JOURNAL OF BIOSOCIAL SCIENCE, 2001, Vol. 33, No. 1
Religion and fertility among the Atyap in Nigeria.
Using data obtained in 1995 from 600 Atyap women in randomly selected dwellings in Kaduna State, Nigeria, multiple regression analysis shows that Catholics and Other Protestants (Anglicans and Baptists) have higher fertility than women affiliated to the Evangelical Churches of West Africa (ECWA), even net of compositional characteristics of the two groups. Above and beyond the denominational differences, the regression analysis also shows that the stronger the religious belief, the higher the fertility. Thus, the study underscores the need for researchers of the religion-fertility association in Nigeria to examine the influence of religious denomination and religiosity on fertility, within each of the main religions.
(NIGERIA, CITIES, FERTILITY DETERMINANTS, RELIGION, CATHOLICS, PROTESTANTS, DIFFERENTIAL FERTILITY, METHODOLOGY, REGRESSION ANALYSIS).
English - pp. 1-12.
H. N. Avong, Demography Program, Australian National University, Canberra, Australia.
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Kimuna, Sitawa R.; Adamchak, Donald J.
Gender relations: Husband-wife fertility and family planning decisions in Kenya.
Although Kenya?s fertility rate has declined from 6?7 births per woman in the mid-1980s to 5?4 births per woman in 1993 (NCPD, 1994), population growth is still high, yielding a doubling time of 35 years. This study uses the 1993 Kenya Demographic Health Survey data collected from 1257 couples to examine the socioeconomic and sociodemographic characteristics of married men and women and their communication with their spouses over fertility and family planning decision-making practices. The logistic regression analysis shows that education for both men and women, discussion of fertility and family planning between spouses, male approval of use of contraception and male family size desires are important factors that influence ever-use of family planning.
(KENYA, REPRODUCTIVE BEHAVIOUR, FAMILY PLANNING, DECISION MAKING, CONTRACEPTIVE USAGE, SEX ROLES, MARITAL ROLES, EDUCATION, FAMILY SIZE, INTERPERSONAL COMMUNICATION).
English - pp. 13-23.
S. R. Kimuna, D. J. Adamchak, Department of Sociology, Kansas State University, Manhattan, Kansas, U.S.A.
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Vienna, A.; Pe?a Garcia, J. A.; Mascie-Taylor, C. G. N.; Biondi., G.
The ethnic minorities of southern Italy and Sicily: Relationships through surnames.
Surnames of grandparents were collected from children in the primary schools of the Albanian-Italian, Croat-Italian and Greek-Italian villages of southern Italy and Sicily. The coefficients of relationships by isonymy show almost no relationship with ethnicity. Ethnolinguistic minorities of southern Italy and Sicily are geographically subdivided into two main clusters: the first cluster comprises the Albanian, Croat and Greek communities of the Adriatic area; and the second cluster comprises the Albanian and Greek communities of the Ionian, Thirrenian and Sicilian areas.
(ITALY, REGIONS, SURNAME, ETHNIC MINORITIES, ETHNIC GROUPS, METHODOLOGY, MULTIVARIATE ANALYSIS).
English - pp. 25-31.
A. Vienna, Dipartimento di Biologia animale e dell?uomo, Universit? di Roma La Sapienza, Rome, Italy; J. A. Pe?a Garcia, Departamento de Biologia Animal y Genetica, Universidad del Pais Vasco, Bilbao, Spain; C. G. N. Mascie-Taylor, Department of Biological Anthropology, University of Cambridge, U.K.; G. Biondi, Dipartimento di Biologia animale e dell?uomo, Universit? di Torino, Torino, Italy.
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Covariates of child mortality in Mali: does the health-seeking behavior of the mother matter?
This paper uses data from the 1995/96 Mali DHS survey to examine the importance of a wide range of socioeconomic, behavioural and biodemographic factors in the determination of child mortality in Mali, with a special focus on maternal education and behaviour. The central hypothesis of the study is that advances in maternal education would contribute little to child survival in settings such as Mali?s urban and rural communities where progress in educational attainment is not matched with improvements in other aspects of socioeconomic development such as economic growth, job creation, financial security and public health and medical resources. Units of analysis are children born in the past 5 years to DHS respondents (women aged 15-45) who were married at the time of the survey. The Cox proportional hazards regression technique has been used to estimate the net effects of variables included as covariates. The findings indicate that the health-seeking behaviour of the mother matters more than maternal education in explaining the observed differences in infant and child mortality in Mali?s urban and rural areas.
(MALI, CHILD MORTALITY, INFANT MORTALITY, RURAL-URBAN DIFFERENTIALS, MORTALITY DETERMINANTS, EDUCATION OF WOMEN, ECONOMIC GROWTH, ECONOMIC AND SOCIAL DEVELOPMENT, PUBLIC HEALTH, METHODOLOGY, PROPORTIONAL HAZARD MODELS).
English - pp. 33-54.
J. M. Uchudi, Population and Development Program, Cornell University, 133 Warren Hall, Ithaca, N. Y. 14853, U.S.A.
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Estimates of cousin marriage and mean inbreeding in the United Kingdom from "birth briefs".
From 626 ascendant genealogies, known as "birth briefs", deposited by members of the Society of Genealogists in their London library, rates of consanguineous marriage and coefficients of mean inbreeding ([alpha]) of offspring were estimated for cohorts of marriages contracted in the late 19th and early 20th centuries. The rate of first cousin marriage in the generation estimated to have married during the 1920s was 0?32%, with no marriages between second cousins. The mean inbreeding coefficient for the offspring of these marriages was estimated as 0?0002. In the previous generation 1?12% of the marriages were between first cousins, and the estimate of mean inbreeding was 0?0007. Comparison with data taken from the published literature suggests that the levels of cousin marriage observed are consistent with a secular decline during the late 19th and 20th centuries.
(ENGLAND, GENEALOGY, HISTORICAL DEMOGRAPHY, HISTORICAL SOURCES, CONSANGUINEOUS MARRIAGE, INBREEDING, FERTILITY TRENDS, FERTILITY MEASUREMENTS).
English - pp. 55-66.
M. T. Smith, Department of Anthropology, University of Durham, 43 Old Elvet, Durham, U.K.
***
Aboriginal mortality in Canada, the United States and New Zealand.
Indigenous populations in New World nations share the common experience of culture contact with outsiders and a prolonged history of prejudice and discrimination. This historical reality continues to have profound effects on their well-being, as demonstrated by their relative disadvantages in socioeconomic status on the one hand, and in their delayed demographic and epidemiological transitions on the other. In this study one aspect of aboriginals? epidemiological situation is examined: their mortality experience between the early 1980s and early 1990s. The groups studied are the Canadian Indians, the American Indians and the New Zealand Maori (data for Australian Aboriginals could not be obtained). Cause-specific death rates of these three minority groups are compared with those of their respective non-indigenous populations using multivariate log-linear competing risks models. The empirical results are consistent with the proposition that the contemporary mortality conditions of these three minorities reflect, in varying degrees, problems associated with poverty, marginalization and social disorganization. Of the three minority groups, the Canadian Indians appear to suffer more from these types of conditions, and the Maori the least.
(CANADA, UNITED STATES, NEW ZEALAND, INDIGENOUS POPULATION, ETHNIC MINORITIES, DIFFERENTIAL MORTALITY, CAUSES OF DEATH, MORTALITY DETERMINANTS, POVERTY, DISCRIMINATION, SOCIAL DISORGANIZATION, COMPARATIVE ANALYSIS).
