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JOURNAL OF BIOSOCIAL SCIENCE, October 1999, Vol. 31, N? 4
Pacific island suicide in comparative perspective.
All available data for thirteen Pacific Island nations are used in a comparative analysis of suicide levels and characteristics. Age, sex and method of suicide are examined in detail. Global comparison shows Pacific rates are amongst the highest reported. Female youth rates exceed male rates in Western Samoa and amongst Fiji Indians. Method of suicide (paraquat ingestion) is instrumental in determining high rates in Western Samoa, especially in females. The broad causal theme is societal transition. Commonality and diversity are discussed.
(OCEANIA, SUICIDE, COMPARATIVE ANALYSIS).
English - pp. 433-448.
H. Booth, Demography Program, Research School of Social Sciences, Australian National University, Canberra ACT 0200, Australia.
***
Community perceptions of reasons for preference for consanguineous marriages in Pakistan.
Although the recent Pakistan Demographic and Health Survey (DHS) shows that two-thirds of marriages in Pakistan are consanguineous, the sociocultural determinants of such marriages remain largely unexplored. This paper examines the relative importance of the three commonly perceived reasons for such marriages: religious, economic and cultural. The analysis is based on qualitative data collected in 1995 from multi-ethnic and multi-religious communities in Karachi, the largest city of Pakistan. Results show that consanguineous marriages are preferred across all ethnic and religious groups to a varying degree, and that parents continue to be the prime decision-makers for marriages of both sons and daughters. The major reasons for a preference for consanguineous marriages are sociocultural rather than any perceived economic benefits, either in the form of consolidation of family property or smaller and less expensive dowries. Among Muslims, following religious traditions is the least commonly cited reason for such marriages. Despite the reported sociocultural advantages of consanguineous marriages, such unions are perceived to be exploitative as they perpetuate the existing power structures within the family.
(PAKISTAN, CONSANGUINEOUS MARRIAGE, PREFERENCES, CULTURE, RELIGION, SOCIO-ECONOMIC CONDITIONS).
English - pp. 449-461.
R. Hussain, Department of Public Health & Nutrition, University of Wollongong, Australia.
***
Family-building patterns and childhood mortality: A family-level analysis.
It has been suggested that altering the pace of reproduction would improve the health of women and children. For formulating intervention policies, it is important to know whether on its own such a strategy is likely to lead to risk reduction. This paper analyses mortality risk in sibships to explore the relationship between family formation factors and other household characteristics that identify women whose families are at higher risk. The analysis allows for the fact that reproductive behaviour may be modified by the family's prior experience of child death, using simultaneous equations methods to purge the model of the 'feedback' effects of death on the endogenous variable, childbearing pace. The strong relationship between reproductive pace and average risk in a family appears to be due to the association of both with other differences between households. Other aspects of family formation patterns are good indicators of which families are likely to experience excess risks to their children. These factors are associated with maternal education, but measure characteristics of the family or mother that educational attainment does not fully capture. They indicate that high-risk mothers are likely to have less control over many aspects of their lives. The pace of family building does not lead to excess average family risk, but may result, at least in part, from the concentration of risk in families with other characteristic patterns of family formation and few resources. The paper argues for a broader conception of household influences on child health and the health-related behaviour of parents.
(MATERNAL AND CHILD HEALTH, FAMILY FORMATION, CHILD MORTALITY, REPRODUCTIVE BEHAVIOUR).
English - pp. 463-485.
P. H. David, Population Reference Bureau, 1875 Connecticut Avenue, NW, Suite 520, Washington, DC 20009, U.S.A.
***
Chinese traditional medicine and abnormal sex ratio at birth in China.
A study of the abnormal sex ratio at birth in China reveals that it is not an entirely new phenomenon that emerged since the 1980s, but is simply more visible at present. Deliberate intervention to determine the sex of children has existed in the past few decades, at least in certain groups. Apart from modern medical methods, traditional Chinese medical practice is shown to be highly accurate in identifying the sex of a fetus. This may lead to sex-selective abortion and an abnormal sex ratio at birth. The possible causes of the abnormal sex ratio at birth include not only the real imbalance due to the disturbance of social factors, but also a spurious one attributable to the under-counting of female births. The real magnitude of the imbalance has been exaggerated by statistical error. The phenomenon is a complicated one reflecting the comprehensive socioeconomic setting. Among these factors, the stage of the fertility transition is one of the most decisive.
(CHINA, SEX PRESELECTION, SEX PREFERENCE, SEX RATIO, TRADITIONAL MEDICINE, INDUCED ABORTION, UNDERREGISTRATION).
English - pp. 487-503.
X. Peng and J. Huang, Institute of Population Research, Fudan University, Shanghai, 200433, PR China.
***
Nutrition, fertility and steady-state population dynamics in a pre-industrial community in Penrith, Northern England.
The effect of nutrition on fertility and its contribution thereby to population dynamics are assessed in three social groups (elite, tradesmen and subsistence) in a marginal, pre-industrial population in northern England. This community was particularly susceptible to fluctuations in the price of grains, which formed their basic foodstuff. The subsistence class, who formed the largest part of the population, had low levels of fertility and small family sizes, but women from all social groups had a characteristic and marked subfecundity in the early part of their reproductive lives. The health and nutrition of the mother during pregnancy was the most important factor in determining fertility and neonatal mortality. Inadequate nutrition had many subtle effects on reproduction which interacted to produce a complex web of events. A population boom occurred during the second half of the 18th century; fertility did not change but there was a marked improvement in infant mortality and it is suggested that the steadily improving nutritional standards of the population, particularly during crucial periods in pregnancy (i.e. the last trimester), probably made the biggest contribution to the improvement in infant mortality and so was probably the major factor in triggering the boom.
(ENGLAND, HISTORICAL DEMOGRAPHY, FERTILITY DETERMINANTS, MALNUTRITION, INFANT MORTALITY).
English - pp. 505-523.
S. Scott and C. J. Duncan, School of Biological Sciences, University of Liverpool, PO Box 147, Liverpool L69 3BX, U.K.
***
BIELICKI, Tadeusz; SZKLARSKA, Alicja.
The stratifying force of family size, urbanization and parental education in socialist-era Poland.
