Afghanistan has made remarkable progress in reducing maternal mortality over the past few decades, and male participation in their pregnant partner’s reproductive health care is crucial for further improvement. This study aimed to examine whether male attendance at antenatal care (ANC) with their pregnant partners might be beneficially associated with the degree of utilization of reproductive health care by the pregnant partners. Data for 2660 couples (women aged 16–49 years) were taken from the 2015 Afghanistan Demographic and Health Survey (AfDHS). Bivariate and multivariate logistic regression models were employed to explore the association between male attendance at ANC with their pregnant partners and reproductive health care utilization outcomes, including adequate utilization (four or more visits) of ANC services, ANC visits during the first trimester (up to 12 weeks) of pregnancy, rate of blood and urine testing during pregnancy, rate of institutional delivery and utilization of postnatal check-up services. The results indicated that the rate of male attendance at ANC with their pregnant partners was 69.4%. After controlling for covariates, pregnant partners who were accompanied to ANC by their male partners were more likely to adequately utilize ANC services (AOR=1.42; 95% CI: 1.18–1.71), commence ANC visits even during the first trimester (AOR=1.21; 95% CI: 1.03–1.42), give birth at a health facility (AOR=1.23; 95% CI: 1.03–1.47) and present themselves for postnatal check-ups (AOR=1.24; 95% CI: 1.04–1.47) than those who were not accompanied by them. The study demonstrated that participation of male partners in ANC was positively associated with their pregnant partners’ utilization of reproductive health care services in Afghanistan. The findings suggest that, to improve maternal and child health outcomes in the country, it would be worthwhile implementing interventions to encourage male partners to become more engaged in the ANC of their pregnant partners.

This study uses three key anthropometric measures of nutritional status among children (stunting, wasting and underweight) to explore the dual effects of household composition and dependency on nutritional outcomes of under-five children in Ghana. The objective is to examine changes in household living arrangements of under-five children to explore the interaction of dependency and nucleation on child health outcomes. The concept of nucleation refers to the changing structure and composition of household living arrangements, from highly extended with its associated socioeconomic system of production and reproduction, social behaviour and values, towards single-family households – especially the nuclear family, containing a husband and wife and their children alone. A negative relationship between levels of dependency, as measured by the number of children in the household, and child health outcomes is premised on the grounds that high dependency depletes resources, both tangible and intangible, to the disadvantage of young children. Data were drawn from the last four rounds of the Ghana Demographic and Health Surveys (GDHSs), from 1993 to 2008, for the first objective – to explore changes in household composition. For the second objective, the study used data from the 2008 GDHS. The results show that, over time, households in Ghana have been changing towards nucleation. The main finding is that in households with the same number of dependent children, in nucleated households children under age 5 have better health outcomes compared with children under age 5 in non-nucleated households. The results also indicate that the effect of dependency on child health outcomes is mediated by household nucleation and wealth status and that, as such, high levels of dependency do not necessarily translate into negative health outcomes for children under age 5, based on anthropometric measures.

This was a hospital-based cross-sectional study of 224 randomly selected antenatal women receiving care at the University College Hospital, Ibadan, Nigeria. The study aimed to seek the attitude and preferences of respondents about social support during childbirth and also identify variables that may influence their decisions. Seventy-five per cent of respondents desired companionship in labour. Approximately 86% preferred their husband as companion while 7% and 5% wanted their mother and siblings as support person respectively. Reasons for their desire for social support were emotional (80·2%), spiritual (17·9%), errands (8·6%) and physical activity (6·8%). Socio-demographic variables found to be statistically significant on logistic regression analysis for the desire of a companion in labour were nulliparity (OR 3·57, 95% CI 1·49–8·52), professionals (OR 3·11, 95% CI 1·22–7·94) and women of other ethnic groups besides Yoruba (OR 2·90, 95% CI 1·02–8·26), which is the predominant ethnic group in the study area. Only those with post-secondary education were found to want their husbands as doula (OR 2·96, 95% CI 1·08–8·11). More than half of the respondents wanted information about labour prior to their experience. It is important that Nigerian women are allowed the benefit of social support during childbirth, particularly as there is a lack of one-to-one nursing care and other critical services, including epidural analgesia in labour, at many of the health care facilities in Nigeria. Men could play a pivotal role in the process of introducing support in labour so as to improve the outcome for both the mother and her newborn.

In England and Wales in 1938–68 the sex ratio of children liveborn or stillborn to women aged 45+ years was lower than the sex ratio among children born to women at any other age. This strengthens the suggestion that the high sex ratio reported by Takahashi among children born to elderly women in Japan is a spurious consequence of false registration.

