Publications Summary

Document Type
Working Papers
Publication Topic(s)
Child Health and Development
Recommended Citation
Annim, Samuel Kobina, Kofi Awusabo-Asare, and Joshua Amo-Adjei. 2013. Household Nucleation, Dependency and Child Health Outcomes in Ghana. DHS Working Papers No. 98. Calverton, Maryland, USA: ICF International.
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Publication Date
August 2013
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The Millennium Development Goals have increased international attention to child malnutrition in the developing world. Goal 1 aims to reduce hunger, and Goal 4 aims to reduce under-five child mortality. The study uses three key anthropometric measures of nutritional status among children—stunting (low height for age), wasting (low weight for height), and underweight (low weight for age) —to explore the dual effects of household composition and dependency on nutritional outcomes of children under age 5. The objectives are to examine changes in household living arrangements of under-five children and to explore the interaction of dependency and nucleation on child health outcomes. The concept of nucleation, which is at the core of this paper, refers to the changing structure and composition of household living arrangements, from highly extended with its associated socioeconomic system of production and reproduction, social behavior and values, toward 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 for the study were drawn from the last four rounds of the Ghana Demographic and Health Surveys (GDHS), from 1993 to 2008, for the first objective—to explore changes in household composition. For the second objective, to explore how dependency affects health outcomes of children under age 5, in the context of household composition, the study used data from the 2008 GDHS. The results show that, over time, households in Ghana have been changing toward 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.


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