This paper examines the association between family structure and child health in India using the third round of the National Family Health Survey, conducted during 2005–06. Two important child health indicators – underweight and full immunization – are used as dependent variables. Descriptive and multivariate statistics are deployed to establish the relationship between family structure and child health. The results of the descriptive statistics show that children who belong to a non-nuclear family have better nutritional status and higher immunization coverage than those in nuclear families. Children living with siblings have worse health status than those living without siblings for both the outcomes. Multivariate analysis shows that family structure has a small effect on the two child health outcomes, which is no longer significant after adjusting for socioeconomic measures and region. However, number of siblings is significantly and negatively associated with the nutritional status of children and full immunization coverage, even after other socio-demographic and geographic factors are controlled for. Along with family structure, parent's educational attainment, age of the mother and household economic status are significant determinants of underweight and full immunization.

This paper illustrates the importance of monitoring health facility-level information to monitor changes in maternal mortality risks. The annual facility-level maternal mortality ratios (MMRs), complications to live births ratios and case fatality ratios (CFRs) were computed from data recorded during 2007 and 2009 in 31 upgraded public sector health facilities across Pakistan. The facility-level MMR declined by about 18%; both the number of Caesarean sections and the episodes of complications as a percentage of live births increased; and CFR based on Caesarean sections and episodes of complications declined by 29% and 37%, respectively. The observed increases in the proportion of women with complications among those who come to these facilities point to a reduction in the delay in reaching facilities (first and second delays; Thaddeus & Maine, 1994); the decrease in CFRs points to improvements in treating obstetric complications and a reduction in the delay in receiving treatment once at facilities (the third delay). These findings point to a decline in maternal mortality risks among communities served by these facilities. A system of woman-level data collection instituted at health facilities with comprehensive emergency obstetric care is essential to monitor changes in the effects of any reduction in the three delays and any improvement in quality of care or the effectiveness of treating pregnancy-related complications among women reaching these facilities. Such a system of information gathering at these health facilities would also help policymakers and programme mangers to measure and improve the effectiveness of safe-motherhood initiatives and to monitor progress being made toward achieving the fifth Millennium Development Goal.

Anthropometric differences between the two Koreas are of considerable public and scientific interest given the unique socio-political status of North Korea and the fact that the nations share the same genetic ancestry. This study provides new biosocial evidence on these differences by analysing mid-upper arm circumference (MUAC) as a human welfare indicator. This is the first study to compare the nutritional status of adults surveyed inside North Korea with South Koreans. The MUAC measurements of 2793 North Korean women obtained through a household survey conducted in 2002 were compared with those of 1428 South Korean women surveyed around 2003. Comparative analysis was conducted by plotting centiles and calculating mean differences in MUAC by age. This paper finds that the MUAC of the South Koreans was on average 2.8 cm greater than that of their North Korean peers, with MUAC gaps ranging from 1.6 cm to 3.9 cm and becoming more pronounced with age. This research confirms previous studies on height and weight in the two Germanies and in the two Koreas that have shown that biosocial performance is worse in socialist economies as compared with free-market regimes.

Studies among migrants show that they are more susceptible to HIV infection than the general population and thereby spread the epidemic from high prevalence to low prevalence areas. It is therefore critical to enhance the body of knowledge on factors associated with condom use among migrants. This study, conducted in 2009 in the State of Maharashtra, covers 4595 single in-migrants aged 15–49 years and aims at understanding the factors associated with non-use of condoms consistently. Information was collected using a Structured Interview Schedule covering demographic, socioeconomic profile, sexual history, knowledge, behaviour and stigma and discrimination indicators. Logistic regression analysis was used to understand the association between unprotected sex and various socio-demographic and environmental factors. The models were run using the Enter method. The goodness-of-fit of the model was assessed using Hosmer and Lemeshow chi-squared statistics. A significant association is observed between sex with sex workers and older migrants (>24 years), the literate, those who are mobile, unmarried, employed in the textile, quarry and construction industries, who often consume alcohol and who watch pornographic films. The factors associated with unprotected sex are age between 30 and 34 years and no literacy. Migrants who are mobile and consume alcohol show a significant association with unprotected sex. The findings suggest a need for a comprehensive HIV prevention programme including strategies to address the stressful work conditions. The prevention programmes should focus not only on skills for safer sex practices, but also on alcohol use reduction.

