A contraceptive study of rural Bangladeshi women indicated that the previous death of children, number of living children, desire for additional children and son preference were important determinants of contraceptive continuation. The importance of these factors varies to some extent with use of different contraceptive methods.

Indirect estimates of maternal mortality in India indicate that fertility decline has reduced maternal deaths by reducing the frequency of pregnancy and childbirth. The earlier stages of fertility decline are also likely to have lowered maternal mortality by reducing the risk of pregnancy and childbirth as the proportion of births among risky multiparous, older women declines. However, further fertility decline may well be associated with some increase in risk. Risk will also remain high if the health status of Indian girls and women remains poor. This study uses a sample of maternal deaths and deliveries among patients who survived which occurred in Civil Hospital, Ahmedabad, Gujarat during 1982–1993 to investigate these issues further. The women in the sample have relatively low fertility and represent a fairly late stage of fertility decline. They also have persistently poor health status. Logit regression analysis reveals that although fertility decline is associated with some increase in risk, poor health status is the more important maternal mortality risk factor. Without attention to female health, even childbearing among expectant mothers with low fertility continues to be hazardous.

Using data from India’s first (1992–93) and third (2005–06) National Family Health Surveys (NFHS-I and NFHS-III) this study examined the fertility differentials between major social groups and the extent to which these varied between states and over time. The analysis was based on a sample of 54,030 and 55,369 currently married women aged 15–34 in the NFHS-I and NFHS-III respectively. Reported parity and desired family size were used to assess variations in fertility behaviour. The results show that interstate variation in childbearing patterns within social groups was at least as high as, if not higher than, variation between states (net of other influences) in both periods, 1992–93 and 2005–06. The variations among Hindus, the poor and Muslims were more noticeable than for other groups. These variations did not decline between 1992–93 and 2005–06 and may have even increased slightly for some groups. Further, there was no consistent north–south divide in either fertility behaviour or desired family size. Together, these results may point to the gradual disappearance of the influences that were once unique to southern or northern India, and the simultaneous emergence of social, political, economic and cultural forces that are pan-Indian in their reach.

Mongolian fertility decline has received only limited analysis in the demographic literature. Using the 2003 Reproductive Health Survey of Mongolia the classical proximate determinants of fertility framework proposed by Bongaarts is applied here in order to analyse which factors shape period fertility. The results indicate that the fertility-inhibiting effect of contraception contributed to reduce period fertility by 54.2% from its theoretical maximum, while induced abortion accounted for only 6.1% of the reduction in fertility. Compared with previous studies made in the early 1990s, these results show that important changes in the control of reproduction took place in Mongolia during the fertility transition. In order to assess the changes implied by the transition to democracy and market economy, the proximate determinants of fertility are estimated for the year 1994. The results show that the importance of induced abortion in the determination of fertility level has reduced and that the use of modern contraception has increased progressively and contributed most in determining fertility level in 2003.

This paper presents information on the opportunity for genetic drift in La Alpujarra, a rural population of the Spanish Mediterranean. This region is characterized by its historical isolation. The analyses were based on a survey of 45% of the population. The Effective Population Size (NE=1986), the Effective Migration Rate (ME=12.4) and the Coefficient of Breeding Isolation (CBI=246.2) of Lasker & Kaplan (1964) were calculated. The value of the latter index indicates that genetic drift in the Alpujarrenian population is negligible at present because of the cessation of reproductive isolation due to the development of communication networks.

Tubal ligation is the modal form of family planning among American women aged 30 and older. As the preference for tubal ligation over cheaper, lower risk and more reliable methods, such as vasectomy, has puzzled experts, a theoretical approach that explains this preference would be useful. The present study investigates the high prevalence of voluntary sterilization among American women from the perspective of life history theory, arguing that the trade-offs between investing in current and future offspring will favour tubal ligation when women cannot obtain reliable male commitment to future parental investment. Data came from the National Survey of Fertility Barriers (NSFB), a nationally representative survey of 4712 American women aged 25–45 conducted between 2004 and 2007. Four novel predictions of the prevalence of tubal ligation, drawn from life history theory, were developed and tested: 1) it is most common among unpartnered women with children, and least common among married women with children; 2) it is negatively correlated with age at first birth; 3) it is least common among highly educated women without children, and most common among less educated women with children; and 4) among women with two or more children, it is positively correlated with lifetime number of long-term partners. These predictions were tested using multivariate regression analysis. The first prediction was not supported: women with children were more likely to be sterilized, regardless of their marital status. The other three predictions were all supported by the data. The results suggest that trade-offs influence women’s decisions to undergo voluntary sterilization. Women are most likely to opt for tubal ligation when the costs of an additional child will impinge on their ability to invest in existing offspring, especially in the context of reduced male commitment.

