To examine the association of environmental factors (including housing) with respiratory infections and diarrhoea in children under 5 years of age, a cross-sectional study of 403 families was conducted in a squatter settlement of Karachi. In the 2-week period before the survey prevalence of diarrhoea and respiratory infections was 14·4% and 15·0% respectively. The factors significantly associated (p>0·05) with diarrhoea in households in the multivariate analysis were: number of children under 5, regular cleaning of sewers, storage of water in small utensils and cooking inside a one room house. Five households risk factors were identified for respiratory infections: the number of children under 5, poor housing structure, increased household density, humidity inside the house less than the humidity outside house, and frequent cooking inside the house. These results suggest that children under 5 years of age in lower income areas are at additional risk to health because of poor environmental conditions.

Scaling-up of skilled attendants and facility-based services is necessary for improving maternal and child care in developing countries but their effectiveness is crucially influenced by the uptake of such services. This study set out to establish the pattern and uptake of maternity services and associated factors against the backdrop of rapid urbanization in Nigeria. A cross-sectional study of socio-demographic and obstetric characteristics of mothers attending the Bacille Calmette-Guérin (BCG) immunization clinics in inner-city Lagos was conducted from July 2005 to December 2007, and their association with non-hospital delivery and use of unskilled attendants was determined by multiple logistic regression analyses. Of the 6465 participants, over half (51.4%) delivered outside hospital facilities and 81.8% of this group had no skilled attendants at delivery. Non-hospital delivery or the presence of unskilled attendants at delivery was associated with teenage mothers, Muslim religion, low or middle social class and use of herbal drugs in pregnancy. Additionally, non-hospital delivery was associated with ethnicity (Yoruba tribe), lack of tertiary education or full-time employment, accommodation with shared sanitation facilities and multiparity. The results suggest that availability of and access/proximity to hospital facilities or skilled attendants is no guarantee of uptake of maternity services. Efforts aimed at improving maternal and child health in developing countries should take cognisance of the socio-demographic and cultural underpinnings of maternal health-seeking behaviour of urban mothers beyond the provision of facility-based services or strengthening of the existing health care systems.

Negotiating safer sex among married women has been identified as an important determinant of vulnerability or resilience to new HIV infections. Using the Cambodia Demographic and Health Survey data of 2010, this paper examined negotiation for safer sex among 11,218 married women in the context of Cambodia's highly touted reduction in HIV/AIDS prevalence. The results from a complementary log-log regression model indicate that wealthier and highly educated married women were more likely to report that they can refuse sexual intercourse and ask their husbands to use a condom. Interestingly, while women who were fully involved in decision-making on their own health care were 19% more likely to refuse sex, they were 14% less likely to be able to ask their husbands to use a condom, compared with their counterparts who were not involved in this decision-making. Women who were partially involved in decision-making on family visits were 17% less likely to be able to ask their husbands to use a condom compared with those who were not involved. In this context, involvement in decision-making may have translated into trust and risk compensation. Those who believed in HIV transmission myths were less likely to negotiate safer sex relative to their counterparts who did not hold such myths to be true. Women's ability to negotiate for safer sex is, therefore, a function of their autonomy in terms of their full participation in decision-making in health care, household expenditure and mobility. Policy implications of the capacity of women to negotiate for safer sex are delineated.

This study examined the nature and correlates of child marriage in eight villages in climate-affected coastal Bangladesh using a mixed-methods approach: focus group discussions and in-depth qualitative interviews of female victims of child marriage as well as quantitative data collected using structured interviews of households. More than two-thirds of the qualitative survey respondents had encountered at least one event of natural disaster before marriage. Quantitative data confirmed significantly higher exposure to flood and river erosion among the coastal population. The quantitative data also suggested a positive association between shocks related to climate events and the incidence of child marriage, while the qualitative data indicated multiple themes related to the causes of child marriage, such as economic vulnerability, coping with risk and patriarchal norms. Yet the qualitative study respondents did not directly refer to natural disasters and climate changes when narrating their marital histories. The qualitative and quantitative evidence does not suggest that dowry-related factors are leading to early marriage. Rather, child marriage appears to be a coping strategy adopted by households in response to their increased vulnerability to natural disasters.

