This study uses the third National Family Health Survey (2005–06) in India to investigate whether differences in women's status, both at the individual and community levels, can explain the persistent gender differential in nutritional allocation among children. The results show that girls are less likely than boys to receive supplemental food and more likely to be malnourished. In general it appears that higher women's status within a community, as well as higher maternal status, have beneficial effects on a daughter's nutritional status. Further, the moderating effects of community appear to be more consistent and stronger than the individual-level characteristics. A positive relationship between the percentage of literate women in a community and the gender differential in malnutrition appears to be an exception to the general findings regarding the beneficial nature of women's status on a daughter's well-being, showing the need for more than just basic adult literacy drives in communities to overcome the problem of daughter neglect.

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.

This study investigates how various social, demographic and economic factors affect spousal agreement on preferred waiting time to next birth. Data for matched cohabiting couples from ten Demographic and Health Surveys in sub-Saharan Africa (Benin, Burkina Faso, Ghana, Guinea, Mali, Ethiopia, Kenya, Mozambique, Zambia and Zimbabwe), conducted between 2003 and 2006, were analysed to compare reported waiting time to next birth by the husband and the wife. Couples where the reported waiting time to next birth was the same for both partners (difference is 0 months) were defined as having agreement on waiting time to next birth. In sub-Saharan Africa, spousal agreement on waiting time to next birth was found to be associated with wanting the next child sooner. When the spouses disagree on waiting time to next birth, the wives want to wait longer than their husbands in most cases. Additionally, the study found that demographic factors are the primary determinants of spousal agreement on waiting time to next birth, not socioeconomic factors. The strongest predictors of spousal agreement on waiting time to next birth were number of living children, difference between the number of ideal and living children and wife's age. Couples with fewer children, a younger wife and those with a difference of five or more children between ideal and living number of children were more likely to agree on waiting time to next birth. Effects of socioeconomic factors, such as education and wealth status, on spousal agreement on waiting time to next birth were generally weak and inconsistent. The findings highlight some of the challenges in developing programmes to promote spousal communication and birth spacing and underscore the need for programmes to be gender-sensitive.

Most studies of the association between family structure and risky sexual behaviour among adolescents and young adults have employed a risk perspective which assumes that, compared with other types, two-parent families are protective. Drawing from a positive-oriented approach in this study, it is hypothesized that within each family type some influential factors may mitigate such anticipated deleterious effects of non-intact families and decrease sexual risk-taking. The paper examines specifically the effects of risk and protective factors with an emphasis on family processes associated with resilience, using data from a pooled sample of 1025 females and males aged 12–24 years from Bandjoun (West Cameroon). Findings show that the quality of parent/guardian–youth relationships significantly decreases the odds of risky sexual behaviour by 36%, 65% and 50% in neither-, one- and two-parent families, respectively. For two-parent families only, parental control acts as a significant protective factor; it decreased by 41% the odds of risky sexual behaviour. Programmatically, protective family factors such as parent/guardian–youth interactions need to be promoted to improve the efficiency of reproductive health and HIV interventions in sub-Saharan Africa.

The aim of this study was to assess the usefulness of the decision trees method as a research method of multidimensional associations between menarche and socioeconomic variables. The article is based on data collected from the rural area of Choszczno in the West Pomerania district of Poland between 1987 and 2001. Girls were asked about the appearance of first menstruation (a yes/no method). The average menarchal age was estimated by the probit analysis method, using second grade polynomials. The socioeconomic status of the girls' families was determined using five qualitative variables: fathers' and mothers' educational level, source of income, household appliances and the number of children in a family. For classification based on five socioeconomic variables, one of the most effective algorithms CART (Classification and Regression Trees) was used. In 2001 the menarchal age in 66% of examined girls was properly classified, while a higher efficiency of 70% was obtained for girls examined in 1987. The decision trees method enabled the definition of the hierarchy of socioeconomic variables influencing girls' biological development level. The strongest discriminatory power was attributed to the number of children in a family, and the mother's and then father's educational level. Using this method it is possible to detect differences in strength of socioeconomic variables associated with girls' pubescence before 1987 and after 2001 during the transformation of the economic and political systems in Poland. However, the decision trees method is infrequently applied in social sciences and constitutes a novelty; this article proves its usefulness in examining relations between biological processes and a population's living conditions.

