5.4 5.6 6.4 6.0 5.2 6.2 5.7 Don’t know/missing 0.0 0.1 0.1 0.0 0.0 0.0 0.0 0.1 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Child and adult populations 0–17 45.6 40.5 42.9 52.0 46.5 49.2 48.7 43.3 45.9 18+ 54.3 59.5 57.1 48.0 53.5 50.8 51.2 56.7 54.1 Don’t know/missing 0.0 0.1 0.1 0.0 0.0 0.0 0.0 0.1 0.0 Total 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 100.0 Adolescents 10–19 21.8 20.1 20.9 24.6 21.2 22.8 23.2 20.6 21.8 Number of persons 15,336 17,770 33,106 14,612 15,530 30,141 29,948 33,299 63,247 Housing Characteristics and Household Population • 23 Table 2.8 Household composition Percent distribution of households by sex of head of household and by household size, mean size of households, and percentage of households with orphans and children under age 18 not living with a biological parent, according to residence, Ghana DHS 2022 Residence Total Characteristic Urban Rural Household headship Male 60.6 67.3 63.4 Female 39.4 32.7 36.6 Total 100.0 100.0 100.0 Number of usual members 0 0.0 0.0 0.0 1 27.6 20.7 24.6 2 15.9 13.2 14.7 3 17.3 15.1 16.4 4 14.3 13.8 14.1 5 11.0 12.2 11.5 6 6.5 9.4 7.8 7 3.6 6.3 4.7 8 1.8 4.0 2.8 9+ 1.8 5.4 3.4 Total 100.0 100.0 100.0 Mean size of households 3.2 4.0 3.5 Percentage of households with children under age 18 who are orphans or not living with a biological parent Double orphans 0.6 0.6 0.6 Single orphans1 6.4 8.4 7.3 Children not living with a biological parent2 14.8 19.1 16.6 Orphans and/or children not living with a biological parent 18.2 22.9 20.2 Number of households 10,320 7,613 17,933 Note: Table is based on de jure household members, i.e., usual residents. 1 Includes children with one dead parent and an unknown survival status of the other parent 2 Children not living with a biological parent are those under age 18 living in households with neither their mother nor their father present. 24 • H ou si ng C ha ra ct er is tic s an d H ou se ho ld P op ul at io n Ta bl e 2. 9 C hi ld re n’ s liv in g ar ra ng em en ts a nd o rp ha nh oo d P er ce nt d is tri bu tio n of d e ju re c hi ld re n un de r a ge 1 8 by li vi ng a rr an ge m en ts a nd s ur vi va l s ta tu s of p ar en ts , p er ce nt ag e of c hi ld re n no t l iv in g w ith a b io lo gi ca l p ar en t, an d pe rc en ta ge o f c hi ld re n w ith o ne o r b ot h pa re nt s de ad , a cc or di ng to b ac kg ro un d ch ar ac te ris tic s, G ha na D H S 2 02 2 Li vi ng w ith m ot he r b ut n ot w ith fa th er Li vi ng w ith fa th er b ut n ot w ith m ot he r N ot li vi ng w ith e ith er p ar en t To ta l P er ce nt ag e no t l iv in g w ith a b io lo - gi ca l p ar en t P er ce nt ag e w ith o ne o r bo th p ar en ts de ad 1 N um be r o f ch ild re n B ac kg ro un d ch ar ac te ris tic Li vi ng w ith bo th p ar en ts Fa th er a liv e Fa th er d ea d M ot he r a liv e M ot he r d ea d B ot h al iv e O nl y m ot he r al iv e O nl y fa th er al iv e B ot h de ad M is si ng in fo rm at io n on fa th er / m ot he r A ge 0– 4 60 .2 29 .3 1. 6 1. 9 0. 1 6. 2 0. 3 0. 3 0. 1 0. 0 10 0. 0 6. 8 2. 3 8, 50 8 <2 62 .0 34 .3 1. 1 0. 6 0. 1 1. 6 0. 0 0. 2 0. 0 0. 0 10 0. 0 1. 9 1. 4 3, 44 3 2– 4 59 .0 25 .9 1. 9 2. 8 0. 1 9. 3 0. 4 0. 3 0. 2 0. 1 10 0. 0 10 .2 3. 0 5, 06 4 5– 9 51 .8 22 .6 3. 5 4. 4 0. 3 14 .7 1. 3 0. 8 0. 3 0. 1 10 0. 0 17 .2 6. 3 8, 65 0 10 –1 4 44 .2 20 .6 5. 6 6. 4 1. 0 17 .7 2. 1 1. 5 0. 8 0. 1 10 0. 0 22 .0 11 .0 8, 31 8 15 –1 7 39 .5 20 .7 7. 8 6. 3 1. 4 17 .7 3. 9 1. 7 0. 9 0. 2 10 0. 0 24 .2 15 .6 3, 53 6 S ex M al e 51 .3 23 .5 4. 2 5. 1 0. 7 12 .5 1. 4 0. 7 0. 5 0. 1 10 0. 0 15 .2 7. 5 14 ,6 27 Fe m al e 49 .9 24 .1 4. 0 3. 8 0. 4 14 .4 1. 7 1. 1 0. 5 0. 1 10 0. 0 17 .6 7. 7 14 ,3 84 R es id en ce U rb an 47 .0 27 .2 4. 2 4. 1 0. 6 13 .8 1. 4 1. 0 0. 6 0. 1 10 0. 0 16 .8 7. 8 14 ,1 64 R ur al 54 .0 20 .5 3. 9 4. 9 0. 6 13 .1 1. 6 0. 9 0. 4 0. 2 10 0. 0 16 .0 7. 4 14 ,8 48 R eg io n W es te rn 50 .4 24 .7 2. 7 4. 2 0. 4 13 .7 1. 6 1. 2 0. 9 0. 2 10 0. 0 17 .4 6. 8 1, 74 1 C en tra l 38 .5 32 .7 4. 0 4. 2 0. 5 16 .5 1. 5 1. 5 0. 5 0. 1 10 0. 0 20 .0 8. 0 3, 18 7 G re at er A cc ra 51 .7 25 .8 4. 3 5. 7 0. 6 10 .3 0. 9 0. 5 0. 2 0. 1 10 0. 0 11 .9 6. 4 3, 67 9 V ol ta 41 .1 28 .4 4. 0 4. 0 0. 3 17 .8 2. 1 1. 4 0. 4 0. 4 10 0. 0 21 .7 8. 5 1, 28 4 E as te rn 39 .6 29 .3 3. 8 3. 4 0. 7 19 .4 1. 4 1. 7 0. 6 0. 1 10 0. 0 23 .1 8. 2 2, 28 6 A sh an ti 43 .6 29 .5 4. 9 3. 1 0. 5 15 .4 1. 7 0. 8 0. 3 0. 2 10 0. 0 18 .2 8. 3 5, 27 2 W es te rn N or th 50 .6 21 .1 3. 1 6. 5 0. 6 13 .8 2. 5 1. 0 0. 6 0. 1 10 0. 0 18 .0 7. 9 82 7 A ha fo 53 .0 22 .2 3. 5 4. 4 0. 4 13 .9 1. 3 0. 8 0. 4 0. 1 10 0. 0 16 .4 6. 4 64 4 B on o 40 .5 33 .5 4. 2 3. 3 0. 3 15 .3 1. 5 0. 9 0. 4 0. 2 10 0. 0 18 .0 7. 2 99 0 B on o E as t 56 .7 20 .6 4. 0 3. 4 0. 7 12 .4 1. 6 0. 7 0. 1 0. 0 10 0. 0 14 .8 7. 1 1, 33 5 O ti 55 .4 18 .0 3. 1 5. 4 0. 5 14 .7 1. 6 1. 0 0. 2 0. 1 10 0. 0 17 .5 6. 5 95 9 N or th er n 77 .2 6. 0 3. 2 4. 2 0. 9 5. 6 1. 3 0. 5 1. 1 0. 0 10 0. 0 8. 5 6. 9 2, 90 7 S av an na h 62 .3 13 .7 3. 3 6. 3 0. 4 10 .2 2. 1 1. 3 0. 3 0. 1 10 0. 0 13 .9 7. 4 80 4 N or th E as t 63 .9 13 .5 2. 5 7. 9 0. 7 9. 8 1. 0 0. 4 0. 2 0. 0 10 0. 0 11 .5 4. 8 87 1 U pp er E as t 53 .1 16 .5 7. 3 7. 5 0. 5 12 .5 1. 8 0. 5 0. 2 0. 0 10 0. 0 15 .0 10 .3 1, 36 0 U pp er W es t 53 .9 19 .3 5. 1 4. 1 0. 2 12 .8 2. 8 1. 2 0. 4 0. 2 10 0. 0 17 .3 9. 8 86 5 W ea lth q ui nt ile Lo w es t 61 .4 14 .9 4. 1 4. 8 0. 7 11 .7 1. 4 0. 7 0. 4 0. 0 10 0. 0 14 .2 7. 3 6, 66 5 S ec on d 46 .9 25 .3 5. 0 4. 2 0. 6 14 .0 2. 0 1. 2 0. 6 0. 2 10 0. 0 17 .8 9. 4 6, 36 2 M id dl e 42 .9 28 .8 4. 4 3. 6 0. 5 16 .4 1. 7 1. 1 0. 4 0. 2 10 0. 0 19 .6 8. 2 5, 72 9 Fo ur th 46 .0 28 .7 3. 9 4. 7 0. 7 13 .4 1. 2 0. 9 0. 4 0. 1 10 0. 0 15 .9 7. 1 5, 24 3 H ig he st 54 .6 22 .8 2. 7 5. 2 0. 3 11 .8 1. 2 0. 9 0. 5 0. 1 10 0. 0 14 .4 5. 6 5, 01 2 To ta l < 15 52 .1 24 .2 3. 6 4. 2 0. 4 12 .8 1. 2 0. 8 0. 4 0. 1 10 0. 0 15 .3 6. 5 25 ,4 75 To ta l < 18 50 .6 23 .8 4. 1 4. 5 0. 6 13 .4 1. 5 0. 9 0. 5 0. 1 10 0. 0 16 .4 7. 6 29 ,0 11 N ot e: T ab le is b as ed o n de ju re m em be rs , i .e ., us ua l r es id en ts . 1 In cl ud es c hi ld re n w ith fa th er d ea d, m ot he r d ea d, b ot h de ad , a nd o ne p ar en t d ea d bu t m is si ng in fo rm at io n on s ur vi va l s ta tu s of th e ot he r p ar en t Housing Characteristics and Household Population • 25 Table 2.10 Birth registration of children under age 5 Percentage of de jure children under age 5 whose births are registered with the civil authorities, according to background characteristics, Ghana DHS 2022 Percentage of children whose births are registered and who: Total percentage of children whose births are registered Number of children Background characteristic Had a birth certificate Did not have a birth certificate Age <1 41.6 19.4 61.1 1,651 1–4 66.2 11.6 77.7 6,857 Sex Male 61.6 12.8 74.4 4,301 Female 61.2 13.4 74.6 4,206 Residence Urban 65.4 12.1 77.5 4,093 Rural 57.7 14.0 71.7 4,415 Region Western 72.1 13.5 85.6 526 Central 59.7 16.5 76.2 887 Greater Accra 59.8 12.5 72.3 1,063 Volta 64.1 6.8 70.9 320 Eastern 56.6 9.0 65.6 616 Ashanti 63.4 11.3 74.7 1,518 Western North 58.4 11.8 70.2 227 Ahafo 56.6 18.5 75.1 185 Bono 61.2 7.2 68.4 279 Bono East 46.4 36.3 82.7 426 Oti 53.5 7.0 60.5 281 Northern 66.4 10.5 76.9 957 Savannah 50.6 14.5 65.1 255 North East 58.0 16.1 74.1 296 Upper East 72.7 10.7 83.4 420 Upper West 66.3 11.7 78.0 253 Wealth quintile Lowest 50.6 15.3 65.8 2,043 Second 61.6 12.6 74.2 1,748 Middle 63.2 12.1 75.3 1,650 Fourth 64.2 12.3 76.5 1,573 Highest 71.0 12.7 83.7 1,494 Total 61.4 13.1 74.5 8,508 26 • Housing Characteristics and Household Population Table 2.11.1 Educational attainment of the female household population Percent distribution of the de facto female household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Ghana DHS 2022 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Don’t know Total Number Median years completed Age 6–9 35.9 63.6 0.0 0.4 0.0 0.0 0.0 100.0 3,487 a 10–14 5.9 69.3 7.1 17.7 0.0 0.1 0.0 100.0 4,205 3.6 15–19 4.4 9.8 5.2 68.3 11.5 0.9 0.0 100.0 2,663 8.0 20–24 6.6 7.3 3.1 39.8 32.7 10.4 0.1 100.0 2,630 8.9 25–29 11.4 8.3 2.7 38.4 22.7 16.3 0.2 100.0 2,308 8.7 30–34 19.5 9.5 4.6 38.1 10.6 17.8 0.0 100.0 2,183 8.3 35–39 24.7 10.2 4.5 38.4 10.0 12.2 0.0 100.0 2,007 8.1 40–44 30.1 11.9 5.1 39.7 5.7 7.6 0.0 100.0 1,636 6.6 45–49 30.1 12.7 6.1 40.7 5.8 4.5 0.2 100.0 1,269 6.1 50–54 42.4 12.6 3.3 36.7 1.6 3.4 0.0 100.0 1,780 3.8 55–59 44.9 11.0 5.1 35.2 1.0 2.7 0.2 100.0 1,115 2.7 60–64 41.4 10.6 4.0 38.7 1.8 3.3 0.3 100.0 919 4.2 65+ 57.3 10.1 2.7 25.9 0.3 3.6 0.1 100.0 2,050 a Don’t know/missing (91.4) (1.1) (2.2) (0.0) (5.3) (0.0) (0.0) 100.0 18 a Residence Urban 16.2 23.3 4.1 35.9 11.3 9.1 0.1 100.0 15,323 7.0 Rural 32.4 28.0 3.9 28.6 4.8 2.2 0.0 100.0 12,946 2.9 Region Western 17.7 24.6 6.1 37.6 8.2 5.7 0.1 100.0 1,754 6.1 Central 19.8 26.0 4.1 38.9 6.6 4.6 0.0 100.0 3,193 5.6 Greater Accra 10.0 22.6 4.2 38.7 13.4 10.9 0.1 100.0 4,104 8.2 Volta 17.2 26.4 6.2 36.7 7.5 5.9 0.1 100.0 1,416 5.8 Eastern 15.7 27.3 5.3 39.2 7.0 5.4 0.1 100.0 2,467 6.0 Ashanti 16.1 25.3 4.2 38.0 9.7 6.7 0.1 100.0 5,410 6.3 Western North 20.9 28.4 2.8 36.8 6.9 4.1 0.1 100.0 750 5.1 Ahafo 23.9 25.5 5.0 35.4 7.0 3.2 0.0 100.0 599 5.1 Bono 21.1 23.3 4.4 36.6 8.5 6.1 0.1 100.0 1,064 5.9 Bono East 32.7 27.6 3.0 25.4 7.3 3.9 0.1 100.0 1,223 3.1 Oti 35.1 31.6 3.2 24.1 3.5 2.5 0.0 100.0 792 1.9 Northern 51.2 23.0 2.0 12.3 6.1 5.3 0.0 100.0 2,162 a Savannah 56.7 24.1 1.7 11.7 4.1 1.6 0.0 100.0 641 a North East 53.8 26.0 1.8 12.7 4.1 1.6 0.0 100.0 603 a Upper East 36.4 27.3 3.0 19.5 9.1 4.6 0.1 100.0 1,274 2.5 Upper West 43.4 27.9 2.4 16.2 5.7 4.4 0.0 100.0 819 0.9 Wealth quintile Lowest 47.6 28.9 3.5 16.7 3.0 0.2 0.0 100.0 5,211 a Second 31.6 29.4 4.8 29.5 4.1 0.5 0.0 100.0 5,661 3.0 Middle 20.2 27.7 4.6 38.5 7.4 1.7 0.0 100.0 5,815 5.3 Fourth 13.9 22.4 3.9 41.7 12.0 5.8 0.2 100.0 5,743 7.6 Highest 7.4 19.3 3.3 34.7 14.5 20.8 0.0 100.0 5,839 8.8 Total 23.6 25.5 4.0 32.6 8.3 6.0 0.1 100.0 28,269 5.1 Note: Figures in parentheses are based on 25–49 unweighted cases. 