A strong case has recently been made by academics and policymakers to develop national programmes for the integrated control of Africa’s ‘neglected tropical diseases’. Uganda was the first country to develop a programme for the integrated control of two of these diseases: schistosomiasis and soil-transmitted helminths. This paper discusses social responses to the programme in Panyimur, north-west Uganda. It shows that adults are increasingly rejecting free treatment. Resistance is attributed to a subjective fear of side-effects; divergence between biomedical and local understandings of schistosomiasis/bilharzia; as well as inappropriate and inadequate health education. In addition, the current procedures for distributing drugs at a district level are problematic. Additional research was carried out in neighbouring areas to explore the generalizability of findings. Comparable problems have arisen. It is concluded that the national programme will not fulfil its stated objectives of establishing a local demand for mass treatment unless it can establish more effective delivery strategies and promote behavioural change in socially appropriate ways. To do so will require new approaches to social, economic and political aspects of distribution. There are reasons why populations infected with the ‘neglected tropical diseases’ are themselves neglected. Those reasons cannot just be wished away.

In India, the eight socioeconomically backward states of Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa, Rajasthan, Uttaranchal and Uttar Pradesh, referred to as the Empowered Action Group (EAG) states, lag behind in the demographic transition and have the highest infant mortality rates in the country. Neonatal mortality constitutes about 60% of the total infant mortality in India and is highest in the EAG states. This study assesses the levels and trends in neonatal mortality in the EAG states and examines the impact of bio-demographic compared with health care determinants on neonatal mortality. Data from India’s Sample Registration System (SRS) and National Family and Health Survey (NFHS-2, 1998–99) are used. Cox proportional hazard models are applied to estimate adjusted neonatal mortality rates by health care, bio-demographic and socioeconomic determinants. Variations in neonatal mortality by these determinants suggest that universal coverage of all pregnant women with full antenatal care, providing assistance at delivery and postnatal care including emergency care are critical inputs for achieving a reduction in neonatal mortality. Health interventions are also required that focus on curtailing the high risk of neonatal deaths arising from the mothers’ younger age at childbirth, low birth weight of children and higher order births with short birth intervals.

This paper explores the course of infant and childhood mortality in the Greek island of Paros from the end of the nineteenth until the mid-twentieth century. For this purpose the method of family reconstitution has been applied to two towns on the island. Official population statistics have been used to derive basic mortality estimates for the Cyclades and Greece as a whole. Reference to other studies concerning island mortality is also made. Hence, there appears the chance to compare insular with mainland mortality and realise that insular mortality presented some distinct features. It is shown that island populations presented lower mortality than the national average until the first decades of the twentieth century. However, by the 1950s Greece’s infant and childhood mortality had dropped to the same or even to lower levels than those of the islands.

Age at menarche is associated with anthropometry in adolescence. Recently, there has been growing support for the hypothesis that timing of menarche may be set early in life but modified by changes in body size and composition in childhood. To evaluate this, a cohort of 255 girls aged <5 years recruited in 1988 were followed up in 2001 in Matlab, Bangladesh. The analysis was based on nutritional status as assessed by anthropometry and recalled age at menarche. Data were examined using lifetable techniques and the Cox regression model. The association between nutritional status indicators and age at menarche was examined in a multivariate model adjusting for potential confounding variables. Censored cases were accounted for. The median age at menarche was 15·1 years. After controlling for early-life predictors (birth size, childhood underweight, childhood stunting) it appeared that adolescent stunting stood out as the most important determinant of age at menarche. Adolescent stunting still resonates from the effect of stunting in early childhood (OR respectively 2·63 (p<0·01 CI: 1·32–5·24) and 8·47 (p<0·001 CI: 3·79–18·93) for moderately and severely stunted under-fives as compared with the reference category). Birth size was not a significant predictor of age at menarche. It is concluded that age at menarche is strongly influenced by nutritional status in adolescence, notably the level of stunting, which is in turn highly dependent on the level of stunting in early childhood. A ‘late’ menarche due to stunting may be detrimental for reproductive health in case of early childbearing because of the association between height and pelvic size.

An isonymic analysis has been carried out using a sample of 1529 reconstituted families residing during 1870–1964 in Aranjuez, an urban area situated south of Madrid, Spain. The random, non-random and total-components inbreeding coefficients from isonymy were obtained and the various combinations of surnames compared in order to infer the patri- or matrilocal pattern of residence. Throughout the period studied the random component of inbreeding (Fr) has not changed, in contrast to the non-random component (Fn), thus suggesting the latter could be responsible for the reduction of total inbreeding. Using several methodological approaches (biplot analysis, α, ν and percentage of immigrants) the predominance of the immigration of grooms was interpreted in terms of Aranjuez as a matrilocal pattern of residence. From this study it can also be concluded that surnames provided by reconstituted families are good estimators of inbreeding and migration.