This study examines the effects of birth month and socioeconomic factors on height in rural Chinese men. The analysis of sample data of 833 adult men, 18–52 years of age, collected from 600 families in rural Hebei in 2005, shows that adult men born in winter months (November to January) are, on average, 1.04 cm shorter (p<0.01) than those born during the rest of the year. In addition to the conventional OLS regression models, the household fixed and random effects models also indicate that the month-of-birth effect exists when socioeconomic variables are controlled for. The birth-month effect on height is, however, smaller than effects of socioeconomic variables, including the household registration status, household economy and father's class status.

In India, nearly one million women of childbearing age are infected with HIV. This study sought to examine the biological effect of HIV on the fertility of HIV-infected Indian women. This is relevant for the provision of pregnancy-related counselling and care to the infected women, and for estimating the HIV prevalence among women and children. The study used retrospectively collected data from the National Family Health Survey (2005–2006) and applied a matched case control study design to compare the effect of HIV on conception, pregnancy rates and pregnancy outcomes among HIV-infected (N=69) and HIV-non-infected (N=345) women, both unaware of their HIV status. Pregnancy rates and pregnancy outcomes were compared through non-parametric statistical tests, whereas the effect of HIV on fecundity was studied by analysing the interval between last two pregnancies using Cox regression. The pregnancy rate was observed to be lower among HIV-infected than HIV-non-infected women (RR=0.77). The difference, however, was not statistically significant (p=0.064). There was also no statistically significant difference in the interval between last two pregnancies (p=0.898). Significantly higher number of pregnancies among HIV-infected women resulted in termination because of miscarriage or stillbirths (p=0.004). Therefore, while providing clinical care and counselling to infected women, the possibility of adverse pregnancy outcomes should be considered. Due to the higher rate of adverse pregnancy outcomes, attendance of HIV-infected women at antenatal clinics might be greater, which could lead to overestimation of HIV prevalence derived from antenatal care surveillance sites.

The present study makes use of nationwide individual-level vital registration data on the single live births occurring in Greece in 2006 to explore associations of socio-demographic factors with adverse pregnancy outcomes, using multinomial logistic regression models. The findings indicate that important risk factors associated with low birth weight preterm and intra-uterine growth retarded births (IUGR) include female sex, primiparity, age of mother over 35, illegitimacy and prior history of stillbirths, infant and child deaths. These constitute risk factors for normal weight preterm births as well, though associations with sex and primiparity in this case point to the opposite direction. Residing in large metropolitan areas is related to a greater risk of an IUGR birth. Among Greek women, educational attainment has a protective effect while housewife status is linked to higher chances of an IUGR birth. For immigrant mothers however, the opposite holds. The study also shows that normal weight preterm births form a distinct group.

The objective of this paper is to identify demographic, social and behavioural risk factors for HIV infection among men in Zambia. In particular, the role of alcohol, condom use and number of sex partners is highlighted as being significant in the prevalence of HIV. Multivariate logistic regressions were used to analyse the latest cross-sectional population-based demographic health survey for Zambia (2007). The survey included socioeconomic variables and HIV serostatus for consenting men (N=4434). Risk for HIV was positively related to wealth status. Men who considered themselves to be at high risk of being HIV positive were most likely to be HIV positive. Respondents who, along with their sexual partner, were drunk during the last three times they had sexual intercourse were more likely to be HIV positive (adjusted odds ratio (AOR) 1.60; 95% confidence interval (CI) 1.00–2.56). Men with more than two sexual life partners and inconsistent condom use had a higher risk for being HIV positive (OR 1.89, 95% CI 1.45–2.46; and OR 1.49, 95% CI 1.10–2.02, respectively). HIV prevention programmes in Zambia should focus even more on these behavioural risk factors.

