A study of employment during pregnancy and its effects was carried out among pregnant women who were under the care of the Community Health Center, Hadassah Medical School, in a neighbourhood of West Jerusalem. Of the women, 46−2% worked during pregnancy, and 78−6% of them were in occupations which demanded light physical activity. Most of the women worked throughout the whole pregnancy. Educational level as well as parity emerged as the main factors in determining whether a pregnant woman worked or not. No significant effects of employment were found in pregnancy complications or length of gestation, but significant differences did emerge in the number of delivery abnormalities. This finding is interpreted as the result of the interaction of several social conditions rather than of work itself. The findings support the hypothesis that work by itself does not affect either pregnancy or its outcome (as measured by birth weight).

This paper reports the results of a June 1980 survey of 1069 children in Changsha, Hunan Province. The data have been unavailable previously either in Chinese or in English. In general, they suggest that comparisons of single children with children from multiple-child families in China regarding quality of life, intellectual development, and behavioural traits are similar to comparisons conducted in the United States and other western countries. As in many western studies, single children in China appear to have a better quality of life than children with siblings. Regarding intellectual development, single children in China perform better than those with siblings, a finding which is consonant with the family intactness model of Falbo. Single children in Changsha are little different from ones from multiple-child families on various aspects of behaviour, and are more co-operative and less hostile. These findings are the opposite of those of the Shanghai study, the other major analysis of single children in China; the Shanghai survey indicated that single children were not as well-behaved as those with siblings, a finding that caused some concern among Chinese social scientists. To the extent that the findings of the Changsha study, and not those of the Shanghai study, reflect the situation of single children in China, this could mean that the one-child family planning campaign may not be having a negative impact on children's behaviour.

Analysis of data on 106,848 marriages in the cities of Bangalore and Mysore, South India, between 1980 and 1989 showed that levels of consanguineous marriage varied between cities through time and by religion. The average coefficient of inbreeding was higher in Bangalore (F = 0·0339) than in Mysore (F = 0·0203), principally reflecting large-scale, post-Independence rural migration into Bangalore. Although there was some evidence of a decline in consanguineous marriages in Mysore, there was no convincing support in either city for earlier projections of a rapid reduction in the popularity of unions between close biological relatives.

Seasonal or monthly fluctuations in suicides and homicides were analysed using US mortality data for the years 1969–78, using periodic regression analysis. The results were generally consistent (year-to-year) over the 10-year period. The pattern for suicide was distinctly seasonal: it was above average all spring and below average all winter. For homicides, the pattern was more monthly, with July–September and December being above average times and January–June being below average.

The primary objective of this report is to use data from a study of infant growth and weaning practices in Kathmandu, Nepal, to investigate universal recommendations about exclusive breast-feeding up to 6 months postpartum. A secondary objective is to demonstrate the complexity of the biocultural nature of infant feeding practices. A sample of 283 children under 5 years of age and their 228 mothers living in a peri-urban district of Kathmandu participated in this study. The children’s height/length and weight were measured three times over 9 months. At each session, a demographic, child health and infant feeding survey was administered; between sessions, in-depth interviews were conducted with mothers regarding infant feeding practices. While a few of the infants under 2 months were receiving non-breast milk foods, at 3 months of age half of the sample had been introduced to non-breast milk foods and by 7 months all infants were eating non-breast milk foods. A comparison of growth indices and velocities between exclusively and partially breast-fed infants from birth to 7 months of age shows no evidence for a difference in nutritional status between the two groups. Although there are cultural rules about breast-feeding that vary by ethnic group, all mothers followed a feeding method that depended on their assessment of whether the child was getting enough breast milk. The conclusion is that exclusive breast-feeding up to 6 months may not be appropriate for all infants. In this sample, breast-feeding duration is not shortened by the early introduction of non-breast milk foods, as the median age of breast-feeding cessation is 36 months. One of the main reasons for severance was the onset of another pregnancy. Investigation of infant feeding practices must be contextualized in the local ecology of the population. While cultural beliefs about breast-feeding are relevant, mothers’ individual assessments of their children’s nutritional needs and demographic events in parents’ lives must also be considered.

The relationship between sleep habits and psychosomatic health complaints was investigated by a questionnaire study in 148 bank workers in Tokyo. Daily bedtime was more flexible than daily rising time, and both mean bedtime and rising time tended to be earlier with increasing age. Multiple logistic regression analysis showed that psychosomatic health complaints of sleep disturbances, fatigue, digestive troubles, and depressive mood were significantly associated with sleep habits and perceived mental stress.