1 Completed grade 6 at the primary level 2 Completed grade 6 at the secondary level a = omitted because more than 50% of girls or women completed 0 years of education Housing Characteristics and Household Population • 27 Table 2.11.2 Educational attainment of the male household population Percent distribution of the de facto male household population age 6 and over by highest level of schooling attended or completed and median years completed, according to background characteristics, Ghana DHS 2022 Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Don’t know Total Number Median years completed Age 6–9 41.4 58.3 0.1 0.1 0.0 0.0 0.0 100.0 3,574 a 10–14 6.6 71.0 6.5 15.8 0.1 0.1 0.0 100.0 4,077 3.3 15–19 4.4 13.6 4.9 66.0 9.9 1.2 0.0 100.0 2,870 7.5 20–24 6.1 7.9 2.9 29.0 40.7 13.3 0.1 100.0 2,187 11.1 25–29 7.7 6.9 3.0 30.8 30.9 20.6 0.0 100.0 1,904 11.1 30–34 11.0 6.3 3.8 33.3 21.8 23.3 0.4 100.0 1,802 9.4 35–39 14.8 7.3 3.6 38.0 15.6 20.5 0.1 100.0 1,606 8.6 40–44 16.5 7.4 4.4 42.2 12.7 16.6 0.2 100.0 1,468 8.5 45–49 19.3 9.0 3.5 43.9 9.5 14.7 0.0 100.0 1,184 8.5 50–54 23.7 7.3 3.7 49.8 3.7 11.4 0.4 100.0 914 8.9 55–59 24.2 6.6 3.5 53.0 2.9 9.8 0.0 100.0 748 9.1 60–64 29.8 4.7 3.5 48.4 1.8 11.4 0.4 100.0 931 9.0 65+ 34.0 7.9 2.8 42.5 0.9 11.5 0.3 100.0 1,555 7.8 Don’t know/missing * * * * * * * 100.0 12 * Residence Urban 10.4 22.7 3.5 34.2 14.7 14.4 0.2 100.0 12,900 8.3 Rural 24.6 29.1 3.7 30.8 7.6 4.2 0.0 100.0 11,932 4.3 Region Western 11.4 24.4 3.7 37.9 12.3 10.2 0.2 100.0 1,547 8.1 Central 11.1 27.5 3.8 38.3 12.0 7.3 0.0 100.0 2,605 6.8 Greater Accra 6.2 20.7 3.5 36.4 15.4 17.7 0.2 100.0 3,870 8.7 Volta 10.9 28.1 4.5 36.2 10.4 9.8 0.1 100.0 1,122 7.1 Eastern 12.5 23.1 5.0 41.6 9.7 8.0 0.2 100.0 2,072 7.6 Ashanti 10.4 25.0 3.6 38.9 13.9 8.2 0.2 100.0 4,453 8.0 Western North 14.2 29.1 2.7 37.3 9.0 7.5 0.1 100.0 729 6.2 Ahafo 19.6 25.5 5.2 33.6 10.3 5.8 0.0 100.0 563 5.7 Bono 15.9 22.9 4.2 33.9 12.0 10.9 0.1 100.0 879 7.6 Bono East 27.9 25.6 2.5 26.4 10.1 7.2 0.2 100.0 1,105 4.2 Oti 26.1 31.1 3.0 26.5 8.4 4.8 0.0 100.0 773 3.6 Northern 38.8 27.9 3.0 14.5 6.9 8.7 0.1 100.0 2,107 1.2 Savannah 48.4 25.9 1.8 12.8 6.9 4.2 0.1 100.0 625 0.0 North East 42.9 29.5 2.1 14.9 6.1 4.4 0.0 100.0 598 0.4 Upper East 23.6 34.3 4.1 21.1 8.2 8.6 0.2 100.0 1,134 3.9 Upper West 33.1 31.8 3.3 18.1 6.4 7.3 0.0 100.0 651 2.4 Wealth quintile Lowest 39.0 31.9 3.4 20.5 4.3 0.9 0.1 100.0 5,011 1.2 Second 21.4 31.5 4.6 32.3 7.8 2.2 0.0 100.0 4,831 4.5 Middle 13.7 27.2 4.4 38.4 11.1 5.1 0.1 100.0 4,901 6.4 Fourth 8.0 21.3 3.6 41.2 16.7 9.1 0.2 100.0 4,981 8.4 Highest 4.3 17.4 2.1 30.5 16.3 29.3 0.2 100.0 5,107 9.8 Total 17.2 25.8 3.6 32.5 11.3 9.5 0.1 100.0 24,832 6.3 Note: An asterisk indicates that a figure is based on fewer than 25 unweighted cases and has been suppressed. 1 Completed grade 6 at the primary level 2 Completed grade 6 at the secondary level a = omitted because more than 50% of boys completed 0 years of education 28 • Housing Characteristics and Household Population Table 2.12 School attendance ratios Net attendance ratios (NAR) and gross attendance ratios (GAR) for the de facto household population by sex and level of schooling, and the gender parity index (GPI), according to background characteristics, Ghana DHS 2022 Net attendance ratio1 Gross attendance ratio2 Background characteristic Male Female Total Gender parity index3 Male Female Total Gender parity index3 PRIMARY SCHOOL Residence Urban 85.9 83.6 84.7 0.97 111.6 108.7 110.1 0.97 Rural 77.7 80.0 78.8 1.03 107.2 106.5 106.9 0.99 Region Western 90.9 90.5 90.7 1.00 122.0 121.4 121.7 1.00 Central 87.0 85.1 86.1 0.98 111.9 112.9 112.4 1.01 Greater Accra 88.8 78.5 83.5 0.88 117.5 105.1 111.1 0.89 Volta 89.4 85.6 87.4 0.96 121.1 113.5 117.2 0.94 Eastern 84.4 90.3 87.5 1.07 110.2 112.6 111.5 1.02 Ashanti 85.9 87.4 86.7 1.02 108.3 108.0 108.1 1.00 Western North 83.7 81.8 82.7 0.98 113.2 104.1 108.7 0.92 Ahafo 79.0 76.3 77.7 0.97 99.6 101.4 100.5 1.02 Bono 86.7 84.2 85.4 0.97 113.2 114.6 113.9 1.01 Bono East 68.6 74.0 71.3 1.08 92.1 98.9 95.5 1.07 Oti 76.7 78.3 77.5 1.02 115.0 104.7 109.7 0.91 Northern 65.0 67.9 66.4 1.04 93.2 94.9 94.0 1.02 Savannah 52.8 57.1 54.8 1.08 78.8 86.0 82.2 1.09 North East 61.6 66.1 63.7 1.07 93.7 89.0 91.6 0.95 Upper East 87.6 85.8 86.7 0.98 127.5 113.7 120.6 0.89 Upper West 82.1 85.4 83.8 1.04 116.3 125.2 120.8 1.08 Wealth quintile Lowest 67.2 71.4 69.2 1.06 94.8 96.4 95.6 1.02 Second 83.9 82.2 83.0 0.98 116.5 111.0 113.7 0.95 Middle 85.4 86.8 86.1 1.02 113.5 111.1 112.3 0.98 Fourth 89.8 88.2 89.0 0.98 112.6 115.3 114.0 1.02 Highest 86.5 81.8 83.9 0.95 112.3 105.7 108.7 0.94 Total 81.6 81.8 81.7 1.00 109.3 107.6 108.5 0.98 SECONDARY SCHOOL Residence Urban 63.4 61.9 62.7 0.98 82.9 86.5 84.7 1.04 Rural 49.0 47.7 48.4 0.97 60.2 62.1 61.1 1.03 Region Western 51.7 55.2 53.4 1.07 64.9 66.4 65.6 1.02 Central 64.8 67.4 66.1 1.04 84.4 84.6 84.5 1.00 Greater Accra 62.4 60.8 61.6 0.97 80.7 86.7 83.7 1.07 Volta 57.5 68.2 63.1 1.19 75.4 86.2 81.1 1.14 Eastern 68.0 61.3 65.0 0.90 83.7 82.2 83.0 0.98 Ashanti 68.2 57.5 63.3 0.84 84.4 88.7 86.4 1.05 Western North 53.7 50.6 52.2 0.94 63.1 65.1 64.0 1.03 Ahafo 51.0 54.3 52.6 1.07 63.9 68.7 66.3 1.07 Bono 57.6 61.0 59.4 1.06 74.9 82.8 79.1 1.10 Bono East 37.7 39.9 38.8 1.06 49.9 53.0 51.5 1.06 Oti 36.8 43.6 39.8 1.19 50.9 52.0 51.4 1.02 Northern 33.4 34.7 34.0 1.04 44.4 49.3 46.5 1.11 Savannah 27.8 26.4 27.1 0.95 39.5 32.9 36.2 0.83 North East 35.4 33.1 34.4 0.94 46.8 43.7 45.4 0.93 Upper East 55.2 53.8 54.6 0.97 68.8 72.0 70.3 1.05 Upper West 46.9 44.7 45.8 0.95 56.1 60.1 58.1 1.07 Wealth quintile Lowest 36.1 33.1 34.8 0.92 45.1 43.5 44.4 0.97 Second 54.6 48.9 52.0 0.90 65.4 66.9 66.1 1.02 Middle 57.2 60.1 58.7 1.05 73.7 80.4 77.1 1.09 Fourth 67.4 64.7 66.1 0.96 84.7 84.5 84.6 1.00 Highest 71.6 68.9 70.2 0.96 98.7 99.5 99.1 1.01 Total 56.0 55.1 55.6 0.98 71.2 74.9 73.0 1.05 1 The NAR for primary school is the percentage of the primary school-age (7–12 years) population that is attending primary school. The NAR for secondary school is the percentage of the secondary school-age (13–18 years) population that is attending secondary school. By definition, the NAR cannot exceed 100.0. 2 The GAR for primary school is the total number of primary school students, expressed as a percentage of the official primary school-age population. The GAR for secondary school is the total number of secondary school students, expressed as a percentage of the official secondary school-age population. If there are significant numbers of overage and underage students at a given level of schooling, the GAR can exceed 100.0. 