"ZERO IS NOT GOOD FOR ME": MEASUREMENT AND CONSEQUENCES OF INFERTILITY IN GHANA
Open Access
- Author:
- Fledderjohann, Jasmine
- Graduate Program:
- Sociology
- Degree:
- Doctor of Philosophy
- Document Type:
- Dissertation
- Date of Defense:
- May 16, 2011
- Committee Members:
- David R Johnson, Dissertation Advisor/Co-Advisor
David R Johnson, Committee Chair/Co-Chair
Jenny Trinitapoli, Committee Member
Leif Jensen, Committee Member
Alan Booth, Committee Member
Francis Dodoo, Committee Member - Keywords:
- Marriage
Reproductive Health
Sub-Saharan Africa
Infertility
Ghana
Cohabitation
Relationship Disruption - Abstract:
- The measurement and consequences of infertility in sub-Saharan Africa (SSA) is an important but under-explored field of research. Given the high value placed on children in SSA, infertility increases the risk of psychological distress and marital conflict, encourages risky sexual behavior, and deprives infertile individuals and couples of an important source of economic and social capital. The following chapters explore the implications and measurement of infertility in Ghana, West Africa. I begin with an analysis of qualitative data I collected in Accra, Ghana, in 2008. This chapter examines the effect of infertility on mental well-being and physical health from the perspective of infertile women seeking treatment in a clinical setting. Additionally, I explore the social consequences of infertility and gendered nature of these experiences from the perspective of both fertile and infertile women. I find that infertility has important consequences for each of the aspects of women's lives, and that these consequences are not perceived to be shared equally by Ghanaian men. Next, using 8 waves of panel data collected by the Population Council of New York and the University of Cape Coast, I consider the optimal measure of infertility for social research in sub-Saharan Africa. Though current infertility research in the SSA suggests a conservative demographic measure is ideal for measuring prevalence, the dearth of self-identified infertility measures in survey data in the region has prevented comparisons. Arguably, however, women's perceptions of their own infertility status may have a greater impact for social outcomes such as marital instability and mental health. Using the Cape Coast data set, I assess the stability of several measures of infertility currently used in the demographic and biomedical literature through the application of a test-retest statistical method. In addition, I examine the correlation between biomedical, demographic, and self-identified infertility, and apply random effects models to explore how each measure relates to background demographic characteristics. The final piece of the dissertation empirically examines the relationship between infertility and union instability using discrete-time hazard models. Previous (primarily qualitative) research in the sub-continent has suggested that there may be a link between infertility a divorce; less is known about the implications of infertility for unmarried couples. I explore this relationship both for marriages and non-marital sexual unions.