This paper reports findings of a pilot survey of adolescent sexual and reproductive health (ASRH) knowledge and behaviour in Homabay County of western Kenya. The study was based on a cross-sectional survey of 523 male and female adolescents aged 10–19 years from 32 Community Health Units (CHUs). Bivariate analysis of gender differences and associations between ASRH knowledge and behaviour was followed with two-level logistic regression analysis of predictors of ASRH behaviour (sexual activity, unprotected sex, HIV testing), taking individual adolescents as level-1 and CHUs as level-2. The findings reveal important gender differences in ASRH knowledge and behaviour. While male adolescents reported higher sexual activity (ever had sex, unprotected last sex), female adolescents reported higher HIV testing. Despite having lower HIV/AIDS knowledge, female adolescents were more likely to translate their SRH knowledge into appropriate behaviour. Education emerged as an important predictor of ASRH behaviour. Out-of-school adolescents had significantly higher odds of having ever had sex (aOR=3.3) or unprotected last sex (aOR=3.2) than their in-school counterparts of the same age, gender and ASRH knowledge, while those with at least secondary education had lower odds of unprotected sex (aOR=0.52) and higher odds of HIV testing (aOR=5.49) than their counterparts of the same age, gender and SRH knowledge who had primary education or lower. However, being out of school was associated with higher HIV testing (aOR=2.3); and there was no evidence of significant differences between younger (aged 10–14) and older (aged 15–19) adolescents in SRH knowledge and behaviour. Besides individual-level predictors, there were significant community variations in ASRH knowledge and behaviour, with relatively more-deprived CHUs being associated with poorer indicators. The overall findings have important policy/programme implications. There is a need for a comprehensive approach that engages schools, health providers, peers, parents/adults and the wider community in developing age-appropriate ASRH interventions for both in-school and out-of-school adolescents in western Kenya.

The interval between successive pregnancies (birth interval) is one of the main indexes used to evaluate the health of a mother and her child. This study evaluated birth intervals in Iran using data from the Iranian Multiple Indicators Demographic and Health Survey (IrMIDHS) conducted in 2010–2011. A total of 20,093 married Iranian women aged 15–54 years from the whole country constituted the study sample. Based on the nature of sampling and the unobserved population heterogeneity for birth intervals in each city and province, a multilevel survival frailty model was applied. Data were analysed for women’s first three birth intervals. The median first and second birth intervals were 30.3 and 39.7 months respectively. Higher education, Caesarean delivery, contraceptive use and exposure to public mass media were found to decrease the hazard rate ratio (HRR) of giving birth. Meanwhile, higher monthly income increased the hazard of giving birth. The results suggest that public mass media can play an effective role in encouraging women to have the recommended birth interval. Furthermore, increasing family income could encourage Iranian couples to decrease the time to their next birth.

This paper examines the background to the recent growth in the number of remarriages of the divorced, tracing the increasing trend in divorce and subsequent remarriage in the last decade. The characteristics of such remarriages are analysed: their manner of solemnization, the distribution of ages at remarriage, seasonal variations, and the differences between metropolitan and non-metropolitan areas. Finally, the topical issue of remarriage of the divorced in church is discussed from a statistical standpoint, and variations by county presented in the form of maps.

