Using data from Bangladesh, this paper examines how the birth order of a child influences parental decisions to place children in one of four activities: ‘study only’, ‘study and work’, ‘neither work nor study’ and ‘work only’. The results of the multinomial logit model show that being a first-born child increases the probability of work as the prime activity, or at least a combination of school and work, rather than schooling only. The results confirm that later-born children are more likely to be in school than their earlier-born counterparts.

Domestic spousal violence against women in developing countries like India, is now beginning to be recognized as a widespread health problem impeding development. This study aimed to explore the risk and protective factors for lifetime spousal physical violence. A cross-sectional household survey was carried out in rural, urban and urban-slum areas across seven sites in India, among women aged 15–49 years, living with a child less than 18 years of age. The sample was selected using the probability proportionate to size method. Trained field workers administered a structured questionnaire to elicit information on spousal physical violence. The main hypothesized variables were social support, witnessed father beating mother and experience of harsh physical violence during childhood, alcohol abuse by spouse and socioeconomic variables. The outcome variables included three physical violence behaviours of hit, kick and beat. Odds ratios were calculated for risk and protective factors of violence using logistic regression. Of 9938 women surveyed, 26% reported experiencing spousal physical violence during the lifetime of their marriage. Adjusted odds ratios calculated using multiple logistic regression analysis suggest that women whose husbands regularly consumed alcohol (OR 5·6; 95% CI 4·7–6·6); who experienced dowry harassment (OR 3·2; 95% CI 2·7–3·8); had reported experiencing harsh physical punishment during childhood (OR 1·6; 95% CI 1·4–1·8) and had witnessed their fathers beat their mothers (OR 1·9; 95% CI 1·6–2·1), were at increased risk of spousal physical violence (beat, hit and kick). Higher socioeconomic status and good social support acted as protective buffers against spousal physical violence. The findings provide compelling evidence of the potential risk factors for spousal physical violence, which in turn could help in planning interventions.

With the objective of reducing maternal and neonatal mortality, the Safe Motherhood Program was implemented in Nepal in 1997. It was launched as a priority programme during the ninth five-year plan period, 1997–2002, with the aim of increasing women’s access to health care and raising their status. This paper examines the association of access to health services and women’s status with utilization of prenatal, delivery, and postnatal care during the plan period. The 1996 Nepal Family Health Survey and the 2001 Nepal Demographic and Health Survey data were pooled and the likelihood of women’s using maternal health care was examined in 2001 in comparison with 1996. Multiple logistic regression analysis indicates that the utilization of maternal health services increased over the period. Programme interventions such as outreach worker’s visits, radio programmes on maternal health, maternal health information disseminated through various mass media sources and raising women’s status through education were able to explain the observed change in utilization. Health worker visits and educational status of women showed a large association, but radio programmes and other mass media information were only partially successful in increasing use of maternal health services. Socioeconomic and demographic variables such as household economic status, number of living children and place of residence showed stronger association with use of maternal health services then did intervention programmes.

The aim of this paper is to investigate the differentials and determinants of female age at first marriage in rural Nepal. The life table technique was employed to calculate median age at marriage. The proportional hazard model was used to study the effect of various socioeconomic variables, and to identify the magnitude and significance of their effects on the timing of first marriage. The data were taken from a sample survey of Palpa and Rupandehi districts in rural Nepal. Both married and unmarried females of marriageable age were included in the survey. Median age at marriage was about 17 years for data from only married females, whereas it was about 18 years for data from married as well as unmarried females of marriageable age. Median age at marriage was about 16 years for uneducated females and 19 years for females educated up to intermediate or higher level. The analysis underestimates the median age at marriage for married females, probably due to right censoring. The risk of getting married early decreased gradually with increasing year-of-birth cohort. The risk of early marriage was higher among females of high socioeconomic status compared with those of low socioeconomic status. Females engaged in service married earlier than those engaged in household work. High socioeconomic status families are motivated, for religious and prestige reasons, to get their daughters married at an early age, preferably before menarche. Thus, education, occupation and age at menarche are the most powerful factors in deciding the timing of first marriage in Nepal.

This paper explores the factors that influence the practice of induced abortion in a very low fertility society, with particular emphasis on son preference and three distinct religions: Confucianism, Buddhism and Christianity. Using multivariate logistic regression models fitted by the generalized estimating equation (GEE) method, this paper analysed the data collected by the 2000 Korea National Fertility and Family Health Survey of 6348 married women aged 15–49 years with a total of 1217 pregnancy outcomes. The results showed that the likelihood of induced abortions in women with two or more children, compared with those with one child, was significantly influenced by the sex composition of the previous children: odds ratio (OR)=12·71 (95% CI=5·49, 29·42) for women with only son(s), and OR=3·91 (95% CI=1·67, 9·14) for women with only daughter(s). At parity two, women with two sons were much more likely to have induced abortions than women with two daughters (OR=5·88, 95% CI=2·70, 12·85). Although Buddhist women were not significantly different from Confucian women in induced abortion practice, Christian women were much less likely than Confucian women to have an induced abortion (OR=0·39, 95% CI=0·18, 0·88 for women with only sons and OR=0·44, 95% CI=0·24, 0·81 for women with two children). This suggests that even in this very low fertility society, son preference and religious affiliation are significant predictors of women’s practice of induced abortion.