3 The gender parity index for primary school is the ratio of the primary school NAR (GAR) for females to the NAR (GAR) for males. The gender parity index for secondary school is the ratio of the secondary school NAR (GAR) for females to the NAR (GAR) for males. Housing Characteristics and Household Population • 29 Table 2.13 Participation rate in organised learning Percent distribution of children 1 year younger than the official primary school entry age at the beginning of the school year by attendance at an early childhood education programme or primary school, and the adjusted net attendance ratio (NAR), according to background characteristics, Ghana DHS 2022 Percent distribution of children attending Adjusted NAR1 Number of children age 5 at the beginning of the school year Background characteristic An early childhood education programme Primary school Neither an early childhood education programme nor primary school Total Sex Male 67.9 21.1 11.0 100.0 89.0 923 Female 66.1 21.7 12.2 100.0 87.8 880 Residence Urban 72.6 23.0 4.4 100.0 95.6 861 Rural 61.9 20.0 18.1 100.0 81.9 942 Region Western 68.8 21.2 10.0 100.0 90.0 104 Central 73.1 18.9 8.1 100.0 91.9 197 Greater Accra 72.3 24.2 3.5 100.0 96.5 223 Volta 79.3 17.7 3.0 100.0 97.0 68 Eastern 79.2 16.5 4.4 100.0 95.6 133 Ashanti 80.1 16.3 3.5 100.0 96.5 337 Western North 61.7 24.3 14.1 100.0 85.9 56 Ahafo 55.0 24.0 21.0 100.0 79.0 42 Bono 73.6 22.7 3.7 100.0 96.3 53 Bono East 62.5 15.0 22.5 100.0 77.5 86 Oti 54.9 20.9 24.2 100.0 75.8 64 Northern 44.5 30.3 25.1 100.0 74.9 207 Savannah 45.3 14.3 40.4 100.0 59.6 58 North East 38.5 32.9 28.6 100.0 71.4 55 Upper East 60.7 30.3 8.9 100.0 91.1 68 Upper West 69.0 22.9 8.1 100.0 91.9 54 Wealth quintile Lowest 49.2 18.4 32.4 100.0 67.6 424 Second 65.7 24.7 9.6 100.0 90.4 402 Middle 76.2 18.6 5.3 100.0 94.7 358 Fourth 76.7 20.7 2.6 100.0 97.4 337 Highest 72.5 25.7 1.8 100.0 98.2 281 Total 67.0 21.4 11.6 100.0 88.4 1,803 1 The adjusted net attendance ratio (NAR) to organised learning is the percentage of children of 1 year younger than the official primary school entry age (at the beginning of the school year) who are attending early childhood education or primary school. Characteristics of Respondents • 31 CHARACTERISTICS OF RESPONDENTS 3 Key Findings ▪ Age: One in five respondents (18% of women and 23% of men) are age 15–19. ▪ Marital status: 55% of women are currently married or living together with a partner as if married. ▪ Education: The percentage of women with no education has declined over time, from 19% in 2014 to 16% in 2022. ▪ Internet usage: 58% of women and 74% of men in urban areas used the internet in the past 12 months, as compared with 24% of women and 46% of men in rural areas. ▪ Employment: The percentage of women who were paid in cash only for their work in the past 12 months decreased from 64% in 2014 to 58% in 2022. ▪ Health insurance: 10% of women and 27% of men age 15–49 are neither registered nor covered under any health insurance scheme. ▪ Migration: 24% of women and 31% of men migrated from urban to rural areas, while 9% of women and 6% of men migrated from rural to urban areas. his chapter presents information on the demographic and socioeconomic characteristics of the survey respondents such as age, education, literacy, marital status, employment, occupation, wealth, health insurance coverage, residence at birth, current place of residence, and recent migration. The chapter also presents information on respondents’ use of alcohol and tobacco. Together, this information is useful for understanding the factors that affect use of reproductive health services, contraceptive use, and other health behaviours. 3.1 BASIC CHARACTERISTICS OF SURVEY RESPONDENTS Table 3.1 shows that 15,014 women and 6,277 men age 15–49 were interviewed in the 2022 GDHS. The percentage of women interviewed declines with increasing age, from 18% among those age 15–24 to 9% among those age 45–49. Similarly, the percentage of male respondents falls from 23% among those age 15–19 to 9% among those age 45–49. Seventy-seven percent of both women and men reported their health status as good or very good. Most respondents are Christian (77% of women and 70% of men). More than 4 in 10 women (42%) and more than 3 in 10 men (35%) are Pentecostal/Charismatic, while 35% of both women and men are Catholic, Anglican, Methodist, Presbyterian, or other Christian. Nineteen percent of women and 21% of men are Muslim. Akans are the predominant ethnic group in Ghana (46% of both women and men), followed by Mole- Dagbanis (19% of women and 18% of men) and Ewes (12% of women and 11% of men). Over half of men (51%) and more than one-third of women (35%) have never been married. Women are more likely to be married or living together with a partner (i.e., in union) than men (55% versus 45%). Also, a higher T 32 • Characteristics of Respondents proportion of women than men are divorced or separated (8% versus 4%) or widowed (2% versus less than 1%). More than half of the survey respondents reside in urban areas (57% of women and 55% of men). 3.2 EDUCATION AND LITERACY Literacy Respondents who had attended higher than secondary school were assumed to be literate. All other respondents were considered literate if they could read aloud all or part of a sentence shown to them. Sample: Women and men age 15–49 Overall, 3% of both women and men age 15–49 have some primary education, 10% of women and 9% of men have completed primary school but gone no further, 15% of women and 14% men have some secondary education, 45% of women and 50% of men have completed secondary education and gone no further, and 10% of women and 15% of men have more than a secondary education (Table 3.2.1, Table 3.2.2, and Figure 3.1). Sixteen percent of women and 10% of men have no formal education. Trends: The median number of years of schooling has increased since the 2014 GDHS, from 7.8 years among women and 8.5 years among men to 11.1 years among women and 11.3 years among men. Literacy, although remaining high among both women (61%) and men (71%), has decreased since 2014 (Table 3.3.1 and Table 3.3.2). Figure 3.1 Education of survey respondents 16 10 3 3 10 9 15 14 45 50 10 15 Women Men Percent distribution of women and men age 15–49 by highest level of schooling attended or completed More than secondary Completed secondary Some secondary Primary complete Primary incomplete No education Characteristics of Respondents • 33 3.3 MASS MEDIA EXPOSURE AND INTERNET USAGE Exposure to mass media Respondents were asked how often they read a newspaper, listened to the radio, or watched television. Those who responded at least once a week are considered regularly exposed to that form of media. Sample: Women and men age 15–49 Use of the internet Respondents were asked if they have ever used the internet from any device, if they used the internet in the last 12 months, and, if so, how often they used it during the last month. Sample: Women and men age 15–49 Data on women’s and men’s exposure to mass media are essential in the development of educational programs and the dissemination of all types of information, particularly information about family planning and other important health topics. In Ghana, television is the most common form of mass media to which men and women are exposed. Sixty-two percent of women and 63% of men watch television at least once a week. One-fourth of women and men reported not accessing any of the three media (27% of women and 23% of men); only 2% of women and 5% of men accessed all three forms of mass media in the last week (Figure 3.2, Table 3.4.1, and Table 3.4.2). Maps 3.1 and 3.2 Secondary education by region Percentage of women and men age 15–49 with secondary education complete or higher Figure 3.2 Exposure to mass media 4 62 42 2 27 8 63 51 5 23 Reads news- paper Watches television Listens to radio All three media None of these media Percentage of women and men age 15–49 who are exposed to media on a weekly basis Women Men 34 • Characteristics of Respondents The internet is a critical tool through which information is shared. Internet use includes accessing web pages, email, and social media. Close to 5 in 10 women (47%) and about 6 out of 10 men (65%) have used the internet at least once, and 43% of women and 62% of men used it in the last 12 months. Among those who used the internet in the last 12 months, most used it almost every day (64% of women and 75% of men) (Figure 3.3, Table 3.5.1, and Table 3.5.2). Trends: Women’s exposure to all three types of media (newspaper, television, and radio) declined from 5% in 2014 to 2% in 2022. The percentage of women who accessed none of the three types of media also declined, from 31% to 27%. With the exception of television (51% in 2014 and 62% in 2022), exposure to media decreased between 2014 and 2022. 