The strength of influence upon statural variation of: (1) the degree of urbanization of the locality of habitat, (2) family size, (3) paternal and (4) maternal educational status was analysed in three generations of 19-year-old Polish conscripts, examined in 1965, 1986 and 1995. Each of the above factors of an individual's social situation was described by a 4-level scale. Each factor was found to exert a highly significant residual effect on stature throughout the three decades considered, even after the effects of other correlated factors were partialled out by three-factor ANOVA. However, the stratifying force of each factor, as expressed by the dispersal of the level-specific main effects around the national mean, has been changing over time. For example, the growth-stunting effect of the condition of coming from a large sibship was dramatic in the 1965 cohort and considerably attenuated in 1986 but ceased to diminish thereafter. The growth-enhancing effect of the condition of being a large-city dweller, initially marked, has almost disappeared; but the growth-stunting effect of the condition of being a rural dweller has remained equally strong across all cohorts. These and other shifts in the relative importance of the social factors, as presumed determinants of family living standards, are described and some explanations attempted.
(POLAND, URBANIZATION, FAMILY SIZE, PARENTS, LEVELS OF EDUCATION, BODY HEIGHT).
English - pp. 525-536.
T Bielicki and A. Szklarska, Institute of Anthropology, Polish Academy of Sciences, Kuznicza 35, 50-951 Wroclaw, Poland.
***
HENNINK, Monique; DIAMOND, Ian; COOPER, Philip.
Contraceptive use dynamics of Asian women in Britain.
In-depth interviews were conducted with married Asian women from Indian, Pakistani and Bangladeshi backgrounds, to investigate patterns of contraceptive use and influences on contraceptive decision making. The results show two distinctively different contraceptive "lifecycles". Non-professional women typically have little knowledge about contraception until after their marriage or first birth. Their patterns of contraceptive behaviour show low levels of contraceptive use until after their first birth, when condom use is most prevalent. Non-professional women are influenced by their extended family, religion and cultural expectations on their fertility and family planning decisions. Professional women show an entirely different pattern of contraceptive behaviour. They are more likely to have knowledge about contraception before marriage, use some method of contraception throughout their childbearing years (typically the pill) and cite personal, practical or economic considerations in their fertility decisions rather than religious, cultural or extended family influences.
(UNITED KINGDOM, ASIA, IMMIGRANTS, CONTRACEPTIVE USAGE, FERTILITY DETERMINANTS, FEMALE EMPLOYMENT).
English - pp. 537-554.
M. Hennink, I. Diamond and P. Cooper, Department of Social Statistics, University of SouthHampton, U.K.
***
JOURNAL OF BIOSOCIAL SCIENCE, January 2000, Vol. 32, N? 1
Determinants of use of maternal-child health services in rural Ghana.
This study uses data from the Ghana Demographic and Health Survey (GDHS) of 1993 to examine factors determining the use of maternal-child health (MCH) services in rural Ghana. The MCH services under study are: (1) use of a doctor for prenatal care; (2) soliciting four or more antenatal check-ups; (3) place of delivery; (4) participation in family planning. Bivariate and multivariate techniques are employed in the analyses. The analyses reveal that the use of MCH services tends to be shaped mostly by level of education, religious background and region of residence, and partially by ethnicity and occupation. The implications of these results are discussed.
(GHANA, RURAL AREAS, MATERNAL AND CHILD HEALTH, HEALTH SERVICES, CHILD CARE SERVICES, FAMILY PLANNING PROGRAMMES).
English - pp. 1-15.
I. Addai, Department of Social Sciences, Lansing Community College, Lansing, Michigan, U.S.A.
***
Women's work and fertility in a sub-Saharan urban setting: A social environment approach.
Data from three separate studies conducted in Maputo, Mozambique, in 1993 are used to analyse the relationship between the type of social environment in which women work and their fertility and contraceptive use. The analysis finds that women who work in more collectivized environments have fewer children and are more likely to use modern contraception than women who work in more individualized milieus and those who do not work outside the home. Most of these differences persist in multivariate tests. It is argued that collectivized work environments are most conducive to diffusion and legitimation of reproductive innovations. In contrast, individualized environments tend to isolate women and therefore may retard their acceptance of innovative fertility-related behaviour.
(MOZAMBIQUE, CAPITAL CITY, FEMALE EMPLOYMENT, CONTRACEPTIVE USAGE, FERTILITY DETERMINANTS, WORKING CONDITIONS).
English - pp. 17-35.
V. Agadjanian, Department of Sociology, Arizona State University, Tempe, Arizona, 85287-2101, U.S.A.
***
Breast-feeding, diarrhoea and sanitation as components of infant and child health: A study of large scale survey data from Ghana and Nigeria.
Using Demographic and Health Survey datasets from Ghana and Nigeria, this study examined whether the protective effects of breast-feeding are greatest where the poorest sanitation conditions prevail. It was found that mixed-fed infants aged between 0 and 11 months tend to have a higher risk of diarrhoea than fully breast-fed children, while the risk of diarrhoea among weaned infants is twice that of mixed-fed infants. The probit regression models employed in the analysis were used to predict the probability of diarrhoea associated with each breast-feeding pattern for both 'poor' and 'good' sanitation areas. It was found that the risk of diarrhoea among mixed-fed infants in the poor sanitation areas tends to be high while the same risk among fully breast-fed infants tends to be minimal. In essence, the health risks of mixed feeding are real, particularly for infants aged less than 7 months, and are even worse for those weaned before 6 months of age.
(GHANA, NIGERIA, BREAT FEEDING, INFANT FEEDING, HEALTH, SANITATION, DIARRHOEAL DISEASES).
English - pp. 47-61.
C. Ahiadeke, Population Dynamics Unit, ISSER, University of Ghana, PO Box 74, Legon, Ghana.
***
The association between health-related behaviours and the risk of divorce in the USA.
This study investigates the link between health-related variables and risks of divorce. The findings indicate that physical characteristics associated with poor health -- namely, obesity and short stature -- are not significantly related to risks of marital dissolution for either men or women. On the other hand, risk-taking behaviours -- such as smoking and drug use -- are strongly related to higher risks of divorce for both sexes. Overall, the results emphasize the need to accommodate health-related variables in the dominant economic and social psychological theories of marital dissolution.
(UNITED STATES, DIVORCE, HEALTH, BEHAVIOUR).
English - pp. 63-88.
H. Fu, Human Development Report Office, United Nations Development Programme, 336 E. 45th Street, New York, NY 10017, U.S.A.; N. Goldman, Office of Population Research, Princeton University, 21 Prospect Avenue, Princeton, NJ 08544-2091, U.S.A.
***
The impact of co-resident spouses and sons on elderly mortality in rural Bangladesh.
This paper uses prospective data from the Matlab surveillance system in rural Bangladesh to demonstrate that initially co-resident spouses and sons have a major impact on the subsequent mortality of old people, with significant differences by the sex of the elderly person, and the age of the son. Spouses significantly reduce mortality by similar magnitudes for both elderly men and women. On the other hand, co-resident adult sons reduce mortality for elderly women much more than for elderly men, with younger sons being more beneficial than older sons. Furthermore, both married and unmarried females appear to benefit equally from co-resident adult sons. Finally, this analysis suggests that the impact of spouses and sons on mortality in old age is not substantially mediated through changes in elderly economic status.