In fertility surveys often women (and sometimes men) are asked their fertility desires, i.e. whether they want a/nother birth or not. Some respond that they are undecided. This study examines whether these persons are more like those who say they want more births or like those who say they want no more births. Data on married men and women in 29 Demographic and Health Surveys with sample sizes ranging from 300 to 3000 are used. A logistic regression equation is estimated within each country for those with known desires and then used to classify each person who was undecided. In all sub-Saharan African countries (n=20) and for both sexes, 50% or more of the undecided persons are classified as wanting more children (with one exception of wives in Kenya). By contrast in all five Latin American countries for both sexes less than 50% of the undecided were classified in the ‘want more’ group (with an exception of husbands in the Dominican Republic). Generally, the undecided tend to be classified the same as the majority among those in the survey with stated desires.

Human water contact patterns were studied in two resettlement communities at the Oyan Reservoir in south-west Nigeria in all four seasons in 1991 and 1992. Water contact was most intensive in the afternoon and in the hot dry season, but different types of activities exhibited different daily and seasonal patterns. Both communities were highly endemic for urinary schistosomiasis. However, knowledge regarding schistosomiasis transmission was very limited and the infection was, in spite of a very high frequency of blood in the urine, not considered a major public health problem. Most water contacts were of either a recreational (swimming, bathing) or economic (fishing) nature, and age- and sex-related patterns were evident. The overall level of exposure peaked in the 10–14 years age group but water contact of an economic nature peaked in the 20–39 years age group. Females had generally more water contact than males.

Child undernutrition is a major public health problem throughout the world, particularly in developing countries. The main objective of this study was to identify the risk factors for acute undernutrition among under-5 children in Bangladesh. Data were taken from the nationally representative Bangladesh Demographic Health and Survey conducted in 2014. The study sample comprised 7131 under-5 children. Of these, 4.6% were found to be severely wasted (Z-score < −3.0), 11.1% moderately wasted (−3.0≤Z-score < −2.0) and 84.3% adequately nourished (Z-score ≥−2.0). Chi-squared analysis was used to investigate the association between child nutrition status and selected covariates. Multinomial logistic regression was applied to identify the risk factors for acute undernutrition. The selected factors division, place of residence, sex of child, place of delivery, child age, respiratory illness, size at birth, measles vaccination, fever, diarrhoea, maternal BMI, maternal education, paternal occupation, wealth index and household toilet facilities were found to be highly significant (p < 0.05) in the analysis. Multinomial regression analysis revealed that residence in Barisal and Chittagong divisions, a smaller than average size at birth and low maternal BMI (≤18.50 kg/m2) were significant determinants of both moderate and severe acute undernutrition among under-5 children in Bangladesh.

This cross-sectional study analysed Bangladesh Demographic and Health Survey 2011 data with the aim of investigating the prevalence of, and risk factors for, hypertension in individuals aged over 35 by rural–urban place of residence. After estimation of the stratified prevalence of hypertension by background characteristics, multivariable logistic regression analysis was conducted to calculate the adjusted odds (AORs) and 95% confidence intervals (CIs) for selected factors. Of the 7839 participants, 1830 were from urban areas and 6009 from rural areas. The overall prevalence of hypertension was 32.6% (95% CI: 30.5–34.8) in urban areas and 23.6% (95% CI: 22.5–24.7) in rural areas. The prevalence and odds of hypertension increased with increasing age, female sex, concomitant diabetes and overweight/obesity and richer wealth status in both urban and rural regions. Although residence in Khulna and Rangpur divisions and higher education level were associated with increased odds of hypertension in urban regions, this was not the case in rural regions (p>0.05). Residence in Sylhet and Chittagong divisions had lower odds of hypertension in rural regions. Furthermore, the proportions of overweight/obese, diabetic and higher wealth status participants were higher in urban than in rural regions. The prevalence and odds of hypertension were found to be associated with several common factors after stratifying by place of residence. Some of these factors are more concentrated in urban regions, so urban residents with these risk factors need to be made more aware of these in order to control hypertension in Bangladesh. Public health programmes also need to be tailored differently for urban and rural regions, based on the different distribution of these significant factors in the two areas.

In the developing world, little is known about the risk and precipitating factors for abortion, due to a dearth of community-based surveys. Most analyses of determinants of induced abortion consider only a small set of household and individual socio-demographic factors and treat abortion as an isolated outcome, which ignores its relationship with prior reproductive health behaviours and experiences. In this paper, data from a cross-sectional survey of abortion knowledge, attitudes and practices among 2571 currently married women of reproductive age in Rajasthan, India, were used to examine contextual-, household- and individual-level determinants of abortion. Bivariate probit models, which jointly determine the probability of pregnancy and the conditional probability of abortion, were used to reflect the probability of abortion as a result of interrelated and sequential events. Increased socioeconomic status and life-cycle factors were associated with both the probability of pregnancy and with the conditional likelihood of abortion. Women who reported personal networks were also more likely to terminate pregnancies, particularly if their network members purportedly had abortion experience. Community knowledge of sex-selective abortion also exerted a significant positive effect on the propensity to terminate a pregnancy. For rural women only, community beliefs regarding spousal consent requirements pre-abortion were also significantly associated with abortion.