Neonatal mortality is one of the leading causes of under-five mortality globally, with the majority of these deaths occurring in low- and middle-income countries. In Ghana, there is a belief in an array of newborn conditions, called Asram, that are thought to have a spiritual, rather than physical, cause. These conditions are predominantly managed by traditional healers as they are considered unable to be treated by allopathic medical providers. Through a series of semi-structured qualitative interviews of medical providers in Kumasi, Ghana, conducted in July–August 2018, this study sought to elucidate perspectives of allopathic medical providers about Asram, including the perceived implications of traditional newborn care patterns on newborn health and higher-level neonatal care. Twenty health care providers participated and represented a tertiary care hospital and a district hospital. Medical providers were universally aware of Asram but varied on the latitude they gave this belief system within the arena of newborn care. Some providers rationalized the existence of Asram in the backdrop of high neonatal mortality rates and long-standing belief systems. Others highlighted their frustration with Asram, citing delays in care and complications due to traditional medical treatments. Providers utilized varying approaches to bridge culture gaps with families in their care and emphasized the importance of open communication with the shared goal of improved newborn health and survival. This study describes the importance of providers being aware of socio-cultural constructs within which pregnant women operate and suggests a focus on the shared goal of timely and effective newborn care in Ghana.

Marital isonymy is frequently used to estimate inbreeding and the repeated pairs method is useful to investigate whether the population under examination has subdivisions. These methods can also be applied to registers, such as population censuses, where both spouses' surnames are noted. In this paper, the 1795 census for Córdoba province is analysed. Numerically speaking, Spanish and mixed-race people are the major ethno-social groups in the register. In order to estimate inbreeding, the isonymic method was applied to both groups, at provincial and at parish level. To appreciate to what extent the parishes were genetically isolated, Wright's Fst was also calculated. The repeated pairs method was also used for both groups to assess if population subdivision existed in the units under study. Finally, to evaluate whether the subdivision based on surnames reflected the ethno-social stratification, the same method was used considering the two groups together. At the provincial scale, both groups displayed low inbreeding and micro-differentiation, although the former was higher for the Spanish and the latter for mixed-race groups, which could indicate a more marked conjugal selectivity in the Spanish. At the parish scale, preferences for isonymic spouses were not pronounced either in Spanish or in mixed-race groups; in the Spanish group population subdivision prevailed, with the opposite occurring in the mixed-race group. The estimations from repeated pairs, taking the two groups together, indicated that for the studied populations the surnames do not allow the two groups to be differentiated into isolated reproductive units.

This study investigates regional variations in the factors associated with acceptance and actual experience of intimate partner violence (IPV) among married women in northern and southern Nigeria - two regions with distinct socio-cultural and economic differences. Data from the 2018 demographic and health survey are analysed to compare these two regions. The sample comprised married/living-with-partner women within the reproductive age of 15-49. Overall, a positive association exists between IPV experience and IPV acceptance, regardless of which is used as the outcome variable. Contrary to the notion that IPV is prevalent where its acceptance is high, this study finds that the reverse is true. IPV acceptance is significantly higher in the north than in the south (39.4% versus 14.7%), but the reverse is the case for the actual experience of IPV (20.1% versus 24.7%). Being employed and having access to the internet reduce the odds of IPV victimisation for women in the south, but increases the chances for northern women. Muslims in the north have significantly higher odds of IPV acceptance than their Christian counterparts in the same region, but the reverse is the case in the south. Regional differences also exist in the influence of decision-making, educational difference between spouses, and media exposure. While the cosmopolitan-success and conservative-failure hypothesis explains the regional differences in the acceptance of IPV, it fails to explain differences in the actual experience of IPV. The study provides alternative explanations for the regional differences in the experience of IPV and acceptance of it in Nigeria, and it points to the need for differing intervention programmes across regions. Notably, the study found that the association between justification of IPV and actual experience of it is bi-directional and suggests caution in making causal inferences.

The high prevalence of chronic diseases in urban slums poses increasing challenges to future social and economic development for these disadvantaged areas. Assessing the health status of slum residents offers guidance for formulating appropriate policies and interventions to improve slum residents’ health outcomes. This research aimed to identify the social determinants of chronic diseases reporting among slum dwellers in Egypt. A cross-sectional survey was conducted from March to December 2021 in three slum areas in Giza governorate, Egypt, including 3,500 individuals. We constructed an asset index and a welfare index to measure the economic status and living conditions of slum residents, respectively. We used these indices, along with demographic and socio-economic factors, as independent variables in the analysis. We modeled factors associated with health status using a two-level mixed logistic model to control the effects of slum areas and the potential correlation between household members. The study contributed significantly to a better understanding of the context in which slum dwellers live and the interlinkages among poor living conditions, low economic status, and health outcomes. The results showed a high rate of self-reported chronic diseases among adults aged 18 and older, reaching more than 22%, while it did not exceed 2.0% among children in the slum areas. Therefore, measuring the determinants of chronic diseases was limited to adults. The sample size was 2530 adults after excluding 970 children. The prevalence of chronic diseases among adults ranged between 16.3% in Zenin and 22.6% in Bein El Sarayat. Our findings indicated that low socio-economic status was significantly associated with reporting chronic diseases. Future policies should be dedicated to improving living conditions and providing necessary healthcare services for these vulnerable areas.