(BANGLADESH, RURAL AREAS, AGED, MORTALITY DETERMINANTS, HOUSEHOLD COMPOSITION, COHABITATION).
English - pp. 89-98.
M. O. Rahman, Department of Population and International Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, U.S.A.
***
STEINER, Markus J.; RAYMOND, Elizabeth; ATTAFUAH, John D.; HAYS, Melissa.
Provider knowledge about emergency contraception in Ghana.
In 1996, the Ministry of Health in Ghana included emergency contraception (EC) in its newly issued National Reproductive Health Service Policy and Standards. A short survey was conducted in the summer of 1997 to evaluate health providers' knowledge of EC. Of the 325 providers interviewed, about one-third (34%) had heard of EC. No provider had sufficient knowledge to prescribe EC correctly. A well-coordinated training programme for providers will have to precede successful introduction of EC in Ghana. Moreover, a dedicated product may be critical for the successful introduction of EC in a country like Ghana, where provider knowledge is low.
(GHANA, POSTCOITAL CONTRACEPTION, FAMILY PLANNING PERSONNEL, KNOWLEDGE OF CONTRACEPTIVES, CONTRACEPTIVE TRAINING).
English - pp. 99-106.
M. J. Steiner, E. Raymond, M. Hays, Family Health International, PO Box 13950, Research Triangle Park, NC 27709, U.S.A.; J. D. Attafuah, Research International, Ghana, PO Box 0 1960, Osu-Accra, Ghana.
***
BAIRAGI, Radheshyam; ISLAM, M. Mazharul; BARUA, Manoj Kumar.
Contraceptive failure: Levels, trends and determinants in Matlab, Bangladesh.
This study investigated the levels, trends and determinants of contraceptive use-failure in Matlab, Bangladesh, using a set of prospective data on 25,960 women of reproductive age. The data were extracted from the Record Keeping System (RKS) of Matlab for the period 1978-94. If there was any live birth during the use or within 7 months after the discontinuation of use, it was considered as a failure. The life table technique and hazard model were used as analytical tools. The results suggest that use-failure for pills, IUDs (TCu 200) and injectables and other temporary methods increased from 1978 to 1988, but began to decline after 1988. The cumulative probability of first-method failure within 1 year of method acceptance of the cohort of 1990-94 acceptors was 12?9% for pills, 2?0% for IUDs, 0?5% for injectables, 22?0% for condoms and 13?4% for 'other' methods (sampoon, foam, jelly and traditional methods). For pills, condoms and 'other' methods, the likelihood of failure declined with the duration of use; by contrast, the probability of an IUD failure increased over time, peaking at 3 years of use. The injectables maintained a low likelihood of failure regardless of the duration of use. The quality of Community Health Workers' (CHWs) performance was associated with the risk of failure of all temporary methods except condoms; women's background characteristics associated with failure varied by method. The effect of the quality of the CHWs' performance and the background variables on failure did not change much over time. It is felt that contraceptive failure deserves the serious attention of programme managers and policy makers to make the Bangladesh national family planning programme more successful.
(BANGLADESH, RURAL AREAS, CONTRACEPTION FAILURES, CONTRACEPTIVE USAGE, CONTRACEPTIVE METHODS, COMPARATIVE ANALYSIS).
English - pp. 107-123.
R. Bairagi, M. M. Islam and M. K. Barua, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), GPO Box 128, Dhaka 1000, Bangladesh.
***
Fertility and population policy in two counties in China 1980-1991.
A survey of women in two highly developed rural counties of China, Sichuan and Jiangsu Provinces, was carried out in late 1991, to gain information about demographic and economic change between 1980 and 1990. Three separate surveys were conducted: the first, a questionnaire administered to married women aged 30-39, eliciting information about childbearing and contraception, as well as the social and economic background of the respondents; the second, focus group interviews emphasizing the motivation for childbearing. Official information about the selected villages, townships and counties was also collected. The purpose of the analysis was to examine the diversity in reproductive behaviour and contraceptive practice, and to discover whether differentials are influenced by area, or else exist between individuals within areas. If the former, then the explanation may be found in differences in policy formulation and implementation between areas: and if the latter, to demand for children, or else differential application of policy restrictions. The main findings were that: (1) the explanation of the pattern of fertility and contraceptive use is to be found at the individual level (within locations) rather than in policy differences between administrative units; (2) the association between income and number of children is negative, as is that between income and the propensity for uniparous women to remain unsterilized. The theory that privilege may be exercised to gain concessions from birth planning cadres is therefore not supported; (3) ideal family size differentials are largely absent, showing that social (education) and economic (income, occupation) characteristics are not responsible for differences in reproductive motivations, and implying that the nature of the demand for children is very different from that in most rural areas of the Third World; (4) data on ideal family size by sex of the existing offspring indicate only a weak preference for sons. These on-going changes imply that any policy of reproductive restriction for the purposes of population control is likely soon to meet with diminishing resistance; and it may later be rendered unnecessary in the eyes of government officials, as fulfilled reproductive intentions lead to a fertility level below replacement level.
(CHINA, ADMINISTRATIVE DISTRICTS, FERTILITY SURVEYS, CONTRACEPTIVE USAGE, POPULATION CONTROL POLICY, FERTILITY DETERMINANTS).
English - pp. 125-140.
N. H. Thomas and Mu Aiping, Department of City and Regional Planning, University of Wales, PO Box 906, Cardiff CF1 3YN, U.K.
***
JOURNAL OF BIOSOCIAL SCIENCE, April 2000, Vol. 32, N? 2
Coitus, the proximate determinant of conception inter-country variance in sub-Saharan Africa.
There is a general consensus in the literature that fertility differences between populations can be accounted for by differences in just four key proximate determinants: nuptiality, the postpartum non-susceptible period, contraception and abortion. Natural fecundibility is generally assumed to be constant between populations. This paper puts the theoretical and empirical case for a re-evaluation of that assumption, drawing on the under-utilized data on sexual activity collected in the Demographic Health Surveys (DHSs). Using data for married women in nine African countries, the analysis finds substantial population level differences in mean monthly coital frequency, which, if accurate, suggest an important demographic effect. There is a clear regional patterning to these differences, with levels of activity considerably lower among women in the West African populations included in the study than those from East and southern Africa. For West Africa in particular the data indicate the normality of exceptionally long periods of very infrequent or no intercourse by married women outside the period of postpartum abstinence. The findings challenge prevailing presumptions concerning susceptibility to pregnancy in marriage on which statistics for unmet need for family planning are derived. While doubts are raised over the precision of the sexual activity data used, the paper argues for the need for a greater effort to operationalize the "proximate determinant of conception", not only for more accurate fertility modelling, but also as a planning tool for a more sensitive provision of family planning services in Africa.