English - pp. 67-86.
F. Trovato, Department of Sociology and Population Research Laboratory, The University of Alberta, Edmonton, Canada T6G 2H4.
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Shakya, Kushum; McMurray, Christine.
Neonatal mortality and maternal health care in Nepal: Searching for patterns of association.
This study explores the factors associated with neonatal mortality and maternal health care in Nepal. The subjects were 4375 births reported in the 1996 Nepal Family Health Survey. Maternal and child health care was found to have a significant association with neonatal mortality, although preceding birth interval and sex of child had stronger effects. Four aspects of maternal care were found to be highly associated with region, household ownership of assets, mother?s education and father?s education. This indicates that accessibility, affordability and availability of maternal health care are important factors to consider in future research on neonatal mortality.
(NEPAL, NEONATAL MORTALITY, MATERNAL AND CHILD HEALTH, MORTALITY DETERMINANTS, BIRTH INTERVALS, SEX DIFFERENTIALS, REGIONS, LEVELS OF EDUCATION, OWNERSHIP).
English - pp. 87-105.
K. Shakya, Population Studies, Tribhuvan University, Kathmandu, Nepal; C. McMurray, Demography Program, The Australian National University, Canberra, Australia.
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Welsh, Michael J.; Puello, Elizardo; Meade, Melinda; Kome, Sam; Nutley, Tara.
Evidence of diffusion from a targeted HIV/AIDS intervention in the Dominican Republic.
The diffusion potential of a targeted HIV/AIDS intervention that enlisted peer educators to disseminate "safer sex" messages and condoms among female commercial sex workers and their clients was evaluated in the Dominican Republic. Levels of interurban interaction potential were ascertained that linked the targeted city of La Romana with the proximate cities of San Pedro de Macoris and Guaymate. Weekly service statistics generated over an 8-month period were analysed to establish activity areas for the peer educators. Data were entered and analysed using a geographic information system and interurban linkages were established. Project outcomes were examined via a series of three cross-sectional Knowledge, Attitudes and Practices (KAP) surveys conducted among convenience samples of commercial sex workers at the start of the intervention and at 4 and 8 months. The results attest to a high degree of interconnectivity between the targeted and proximate cities, and a pattern of interurban mobility that links commercial sex workers, clients and establishments in all three cities. The examination of project outcomes revealed statistically significant changes in condom use in the targeted city of La Romana among commercial sex workers, as well as among their counterparts interviewed in the proximate cities of San Pedro de Macoris and Guaymate. These data suggest a diffusion effect. It is concluded that a targeted intervention may influence proximate cities within a relatively compressed period of time. The findings suggest the importance of considering geographic diffusion principles, such as urban hierarchies, regional nodes and transportation linkages, when designing HIV/AIDS prevention efforts. It also has important implications in the selection of control sites when conducting experimental studies of HIV/AIDS interventions.
(DOMINICAN REPUBLIC, AIDS, DIFFUSION OF INNOVATIONS, INFORMATION DISSEMINATION, INFORMATION NETWORKS, URBAN HIERARCHY, SEXUAL BEHAVIOUR, PROSTITUTION, CONTRACEPTIVE USAGE, CONDOM, ATTITUDE, METHODOLOGY, KAP SURVEYS).
English - pp. 107-119.
M. J. Welsh, Family Planning and Reproductive Health Programs, Family Health International, Nairobi, Kenya; E. Puello, Coordinator de Animacion Socio-Cultural, Santo Domingo, Dominican Republic; M. Meade, University of Carolina at Chapel Hill, North Carolina, U.S.A.; S. Kome, JCH and Associates, Durham, North Carolina, U.S.A.; T. Nutley, Family Health International, North Carolina, U.S.A.
***
Adetunji, Jacob; Meekers, Dominique.
Consistency in condom use in the context of HIV/AIDS in Zimbabwe.
Against the backdrop of a high prevalence of the human immunodeficiency virus infection in Zimbabwe, this paper analyses data from the 1997 Zimbabwe Sexual Behaviour and Condom Use Survey to throw light on the degree to which sexually active adults consistently use condoms in high-risk sexual situations. The multivariate results indicate that at the time of the survey, consistent condom use in non-marital relationships is significantly higher for males than females, higher among those who had access to information about condoms from multiple sources than among those with limited access, and higher among those who have positive attitudes to condoms than among those with negative attitudes. Even though consistent condom use with non-marital partners is higher for those who know a source where condoms can be obtained, this effect is due to the fact that these respondents have more positive attitudes towards condoms. Likewise, the higher levels of consistent condom use exhibited by those who are aware of the efficacy of condoms are due to the fact that men have higher awareness of this, and men use condoms more consistently than women. In sum, the results suggest that the effects of the respondents? sex and their knowledge of the prophylactic importance of condoms and where condoms might be obtained are a function of other socioeconomic advantages they have. It is, therefore, concluded that programmes that use mass media information, education and communication campaigns to reduce shyness, embarrassment and stigma about condom use can help increase consistent use of condoms in non-marital relationships in Zimbabwe.
(ZIMBABWE, AIDS, CONDOM, CONTRACEPTIVE USAGE, KNOWLEDGE OF CONTRACEPTIVES, ATTITUDE, SEX DIFFERENTIALS, SEXUAL BEHAVIOUR, SEXUAL RELATIONSHIPS, RISK EXPOSURE, MULTIVARIATE ANALYSIS).
English - pp. 121-138.
J. Adetunji, Bowling Green State University, Bowling Green, OH 43403, U.S.A.; D. Meekers, Population Services International, 1120 Nineteenth Street NW, Suite 600, Washington, DC 20036, U.S.A.
***
Holman, Darryl J.; Grimes, Michael A.
Colostrum feeding behaviour and initiation of breast-feeding in rural Bangladesh.
Human breast milk is primarily colostrum immediately following birth. Colostrum gradually changes to mature milk over the next several days. The role of colostrum in fighting infections and promoting growth and development of the newborn is widely acknowledged. This role is mediated by differences across cultures in the acceptability of colostrum and the prevalence of colostrum feeding. This study examined the prevalence of colostrum feeding and time to initiation of breast-feeding in 143 rural Bangladeshi women in Matlab thana. Structured interviews were collected during a 9-month prospective study conducted in 1993. Women were usually interviewed within 4 days of giving birth and were asked about whether or not they fed their child colostrum and the number of hours until they began breast-feeding the baby. Ninety per cent of the mothers reported feeding their newborn colostrum. A logistic regression found no effect on the prevalence of colostrum feeding from the following covariates: mother's age, parity, history of pregnancy loss, child's sex, mother's self-report of delivery complications, and the time from birth to interview. Fifty-nine per cent of mothers initiated breast-feeding within 4 h, and 88% within 12 h of parturition. Survival analysis was used to estimate the effects of covariates on the time from delivery to initial breast-feeding. Time to initial breast-feeding was delayed slightly, but significantly, for older mothers, for male infants, and by mothers who did not report delivery complications. The percentage of mothers who fed their child colostrum was higher, and times to initial breast-feeding were shorter, than almost all previous reports from South Asia. These findings might be explained, in part, by methodological differences among studies, but it is suggested that recent changes towards earlier initiation of breast-feeding have taken place in rural Bangladesh.