The existence of very low rates of fertility among non-contracepting human populations has intrigued researchers in demography and reproductive ecology. Long inter-birth intervals, driven primarily by the lactational amenorrhoea associated with breast-feeding, have been shown to be important determinants of low natural fertility in several populations. Other reports have suggested that sterility brought about by sexually transmitted diseases (STDs) might also explain low fertility in some populations, especially in Africa. This report presents an analysis of 1981 Indian census data that documents low natural fertility in Ladakh, a high-altitude region of the Himalaya in north India. In Ladakh, there is evidence for low rates of marriage among women that may be attributable to the practice of polyandry, but also high rates of primary and secondary sterility within marriage, resulting in low completed parities for post-reproductive age married women. Age-specific fertility rates derived from the number of current births are also unexpectedly low. Hypotheses to explain very low fertility in Ladakh are considered from among the likely proximate determinants and evaluated using two supplementary sources of information derived from fieldwork in Ladakh in the early 1990s. The most likely explanations for low marital fertility include sterility from STDs, high rates of fetal loss, and possibly nutritional contraints on ovarian hormone status.

Substantial numbers of married women use contraceptives without their partner’s knowledge in sub-Saharan Africa, but studies of female covert use across time are rare. This study investigates the levels, trends and correlates of covert use in nine countries and determines which contraceptive methods are more frequently used covertly by women. Data from monogamous couples in Demographic and Health Surveys were used from nine sub-Saharan African countries that had experienced an increase of 10 percentage points in current modern contraceptive use between an earlier (1991–2004) and later (2007–2011) survey. Covert use was indirectly estimated as the percentage of women who reported a female modern method whose husband did not report a modern method. The percentage of women using covertly increased in eight of the countries studied (significantly in three of them), yet when comparing across countries cross-sectionally, covert use was lower where contraceptive prevalence was higher. In general, women with more years of schooling and those with larger spousal schooling gaps had lower odds of covert use. There was no significant difference between covert and open injectable use, though more than half of both groups used this method in the later surveys. Encouraging couple communication about contraception, where the woman feels it is safe to do so, could be an important strategy to minimize covert use. Further research is needed to better identify the contraceptive prevalence and social context in which covert use declines within a country.

Intimate partner violence is widespread worldwide. While assumed to impact women’s ability to use contraceptive methods, few data are available to support this claim. In this study, eight focus group discussions were conducted to guide questionnaire development and to provide contextual information. Participants were women who were currently using the pill and women who had used the pill previously. In addition, 300 women were interviewed who initiated oral contraceptive pill use between December 1995 and April 1996. Participants were interviewed 3–6 months later to investigate the role intimate partner violence played in covert pill use and pill discontinuation. Special study procedures for asking women questions about violence were employed. Nineteen per cent of the women interviewed were using the pill covertly. The odds of covert pill use were four times higher in El Alto and La Paz than in Santa Cruz. Women who used the pill covertly were more likely to have experienced method-related partner violence (OR=21.27) than women whose partners knew of their pill use. One-third of the women had discontinued pill use at the time of the interview. In the final multivariate analysis, having experienced side-effects (OR=2.37) was a significant predictor of pill discontinuation and method-related partner violence was marginally predictive (OR=1.91; 95% CI 1.0–3.66). While efforts are ongoing to incorporate men into family planning programmes, some male partners oppose, and in some situations violently oppose, contraceptive use. The needs of women with these types of partners must not be overlooked.

A sample of 842 rural women from Morocco (Amizmiz, Marrakech) was used to examine the relationship between a number of biosocial variables and fertility patterns. For women still in their reproductive years there were significant correlations between family size and woman's age, age at marriage and years of marriage. Among women with completed families, those with early age at marriage ceased childbearing about 10 years before reaching menopause, while women who married later continued to bear children until the end of their fertile life.

India is the highest contributor to child anaemia among developing countries. To see the latest picture of child anaemia in India, data for 6- to 59-month-old children were taken from the fourth round of the National Family Health Survey conducted in 2015–16 (NFHS-4). The study sample consisted of 1,37,347 children. The dependent variable was the anaemia status of the child. The objectives of the study were to assess (i) the distribution of anaemia prevalence by child age group, (ii) the prevalence of child anaemia by zone and state and (iii) the relation of child anaemia prevalence with social, demographic and economic variables, including maternal nutritional status and low birth weight. The study found that in India in 2015–16, 56% of 6- to 59-month-old children were anaemic – a decrease of only 13.5 percentage points since the NFHS-3 study conducted in 2005–06. It is well known that iron supplementation is necessary for child growth and brain development. This study suggests that, in addition, the socioeconomic conditions of households in India need to be improved to prevent child anaemia. Low birth weight and low maternal nutritional status are also responsible for the high prevalence of anaemia among children in India.