This study examined the secular changes in height, body weight, body mass index and pubertal development in male children and adolescents in Krakow (Poland) over the past 80 years, with an emphasis on the last decade (2000–2010). The survey of the population of Krakow is a continuation of observations conducted in that area for many years. The analysis aims to determine whether in the last decade Krakow still witnessed the secular trend, and what form the trend took. The body height and weight, and body mass index (BMI), of 1862 boys aged 3.5–18.5 years were analysed, against the background of a survey series from the years 1938 (N=1801), 1971 (N=2045), 1983 (N=3124) and 2000 (N=2328). The mean body height, in almost all age categories, was greater than in the past; however the final height over the last decade remained the same. The mean values of body weight and BMI increased, especially in the last decade. Also, an acceleration of puberty in boys was observed. The last 10 years saw an over 3-month decrease in the age of initial appearance of pubic hair in boys. In conclusion, the last decade saw cessation of the growing taller trend: maximum body height stabilized at approximately 179 cm, but weight and BMI increased. Also, a distinct acceleration of puberty was noticed. Lack of height increase, at the same time as weight gain and puberty acceleration, indicate a progressing developmental disharmony.

Who are the men and women who are single in their mid-30s? This study, which uses life history data for a British cohort born in 1946, shows that an important minority are ‘handicapped’ and these adults are cared for primarily by their families, in particular by elderly parents. Celibates tend to be more introverted, ambitious and to have older marrying parents than their ever-married peers. Single women differ from single men. The women are more likely to be of higher ability, to be graduates and to be in high status occupations whilst single men are more likely to be members of the lowest social class or unemployed. The great majority of single people live either with their parents or on their own.

Consanguineous marriage is traditionally common throughout the Eastern Mediterranean region, especially in the mainly Muslim countries. To date, there is little information on consanguinity in Yemen. The aim of this study was to ascertain the rate of consanguineous marriage and average coefficient of inbreeding in Sana’a City, Yemen. A population survey was conducted with the intention of covering married couples resident in Sana’a City by means of a multi-stage random sampling technique. A total of 1050 wives and husbands were interviewed on consanguinity in their households. The total incidence of consanguinity was 44·7% (95% CI 41·7–47·7%) with first-cousin marriages constituting 71·6% of the total consanguineous marriages and 32% of all marriages. Paternal parallel first cousins (Type I) accounted for 49% of first-cousin marriages. The average coefficient of inbreeding (F) was 0·02442. The incidence of consanguinity is relatively high in Yemen with predominantly first-cousin marriage. This might be related to the deeply rooted social and cultural beliefs in the country.

This study uses data from thirteen Demographic and Health Surveys to examine effects of female migration on fertility in African cities. Contrary to expectations, migration from villages and towns in the 1980s and 1990s reduced total fertility rates in African cities by about one birth, from an estimated average of 5·55 in the absence of migration to 4·59. New arrivals experience much lower fertility in their first few years in cities than long term residents of similar age and parity. This results from the initial unmarried status of most migrants, high levels of spousal separation among new arrivals who are married, dramatic increases in use of modern methods of contraception after 2 years in cities, and continuation of traditionally long durations of postpartum abstinence. Accomodation of additional migrants thus appears consistent with efforts to reduce fertility in cities. Moreover, prospects for increased contraceptive prevalencein Africa may depend heavily on changes in population distribution that influence the demand for children, specifically movement to cities.