(africa south of sahara, differential fertility, fertility determinants, coital frequency, comparative analysis).
English - pp. 145-159.
M. S. Brown, Cathie Marsh Centre for Census and Survey Research, University of Manchester, U.K.
***
Is low income a constraint to contraceptive use among the Pakistani poor?
This paper examines whether low income is a barrier to contraceptive use in Pakistan, a country in which economic conditions are deteriorating at a time when the private sector is becoming a more important supplier of contraception. Multivariate regression analysis performed using the Pakistan Contraceptive Demand Survey suggests that low income is a deterrent to modern contraceptive use in Pakistan. This is particularly the case for contraceptive methods supplied through the private sector. It is concluded that, if the aim of family planning programmes is to reach low-income people, the prices of contraceptives supplied through the private sector should be kept as low as possible.
(pakistan, contraceptive usage, poverty, costs).
English - pp. 161-175.
S. Agha, Research Division, Population Services International, 1120 Nineteenth Street NW, Suite 600, Washington DC 20036, U.S.A.
***
Demographic and health status risk factors in childbearing among Indian women. Evidence from hospital data for the later stages of fertility decline.
Indirect estimates of maternal mortality in India indicate that fertility decline has reduced maternal deaths by reducing the frequency of pregnancy and childbirth. The earlier stages of fertility decline are also likely to have lowered maternal mortality by reducing the risk of pregnancy and childbirth as the proportion of births among risky multiparous, older women declines. However, further fertility decline may well be associated with some increase in risk. Risk will also remain high if the health status of Indian girls and women remains poor. This study uses a sample of maternal deaths and deliveries among patients who survived which occurred in Civil Hospital, Ahmedabad, Gujarat during 1982-1993 to investigate these issues further. The women in the sample have relatively low fertility and represent a fairly late stage of fertility decline. They also have persistently poor health status. Logit regression analysis reveals that although fertility decline is associated with some increase in risk, poor health status is the more important maternal mortality risk factor. Without attention to female health, even childbearing among expectant mothers with low fertility continues to be hazardous.
(india, maternal mortality, mortality trends, fertility decline, health, maternal and child health).
English - pp. 191-206.
K. McNay, St Catharine's College, Cambridge CB2 1RL, U.K.
***
The effects of water supply and sanitation on childhood mortality in urban Eritrea.
Child mortality differentials according to water supply and sanitation in many urban areas of developing countries suggest that access to piped water and toilet facilities can improve the survival chances of children. The central question in this study is whether access to piped water and a flush toilet affects the survival chance of children under five in urban areas of Eritrea. The study uses data collected by the Demographic and Health Survey (DHS) project in Eritrea in 1995. The results show that while the unadjusted effect of household environment (water supply and toilet facility) is large and statistically significant during the post-neonatal and child periods, it is relatively small and statistically insignificant during the neonatal period. The effect of household environment remains substantial during the post-neonatal and child periods, even when other socioeconomic variables are held constant. However, the household environment effect totally disappears during the neonatal period when the socioeconomic factors are controlled for.
(eritrea, urban areas, child mortality, infant mortality, sanitation, water supply, mortality determinants).
English - pp. 207-227.
G. Woldemicael, Department of Statistics and Demography, University of Asmara, Eritrea.
***
Teenage motherhood and infant mortality in Bangladesh: Maternal age-dependent effect of parity one.
Nuptiality norms in rural Bangladesh favour birth during the teenage years. An appreciable proportion of teenage births are, in fact, second births. This study examines the relationship between teenage fertility and high infant mortality. It is hypothesized that if physiological immaturity is responsible, then the younger the mother, the higher would be the mortality risk, and the effect of mother's 'teenage' on mortality in infancy, particularly in the neonatal period, would be higher for the second than the first births. Vital events recorded by the longitudinal demographic surveillance system in Matlab, Bangladesh, in 1990-92 were used. Logistic regression was used to estimate the effects on early and late neonatal (0-3 days and 4-28 days respectively) and post-neonatal mortality of the following variables: mother's age at birth, parity, education and religion, sex of the child, household economic status and exposure to a health intervention programme. The younger the mother, the higher were the odds of her child dying as a neonate, and the odds were higher for second children than first children of teenage mothers. First-born children were at higher odds of dying in infancy than second births if mothers were in their twenties. Unfavourable mother's socioeconomic conditions were weakly, but significantly, associated with higher odds of dying during late neonatal and post-neonatal periods. The results suggest that physical immaturity may be of major importance in determining the relationship between teenage fertility and high neonatal mortality.
(bangladesh, infant mortality, adolescent fertility, mortality determinants, birth order, differential mortality).
English - pp. 229-236.
N. Alam, International Centre for Diarrhoeal Disease Research (ICDDR), Bangladesh, Dhaka, Bangladesh.
***
BLOOM, Shelah S.; TSUI, Amy Ong; PLOTKIN, Marya; BASSETT, Sarah.
What husbands in northern India know about reproductive health: Correlates of knowledge about pregnancy and maternal and sexual health.
Women in India suffer from a high incidence of reproductive disease, disability and death. Very little work has been done on men, but a much higher incidence of sexual experience outside marriage and sexually transmitted diseases (STDs) among males than previously expected for this population is now being documented. In north India, women are dependent on their husbands and other family members for health-related decisions. Therefore, the behaviour, knowledge and attitudes of men are integral to the reproductive health status of couples there. This study explores knowledge about three distinct areas of reproductive health among 6549 married men in five districts of the northern state of Uttar Pradesh, India. Factors contributing to men's knowledge in the areas of fertility, maternal health and STDs were investigated. Results showed that very few men had basic knowledge in any of these areas. The likelihood of reporting knowledge was associated with a set of determinants that differed in their magnitude and effect across the areas of reproductive health explored. In particular, men's belief about the ability of an individual to prevent pregnancy demonstrated an independent association with men's knowledge. After controlling for factors such as age, parity and educational and economic status, men who believed it not possible to prevent a pregnancy were less likely to know when during the menstrual cycle women would become pregnant and certain facts about STDs, but they were more likely to be able to name two or more symptoms of serious maternal health conditions. Possible explanations for this trend are discussed.
(india, regions, kap surveys, married men, public health, reproduction).