Consistency in reporting contraceptive use between spouses is little understood, especially in developing settings. This research challenges the accuracy of measuring contraceptive prevalence rate, which is traditionally calculated based on women's responses. Multinomial logistic regression techniques are employed on a couple dataset from the 1999–2000 Bangladesh Demographic and Health Survey (DHS) to investigate the consistency in reporting condom use between husbands and wives. The level of inconsistency in reporting condom use was about 46%, of which about 32% was explained by husbands reporting condom use while wives did not, and 14% by wives reporting condom use while husbands did not. Regression analysis showed that couple education and age difference between the spouses are significant determinants of inconsistent reporting behaviour. The findings suggest the need for alternative approaches (questions) in the DHS to ensure consistency in the collection of data related to use of family planning methods.

Persons with mental illnesses may experience stigma from their immediate family members in addition to other forms of stigma. Using semi-structured interviews, we investigated experiences of familial mental illness stigma among 15 people diagnosed with mental illnesses in a mid-sized city in Canada. We identified five themes that speak to participants’ experiences of familial mental illness stigma and ways to reduce it. The themes include the following: diagnosis as a ‘double-edged sword,’ potential familial isolation, familial stigma as societal stigma localized, stories of acceptance, and confronting potential familial mental illness stigma. Participants’ narratives indicate that familial mental illness stigma is rooted in the broader social or public stigma, which sees its way into familial relations as well. This stigma takes various forms, including relationship bias or unfair treatment, breakdown in romantic relationships, loss of status, verbal and emotional abuse, exclusion from decision-making, and alienation within their immediate and extended families. Familial mental illness stigma experiences negatively impact participant’s psychological well-being and personal empowerment. However, participants also shared ways that family members create supportive environments or actively confront or prevent stigma. Overall, this study has contributed to knowledge on mental illness stigma, particularly familial mental illness stigma from the perspective of participants living with a mental illness in a high-income country. Suggestions for future research include a focus on strategies to prevent ongoing familial mental illness stigma and large-scale studies to explore familial mental illness stigma to understand why families might perpetrate stigma.

‘From a black perspective…the notion that a black (who passes for white) might reclaim his ethnic identity to take advantage of preferential admissions can only trigger an almost inexpressible sense of outrage.’ (Livingston, 1979)

‘Turning an elephant loose in a crowd offers everyone, except the beast and his rider, equal opportunities of being trampled.’ (Tawney, 1931)

Although the face is one of the most variable parts of the human physique, there is little recent work on this region. Consequently, there is a need for an appraisal of the variation, new thinking as regards the methodology of recording and analysis, and further thought as to the possible applications of such methods. The present exploratory study uses information derived from standardized photographs, to try to elucidate the affinities—and thus the population history—of the people of Tristan da Cunha and the Ainu of Japan. The methods used have also permitted a consideration of within-group variation from the point of view of family differences and varying degrees of admixture. The potential biosocial as well as anthropological value of this type of investigation is discussed.

In a pilot survey about family size and the use of contraception for which the sample was the parents of legitimate babies the interviews with fathers were systematically divided between men and women interviewers. There was no difference in the response rate of the two groups and although there were some differences in the types of answers given to certain questions most of the differences might have occurred by chance. We could not see any clear pattern in the sorts of response that varied.

A hypothesis about the variation was put forward by some of our advisers and we collected some further information about this which did not support the hypothesis. On the basis of this study we do not feel it necessary to recruit and train men to interview the fathers on the main study but are using women interviewers for both mothers and fathers.