The conventional view that childlessness was associated with higher than average risk of marital breakdown was questioned by Chester (1972) and Gibson (1980) on the basis of analysis of divorce records. Data from the 1980 General Household Survey are used to show that childless couples, and those who have children early in marriage (and are thus more likely to have large families) are considerably more at risk of breakdown at all marriage durations than delayed two-child families. The reasons for the different conclusions of these three studies are assessed and it is concluded that standardization has many unattractive features for demographic analysis (especially in areas other than mortality), and that presentations based on relative or absolute risk of breakdown allow the key features to be assessed most satisfactorily.

This paper examines the seasonality of induced abortion in North Carolina between 1980 and 1993. Distinct seasonal patterns are found, with a peak in February and a valley in September. These patterns correspond to the implicit seasonality of conceptions associated with the seasonality of birth pattern. One notable difference from the general pattern is among unmarried women aged 18 and younger. They have the February peak and an additional peak in August that may be associated with the summer vacation from school.

The common belief that childlessness is positively associated with instability of marriage derives from official statistics which appear to show higher divorce rates for childless than for fertile couples. The official findings are a procedural artifact, however, and the relationship shown is certainly exaggerated and possibly spurious.

The appropriate strategy in determining whether divorcees are relatively infertile is to find a population with disrupted marriages and measure its fertility experience. In doing so it is necessary to take note of the definition of fertility, the remarriage factor, and (most importantly) the duration of marriage. The official statistics use the conception of legal duration of marriage. Since this ignores separation before divorce, its use exaggerates the infertility of divorcees, as does failure to exclude remarriages. De facto duration of marriage (wedding to separation) is a superior statement of opportunity to conceive, and calculations on this basis eliminate or even reverse the fertility differential between divorcing and stable couples. Local figures are used to illustrate this effect, and the finding is supported by evidence from a sample of marriages ending in legal proceedings lesser than divorce. It is concluded that the alleged relationship between childlessness and instability of marriage is probably either non-existent or the reverse of that normally assumed, and that in any case measurement of the net overall effect of childlessness does not provide a helpful datum. An alternative strategy of research is suggested, which would seek patterns of effect rather than net overall effect, taking heed of relevant variables, and also considering all forms of marital breakdown including marriages in which cohabitation continues only with disharmony.

The familiar and well-established negative association between a woman's age at marriage and family size has received somewhat less attention in recent years. No doubt this is because, with the reduction in fertility of the past century, the observed differentials appear less striking and seem less significant. Age at marriage is a less obvious determinant of family size than in the past. Glass & Grebenik (1954), commenting on the data produced by the 1946 Family Census, emphasized the decreasing importance of the association both absolutely and relatively. Contrasting the completed fertility of the 1900–09 and the 1925 marriage cohorts in Great Britain (Table 1), they argued that, though for all, married women the relative influence of age at marriage was unchanged, the figures for fertile marriages only (those where the wife had at least one child) appeared to indicate ‘that age at marriage and fertility were not quite so tightly linked for the more recent group’. And they added ‘this is the kind of development which would be expected with the increasing spread of family planning’.

Children's intelligence increased in the United States by approxi-mately 3 IQ points per decade over the period 1932–78. New evidence shows that these increases have been sustained during the last 20 years. Two recent studies indicate that the rates of increase for 1972–89 and 1978–89 were 3·3 and 3·5 IQ points per decade respectively.

Globally, unplanned pregnancies and sexually transmitted infections (STIs) persist as significant threats to women’s reproductive health. Barriers to the use of modern contraceptives by women might inhibit uptake of novel woman-controlled methods for preventing STIs/HIV. Use of modern contraceptives and perceptions and attitudes towards contraceptive use were investigated among women in Antananarivo, Madagascar, using qualitative research. The hypothetical acceptability of the diaphragm – a woman-controlled barrier contraceptive device that also holds promise of protecting against STIs/HIV – was assessed. Women consecutively seeking care for vaginal discharge at a public health clinic were recruited for participation in a semi-structured interview (SSI) or focus group discussion (FGD). Audiotaped SSIs and FGDs were transcribed, translated and coded for predetermined and emerging themes. Of 46 participating women, 70% reported occasional use of male condoms, mostly for preventing pregnancy during their fertile days. Although women could name effective contraceptive methods, only 14% reported using hormonal contraception. Three barriers to use of modern contraceptives emerged: gaps in knowledge about the range of available contraceptive methods; misinformation and negative perceptions about some methods; and concern about social opposition to contraceptive use, mainly from male partners. These results demonstrate the need for programmes in both family planning and STI prevention to improve women’s knowledge of modern contraceptives and methods to prevent STI and to dispel misinformation and negative perceptions of methods. In addition, involvement of men will probably be a critical component of increased uptake of woman-controlled pregnancy and STI/HIV prevention methods and improved health.