(BANGLADESH, ANTHROPOLOGY, RURAL AREAS, RURAL WOMEN, BREAST FEEDING, LACTATION, METHODOLOGY, REGRESSION ANALYSIS).
English - pp. 139-154.
D. J. Holman, M. A. Grimes, Department of Anthropology and Population Research Institute, Pennsylvania State University, University Park, PA 16802, U.S.A.
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JOURNAL OF BIOSOCIAL SCIENCE, 2001, Vol. 33, No. 2
Quality of care and contraceptive pill discontinuation in rural Egypt.
Indicators of family planning service access and quality were generated using the Egypt DHS-I (1988) and the Egypt Service Availability Survey (1989), and linked to episodes of contraceptive pill use. Multilevel analysis was used to ascertain whether or not these access and quality indicators influence the continuation of pill use, net of women?s socioeconomic, demographic and motivational characteristics. A model with random components at the cluster and women levels was fitted for all reasons of discontinuation, except desire for pregnancy, at 24 months of use. Net of women?s background characteristics, the results show that facilities with smaller numbers of health personnel trained in family planning, a lack of access to facilities with female doctors and a lack of range of available methods are associated with a high risk of discontinuation of pill use for all reasons except desire for pregnancy.
(EGYPT, RURAL AREAS, ORAL CONTRACEPTIVES, CONTRACEPTIVE USAGE, CONTRACEPTION CONTINUATION, FAMILY PLANNING PERSONNEL, HEALTH FACILITIES, HEALTH SERVICES, ATTITUDE, SOCIO-ECONOMIC STATUS).
English - pp. 161-172.
M. M. Ali, Centre for Population Studies, London School of Hygiene & Tropical Medicine, 49-51 Bedford Square, London WC1B 3DP, U.K.
***
Bruce, Neville W.; Sanders, Katherine A.
Incidence and duration of romantic attraction in students progressing from secondary to tertiary education.
There is increasing interest in the nature and biological significance of romantic love but few quantitative data are available for testing specific hypotheses. This paper describes the use of a survey instrument to assess incidence and duration of romantic attractions over a 2-year period amongst students (121 male; 162 female) progressing from school to university education. The results for males and females were similar and schooling - single-sex or co-educational - had little effect. Students averaged 1?45 romantic episodes per year and 93% of students reported at least one episode over the survey period. Duration of attraction was around 9 weeks if never reciprocated and around 12 weeks if reciprocated. There was seasonal variation of onset of episodes with peak incidence over the summer or early autumn seasons. Collectively the results accord with the view that frequent, short-duration romantic episodes could have a role in selection of appropriate long-term reproductive partnerships.
(AUSTRALIA, CITIES, BIOLOGY, ANTHROPOLOGY, PSYCHOLOGY, YOUTH, MATE SELECTION, PSYCHOLOGICAL FACTORS, REPRODUCTIVE BEHAVIOUR).
English - pp. 173-184.
N. W. Bruce, K. A. Sanders, Department of Anatomy and Human Biology, The University of Western Australia, Nedlands 6907, Western Australia, Australia.
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Krishnamoorthy, S.; Audinarayana, N.
Trends in consanguinity in south India.
This study uses data from the 1992-93 National Family Health Survey to assess trends in consanguinity in the South Indian states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. In Kerala, the frequency of consanguineous marriages is very low and one type of preferred marriage of the Dravidian marriage system - uncle-niece marriage - is conspicuously absent. In the other states of South India, consanguinity and the coefficient of inbreeding are high. While no change in consanguinity is observed during the past three to four decades in Karnataka, a definite decline is observed in Andhra Pradesh and Tamil Nadu. Due to recent changes in the demographic and social situation in these states, this decline in consanguinity is likely to continue.
(INDIA, REGIONS, CONSANGUINEOUS MARRIAGE, INBREEDING, SOCIAL CHANGE, CULTURAL CHANGE, NUPTIALITY).
English - pp. 185-197.
S. Krishnamoorthy, N. Audinarayana, Department of Population Studies, Bharathiyar University, Coimbatore - 641 046, Tamil Nadu, India.
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Magadi, Monica; Madise, Nyovani; Diamond, Ian.
Factors associated with unfavourable birth outcomes in Kenya.
Studies addressing factors associated with adverse birth outcomes have almost exclusively been based on hospital statistics. This is a serious limitation in developing countries where the majority of births do not occur within health facilities. This paper examines factors associated with premature deliveries, small baby?s size at birth and Caesarean section deliveries in Kenya based on the 1993 Kenya Demographic and Health Survey data. Due to the hierarchical nature of the data, the analysis uses multilevel logistic regression models to take into account the family and community effects. The results show that the odds of unfavourable birth outcomes are significantly higher for first births than for higher order births. Furthermore, antenatal care (measured by frequency of antenatal care visits and tetanus toxoid injection) is observed to have a negative association with the incidence of premature births. For the baby?s size at birth, maternal nutritional status is observed to be a predominant factor. Short maternal stature is confirmed as a significant risk factor for Caesarean section deliveries. The observed higher odds of Caesarean section deliveries among women from households of high socioeconomic status are attributed to the expected association between socioeconomic status and the use of appropriate maternal health care services. The odds of unfavourable birth outcomes vary significantly between women. In addition, the odds of Caesarean section deliveries vary between districts, after taking into account the individual-level characteristics of the woman.
(KENYA, CHILDBIRTH, PREMATURE BIRTH, BIRTH WEIGHT, CAESARIAN SECTION, MATERNAL AND CHILD HEALTH, PRENATAL CARE, BIRTH ORDER, FIRST BIRTH, BODY HEIGHT, HEALTH SERVICES, SOCIO-ECONOMIC STATUS, DEMOGRAPHIC AND HEALTH SURVEYS, METHODOLOGY, REGRESSION ANALYSIS).
English - pp. 199-225.
M. Magadi, African Population and Health Research Center, Population Council, PO Box 17643, Nairobi, Kenya; N. Madise, I. Diamond, Department of Social Statistics, University of Southampton, Southampton SO17 1BJ, U.K.
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Terra De Souza, Ana Cristina; Peterson, Karen E.; Cufino, Ennio; Vasconcelos Do Amaral, Maria Ines; Gardner, Jane.
Underlying and proximate determinants of diarrhoea-specific infant mortality rates among municipalities in the state of Cear?, North-East Brazil: An ecological study.
This ecological study examines the variations in diarrhoea-specific infant mortality rates among municipalities in the State of Cear?, north-east Brazil, using data from a community health workers? programme. Diarrhoea is the main cause of postneonatal deaths in Cear?, and diarrhoea mortality rates vary substantially among municipalities, from 7 to 50 per thousand live births. To determine the inter-relationships between potential predictors of diarrhoea-specific infant mortality, eleven variables were classified into proximate determinants (i.e. adequate weight gain and exclusive breast-feeding in first 4 months) and underlying determinants (i.e. health services and socioeconomic variables). The health services variables included percentage with prenatal care up-to-date, participation in growth monitoring and immunization up-to-date, while the socioeconomic factors included female illiteracy rate, per capita gross municipality product and percentage of households with low income, percentage of households with inadequate water supply and inadequate sanitation, and urbanization. Using linear regression analysis variables were included from each group to build regression models. The significant determinants of variability in diarrhoea-specific infant mortality between municipalities were prevalence of infants exclusively breast-feeding, percentage of infants with adequate weight gain, percentage of pregnant women with prenatal care up-to-date, female illiteracy rate and inadequate water supply. These findings suggest that community-based promotion of exclusive breast-feeding in the first 4 months and care-giving behaviours that prevent weight faltering, including weaning practices and feeding during and following diarrhoea episodes, may further reduce municipality-level diarrhoea-specific mortality. Primary heath care strategies addressing these two proximate determinants provide only a partial solution to reducing diarrhoeal disease mortality. Improvements in municipal health services (prenatal care) and socioeconomic status variables, including water supply and maternal education, can also contribute to reduction of infant mortality due to diarrhoea. These results may be used by government health officials to set priorities by considering not only the strength of the association between selected risk factors and diarrhoea mortality rates, but also the prevalence of the risk factors being considered at the municipality level. Finally, the methods used are applicable to other settings with community-based primary health care decentralized to the state or municipal level.