Natural selection and genetic drift are two evolutionary mechanisms that can be analysed in human populations using their fertility and mortality patterns, and their reproductive size and isolation, respectively. This paper analyses the models of natural selection and genetic drift in Bayárcal, south-east Spain, and compares them with the observed models in the rest of the Alpujarran region. Demographic data were obtained from a sample of 77 families (48.45% of the population, with 547 inhabitants). The genetic drift and natural selection action was evaluated with the Coefficient of Breeding Isolation (CBI of Lasker and Kaplan) and Crow's index, respectively. The CBI (23.23/12.61) suggests that genetic drift is near to acting, and Crow's index (I=0.58) is slightly higher than that observed in the rest of La Alpujarra. Although the reproductive isolation of Bayárcal is not effective enough for genetic drift to act, it is near when marital migrants inside the Bayárcal valley are considered as a native population. The natural selection pattern is not different from that of the rest of La Alpujarra, but it tends towards the model of developing communities, where the demographic transition has not yet begun.

This paper assesses the reasons for entry into sex work and its association with HIV risk behaviours among mobile female sex workers (FSWs) in India. Data were collected from a cross-sectional survey conducted in 22 districts across four high HIV prevalence states in India during 2007–2008. Analyses were limited to 5498 eligible mobile FSWs. The reasons given by FSWs for entering sex work and associations with socio-demographic characteristics were assessed. Reported reasons for entering sex work include poor or deprived economic conditions; negative social circumstances in life; own choice; force by an external person; and family tradition. The results from multivariate analyses indicate that those FSWs who entered sex work due to poor economic conditions or negative social circumstances in life or force demonstrated elevated levels of current inconsistent condom use as well as in the past in comparison with those FSWs who reported entering sex work by choice or family tradition. This finding indicates the need for a careful assessment of the pre-entry contexts among HIV prevention interventions since these factors may continue to hinder the effectiveness of efforts to reduce the spread of HIV/AIDS in India and elsewhere.

Though HIV/AIDS poses serious risks to economic security, there is very little economics literature quantifying awareness and knowledge of this disease and their principal socioeconomic determinants. This is what the present study attempts to do in the context of India, which faces a significant threat from HIV/AIDS. The study is based on India's National Family Health Surveys covering the period of economic reforms and beyond. The contribution is both methodological and empirical. The study shows that the recent multi-dimensional deprivation approach to poverty can also be used to measure and analyse awareness and lack of knowledge of HIV/AIDS. The use of decomposable multi-dimensional measures helps in identifying regions, socioeconomic groups and aspects of HIV knowledge that should be targeted in policy interventions. The study identifies the importance of safe sex practices as an area that needs to be targeted in future information campaigns. The study also explores the impact of increased female autonomy in health and economic decision-making on their and their partners' knowledge of the disease, along with a host of other economic and demographic determinants.

Postponing the start of childbearing raises the question of fertility postponed versus fertility foregone. One of the limitations of previous studies of ‘How late can you wait?’ is that any observed decline in the probability of conception with age could be due to a decline in fecundability with age or due to a decline in coital frequency with age or due to both factors. Using data from a multinational longitudinal study conducted to determine the daily probability of conception among healthy subjects, a discrete-time event history model with long-term survivors (sterile population) is used to study the relationship between age and fecundability for childless women, while controlling for the pattern of intercourse within a menstrual cycle. The findings suggest that women can wait until their early thirties to try for a first birth, providing that they are not already sterile, as the magnitude of the decline in fecundability is very modest and of little practical importance.