English - pp. 237-251.
S. S. Bloom, A. O. Tsui, M. Plotkin and S. Bassett, Carolina Population Center, University of North Carolina at Chapel Hill, Room 302B CB# 8120, 123 West Franklin Street, Chapel Hill, NC 27516, U.S.A.
***
KAPOOR, A. K.; KSHATRIYA, Gautam K.
Fertility and mortality differentials among selected tribal population groups of north-western and eastern India.
Selection potential based on differential fertility and mortality has been computed for six tribal groups inhabiting different geo-climatic conditions, namely: Sahariya, Mina and Bhil of the State of Rajasthan, north-western India, and Munda, Santal and Lodha of the State of West Bengal, eastern India. Irrespective of the methodology, the total index of selection was found to be highest among Lodhas (0?668), followed by Sahariyas (0?524), Santals (0?462), Bhils (0?386), Mundas (0?353) and Minas (0?334). Incidently, Lodha and Sahariya are two of the seventy-four notified primitive tribal groups of India, and these two study populations show the highest index of total selection, mainly because of a higher embryonic and postnatal mortality. The relative contribution of the fertility component to the index of total selection is higher than the corresponding mortality component in all tribal groups. The analysis of postnatal mortality components indicates that childhood mortality constitutes the bulk of postnatal mortality, suggesting that children under 5 years need better health care in these tribal groups.
(india, regions, differential fertility, differential mortality, population dynamics, tribes).
English - pp. 253-264.
A. K. Kapoor and G. K. Kshatriya, Department of Anthropology, University of Delhi, Delhi-110 007, India.
***
Sibling mortality correlation in Kenya.
This paper examines whether infant and child mortality risks among successive siblings are closely correlated, and if so, whether the survival status of the preceding child is an important factor affecting infant and child mortality in Kenya. The data were drawn from the 1988/89 Kenya Demographic and Health Survey. Logistic regression was used as the major method of data analysis. The results show that both infant and child mortality rates are significantly higher among subsequent children whose preceding siblings had died in infancy than for those whose preceding sibling had survived through infancy. The effect of the survival status of the preceding child on infant mortality was statistically strong, even after a large number of control variables were taken into account. However, its effect on child mortality appears to be spurious since it was rendered statistically insignificant when just a few control variables were introduced into the analysis. The results provide empirical evidence that infant and child mortality risks among successive siblings are closely correlated in Kenyan families, and that the effect of the survival status of the preceding child is important in determining infant mortality but not child mortality.
(kenya, infant mortality, child mortality, siblings, correlation, mortality determinants).
English - pp. 265-278.
L. Ikamari, Population Studies and Research Institute, University of Nairobi, PO Box 30197, Nairobi, Kenya.
***
MURPHY, M. F. G.; HEY, K.; WHITEMAN, D.; O'DONNELL, M.; WILLIS, B.; BARLOW, D.
Is the natural twinning rate now stable?
As contribution to a recent debate (James, 1998; Murphy et al., 1997, 1998) the proportion of twins following ovulation induction (OI) or assisted conception (AC) in 1994 in Oxfordshire and West Berkshire was estimated, and by extrapolation the natural twinning rate in England and Wales was judged to have maintained a plateau phase since the 1970s. Similar figures for 1995 and 1996 from the same study, and hence a more stable local estimate, are now provided. The proportions, as before, were estimated from women's responses to a questionnaire within a case-control study, with ascertainment from general practitioners' records or hospital case-notes for non-responders or for those excluded from the study originally. In 1994, 1995 and 1996 the proportion of twins following OI/AC was overall 27% (24%, 30% and 27% respectively). Restriction to the 87% locally resident made no difference. The national crude twinning rate for those years was overall 13?3 per 1000 maternities (12?8, 13?6 and 13?4 respectively).
(united kingdom, twins, rate, induced ovulation, in vitro fertilization).
English - pp. 279-281.
M. F. G. Murphy, K. Hey, D. Whiteman, ICRF General Practice Research Group, M. O'Donnell, B. Willis, Department of Public Health, Institute of Health Sciences, Old Road, Headington, Oxford OX3 7LF, U.K.; D. Barlow, Nuffield Department of Obstetrics & Gynaecology, John Radcliffe Hospital, Oxford OX3 9DU, U.K.
***
JOURNAL OF BIOSOCIAL SCIENCE, July 2000, Vol. 32, N? 3
MOZUMDER A. B. M. Khorshed Alam; BARKAT-E-KHUDA; KANE, Thomas T.; LEVIN, Ann; AHMED, Shameem.
The effect of birth interval on malnutrition in Bangladesh infants and young children.
This study was undertaken to investigate the independent effect of the length of birth interval on malnutrition in infants, and children aged 6-39 months. Data for this study were drawn from a post-flood survey conducted during October-December 1988 at Sirajganj of the Sirajgani district and at Gopalpur of the Tangail district in Bangladesh. The survey recorded the individual weights of 1887 children. Cross-tabulations and logistic regression procedures were applied to analyse the data. The proportion of children whose weight-for-age was below 70% (moderate-to-severely malnourished) and 60% (severely malnourished) of the NCHS median was tabulated against various durations of previous and subsequent birth intervals. The odds of being moderately or severely malnourished were computed for various birth intervals, controlling for: the number of older surviving siblings; maternal education and age; housing area (a proxy for wealth); age and sex of the index child; and the prevalence of diarrhoea in the previous 2 weeks for the index child. About one-third of infants and young children were moderately malnourished and 15% were severely malnourished. The proportion of children who were under 60% weight-for-age decreased with the increase in the length of the subsequent birth interval, maternal education and housing area. The proportion of malnourished children increased with the number of older surviving children. Children were at higher risk of malnutrition if they were female, their mothers were less educated, they had several siblings, and either previous or subsequent siblings were born within 24 months. This study indicates the potential importance of longer birth intervals in reducing malnutrition in children.
(Bangladesh, malnutrition, infant feeding, child nutrition, birth intervals).
English - pp. 289-300.
A. B. M. K. A. Mozumder, Barkat-E-Khuda, T. T. Kane, A. Levin and S. Ahmed, Operations Research Project (ORP), Health and Population Extension Division, ICDDR,B, Dhaka, Bangladesh.
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Social-demographic influence on first birth interval in China, 1980-1992.
This study examines the delay between first marriage and first live birth in China among a sample of women who married between 1980 and 1992. Most couples in China only use contraception after the first child is born. Most sample women had their first child within 2 years of marriage. However, there are significant rural-urban differences in the first birth interval, indicating that there was most probably deliberate fertility regulation after marriage among many urban couples. Survival analysis shows that place of residence, level of education, age at first marriage and marriage cohort affect the first birth interval.