(BRAZIL, ADMINISTRATIVE DISTRICTS, DIARRHOEAL DISEASES, INFANT MORTALITY, MORTALITY DETERMINANTS, BREAST FEEDING, INFANT FEEDING, MATERNAL AND CHILD HEALTH, PRENATAL CARE, PRIMARY HEALTH CARE, EDUCATION OF WOMEN, WATER SUPPLY, SOCIO-ECONOMIC CONDITIONS).
English - pp. 227-244.
A. C. Terra De Souza, K. E. Peterson, J. Gardner, Department of Maternal and Child Health, Harvard School of Public Health, Boston, Massachusetts, U.S.A.; E. Cufino, UNICEF, Fortaleza, Cear?, Brazil; M. I. Vasconcelos Do Amaral, Secretaria Estadual da Saude do Cear?, Fortaleza, Cear?, Brazil.
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The evolution of the family planning programme and its role in influencing fertility change in Kenya.
Kenya was one of the first sub-Saharan countries to enter the fertility transition, and analysts have suggested various explanations for this. This paper examines the growth in contraceptive availability in Kenya by looking at the Kenya family planning programme and its association with the fertility transition. This is of critical programmatic importance because the fertility transition is not yet underway in many sub-Saharan countries. Policymakers will find the information from this study helpful in evaluating the efficacy of current programmes and replicating the Kenyan programme in areas where fertility decline has not yet occurred. For researchers, the study attempts to highlight some of the major factors driving Kenya?s fertility decline, apart from the conventional arguments about social and economic development.
(KENYA, FERTILITY DECLINE, FAMILY PLANNING PROGRAMMES, FERTILITY DETERMINANTS, ECONOMIC AND SOCIAL DEVELOPMENT).
English - pp. 245-260.
C. Toroitich-Ruto, Family Health International, The Chancery, 2nd Floor, Valley Rd, PO Box 38835, Nairobi, Kenya.
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Cindoglu, Dilek; Sirkeci, Ibrahim.
Variables that explain variation in prenatal care in Turkey: Social class, education and ethnicity revisited.
The extent and quality of prenatal care are important for the health of women and their babies. Recent studies suggest that women lack adequate prenatal care in contemporary Turkey. This paper uses regression models to examine the major factors impacting on the access of women to prenatal care through the 1993 Turkish Demographic and Health Survey. The findings suggest that after controlling for class, ethnicity does not explain the likelihood of a woman?s access to prenatal care, partly because the predominant patriarchal ideology in Turkey determines women?s access to education, which in turn determines their access to prenatal care. It can be argued that unless women?s socioeconomic status in the family improves, their access to health care in general and prenatal care in particular will not increase significantly.
(TURKEY, PRENATAL CARE, MATERNAL AND CHILD HEALTH, WOMEN?S STATUS, SOCIO-ECONOMIC STATUS, EDUCATION OF WOMEN, ETHNICITY, PATRIARCHY, CULTURE, REGRESSION ANALYSIS).
English - pp. 261-270.
D. Cindoglu, Department of Political Science, Bilkent University, Bilkent 06533, Ankara, Turkey; I. Sirkeci, Department of Geography, University of Sheffield, Winter Street, Sheffield S10 2TN, U.K.
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Alam, Nurul; Saha, Sajal K.; Razzaque, Abdur; Van Ginneken, Jeroen K.
The effect of divorce on infant mortality in a remote area of Bangladesh.
The process of divorce is usually lengthy and hazardous, and can start quarrels that can lead to the abuse of women and their children. This study examines the effects of divorce on neonatal and postneonatal mortality of babies born before and after divorce in Teknaf, a remote area of Bangladesh. The longitudinal demographic surveillance system (DSS) followed 1762 Muslim marriages in 1982-83 for 5 years to record divorce, deaths of spouse, emigration and births. It recorded 2696 live births during the follow-up period, and their survival status during infancy. Logistic regression models were used to estimate the effect of divorce on neonatal and postneonatal mortality, controlling for maternal age at birth, parity, sex of the child and household economic status. The odds of neonatal and postneonatal deaths among babies born after divorce or less than 12 months before mothers were divorced were more than double the odds of those born to mothers of intact marriages. The odds of postneonatal deaths were two times higher among babies born more than 12 months before divorce happens than their peers. The high mortality of infants born before and after mothers were divorced may reflect how abusive marriage and divorce increase the vulnerability of women and children in rural Bangladesh. Divorce and abuse of women are difficult and intractable social and health problems that must be addressed.
(BANGLADESH, RURAL AREAS, DIVORCE, NEONATAL MORTALITY, POST-NEONATAL MORTALITY, DIFFERENTIAL MORTALITY, WOMEN?S STATUS, SOCIAL PROBLEMS, REGRESSION ANALYSIS).
English - pp. 271-278.
N. Alam, S. K. Saha, A. Razzaque, J. K. Van Ginneken, Health and Demographic Surveillance Programme, Public Health Sciences Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh.
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Van Poppel, Frans; Joung, Inez.
Long-term trends in marital status mortality differences in the Netherlands 1850-1970.
This article describes the long-term trends in marital status mortality differences in the Netherlands using a unique dataset relating to the period 1850-1970. Poisson regression analysis was applied to calculate relative mortality risks by marital status. For two periods, cause-of-death by marital status could be used. Clear differences in mortality by marital status were observed, with strongly increasing advantages for married men and women and a relative increase in the mortality of widowed compared with non-married people. Excess mortality among single and formerly married men and women was visible in many cause-of-death categories, and this became more widespread during the last decades of the nineteenth century. Hypotheses are formulated that might explain why married men and women underwent a stronger decrease in mortality up until the end of World War II.
(NETHERLANDS, MARITAL STATUS, MARRIED PERSONS, UNMARRIED PERSONS, DIFFERENTIAL MORTALITY, MORTALITY TRENDS, MORTALITY DECLINE, REGRESSION ANALYSIS).
English - pp. 279-303.
F. Van Poppel, I. Joung, Netherlands Interdisciplinary Demographic Institute (NIDI), PO Box 11650, 2502 AR The Hague, the Netherlands.
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Biondi, G.; Raspe, P.; Mascie-Taylor, C. G. N.
Migration through surnames in Campobasso Province, Italy.
Data on grandparental surnames were obtained from schoolchildren in 22 communes from Campobasso Province, Italy (Molise Region). The distribution of surnames was shown to be almost exactly linear by a log2-log2 transformation, which justified the fitting of the data to Fisher?s logarithmic distribution. The values for [nu] were higher among women. When [nu] was standardized to minimize bias due to sample size, the value was one-third the estimate of migration from exogamy data. The higher values of [nu] for females indicate that there is greater mobility of female marriage partners than males.
