Can married or cohabitating women in patriarchal societies, who are often disproportionately affected by STI/HIV infections, negotiate protective sex when perceived necessary by refusing sex or asking for condom use during sex? Protective sex negotiation was examined through measures of power relations related to whether or not a woman has a say in sexual activities within marriage. The study hypothesis was that women who are more able to refuse sex or ask for condom use before sexual intercourse will be more able to discuss and reach agreement with their spouses on protective sex practices when needed. The study used data from DHS surveys conducted in Cote d’Ivoire and Nigeria in 2012 and 2013 respectively. Multivariate logistic regression models were used to predict women’s ability to negotiate protective sex in Cote d’Ivoire and Nigeria. The findings show that moderately high percentages of women in both countries reported the ability to negotiate protective sex, with a higher percentage reporting the ability to refuse sex compared with the ability to ask partners to use a condom. The logistic regression results showed that, in the two countries, women’s ability to refuse sex or ask their partners to use a condom, varied by gender- and power-mediating factors, women’s characteristics and behavioural factors. The study draws attention to the need to intensify efforts to promote more-egalitarian relationships between partners through culturally appropriate interventions.

Using data from the family and genealogical reconstitutions of the Gitano population of 22 contiguous localities in eastern Andalusia, Spain, this study analysed the intensity, structure and historical evolution of consanguinity in 3056 couples formed from 1925 to 2006. Of these unions, 54.8% were consanguineous, and 28.7% involved relatives up to and including second cousins, resulting in a mean coefficient of inbreeding up to the third degree α3 = 12.4 × 10−3. The rest of the consanguineous unions (26.1% of all) involved more-distant relatives, such as third cousins, fourth cousins and so forth. When all consanguinity degrees found in the genealogical reconstitution were considered, the total mean coefficient of inbreeding was αt = 14.8 × 10−3. The merging of families and pedigrees generated a complex genealogical network with many inbreeding loops and important founder effects. This network revealed a high rate (62%) of Multiple Consanguineous Marriages (MCMs) in which second and subsequent consanguineous ties increased inbreeding levels by a fifth (20.5%). The accumulation of multiple degrees of distant relatedness, many of which had little social or biological importance, has contributed to a significant increase in inbreeding rates. Among Gitano people, intra-family marriages have remained common in the last decades, in sharp contrast to other Spanish populations. Hence the highest rates of close consanguinity (34%) and inbreeding (α3 = 14.6 × 10−3) were found in the 1960s, the decade that saw the onset of Spain’s socioeconomic modernization, internationalization and massive migration. These are among the highest rates of inbreeding found in any European population, including the most endogamous Spanish isolates. They reveal marriage strategies not constrained primarily by geographical barriers, but by ethnocultural separation. Interestingly, in recent decades mixed marriages have been increasing rapidly in this minority, although they are compatible with high rates of consanguinity. Gitano secular endogamy is breaking up, but not uniformly.

This study aimed to identify the social and demographic correlates of the trend in age at first marriage among women in Malawi, using Malawi Demographic and Health Survey data collected between 1992 and 2016. Employing Cox Proportional Hazard modelling, the results showed that the mean age at first marriage during the 18-year period remained constant at 17.4 years. Furthermore, across all the surveys, younger women married at an early age compared with their older counterparts. The results further showed that having no education, residing in the Northern region, working, belonging to the middle and rich wealth index categories, and belonging to Tumbuka, Lomwe, Yao, Ngoni and Amanganja/Anyanja ethnicities increased the risk of early marriage. The findings suggest that policies such as promoting access to education for women and enforcing the law that restricts the legal age at which a woman can marry (18 years) should be maintained and enforced in Malawi.

Research on informed choice in modern contraceptive method acceptance by young married women is pertinent in the broader context of individual freedom and reproductive rights, especially in countries where women continue to have limited control over their reproductive and contraceptive choices. This study in India asked: (1) is young married women’s acceptance of specific modern contraceptive methods an informed choice? and (2) what are the enablers and barriers to informed choice? The study used data for currently married women aged 15–24 (N = 20,752) from the fourth round of the National Family Health Survey (NFHS-4) conducted in 2015–16. A Method Information Index (MII) was calculated as a measure of informed choice from the percentage of users who responded ‘yes’ to all three questions on: whether they were informed about methods other than the one they received, told about the method-specific side-effects, and advised what to do if they experienced side-effects. Binary logistic regression analysis was carried out to examine the adjusted effect of factors associated with the MII separately for female sterilization, the intrauterine device and the oral contraceptive pill, and a combined MII including all three methods plus injectables. One-fifth of the study women used any modern contraceptive method at the time of survey, of which only 36% had fully informed choice. The likelihood of being informed about the methods was significantly higher among those using the oral contraceptive pill (OR: 1.75, CI 1.58–1.94), IUD (OR: 2.23, CI 1.97–2.52) and injectables (OR: 1.37, CI 0.97–1.94) compared with those who were sterilized. Informed choice varied by region and the socioeconomic profile of the users. Inadequately informed choice violates the reproductive rights of young women and might result in higher post-use health problems, discontinuation of and unmet need for contraceptives, unintended pregnancies, induced abortions and regret, adversely affecting women’s health. Training of health/family planning workers in India about the importance of reproductive rights is urgently required to enhance informed contraceptive choice and improve the health of young married women.