Creating community awareness of reproductive tract infections (RTI), including sexually transmitted infections (STI), and how to prevent them is essential to minimize their spread. Data on people's views about RTI/STI are entirely lacking in Laos. The aim of this study was thus to explore people's perceptions, treatment-seeking behaviour and understanding of information about RTI/STI, in urban and rural communities in two provinces in Laos. Fourteen focus group discussions and 20 in-depth interviews were held with 76 women and 56 men, selected purposively to provide diversity of socio-demographic backgrounds. Qualitative content analysis was employed for the data analysis. The major finding was that both male and female participants had a variety of misconceptions about the causes and symptoms of RTI/STI and their cure, and a reluctance to seek health care, which could cause delay in appropriate diagnosis and treatment. The most common treatment-seeking behaviour was self-medication through private pharmacies, following advice mostly given by friends and drug sellers. The main reasons for not going to health facilities were fear of social discrimination or shyness of genital examination. Complaints were also made about clinicians' negative attitudes towards ‘dirty disease’. Although condom use was mentioned as a way to prevent RTI/STI, an unwillingness to use condoms was commonly expressed. The main media sources of RTI/STI information were radio and television, and access to health information was more difficult in rural areas. The health messages provided were mostly understood, except for some technical terms. The findings indicate that strengthening health education and promotion through interventions at the community level is recommended to improve quality of RTI/STI management. Health education messages should be more accessible in rural areas. There is also an urgent need to improve communication between RTI/STI patients and clinicians.

Birth weight is known to be closely related to child health, although as many infants in developing countries are not weighed at birth and thus will not have a recorded birth weight it is difficult to use birth weight when analysing the determinants of child illness. It is common to use a proxy for birth weight instead, namely the mother's perception of the baby's size at birth. Using DHS surveys in Cambodia, Kazakhstan and Malawi the responses to this question were assessed to indicate the relationship between birth weight and mother's perception. The determinants of perception were investigated using multilevel ordinal regression to gauge if they are different for infants with and without a recorded birth weight, and to consider if there are societal or community influences on perception of size. The results indicate that mother's perception is closely linked to birth weight, although there are other influences on the classification of infants into size groups. On average, a girl of the same birth weight as a boy will be classified into a smaller size category. Likewise, infants who died by the time of the survey will be classified as smaller than similarly heavy infants who are still alive. There are significant variations in size perception between sampling districts and clusters, indicating that mothers mainly judge their child for size against a national norm. However, there is also evidence that the size of infants in the community around the newborn also has an effect on the final size perception classification. Overall the results indicate that mother's perception of size is a good proxy for birth weight in large nationally representative surveys, although care should be taken to control for societal influences on perception.

This note categorizes the evidence for the hypothesis that mammalian offspring sex ratios (proportions male) are causally related to the hormone levels of both parents around the time of conception. Most of the evidence may be acknowledged to be correlational and observational. As such it might be suspected of having been selected; or of having been subject to other forms of bias or confounding; or, at any rate, of being inadequate as a firm basis for causal inference. However, there are other types of evidence that are not vulnerable to these types of criticism. These are from the following sources: (1) previously neglected data from Nazi Germany and Soviet Russia; (2) fulfilled predictions; (3) genetics; and (4) a network of logically (mathematically) related propositions, for some of which there is overwhelming empirical evidence. It is suggested that this variety of evidence confers greater overall credibility on the hypothesis than would be the case if all the evidence were of the same observational/correlational status. This observational/correlational evidence is tabulated to illustrate its consistency.

Most studies on consanguinity have been conducted on contemporary populations and have focused on the prevalence and types of preferred intra-familial marriage. With its comprehensive birth, marriage and deaths records dating back to the late 17th century, and the legal bar on first cousin marriage removed in the mid-19th century, Sweden offers unique opportunities to examine the factors that determine by whom, where and why consanguineous marriages were contracted. The present study covers the period 1780–1899 and presents a detailed portrait of cousin and sibling exchange marriages in the Skellefteå region of northern coastal Sweden. The combined prevalence of first, second and third cousin marriage increased from 2.3% in 1790–1810 to 8.8% in 1880–1899, and multi-generation consanguinity also increased significantly over the study period. The distribution and prevalence of first cousin marriages was strikingly non-random, with a significantly greater propensity for consanguinity among land-owning families, especially involving first-born sons, within specific pedigrees, and in a number of more remote inland communities. Additional factors associated with a greater likelihood of consanguineous marriage included physical or mental disability among males, and among females the prior birth of an illegitimate child. Besides the inherent interest in the social and demographic structure of this region of northern Sweden during the course of the 19th century, in future studies it will be important to determine the degree to which the observed patterns of consanguineous and sibling exchange marriages in these past generations could have influenced present-day genetic structure.