(ITALY, REGIONS, SURNAME, MIGRATION TRENDS, DIFFERENTIAL MIGRATION, MIGRATION MEASUREMENT, METHODOLOGY, RESEARCH METHODS).
English - pp. 305-310.
G. Biondi, Dipartimento di Biologia animale e dell?uomo, Universit? di Torino, Italy; P. Raspe, C. G. N. Mascie-Taylor, Department of Biological Anthropology, University of Cambridge, U.K.
***
JOURNAL OF BIOSOCIAL SCIENCE, 2001, Vol. 33, No. 3
A biocultural investigation of the weanling's dilemma in Kathmandu, Nepal: Do universal recommendations for weaning practices make sense?
The primary objective of this report is to use data from a study of infant growth and weaning practices in Kathmandu, Nepal, to investigate universal recommendations about exclusive breast-feeding up to 6 months postpartum. A secondary objective is to demonstrate the complexity of the biocultural nature of infant feeding practices. A sample of 283 children under 5 years of age and their 228 mothers living in a peri-urban district of Kathmandu participated in this study. The children?s height/length and weight were measured three times over 9 months. At each session, a demographic, child health and infant feeding survey was administered; between sessions, in-depth interviews were conducted with mothers regarding infant feeding practices. While a few of the infants under 2 months were receiving non-breast milk foods, at 3 months of age half of the sample had been introduced to non-breast milk foods and by 7 months all infants were eating non-breast milk foods. A comparison of growth indices and velocities between exclusively and partially breast-fed infants from birth to 7 months of age shows no evidence for a difference in nutritional status between the two groups. Although there are cultural rules about breast-feeding that vary by ethnic group, all mothers followed a feeding method that depended on their assessment of whether the child was getting enough breast milk. The conclusion is that exclusive breast-feeding up to 6 months may not be appropriate for all infants. In this sample, breast-feeding duration is not shortened by the early introduction of non-breast milk foods, as the median age of breast-feeding cessation is 36 months. One of the main reasons for severance was the onset of another pregnancy. Investigation of infant feeding practices must be contextualized in the local ecology of the population. While cultural beliefs about breast-feeding are relevant, mothers? individual assessments of their children?s nutritional needs and demographic events in parents? lives must also be considered.
(NEPAL, CITIES, ANTHROPOLOGY, PAEDIATRICS, BREAST FEEDING, WEANING, DURATION OF LACTATION, INFANT FEEDING, CHILD NUTRITION, CHILD DEVELOPMENT, CULTURE).
English - pp. 321-338.
T. Moffat, Department of Anthropology, McMaster University, Hamilton, Ontario, L8S 4L9, Canada.
***
Griffiths, Paula; Stephenson, Rob.
Understanding users' perspectives of barriers to maternal health care use in Maharashtra, India.
This paper uses data collected using in-depth, semi-structured interviews to examine utilization of maternal health care services among two rural and urban populations of Pune and Mumbai in Maharashtra, India. The study aims to identify key social, economic and cultural factors influencing women?s decisions to use maternal health care and the places used for child delivery, whilst considering the accessibility of facilities available in the local area. Socioeconomic status was not found to be a barrier to service use when women perceived the benefits of the service to outweigh the cost, and when the service was within reasonable distance of the respondent?s place of residence. A large number of women perceived private services to be superior to those provided by the government, although cost often meant they were unable to use them. The provision of services did not ensure that women used them; they had to first perceive them to be beneficial to their health and that of their unborn child. Respondents identified the poor quality of services offered at government institutions to be a motivating factor for delivering at home. Thus further investigation is needed into the quality of services provided by government facilities in the area. A number of respondents who had received antenatal care went on to deliver in the home environment without a trained birth attendant. Further research is needed to establish the types of care provided during an antenatal consultation to establish the feasibility of using these visits to encourage women, particularly those with high-risk pregnancies, to be linked to a trained attendant for delivery.
(INDIA, CITIES, MATERNAL AND CHILD HEALTH, HEALTH SERVICES, PRENATAL CARE, CHILDBIRTH AT HOME, HOSPITAL BIRTHS, COSTS, SOCIO-ECONOMIC STATUS, CULTURE).
English - pp. 339-359.
P. Griffiths, Carolina Population Center, University Square, CB#8120, 123 West Franklin Street, Chapel Hill, NC 27516-3997, U.S.A.; R. Stephenson, Department of Social Statistics, University of Southampton, Highfield, Southampton, SO17 1BJ, U.K.
***
Lima, M.; Smith, M.; Silva, C.; Abade, A.; Mayer, F.; Coutinho, P.
Natural Selection at the MJD locus: Phenotypic diversity, survival and fertility among Machado-Joseph Disease patients from the Azores.
Machado-Joseph Disease (MJD) is an autosomal dominant neurodegenerative disorder of adult onset, associated with the expansion of a (CAG)n tract in the coding region of the causative gene, localized on 14q32.1. Machado-Joseph Disease shows non-Mendelian features typical of other triplet repeat disorders, including clinical heterogeneity, variable age at onset and anticipation. Three phenotypes have been proposed (clinical types 1, 2 and 3). Type 1 is associated with early age at onset and a high repeat number of the CAG sequence, and Types 2 and 3 have later onset and lower numbers of CAG repeats. This paper investigates whether there is selection against the MJD gene, acting through differential survival, nuptiality and fertility associated with clinical type and age at onset. The study sample comprised 40 MJD patients from the Azores (Portugal) having fully documented reproductive histories and known dates of death. The proportion of married patients of each clinical type increased from 0?22 among Type 1 patients, to 0?40 in Type 2 and 0?95 in Type 3. Age at onset and length of survival were also associated with marital status, with the married cases having later mean age at onset and longer mean survival time. In the whole sample, clinical type was associated with fertility, with significantly fewer children born to Type 1 patients. Among married patients clinical type was not associated with age at marriage, reproductive span or number of children. No reduction of fertility was detected among married patients in whom the onset of MJD was below the age of 50. The authors? interpretation of these results is that the high-repeat CAG haplotypes associated with early age at onset and clinical Type 1 are selected against through reduced survival and fertility. The fertility component of selection is mediated by nuptiality rather than marital fertility.
(PORTUGAL, CITIES, GENETICS, GENETIC DISEASES, NATURAL SELECTION, PHENOTYPE, NUPTIALITY, LEGITIMATE FERTILITY RATE, DIFFERENTIAL FERTILITY, LIFE EXPECTANCY, DIFFERENTIAL MORTALITY).
English - pp. 361-373.
M. Lima, C. Silva, Department of Biology, University of the Azores, Portugal; M. Smith, Department of Anthropology, University of Durham, U.K.; A. Abade, Department of Anthropology, University of Coimbra, Portugal; F. Mayer, Department of Biological Sciences, University of Quebec in Montreal, Montreal, Canada; P. Coutinho, Department of Neurology, Hospital of Porto, Portugal.
***
Magadi, Monica; Diamond, Ian; Madise, Nyovani.
Analysis of factors associated with maternal mortality in Kenyan hospitals.