3.4 EMPLOYMENT Currently employed Respondents who were employed in the 7 days before the survey. Sample: Women and men age 15–49 Seventy-five percent of women and 83% of men age 15–49 are currently employed; 4% of women and 3% of men were employed in the last 12 months but are not currently employed, and 22% of women and 14% of men were not employed in the last 12 months (Figure 3.4, Table 3.6.1, and Table 3.6.2). Trends: The percentage of respondents who are currently employed has increased slightly since 2014, from 73% to 75% among women and from 82% to 83% among men. 3.5 OCCUPATION Occupation Categorized as professional/technical/managerial, clerical, sales and services, skilled manual, unskilled manual, domestic service, agriculture, and other. Sample: Women and men age 15–49 who were currently employed or had worked in the 12 months before the survey Figure 3.3 Internet usage by sex Figure 3.4 Employment status by sex 43 62 Percentage of women and men age 15–49 who used the internet in the last 12 months Women Men 75 83 Percentage of women and men age 15–49 who are currently employed Women Men Characteristics of Respondents • 35 Among those who worked in the 12 months preceding the survey, 9% of women and 12% of men are employed in professional, technical, or managerial positions; 2% of both women and men are engaged in clerical work; 69% of women and 34% of men work in sales and services; 13% of women and 33% of men are engaged in skilled manual work; and 6% of women and 12% of men are employed in agricultural work (Figure 3.5, Table 3.7.1, and Table 3.7.2). Fifty-seven percent of women and 73% of men who worked in the 12 months preceding the survey reported being paid in cash only; 17% and 9%, respectively, are not paid for their work (Table 3.8.1 and Table 3.8.2). Women and men engaged in agricultural work are much more likely (33% and 30%, respectively) than those working in nonagricultural occupations (16% and 6%, respectively) to not be paid for their work. In addition, 61% of women are self-employed, 25% are employed by a non-family member, and 14% are employed by a family member. Most women (79%) are employed year-round (Table 3.8.1). Trends: Sales and services has been the dominant occupation among women in Ghana since 1998. Forty- six percent of women worked in that sector in 1998, and the percentage subsequently increased to 51% in 2008 and 2014 and 69% in 2022. 3.6 HEALTH INSURANCE COVERAGE The National Health Insurance Scheme (NHIS) was introduced in 2003 through the National Health Insurance Act (Act 650), which was repealed and replaced by Act 852 in 2012 with the goal of removing financial barriers to health care access among the residents of Ghana. National/district health insurance is the most common type of health insurance, covering 90% of women and 73% of men. One percent of both women and men have other employer-based insurance, less than 1% of women and men have mutual health organization/community-based insurance, and less than 1% of women and 1% of men have private insurance. Ten percent of women and 27% of men are neither registered nor covered under any scheme (Table 3.9.1 and Table 3.9.2). Figure 3.5 Occupation 69 1 1 13 9 6 2 34 5 1 33 12 12 2 Sales and services Unskilled manual Other Skilled manual Professional/ technical/ managerial Agriculture Clerical Percentage of women and men age 15–49 employed in the 12 months before the survey by occupation Women Men 36 • Characteristics of Respondents 3.7 TOBACCO USE Smoking is a risk factor for cardiovascular diseases and multiple forms of cancer. It contributes to the severity of pneumonia, emphysema, and chronic bronchitis symptoms. Through secondhand smoke, tobacco use affects the health status of all household members. Overall, 1% of women and 4% of men age 15–49 smoke cigarettes or any type of tobacco, and less than 1% of women and 1% of men smoke other forms of tobacco (Figure 3.6, Table 3.10.1, and Table 3.10.2). Sixty-four percent of men smoke less than five cigarettes per day, while 18% smoke five to nine cigarettes per day (Table 3.11). Use of any form of smokeless tobacco is also low (less than 1% among women and 1% among men) (Table 3.12). Overall, 1% of women and 5% of men age 15–49 use any type of tobacco (Table 3.13). Trends: The percentage of men who use any type of tobacco declined from 8% in 2003 to 5% in 2014 and 2022. 3.8 ALCOHOL CONSUMPTION Alcohol intake in large amounts is associated with an increased risk of alcoholism, malnutrition, chronic pancreatitis, alcohol liver disease, and cancer. Maternal alcohol use in the prenatal period is also of concern as it may cause miscarriage and stillbirth and contribute to a range of lifelong physical, behavioural, and intellectual disabilities. These disabilities are known as foetal alcohol spectrum disorders (CDC 2018). Fourteen percent of women and 30% of men age 15–49 consumed any alcohol in the last month. Eighty percent of women and 64% of men who consumed alcohol did so 1–5 days during the preceding month. Only 6% of women and 12% of men consumed alcohol every day or almost every day (Table 3.14.1 and Table 3.14.2). Among respondents who drank any alcohol in the previous month, 58% of women and 43% of men consumed one drink on days when alcohol was consumed, 20% of women and 23% of men consumed two drinks, and 9% of women and 14% of men consumed six or more drinks (Table 3.15.1 and Table 3.15.2). 3.9 PLACE OF BIRTH AND RECENT MIGRATION Recent migration Percentage of respondents who were born outside of their current place of residence and moved to their current place of residence in the 5 years preceding the survey. Sample: Women and men age 15–49 who were born outside their current place of residence Migration is linked with global issues including economic growth, poverty, and human rights. Thirty-two percent of women and 48% of men report that they have always lived in their current place of residence. Among the 66% of women and 50% of men who were born in Ghana but outside of their current place of residence, 40% of women and 34% of men moved to their current place of residence in the last 5 years (Table 3.16.1 and Table 3.16.2). Figure 3.6 Use of tobacco among women and men 1 <1 <1 14 1 1 5 Cigarettes Snuff Other tobacco Any tobacco use Percentage of women and men age 15–49 who use tobacco products Women Men Characteristics of Respondents • 37 3.9.1 Type of Migration Table 3.17 shows that most women and men who moved to their current place of residence in the 5 years before the survey moved from an urban area to another urban area (53% and 56%, respectively). The next most common type of migration is urban to rural (24% and 31%, respectively). 3.9.2 Reason for Migration Women and men mostly migrate for family-related reasons (45% and 46%, respectively). Twenty-eight percent of women migrate because of marriage, and 37% of men migrate for employment-related reasons (Table 3.18.1 and Table 3.18.2). LIST OF TABLES For more information on the characteristics of survey respondents, see the following tables: ▪ Table 3.1 Background characteristics of respondents ▪ Table 3.2.1 Educational attainment: Women ▪ Table 3.2.2 Educational attainment: Men ▪ Table 3.3.1 Literacy: Women ▪ Table 3.3.2 Literacy: Men ▪ Table 3.4.1 Exposure to mass media: Women ▪ Table 3.4.2 Exposure to mass media: Men ▪ Table 3.5.1 Internet usage: Women ▪ Table 3.5.2 Internet usage: Men ▪ Table 3.6.1 Employment status: Women ▪ Table 3.6.2 Employment status: Men ▪ Table 3.7.1 Occupation: Women ▪ Table 3.7.2 Occupation: Men ▪ Table 3.8.1 Type of employment: Women ▪ Table 3.8.2 Type of employment: Men ▪ Table 3.9.1 Health insurance coverage: Women ▪ Table 3.9.2 Health insurance coverage: Men ▪ Table 3.10.1 Tobacco smoking: Women ▪ Table 3.10.2 Tobacco smoking: Men ▪ Table 3.11 Average number of cigarettes smoked daily: Men ▪ Table 3.12 Smokeless tobacco use and any tobacco use ▪ Table 3.13 Any tobacco use by background characteristics ▪ Table 3.14.1 Alcohol consumption: Women ▪ Table 3.14.2 Alcohol consumption: Men ▪ Table 3.15.1 Usual number of alcoholic drinks consumed: Women ▪ Table 3.15.2 Usual number of alcoholic drinks consumed: Men ▪ Table 3.16.1 Place of birth and recent migration: Women ▪ Table 3.16.2 Place of birth and recent migration: Men ▪ Table 3.17 Type of migration ▪ Table 3.18.1 Reason for migration: Women ▪ Table 3.18.2 Reason for migration: Men 38 • Characteristics of Respondents Table 3.1 Background characteristics of respondents Percent distribution of women and men age 15–49 by selected background characteristics, Ghana DHS 2022 Women Men Background characteristic Weighted percent Weighted number Unweighted number Weighted percent Weighted number Unweighted number Age 15–19 17.9 2,682 2,835 22.7 1,424 1,430 20–24 17.9 2,695 2,669 16.5 1,033 1,023 25–29 15.6 2,340 2,386 14.1 888 882 30–34 15.0 2,252 2,228 13.6 853 899 35–39 13.7 2,059 2,021 12.9 809 806 40–44 11.2 1,675 1,646 11.4 713 711 45–49 8.7 1,312 1,229 8.9 557 542 Self-reported health status Very good 31.2 4,680 4,879 31.3 1,965 1,788 Good 45.7 6,862 6,934 46.0 2,887 3,075 Moderate 19.7 2,957 2,648 19.4 1,216 1,187 Bad 3.0 451 480 3.1 192 222 Very bad 0.4 63 73 0.3 18 21 Religion Catholic 9.1 1,367 1,669 8.1 508 676 Anglican 0.8 125 110 0.8 52 38 Methodist 5.0 751 567 5.5 346 244 Presbyterian 5.6 840 707 5.5 347 283 Pentecostal/Charismatic 41.6 6,251 5,366 35.0 2,199 1,793 Other Christian 14.6 2,197 2,011 15.4 965 856 Islam 19.4 2,906 3,994 21.1 1,322 1,808 Traditional/spiritualist 1.8 277 305 3.7 235 289 No religion 1.9 280 268 4.8 300 302 Other 0.1 20 17 0.1 4 4 Ethnic group Akan 46.1 6,917 5,217 46.0 2,887 2,146 Ga/Dangme 6.5 976 593 7.3 456 288 Ewe 11.6 1,746 1,641 10.9 687 662 Guan 3.2 476 697 3.5 223 314 Mole-Dagbani 18.6 2,789 4,024 18.4 1,155 1,646 Grusi 3.5 533 747 3.3 209 318 Gurma 6.7 1,013 1,484 6.7 422 615 Mande 3.0 445 479 2.6 161 212 Other 0.8 119 