The aim of this paper is to investigate the differentials and determinants of female age at first marriage in rural Nepal. The life table technique was employed to calculate median age at marriage. The proportional hazard model was used to study the effect of various socioeconomic variables, and to identify the magnitude and significance of their effects on the timing of first marriage. The data were taken from a sample survey of Palpa and Rupandehi districts in rural Nepal. Both married and unmarried females of marriageable age were included in the survey. Median age at marriage was about 17 years for data from only married females, whereas it was about 18 years for data from married as well as unmarried females of marriageable age. Median age at marriage was about 16 years for uneducated females and 19 years for females educated up to intermediate or higher level. The analysis underestimates the median age at marriage for married females, probably due to right censoring. The risk of getting married early decreased gradually with increasing year-of-birth cohort. The risk of early marriage was higher among females of high socioeconomic status compared with those of low socioeconomic status. Females engaged in service married earlier than those engaged in household work. High socioeconomic status families are motivated, for religious and prestige reasons, to get their daughters married at an early age, preferably before menarche. Thus, education, occupation and age at menarche are the most powerful factors in deciding the timing of first marriage in Nepal.

This paper examines the relationship of the national IQs reported by Lynn & Vanhanen (2002, 2006) to national achievement in mathematics and science among 8th graders in 67 countries. The correlation between the two is 0·92 and is interpreted as establishing the validity of the national IQs. The correlation is so high that national IQs and educational achievement appear to be measures of the same construct. National differences in educational achievement are greater than differences in IQ, suggesting an amplifier effect such that national differences in IQs amplify differences in educational achievement. Controlling for national differences in IQ, slight inverse relationships of educational achievement are observed with political freedom, subjective well-being, income inequality, and GDP. However, public expenditure on education (as % of GDP) was not a significant predictor of differences in educational achievement.

This article explores to what extent married middle-aged individuals in Europeare governed by the risk of experiencing divorce, when shaping their physicalappearance. The main result is that divorce risks, proxied by national divorcerates, are negatively connected to body mass index (BMI) among marriedindividuals but unrelated to BMI among singles. Hence, it seems that marriedpeople in societies where divorce risks are high are more inclined to invest intheir outer appearance. One interpretation is that high divorce rates makemarried people prepare for a potential divorce and future return to the marriagemarket.

Access to and quality of services have increasingly been the focus of family planning programme managers, implementers and researchers in the developing world. In Vietnam, a country characterized by recent significant achievements in family planning, not much is known about the linkages between service accessibility and quality and contraceptive behaviour. Data for this study come from the Vietnam 1997 Demographic and Health Survey, with individual contraceptive use information recorded in the calendar section. Measures of access to and quality of services come from the Community/Health Facility Questionnaire, with key informant interviews and facility visits. The study focuses on the effects of the outreach programme and commune health centres on contraceptive method discontinuation for three modern, temporary methods: the IUD, oral pills and condoms. Longer travel time to commune health centres is found to be associated with significantly increased risks of first- and all-method discontinuation for any reason, while residence in communities with higher quality health centres is associated with significantly lower risks of method discontinuation. Access to and quality of the outreach programme are, in contrast, not significant determinants of method discontinuation for any reason. Similar results are found for first- and all-method discontinuation for service-related reasons. The effects of programmatic factors are more pronounced among older women and during the first three months of method use. This study provides evidence for the importance of family planning services for contraceptive method continuation in Vietnam. The results also highlight the need for a thorough evaluation of the family planning outreach programme in terms of its facilitation of women’s continued use of contraception.

Causality for the seasonality of human births, which affects populations wordwide, has been a profound mystery for nearly two centuries. Most explanations for seasonality fail because of inconsistent global application. In two previous studies, Cummings (2002, 2003) hypothesized that human reproduction has been responsive to changes in both seasonal environmental light intensity (surface luminosity) and photoperiod. Except at higher latitudes, photoperiod is of secondary importance to that of environmental light intensity. Because of a lack of data, the presence or lack of cloud cover is used as a general proxy for environmental light intensity. These studies show a positive correlation between conceptual seasonality and cloud cover on a worldwide basis, and propose that there is a delay between exposure to increased light and the onset of conceptions. This delay is three months at higher latitudes and one to two months for lower latitudes. Both studies suggest that an excellent means of hypothesis confirmation would be to provide one or more examples of how a seasonal change in cloud cover might alter the number of conceptions in subsequent months. The present study tests this hypothesis. The percentage of possible sunshine and averaged sunshine hours are used to investigate their influence on seasonality of births in Germany and the Netherlands. The evidence shows that a seasonal change in environmental light intensity preceded a change in the peak months for conceptions in Germany and the Netherlands. Although secondary influences are possible, the primary reason for this transition in peak conceptual months seems to be related to the seasonal changes in environmental light intensity for both countries. Although this transitional relationship was predicted in Cummings (2002, 2003), further research is required, especially with regard to more precise measurements of environmental light intensity and its physiological effect on the human endocrine system.