Abortion is illegal in Uganda except to save the life of the woman. Nevertheless, the practice is quite common: about 300,000 induced abortions occur annually among Ugandan women aged 15–49 (Singh et al., 2005) and a large proportion of these women require treatment for post-abortion complications. In the male-dominant culture of Uganda, where men control most of the financial resources, men play a critical part in determining whether women receive a safe abortion, or appropriate treatment if they experience abortion complications. This study examines men's roles in determining women's access to a safer abortion and post-abortion care. It draws on in-depth interviews carried out in 2003 with 61 women aged 18–60 and 21 men aged 20–50 from Kampala and Mbarara, Uganda. Respondents' descriptions of men's involvement in women's abortion care agreed that men's stated attitudes about abortion often prevented women from involving them in either the abortion or post-abortion care. Most men believe that if a woman is having an abortion, it must be because she is pregnant with another man's child, although this does not correspond with women's reasons for having an abortion – a critical disjuncture revealed by the data between men's perceptions of, and women's realities regarding, reasons for seeking an abortion. If the woman does experience post-abortion complications, the prevailing attitude among men in the sample was that they cannot support a woman in such a situation seeking care because if it had been his child, she would not have had a covert abortion. Since money is critical to accessing appropriate care, without men's support, women seeking an abortion may not be able to access safer abortion options and if they experience complications, they may delay care-seeking or may not obtain care at all. Barriers to involving men in abortion decision-making endanger women's health and possibly their lives.

This study sought to assess the prevalence of consistent condom application on male clients by female sex workers (FSWs) in Armenia and its association with demographic, psychosocial and behavioural factors. In this cross-sectional study, 120 street-based FSWs aged 20–52 completed an interviewer-administered questionnaire. The primary outcome measure was consistent application of condoms by FSWs on their male clients. A total of 21.7% of participants reported consistently applying condoms on clients. Logistic regression analysis demonstrated that higher condom use self-efficacy (Adjusted Odds Ratio, AOR=1.1; p=0.01), lower perceived condom use barriers (AOR=0.9; p=0.04) and not using douching as a method to prevent STI/HIV (AOR=4.8; p=0.04) significantly predicted consistent condom application. Higher HIV/AIDS knowledge was a marginally significant predictor of condom application (AOR=1.3; p=0.05). Future interventions should address these modifiable factors to encourage FSWs to apply condoms on clients themselves, which may reduce condom failure and exposure to HIV transmission.

This study investigates the correlates of traditional contraceptive use in Moldova, a poor country in Europe with one of the highest proportions of traditional contraceptive method users. The high reliance on traditional methods, particularly in the context of sub-replacement level fertility rate, has not been systematically evaluated in demographic research. Using cross-sectional data on a sub-sample of 6039 sexually experienced women from the 2005 Moldovan Demographic and Health Survey, this study hypothesizes that (a) economic and spatial disadvantages increase the likelihood of traditional method use, and (b) high exposure to family planning/reproductive health (FP/RH) programmes increases the propensity to modern method use. Multilevel multinomial models are used to examine the correlates of traditional method use controlling for exposure to sexual activity, socioeconomic and demographic characteristics and data structure. The results show that economic disadvantage increases the probability of traditional method use, but the overall effect is small. Although higher family planning media exposure decreases the reliance on traditional methods among younger women, it has only a marginal effect in increasing modern method use among older women. Family planning programmes designed to encourage women to switch from traditional to modern methods have some success – although the effect is considerably reduced in regions outside of the capital Chisinau. The study concludes that FP/RH efforts directed towards the poorest may have limited impact, but interventions targeted at older women could reduce the burden of unwanted pregnancies and abortions. Addressing differentials in accessing modern methods could improve uptake in rural areas.