This study examines the prevalence of self-reported reproductive tract infections (RTIs) and treatment seeking among married, recently pregnant women in Uttar Pradesh state, India. Associations between RTI symptom reporting and background characteristics are examined in a population-based sample of 18,506 married women with a pregnancy in the 3 years prior to a 1995 statewide survey. Logistic regression analyses are used to assess the effects of sociodemographic covariates on the probability of reporting an RTI symptom. Nearly one out of four women reports experiencing at least one RTI symptom, with the most common symptoms being abnormal vaginal discharge and pain during urination. Reporting of RTI symptoms significantly increases if the woman’s last pregnancy did not end in a live birth or if she has low economic status. Symptom reports also increase with age and decrease with parity. Only one-third of women reporting an RTI symptom sought treatment. The results indicate that survey interviews can be a cost-effective option for measuring the magnitude of RTI symptoms experienced and identifying sociodemographic influences. The findings suggest the need for improved RTI screening procedures and treatment at health facilities in this populous state of northern India.

Indigenous populations in New World nations share the common experience of culture contact with outsiders and a prolonged history of prejudice and discrimination. This historical reality continues to have profound effects on their well-being, as demonstrated by their relative disadvantages in socioeconomic status on the one hand, and in their delayed demographic and epidemiological transitions on the other. In this study one aspect of aboriginals’ epidemiological situation is examined: their mortality experience between the early 1980s and early 1990s. The groups studied are the Canadian Indians, the American Indians and the New Zealand Maori (data for Australian Aboriginals could not be obtained). Cause-specific death rates of these three minority groups are compared with those of their respective non-indigenous populations using multivariate log-linear competing risks models. The empirical results are consistent with the proposition that the contemporary mortality conditions of these three minorities reflect, in varying degrees, problems associated with poverty, marginalization and social disorganization. Of the three minority groups, the Canadian Indians appear to suffer more from these types of conditions, and the Maori the least.

Maternal ages at the first maternity (starting), at the last maternity (stopping) and the lengths of intervals between maternities (spacing) have been studied in the Outer Hebridean islands of Harris and Barra for births between the years of 1855 and 1990, a period during which a considerable ‘fertility transition’ occurred. There was a tendency in each island for increases with time in the ages at starting among less-fecund women (although after 1936 starting ages declined), and highly significant heterogeneity of covariance: adjusted means dependent on the total numbers of maternities experienced. The same result was seen for the ages at stopping. Lengths of reproductive life (the difference between ages at starting and stopping) rose to 1876–1895, and then fell, apart from a short-lived rise in Barra during 1956–1975, possibly due to the papal encyclical Humanae Vitae. Intervals between marriage and first maternity and between successive maternities were studied by hazard function survival analysis. The marriage–first birth interval remained very constant, unaffected by total maternities. The father’s occupation and the mother’s age at first maternity showed no significant relationships. In Barra there was a weak negative relationship with the date of the marriage. For intervals between maternities in both islands, total maternities and the death of a previous infant were associated with shorter, and birth order with longer intervals. In Harris, there were tendencies for intervals to be consistently long or short in families, and for the age of the mother and date at first maternity to be negatively related to the length of the interval. In Barra, a previous multiple birth was followed by a longer interval. The date of the previous maternity, father’s occupation, maternal age at the previous maternity, the sex of the previous child, and the duration of the marriage appeared to have no influence on maternity intervals. Evidence for an effect of economic deprivation during the 19th century on the variables considered was equivocal. During the 20th century, it is suggested that economic depression during the inter-war years, the spread of contraception, and improvements in health care may have acted ‘synergistically’ toproduce the lower ages of childbearing and the shortening of maternity intervals and reproductive lives.

Kenya was one of the first sub-Saharan countries to enter the fertility transition, and analysts have suggested various explanations for this. This paper examines the growth in contraceptive availability in Kenya by looking at the Kenya family planning programme and its association with the fertility transition. This is of critical programmatic importance because the fertility transition is not yet underway in many sub-Saharan countries. Policymakers will find the information from this study helpful in evaluating the efficacy of current programmes and replicating the Kenyan programme in areas where fertility decline has not yet occurred. For researchers, the study attempts to highlight some of the major factors driving Kenya’s fertility decline, apart from the conventional arguments about social and economic development.

The extent and quality of prenatal care are important for the health of women and their babies. Recent studies suggest that women lack adequate prenatal care in contemporary Turkey. This paper uses regression models to examine the major factors impacting on the access of women to prenatal care through the 1993 Turkish Demographic and Health Survey. The findings suggest that after controlling for class, ethnicity does not explain the likelihood of a woman’s access to prenatal care, partly because the predominant patriarchal ideology in Turkey determines women’s access to education, which in turn determines their access to prenatal care. It can be argued that unless women’s socioeconomic status in the family improves, their access to health care in general and prenatal care in particular will not increase significantly.