This paper presents an analysis of trends in sexual activity by marital status and age, and their associations with contraceptive use. Understanding levels of, and trends in, sexual activity is important for assessing the needs for family planning services and for analysing commonly used family planning indicators. Data were taken from 220 Demographic and Health Surveys (DHSs) and 62 Multiple Indicator Cluster Surveys (MICSs) to provide insights into sexual activity by marital status and age in a total of 94 countries in different regions of the world. The results show the sensitivity of the indicator with respect to the definition of currently sexually active, based on the timing of last sexual intercourse (during the last 4 weeks, 3 months, or 1 year). Substantial diversity in sexual activity by marital status and age was demonstrated across countries. The proportion of married women reporting recent sexual activity (sexual intercourse during the last 4 weeks) ranged from 50% to 90%. The proportion of unmarried women reporting recent sexual activity did not exceed 50% in any of the 94 countries with available data, but showed substantial regional differences: it appeared to be rare in Asia and extremely varied within Africa, Europe and Latin America and the Caribbean. Among married women, sexual activity did not vary much by age group, while for unmarried women, there was an inverted U-pattern by age, with the youngest age group (15–19 years old) having the lowest proportion sexually active. The proportion of women who reported currently using contraception and reported not being sexually active varied by the contraceptive method used and was overall much greater among unmarried women. The evidence presented in this paper can be used to improve family planning policies and programmes to serve the diverse needs, for example regarding method choice and service provision, of unmarried women.

This study explores the link between height and earnings, using data from the Russian Longitudinal Monitoring Survey for the year 2015 (24th wave). The dependent variable was average monthly income and the key independent variable was self-reported height, measured in centimetres. The empirical model also included a rich vector of personal and job-related factors that have been shown to be associated with earnings in the relevant literature. Sequential multiple regression and one-way analyses of variance (ANOVA) were used to analyse the data. The results suggest that height is a significant predictor of earnings in Russia. The results were found to be robust for a set of controls and tests.

Socioeconomic changes occurring over time influence the lifestyle choices of a population, and these can significantly affect children’s body weight and composition. The aim of this study was to assess the changes in prevalence of overweight, obesity and adiposity in pre-school children in Poland between 2008 and 2018. Body height, body weight and subscapular and triceps skinfolds were measured in 2167 children aged 3–7 years from Kraków. Body mass index and adiposity (percentage body fat, %BF) were calculated for the children, who were then categorized as underweight, normal weight, overweight or obese according to Cole’s cut-off points. Adiposity was categorized according to the z-scores for %BF as low (<−1), normal (−1 to 1) or high (>1). Differences between cohorts were analysed using the chi-squared test. Only the decrease in the prevalence of obesity in 5-year-old girls was found to be statistically significant. However, some overall tendencies were noted. Decreases in the prevalence of underweight, overweight and obesity were observed for both sexes, as well as in the incidence of high adiposity in boys and low adiposity in girls. Increases in the prevalence of high adiposity in girls and low adiposity in boys were also noted. There was no significant change in the prevalence of overweight and obesity among pre-school children over the study decade, and the visible tendencies included decreases in the prevalence of excess body weight and adiposity as well as underweight and low body fat. Also, the visible trends in adiposity were mostly negative. Further studies should, however, also consider the levels of physical fitness and activity of children, as these have a crucial influence on the measured characteristics.

A growing number of studies have tested the association between intimate partner violence (IPV) and the unintendedness of pregnancy or birth, and most have suggested that unintendedness of pregnancy is a cause of IPV. However, about nine in every ten women face violence after delivering their first baby. This study examined the effects of the intendedness of births on physical IPV using data from the National Family Health Survey (2015–16). The multivariate logistic regression model analysis found that, compared with women with no unwanted births (2.9%), physical IPV was higher among those women who had unwanted births (6.9%, p<0.001), followed by those who had mistimed births (4.4 %, p<0.001), even after adjusting for several women’s individual and socioeconomic characteristics. Thus, the reduction of women with mistimed and unwanted births could reduce physical IPV in India. The study highlights the unfinished agenda of family planning in the country and argues for the need to integrate family planning and Reproductive, Maternal and Child Health Care (RMNCH) services to yield multi-sectoral outcomes, including the elimination of IPV.

The sex ratio question has been an area of growing interest in population dynamics, especially in developing countries with respect to the issue of missing women, but few studies have examined this in sub-Saharan Africa. Both at birth and in the general population, sex ratios follow an expected demographic pattern in the absence of the interference of historical events affecting either males or females in a population. In Zambia, an unexpected demographic pattern of sex ratios is exhibited in census and survey data. This study used data from censuses and surveys conducted from 1969 to 2014 to examine variations in sex ratios in the Zambian population. It was found that sex ratio imbalances were largely due to data deficiencies due to age misreporting and under-enumeration. A consistent under-enumeration of young adult males in the 20–34 years age group was found. A systematic pattern of high sex ratios, above 100, for ages 40+ was found, represented by synthetic cohorts traceable from the 1969 census, progressing to the 2000 census and phased out in the 2010 census. Extremely high adult male mortality was found in 2010 in the 35–59 years age group, primarily attributable to HIV/AIDS. Understanding the demographic pattern of sex ratios in a population is relevant for policies to improve the quality of data collection systems, and socioeconomic development planning, for the young age group population, which is prone under-enumeration.