(china, first birth interval, differential fertility, fertility determinants).
English - pp. 315-327.
Z. Zheng, Institute of Population Research, Peking University, Beijing 100871, China.
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Determinants of contraceptive use and method choice in Turkey.
In this study, the determinants of contraceptive use and method choice are examined based on various variables, classified as individual, cultural, fertility and contextual. The data used came from the 1993 Turkish Demographic and Health Survey. The main finding is that there exists a positive association between the educational level of both spouses and the use of contraceptive methods in Turkey. After all individual, cultural, fertility and contextual variables are controlled, a woman's education is a stronger predictor of method use and method choice than that of her husband. Increasing the educational level of women may be the most effective means of advancing family planning acceptance and increasing the demand for contraceptive services in Turkey. The study also shows that, to a great extent, contraceptive use and choice of modern method depend on the sex of a couple's living children, implying some preference for sons, although generally women prefer to have children of both sexes.
(turkey, contraceptive usage, contraceptive methods, choice, levels of education).
English - pp. 329-342.
I. Koc, Hacettepe University Institute of Population Studies (HIPS), 06100 Ankara, Turkey.
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NATH, Dilip C.; LEONETTI, Donna L.; STEELE, Matthew S.
Analysis of birth intervals in a non-contracepting Indian population: An evolutionary ecological approach.
Reproductive strategies are related to ecological constraints. This paper examines data on early birth spacing in a scheduled caste, Bengali-speaking, non-contracepting population of the Karimganj district of southern Assam, India, taking an evolutionary ecological perspective. It is found that on average birth intervals closed by boy-boy are longer than those closed by girl-girl. Birth spacing tends to be longer among upper-income and Craftsman sub-caste mothers. The presence of a 'grandmother' in the household shortens spacing. These findings are compatible with an evolutionary-based reproductive decision-making process.
(india, regions, birth intervals, castes, natural fertility, differential fertility).
English - pp. 343-354.
D. C. Nath, D. L. Leonetti and M. S. Steele, Department of Anthropology and Center for Studies in Demography and Ecology, University of Washington, Seattle, WA 98195-3100, U.S.A.
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Divorce in Ethiopia: The impact of early marriage and childlessness.
Forty-five per cent of first marriages in Ethiopia end in divorce within 30 years, and two-thirds of women who divorce do so within the first 5 years of marriage. This paper looks at two factors that may have an impact on the risk of divorce in Ethiopia: early age of first marriage, and childlessness within the first marriage. Data used were from the 1990 National Family and Fertility Survey conducted by the Government of Ethiopia. A total of 8757 women of reproductive age (15-49) were analysed. Life table analysis was used to determine the median age at first marriage, first birth and the median duration of marriage. Cox models were analysed to determine the differentials of divorce. The results of this analysis showed that both early age at marriage and childlessness have a significant impact on the risk of divorce. An inverse relationship was found between age at marriage and risk of divorce. Having a child within the first marriage also significantly reduced the risk of divorce. In addition, several cultural and socioeconomic variables were significant predictors of divorce.
(ethiopia, divorce, early marriage, childless couples).
English - pp. 355-372.
D. Tilson and U. Larsen, Department of Population and International Health, Harvard School of Public Health, 655 Huntington Avenue, Boston, MA 02115, U.S.A.
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EGGLESTON, Elizabeth; TSUI, Amy Ong; FORTNEY, Judith.
Assessing survey measures of infant birth weight and birth size in Ecuador.
The purpose of this study was to assess the utility of using maternal assessments of infant birth size as proxy measures for birth weight in Ecuador, a country in which a sizeable proportion of births take place at home, where birth weight is typically not recorded. Four thousand and seventy-eight women who experienced a live singleton birth between January 1992 and August 1994 were interviewed in the Ecuador Demographic and Maternal-Child Health Survey. All women were asked if their child was weighed at birth, his/her weight, and what they considered to be his/her birth size relative to other newborns. The consistency between birth size and birth weight measures was assessed, and the differences between infants with and without reported birth weights were explored. The authors conclude that maternal assessments of birth size are poor proxy indicators of birth weight. Estimates of low birth weight based on maternal assessments of birth size as very small should be recognized as underestimates of the actual prevalence of low birth weight. Moreover, infants for whom birth weights are missing should not be considered similar to those for whom weight was reported. Those without reported birth weights are more likely to be low birth weight. Thus, relying solely on reports of numeric birth weight will underestimate the prevalence of low birth weight.
(ecuador, body height, birth weight, child development, measurement, data collection, quality of data, methodology).
English - pp. 373-382.
E. Eggleston, A. O. Tsui, Department of Maternal and Child Health, University of North Carolina at Chapel Hill, U.S.A.; J. Fortney, Family Health International, Research Triangle Park, NC, U.S.A.
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VAREA, C.; BERNIS, C.; MONTERO, P.; ARIAS, S.; BARROSO, A.; GONZ?LEZ, B.
Secular trend and intrapopulational variation in age at menopause in Spanish women.
Menopause is associated with the general ageing process and marks the end of follicular depletion, a process that begins in the intrauterine stage and lasts throughout the lifetime of women until their reproductive senescence. Controversy persists about whether the age at menopause is sensitive to the ecological determinants prevailing during the lifecycle or whether it has a predominantly genetic component that would allow groups of women to be characterized with respect to particular menstrual characteristics manifested throughout their fertile life. By contrast, there is a definite secular trend in age at menarche in populations that have registered improvements in their environment: sexual maturation is closely associated with the general processes of growth and development. These aspects were analysed in a sample of Spanish women, mothers and daughters, born between 1883 and 1941. The results show (a) indications - although not conclusive - of a secular trend in the age at menopause, (b) a possible association between the age at menopause of mothers and their daughters, and (c) an association at the individual level between age at menarche, particular characteristics of ovarian function (fetal loss) and age at menopause. The reproductive ageing process therefore seems to result from the expression of the influence of ecological conditions in which the lifecycle of the women develops and of a degree of heritability that affects not only the age at menopause but also a range of characteristics of ovarian function.
(spain, age at menopause, trends).
English - pp. 383-393.
C. Varea, C. Bernis, P. Montero, S. Arias, A. Barroso and B. Gonz?lez, Unidad de Antropolog?a, Departamento de Biolog?a, Universidad Aut?noma, 28049 Madrid, Spain.
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EZRA, Markos; KIROS, Gebre-Egziabher.
Household vulnerability to food crisis and mortality in the drought-prone areas of northern Ethiopia.
