Ghana is one of the most populous countries in Western Africa, second only to Nigeria. Since achieving political independence in 1957, its population has nearly tripled in size, from about 6 million to nearly 18 million in 1996, and is expected to increase to 27 million by 2020. The past rapid growth of Ghana's population is an outcome of high fertility, which until recently remained fairly constant, and declining mortality. This combination of high fertility and declining mortality is also the cause for the young age structure of the Ghanaian population with 43 percent under 15 years of age (figure 1).