132 1.2 77 92 Marital status Never married 35.1 5,268 4,916 51.1 3,208 3,024 Married 40.0 6,008 6,884 37.8 2,374 2,603 Living together 14.6 2,197 1,927 7.2 454 417 Divorced/separated 7.8 1,175 960 3.6 224 229 Widowed 2.4 367 327 0.3 18 20 Residence Urban 57.0 8,557 7,362 54.8 3,442 2,925 Rural 43.0 6,457 7,652 45.2 2,835 3,368 Region Western 6.4 955 797 6.6 414 345 Central 11.3 1,703 979 10.9 686 396 Greater Accra 15.5 2,327 969 17.2 1,076 438 Volta 4.7 713 837 3.7 235 285 Eastern 8.1 1,220 854 7.4 466 325 Ashanti 19.5 2,928 1,131 18.8 1,179 438 Western North 2.7 411 792 2.9 181 351 Ahafo 2.1 317 849 2.1 133 359 Bono 3.8 567 835 3.5 222 324 Bono East 4.5 676 974 5.0 316 461 Oti 2.7 403 921 3.0 187 411 Northern 7.7 1,149 1,169 7.7 484 491 Savannah 2.1 319 999 2.5 155 490 North East 1.9 290 963 1.9 119 386 Upper East 4.3 640 987 4.3 267 415 Upper West 2.7 398 958 2.5 155 378 Education No education 16.1 2,411 3,357 10.0 628 938 Primary 13.8 2,071 2,245 11.5 725 833 Secondary 59.9 8,999 8,111 63.6 3,990 3,652 More than secondary 10.2 1,533 1,301 14.9 935 870 Wealth quintile Lowest 16.3 2,447 3,666 17.3 1,089 1,635 Second 18.1 2,712 3,366 18.0 1,133 1,391 Middle 20.8 3,121 3,008 18.1 1,137 1,176 Fourth 22.5 3,379 2,686 23.4 1,466 1,119 Highest 22.3 3,355 2,288 23.1 1,453 972 Continued… Characteristics of Respondents • 39 Table 3.1—Continued Women Men Background characteristic Weighted percent Weighted number Unweighted number Weighted percent Weighted number Unweighted number Total 15–49 100.0 15,014 15,014 100.0 6,277 6,293 50–59 na na na na 767 751 Total 15–59 na na na na 7,044 7,044 Note: Education categories refer to the highest level of education attended, whether or not that level was completed. na = not applicable Table 3.2.1 Educational attainment: Women Percent distribution of women age 15–49 by highest level of schooling attended or completed, and median years completed, according to background characteristics, Ghana DHS 2022 Highest level of schooling Total Median years completed Number of women Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Age 15–24 5.5 3.1 9.1 21.7 54.9 5.8 100.0 11.2 5,376 15–19 3.7 3.9 11.1 29.1 51.0 1.1 100.0 11.0 2,682 20–24 7.2 2.2 7.0 14.2 58.8 10.5 100.0 11.3 2,695 25–29 11.2 2.5 8.9 12.3 48.4 16.6 100.0 11.3 2,340 30–34 19.0 3.3 10.2 10.0 39.8 17.6 100.0 11.2 2,252 35–39 25.1 4.7 10.1 11.1 36.5 12.4 100.0 10.7 2,059 40–44 28.7 4.3 13.2 10.6 35.9 7.3 100.0 9.4 1,675 45–49 32.7 3.7 15.1 11.5 32.6 4.4 100.0 5.9 1,312 Residence Urban 9.2 2.5 8.8 15.3 49.4 14.9 100.0 11.3 8,557 Rural 25.2 4.6 12.5 14.4 39.3 4.0 100.0 9.8 6,457 Region Western 9.7 2.6 10.8 19.9 49.1 7.8 100.0 11.1 955 Central 7.4 5.1 10.9 26.2 42.6 7.8 100.0 11.0 1,703 Greater Accra 4.4 2.1 8.9 11.7 54.8 18.0 100.0 11.4 2,327 Volta 6.7 5.5 11.5 18.7 47.6 10.1 100.0 11.2 713 Eastern 7.8 4.7 11.9 15.7 50.3 9.5 100.0 11.2 1,220 Ashanti 9.0 2.3 8.9 12.3 56.0 11.5 100.0 11.3 2,928 Western North 14.0 4.8 10.2 21.8 41.7 7.6 100.0 10.9 411 Ahafo 17.5 3.3 8.6 21.9 43.7 5.1 100.0 10.9 317 Bono 11.8 2.9 7.9 20.9 46.3 10.2 100.0 11.1 567 Bono East 24.0 5.2 13.0 16.0 35.6 6.3 100.0 9.7 676 Oti 28.2 6.5 16.5 12.4 32.6 3.9 100.0 5.9 403 Northern 53.4 2.1 6.7 6.7 21.6 9.4 100.0 a 1,149 Savannah 46.9 4.2 17.1 6.0 22.5 3.3 100.0 3.9 319 North East 55.1 1.7 10.0 5.7 24.5 3.0 100.0 a 290 Upper East 25.9 3.7 13.6 9.6 38.0 9.1 100.0 10.1 640 Upper West 34.6 4.4 13.7 7.7 31.0 8.5 100.0 5.8 398 Wealth quintile Lowest 43.3 6.3 14.4 10.0 25.5 0.5 100.0 5.0 2,447 Second 24.6 4.7 13.9 16.6 39.1 1.1 100.0 9.6 2,712 Middle 11.7 4.1 12.6 18.6 50.2 2.8 100.0 11.1 3,121 Fourth 7.4 2.6 7.9 15.6 57.1 9.4 100.0 11.3 3,379 Highest 2.0 0.6 4.9 12.9 47.2 32.4 100.0 11.6 3,355 Total 16.1 3.4 10.4 14.9 45.0 10.2 100.0 11.1 15,014 1 Completed 6 grade at the primary level 2 Completed 6 grade at the secondary level a = Omitted because more than 50% of the women completed 0 years of education 40 • Characteristics of Respondents Table 3.2.2 Educational attainment: Men Percent distribution of men age 15–49 by highest level of schooling attended or completed, and median years completed, according to background characteristics, Ghana DHS 2022 Highest level of schooling Total Median years completed Number of men Background characteristic No education Some primary Completed primary1 Some secondary Completed secondary2 More than secondary Age 15–24 4.5 3.9 9.0 21.0 53.7 7.9 100.0 11.2 2,458 15–19 3.7 4.7 10.6 27.2 52.5 1.3 100.0 11.1 1,424 20–24 5.6 2.9 6.9 12.4 55.3 17.0 100.0 11.4 1,033 25–29 8.0 1.9 7.0 10.4 52.0 20.7 100.0 11.4 888 30–34 12.1 2.2 9.6 7.4 45.7 23.0 100.0 11.4 853 35–39 15.0 2.1 8.7 11.0 43.6 19.6 100.0 11.3 809 40–44 16.2 1.7 8.4 9.2 49.2 15.3 100.0 11.3 713 45–49 19.0 3.4 8.4 10.3 42.0 16.9 100.0 11.2 557 Residence Urban 4.7 1.8 6.0 14.1 51.7 21.6 100.0 11.5 3,442 Rural 16.4 4.2 11.9 13.9 46.9 6.8 100.0 11.1 2,835 Region Western 5.0 1.7 9.9 10.9 61.3 11.3 100.0 11.4 414 Central 3.7 5.9 5.8 21.2 50.6 13.0 100.0 11.3 686 Greater Accra 1.8 1.1 6.1 11.5 53.2 26.3 100.0 11.6 1,076 Volta 3.5 1.4 10.6 19.8 48.2 16.5 100.0 11.3 235 Eastern 3.7 4.9 8.8 18.6 50.7 13.4 100.0 11.3 466 Ashanti 4.1 0.8 7.4 13.6 63.6 10.5 100.0 11.4 1,179 Western North 4.9 1.9 12.2 19.9 50.8 10.3 100.0 11.2 181 Ahafo 9.3 1.4 8.6 16.2 53.4 11.0 100.0 11.3 133 Bono 7.6 3.2 8.1 17.8 45.1 18.3 100.0 11.3 222 Bono East 24.2 2.0 10.7 7.8 43.0 12.3 100.0 11.1 316 Oti 18.7 9.2 11.1 16.6 35.4 9.1 100.0 10.0 187 Northern 34.2 5.2 8.9 11.8 25.1 14.9 100.0 8.5 484 Savannah 38.1 2.4 12.7 6.8 30.9 9.1 100.0 5.7 155 North East 33.8 6.7 8.9 8.9 31.3 10.4 100.0 8.3 119 Upper East 12.7 2.9 16.4 9.0 42.9 16.0 100.0 11.2 267 Upper West 25.6 3.6 14.3 12.3 30.9 13.3 100.0 9.4 155 Wealth quintile Lowest 31.7 7.1 15.3 12.4 31.6 1.8 100.0 5.7 1,089 Second 14.3 4.2 12.8 18.1 46.1 4.5 100.0 11.0 1,133 Middle 6.1 3.3 10.4 16.8 55.1 8.3 100.0 11.2 1,137 Fourth 2.5 1.1 6.3 13.9 62.7 13.4 100.0 11.4 1,466 Highest 0.9 0.1 1.6 10.0 47.9 39.5 100.0 11.8 1,453 Total 15–49 10.0 2.9 8.7 14.0 49.5 14.9 100.0 11.3 6,277 50–59 22.5 2.8 10.5 10.8 43.4 10.1 100.0 11.1 767 Total 15–59 11.4 2.9 8.9 13.7 48.8 14.4 100.0 11.3 7,044 1 Completed 6 grade at the primary level 2 Completed 6 grade at the secondary level Characteristics of Respondents • 41 Table 3.3.1 Literacy: Women Percent distribution of women age 15–49 by level of schooling attended and level of literacy, and percentage literate, according to background characteristics, Ghana DHS 2022 Higher than secondary schooling No schooling, primary or secondary school Total Percent- age literate1 Number of women Background characteristic Can read a whole sentence Can read part of a sentence Cannot read at all No card with required language Blind/ visually impaired Age 15–24 5.8 58.8 14.2 20.9 0.2 0.0 100.0 78.9 5,376 15–19 1.1 66.2 15.1 17.3 0.2 0.0 100.0 82.4 2,682 20–24 10.5 51.4 13.3 24.4 0.2 0.0 100.0 75.3 2,695 25–29 16.6 38.1 13.0 31.9 0.4 0.0 100.0 67.7 2,340 30–34 17.6 27.0 12.8 42.2 0.4 0.0 100.0 57.4 2,252 35–39 12.4 24.8 10.9 51.5 0.4 0.0 100.0 48.1 2,059 40–44 7.3 18.0 11.5 62.9 0.0 0.3 100.0 36.8 1,675 45–49 4.4 17.3 9.0 69.0 0.1 0.1 100.0 30.7 1,312 Residence Urban 14.9 44.2 12.4 28.1 0.3 0.1 100.0 71.5 8,557 Rural 4.0 29.8 12.9 53.1 0.2 0.0 100.0 46.6 6,457 Region Western 7.8 41.5 16.0 34.6 0.0 0.0 100.0 65.4 955 Central 7.8 50.0 15.0 26.9 0.3 0.0 100.0 72.9 1,703 Greater Accra 18.0 50.0 11.2 20.5 0.2 0.1 100.0 79.2 2,327 Volta 10.1 51.5 10.4 26.3 1.4 0.3 100.0 72.0 713 Eastern 9.5 40.9 16.3 33.2 0.1 0.0 100.0 66.7 1,220 Ashanti 11.5 37.3 12.8 38.3 0.2 0.0 100.0 61.5 2,928 Western North 7.6 28.0 12.2 52.2 0.0 0.0 100.0 47.8 411 Ahafo 5.1 28.5 14.7 51.7 0.0 0.0 100.0 48.3 317 Bono 10.2 36.7 14.6 38.1 0.2 0.1 100.0 61.5 567 Bono East 6.3 28.6 10.1 54.7 0.4 0.0 100.0 44.9 676 Oti 3.9 26.4 10.4 57.8 1.0 0.4 100.0 40.8 403 Northern 9.4 15.7 9.0 65.9 0.0 0.0 100.0 34.1 1,149 Savannah 3.3 17.6 9.9 68.4 0.7 0.0 100.0 30.9 319 North East 3.0 15.8 8.4 72.0 0.8 0.0 100.0 27.2 290 Upper East 9.1 33.8 12.3 44.7 0.1 0.1 100.0 55.2 640 Upper West 8.5 29.7 12.8 48.6 0.3 0.1 100.0 51.0 398 Wealth quintile Lowest 0.5 18.2 10.0 71.0 0.3 0.0 100.0 28.7 2,447 Second 1.1 28.9 13.8 56.0 0.1 0.1 100.0 43.7 2,712 Middle 2.8 41.0 15.8 40.0 0.2 0.2 100.0 59.6 3,121 Fourth 9.4 49.6 13.2 27.5 0.3 0.0 100.0 72.1 3,379 Highest 32.4 45.1 10.1 12.0 0.4 0.0 100.0 87.7 3,355 Total 10.2 38.0 12.6 38.9 0.3 0.1 100.0 60.8 15,014 1 Refers to women who attended schooling higher than the secondary level and women with less schooling who can read a whole sentence or part of a sentence 42 • Characteristics of Respondents Table 3.3.2 Literacy: Men Percent distribution of men age 15–49 by level of schooling attended and level of literacy, and percentage literate, according to background characteristics, Ghana DHS 2022 Higher than secondary schooling No schooling, primary or secondary school Total