This paper examines the impact of rural–urban migration on under-two mortality in India, using data from the 1992/93 Indian National Family Health Survey. Multilevel logistic models are fitted for mortality in three age groups: neonatal, early post-neonatal, and late post-neonatal and toddler. Migration status was not a significant determinant of mortality in any of the three age groups. Further analysis shows that a relationship between migration status and mortality exists when socioeconomic and health utilization variables are omitted from the models. The relationship between migration and mortality is thus explained by differences in socioeconomic status and use of health services between rural–urban migrant and non-migrant groups. The selectivity of rural–urban migrants on socioeconomic characteristics creates mortality differentials between rural–urban migrants and rural non-migrants. Problems faced by migrants in assimilating into urban societies create mortality differentials between rural–urban migrants and urban non-migrants. These results highlight the need to target migrants in the provision of health services, and demonstrate that rural areas continue to have the highest levels of infant–child mortality. Further research is needed to understand the health care needs of rural–urban migrants in order to inform the provision of appropriate health care.

Gender inequality is often cited as a barrier to improving women’s sexual and reproductive health outcomes, including contraceptive use, in low- and middle-income countries such as those in sub-Saharan Africa. To date there is limited, recent, evidence available regarding women’s empowerment, household status and contraceptive use in Ghana. The objective of this study was to investigate whether women’s empowerment and status in the household were associated with contraceptive use and unmet need for contraception using the 2014 Ghana Demographic and Health Survey. The study sample consisted of 1828 women aged 15–49. Women’s empowerment was measured based on two composite indexes created by the DHS: attitudes towards intimate partner violence and decision-making. Women’s status in the home was measured using indicators of work status, relationship to household head, control over monetary earnings and land ownership. Decision-making was found to be positively associated with contraceptive use and not having unmet need for contraception. Women who justified wife beating in one or more instances were less likely to use contraception, and more likely to have unmet need for contraception. Current or past employment and higher levels of male partner education were associated with contraceptive use. This study indicates that women’s empowerment and household status are influential for contraceptive indicators. Future interventions aimed at improving contraceptive uptake and use should promote women’s empowerment, i.e. decision-making, self-worth and education.

This study investigates the link between health-related variables and risks of divorce. The findings indicate that physical characteristics associated with poor health – namely, obesity and short stature – are not significantly related to risks of marital dissolution for either men or women. On the other hand, risk-taking behaviours – such as smoking and drug use – are strongly related to higher risks of divorce for both sexes. Overall, the results emphasize the need to accommodate health-related variables in the dominant economic and social psychological theories of marital dissolution.

Using a unique set of birth registration data from the Demographic Surveillance System of the International Centre for Diarrhoeal Disease Research, Bangladesh, for the period 1974–77, and socioeconomic information collected in the 1974 census, fertility was studied in relation to occupation, size of dwelling, number of cows and number of boats owned. The total fertility rate was found to vary between 6 and 6·5 except in the famine year of 1975. There was no consistent relationship between fertility and education of women. Fertility differentials by occupation showed that the household heads who were farm labourers had relatively lower fertility compared to other occupational groups, except for the year 1977 where the families of service holders were found to have relatively lower fertility. There was a consistent direct relationship between the dwelling size and fertility for each of the years.

Variations in sex ratio with maternal age, paternal age, parity and time have been examined in data on all legitimate births (live and stillbirths) in England and Wales, 1968–77. There were significant linear declines in sex ratio with both increasing parity and increasing paternal age, and a curvilinear relationship with maternal age. These effects were largely independent. Before 1955 it seems likely that sex ratio declined with increase in maternal age. But it seems that between 1955 and 1968 there was an unexplained decline in the sex ratio of births to women aged 20–24 and an increase in that of births to women aged 30–34. There was no significant secular trend in sex ratio during the period 1968–77.

