Household Nucleation, Dependency and Child Health Outcomes in Ghana

Abstract

This study uses three key anthropometric measures of nutritional status among children (stunting, wasting and underweight) to explore the dual effects of household composition and dependency on nutritional outcomes of under-five children in Ghana. The objective is to examine changes in household living arrangements of under-five children to explore the interaction of dependency and nucleation on child health outcomes. The concept of nucleation refers to the changing structure and composition of household living arrangements, from highly extended with its associated socioeconomic system of production and reproduction, social behaviour and values, towards single-family households - especially the nuclear family, containing a husband and wife and their children alone. A negative relationship between levels of dependency, as measured by the number of children in the household, and child health outcomes is premised on the grounds that high dependency depletes resources, both tangible and intangible, to the disadvantage of young children. Data were drawn from the last four rounds of the Ghana Demographic and Health Surveys (GDHSs), from 1993 to 2008, for the first objective - to explore changes in household composition. For the second objective, the study used data from the 2008 GDHS. The results show that, over time, households in Ghana have been changing towards nucleation. The main finding is that in households with the same number of dependent children, in nucleated households children under age 5 have better health outcomes compared with children under age 5 in non-nucleated households. The results also indicate that the effect of dependency on child health outcomes is mediated by household nucleation and wealth status and that, as such, high levels of dependency do not necessarily translate into negative health outcomes for children under age 5, based on anthropometric measures.

Little cash to large households: Cash transfers and children's care in disadvantaged families inGhana

“…Household size was mentioned frequently as a barrier to well‐being and high‐quality care, as indicated by a female LEAP beneficiary from AOB: “The children's well‐being dropped when the number of children increased. It meant more mouths to feed and the room we shared became too small for us.” This mirrors findings by Annim, Awusabo‐Asare and Amo‐Adjei () about the presence of many household members depleting resources for young children. Large family size was also considered to be a confounding factor playing into differences between biological and non‐biological children within the household, as it requires further prioritization in the allocation of household resources.…”

“…A result is that Ghana has high rates of informal kinship care (MOESW and UNICEF, ). Figure presents trends in living arrangements for children over time, indicating that although the proportion of children living within a nuclear family (with their biological parents) has grown, proportions of children living in other forms of extended families (with one or more non‐biological caregiver) has equally increased (Annim, Awusabo‐Asare and Amo‐Adjei, ).…”

“…Despite a “fertility transition” having led to a decline in fertility rates in the late 1990s and early 2000s, factors such as decreasing infant mortality rates and the relatively low use of contraceptives stall further decline (Agyei‐Mensah, ). Notwithstanding a process of “physical nucleation” with household living arrangements moving from “from highly extended with its associated socioeconomic system of production and reproduction, social behaviour and values, toward single‐family households” (Annim, Awusabo‐Asare and Amo‐Adjei, , p. 5), the national dependency ratio is 73.9, indicating that 100 persons of working age are supporting 73.9 dependants, including elderly persons, children and people living with disabilities (World Bank, ). Large household size and the presence of many dependant members is commonly associated with a higher risk to poverty, as also evidenced in the case of Ghana by Novignon et al.…”

“…(), and can compromise well‐being and quality of care for children. Pooled family resources are spread more thinly across household members (Annim, Awusabo‐Asare and Amo‐Adjei, ), which can prove particularly challenging for caregivers looking after many children, especially when households include biological and non‐biological children (Dako‐Gyeke and Oduro, ).…”

The dynamic interdependence between family support and depressive symptoms among adolescents in Ghana

“…One is the greater importance of extended family relative to the nuclear family in sub-Saharan Africa. Many youth in sub-Saharan Africa reside with family units including aunts, uncles, grandparents, and other adult relatives in addition to biological parents (Annim et al 2013). A second feature is the institution of child fosterage, in which a child from one family is sent to live in the household of an extended family member.…”