Percent- age literate1 Number of men Background characteristic Can read a whole sentence Can read part of a sentence Cannot read at all No card with required language Blind/ visually impaired Age 15–24 7.9 55.1 17.2 19.8 0.1 0.0 100.0 80.1 2,458 15–19 1.3 57.4 20.5 20.7 0.1 0.0 100.0 79.2 1,424 20–24 17.0 51.9 12.6 18.5 0.0 0.1 100.0 81.4 1,033 25–29 20.7 42.3 15.3 21.4 0.3 0.1 100.0 78.3 888 30–34 23.0 35.0 16.4 25.5 0.0 0.0 100.0 74.5 853 35–39 19.6 27.2 23.4 29.8 0.1 0.0 100.0 70.1 809 40–44 15.3 25.8 21.2 37.5 0.2 0.0 100.0 62.3 713 45–49 16.9 22.0 19.3 41.6 0.1 0.2 100.0 58.1 557 Residence Urban 21.6 44.9 18.7 14.7 0.1 0.0 100.0 85.2 3,442 Rural 6.8 35.5 17.7 39.8 0.1 0.0 100.0 60.0 2,835 Region Western 11.3 40.9 23.9 24.0 0.0 0.0 100.0 76.0 414 Central 13.0 45.6 15.6 25.9 0.0 0.0 100.0 74.1 686 Greater Accra 26.3 42.4 25.2 5.8 0.4 0.0 100.0 93.9 1,076 Volta 16.5 56.2 14.1 12.7 0.5 0.0 100.0 86.8 235 Eastern 13.4 46.0 13.4 27.2 0.0 0.0 100.0 72.8 466 Ashanti 10.5 49.3 17.1 23.2 0.0 0.0 100.0 76.8 1,179 Western North 10.3 35.7 28.6 25.5 0.0 0.0 100.0 74.5 181 Ahafo 11.0 45.0 14.1 29.9 0.0 0.0 100.0 70.1 133 Bono 18.3 37.2 20.7 23.9 0.0 0.0 100.0 76.1 222 Bono East 12.3 29.7 22.4 35.7 0.0 0.0 100.0 64.3 316 Oti 9.1 37.4 11.0 41.6 0.7 0.2 100.0 57.5 187 Northern 14.9 24.7 12.8 47.3 0.0 0.2 100.0 52.4 484 Savannah 9.1 26.4 15.5 48.6 0.0 0.4 100.0 51.0 155 North East 10.4 25.0 15.2 49.4 0.0 0.0 100.0 50.6 119 Upper East 16.0 31.7 15.7 36.3 0.0 0.2 100.0 63.5 267 Upper West 13.3 26.9 11.2 48.7 0.0 0.0 100.0 51.3 155 Wealth quintile Lowest 1.8 24.3 16.3 57.3 0.1 0.1 100.0 42.5 1,089 Second 4.5 36.7 18.1 40.6 0.0 0.1 100.0 59.3 1,133 Middle 8.3 44.5 22.2 24.7 0.1 0.1 100.0 75.1 1,137 Fourth 13.4 50.8 20.8 15.0 0.1 0.0 100.0 84.9 1,466 Highest 39.5 42.8 14.2 3.4 0.2 0.0 100.0 96.4 1,453 Total 15–49 14.9 40.7 18.3 26.0 0.1 0.0 100.0 73.8 6,277 50–59 10.1 24.4 19.6 45.1 0.0 0.9 100.0 54.0 767 Total 15–59 14.4 38.9 18.4 28.1 0.1 0.1 100.0 71.7 7,044 1 Refers to men who attended schooling higher than the secondary level and men with less schooling who can read a whole sentence or part of a sentence Characteristics of Respondents • 43 Table 3.4.1 Exposure to mass media: Women Percentage of women age 15–49 who are exposed to specific media on a weekly basis, according to background characteristics, Ghana DHS 2022 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of women Age 15–19 5.0 61.9 34.7 1.9 29.1 2,682 20–24 3.8 60.4 38.5 1.7 28.0 2,695 25–29 3.8 66.8 41.1 2.3 23.8 2,340 30–34 3.9 65.7 44.7 2.5 24.5 2,252 35–39 2.2 62.7 47.4 1.4 25.7 2,059 40–44 2.8 59.0 48.9 2.1 28.4 1,675 45–49 2.6 48.8 46.8 1.9 34.6 1,312 Residence Urban 5.0 73.0 45.3 2.8 19.1 8,557 Rural 1.7 46.4 38.3 0.9 38.3 6,457 Region Western 3.5 69.3 51.2 1.7 19.3 955 Central 5.3 73.5 46.0 2.1 17.7 1,703 Greater Accra 7.6 82.8 47.6 4.7 13.4 2,327 Volta 4.1 56.8 50.3 2.8 27.0 713 Eastern 3.0 71.3 47.6 1.8 17.9 1,220 Ashanti 1.8 62.4 47.6 1.0 24.0 2,928 Western North 3.4 57.6 38.3 1.5 28.4 411 Ahafo 1.1 43.5 33.4 1.0 39.7 317 Bono 1.8 61.4 40.2 0.9 27.5 567 Bono East 3.7 51.8 32.3 1.9 37.3 676 Oti 2.2 53.0 44.3 1.1 30.0 403 Northern 1.8 41.0 19.1 1.0 53.8 1,149 Savannah 1.0 37.9 30.0 0.6 44.7 319 North East 1.3 38.7 28.6 0.7 45.3 290 Upper East 3.5 30.8 36.2 1.7 49.4 640 Upper West 1.8 29.3 29.2 1.0 53.1 398 Education No education 0.2 33.1 29.2 0.1 52.2 2,411 Primary 0.7 54.7 38.0 0.1 32.6 2,071 Secondary 3.4 67.8 45.3 1.8 21.7 8,999 More than secondary 14.0 79.4 50.8 8.3 14.0 1,533 Wealth quintile Lowest 1.1 15.5 31.0 0.5 61.9 2,447 Second 1.8 46.7 36.7 0.5 38.1 2,712 Middle 1.4 67.4 40.3 0.7 22.8 3,121 Fourth 4.1 78.7 47.7 2.5 14.9 3,379 Highest 8.5 84.6 51.4 4.9 10.2 3,355 Total 3.6 61.6 42.3 2.0 27.3 15,014 44 • Characteristics of Respondents Table 3.4.2 Exposure to mass media: Men Percentage of men age 15–49 who are exposed to specific media on a weekly basis, according to background characteristics, Ghana DHS 2022 Background characteristic Reads a newspaper at least once a week Watches television at least once a week Listens to the radio at least once a week Accesses all three media at least once a week Accesses none of the three media at least once a week Number of men Age 15–19 5.5 62.1 34.3 3.4 29.0 1,424 20–24 8.6 61.1 48.2 5.8 25.2 1,033 25–29 9.0 64.9 51.8 5.0 22.4 888 30–34 8.7 67.4 54.4 5.5 18.7 853 35–39 7.8 66.7 61.6 5.9 17.6 809 40–44 8.1 62.7 59.2 5.8 18.4 713 45–49 8.0 57.8 66.0 6.4 21.0 557 Residence Urban 9.2 71.7 51.6 6.0 18.2 3,442 Rural 6.0 53.2 50.1 4.1 28.0 2,835 Region Western 36.1 86.3 76.3 31.9 6.5 414 Central 4.3 65.4 47.5 2.0 18.8 686 Greater Accra 7.2 74.2 58.7 4.4 14.3 1,076 Volta 9.3 69.6 60.6 4.8 16.6 235 Eastern 4.5 75.9 46.4 3.3 15.0 466 Ashanti 7.1 65.3 52.8 4.2 21.9 1,179 Western North 2.6 53.0 54.3 2.3 27.0 181 Ahafo 3.0 43.5 54.3 0.9 29.6 133 Bono 8.3 66.1 47.4 4.1 19.4 222 Bono East 2.6 46.6 31.2 2.3 44.0 316 Oti 5.2 56.7 50.5 2.5 25.7 187 Northern 6.4 49.5 42.8 3.2 31.6 484 Savannah 3.6 42.1 35.1 1.5 41.5 155 North East 4.9 43.4 37.8 3.6 41.6 119 Upper East 4.4 47.2 42.4 2.0 31.0 267 Upper West 2.6 30.0 34.5 0.9 49.5 155 Education No education 0.5 33.1 40.5 0.0 44.8 628 Primary 0.7 48.9 48.4 0.4 32.2 725 Secondary 7.0 68.1 52.3 5.1 19.8 3,990 More than secondary 21.5 74.4 54.4 12.7 12.7 935 Wealth quintile Lowest 1.5 24.3 42.6 0.5 46.6 1,089 Second 5.5 58.4 46.2 4.0 27.6 1,133 Middle 5.9 69.4 54.1 3.2 17.6 1,137 Fourth 9.4 76.6 57.1 6.4 13.6 1,466 Highest 14.0 78.3 52.1 9.9 14.0 1,453 Total 15–49 7.8 63.3 50.9 5.2 22.7 6,277 50–59 7.7 52.7 64.5 6.3 24.0 767 Total 15–59 7.7 62.2 52.4 5.3 22.8 7,044 Characteristics of Respondents • 45 Table 3.5.1 Internet usage: Women Percentage of women age 15–49 who have ever used the internet and percentage who have used the internet in the last 12 months, and among women who have used the internet in the last 12 months, percent distribution by frequency of internet use in the last month, according to background characteristics, Ghana DHS 2022 Ever used the internet Used the internet in the last 12 months Number Among respondents who have used the internet in the last 12 months, percentage who, in the last month, used the internet: Background characteristic Almost every day At least once a week Less than once a week Not at all Total Number Age 15–19 40.1 35.7 2,682 56.0 27.6 12.1 4.3 100.0 957 20–24 62.9 58.9 2,695 69.6 21.0 6.2 3.2 100.0 1,588 25–29 58.1 54.9 2,340 67.7 21.7 6.7 3.9 100.0 1,284 30–34 49.9 47.6 2,252 67.4 24.1 5.7 2.8 100.0 1,073 35–39 41.4 38.4 2,059 62.4 24.6 10.6 2.4 100.0 790 40–44 32.2 29.8 1,675 56.4 28.6 10.0 5.0 100.0 500 45–49 26.1 23.8 1,312 51.6 30.7 14.0 3.8 100.0 313 Residence Urban 60.7 57.8 8,557 67.0 23.1 6.8 3.0 100.0 4,950 Rural 27.8 24.1 6,457 54.9 27.3 12.9 4.9 100.0 1,555 Region Western 50.9 47.7 955 58.4 23.6 13.5 4.5 100.0 455 Central 51.4 46.7 1,703 62.7 20.5 10.2 6.7 100.0 794 Greater Accra 69.3 67.8 2,327 72.3 21.7 3.9 2.2 100.0 1,578 Volta 38.8 36.4 713 65.3 24.5 7.0 3.2 100.0 259 Eastern 42.0 40.0 1,220 75.9 15.2 5.8 3.0 100.0 488 Ashanti 57.2 52.0 2,928 60.1 29.6 7.4 2.9 100.0 1,522 Western North 32.1 28.5 411 57.0 25.5 11.7 5.7 100.0 117 Ahafo 34.6 31.1 317 40.0 39.4 19.9 0.7 100.0 98 Bono 45.3 41.7 567 63.6 24.3 8.1 4.0 100.0 237 Bono East 32.7 30.5 676 64.0 26.9 8.1 0.9 100.0 206 Oti 18.8 17.8 403 61.4 30.9 5.9 1.8 100.0 72 Northern 31.5 28.1 1,149 54.0 20.6 20.7 4.8 100.0 323 Savannah 16.8 15.3 319 52.4 32.2 13.6 1.8 100.0 49 North East 13.5 11.7 290 57.3 35.9 6.8 0.0 100.0 34 Upper East 33.0 30.1 640 64.0 20.4 10.6 5.0 100.0 192 Upper West 22.4 20.3 398 46.5 37.6 8.5 7.3 100.0 81 Education No education 12.2 11.0 2,411 29.2 38.0 26.4 6.4 100.0 264 Primary 20.8 17.9 2,071 44.8 31.6 17.5 6.1 100.0 370 Secondary 53.0 48.9 8,999 59.8 27.4 8.8 4.0 100.0 4,396 More than secondary 97.0 96.2 1,533 88.0 10.0 1.3 0.8 100.0 1,474 Wealth quintile Lowest 11.3 8.8 2,447 39.7 28.2 21.9 10.3 100.0 215 Second 24.2 21.1 2,712 48.5 32.9 13.7 5.0 100.0 571 Middle 39.5 35.6 3,121 51.5 31.0 12.0 5.5 100.0 1,112 Fourth 60.5 56.8 3,379 61.9 26.0 9.2 2.9 100.0 1,918 Highest 82.7 80.1 3,355 76.2 17.7 3.9 2.2 100.0 2,689 Total 46.5 43.3 15,014 64.1 24.1 8.3 3.5 100.0 6,505 46 • Characteristics of Respondents Table 3.5.2 Internet usage: Men Percentage of men age 15–49 who have ever used the internet and percentage who have used the internet in the last 12 months, and among men who have used the internet in the last 12 months, percent distribution by frequency of internet use in the last month, according to background characteristics, Ghana DHS 2022 Ever used the internet Used the internet in the last 12 months Number Among respondents who have used the internet in the last 12 months, percentage who, in the last month, used the internet: Background characteristic Almost every day At least once a week Less than once a week Not at all Total Number Age 