This study used data from a community-based survey to examine women’s experiences of abortion in Nigeria. Fourteen per cent of respondents reported that they had ever tried to terminate a pregnancy, and 10% had obtained an abortion. The majority of women who sought an abortion did so early in the pregnancy. Forty-two per cent of women who obtained an abortion used the services of a non-professional provider, a quarter experienced complications and 9% sought treatment for complications from their abortions. Roughly half of the women who obtained an abortion used a method other than D&C or MVA. The abortion prevalence and conditions under which women sought abortions varied by women’s socio-demographic characteristics. Because abortion is illegal in Nigeria except to save the woman’s life, many women take significant risks to terminate unwanted pregnancies. Reducing the incidence of unwanted pregnancy and unsafe abortion can significantly impact the reproductive health of women in Nigeria.

South Korea reported a total fertility rate (TFR) of 1·08 in 2005. This is the lowest level of all nations in the Organisation for Economic Co-operation and Development (OECD). Recently, the decline in the fertility rate has been a dominant phenomenon in Korea’s major cities. This study investigated the relationship between social environmental factors and fertility intentions for married women in Seoul, the capital of Korea, using a sample of 2211 married women who responded to the Seoul Citizens Health and Social Indicators Survey, 2005. Here, the effects of selected social environmental characteristics on fertility intentions are explored using multivariate logistic regression models. The relationships among a woman’s age, number of living children, job type, housing type, and social group participation were strong indicators of the intention to have additional children. Younger women living with fewer children generally have a higher intention to have additional children. Among women’s job types, blue-collar workers have a lower preference for additional children than white-collar workers and housewives. Married women participating in social groups have a lower preference for additional children than non-participants. Women’s participation in social activities appears to have various benefits, both individually and socially. However, whereas women’s participation in economic activities has been linked to questions of fertility in previous studies, the relationship between fertility and social activities has been downplayed. Women’s participation in social activities has increased over the past several decades, and the trend continues to grow. Therefore, women’s participation in social activities must be accepted as the status quo, and compatibility between women’s participation in social activities and childrearing needs to be increased. Consequently, a strong foundation for a fertility-friendly environment is needed, focusing on blue-collar workers and participation in social activities by married women.

Available data in Uganda indicate a resurgence of malaria morbidity and mortality countrywide. This study assessed the burden of malaria, treatment and prevention practices in order initiate a policy debate on the scaling-up of current interventions. A triangulation of methods using a cross-sectional survey and key informant interviews was used to assess self-reported malaria at a household level in Mukono District, Uganda. A total of 5583 households were surveyed, and a high proportion (2897, 51·9%) reported a person with malaria two weeks prior to the survey. Only 546 households (9·8%) owned and used insecticide-treated nets (ITNs) for malaria prevention. Similarly, only a few households (86, 1·5%) used indoor residual spraying. Self-treatment with home-stocked drugs was high, yet there was low awareness of the effectiveness of expired drugs on malaria treatment. Self-reported malaria was associated with socioeconomic, behavioural and environmental factors, but more especially with household ownership of ITNs. These results will contribute to the current debate on identifying new approaches for scaling-up prevention interventions and effective case management, as well as selection of priority interventions for malaria control in Uganda.

In recent years, sex differences in mortality have followed diverse patterns of change in developed countries. As there is no analogous evidence from Poland, the aim of this study was to describe the pattern of change in excess male mortality among Polish inhabitants aged 35–64 during 1995–2002, when the major socioeconomic transformation occurred, and compare it with sex differences in mortality observed in the late 1980s. During the study period, excess male mortality decreased significantly, independently of age and educational level. The reduction in mortality was observed in both sexes, but its magnitude was greater in men. These changes resulted mainly from a reduction in mortality rates due to cardiovascular disease and lung cancer in males and a concomitant increase in mortality rates due to lung cancer and suicides in females. Although, in general, excess male mortality decreased, social gradients related to this phenomenon increased. Subjects (in particularly men) who had graduated from university benefited the most, their magnitude of reduction in mortality rates being the greatest. Changes in social environment during the transformation period in Poland are suggested as major determinants of these changes, but further studies are needed.

The origin of talent and expertise is currently the subject of intense debate, with explanations ranging from purely biological to purely environmental. This report shows that the population of expert chess players in the northern hemisphere shows a seasonal pattern, with an excess of births in late winter and early spring. This effect remains when taking into account the distribution of births in the population at large, using statistics from the European Union member countries. A similar pattern has been found with schizophrenia, and the possible link between these two phenomena is discussed.