There is now widespread agreement on the importance of men's role in reproductive decision-making. Several studies have argued that fertility preferences and their translation into behaviour differ between polygamous and monogamous unions. Studies investigating the dominance of men's preferences over women's preferences, in cases of couple disagreement, found mixed evidence of the effect of polygamy. However, an often cited limitation of these studies has been the inability to link husband's intention with each of his wives in a polygamous union. By adding fertility-intention questions to an on-going Demographic Surveillance Site in Karonga District in northern Malawi the fertility preferences and contraceptive use of husbands and wives were investigated. An analysis of the relationship between the level of agreement and disagreement between husbands' and wives' fertility preferences was then performed to gain insight into the reproductive decision-making process of polygamous couples.

As India rapidly urbanizes, within urban areas socioeconomic disparities are rising and health inequality among urban children is an emerging challenge. This paper assesses the relative contribution of socioeconomic factors to child health inequalities between the less developed Empowered Action Group (EAG) states and more developed South Indian states in urban India using data from the 2005–06 National Family Health Survey. Focusing on urban health from varying regional and developmental contexts, socioeconomic inequalities in child health are examined first using Concentration Indices (CIs) and then the contributions of socioeconomic factors to the CIs of health variables are derived. The results reveal, in order of importance, pronounced contributions of household economic status, parent's illiteracy and caste to urban child health inequalities in the South Indian states. In contrast, parent's illiteracy, poor economic status, being Muslim and child birth order 3 or more are major contributors to health inequalities among urban children in the EAG states. The results suggest the need to adopt different health policy interventions in accordance with the pattern of varying contributions of socioeconomic factors to child health inequalities between the more developed South Indian states and less developed EAG states.

In Ethiopia, despite some recent improvements, the health and nutritional status of children is very poor. A better understanding of the main socioeconomic determinants of child health and nutrition is essential to address the problem and make appropriate interventions. In the present study, an attempt is made to explore the effect of maternal characteristics on the health and nutritional status of under-five children using the 2005 Ethiopian Demographic and Health Survey. The health and nutritional status of children are measured using the two widely used anthropometric indicators height-for-age (HAZ) and weight-for-height (WHZ). In the ordinary least squares (OLS) estimation, it is observed that maternal characteristics have a significant impact on child health and nutritional status. The magnitudes of the coefficients, however, are found to slightly increase when maternal education is instrumented in the 2SLS estimation. Moreover, in the quantile regression (QR) estimation, the impacts of maternal characteristics are observed to vary between long-term and current child health and nutritional status.

Many abortion seekers in India attempt to induce abortion on their own, by accessing oral medication/preparations from a chemist without a prescription or from an unauthorized provider, and present at registered facilities if these attempts fail. However, little is known about those whose efforts fail or the ways in which programmes and policies may address the needs of such women. This paper explores the experiences of women whose efforts failed, including their socio-demographic profile, the preparations they used, and the extent to which they experienced serious complications, delayed seeking care from an authorized provider, or delayed abortion until the second trimester of pregnancy. Data come from a larger study assessing the feasibility of the provision of medical abortion by non-physicians; a total of 3394 women who sought medical abortion from selected clinical settings in Bihar and Jharkhand between 2008 and 2010 constitute the sample. Prior to visiting the clinic, nearly a third of these women (31%) had made at least one unsuccessful attempt to terminate the unwanted pregnancy by using a range of oral medications/preparations available over-the-counter in medical shops. Logistic regression analysis suggests that educated women (OR 1.6–1.7), those from urban areas (OR 6.2) and those from Bihar (OR 1.6) were significantly more likely than women with no education, rural women and those from Jharkhand to have used such medication. Also notable is that the average gestational age of women who had made a previous attempt to terminate their pregnancy was almost identical to that of women who had not done so when they presented at the registered facility. These findings may inform policies and programmes that seek to identify and reduce the potential risks associated with unauthorized abortion-seeking practices, and highlight the need to fully inform women, chemists and providers about oral medications, what works and what does not, and how effective medication must be taken.

Several studies have documented increased prevalence of overweight and obesity in inhabitants of rural regions, but determinants of their prevalence are complex and not always in one direction. The aim of this study was to estimate both the prevalence and extent of overweight and obesity among rural girls in Poland between 1987 and 2001, as well as to assess differentiation of the phenomenon between regions of different social structures. The data come from two series of cross-sectional studies; the first in 1987 included 7764 girls, and the second in 2001 included 9431 girls aged 9–18. Body mass index (according to the International Obesity Task Force, IOTF) and the EOW index (extent of overweight), which shows by what mean BMI value the overweight boundaries are exceeded, were calculated. Overweight and obesity prevalences in the whole sample, were, respectively, 14.9% and 2.7% in 1987 and 15.5% and 2.5% in 2001, but significant differentiation in the direction of the changes was observed between the examined regions. In one of them, characterized by sudden, mass and long-term unemployment, there was a considerable decrease in overweight and obesity prevalence, whereas in a relatively wealthier region no changes were observed during the 14-year period. Two other regions with a relatively low standard of living and low incomes and education status presented a significant increase in overweight and obesity prevalence. The EOW index increased from 1.9 to 2.1 in the whole examined sample, and it also confirmed significant differences in expansion of overweight and obesity between the examined regions. The complex character of political and socioeconomic changes in Poland during the 1990s has resulted in two-directional changes in biological measures of living conditions. The analysis of the whole sample led to different results in comparison to separate analyses of each of the examined regions.