The latest National Family Health Survey conducted in 2015–16 (NFHS-4) showed that malnutrition and anaemia still pose huge health challenges in India. Data on 651,642 adult non-pregnant women aged 15–49 years were taken from the survey to study the nutritional and anaemia statuses of adult women by Indian zone and state. The relationships of these two variables with the women’s urban/rural place of residence, education level, religion and eating habits, and wealth index of the family, were assessed. Body Mass Index (BMI) and haemoglobin level were used to assess nutritional status and level of anaemia, respectively. The results show that in 2015–16 in India the percentages of underweight and obese/overweight people were 22.4% and 18.4%, respectively. The percentages of undernutrition and overnutrition were more or less same. The percentage of underweight people was higher in the middle belt region of India. Zones with high levels of overweight or obesity were concentrated in the West, North and South zones. A comparison of the two national-level data sets, i.e. NFHS-4 and NFHS-3, showed that the prevalences of undernutrition and anaemia reduced by 13 and 5 percentage points, respectively, from NFHS-3 to NFHS 4, i.e. over the 10-year period from 2004–05 to 2015–16, whereas overnutrition increased by 4 percentage points during this period. Analysis of possible socio-demographic factors and eating habits thought to influence underweight, obesity and anaemia revealed substantive causal relations. More specifically, education and eating habit were found to influence underweight, overweight or obesity and anaemia significantly. The nutritional status of a woman was also found to depend on household income.

One hundred and fifty-two randomly selected pregnant women were examined and followed up by interviews and psychological tests during pregnancy and after parturition. The present paper is focused upon factors which determine the woman's preference for the sex of her expected child. It was shown that women who already have one or more children generally wanted the expected child to be of the opposite sex to her youngest child. Thus, the main part of the study was limited to eighty-one nulliparous women.

Associations were found between the woman's preference for the sex of the child and several factors such as the sex of her own siblings and her position among them, her education, intelligence and degree of field-dependence indicating immaturity and lack of autonomy.

Several of the findings presented refute the common supposition that nulliparous women generally want to give birth to a son, and that the arrival of a son is more satisfactory. Women wishing for a son were found to be somewhat more field-dependent than other women and somewhat more often reported that they had experienced a range of mental symptoms before the current pregnancy. Women wishing for a boy also reported more mental symptoms during the post-partum period. Moreover, those women who gave birth to a son reperted more symptoms at this time than those who gave birth to a daughter, and paradoxically the most affected were those who had wished for a son and had had their wishes fulfilled. The arrival of a daughter therefore seems to be equally satisfactory to the mother, at least as measured by the criteria used in this investigation.

The prevalence of preferential patrilateral parallel cousin marriage is recognized as a specific trait of the Arabs and their immediate Muslim neighbours. Most earlier studies have been of localized groups, villages or nomadic camps and, despite the urbanization and industrialization occurring in the Middle East, no recent data from urban contexts have been examined. In this paper the genealogical ties between spouses are analysed in a sample of 750 recently married couples from the city of Beirut. Consanguineous marriages are frequent, mainly first-cousin marriages. However, the classical predominance of patrilateral parallel cousin marriage is no longer evident in the most recent generation, which displays an equal preference for all types of cousin marriage. Hence, whereas endogamy persists in this town, its manifestation may well be changing.

This paper addresses the overall performance and inequalities in the immunization of children in Vietnam. Descriptive and logistic analysis of cross-national demographic and health data was used to examine inequality in immunization, identify the most vulnerable groups in immunization coverage, and identify the gap in coverage between hard-to-access people and the remainder of the population. The gap in the coverage was found to occur primarily in vulnerable groups such as the poor minority or poor rural children. No evidence was found of a difference in immunization coverage because of sex or birth order. However, the age of children showed a significant influence on the rate of immunization. Mother’s education and regular watching of television had a significant influence on child immunization. In order to improve child immunization coverage in Vietnam, efforts should be concentrated on poor children from minority groups and those living in rural areas, especially remote ones. Community development, investment for immunization and re-organization of immunization services at the grassroots level are also key factors to remove the barriers to immunization for vulnerable populations in Vietnam.

Based on evolutionary reasoning, Trivers & Willard (1973) predicted status-biased sex composition and parental investment with son-preferencing effects in higher, and daughter-preferencing effects in lower status groups. Previous research shows mixed results. This study uses event-history methods and Swedish register data to study one possible mechanism in isolation: do parents in different status groups vary in their proclivities to continue fertility based on the sex composition of previous offspring? The results show no support for the Trivers–Willard hypothesis on a wide range of different status indicators. Future research on the stated hypothesis should focus on physiological rather than behavioural mechanisms.