In Guatemala, especially in rural areas, gender norms contribute to high fertility and closely spaced births by discouraging contraceptive use and constraining women from making decisions regarding the timing of their pregnancies and the size of their families. Community workshops for men, women and couples were conducted in 30 rural communities in Guatemala to test the hypothesis that the promotion of gender equity in the context of reproductive health will contribute to gender-equitable attitudes and strengthen the practice of family planning. Communities were randomly assigned to intervention and control groups. Pre/post surveys were conducted. Odds ratios estimated with mixed effect models to account for community-level randomization and repeated measures per participant were compared. The analyses showed statistically significant effects of the intervention on two of the three outcomes examined: gender attitudes and contraceptive knowledge. Findings regarding contraceptive use were suggestive but not significant. The results suggest that it is possible to influence both inequitable gender norms and reproductive health knowledge and, potentially, behaviours in a short span of time using appropriately designed communications interventions that engage communities in re-thinking the inequitable gender norms that act as barriers to health.

The present paper is based on information on marital patterns and reproductive performance (reconstituted families) in the rural community of Los Nogales, Galicia, Spain. Biodemographic data were used to analyse temporal changes and structure of consanguinity in the population, as well as consanguinity versus reproductive success. Of 2347 marriages celebrated between 1871 and 1977, 5·15% were between relatives (up to third degree). The population’s inbreeding coefficient was above the Spanish average after 1890, and levels were high during the first part of the 20th century. A possible underestimation of inbreeding coefficients is attributed to the elevated frequency of extramarital births occurring in the Los Nogales population (13·47%). The structures of consanguineous matings, expressed as C22/C33 and C33/C44, turned out to be 0·86 and 0·82 respectively. Regarding migration, before 1920 consanguinity increased, but net migration was negative. In the period 1920–1929 consanguinity began to decrease, prior to maximum emigration. As for reproductive success, information from 1503 reconstituted families shows that complete fertility was slightly higher among consanguineous families despite a greater infant mortality. Lower infertility in consanguineous matings, as well as lower age at marriage and first maternity, could explain the above results.

This study was carried out in two medical facilities in Enugu, Nigeria, from September to November 2007. An interviewer-administered questionnaire was used to collect data from HIV-positive pregnant women accessing PMTCT (prevention of maternal-to-child transmission) services at the two centres. Ninety-two women were interviewed: 89 (96.7%) had disclosed their status, while 3 (3.3%) had not. Of the 89 women who had disclosed, 84 (94.4%) had disclosed to partners, 82 (92.1%) to husbands, 2 (2.2%) to fiancés, 18 (20.2%) to sisters, 13 (14.6%) to mothers, 10 (11.2%) to brothers, 10 (11.2%) to fathers and 10 (11.2%) to priests. Fifty-two (58.4%) gave emotional support as the reason for disclosure and 46 (51.7%) gave economic and financial support as reasons. Fifty-six (62.9%) reported understanding from partner as a positive outcome and 44 (49.4%) reported financial support. Forty-six (51.7%) reported no negative outcome. Serostatus disclosure rate in this study was high with most women disclosing to their partners.

This study applied a gender perspective to establish some of the anthropometric, body composition, health and socio-cultural determinants of active ageing. The variable ‘active ageing’ (presence/absence) was created based on cognitive and disability/illness/physical functioning, subjective health, satisfaction with life and productive activity performed, and used in predictive models to establish its relationship with anthropometric variables, physical health indicators and educational level. The sample consisted of 456 home-living individuals (169 men and 287 women; age range 54–75 years) from Madrid and Toledo in Spain. The women had a higher prevalence of obesity than the men (37.6% vs 29.0%), significantly greater fat accumulation in the abdominal area and worst perceived health (p=0.003). The frequency of active agers is higher in men than in women (38.4% vs 21.9%; p<0.001). Men and women were found to have distinctive ageing patterns. Health factors condition the presence of active ageing in women, while education factors are also relevant in men.

The incidence of Down syndrome in Scotland between 1960 and 1974 was estimated using data from thirteen Area Health Boards. Incidences in individual years, in different months of the year and in different maternal age groups were also determined. There was an apparent increase in incidence in more recent years almost certainly due to increased ascertainment. This may have obscured any decrease in incidence which might be expected as a result of a decrease in mean maternal age during this period and the introduction of antenatal diagnosis. No seasonal differences in incidence could be detected either in the whole area or in individual Area Health Boards. There was an increase in incidence with maternal age which was not significantly different from that found by other investigators. There was also an indication of an increase in relative incidence (% Down syndrome births/% live births) over the period 1966–74 in mothers aged 35 years and older.