Although gains in generational intelligence test scores have been widely demonstrated around the world, researchers still do not know what has caused them. The cognitive stimulation and nutritional hypotheses summarize the several diverse potential causes that have been considered. This article analyses data for a sample of 499 children tested in 1930 and one equivalent sample of 710 children tested 72 years later, the largest gap ever considered. Both samples comprised children aged between 7 and 11 who were assessed by the Draw-a-Man test in the city of Belo Horizonte, Brazil. Further, one additional sample of 132 children was assessed in 2004 in a rural area very similar in several diverse factors to the 1930 urban sample. The results are consistent with both the cognitive stimulation and the nutritional hypotheses.

This paper explores the factors that influence the practice of induced abortion in a very low fertility society, with particular emphasis on son preference and three distinct religions: Confucianism, Buddhism and Christianity. Using multivariate logistic regression models fitted by the generalized estimating equation (GEE) method, this paper analysed the data collected by the 2000 Korea National Fertility and Family Health Survey of 6348 married women aged 15–49 years with a total of 1217 pregnancy outcomes. The results showed that the likelihood of induced abortions in women with two or more children, compared with those with one child, was significantly influenced by the sex composition of the previous children: odds ratio (OR)=12·71 (95% CI=5·49, 29·42) for women with only son(s), and OR=3·91 (95% CI=1·67, 9·14) for women with only daughter(s). At parity two, women with two sons were much more likely to have induced abortions than women with two daughters (OR=5·88, 95% CI=2·70, 12·85). Although Buddhist women were not significantly different from Confucian women in induced abortion practice, Christian women were much less likely than Confucian women to have an induced abortion (OR=0·39, 95% CI=0·18, 0·88 for women with only sons and OR=0·44, 95% CI=0·24, 0·81 for women with two children). This suggests that even in this very low fertility society, son preference and religious affiliation are significant predictors of women’s practice of induced abortion.

Data from a national representative sample of 1023 elderly and near-elderly Taiwanese were used to explore whether allostatic load is associated with health outcomes and mediates the association between socioeconomic status and health in a non-Western population. The information collected included: demographic characteristics; allostatic load scores; socioeconomic status, measured by education and income; health behaviours; health-related variables, including self-rated health, basic activities of daily living difficulties, instrumental activities of daily living difficulties, and physical activity difficulties. The adjusted prevalent odds ratios of higher allostatic load level were 1·25 (95% CI: 1·00, 1·56) for reporting one level worse in self-rated health and 1·43 (95% CI: 1·14, 1·82) for reporting one more physical activity difficulty. There were significant associations of lower education or less income with worse self-rated health and more difficulties with physical functioning. The associations between education, income and health status are not mediated by the conventional ten-point measure of allostatic load in older Taiwanese adults.

Body mass index (BMI) is the ‘measuring rod’ of nutritional status. This study investigates the type and extent of correlation between adult male BMI and socioeconomic, cultural and bio-demographical variables using data from 11,496 individuals from 38 districts of Central India. For each individual, stature, body weight and sitting height data were collected, their Cormic index and BMI computed, and averages for each district calculated. Mean BMI was found to be lowest for the population of Tikamgarh (17·90±1·91 kg m−2) and highest for that of Durg district (19·33±2·16 kg m−2), whereas the mean BMI for the total population of Central India was 18·67±2·18 kg m−2, which is lower than that of well-to-do individuals in India as a whole. The F ratio indicates that there is inter-district variation in anthropometric characteristics of populations. District-wise biosocial indicators were obtained, namely population density per square kilometre, percentage urban population, percentage of population that is of scheduled caste/tribe, sex ratio, average rural population per PHC/CHC (primary or community health centre), literacy rate, life expectancy, total fertility rate, infant mortality rate, gender development index and human development index. Most of these variables were found to be significantly correlated with each other, but BMI was only significantly correlated with three of them, viz. gender development index (R2=0·211), life expectancy (R2=0·130) and infant mortality rate (R2=0·128). Gender development index and life expectancy were positively correlated with BMI, whereas infant mortality rate was negatively correlated. It is concluded that if BMI increases then life expectancy will also increase. Thus better nutritional status may be a helpful tool for reducing infant mortality rate, which is an indicator of socioeconomic status, health condition, health care and ultimately overall development of a region or population.