This study explores the factors associated with neonatal mortality and maternal health care in Nepal. The subjects were 4375 births reported in the 1996 Nepal Family Health Survey. Maternal and child health care was found to have a significant association with neonatal mortality, although preceding birth interval and sex of child had stronger effects. Four aspects of maternal care were found to be highly associated with region, household ownership of assets, mother’s education and father’s education. This indicates that accessibility, affordability and availability of maternal health care are important factors to consider in future research on neonatal mortality.

Using cross-sectional, individual-level survey data from Maharashtra, Tamil Nadu and Uttar Pradesh collected under the Indian National Family Health Survey programme of 1992–93, statistical modelling was used to analyse the impact of a range of variables on the survival status of children during their first 2 years of life. Attention was focused on the potential impact of the mother’s autonomy. The strongest predictors of mortality were demographic and biological factors, breast-feeding behaviour, and use and knowledge of health services. Variables that can be interpreted as being related to maternal autonomy, such as the presence of a mother-in-law in the household, did not have a significant direct effect on child survival at the individual level, and their indirect effects were very limited.

This study investigates seasonality of marriages and reproductive isolation in six long-isolated communities in the central Apennines (Italy). It had two objectives: (1) the identification of an Apennine biodemographic model in comparison with mountain communities of other regions, and with non-Apennine communities in Abruzzo, and (2) to identify the possible effects of the drainage of Lake Fucino (1854–1876) on that area. Marriages in this region show two very stable seasonal patterns: one is typical of sedentary rural societies, with summer migrations and marriages preferentially celebrated in the winter, and the other has marriages that are strongly concentrated in the summer months, i.e. between 75% and 93·5% of marriages were celebrated between June and October in these communities in the 1800s. These were traditionally pastoral communities with winter transhumance of the flocks and their shepherds towards the lowlands of southern Italy. In both groups, restrictions imposed by the Catholic Church do not seem to have affected the timing of marriages. Indeed, economic factors related to work activities seem to have had more influence. Concerning reproductive isolation, the results show high rates of endogamy: between 85% and 98% in both the 19th and 20th centuries. Rates of consanguineous marriages were between 5% and 20%, and those of isonymous marriages rarely exceeded 9%. The coefficient of inbreeding α shows that there was a delayed, limited period of increased consanguinity in the few decades around the turn of the century. This is different from the national situation, and thus could be a consequence of the Lake Fucino drainage.

The diffusion potential of a targeted HIV/AIDS intervention that enlisted peer educators to disseminate ‘safer sex’ messages and condoms among female commercial sex workers and their clients was evaluated in the Dominican Republic. Levels of interurban interaction potential were ascertained that linked the targeted city of La Romana with the proximate cities of San Pedro de Macoris and Guaymate. Weekly service statistics generated over an 8-month period were analysed to establish activity areas for the peer educators. Data were entered and analysed using a geographic information system and interurban linkages were established. Project outcomes were examined via a series of three cross-sectional Knowledge, Attitudes and Practices (KAP) surveys conducted among convenience samples of commercial sex workers at the start of the intervention and at 4 and 8 months. The results attest to a high degree of interconnectivity between the targeted and proximate cities, and a pattern of interurban mobility that links commercial sex workers, clients and establishments in all three cities. The examination of project outcomes revealed statistically significant changes in condom use in the targeted city of La Romana among commercial sex workers, as well as among their counterparts interviewed in the proximate cities of San Pedro de Macoris and Guaymate. These data suggest a diffusion effect. It is concluded that a targeted intervention may influence proximate cities within a relatively compressed period of time. The findings suggest the importance of considering geographic diffusion principles, such as urban hierarchies, regional nodes and transportation linkages, when designing HIV/AIDS prevention efforts. It also has important implications in the selection of control sites when conducting experimental studies of HIV/AIDS interventions.

This study’s first objective was to compare the mean birth weights of homosexual and heterosexual men and women. Its second objective was to investigate whether prior male and female fetuses have different effects on the birth weight of subsequent fetuses. The subjects were 3229 adult men and women (the probands), who weighed at least 2500 g at birth, and whose mothers knew the sex of the child (or fetus) for each pregnancy prior to the proband. Information on birth weight, maternal gravidity and other demographic variables was reported on questionnaires completed by the probands’ mothers. The results confirmed earlier reports that boys with older brothers weigh less at birth than boys with older sisters, but they did not confirm reports that girls with older brothers weigh less than girls with older sisters. The results did not show across-the-board differences in the mean birth weights of homosexual versus heterosexual women or homosexual versus heterosexual men. However, the homosexual males with older brothers weighed about 170 g less at birth than the heterosexual males with older brothers. It is suggested that this pattern of results may reflect a maternal immune response to Y-linked minor histocompatibility antigens (H–Y antigens). According to this hypothesis, when the maternal immune response is mild, it produces only a slightly reduced birth weight, but when it is stronger, it produces a markedly reduced birth weight as well as an increased probability of homosexuality.