Access to voluntary counselling and HIV testing (VCT) remains limited in most parts of Ghana with rural populations being the least served. Services remain facility-based and employ the use of an ever-dwindling number of health workers as counsellors. This study assessed approval for the use of lay counsellors to promote community-based voluntary counselling and testing for HIV and the extent of HIV/AIDS-related stigma in the Kassena-Nankana district of rural northern Ghana. A cross-sectional questionnaire survey was conducted. Logistic regression was used to identify predictors of the tendency to stigmatize people living with HIV/AIDS (PLWHAs). Focus group discussions were held and analytical coding of the data performed. The majority (91·1%) of the 403 respondents indicated a desire to know their HIV status. Most (88·1%) respondents considered locations outside of the health facility as preferred places for VCT. The majority (98·7%) of respondents approved the use of lay counsellors. About a quarter (24%) of respondents believed that it was possible to acquire HIV through sharing a drinking cup with a PLWHA. About half (52·1%) of the respondents considered that a teacher with HIV/AIDS should not be allowed to teach, while 77·2% would not buy vegetables from a PLWHA. Respondents who believed that sharing a drinking cup with a PLWHA could transmit HIV infection (OR 2·50, 95%CI 1·52–4·11) and respondents without formal education (OR 2·94, 95%CI 1·38–6·27) were more likely to stigmatize PLWHAs. In contrast, respondents with knowledge of the availability of antiretroviral (ARV) drugs were less likely to do so (OR 0·40, 95%CI 0·22–0·73). Findings from the thirteen focus group discussions reinforced approval for community-based VCT and lay counsellors but revealed concerns about stigma and confidentiality. In conclusion, community-based VCT and the use of lay counsellors may be acceptable options for promoting access. Interventional studies are required to assess feasibility and cost-effectiveness.

The purpose of this paper is to review the patterns of contraceptive use in Australia, using data from a nationally representative sample of 5872 women aged 18 to 49. This survey was conducted by the Australian Bureau of Statistics in 2001 as part of the National Health Survey. Results of the analysis indicate that the oral contraceptive pill and condom were the two most frequently used methods. More than 76% of the respondents reported having ever used the pill. Over 23% of women were currently using condoms; of these 80% of the condom users used them for contraception – this included 36% who used condoms for both protection against infection and for contraception – and the remainder used them only for protection. Withdrawal was the third most popular non-surgical method up to age 40. Few women used IUDs, injections or diaphragms. Just over 3% of the respondents were using natural methods with the highest rate reported among those in their 30s. The ‘morning-after pill’ was reported mostly by women aged 18–24; however, there was no evidence to suggest that it was being used as a primary method of birth control. Contraceptive use declined in older women who turned to sterilization for themselves and/or their partners. Use of the contraceptive pill was somewhat higher among better-educated women, but lower among less-educated women and those from non-English-speaking backgrounds.

Bangladesh society is profoundly gender stratified, and yet male roles in reproductive health processes have not been rigorously investigated. This study examines the association between men’s reproductive health knowledge, attitude and behaviour and their wives’ subsequent reproductive behaviour using longitudinal data from the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). A total of 4969 matched husband-and-wife data from a 1998 survey and women’s contraceptive use history data following this survey are used. Results show a significant association between husbands’ fertility preferences and current use of any family planning method. When wives’ background characteristics, and husbands’ background and socioeconomic characteristics are controlled for, the predicted probability of using a method of contraception among non-educated wives whose husbands want more children is 0·49 compared with 0·64 for those whose husbands do not want more children. However, the net effect of husbands’ preference for additional children diminishes as wives’ level of education increases. Among wives who had completed high school, the predicted probability of using a method of contraception is 0·70 for those whose husbands want more children compared with 0·69 for those whose husbands do not want more children.

This paper reviews various theoretical approaches towards an explanation of parental gender preferences and empirical findings from developing as well as from industrialized countries, focusing on the role of gender preferences in reproductive decisions. Although various attempts have been made to shed light on the mechanisms underlying the observed patterns of sex preferences for children, a fully satisfying theoretical explanation is still not at hand. Empirically, a distinct and stable preference for at least one child of each sex can be observed as a common pattern of parental sex preferences across many different social, economic and cultural contexts. Further – and ideally multidisciplinary – research that helps to improve our understanding of this phenomenon is highly desirable.