The objective of this study was to analyse the association between socioeconomic indicators and cardiovascular disease risk factors in adult residents of Rio de Janeiro city, Brazil. Data were obtained by direct interview and physical examination in a population-based cross-sectional study in the city of Rio de Janeiro, 1995–96. Subjects were selected by two-stage random sampling and information was collected on socioeconomic, anthropometric and demographic characteristics, as well as on existing risk factors for cardiovascular disease. An index to express the risk of cardiovascular disease (CVD) was built, based on the presence of two or more of the following risk factors: overweight (measured by the body mass index, BMI), fat location (measured by the waist–hip ratio index, WHR), smoking, hypertension, sedentary lifestyle and alcohol consumption. The association between this risk index and the socioeconomic variables level of schooling, per capita income and residence location (slum vs non-slum) was evaluated through logistic regression models that controlled for the age of the subjects. Two separate models were built, according to the gender of the subjects. Complete data were collected for 1413 males and 1866 females over the age of 20 years (82% of the intended sample). In the studied population, a considerable prevalence of risk for CVD was found: 42·2% among males and 65·4% among females. For males, the socioeconomic and demographic indicators retained in the logistic model were age (OR 1·01, 95% CI 1·00–1·01), level of schooling (1·77, 95% CI 1·39–2·26) and per capita income (OR 0·77, 95% CI 0·61–0·97). For females, the indicators retained were age (OR 1·02, 95% CI 1·01–1·02) and level of schooling (OR 2·26, 95% CI 1·84–2·77). The findings indicate that cardiovascular disease risk is already an alarming problem in the urban populations of developing countries, and that educational level is the most important socioeconomic factor associated with its presence.

Coercion may play an important role in compelling young women to engage in sexual intercourse at an early age. With a decline in age at first intercourse and increased reporting of coercive first sex, concerns of adverse reproductive health outcomes such as unintended pregnancy and sexually transmitted infections (STIs), including HIV, have become important issues, particularly in the context of a high HIV prevalence. This paper uses data collected in 2001 from the second round of a longitudinal study of 1130 sexually experienced young women in KwaZulu-Natal to investigate the relationship between coerced first intercourse and selected reproductive health outcomes and behaviours. Nearly 46% of all sexually experienced young women had reported that their first sexual encounter had been coerced. Young women who reported being coerced at first sex were significantly more likely to be Black and living in an urban area. Those who had been coerced at first sex were also more likely to report having had an STI and having experienced unintended pregnancy, than those who had not been coerced at first sex. Coercion at first sex is an important social and public health problem that has a serious impact on the reproductive health and behaviours of young women. Interventions should directly address the issue of sexual coercion by ensuring young women are aware of their reproductive rights.

Factors contributing to India’s vulnerability to the AIDS epidemic include pervasive poverty, low levels of education and high gender stratification. This study uses data collected in the 1998–99 National Family Health Survey-2 (NFHS-2) to investigate the relationship between aspects of women’s autonomy and four measures of HIV-related knowledge and behaviour – awareness and knowledge of HIV/AIDS, condom awareness and condom use – in three culturally contrasting states in India: Kerala (n=2884), Karnataka (n=4357) and Uttar Pradesh (n=8981). The NFHS-2 is a nationally representative survey of India, with a sampling scheme that was designed such that each state sample can be generalized back to represent ever-married women aged 15–49 living in the state. Kerala scores highest in the four health outcome measures, followed by Karnataka and then Uttar Pradesh, but condom use is lowest in Karnataka. Kerala also leads in the four dimensions of autonomy examined and in socio-demographic status, followed again by Karnataka and Uttar Pradesh. Despite these observed differences, in all three states, women with greater autonomy as measured by this study were more likely to be knowledgeable about AIDS and condoms and to use condoms, after controlling for socio-demographic factors. These results concur with other studies focusing on women’s autonomy and health outcomes around the world, and point to the importance of incorporating a gender-based approach to AIDS prevention programmes in India.