This paper examines the association of the sociodemographic characteristics of women and the unobserved hospital factors with maternal mortality in Kenya using multilevel logistic regression. The data analysed comprise hospital records for 58,151 obstetric admissions in sixteen public hospitals, consisting of 182 maternal deaths. The results show that the probability of maternal mortality depends on both observed factors that are associated with a particular woman and unobserved factors peculiar to the admitting hospital. The individual characteristics observed to have a significant association with maternal mortality include maternal age, antenatal clinic attendance and educational attainment. The hospital variation is observed to be stronger for women with least favourable sociodemographic characteristics. For example, the risk of maternal death at high-risk hospitals for women aged 35 years and above, who had low levels of education, and did not attend antenatal care is about 280 deaths per 1000 admissions. The risk for similar women at low-risk hospitals is about 4 deaths per 1000. To complement results from the analysis of individual patient records, the paper includes findings from hospital staff reports regarding the maternal mortality situation at the hospitals.
(KENYA, MATERNAL MORTALITY, HOSPITALS, MORTALITY DETERMINANTS, PRENATAL CARE, MATERNAL AGE, LEVELS OF EDUCATION, SOCIO-ECONOMIC STATUS, HEALTH SERVICES, METHODOLOGY).
English - pp. 375-389.
M. Magadi, African Population and Health Research Center, Population Council, PO Box 17643, Nairobi, Kenya; I. Diamond, N. Madise, Department of Social Statistics, University of Southampton, Southampton S017 1BJ, U.K.
***
Letamo, Gobopamang; Majelantle, Rolang.
Factors influencing low birth weight and prematurity in Botswana.
The purpose of this study was to investigate the socioeconomic, biological and behavioural factors influencing low birth weight and prematurity in Botswana. Data were from the Botswana Obstetric Record covering the years 1990 to 1995, and were analysed with both descriptive statistics and multivariate analysis. The study found that the major positive risk factors for low birth weight were: late and less frequent attendance of antenatal care services, having experienced pregnancy termination before, low or no education, unmarried motherhood and place of birth. With regard to prematurity, age, late and less frequent attendance of antenatal care services, unmarried motherhood and place of birth were found to be the major positive risk factors. The importance of early and regular antenatal care attendance, marriage and place of birth cut across both low birth weight and prematurity.
(BOTSWANA, MEDICAL DEMOGRAPHY, EPIDEMIOLOGY, PREMATURE BIRTH, BIRTH WEIGHT, RISK, POPULATION AT RISK, PRENATAL CARE, LEVELS OF EDUCATION, UNMARRIED MOTHERS, METHODOLOGY, MULTIVARIATE ANALYSIS).
English - pp. 391-403.
G. Letamo, R. Majelantle, Department of Demography, University of Botswana, Private Bag 0022, Gaborone, Botswana.
***
Starting, spacing and stopping in the reproductive histories of outer Hebridean families.
Maternal ages at the first maternity (starting), at the last maternity (stopping) and the lengths of intervals between maternities (spacing) have been studied in the Outer Hebridean islands of Harris and Barra for births between the years of 1855 and 1990, a period during which a considerable ?fertility transition? occurred. There was a tendency in each island for increases with time in the ages at starting among less-fecund women (although after 1936 starting ages declined), and highly significant heterogeneity of covariance: adjusted means dependent on the total numbers of maternities experienced. The same result was seen for the ages at stopping. Lengths of reproductive life (the difference between ages at starting and stopping) rose to 1876-1895, and then fell, apart from a short-lived rise in Barra during 1956-1975, possibly due to the papal encyclical Humanae Vitae. Intervals between marriage and first maternity and between successive maternities were studied by hazard function survival analysis. The marriage-first birth interval remained very constant, unaffected by total maternities. The father?s occupation and the mother?s age at first maternity showed no significant relationships. In Barra there was a weak negative relationship with the date of the marriage. For intervals between maternities in both islands, total maternities and the death of a previous infant were associated with shorter, and birth order with longer intervals. In Harris, there were tendencies for intervals to be consistently long or short in families, and for the age of the mother and date at first maternity to be negatively related to the length of the interval. In Barra, a previous multiple birth was followed by a longer interval. The date of the previous maternity, father?s occupation, maternal age at the previous maternity, the sex of the previous child, and the duration of the marriage appeared to have no influence on maternity intervals. Evidence for an effect of economic deprivation during the 19th century on the variables considered was equivocal. During the 20th century, it is suggested that economic depression during the inter-war years, the spread of contraception, and improvements in health care may have acted ?synergistically? to produce the lower ages of childbearing and the shortening of maternity intervals and reproductive lives.
(SCOTLAND, CITIES, REPRODUCTIVE BEHAVIOUR, REPRODUCTIVE PERIOD, PREGNANCY HISTORY, FIRST BIRTH, BIRTH ORDER, FIRST BIRTH INTERVAL, BIRTH INTERVALS, MATERNAL AGE, CONTRACEPTIVE USAGE, PROPORTIONAL HAZARD MODELS).
English - pp. 405-426.
E. Clegg, Department of Biomedical Sciences, Marischal College, University of Aberdeen, Aberdeen AB9 1AS, U.K.
***
Danubio, Maria Enrica; Amicone, Elisa.
Biodemographic study of a central Apennine area (Italy) in the 19th and 20th centuries: Marriage seasonality and reproductive isolation.
This study investigates seasonality of marriages and reproductive isolation in six long-isolated communities in the central Apennines (Italy). It had two objectives: (1) the identification of an Apennine biodemographic model in comparison with mountain communities of other regions, and with non-Apennine communities in Abruzzo, and (2) to identify the possible effects of the drainage of Lake Fucino (1854-1876) on that area. Marriages in this region show two very stable seasonal patterns: one is typical of sedentary rural societies, with summer migrations and marriages preferentially celebrated in the winter, and the other has marriages that are strongly concentrated in the summer months, i.e. between 75% and 93?5% of marriages were celebrated between June and October in these communities in the 1800s. These were traditionally pastoral communities with winter transhumance of the flocks and their shepherds towards the lowlands of southern Italy. In both groups, restrictions imposed by the Catholic Church do not seem to have affected the timing of marriages. Indeed, economic factors related to work activities seem to have had more influence. Concerning reproductive isolation, the results show high rates of endogamy: between 85% and 98% in both the 19th and 20th centuries. Rates of consanguineous marriages were between 5% and 20%, and those of isonymous marriages rarely exceeded 9%. The coefficient of inbreeding [alpha] shows that there was a delayed, limited period of increased consanguinity in the few decades around the turn of the century. This is different from the national situation, and thus could be a consequence of the Lake Fucino drainage.
(ITALY, RURAL COMMUNITIES, HISTORICAL DEMOGRAPHY, ANTHROPOLOGY, NUPTIALITY, TRANSHUMANCE, CATHOLICISM, CONSANGUINEOUS MARRIAGE, ENDOGAMY, INBREEDING).
English - pp. 427-449.
M. E. Danubio, E. Amicone, Universit? dell'Aquila, Dipartimento di Scienze Ambientali, L?Aquila, Italy.
***
Birth weight, sexual orientation and the sex of preceding siblings.