The process of divorce is usually lengthy and hazardous, and can start quarrels that can lead to the abuse of women and their children. This study examines the effects of divorce on neonatal and postneonatal mortality of babies born before and after divorce in Teknaf, a remote area of Bangladesh. The longitudinal demographic surveillance system (DSS) followed 1762 Muslim marriages in 1982–83 for 5 years to record divorce, deaths of spouse, emigration and births. It recorded 2696 live births during the follow-up period, and their survival status during infancy. Logistic regression models were used to estimate the effect of divorce on neonatal and postneonatal mortality, controlling for maternal age at birth, parity, sex of the child and household economic status. The odds of neonatal and postneonatal deaths among babies born after divorce or less than 12 months before mothers were divorced were more than double the odds of those born to mothers of intact marriages. The odds of postneonatal deaths were two times higher among babies born more than 12 months before divorce happens than their peers. The high mortality of infants born before and after mothers were divorced may reflect how abusive marriage and divorce increase the vulnerability of women and children in rural Bangladesh. Divorce and abuse of women are difficult and intractable social and health problems that must be addressed.

Against the backdrop of a high prevalence of the human immunodeficiency virus infection in Zimbabwe, this paper analyses data from the 1997 Zimbabwe Sexual Behaviour and Condom Use Survey to throw light on the degree to which sexually active adults consistently use condoms in high-risk sexual situations. The multivariate results indicate that at the time of the survey, consistent condom use in non-marital relationships is significantly higher for males than females, higher among those who had access to information about condoms from multiple sources than among those with limited access, and higher among those who have positive attitudes to condoms than among those with negative attitudes. Even though consistent condom use with non-marital partners is higher for those who know a source where condoms can be obtained, this effect is due to the fact that these respondents have more positive attitudes towards condoms. Likewise, the higher levels of consistent condom use exhibited by those who are aware of the efficacy of condoms are due to the fact that men have higher awareness of this, and men use condoms more consistently than women. In sum, the results suggest that the effects of the respondents’ sex and their knowledge of the prophylactic importance of condoms and where condoms might be obtained are a function of other socioeconomic advantages they have. It is, therefore, concluded that programmes that use mass media information, education and communication campaigns to reduce shyness, embarrassment and stigma about condom use can help increase consistent use of condoms in non-marital relationships in Zimbabwe.

Evidence from eleven samples indicates that the mean IQ of third world immigrants in the Netherlands is lower than the Dutch mean by approximately one standard deviation for Surinamese and Antillians, and by approximately one and a half standard deviations for Turks and Moroccans. Since IQ tests provide the best prediction of success in school and organizations, it could be that the immigrants’ lower mean IQ is an important factor in their low status on the Dutch labour market. The IQs of second-generation immigrants are rising.

This article describes the long-term trends in marital status mortality differences in the Netherlands using a unique dataset relating to the period 1850–1970. Poisson regression analysis was applied to calculate relative mortality risks by marital status. For two periods, cause-of-death by marital status could be used. Clear differences in mortality by marital status were observed, with strongly increasing advantages for married men and women and a relative increase in the mortality of widowed compared with non-married people. Excess mortality among single and formerly married men and women was visible in many cause-of-death categories, and this became more widespread during the last decades of the nineteenth century. Hypotheses are formulated that might explain why married men and women underwent a stronger decrease in mortality up until the end of World War II.

Human breast milk is primarily colostrum immediately following birth. Colostrum gradually changes to mature milk over the next several days. The role of colostrum in fighting infections and promoting growth and development of the newborn is widely acknowledged. This role is mediated by differences across cultures in the acceptability of colostrum and the prevalence of colostrum feeding. This study examined the prevalence of colostrum feeding and time to initiation of breast-feeding in 143 rural Bangladeshi women in Matlab thana. Structured interviews were collected during a 9-month prospective study conducted in 1993. Women were usually interviewed within 4 days of giving birth and were asked about whether or not they fed their child colostrum and the number of hours until they began breast-feeding the baby. Ninety per cent of the mothers reported feeding their newborn colostrum. A logistic regression found no effect on the prevalence of colostrum feeding from the following covariates: mother's age, parity, history of pregnancy loss, child's sex, mother's self-report of delivery complications, and the time from birth to interview. Fifty-nine per cent of mothers initiated breast-feeding within 4 h, and 88% within 12 h of parturition. Survival analysis was used to estimate the effects of covariates on the time from delivery to initial breast-feeding. Time to initial breast-feeding was delayed slightly, but significantly, for older mothers, for male infants, and by mothers who did not report delivery complications. The percentage of mothers who fed their child colostrum was higher, and times to initial breast-feeding were shorter, than almost all previous reports from South Asia. These findings might be explained, in part, by methodological differences among studies, but it is suggested that recent changes towards earlier initiation of breast-feeding have taken place in rural Bangladesh.

Data on grandparental surnames were obtained from schoolchildren in 22 communes from Campobasso Province, Italy (Molise Region). The distribution of surnames was shown to be almost exactly linear by a log2–log2 transformation, which justified the fitting of the data to Fisher’s logarithmic distribution. The values for ν were higher among women. When ν was standardized to minimize bias due to sample size, the value was one-third the estimate of migration from exogamy data. The higher values of ν for females indicate that there is greater mobility of female marriage partners than males.