In the Terai region, despite its ecological richness, the people have long suffered from a deficiency of micronutrients such as vitamin A, iron and zinc. The aim of this study was to investigate dietary and nutritional intakes among people in the Terai region of Nepal. The results were compared by sex and ethnicity. Food consumption surveys (one-day weighed records) were conducted among 114 people (55 Mushar and 59 Tharu). Nutritional intakes were calculated using Nepali food composition and other tables. The diet in the Terai region was characterized by a large amount of rice consumed with a tiny amount of curry or dal as a side dish. Intakes of vitamin A, iron, riboflavin and selenium were less than 50% of the recommended daily allowance irrespective of ethnicity or sex (with the exception of iron intake among Tharu males). Intakes of thiamine, riboflavin, niacin, phosphorus and zinc were higher among the Tharu than the Mushar, while intakes of selenium and iodine were higher among the Mushar than the Tharu. The nutritional significance of these differences was slight. Protein intake (per kg body weight) was lower in females than in males, while the energy-adjusted micronutrient intakes did not differ by sex. Intakes of vitamin A, iron, riboflavin and selenium were deficient among the participants. Intervention projects such as the introduction of kitchen gardens or fish farming may be effective, but will increase the degree of inequality between the two ethnic groups.

Early sexual debut is of major concern because it is a correlate for health and economic shocks experienced in adulthood. In South Africa, this concern has provided impetus for research directed at the HIV and AIDS epidemic, teenage pregnancy and the effect of adolescent sexual behaviour on persistence in school. Of interest to the present study is high school completion, which is a well-established empirical barometer of adult socioeconomic opportunities. Using data from the five waves of the Cape Area Panel Study (CAPS), this paper examines the association between sexual behaviours initiated in pre- and early adolescence and high school completion rates. The CAPS study is a longitudinal survey that was designed to investigate young people’s (aged 14–22 years) educational attainment and sexual behaviours in Cape Town, South Africa. The sample was constituted from 3213 individuals who had initiated sex during their teenage years and the analysis was undertaken when the youngest cohort was aged 21, an age at which they should have completed high school if they were on time. Logistic regression models were fitted separately for males and females. Overall, the results reveal that early sexual debut is correlated with long-term negative educational outcomes. Individuals who experience early sexual debut are less likely to complete high school than their counterparts who make their sexual debut later on in life. This effect is worse for Africans, who also disproportionately have an earlier sexual debut than other race groups. Apart from race however, the findings also reinforce the effect of other demographic factors on high school completion, namely, place of residence and family socioeconomic status as measured by parental education and household income. Hence, early sexual debut adds another layer of inequality and worsens the plight of Africans, females, those living in rural areas and those who come from low-income families.

This study examines the prevalence and determinants of adolescents' unintended pregnancy and induced abortion in Owerri, Nigeria. A pre-coded questionnaire was used to obtain information from 540 female adolescents of mean age 15.8 years. In addition, four FGDs were held with female adolescents in selected localities and in-depth interviews held with fifteen health-care service providers. Almost all the adolescents (99.8%) were Christians, with 70.3% being Catholics and 68.2% living with their parents. Over half (57.2%) of the adolescents had had sex. Contraceptives were rarely used owing to deep-seated cultural values. The data show that 31.6% of those who had ever had sex had an unintended pregnancy. Of these, 78.9% had recurrent pregnancies and 20.2% had an abortion. Of the latter, 41.8% had a recurrent abortion and 72.7% a post-abortion problem, for which 70.2% never sought treatment, increasing the risk of infertility in later life. The abortion seekers mostly went to patent medicine operators. A more acceptable and cost-effective contraceptive campaign involving use of local vernacular and traditional/local opinion leaders should be explored.

This paper is based on a study aimed at understanding the perceptions of men to induced abortion and contraceptive use within marriage in rural Zimbabwe. Two qualitative methods were combined. Men were found to view abortion not as a reproductive health problem for women. Instead, they described abortion as a sign of illicit sexual activity and contraceptive use as a strategy married women use to conceal their involvement in extramarital sexual activity. Men felt anxious and vulnerable for lack of control over women. In the absence of verbal communication on sexual matters, women and men resort to what are called here ‘hide-and-seek’ strategies, where women acquire and use contraceptives secretly while men search for evidence of such use. It is concluded that promoting women’s sexual and reproductive health requires both short- and long-term strategies. The short-term strategy would entail providing women with reproductive technology they can use without risking violence. The long-term strategy would entail understanding men’s concerns and the way these are manifested. In turn this requires the use of methodologies that encourage dialogue with research participants, in order to capture their deep meanings and experiences.