Breast-feeding and weaning practices were observed for a cohort of 81 children under 3 years of age in the context of a longitudinal study of social, ecological and nutritional factors affecting growth in a semi-nomadic population of pastoralists in northern Tanzania (WaDatoga of Mbulu District). The adequacy of indigenous infant and young child feeding practices was assessed in relation to current international recommendations. Objectives were to provide baseline data for future investigations of any changes in young child feeding practices which accompany population shifts towards settlement and non-pastoral modes of subsistence, and to improve understanding of the strengths and limitations of indigenous feeding practices in this type of population. It was found that while breast-feeding was universally initiated, other aspects of young child feeding practices do not meet current international recommendations. Prelacteal feeds are commonly used, supplementary feeding with non-human milks usually occurs before 4 months of age, use of solid foods normally begins later than 6 months, and breast-feeding does not continue until 2 years of age for the majority of children. The data have implications for the design of breast-feeding promotion and improved weaning food interventions among African pastoralists.

This study investigated the social factors associated with body-shape preferences for females and males as perceived by Arab women living in Qatar, and correlated the current weight status of women studied with these preferences. The subjects were 535 non-pregnant Arab women aged 20–67 years, who attended heath centres in Doha City, the capital of the State of Qatar. Illustrations of male and female body shapes ranging from very thin to very obese using the 9-figure Silhouettes scale were shown to women, and they were asked to select their preferred figure. Body mass index (BMI) was used to determine the weight status of women studied. Age, educational level and employment status were found to be significantly associated with ideal body-shape preference for both males and females, whereas marital status and current weight status had no significant association. In general, the Arab women studied selected a more mid-range of body fatness for males than for females. It is concluded that attention should be given to sociocultural factors, such as body-shape preferences, in any programmes to promote ideal body weight for the public.

This study was undertaken to investigate the independent effect of the length of birth interval on malnutrition in infants, and children aged 6–39 months. Data for this study were drawn from a post-flood survey conducted during October–December 1988 at Sirajganj of the Sirajgani district and at Gopalpur of the Tangail district in Bangladesh. The survey recorded the individual weights of 1887 children. Cross-tabulations and logistic regression procedures were applied to analyse the data. The proportion of children whose weight-for-age was below 70% (moderate-to-severely malnourished) and 60% (severely malnourished) of the NCHS median was tabulated against various durations of previous and subsequent birth intervals. The odds of being moderately or severely malnourished were computed for various birth intervals, controlling for: the number of older surviving siblings; maternal education and age; housing area (a proxy for wealth); age and sex of the index child; and the prevalence of diarrhoea in the previous 2 weeks for the index child.

About one-third of infants and young children were moderately malnourished and 15% were severely malnourished. The proportion of children who were under 60% weight-for-age decreased with the increase in the length of the subsequent birth interval, maternal education and housing area. The proportion of malnourished children increased with the number of older surviving children. Children were at higher risk of malnutrition if they were female, their mothers were less educated, they had several siblings, and either previous or subsequent siblings were born within 24 months. This study indicates the potential importance of longer birth intervals in reducing malnutrition in children.

Psychological determinants of contraceptive use were investigated in Great Britain and Germany, using national data obtained in 1992. It was hypothesised that current contraceptive use among sexually active, fertile women aged 15-45 was related to their attitude towards the various contraceptive methods, social influences, perceptions of being able to use a method correctly and consistently, a correct estimation of fertility, and communication with their partner. Effects of age and country were also taken into account.

The attitude of respondents towards the various contraceptive methods was ambivalent and no method was seen as ideal. On medical methods (OCs, IUDs and sterilisation) many respondents expressed doubts as to their safety for health. Social influences most frequently concerned the use of OCs. Respondents considered themselves able to use oral contraceptives correctly, but expressed general fear about intrauterine devices and sterilisation, and many women believed they were not able to use condoms and periodic abstinence consistently.