The secondary sex ratio (the ratio of boys to girls at birth) may demonstrate a decline following community stress-inducing major destructive events. This study aims to investigate whether or not moderate adverse life events, in conjunction with endogenous psychological characteristics, can induce sufficient community stress to affect the sex ratio. From April 3rd to May 8th 2006 a moderate sized earthquake sequence occurred offshore the Greek island of Zakynthos, which had been hit by a destructive earthquake half a century earlier. The monthly sex ratio after the earthquake sequence was estimated and compared with that of previous and following years. Eleven months after the onset of the earthquakes the sex ratio fell to 1.000, and during the next two months (March and April) it declined further to 0.612. The sex ratio one year before its decline was 1.158 and over a total 6-year period, 3 years before and 3 years after the sequence, it was 1.063; the March–April decline in male births is significant (OR=0.53, 95% CI=0.32–0.86, p=0.013, and OR=0.57, 95% CI=0.36–0.91, p=0.023, respectively). Also, the number of boys relative to girls in March–April 2007 was significantly lower than during the same months 3 years before and after the sequence (OR=0.50, 95% CI=0.31–0.82, p=0.007). The findings suggest that basic biological characteristics, such as the sex ratio, can be affected by psychological stressors interwoven with the pertaining psychology of the population.

Utah has the highest total fertility of any state in the United States and also the highest proportion of population affiliated with the Church of Jesus Christ of Latter-day Saints (the LDS or Mormon Church). Data were used from the 1996 Utah Health Status Survey to investigate how annual household income, education and affiliation with the LDS Church affect fertility (children ever born) for married women in Utah. Younger age and higher education were negatively correlated with fertility in the sample as a whole and among non-LDS respondents. Income was negatively associated with fertility among non-LDS respondents. However, income was positively correlated with fertility among LDS respondents. This association persisted when instrumental variables were used to address the potential simultaneous equations bias arising from the potential endogeneity of income and fertility. The LDS religion's pronatalist stance probably encourages childbearing among those with higher income.

It is evident that sexual activity tends to decrease with age. Nonetheless, it is still prevalent enough to be considered a risk factor for the spread of HIV among older people. This paper uses quantitative data for 2053 individuals to examine HIV risk perception and correlates of perceived risk among older people aged 50 years and older living in Nairobi slums. It emerged that a majority of older people did not consider themselves at risk of infection. Of those who felt at risk, a greater proportion sensed only a small chance of contracting HIV. Women cited ‘no sexual activity’ while men mentioned ‘having only one and/or a faithful sexual partner’ as the primary reasons for perceiving minimal risk of HIV infection. There were no differences by sex in the basis for perceiving moderate-to-great risk of infection. Religion is a key factor in risk perception with Muslims perceiving higher levels of risk and, conversely, devotees irrespective of faith perceiving lower levels of risk. Older people willing to be tested for HIV had a decreased likelihood of perceived risk compared with those unwilling to be tested. This paper recommends evaluation of older people's perception of risk in order to better inform interventions aimed at minimizing their vulnerability to HIV infection.

Prior studies examining the association between self-reported experiences of racial/ethnic discrimination and obesity have had mixed results and primarily been cross-sectional. This study tests the hypothesis that an increase in self-reported experiences of racial/ethnic discrimination predicts gains in waist circumference and body mass index in Black and White women and men over eight years. In race/ethnicity- and gender-stratified models, this study examined whether change in self-reported experiences of racial/ethnic discrimination predicts changes in waist circumference and body mass index over time using a fixed-effects regression approach in SAS statistical software, providing control for both measured and unmeasured time-invariant covariates. Between 1992–93 and 2000–01, self-reported experiences of racial/ethnic discrimination decreased among 843 Black women (75% to 73%), 601 Black men (80% to 77%), 893 White women (30% to 23%) and 856 White men (28% to 23%). In fixed-effects regression models, controlling for all time-invariant covariates, social desirability bias, and changes in education and parity (women only) over time, an increase in self-reported experiences of racial/ethnic discrimination over time was significantly associated with an increase in waist circumference (β=1.09, 95% CI: 0.00–2.19, p=0.05) and an increase in body mass index (β=0.67, 95% CI: 0.19–1.16, p=0.007) among Black women. No associations were observed among Black men and White women and men. These findings suggest that an increase in self-reported experiences of racial/ethnic discrimination may be associated with increases in waist circumference and body mass index among Black women over time.

The secondary sex ratio (SSR) has been suggested to decrease with adverse physical and psychological environments. Previous studies have focused on reduced SSR under adverse conditions, such as war, terrorism attack and earthquake, but few studies have investigated fluctuations in SSR in moderately adverse environments. This study analysed municipality-level vital statistics records in Japan collected between 1998 and 2002 to identify high-SSR clusters and low-SSR clusters with spatial-scan statistics. In 999 runs of simulation, high- and low-SSR clusters were detected but fewer than 950 times, indicating that SSR was not geographically clustered in Japan if type I error of 5% was adopted. Explorative analyses comparing demographic attributes between high-SSR clusters and low-SSR clusters that were detected more than 500 times in 999 runs of simulation, showed that rate of spontaneous abortion, rate of artificial abortion and divorce rate were higher in low-SSR clusters, while male life expectancy, female life expectancy and total fertility rate were higher in a high-SSR cluster.