Access to voluntary counselling and HIV testing (VCT) remains limited in most parts of Ghana with rural populations being the least served. Services remain facility-based and employ the use of an ever-dwindling number of health workers as counsellors. This study assessed approval for the use of lay counsellors to promote community-based voluntary counselling and testing for HIV and the extent of HIV/AIDS-related stigma in the Kassena-Nankana district of rural northern Ghana. A cross-sectional questionnaire survey was conducted. Logistic regression was used to identify predictors of the tendency to stigmatize people living with HIV/AIDS (PLWHAs). Focus group discussions were held and analytical coding of the data performed. The majority (91·1%) of the 403 respondents indicated a desire to know their HIV status. Most (88·1%) respondents considered locations outside of the health facility as preferred places for VCT. The majority (98·7%) of respondents approved the use of lay counsellors. About a quarter (24%) of respondents believed that it was possible to acquire HIV through sharing a drinking cup with a PLWHA. About half (52·1%) of the respondents considered that a teacher with HIV/AIDS should not be allowed to teach, while 77·2% would not buy vegetables from a PLWHA. Respondents who believed that sharing a drinking cup with a PLWHA could transmit HIV infection (OR 2·50, 95%CI 1·52–4·11) and respondents without formal education (OR 2·94, 95%CI 1·38–6·27) were more likely to stigmatize PLWHAs. In contrast, respondents with knowledge of the availability of antiretroviral (ARV) drugs were less likely to do so (OR 0·40, 95%CI 0·22–0·73). Findings from the thirteen focus group discussions reinforced approval for community-based VCT and lay counsellors but revealed concerns about stigma and confidentiality. In conclusion, community-based VCT and the use of lay counsellors may be acceptable options for promoting access. Interventional studies are required to assess feasibility and cost-effectiveness.

Over the past five to ten years, the proportion of women who report recent sexual activity has declined in twelve countries in southern and eastern Africa, but not in most of eleven countries in West Africa. Although concentrated among unmarried women, slight declines are evident among married women and across most ages. Although it is difficult to prove, the most likely explanation is the higher prevalence of HIV/AIDS in southern and eastern Africa.

Women in Benue State have for years had the highest HIV rate in the country, but because the sentinel surveys are anonymized and unlinked, not much is known about the socio-demographic, behavioural and other risk factors that predispose these women to the disease. The HIV/AIDS epidemic in Nigeria does not appear to be a single epidemic but rather multiple epidemics of varying magnitude and trends. This cross-sectional study was therefore carried out to identify the risk factors for HIV/AIDS among these women. A total of 404 consecutive consenting mothers enrolled at the booking clinic were followed up until delivery of their babies. They were interviewed using a semi-structured questionnaire and tested for HIV infection using an ELISA-based kit after obtaining informed consent. Mean age of the mothers was 26±6·1 years, 94·8% were married while 50·5% had at least secondary level education. Sixty-one (15·1%) mothers were HIV positive with mothers aged 15–24 years being responsible for 50·8% of all infection. Following bivariate analysis, being single, having a partner with low level of formal education, living in a rural location, being in a polygamous/multiple partner union, being a higher order polygamous wife, being married more than once and reporting a history of a sexually transmitted infection were significantly associated with HIV infection. Monogamous women who lived apart from their partners and women who had ever had blood transfusion were also more likely to be HIV positive. Following multivariate logistic regression, a young age of 15–24 years (multivariate OR=3·3, 95% CI=1·2–8·4, p=0·02); ever had other STIs (OR=1·6, 95% CI 1·1–2·3, p=0·009); no formal maternal education (OR=0·6, 95% CI 0·4–0·9, p=0·021) and having one lifetime sexual partner (OR=0·4, 95% CI 0·3–0·5, p<0·00001) were significantly associated with HIV infection in the study population. Appropriate interventions must be directed at young people and should include STI control and abstinence education. Blood safety must be ensured as well as a general improvement in the level of formal and health education in this community.