Young people, especially university students, are at high risk of HIV infections because of little or no parental or administrative prohibitions in campus environments. The aim of this study was to ascertain the level of condom use among university students in Zimbabwe; that is, condom use at last sex and consistent condom use among both regular and casual partners. The study draws on self-completed questionnaires administered to university students. The results reveal that, while 78.3% of sexually active respondents had used condoms in penetrative sexual encounters before, only 56.2% had used condoms at their last sexual encounter. As expected, consistent condom use was lower in regular sexual partnerships than it was in casual partnerships (30.6% versus 54.6%). Condom use at first sex and high personal HIV risk perception were found to be the most important factors in explaining condom use at last sex and consistent condom use with casual partners. Condom use intentions were high, as 75% of respondents indicated that they would use condoms at their next sexual encounters. Whilst this is commendable, use rates should ideally be higher still. Campus HIV/AIDS programmers should endeavour to ensure that condoms are available at all times in order to help translate these intentions into actual condom use. In addition, promotional programmes should encourage those who have not yet initiated sexual intercourse to use condoms at their first sex and also to improve personal HIV risk perceptions in order to trigger initiation of protective sexual behaviours.

The study objective was to analyse the association between food insecurity and the weight and height status of adolescents from a low-income area in the metropolitan region of Rio de Janeiro, Brazil. The population-based cross-sectional survey included 523 adolescents aged 12–18 years, selected by a three-stage cluster sample. Dietary intake was ascertained with a food frequency questionnaire and family food insecurity was assessed with a validated questionnaire. The analysis estimated weighted means of energy and nutrient intakes by families' socioeconomic characteristics and the association between dietary intake with overweight and stunting. The prevalence of mild family food insecurity was 36%, and 24% of the families reported moderate or severe food insecurity. Overweight prevalence was 24%, and the prevalence of stunting was 9%, with no significant differences between sex or age groups. Family food insecurity was associated with unfavourable socioeconomic characteristics, but there was no association between socioeconomic characteristics (including family food insecurity) and overweight or stunting. Moderate or severe family food insecurity was inversely associated with intake of protein and calcium. In addition, stunting was associated with low calcium and iron intake. The co-existence of family food insecurity with overweight and stunting implies a high nutritional risk for adolescents from poor areas of Rio de Janeiro. Nevertheless, the observed absence of a statistical association between family food insecurity and weight status attests to the complexity of this issue.

In genetics, a consanguineous marriage means union between couples who are related as second cousins or closer. The present cross-sectional study was carried out in order to illustrate the prevalence and types of consanguineous marriages in the Shi'a population living in widespread territories in Lebanon including the Bekaa Valley, the south of Lebanon and the southern suburb of Beirut. Data on types of marriages were collected using a simple questionnaire. The total number of couples in the study was 1203. Consanguineous marriage was classified by the degree of relationship between couples. The overall frequency of consanguinity was found to be 28.4%, with first cousin marriages (21.3%) being the most common type followed by first cousins once removed (5.5%), then double first cousins (0.8%). The frequencies of second cousin and beyond second cousin marriages were the same at 0.4% of all the marriages. The mean inbreeding coefficient (α) was estimated at about 0.0161 for the population. There were no significant differences between the three studied territories for frequencies of different types of marriages (p>0.1), nor were there significant differences between the rural and urban areas (p>0.1).

Based on evolutionary reasoning, Trivers & Willard (1973) predicted status-biased sex composition and parental investment with son-preferencing effects in higher, and daughter-preferencing effects in lower status groups. Previous research shows mixed results. This study uses event-history methods and Swedish register data to study one possible mechanism in isolation: do parents in different status groups vary in their proclivities to continue fertility based on the sex composition of previous offspring? The results show no support for the Trivers–Willard hypothesis on a wide range of different status indicators. Future research on the stated hypothesis should focus on physiological rather than behavioural mechanisms.

Early onset of menarche has been shown to be associated with breast cancer and ischaemic heart disease. Studies on age at menarche of the Malaysian population are poorly documented. This study aimed to determine the influence of anthropometric and socio-demographic factors on the age at menarche of university students in Malaysia. Data were obtained in 2010–11 from 961 students between the ages of 18 and 25 years from the University of Malaya using stratified sampling, and multiple regression analysis was applied. Sixty-three per cent of students reached menarche at the age of 12 or 13 years, with the mean and median of age at menarche being 12.45±1.17 and 12.01 years, respectively. Menarcheal age was positively associated with height (p<0.05) and negatively associated with BMI (p<0.001). Students from urban areas attained menarche earlier than those from rural areas (p<0.05). Students from small-sized families attained menarche earlier than those from larger families (p<0.05). First-born students experienced menarche earlier than those who were seventh-born or later. Obese and overweight students reached menarche earlier than students who were underweight or of normal weight (p<0.01). The variations in age at menarche among the Malaysian ethnic groups were statistically insignificant. The results suggest that heavier and first-born students from small families are more likely to attain menarche earlier than their counterparts.