15–19 56.8 50.2 1,424 61.1 26.2 10.0 2.7 100.0 715 20–24 81.7 79.2 1,033 76.8 14.0 7.6 1.6 100.0 818 25–29 79.5 76.3 888 83.3 12.0 3.6 1.1 100.0 677 30–34 71.4 68.3 853 78.7 16.3 2.7 2.3 100.0 582 35–39 61.9 59.6 809 78.9 16.0 4.0 1.0 100.0 482 40–44 52.3 50.7 713 70.1 23.9 4.9 1.1 100.0 362 45–49 43.2 40.9 557 71.5 20.9 5.8 1.9 100.0 228 Residence Urban 77.2 74.4 3,442 81.2 13.7 4.2 0.9 100.0 2,560 Rural 50.3 46.0 2,835 61.8 26.1 8.8 3.2 100.0 1,304 Region Western 69.8 66.4 414 84.0 11.0 2.6 2.4 100.0 275 Central 60.0 57.9 686 66.8 25.4 6.7 1.0 100.0 398 Greater Accra 84.7 82.1 1,076 89.0 9.2 1.8 0.0 100.0 884 Volta 68.4 66.3 235 73.1 17.9 2.0 7.0 100.0 156 Eastern 59.7 59.2 466 70.1 14.8 15.1 0.0 100.0 276 Ashanti 75.0 68.6 1,179 71.6 22.4 6.0 0.0 100.0 809 Western North 60.5 59.1 181 51.2 28.2 20.7 0.0 100.0 107 Ahafo 50.0 46.6 133 71.5 20.0 3.7 4.7 100.0 62 Bono 66.6 62.0 222 72.3 18.1 9.0 0.6 100.0 138 Bono East 54.8 52.8 316 76.6 20.5 1.5 1.3 100.0 167 Oti 53.9 49.4 187 50.7 29.9 8.5 10.9 100.0 92 Northern 44.7 39.6 484 70.9 18.0 5.4 5.7 100.0 192 Savannah 41.2 38.1 155 63.8 21.1 5.3 9.8 100.0 59 North East 37.9 37.1 119 86.2 11.6 0.4 1.8 100.0 44 Upper East 58.7 54.2 267 67.9 21.5 5.4 5.3 100.0 145 Upper West 42.8 39.5 155 52.0 23.6 18.5 5.9 100.0 61 Education No education 24.4 22.0 628 54.8 32.0 7.5 5.7 100.0 138 Primary 36.3 31.5 725 62.4 21.4 14.5 1.8 100.0 229 Secondary 69.2 65.0 3,990 70.7 20.8 6.6 2.0 100.0 2,593 More than secondary 97.0 96.8 935 92.2 6.3 1.1 0.4 100.0 905 Wealth quintile Lowest 31.4 27.8 1,089 50.2 30.6 13.2 6.0 100.0 303 Second 49.0 43.9 1,133 60.0 25.7 11.0 3.4 100.0 497 Middle 62.7 59.0 1,137 67.0 22.2 8.5 2.3 100.0 670 Fourth 77.8 74.7 1,466 76.7 17.4 4.8 1.0 100.0 1,095 Highest 91.7 89.3 1,453 88.1 10.0 1.5 0.4 100.0 1,298 Total 15–49 65.0 61.6 6,277 74.7 17.9 5.8 1.7 100.0 3,864 50–59 30.8 29.0 767 62.9 22.1 14.0 1.0 100.0 223 Total 15–59 61.3 58.0 7,044 74.0 18.1 6.2 1.7 100.0 4,087 Characteristics of Respondents • 47 Table 3.6.1 Employment status: Women Percent distribution of women age 15–49 by employment status, according to background characteristics, Ghana DHS 2022 Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Total Number of women Background characteristic Currently employed1 Not currently employed Age 15–19 37.5 3.0 59.4 100.0 2,682 20–24 65.0 5.1 29.9 100.0 2,695 25–29 80.3 4.5 15.1 100.0 2,340 30–34 87.6 3.9 8.6 100.0 2,252 35–39 89.3 3.0 7.7 100.0 2,059 40–44 92.4 2.2 5.5 100.0 1,675 45–49 92.1 2.0 5.9 100.0 1,312 Marital status Never married 54.9 3.7 41.3 100.0 5,268 Married or living together 84.6 3.4 12.0 100.0 8,205 Divorced/separated/ widowed 88.9 4.0 7.1 100.0 1,542 Number of living children 0 53.9 3.6 42.4 100.0 4,925 1–2 78.9 4.4 16.7 100.0 4,598 3–4 88.7 3.0 8.2 100.0 3,391 5+ 91.0 2.5 6.5 100.0 2,100 Residence Urban 73.0 3.6 23.4 100.0 8,557 Rural 76.8 3.5 19.7 100.0 6,457 Region Western 76.7 2.7 20.7 100.0 955 Central 75.8 4.4 19.8 100.0 1,703 Greater Accra 70.1 4.0 25.9 100.0 2,327 Volta 74.9 3.7 21.4 100.0 713 Eastern 73.2 2.1 24.7 100.0 1,220 Ashanti 79.4 2.4 18.3 100.0 2,928 Western North 79.5 4.3 16.2 100.0 411 Ahafo 64.9 7.9 27.2 100.0 317 Bono 75.3 3.1 21.7 100.0 567 Bono East 71.2 3.2 25.5 100.0 676 Oti 80.0 4.4 15.6 100.0 403 Northern 74.6 3.5 21.8 100.0 1,149 Savannah 64.0 5.3 30.6 100.0 319 North East 70.7 5.6 23.6 100.0 290 Upper East 78.7 3.2 18.1 100.0 640 Upper West 67.3 6.9 25.8 100.0 398 Education No education 84.2 3.1 12.7 100.0 2,411 Primary 79.3 3.7 17.0 100.0 2,071 Secondary 70.5 3.5 26.0 100.0 8,999 More than secondary 77.7 4.4 17.9 100.0 1,533 Wealth quintile Lowest 75.9 3.9 20.2 100.0 2,447 Second 74.2 4.1 21.7 100.0 2,712 Middle 73.8 3.5 22.7 100.0 3,121 Fourth 74.8 3.7 21.5 100.0 3,379 Highest 74.7 2.9 22.4 100.0 3,355 Total 74.6 3.6 21.8 100.0 15,014 1 Currently employed is defined as having done work in the last 7 days. Includes persons who did not work in the last 7 days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. 48 • Characteristics of Respondents Table 3.6.2 Employment status: Men Percent distribution of men age 15–49 by employment status, according to background characteristics, Ghana DHS 2022 Employed in the 12 months preceding the survey Not employed in the 12 months preceding the survey Total Number of men Background characteristic Currently employed1 Not currently employed Age 15–19 49.2 6.1 44.7 100.0 1,424 20–24 77.3 5.2 17.5 100.0 1,033 25–29 93.9 1.8 4.3 100.0 888 30–34 95.7 2.4 1.9 100.0 853 35–39 98.6 0.7 0.7 100.0 809 40–44 98.6 0.2 1.3 100.0 713 45–49 97.1 0.8 2.1 100.0 557 Marital status Never married 67.8 5.0 27.2 100.0 3,208 Married or living together 98.6 0.9 0.5 100.0 2,828 Divorced/separated/ widowed 93.3 1.2 5.5 100.0 242 Number of living children 0 68.3 5.0 26.7 100.0 3,270 1–2 98.0 1.1 1.0 100.0 1,356 3–4 98.8 0.7 0.4 100.0 1,014 5+ 98.2 0.7 1.1 100.0 636 Residence Urban 80.3 3.5 16.2 100.0 3,442 Rural 85.6 2.4 12.0 100.0 2,835 Region Western 73.5 4.6 21.9 100.0 414 Central 75.5 2.7 21.8 100.0 686 Greater Accra 82.9 3.4 13.6 100.0 1,076 Volta 78.0 3.6 18.4 100.0 235 Eastern 85.3 0.9 13.8 100.0 466 Ashanti 83.2 4.0 12.8 100.0 1,179 Western North 85.5 2.0 12.5 100.0 181 Ahafo 82.3 1.1 16.6 100.0 133 Bono 77.0 2.8 20.2 100.0 222 Bono East 90.5 0.9 8.6 100.0 316 Oti 89.2 5.6 5.2 100.0 187 Northern 89.4 2.3 8.3 100.0 484 Savannah 84.7 4.5 10.8 100.0 155 North East 91.5 0.4 8.2 100.0 119 Upper East 81.2 1.7 17.1 100.0 267 Upper West 86.3 4.6 9.1 100.0 155 Education No education 96.2 1.3 2.5 100.0 628 Primary 85.5 2.2 12.3 100.0 725 Secondary 80.0 3.2 16.8 100.0 3,990 More than secondary 82.9 3.8 13.3 100.0 935 Wealth quintile Lowest 89.0 1.5 9.5 100.0 1,089 Second 81.6 3.0 15.3 100.0 1,133 Middle 82.9 4.1 13.0 100.0 1,137 Fourth 81.7 3.0 15.3 100.0 1,466 Highest 79.7 3.2 17.1 100.0 1,453 Total 15–49 82.7 3.0 14.3 100.0 6,277 50–59 96.4 1.8 1.8 100.0 767 Total 15–59 84.2 2.9 13.0 100.0 7,044 1 Currently employed is defined as having done work in the last 7 days. Includes persons who did not work in the last 7 days but who are regularly employed and were absent from work for leave, illness, vacation, or any other such reason. Characteristics of Respondents • 49 Table 3.7.1 Occupation: Women Percent distribution of women age 15–49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Ghana DHS 2022 Background characteristic Profes- sional/ technical/ managerial Clerical Sales and services Skilled manual Unskilled manual Agriculture Other Total Number of women Age 15–19 3.0 1.0 57.6 15.8 1.0 18.3 3.4 100.0 1,088 20–24 7.4 3.7 58.0 22.0 1.3 6.2 1.5 100.0 1,889 25–29 11.3 3.8 63.4 16.4 0.8 4.0 0.3 100.0 1,986 30–34 12.4 1.2 68.7 11.6 0.9 4.2 0.9 100.0 2,059 35–39 10.5 1.3 73.6 9.7 0.6 3.9 0.5 100.0 1,901 40–44 5.6 0.5 81.4 8.3 0.3 3.6 0.3 100.0 1,583 45–49 5.1 0.5 83.8 5.6 0.8 3.9 0.3 100.0 1,235 Marital status Never married 11.1 4.1 56.2 16.4 1.0 8.9 2.3 100.0 3,090 Married or living together 8.1 1.2 72.6 12.5 0.5 4.8 0.4 100.0 7,218 Divorced/separated/ widowed 5.4 0.7 79.7 9.0 1.9 2.9 0.5 100.0 1,433 Number of living children 0 13.7 3.9 51.4 18.0 1.0 9.4 2.6 100.0 2,835 1–2 10.3 2.2 66.4 15.7 0.9 4.0 0.6 100.0 3,830 3–4 6.2 0.8 77.6 10.5 0.8 3.9 0.2 100.0 3,113 5+ 1.4 0.2 86.7 5.0 0.3 6.0 0.4 100.0 1,963 Residence Urban 11.6 2.7 67.9 13.7 0.7 2.2 1.2 100.0 6,553 Rural 4.7 0.8 70.7 12.3 0.9 10.0 0.6 100.0 5,188 Region Western 8.9 1.8 69.3 14.7 1.1 4.1 0.2 100.0 757 Central 6.8 1.3 73.6 12.9 1.0 3.1 1.2 100.0 1,365 Greater Accra 13.1 2.5 70.0 11.1 1.1 1.2 1.0 100.0 1,725 Volta 10.4 1.3 70.6 13.7 0.3 2.7 1.0 100.0 560 Eastern 10.5 1.6 72.4 14.4 0.3 0.4 0.3 100.0 919 Ashanti 8.6 2.9 71.4 11.8 1.5 3.0 0.8 100.0 2,393 Western North 5.8 1.2 60.2 14.4 0.8 17.3 0.3 100.0 344 Ahafo 4.4 1.6 70.6 11.7 0.9 9.8 1.1 100.0 231 Bono 9.7 2.3 63.5 13.2 0.5 7.6 3.1 100.0 444 Bono East 6.2 2.4 60.6 11.9 0.0 18.5 0.4 100.0 503 Oti 4.7 0.6 81.9 7.9 0.0 4.5 0.4 100.0 340 Northern 6.5 0.9 62.9 13.0 0.2 15.7 0.8 100.0 898 Savannah 3.1 0.8 64.8 14.3 0.7 16.1 0.2 100.0 222 North East 2.3 0.7 77.4 12.6 0.1 6.5 0.3 100.0 221 Upper East 8.8 1.5 58.5 20.7 0.1 7.6 2.8 100.0 524 Upper West 7.0 1.6 64.2 19.8 0.2 6.6 0.6 100.0 295 Education No education 0.6 0.0 80.7 8.0 0.4 10.0 0.2 100.0 2,104 Primary 0.2 0.0 78.7 12.7 1.3 6.5 0.6 100.0 1,719 Secondary 3.8 2.2 71.2 16.2 0.9 4.7 0.9 100.0 6,660 More than secondary 58.1 5.9 25.9 5.6 0.1 1.7 2.6 100.0 1,259 Wealth quintile Lowest 0.7 0.1 71.1 11.1 0.5 15.9 0.5 100.0 1,952 Second 1.5 0.6 75.0 12.7 0.4 9.0 0.8 100.0 2,124 Middle 4.5 1.3 72.1 16.3 1.8 3.4 0.6 100.0 2,412 Fourth 8.2 3.2 71.9 13.3 0.8 1.8 0.8 100.0 2,652 Highest 24.3 3.5 57.4 11.7 0.4 1.2 1.7 100.0 2,602 Total 8.6 1.9 69.1 13.1 0.8 5.6 0.9 100.0 11,741 50 • Characteristics of Respondents Table 3.7.2 Occupation: Men Percent distribution of men age 15–49 employed in the 12 months preceding the survey by occupation, according