Multifactorial analyses revealed that current contraceptive use was principally determined by social influences, attitude and self-efficacy with respect to medical methods. Age and country, and, for use of unreliable methods, fertility awareness also played a role. Communication with the partner was less relevant.

Contraceptive choice (and the use of non-medical methods) depended greatly on encouragement to use and being in favour of medical methods. A lack of social support for use of medical methods and a negative attitude towards them was related to higher use rates of condoms, periodic abstinence, withdrawal and reliance on ‘luck’. In the case of withdrawal and/or no method, underestimation of fertility played an additional role.

Contraceptive choice appears to be determined more by a general like or dislike of medical methods rather than on a weighing of the merits of individual available methods.

The low contraceptive prevalence rate and the existence of unmet demand for family planning services present a challenge for parties involved in family planning research in Tanzania. The observed situation has been explained by the demand-side variables such as socioeconomic characteristics and cultural values that maintain the demand for large families. A small, but growing body of research is examining the effect of supply-side factors such as quality of care of family planning services on the demand for contraceptives. This paper analyses the demand and supply factors determining contraceptive use in Tanzania using the Tanzania Service Availability Survey (1996) and the Tanzania Demographic and Health Survey (1996) data sets. The results show that access to family planning services and quality of care of services are important determinants of contraceptive use in Tanzania even after controlling for demand-side factors.

The incidence of anencephalus and other malformations of the central nervous system (CNS) is much higher in the United Kingdom than in other countries of Western Europe which were not industrialized to the same extent. In the UK the incidence is highest in the unskilled manual occupational group, especially in the large cities of the North of England, Scotland and Northern Ireland. Standards of living have been low in these areas for many years and deteriorated sharply at the time of the worldwide industrial depression from 1928 to 1934. The population tended to be stunted in stature and to show other signs of chronic malnutrition.

The cohort of women born in these years had an unusually high stillbirth rate from anencephalus (and from all other CNS malformations) from about 1946 onwards. It was highest in the early 1960s when these women were at the peak of their reproductive activity. This suggests that the severe malnutrition to which they were subjected before and soon after birth resulted in severe damage, which reduced their reproductive efficiency as demonstrated by the unusually high perinatal death rate from all CNS malformations. Not surprisingly the death rate rose sooner, lasted longer and reached a higher level in social classes IV and V than in social classes I and II. Other evidence of damage was an increase in the incidence of low birth weight babies with a corresponding increase in the perinatal death rate from this cause.

In Scotland the stillbirth rate from anencephalus was approximately 2·1 per 1000 in 1948–49, 3·4 at its highest point between 1961 and 1963 and 2·1 in 1968, by which time the women born in the years of the depression had completed their childbearing. A teratogen acting during a particular period of time could not provide a satisfactory explanation for this sequence of events.

Recent work in human behavioural ecology has suggested that analyses focusing on early childhood may underestimate the importance of paternal investment to child outcomes since such investment may not become crucial until adolescence or beyond. This may be especially important in societies with a heritable component to status, as later investment by fathers may be more strongly related to a child's adult status than early forms of parental investment that affect child survival and child health. In such circumstances, the death or absence of a father may have profoundly negative effects on the adult outcomes of his children that cannot be easily compensated for by the investment of mothers or other relatives. This proposition is tested using a multigenerational dataset from Bangalore, India, containing information on paternal mortality as well as several child outcomes dependent on parental investment during adolescence and young adulthood. The paper examines the effects of paternal death, and the timing of paternal death, on a child's education, adult income, age at marriage and the amount spent on his or her marriage, along with similar characteristics of spouses. Results indicate that a father's death has a negative impact on child outcomes, and that, in contrast to some findings in the literature on father absence, the effects of paternal death are strongest for children who lose their father in late childhood or adolescence.