While a country’s health policy aims to provide health services to all who need them, very little in known about unmet need for additional medical care from users’ perspectives in Bangladesh. This study examined unmet medical need (defined as whether a mother felt that, to manage sickness, her child had required medical care that was not available, regardless of reasons and medical care sought) of 2123 under-15 sick children by illness and child’s socioeconomic characteristics in rural Bangladesh. The 1996 Health and Socioeconomic Survey conducted in Matlab recorded children’s chronic (a disease or a condition lasting 3 months or more) and acute (a disease or a condition with a rapid onset and a short, severe course) morbidity, medical care sought to combat illness and unmet needs for additional medical services in mothers’ views to manage the illness. The survey also recorded household socioeconomic data. Logistic regression was used to examine the data. The results reveal that unmet needs for additional medical care were 5·4% for children with acute illnesses, and 30·2% for children with chronic illnesses. For chronic illnesses, seeking medical care to manage illness from any health provider outside the home reduced unmet medical needs. Economic inequalities existed for both acute and chronic illnesses: the odds ratio of unmet medical needs for sick children of the least poor households was 0·42 (95% CI: 0·28–0·64) times that for sick children of the very poor households. The critically high unmet needs for children’s chronic morbidity reveal that the chronic disease control programme in Bangladesh needs urgent revisiting and strengthening.

A cross-sectional study of 212 adult (>18 years) male slum dwellers (mean age=34·6±14·4 years) of Midnapore town, West Bengal, India, was undertaken to study the inter-relationships of chronic energy deficiency (CED), monthly family income (MFI), self-reported morbidity and hospitalization due to severe illness. The mean height, weight and body mass index (BMI) of the subjects were 160·0 cm, 50·8 kg and 19·9 kg/m2, respectively. The overall frequencies of CED (BMI<18·5 kg/m2), morbidity and hospitalization were 38·2%, 34·4% and 13·7%, respectively. Based on the WHO classification, the prevalence of CED among this population was high (20–39%), indicating a serious situation. Overall, MFI was significantly (p<0·01) positively correlated with BMI (r=0·21). Linear regression analyses showed that MFI had a significant impact (t=3·08; p<0·002) on BMI. Overall, MFI explained 3·9% variation in BMI. Subjects belonging to the lowest family income group (FIG I) had the lowest mean BMI (19·1 kg/m2) and the highest rate of CED (46·3%) and morbidity (36·6%). Those in the highest family income group (FIG III) had the largest mean BMI (20·8 kg/m2) and lowest rate of CED (30·2%) and morbidity (30·2%). The highest rate (18·9%) of hospitalization was found in this group. There were significant family income group differences in mean BMI (F=3·134, p<0·05). The frequency of morbidity (24·6%) and hospitalization (11·9%) was lowest among normal BMI individuals. Morbidity was significantly higher (χ2=11·92, p=0·0026) among CED (48·2%) subjects compared with normal BMI individuals (OR=2·85; CI=1·49–5·46). Similarly, compared with normal BMI subjects, morbidity was higher (38·5%; OR=1·92; 95% CI=0·50–7·18) among overweight subjects. Hospitalization was more common among CED subjects (16·1%; OR=1·42; CI=0·58–3·45) compared with normal BMI subjects. Similarly, the frequency of hospitalization was more among overweight individuals (15·4%; OR=1·35; 95% CI=0·0–7·59). In conclusion, this study provides evidence that the frequency of CED among this population is high, indicating a serious situation. Moreover there exists strong inter-relationships between BMI, CED, MFI and morbidity.

Page 782, line 4–5, should read:

The mean age of the subjects was 34·6 years (SD=14·4 years).

Page 783, lines 21–27, should read:

There were significant differences (F=6·101; p=0·00266) between BMI categories in mean years of schooling (results not presented). Persons with CED had the least amount of schooling (mean 2·6 years), whereas overweight individuals had the most (7·37 years), with normal BMI subjects having an intermediate amount of schooling (mean 5·6 years). Similarly, FIG I subjects had significantly (F=4·675; p<0·05) lower mean years of schooling (2·9 years) compared with FIG III individuals (5·6 years).

The superiority of men over women in chess has been cited as evidence that there are fundamental differences in male and female intelligence (Howard, 2005a, 2006; Irwing & Lynn, 2005). An alternative interpretation of the difference is that it is due to differential male and female participation rates in chess (Charness & Gerchak, 1996; Bilalić & McLeod, 2006; Chabris & Glickman, in press). This has been dismissed by Howard (2006) on the grounds that changes in the difference in skill level between top male and female players in recent years are not correlated with changing relative participation rates. Here it is shown that Howard’s analysis is misleading. The data are consistent with differential participation rates as the explanation of the gap between the performance of women and men in chess.