An adapted ‘sense of coherence’ scale short form (SOC-13) was administered in nine languages of Eritrea with a total of 265 participants (162 women and 103 men) in order to assess ‘resilience’ in quantitative terms. Statistical analysis yielded significant differences in SOC scores between the displaced and non-displaced: mean=54·84 (SD=6·48) in internally displaced person (IDP) camps, compared with mean=48·94 (SD=11·99) in urban and rural settlements (t=3·831, p<0·001). Post-hoc tests revealed that the main difference is between IDP camp dwellers and urban (non-displaced) residents. Those in rural but traditionally mobile (pastoralist or transhumant) communities scored more or less the same as the urban non-displaced – i.e. significantly higher than those in IDP camps (p<0·05). Analysis of variance showed that displacement has a significantly negative effect on women compared with men (RR=0·262, p<0·001). Repeating the analysis for the three groups confirmed that urban and pastoralist/transhumant groups are similar, while women in IDP camps are lower scoring (RR=0·268, p<0·001), Hamboka women being worst affected due to their experience of serial displacement. These findings are interpreted and discussed in the light of qualitative information gleaned from the study participants’ interrogation of the content of the SOC scale; and in the wider context of historical, socio-political and cultural characteristics of Eritrea. The study’s implications for humanitarian and public health policy are considered.

Skilled attendance at delivery is one of the key indicators to reflect progress toward the Millennium Development Goal of improving maternal health. This paper assesses global progress in the use of skilled attendants at delivery and identifies factors that could assist in achieving Millennium Development Goals for maternal health. National data covering a substantial proportion of all developing country births were used for the estimation of trends and key differentials in skilled assistance at delivery. Between 1990 and 2000, the percentage of births with a skilled attendant increased from 45% to 54% in developing countries, primarily as a result of an increasing use of doctors. A substantial proportion of antenatal care users do not deliver with a skilled attendant. Delivery care use among antenatal care users is highly correlated with wealth. Women aged 35 and above, who are at greatest risk of maternal death, are the least likely to receive professional delivery care. Births in mid-level facilities appear to be a strategy that has been overlooked. More effective strategies are needed to promote skilled attendance at birth during antenatal care, particularly among poor women. Specific interventions are also needed to encourage older and high parity mothers to seek professional care at delivery.

The present paper seeks to analyse the spatial distribution of surnames in the province of Belluno in the Italian Alps, and describes the internal mobility of the population taking into consideration one of the most important and ancient roads in the area. The study is based on the analysis of the similarity of the frequencies of some autochthonous surnames depending on their geographical distance apart. The population considered turned out to be basically sedentary. When forced to migrate, the population preferred to go far from their homeland rather than inside the area: this happened probably because the opportunities that the province of Belluno could offer were quite scarce throughout the whole territory, and people hoped to improve their economic situation by going abroad.

This study examines the relationship between family size and children’s education in Bangladesh for two periods – 1982 with high fertility and 1996 with low fertility – using data from the Matlab Health and Demographic Surveillance System of the ICDDR,B: Centre for Health and Population Research. Children aged 8–17 years (27,448 in 1982 and 32,635 in 1996) were selected from households where the mother was aged 30–49 years and the father was the head of household. Children’s education was measured in terms of completed years of schooling: at least class 1 (among 8–17 year olds), at least class 5 (among 12–17 year olds) and at least class 7 (among 15–17 year olds). After controlling for all variables in the multivariate analyses, level of children’s education was not found to be associated with family size during the high fertility period. The family size–education relationship became negative during the low fertility period. In both periods children of educated mothers from wealthier households and those who lived close to primary/high schools had more education, but this socioeconomic difference reduced substantially over time. Boys had more education than girls during the high fertility period but this difference disappeared during the low fertility period. As birth rates fall and the proportion of children from small families increases an increase in children’s education is to be expected.

The purpose of this paper is to review the patterns of contraceptive use in Australia, using data from a nationally representative sample of 5872 women aged 18 to 49. This survey was conducted by the Australian Bureau of Statistics in 2001 as part of the National Health Survey. Results of the analysis indicate that the oral contraceptive pill and condom were the two most frequently used methods. More than 76% of the respondents reported having ever used the pill. Over 23% of women were currently using condoms; of these 80% of the condom users used them for contraception – this included 36% who used condoms for both protection against infection and for contraception – and the remainder used them only for protection. Withdrawal was the third most popular non-surgical method up to age 40. Few women used IUDs, injections or diaphragms. Just over 3% of the respondents were using natural methods with the highest rate reported among those in their 30s. The ‘morning-after pill’ was reported mostly by women aged 18–24; however, there was no evidence to suggest that it was being used as a primary method of birth control. Contraceptive use declined in older women who turned to sterilization for themselves and/or their partners. Use of the contraceptive pill was somewhat higher among better-educated women, but lower among less-educated women and those from non-English-speaking backgrounds.