The physical, achievement, and personality characteristics of Chinese schoolchildren are evaluated. The results of two surveys of Chinese schoolchildren, conducted in Beijing and Jilin Province, are presented. In the Beijing sample, the differences between only children and others were small but statistically significant, with the only children having higher scores in achievement and physical size. In the Jilin Province sample, the differences between only children and others were also small but significant. These differences were found entirely in physical characteristics, with only children being smaller, perhaps because the only children in the Jilin sample were much younger than the non-only children. Analyses of the combined sample of Beijing and Jilin schoolchildren indicated that the only-child advantages in achievement were found among children from urban families, not rural peasant families. While significant differences in height and weight were found in all three samples, none of the results indicated a significant difference in the proportion of body fat. None of the analyses indicated that only children had undesirable personalities, as judged by teachers and mothers.

Understanding treatment-seeking practices for malaria in pregnancy is necessary in designing effective programmes to address the high malaria morbidity in pregnancy. This study assessed women’s perceptions on malaria in pregnancy, recognition of early signs of pregnancy and of malaria, and the cultural context in which treatment seeking takes place in Mukono District. Focus group discussions (FGD) and key informant interviews were conducted among pregnant women, non-pregnant women, adolescents and men. The results showed that malaria, locally known as omusujja, was perceived as the most common cause of ill health among pregnant women. Although malaria commonly presents with fever, some pregnant women feel hot in the womb with or without signs of fever and this illness, locally known as nabuguma, may lead to progressive weakness and occasionally to miscarriage and few respondents associated it with malaria. Primigravidae, adolescents and men were not considered at risk of omusujja or nabuguma. Similarly anaemia and low birth weight were not associated with malaria; in fact paleness was described as a normal sign of pregnancy. There are cultural and social pressures on married women to get pregnant and this forces them to conceal symptoms like feeling feverishness, backache, nausea, general weakness, loss of appetite and vomiting until they are sure these are due to pregnancy. Most women, however, could not differentiate symptoms of malaria from those of early pregnancy. There is a belief that omusujja is a normal sign of pregnancy and this is coupled with a strong cultural practice of using herbs and clays as a first resort to treat pregnancy ailments including malaria. The cultural beliefs and practices regarding delivery of twin and first births, coupled with the high cost of care, prevent women from delivering and using other services at health units.

Few studies have examined the impact of unintended pregnancy on women in developing countries. This paper examines the impact of unintended pregnancy on Indonesian women’s psychological well-being. It is hypothesized that experiencing unintended pregnancy is associated with lower psychological well-being and that use of family planning and small family size are associated with higher levels of psychological well-being. Data are drawn from a 1996 survey of 796 women aged 15–49 from two Indonesian provinces, Lampung and South Sumatra. This article focuses on the 71% of women (n=562) who answered all 41 survey items related to psychological well-being. In cluster analysis, women grouped into three clusters, differentiated by their scores on four scales of well-being established through factor analysis (general negative feelings, satisfaction with relationships, satisfaction with economic/family/personal conditions, and negative feelings regarding domestic issues). Women in cluster 3 were characterized mainly by their high level of psychological well-being. Women in cluster 1 had the lowest level of well-being, and women in cluster 2 were in the middle. Multinomial logistic regression was used to assess jointly the effect of unintended pregnancy, contraceptive use, number of children and other factors on a woman’s level of psychological well-being. Unintended pregnancy was associated with lower levels of psychological well-being and contraceptive use was associated with higher levels of psychological well-being, while number of children was not associated with level of well-being. Women who had experienced an unintended pregnancy were less likely to be in the high psychosocial well-being cluster versus both the medium and low clusters. In addition, women using contraception were more likely to be classified in the high than in the low or medium well-being clusters.