to background characteristics, Ghana DHS 2022 Background characteristic Profes- sional/ technical/ managerial Clerical Sales and services Skilled manual Unskilled manual Agriculture Other Total Number of men Age 15–19 2.2 0.1 35.3 27.2 8.9 23.9 2.4 100.0 787 20–24 9.2 2.8 30.9 34.5 7.6 13.2 1.7 100.0 852 25–29 17.0 3.0 25.7 36.6 6.5 10.1 1.1 100.0 849 30–34 16.2 2.3 31.1 36.0 4.0 9.6 0.9 100.0 837 35–39 14.3 2.2 36.2 34.4 3.6 8.1 1.1 100.0 803 40–44 10.9 1.9 40.9 32.5 2.4 10.9 0.6 100.0 704 45–49 16.0 0.5 41.3 29.5 2.7 9.6 0.4 100.0 545 Marital status Never married 12.0 2.5 30.6 32.0 6.9 14.0 2.0 100.0 2,337 Married or living together 12.8 1.5 35.8 34.8 3.8 10.8 0.5 100.0 2,813 Divorced/separated/ widowed 6.2 1.4 44.8 26.0 7.2 12.9 1.5 100.0 228 Number of living children 0 12.2 2.3 30.3 32.7 6.5 14.6 1.6 100.0 2,396 1–2 13.7 3.0 30.4 36.3 5.5 9.3 1.8 100.0 1,343 3–4 13.3 0.8 37.6 36.8 3.2 7.9 0.3 100.0 1,010 5+ 7.0 0.3 49.4 23.0 3.1 17.1 0.1 100.0 629 Residence Urban 16.6 2.7 25.5 43.3 4.8 5.4 1.7 100.0 2,883 Rural 7.0 1.1 43.6 21.6 5.8 20.2 0.7 100.0 2,496 Region Western 10.3 1.5 35.9 36.2 10.0 5.1 1.0 100.0 324 Central 11.0 2.8 27.3 42.7 7.4 8.5 0.5 100.0 537 Greater Accra 18.1 1.8 24.2 47.6 5.4 1.2 1.8 100.0 930 Volta 14.3 4.5 36.4 33.3 0.6 8.7 2.1 100.0 192 Eastern 9.9 4.3 30.9 29.4 4.6 17.9 3.1 100.0 401 Ashanti 13.0 1.9 33.0 40.1 8.2 3.4 0.5 100.0 1,028 Western North 7.7 1.1 29.7 21.7 5.9 33.3 0.7 100.0 158 Ahafo 7.1 1.8 50.7 30.3 2.5 7.1 0.4 100.0 111 Bono 14.9 1.8 43.2 26.3 2.4 7.2 4.2 100.0 177 Bono East 9.7 1.5 44.7 16.6 2.1 24.3 1.1 100.0 289 Oti 8.4 1.0 39.9 17.7 0.7 31.2 1.1 100.0 177 Northern 9.4 0.9 28.9 20.7 0.7 39.1 0.3 100.0 444 Savannah 7.8 0.7 53.3 17.2 2.0 17.8 1.2 100.0 139 North East 8.9 0.7 39.8 11.5 1.8 37.1 0.4 100.0 109 Upper East 13.3 1.2 41.4 25.9 8.3 8.8 1.1 100.0 221 Upper West 8.8 1.2 61.9 17.5 5.1 5.5 0.0 100.0 141 Education No education 0.4 0.0 50.9 14.5 2.6 31.5 0.1 100.0 612 Primary 1.0 0.1 41.8 33.4 6.0 16.8 0.8 100.0 636 Secondary 5.8 1.5 32.9 41.3 6.7 10.5 1.2 100.0 3,320 More than secondary 55.8 6.7 19.0 14.0 0.7 1.7 2.2 100.0 810 Wealth quintile Lowest 1.4 0.6 53.2 10.0 3.2 31.2 0.4 100.0 985 Second 4.2 0.5 42.2 27.2 5.1 19.8 1.0 100.0 959 Middle 7.0 1.4 31.2 41.9 9.3 7.6 1.5 100.0 989 Fourth 12.8 3.0 24.6 46.3 6.8 5.3 1.2 100.0 1,241 Highest 30.9 3.4 23.4 36.4 2.1 1.9 1.8 100.0 1,204 Total 15–49 12.2 1.9 33.9 33.2 5.3 12.3` 1.2 100.0 5,378 50–59 9.2 0.9 54.7 22.6 3.5 8.8 0.4 100.0 754 Total 15–59 11.8 1.8 36.5 31.9 5.0 11.9 1.1 100.0 6,132 Characteristics of Respondents • 51 Table 3.8.1 Type of employment: Women Percent distribution of women age 15–49 employed in the 12 months preceding the survey by type of earnings, type of employer, and continuity of employment, according to type of employment (agricultural or nonagricultural), Ghana DHS 2022 Employment characteristic Agricultural work Nonagricultural work Total Type of earnings Cash only 22.8 59.1 57.0 Cash and in-kind 19.0 20.2 20.1 In-kind only 24.9 4.6 5.8 Not paid 33.3 16.2 17.1 Total 100.0 100.0 100.0 Type of employer Employed by family member 55.9 11.7 14.2 Employed by non-family member 20.7 24.9 24.7 Self-employed 23.4 63.4 61.1 Total 100.0 100.0 100.0 Continuity of employment All year 49.5 81.1 79.3 Seasonal 31.2 14.3 15.2 Occasional 19.3 4.6 5.4 Total 100.0 100.0 100.0 Number of women employed during the last 12 months 661 11,081 11,741 Note: Total includes women with missing information on type of employment who are not shown separately. Table 3.8.2 Type of employment: Men Percent distribution of men age 15–49 employed in the 12 months preceding the survey by type of earnings and continuity of employment, according to type of employment (agricultural or nonagricultural), Ghana DHS 2022 Employment characteristic Agricultural work Nonagricultural work Total Type of earnings Cash only 32.7 78.8 73.3 Cash and in-kind 29.5 12.5 14.5 In-kind only 7.6 2.5 3.1 Not paid 30.2 6.2 9.1 Total 100.0 100.0 100.0 Continuity of employment All year 44.2 72.9 69.5 Seasonal 42.6 20.0 22.7 Occasional 13.2 7.1 7.9 Total 100.0 100.0 100.0 Number of men employed during the last 12 months 727 5,405 6,132 Note: Total includes men with missing information on type of employment who are not shown separately. 52 • Characteristics of Respondents Table 3.9.1 Health insurance coverage: Women Percentage of women age 15–49 with specific types of health insurance coverage, and percentage with any health insurance, according to background characteristics, Ghana DHS 2022 Background characteristic National/ district health insurance Other employer- based insurance Mutual health organization/ community- based insurance Privately purchased commercial insurance None Any health insurance Number of women Age 15–19 85.8 0.5 0.1 0.1 14.1 85.9 2,682 20–24 90.6 0.3 0.0 0.2 9.4 90.6 2,695 25–29 91.2 1.0 0.6 0.3 8.2 91.8 2,340 30–34 91.9 1.7 0.4 0.8 7.7 92.3 2,252 35–39 91.3 1.5 0.2 0.6 7.9 92.1 2,059 40–44 90.5 1.5 0.2 0.4 8.9 91.1 1,675 45–49 86.5 1.1 0.2 0.4 13.2 86.8 1,312 Residence Urban 90.3 1.5 0.3 0.5 9.2 90.8 8,557 Rural 89.1 0.4 0.1 0.2 10.8 89.2 6,457 Region Western 88.2 0.9 0.4 0.3 11.6 88.4 955 Central 83.3 0.3 0.1 0.2 16.5 83.5 1,703 Greater Accra 85.2 3.7 0.6 0.3 13.4 86.6 2,327 Volta 93.2 0.1 0.5 0.2 6.8 93.2 713 Eastern 93.1 1.0 0.4 0.6 6.7 93.3 1,220 Ashanti 92.3 1.0 0.1 0.7 7.5 92.5 2,928 Western North 91.2 0.3 0.0 0.5 8.7 91.3 411 Ahafo 94.9 0.6 0.0 0.7 4.7 95.3 317 Bono 98.5 0.3 0.0 0.9 1.5 98.5 567 Bono East 93.2 0.0 0.2 0.0 6.8 93.2 676 Oti 84.1 0.2 0.0 0.1 15.9 84.1 403 Northern 86.6 0.6 0.2 0.3 12.7 87.3 1,149 Savannah 85.8 0.0 0.0 0.0 14.2 85.8 319 North East 92.7 0.0 0.0 0.0 7.3 92.7 290 Upper East 96.8 0.2 0.0 0.1 3.2 96.8 640 Upper West 93.3 0.1 0.1 0.4 6.7 93.3 398 Education No education 87.1 0.0 0.1 0.1 12.8 87.2 2,411 Primary 86.7 0.1 0.2 0.1 13.1 86.9 2,071 Secondary 90.7 0.8 0.1 0.1 9.1 90.9 8,999 More than secondary 92.7 5.2 1.2 2.9 5.5 94.5 1,533 Wealth quintile Lowest 87.1 0.0 0.0 0.1 12.8 87.2 2,447 Second 89.1 0.0 0.0 0.0 10.9 89.1 2,712 Middle 89.3 0.2 0.0 0.0 10.4 89.6 3,121 Fourth 90.3 0.6 0.2 0.3 9.4 90.6 3,379 Highest 92.1 3.8 0.8 1.3 6.9 93.1 3,355 Total 89.8 1.0 0.2 0.4 9.9 90.1 15,014 Characteristics of Respondents • 53 Table 3.9.2 Health insurance coverage: Men Percentage of men age 15–49 with specific types of health insurance coverage, and percentage with any health insurance, according to background characteristics, Ghana DHS 2022 Background characteristic National/ district health insurance Other employer- based insurance Mutual health organization/ community- based insurance Privately purchased commercial insurance None Any health insurance Number of men Age 15–19 84.5 0.0 0.0 0.2 15.5 84.5 1,424 20–24 79.2 0.2 0.2 0.2 20.5 79.5 1,033 25–29 67.4 1.2 0.1 1.1 32.3 67.7 888 30–34 66.6 0.4 0.4 0.9 32.5 67.5 853 35–39 63.8 2.9 0.1 2.0 33.0 67.0 809 40–44 61.7 1.1 0.4 1.8 37.4 62.6 713 45–49 73.6 3.3 0.0 1.1 25.3 74.7 557 Residence Urban 75.8 1.8 0.1 1.5 22.8 77.2 3,442 Rural 68.6 0.1 0.2 0.2 31.2 68.8 2,835 Region Western 75.1 0.1 0.0 0.3 24.8 75.2 414 Central 59.5 0.3 0.0 0.5 40.2 59.8 686 Greater Accra 65.0 3.6 0.2 3.7 32.2 67.8 1,076 Volta 80.1 1.6 0.0 0.0 19.9 80.1 235 Eastern 75.0 0.3 0.0 0.6 24.8 75.2 466 Ashanti 76.9 1.2 0.0 0.4 22.2 77.8 1,179 Western North 82.1 0.7 0.5 0.4 17.9 82.1 181 Ahafo 78.3 0.5 0.2 1.2 21.2 78.8 133 Bono 75.9 0.8 0.9 0.8 22.5 77.5 222 Bono East 81.6 0.2 0.0 0.2 18.2 81.8 316 Oti 64.0 0.0 0.0 0.0 36.0 64.0 187 Northern 70.9 0.2 0.3 0.2 28.9 71.1 484 Savannah 67.2 0.1 0.3 0.0 32.8 67.2 155 North East 87.7 0.0 0.0 0.0 12.3 87.7 119 Upper East 85.7 0.0 0.9 0.0 13.9 86.1 267 Upper West 71.3 0.0 0.0 0.2 28.5 71.5 155 Education No education 58.5 0.0 0.2 0.5 41.3 58.7 628 Primary 61.8 0.0 0.1 0.0 38.2 61.8 725 Secondary 74.3 0.5 0.1 0.5 25.2 74.8 3,990 More than secondary 82.9 4.7 0.4 3.8 13.8 86.2 935 Wealth quintile Lowest 64.8 0.0 0.2 0.0 35.1 64.9 1,089 Second 71.4 0.0 0.1 0.0 28.6 71.4 1,133 Middle 73.5 0.2 0.1 0.6 26.2 73.8 1,137 Fourth 73.8 0.9 0.1 0.3 25.8 74.2 1,466 Highest 77.3 3.5 0.2 3.2 19.9 80.1 1,453 Total 15–49 72.6 1.0 0.2 0.9 26.6 73.4 6,277 50–59 72.4 2.3 0.6 1.4 26.5 73.5 767 Total 15–59 72.5 1.2 0.2 1.0 26.6 73.4 7,044 54 • Characteristics of Respondents Table 3.10.1 Tobacco smoking: Women Percentage of women age 15–49 who smoke various tobacco products, according to background characteristics, Ghana DHS 2022 Percentage who smoke:1 Number of women Background characteristic Cigarettes2 Other type of tobacco3 Any type of tobacco Age 15–19 0.7 0.1 0.7 2,682 20–24 1.0 0.5 1.1 2,695 25–29 1.0 0.1 1.1 2,340 30–34 1.1 0.1 1.1 2,252 35–39 1.3 0.1 1.3 2,059 40–44 0.6 0.1 0.7 1,675 45–49 0.2 0.1 0.2 1,312 Residence Urban 1.1 0.2 1.1 8,557 Rural 0.6 0.2 0.7 6,457 Region Western 0.4 0.1 0.4 955 Central 0.7 0.1 0.8 1,70

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