This study examines the association between a household's degree of vulnerability to food crisis and the incidence of deaths using primary survey data carried out to look at the demographic consequences of drought and famine in the drought-prone areas of northern Ethiopia. Retrospective data on the occurrences of deaths within a household were collected for the period 1984 to 1994. Consistent with previous studies, the findings confirm that mortality was clustered among the age groups 1-4 and 5-9 and varied considerably by famine and non-famine years. Enormous variation in incidence of deaths was also observed by region, ethnicity and religion. Most importantly, the analysis provides substantial evidence that the level of household vulnerability to food crisis is strongly related to the number of hunger-related deaths reported in a household.
(ethiopia, drought, food shortage, excess mortality).
English - pp. 395-409.
M. Ezra, Demographic Training and Research Centre, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia; G.-E. Kiros, Population Studies and Training Centre, Brown University, PO Box 1916, Providence, RI 02912, U.S.A.
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The impact of mass media family planning programmes on current use of contraception in urban Bangladesh.
A sample of 871 currently married urban Bangladeshi women was used to assess the impact of mass media family planning programmes on current contraceptive use. The analyses suggested that radio had been playing a significant role in spreading family planning messages among eligible clients; 38% of women with access to a radio had heard of family planning messages while the figures for TV and newspaper were 18?5% and 8?5% respectively. Education, number of living children and current contraceptive use were important predictors of exposure to any mass media family planning messages. There was a negative relationship between breast-feeding and the current use of contraception indicating a low need for contraception among women who were breast-feeding.
(bangladesh, urban areas, family planning programmes, contraceptive usage, mass media).
English - pp. 411-419.
M. Kabir and M. A. Islam, Department of Statistics, Jahangirnagar University, Savar, Dhaka, Bangladesh.
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JOURNAL OF BIOSOCIAL SCIENCE, October 2000, Vol. 32, N? 4
Sociodemographic correlates of consanguineous marriage in the Muslim population of India.
Using data derived from the 1992-1993 National Family Health Survey, the sociodemographic characteristics of consanguineous marriage were determined in the Muslim population of India. In this nationally representative sample of 8436 women, consanguineous marriages accounted for 22?0% of the total. No differences between the consanguineous and non-consanguineous groups were observed in terms of mean age at marriage or mean age at cohabitation. The study confirmed the negative association between consanguineous marriage and maternal education but also indicated that women in consanguineous unions were more likely to be employed, albeit mainly in agricultural work on behalf of the family. Consanguineous couples more frequently lived in smaller towns and in an extended family environment. Somewhat conflicting results were obtained with indicators of socioeconomic status, but the overall picture suggested that consanguineous households had greater access to consumer goods because of their larger number of co-resident persons.
(india, muslims, consanguineous marriage, levels of education, female employment).
English - pp. 433-442.
R. Hussain, The University of New England, Armidale, Australia; A. H. Bittles, Edith Cowan University, Perth, Australia.
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CHATTERJEE, Uma; ACHARYA, Rajib.
Seasonal variation of births in rural West Bengal: Magnitude, direction and correlates.
This paper examines seasonal variation of births in a rural community of West Bengal, India, by exploring data from the 1992-93 National Family Health Survey. Suitable time series analyses were used to determine the seasonal pattern of births and to estimate peaks. The trigonometric regression technique was used to carry out this objective. The study attempted to link the results of the regression analysis to the atmospheric temperature of the region during 1987-91, the distribution of respondents? husbands? occupations and the marriage pattern of the community. It was found that, in the study population, conceptions were numerous in the first quarter of a calendar year and the distribution of conceptions over calendar months was negatively associated with the average monthly temperature. In addition, the marriage pattern of the community and the occupational distribution of the fathers also had a significant effect on the distribution of births over calendar months. It is hoped that the findings will boost the development of needs-based maternal and child health (MCH) and family planning programmes in the community.
(india, regions, fertility, seasonal fluctuations, fertility determinants).
English - pp. 443-458.
U. Chatterjee, International Institute for Population Sciences, Govandi Station Road, Deonar, Mumbai 400 088, India; R. Acharya, ORC Macro, Calverton, Maryland, U.S.A.
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BIONDI, G.; RASPE, P.; MASCIE-TAYLOR, C. G. N.
Genetic structure through surnames in Campobasso Province, Italy.
The population of Campobasso Province shows a level of inbreeding that is distinct from most Italian rural populations, regardless of their geographic location (Fr=0?0040; Fn=0?0102; Ft=0?0142). The genetic structure of the Italian-Greek communities of Lecce and Reggio Calabria Provinces does not appear to be affected by ethnicity. The level of inbreeding in Italian-Greeks of Reggio Calabria Province is similar to other Italians of Campobasso Province (Fr=0?0041; Fn=0?0127; Ft=0?0168). The Italian-Greeks of Lecce Province show random mating, and their inbreeding is in fact very low (Fr=0?0038; Fn=0?0024; Ft=0?0062).
(italy, provinces, inbreeding, genetic structure, population genetics).
English - pp. 459-465.
G. Biondi, Dipartimento di Biologia animale e dell?uomo, Universit? di Torino, Italy; P. Raspe and C. G. N. Mascie-Taylor, Department of Biological Anthropology, University of Cambridge, U.K.
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MEEKERS, Dominique; AHMED, Ghyasuddin.
Contemporary patterns of adolescent sexuality in urban Botswana.
In Botswana, as in other areas in southern Africa, there is a growing concern about the risks associated with adolescent sexuality. To facilitate the design of policies that can address these problems, it is necessary to gain a thorough understanding of contemporary patterns of adolescent sexual behaviour, and the factors that affect them. This paper examines these issues using data from the 1995 Botswana Adolescent Reproductive Health Survey in conjunction with data from focus group discussions. The results suggest that adolescents become sexually active at an early age, and that many of them, males and females alike, have multiple sex partners. This early sexual initiation implies that adolescent reproductive health programmes should target youths aged 13 or younger. For school-based programmes this implies starting no later than Grade 6 or Standard 1, and preferably earlier. Young males appear to be a particularly vulnerable group that needs further attention. Adolescents perceive that teachers, peers and parents have the largest influence on their reproductive health attitudes. Schools appear to have the most potential for providing reproductive health information, because they reach youths both directly and indirectly by educating their peers. The results also show that male and female sexual behaviour is affected by different factors. Among males, having secondary education strongly increases the odds of being sexually active, presumably because such males make attractive partners. Among females, on the other hand, being in school significantly reduces the odds of being sexually active. This finding is consistent with the policy imposing a one-year school expulsion for pregnant schoolgirls, which was implemented as a deterrent to schoolgirl pregnancy.
(botswana, urban areas, adolescents, sexual behaviour, sex education).