The disease burden in both developed and developing countries is moving towards higher proportions of chronic diseases, and diseases such as cancers are now considered to be of public health concern. In sub-Saharan Africa, healthy behaviours such as fruit and vegetable consumption are recommended to reduce the chances of onset of chronic diseases. This paper examines the determinants of fruit and vegetable consumption in Ghana with particular emphasis on consumption by ecological zone. Data were from the 2008 Ghana Demographic and Health Survey (n=4916 females; n=4568 males). Univariate and multivariate analyses were performed using basic descriptive and Poisson regression. The main independent variable was ecological zone and the dependent variables were levels of fruit and vegetable consumption. The mean number of fruits and vegetables consumed in a week was higher among females (fruits: 7.5, 95% CI=7.3–7.7; vegetables: 8.1, 95% CI=7.8–8.3) than males (fruits: 6.2, 95% CI=6.0–6.4; vegetables: 7.9, 95% CI=7.7–8.2). There were significant differences in consumption by ecological zone. Respondents in the Savannah zone consumed less fruit than those in the Coastal and Forest zones, but the differences in fruit and vegetable consumption between the Coastal and Savannah zones were not consistent, especially for vegetable consumption. The findings suggest that one of the key interventions to improve fruit and vegetable consumption could lie in improving distribution systems since their consumption is significantly higher in the Forest zone, where the production of fruit and vegetables is more developed than in the Savannah and Coastal zones. The findings relating to household wealth challenge conventional knowledge on fruit and vegetable consumption, and rather argue for equal consideration of spatial differences in critical health outcomes.

This paper examines contraceptive method use at different stages of the reproductive life course. Previous research on contraceptive practice in developed countries typically applies age as a proxy for reproductive history. While age is an essential and useful life course measure for understanding contraceptive use, investigations of contraceptive practice should also consider parity and fertility intentions, as they may be more accurate measures of reproductive life course stage. Analysis is based on data collected in the 2005 Household, Income and Labour Dynamics in Australia (HILDA) survey, a nationally representative sample of women of reproductive age (18–44). For women at risk of pregnancy, the most commonly used methods are easily reversed methods such as the oral contraceptive pill (30%) and condom (23%), medium-term methods such as the intrauterine device and implantation (5%) and permanent methods (7% tubal ligation and 9% vasectomy of partner). Logistic regression models are used to investigate the use of four popular contraceptive methods by parity, age and fertility intentions controlling for socio-demographic factors. The main findings indicate that the use of these methods varies substantially by the stage of a woman's reproductive life course: age, parity and fertility intentions are all associated with method use.

In a previous pilot project (Rosenzweig & Adelman, 1976) the sex choice attitudes of married couples with university (graduate school) education were explored. The present study extends this work by investigating the sex-choice attitudes of high school and partially college-educated subjects. Once again, the basic decision-making unit of husband and wife was sampled. Differences in sex preferences and sex-choice attitudes, based on the size of the marital family (no child, one child), were systematically explored. A greater effort was made to determine the effect of additional information regarding new methods of fetal sex determination, contraception, and related topics on sex-choice attitudes. Questionnaires were completed before and after information had been provided. Discussion was encouraged between husband and wife but discouraged with others. Results indicated that the exercise of sex choice is favoured by the majority of subjects across all three educational groups. Most individuals would employ sex control to ensure a balance of the sexes in a limited, two-child family. Little desire was shown to choose first child sex but active choice of a second child of opposite sex from the first appears a strong probability. Male preference, while pronounced, was a much weaker influence on the desire to make choices than the balance principle. Selective intercourse and a sex-choice pill were acceptable methods of sex control, but both artificial insemination and fetal sex determination combined with selective early abortion were rejected. Added information had a measurable but only slight effect on attitudes. Public education as to the possibilities of sex choice and control will be gradual and sex control will probably be selectively employed in the near future. But general use of such procedures is not imminent. Once put into practice, however, sex choice will create new marital problems that may require professional counselling.

The present paper examines the association between the type of household and maternal health in India using data from the National Family Health Survey 1998–99. The indicators of maternal health used in the analysis are contraceptive use, visit to obtain antenatal care in the first trimester, safe delivery and nutritional status of women measured in terms of body mass index (BMI). Binary and multinomial logistic regressions are used to establish associations. The type of household is coded into three categories, viz. nuclear household, joint household with in-laws and joint household without in-laws. The other independent variables used in the analysis are age, children ever born, work status, education of women, religion, caste, standard of living, exposure to mass media, women’s autonomy and presence of others at the time of interview. The findings clearly suggest that type of household is significantly associated with the utilization of the above-mentioned services that positively affect maternal health. Women in nuclear households are more likely to utilize these services compared with women in joint households. However, an association between type of household and BMI was not found.