This study?s first objective was to compare the mean birth weights of homosexual and heterosexual men and women. Its second objective was to investigate whether prior male and female fetuses have different effects on the birth weight of subsequent fetuses. The subjects were 3229 adult men and women (the probands), who weighed at least 2500 g at birth, and whose mothers knew the sex of the child (or fetus) for each pregnancy prior to the proband. Information on birth weight, maternal gravidity and other demographic variables was reported on questionnaires completed by the probands? mothers. The results confirmed earlier reports that boys with older brothers weigh less at birth than boys with older sisters, but they did not confirm reports that girls with older brothers weigh less than girls with older sisters. The results did not show across-the-board differences in the mean birth weights of homosexual versus heterosexual women or homosexual versus heterosexual men. However, the homosexual males with older brothers weighed about 170 g less at birth than the heterosexual males with older brothers. It is suggested that this pattern of results may reflect a maternal immune response to Y-linked minor histocompatibility antigens (H-Y antigens). According to this hypothesis, when the maternal immune response is mild, it produces only a slightly reduced birth weight, but when it is stronger, it produces a markedly reduced birth weight as well as an increased probability of homosexuality.
(UNITED STATES, OBSTETRICS, IMMUNOLOGY, BIRTH WEIGHT, SIBLINGS, HOMOSEXUALITY, SEX DIFFERENTIALS).
English - pp. 451-467.
R. Blanchard, Centre for Addiction and Mental Health - Clarke Division, Toronto, Ontario, Canada; L. Ellis, Minot State University, Minot, North Dakota, U.S.A.
***
Nijenhuis, Jan Te; Van Der Flier, Henk.
Group differences in mean intelligence for the Dutch and Third World immigrants.
Evidence from eleven samples indicates that the mean IQ of third world immigrants in the Netherlands is lower than the Dutch mean by approximately one standard deviation for Surinamese and Antillians, and by approximately one and a half standard deviations for Turks and Moroccans. Since IQ tests provide the best prediction of success in school and organizations, it could be that the immigrants? lower mean IQ is an important factor in their low status on the Dutch labour market. The IQs of second-generation immigrants are rising.
(NETHERLANDS, PSYCHOLOGY, INTELLIGENCE, IMMIGRANTS, NON-MIGRANTS, SECOND GENERATION MIGRANTS, MIGRANT ASSIMILATION, LABOUR MARKET, SCHOOL SUCCESS).
English - pp. 469-475.
J. T. Nijenhuis, Department of Work and Organizational Psychology, University of Amsterdam, Netherlands; H. Van Der Flier, Department of Work and Organizational Psychology, Vrije Universiteit, Amsterdam, Netherlands.
***
JOURNAL OF BIOSOCIAL SCIENCE, 2001, Vol. 33, No. 4
Spouses' socioeconomic characteristics and fertility differences in sub-Saharan Africa: Does spouse's education matter?
Although the general objective of this study is to examine the extent to which spouses? socioeconomic characteristics determine whether modern contraception is used and whether family limitation (the demand for no more children) is desired, its central goal is to evaluate the degree to which the net effect of a woman?s education on those fertility decisions is altered once a control is made for the level of schooling of the husband. Individual characteristics of spouses included as controls in this analysis are on the one hand women?s attributes relating to employment, age, parity, ethnic identity, and urban residence and, on the other hand, the occupation of the husband. Data used in this research are provided by DHS surveys conducted in fourteen sub-Saharan countries: Mali, Burkina Faso, Niger, Nigeria, Cameroon, Benin, Senegal, Ghana, Central African Republic, Kenya, Zambia, Zimbabwe, Namibia and Rwanda. With two dichotomous outcome variables, logistic regression was used to estimate two nested models for each dependent variable and for each country covered by the study. DHS respondents used as units of analysis in this study are women who were married (any kind of union) and non-pregnant at the time when each national survey was conducted. The findings suggest that, while an educated wife needs the support of an educated husband to state a preference for family limitation in contemporary sub-Saharan Africa, controlling for husband?s education and other relevant covariates does little to undermine the evidence that woman?s advanced education and the adoption of modern family planning are positively related in the developing world.
(AFRICA SOUTH OF SAHARA, EDUCATION OF WOMEN, HOMOGAMY, MARITAL UNION, SOCIO-ECONOMIC STATUS, REPRODUCTIVE BEHAVIOUR, CONTRACEPTIVE USAGE, DECISION MAKING).
English - pp. 481-502.
J. M. Uchudi, Center on Population, Gender and Social Inequality, University of Maryland, 2112 Art-Sociology Building, College Park, MD 20742-1315, U.S.A.
***
Hagen, Edward H.; Hames, Raymond B.; Craig, Nathan M.; Lauer, Matthew T.; Price, Michael E.
Parental investment and child health in a Yanomam? village suffering short-term food stress.
The 1998 El Ni?o significantly reduced garden productivity in the Upper Orinoco region in Venezuela. Consequently, parents were forced to allocate food carefully to their children. Nutrition data collected from village children combined with genealogical data allowed the determination of which children suffered most, and whether the patterns of food distribution accorded with predictions from parental investment theory. For boys, three social variables accounted for over 70% of the variance in subcutaneous fat after controlling for age: number of siblings, age of the mother?s youngest child, and whether the mother was the senior or junior co-wife, or was married monogamously. These results accord well with parental investment theory. Parents experiencing food stress faced a trade-off between quantity and quality, and between investing in younger versus older offspring. In addition, boys with access to more paternal investment (i.e. no stepmother) were better nourished. These variables did not account for any of the variance in female nutrition. Girls? nutrition was associated with the size of their patrilineage and the number of non-relatives in the village, suggesting that lineage politics may have played a role. An apparent lack of relationship between orphan status and nutrition is also interesting, given that orphans suffered high rates of skin flea infections. The large number of orphans being cared for by only two grandparents suggests that grooming time may have been the resource in short supply.
(VENEZUELA, CITIES, FOOD SHORTAGE, FOOD SUPPLY, CHILD NUTRITION, ADJUSTMENT, FAMILY ENVIRONMENT, FAMILY SIZE, COST OF CHILDREN, VALUE OF CHILDREN, PREFERENCES, ORPHANS).
English - pp. 503-528.
E. H. Hagen, N. M. Craig, M. T. Lauer, M. E. Price, Department of Anthropology, University of California, Santa Barbara, CA 93106, U.S.A.; R. B. Hames, Department of Anthropology, University of Nebraska-Lincoln, U.S.A.
***
Le Strat, Y.; Thalabard, J. C.
Analysis of postpartum lactational amenorrhoea in relation to breast-feeding: Some methodological and practical aspects.
A large multicentre epidemiological study was carried out by WHO between 1991 and 1995 to analyse the duration of lactational amenorrhoea in relation to breast-feeding. The main results of this analysis, which used classical statistical modelling, have been already published. However, some specific aspects of the postpartum fertility amenorrhoea and breast-feeding covariates, and more specifically the observed progressive exhaustion of the breast-feeding inhibitory effect on the reproductive axis, may justify a closer look at the validity of the statistical tools. Indeed, as has already been emphasized, analysis of large longitudinal data sets in reproduction often faces three difficulties: (i) the precise determination of the event of interest, (ii) the way to handle the time evolution of both the studied variables and their effect on the event of interest and (iii) the often discrete nature of the data and the associated problem of tied events. The first objective of the present work was to give additional insights into the estimation and quantification of the dynamics of the effect of breast-feeding over time, considering this covariate either as fixed or time-dependent. The second objective was to show how to perform the analyses using corresponding adapted procedures in widely available statistical packages, without the need for acquiring particular programming skills.
(WHO, EPIDEMIOLOGY, PHYSIOLOGY, ENDOCRINOLOGY, REPRODUCTION, POST-PARTUM AMENORRHOEA, BREAST FEEDING, FERTILITY DETERMINANTS, METHODOLOGY, COHORT ANALYSIS, EVENT HISTORY ANALYSIS).