This study compares the effects of two distinct forms of human capital – income and education – on marital status and childlessness separately by sex in six different countries. Nearly 10 million individual records on individuals aged 16 to 50 were used from censuses from Brazil, Mexico, Panama, South Africa, USA and Venezuela dating from 2000 or later, to analyse the relationship between education, income and marital status and childlessness in men and women. Regarding income, the findings for both outcome variables are strongly consistent across all six countries. Highest-income males and lower-income females have the highest proportion of ever-married and the lowest proportion of childlessness (using a proxy for childlessness: own children in the household or not). There is no corresponding consistency of findings as regards education either between the sexes or among the countries. To conclude, a lower percentage of low-income men are selected by females, because for women male status and resources provided by men are important criteria in mate selection. Therefore a higher proportion of low-income men remain unmarried and childless. Thus selection seems to play a role in modern societies.

In 1984 and 1985, a survey was conducted of 7696 women aged 15–44 living in Italy, France, Great Britain, Spain and the Federal Republic of Germany. The aim of the study was to examine the use of contraceptive methods, the differences in contraceptive use, knowledge of fertility, communication about contraception, motives for choice and the perceptions held by women regarding contraceptive methods, particularly oral contraception. The results show important differences between the countries studied.

The purpose of this study was to investigate whether the well-established relationship between parity and birth weight is affected by the sex composition of siblings, especially for male newborns. Subjects were 856 male and 862 female newborns who weighed at least 2500 g at birth, who were born after 37 completed weeks of gestation, who obtained an Apgar score of 7 or higher, who had the same biological parents as all other children in the sibship, and who lived in the same household. Information on birth weight was collected from hospital records. Results showed that male newborns with older brothers weighed less than male newborns with older sisters. In contrast, the weight of female newborns with older brothers did not differ from the weight of female newborns with older sisters. One explanation of these results is that maternal immunoreactivity to some male-specific feature of the fetus affects prenatal development and consequently reduces birth weight in males. The relation between older brothers and birth weight may have theoretical significance for behavioural variables.

The effects of socioeconomic factors on secular trends in suicide rates in Japan for the periods 1953–72 and 1973–86 were investigated using twelve socioeconomic indicators. Multiple regression analysis showed that the socioeconomic indicators affecting suicide rates were not identical in the two periods. The rates in both sexes in 1953–72 were closely related to unemployment rate and the labour force but between 1973 and 1986, divorce rate and the proportion in tertiary industry were most influential. The changes reflect the socioeconomic changes in industrial structure in Japan in transition from an industrial to a service economy.

Do girls fall in love with an image of their father? This study tested the hypothesis that, in choosing a partner, people tend to replicate the physical and mental attributes of their opposite-sex parent more than of the same-sex parent. A sample of 314 women, mostly in their late teens and describing themselves as ‘in love’, supplied details of their boyfriends and parents. A tendency for the boyfriend's eye colour to match that of the father more than of the mother was found, as well as a tendency for girls to replicate the age and dominance relationships of the parental partnership in their own relationship. These effects were very small and of marginal significance.

This was a cross-sectional study carried out on 462 pregnant women attending antenatal care in Ibadan, Nigeria. The study's aims were to assess the level of participation of Nigerian men in pregnancy and birth, the attitude of the women and likely targets for improved care delivery. Three hundred and forty-nine women (75.5%) were aware that husbands could participate in childbirth. Most women did not think it was their husbands' place to attend antenatal clinic (48.3%) or counselling sessions (56.7%). Nearly all husbands (97.4%) encouraged their wives to attend antenatal clinic – paying antenatal service bills (96.5%), paying for transport to the clinic (94.6%) and reminding them of their clinic visits (83.3%). Three hundred and thirty-five husbands (72.5%) accompanied their wives to the hospital for their last delivery, while 63.9% were present at last delivery. More-educated women were less likely to be accompanied to the antenatal clinic, while more-educated men were likely to accompany their wives. Yoruba husbands were less likely to accompany their wives, but Yoruba wives with non-Yoruba husbands were 12 times more likely to be accompanied. Women in the rural centre were less likely to receive help with household chores from their husbands during pregnancy, while educated women were more likely to benefit from this. Monogamous unions and increasing level of husbands' education were associated with spousal presence at delivery. It appears that male participation is satisfactory in some aspects, but increased attendance at antenatal services and delivery would be desirable.