The relationships between selected demographic and socioeconomic variables and current use status of contraception were examined using logistic regression technique. Information on current contraceptive use was provided by 3156 out of 4488 currently married women aged 15–49 interviewed in the 1988 Ghana Demographic and Health Survey. Respondents' approval of family planning emerged as the most important predictor of current contraceptive use, followed by discussion of family planning with partner and level of education. As a policy measure, information, education and communication programmes on family planning should be intensified, particularly in rural areas. Female education, at least up to secondary level, should be given top priority.

An experiment was designed to test the effect of a synthetic hypothetical human female pheromone on sexual behaviour. Sixty-two married couples participated for 3 menstrual months. No effect was found.

In the population of 242,633 draftees examined in the Copenhagen area for the period 1956–77, 1143 were extremely overweight. Compared to 2123 controls, selected at random from the remaining draftee population, the obese had a lower educational attainment, even at each level of intelligence test score. Conversely, at each educational level, the obese did not differ from the controls in intelligence test score. When taking into account, by regression analysis, both intelligence test score and parental social class, the chance for the obese of exceeding the educational level of minimum years of schooling followed by elementary trade training increased from 37% to only 52% of that for the controls. The results suggest that obesity, irrespective of social origin, is associated with poor educational attainment which may be responsible for the cognitive deficiency manifested in lower intelligence test scores.

The role of family health-seeking behaviour in under-five-year child mortality was explored through the combined approach of examining health-seeking behaviour regarding treatment generally, and in specific in relation to illness before death. A population-based case control study was carried out during the period 1993–1994 using 222 deaths from diarrhoea and acute respiratory illness (ARI) in children under five years of age in six slums of Karachi as cases, and 419 controls matched on age, disease (diarrhoea and ARI) and slum. Factors significantly associated (p<0·05) with child mortality in the multivariate analysis were: mothers changing healers quickly, using a traditional healer or an unqualified doctor and mothers to whom doctors did not explain the treatment, even when maternal education was controlled for. Seeking effective medical services is highly influential on whether the child survives or succumbs to ARI or diarrhoea. As mothers are the first providers of care, an attempt should be made to try and improve their skills through health education so that they can use simple and effective treatments for minor illnesses. They should also be taught to recognize potentially life-threatening conditions, to seek care early and to persist with treatment.

Malaria remains one of the main causes of mortality among young children in sub-Saharan Africa. In Nigeria traditional healers play an important role in health care delivery and the majority of the population depend on them for most of their ailments. The aim of this study was to investigate the perceptions of traditional healers regarding causes, symptoms, treatment of uncomplicated malaria and referral practices for severe malaria with a view to developing appropriate intervention strategies aimed at improving referral practices for severe malaria. A qualitative study was carried out in Ugwogo-Nike, a rural community in south-east Nigeria, which included in-depth interviews with 23 traditional healers. The traditional healers believed that the treatment of severe malaria, especially convulsions, with herbal remedies was very effective. Some traditional healers were familiar with the signs and symptoms of malaria, but malaria was perceived as an environmentally related disease caused by heat from the scorching sun. The majority of traditional healers believed that convulsions are inherited from parents, while a minority attributed them to evil spirits. Most (16/23) will not refer cases to a health facility because they believe in the efficacy of their herbal remedies. The few that did refer did so after several stages of traditional treatment, which resulted in long delays of about two weeks before appropriate treatment was received. The fact that traditional healers are important providers of treatment for severe malaria, especially convulsions, underlines the need to enlist their support in efforts to improve referral practices for severe malaria.