English - pp. 529-549.
Y. Le Strat, Service de Biostatistique et d?Informatique M?dicale, J. C. Thalabard, Service d?Endocrinologie et M?decine de la Reproduction, Groupe Hospitalier Necker, 149 rue de S?vres, F-75743 Paris, Cedex 15, France.
***
Janowitz, Barbara; Thompson, Andy.
Why it is difficult to determine resource requirements for family planning.
This paper describes the efforts of Family Health International to develop a simple, standard and replicable methodology to estimate expenditures on family planning in developing countries. The study found that it is not possible, at least at this time, to develop such a methodology. Numerous problems were encountered in making expenditure estimates. First and most important, expenditure accounts are not always readily available. Even when these accounts are available, they may require some adjustments. In some instances, for example, the salaries of health workers who also provide family planning are in the health accounts, whereas in other cases the workers covered in the family planning accounts spend some of their time providing health services. Allocation variables then must be developed to separate spending on family planning from that on health. In some instances allocation variables were developed and used to separate family planning from health expenditures, but in this case allocation variables were not available and a cost analysis was performed. It is concluded that it takes considerable time and effort to estimate expenditures, and that the approach that was followed varied by country, reflecting the data available to make estimates.
(DEVELOPING COUNTRIES, FAMILY PLANNING PROGRAMMES, MATERNAL AND CHILD HEALTH, EXPENDITURES, RESOURCE ALLOCATION, METHODOLOGY, MEASUREMENT, COST ANALYSIS).
English - pp. 551-567.
B. Janowitz, Health Services Research, Family Health International, 2224 East NC Highway 54, Durham, NC 27713, U.S.A.; A. Thompson Health Policy Unit, Organization for Economic Cooperation & Development, F-75016 Paris, France.
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Olsen, A.; Samuelsen, H.; Onyango-Ouma, W.
A study of risk factors for intestinal Helminth infections using epidemiological and anthropological approaches.
This study, conducted in Kisumu District, Kenya, identified important risk factors for infection with intestinal helminths using traditional epidemiological methods. This was combined with a rapid assessment study using qualitative methods, which focused on sanitation practices and local illness perceptions. The multiple logistic regression analysis revealed that the absence of latrines was a significant predictor for hookworm infection with an odds ratio (OR) of 1?9. The analysis also revealed that households without soap had a 2?6 times higher risk of being infected with Ascaris lumbricoides compared with households where soap was available, and that the number of inhabitants living in a household was a significant predictor for infections with hookworms (OR=3.2). Furthermore, the presence of children of 5 years and under in the household was a predictor for infection with A. lumbricoides (OR=2.7), while the absence of this age group was a predictor for hookworm infection (OR=3.8). The qualitative part of the study revealed that people did not consider worms as a serious health threat, but as a nuisance. Among the population, latrines were seen as beneficial because they were believed to prevent disease, to provide privacy and to keep the environment free of faeces. Handwashing was done many times a day but usually not with soap, which was mainly used when bathing or washing the whole body. Many inhabitants in a household or the presence of children of 5 years and under were never mentioned as being a disadvantage, and these elements would therefore be difficult to include in a control strategy. Since the lack of latrines and of soap were identified as risk factors for infection, while latrines, soap and medicine were seen as assets by the population, it is suggested that helminth control interventions should be concentrated within these areas in this particular society.
(KENYA, CITIES, EPIDEMIOLOGY, ANTHROPOLOGY, PARASITIC DISEASES, RISK, ATTITUDE, HEALTH CONDITIONS, HOUSING CONDITIONS, HYGIENE, SANITATION, DISEASE CONTROL, PUBLIC HEALTH).
English - pp. 569-584.
A. Olsen, Danish Bilharziasis Laboratory, Jaegersborg All? 1 D, DK-2920, Charlottenlund, Denmark; H. Samuelsen, Department of International Health, Institute of Public Health, University of Copenhagen, Denmark; W. Onyango-Ouma, Institute of African Studies, University of Nairobi, PO Box 30197, Nairobi, Kenya.
***
Maitra, Kuhu; Degraft-Johnson, Joseph; Singh, Kaushalendra K.; Tsui, Amy O.
Prevalence of self-reported symptoms of reproductive tract infections among recently pregnant women in Uttar Pradesh, India.
This study examines the prevalence of self-reported reproductive tract infections (RTIs) and treatment seeking among married, recently pregnant women in Uttar Pradesh state, India. Associations between RTI symptom reporting and background characteristics are examined in a population-based sample of 18,506 married women with a pregnancy in the 3 years prior to a 1995 statewide survey. Logistic regression analyses are used to assess the effects of sociodemographic covariates on the probability of reporting an RTI symptom. Nearly one out of four women reports experiencing at least one RTI symptom, with the most common symptoms being abnormal vaginal discharge and pain during urination. Reporting of RTI symptoms significantly increases if the woman?s last pregnancy did not end in a live birth or if she has low economic status. Symptom reports also increase with age and decrease with parity. Only one-third of women reporting an RTI symptom sought treatment. The results indicate that survey interviews can be a cost-effective option for measuring the magnitude of RTI symptoms experienced and identifying sociodemographic influences. The findings suggest the need for improved RTI screening procedures and treatment at health facilities in this populous state of northern India.
(INDIA, REGIONS, MEDICAL DEMOGRAPHY, GYNAECOLOGY, MATERNAL AND CHILD HEALTH, UROGENITAL SYSTEM, INFECTIOUS DISEASES, SEXUALLY TRANSMITTED DISEASES, MARRIED WOMEN, SOCIO-ECONOMIC STATUS, STILL BIRTHS, DATA COLLECTION, INTERVIEWS).
English - pp. 585-601.
K. Maitra, Population Council, India; J. Degraft-Johnson, Save the Children Federation, U.S.A; K. K. Singh, Department of Statistics, Banaras Hindu University, India; A. O. Tsui, Department of Maternal and Child Health and the Carolina Population Center, University of North Carolina at Chapel Hill, U.S.A.
***
Griffiths, Paula; Hinde, Andrew; Matthews, Zo?.
Infant and child mortality in three culturally contrasting States of India.
Using cross-sectional, individual-level survey data from Maharashtra, Tamil Nadu and Uttar Pradesh collected under the Indian National Family Health Survey programme of 1992-93, statistical modelling was used to analyse the impact of a range of variables on the survival status of children during their first 2 years of life. Attention was focused on the potential impact of the mother?s autonomy. The strongest predictors of mortality were demographic and biological factors, breast-feeding behaviour, and use and knowledge of health services. Variables that can be interpreted as being related to maternal autonomy, such as the presence of a mother-in-law in the household, did not have a significant direct effect on child survival at the individual level, and their indirect effects were very limited.
(INDIA, REGIONS, INFANT MORTALITY, CHILD MORTALITY, DIFFERENTIAL MORTALITY, MORTALITY DETERMINANTS, BREAST FEEDING, HEALTH SERVICES, SEX ROLES, WOMEN?S ROLE).
English - pp. 603-622.
P. Griffiths, Carolina Population Center, University Square CB#8120, 123 West Franklin Street, Chapel Hill, NC 27516-3997, U.S.A.; A. Hinde, Z. Matthews, Department of Social Statistics, University of Southampton, Southampton SO17 1BJ, U.K.
***
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