English - pp. 467-485.
D. Meekers and G. Ahmed, Population Services International, 1120 Nineteenth Street NW, Suite 600, Washington DC 20036, U.S.A.
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AHMED, Farid Uddin; KARIM, Enamul; BHUIYAN, Syeda Nurjahan.
Mid-arm circumference at birth as predictor of low birth weight and neonatal mortality.
In Bangladesh, like other developing countries, most births occur at home or in the community, so logistic problems and taboos prevent the weighing of every newborn child. This study was performed to see whether other simpler measurements could be substituted for weight to identify neonates of low birth weight. A total of 1676 live births at the Chittagong Medical College Hospital constituted the study sample, and this showed a high correlation between mid-arm circumference and birth weight (r=0.792, p<0?000). A mid-arm circumference of <9?0 cm had the best sensitivity and specificity for identifying newborns with a birth weight of less than 2500 g. These neonates were followed up to record neonatal deaths. Neonatal mortality showed an inverse relation with mid-arm circumference. A mid-arm circumference of <9?0 cm and a birth weight of <2500 g were equally useful in predicting neonatal outcome. Mid-arm circumference is a simple, quick and reliable indicator for predicting low birth weight and neonatal outcome, and can be easily measured by medical practitioners and traditional birth attendants in the community of developing countries like Bangladesh.
(bangladesh, neonatal mortality, birth weight, measurement, data collection, methodology).
English - pp. 487-493.
F. U. Ahmed, S. N. Bhuiyan, Chittagong Medical College, Chittagong, Bangladesh; E. Karim, Institute of Epidemiology, Disease Control and Research, Dhaka, Bangladesh.
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AGYEI, William K. A.; BIRITWUM, Richard B.; ASHITEY, A. G.; HILL, Robert B.
Sexual behaviour and contraception among unmarried adolescents and young adults in Greater Accra and Eastern regions of Ghana.
A fertility survey of unmarried adolescents and young adults (953 males and 829 females) in Greater Accra and Eastern regions of Ghana revealed that a substantial proportion of the respondents were sexually experienced. Overall, 66?8% of the males and 78?4% of the females were sexually experienced. The mean ages (?SD) of the males and females were 15?5?2?5 and 16?2?2?0 years, respectively. Most respondents claimed to have received adequate information on reproductive health and sexually transmitted diseases (STDs), including AIDS. However, 20% and 30% of the respondents in peri-urban and rural areas, respectively, did not know that a girl could get pregnant the first time she has sexual intercourse. The incidence of pregnancy among the unmarried female respondents was relatively high (37%), and was higher in urban than in rural areas. Approximately 47% of those who had ever been pregnant reported that they had had an abortion. Levels of contraceptive awareness were high (98?2% among males and 95?5% among females) but many still engaged in unprotected sexual relations. The most commonly used methods were the condom and the pill. The main reasons given for non-use were that they did not think about contraception, were concerned about the safety of contraceptives, and partner objection. These findings point to the need for targeting of unmarried adolescents and young adults with information on reproductive health and family planning to increase their awareness of the risks of pregnancy, STDs and HIV infection.
(ghana, capital city, regions, adolescents, premarital sex behaviour, sex education, contraceptive usage).
English - pp. 495-512.
W. K. A. Agyei, School of Liberal Arts, Norfolk State University, Norfolk, VA 23504, U.S.A.; R. B. Biritwum, A. G. Ashitey, Department of Community Health, Ghana Medical School, Accra, Ghana; R. B. Hill, The Institute for Urban Research, Morgan State University, Baltimore, MD 21239, U.S.A.
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ISLAM, M. Mazharul; HASAN, A. H. M. Saidul.
Mass media exposure and its impact on family planning in Bangladesh.
This paper analyses mass media exposure and its effect on family planning in Bangladesh using data from the Bangladesh Demographic and Health Survey (BDHS) 1993-94. The findings indicate that radio and television are two important mass media for disseminating family planning information in Bangladesh. However, access to them and exposure to family planning through them are still limited. Slightly more than 40% (42?1%) of respondents reported that they had heard family planning messages via radio, while 17?2% said television, 8?4% said poster and 5?4% said billboard. Respondent?s place of residence, education, economic status, geographical region and number of living children appeared to be the most important variables determining mass media exposure to family planning. Multivariate analysis shows that both radio and TV exposure to family planning messages and ownership of a radio and TV have a significant effect on current use of family planning methods. These factors remain significant determinants of contraceptive use, even after controlling socioeconomic and demographic factors. The study reveals that both socioeconomic development policies and family planning programmes with a special emphasis on mass media, especially radio, may have a significant effect on contraceptive use in Bangladesh. The principal policy challenge is to design communications strategies that will reach the less privileged, rural and illiterate people who are by far the majority in Bangladesh.
(bangladesh, mass media, programme evaluation, family planning programmes, information dissemination, contraceptive usage).
English - pp. 513-526.
M. M. Islam, Department of Statistics, University of Dhaka, Bangladesh; A. H. M. S. Hasan, Dhaka Commerce College, Dhaka, Bangladesh.
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Determinants of infant and child mortality in the West Bank and Gaza Strip.
Infant and child mortality in the West Bank and Gaza Strip has steadily reduced since 1967, even though fertility has remained extremely high. In this paper the determinants of infant and child mortality are discussed, with particular emphasis on the role of consanguineous marriages, short birth spacing and maternal education. It is shown that short birth spacings and type of marriage are more important determinants of infant mortality than maternal education. Moreover, the relative role of consanguineous marriages appears to increase with time.
(gaza strip, infant mortality, child mortality, mortality determinants, mortality decline, consanguineous marriage).
English - pp. 527-546.
J. Pedersen, Fafo, Institute for Applied Social Science, Box 2947 T?yen, N-0608 Oslo, Norway.
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RAMANATHAN, Mala; MISHRA, U. S.
Correlates of female sterilization regret in the Southern States of India.
This study analyses factors associated with the incidence of sterilization regret in the four south Indian states of Andhra Pradesh, Karnataka, Kerala and Tamil Nadu. Using data from the National Family Health Surveys, in all four states the incidence of regret was found to be less than 10% and the factors significantly associated with it were child loss experience and quality of services. Hence, there is a need to improve the quality of services, both in terms of counselling and service provision, and women need to be counselled about the permanent nature of sterilization in order to avoid future regret.
(india, province, female sterilization, programme evaluation).
English - pp. 547-558.
M. Ramanathan, Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695 011, Kerala, India; U. S. Mishra, Global Training Programme in Population and Development, Centre for Development Studies, Trivandrum 695 011, Kerala, India.
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