This study explores the association between type of female circumcision and infertility and fertility in Sudan using the 1989–90 Demographic and Health Survey. It is hypothesized that women with either Pharaonic or Intermediate circumcision would have higher infertility and lower fertility compared with women with Sunna circumcision, and that uncircumcised women would have the lowest infertility and highest fertility of the three groups. This hypothesis, a widely held assumption, proved to be largely incorrect. Though women with Pharaonic or Intermediate circumcision did have a higher prevalence of primary infertility than uncircumcised women, women with Sunna circumcision had even lower rates of primary infertility compared with uncircumcised women. This pattern prevailed in multivariate models controlling for confounding variables, where women with Pharaonic or Intermediate circumcision had significantly higher primary infertility. Moreover, though women with Pharaonic or Intermediate circumcision also had the highest prevalence of secondary infertility, once confounding covariates were controlled in multivariate models, there was no significant difference among the three groups of women. With respect to fertility, the total fertility rate was 7·6 for women with Pharaonic or Intermediate circumcision, 8·1 for women with Sunna circumcision and 8·3 for uncircumcised women. Differences in fertility were found to be insignificant when covariates were controlled. The multivariate models were estimated using logistic regression. In conclusion, Pharaonic or Intermediate circumcision may be associated with higher primary infertility while there was no evidence suggesting that either secondary infertility or fertility was associated with a woman’s circumcision status.

The duration of lactational amenorrhoea, and infant feeding patterns and behaviour, were investigated in a sample of 97 mother–infant pairs living in a poor urban area of Dhaka, Bangladesh. A seven-hour time allocation method was used to determine the number of breast-feeding bouts and their duration. The seven-hour observation period was conducted on five occasions: at birth, 1 month, 4 months, 8 months and either 10 or 11 months. The median duration of lactational amenorrhoea was determined to be 24·07 weeks using survival analysis. Mothers who breast-fed their babies for longer and more frequently had, on average, a longer period of lactational amenorrhoea. There was no relationship between sociodemographic characteristics of the mother and duration of lactational amenorrhoea, nor was there any significant relationship between maternal anthropometry and birth weight of the baby and duration of lactational amenorrhoea, but there was a tendency for women with lower body mass index to have longer durations. Using the Cox proportional hazards model, the best predictor of duration of lactational amenorrhoea was the mean of months 0 and 1 durations of breast-feeding, adjusted for the mean frequencies for those months. The introduction of weaning food was also an important predictor.

This paper examines determinants of one aspect of sexual behaviour – coital frequency – among 2188 married women in the Central African Republic using a secondary analysis of data from the Demographic and Health Survey of 1994–95. Female genital cutting (or circumcision) is practised in the Central African Republic and self-reported circumcision status was included in the questionnaire enabling it to be examined as a possible determinant of coital frequency. Multiple logistic regression was used to find a subset of factors independently associated with coital frequency. Decreased coital frequency was found in those who had longer duration of marriage, those who were not the most recent wife in a polygamous marriage and those who had more surviving children. Coital frequency was higher in more educated women and those not contracepting because they wanted to get pregnant. After adjusting for confounders no association between female genital cutting and coital frequency was found. The extent to which women can control coital frequency in this culture is not known and fertility desires may override any negative effects of circumcision on sexual pleasure. It was therefore not possible to draw conclusions about how female genital cutting affects a woman’s desire for sexual intercourse and consequently there is a need to develop research methods further to investigate this question.

Seasonality of births has been related to multiple factors, including environmental, biological and sociocultural ones, in populations of diverse geographic and cultural origin. However, the relationship between this variable of bioanthropologic interest and geographic altitude has not been adequately explored. The aim of this study was to analyse the monthly distribution pattern of birth rates in Jujeño (north-west Argentina) populations located at different geographic altitude levels. Data were provided by the Statistical Reports on Liveborns (n=110,404) in the province of Jujuy, 1985–1992. Records were grouped by birthplace into the four geographic regions of the province: Ramal (350 m.a.s.l.), Valle (1200 m.a.s.l.), Quebrada (2500 m.a.s.l.) and Puna (3500 m.a.s.l.). Henry’s coefficients of seasonality were estimated. A chi-square test for goodness of fit (χ2) was used to identify statistically significant seasonal variations. Edwards’ test was used to detect simple harmonic cycles in birth distribution. Statistically significant seasonal patterns were found in the four geographic regions and they respond to a cyclic model of simple harmonic variation. The greatest Henry coefficients were observed in spring and summer in the higher regions (Puna and Quebrada), whereas they were seen in autumn and winter in the lowlands (Valle and Ramal). It is suggested that these patterns reflect the influence of environmental and socioeconomic altitude-related factors and inter-regional cultural diversity, rather than the influence of geographical altitude per se.

After the onset of liberlization of the Mongolian economy in 1989, the laws governing abortion were relaxed. Furthermore, the availability and use of modern contraceptives also started to improve. The Demographic Survey of Mongolia, conducted during June–July 1996, collected information on different aspects of abortion. This paper presents the results on the prevalence of induced abortion and other related issues. It was found that in the absence of adequate knowledge and availability of modern contraceptives in Mongolia, the prevalence of induced abortion was relatively high. About 24% of women undergoing abortion were using it as a contraceptive because they thought it to be a safe method of contraception. Though the abortion rules stipulate counselling on the use of modern contraceptives just after an abortion, only 60% of women undergoing an abortion were given such counselling.

This article examines the provision of family planning services in selected countries in the Caribbean. The potential impact of the funding shortfall resulting from the phasing out of funding by the International Planned Parenthood Federation (IPPF), and the strategies being adopted by the selected countries to cope with this, are considered. Stratified random sampling methods were employed to select eight Caribbean countries and a pre-designed questionnaire was administered to the agency responsible for family planning services in each country. The sample was stratified geographically to include countries from different parts of the Caribbean. The questionnaire was designed to collect information on the services provided, the name of the agency responsible for the provision of services and, where possible, the number of users of each type of service in 1998 and 1997. Vast disparities were found in the provision of family planning services in different Caribbean countries, in terms of the groups involved, the services available in each country, as well as methods of data collection and compilation. Anguilla and Bermuda were found to provide only limited family planning services, while Barbados, Jamaica and Grenada provide much more sophisticated services. A salient finding was the innovative approaches that various countries in the region have adopted to fund family planning programmes in anticipation of the phasing out of IPPF funding. The standpoint taken in the study is that countries such as Anguilla and Bermuda must strive to improve their provision of family planning services, and that they could learn from Barbados, Grenada and Jamaica, which provide much more comprehensive services. It is also concluded that, unless alternative funding sources are identified and accessed, the provision of family planning services in the Caribbean is likely to decline in the future.

This study presents a multivariate behavioural genetic analysis of the relationship between education, intelligence and age of first birth. Analyses investigated the mediational role of education in explaining the relationship between intelligence and age of first birth at both the phenotypic and behavioural genetic level. The data come from the National Longitudinal Survey of Youth (NLSY), a nationally representative survey that included genetically informative full- and half-sibling pairs (n=1423 pairs). Respondents were aged 14 to 22 when contacted in 1979. Heritability estimates were 0·32, 0·50 and 0·06 for IQ, education and age of first birth, respectively. Shared environment estimates were 0·35, 0·23 and 0·20 respectively. Common genetic and shared environmental factors were substantial in explaining the relationship between intelligence and education, and also education and age of first birth. Education partially mediated the relationship between intelligence and age of first birth only in the phenotypic analyses. After considering the genetic and shared environmental factors that influence all three variables, evidence for mediation was less convincing. This pattern of results suggests that the apparent mediational role of education at the phenotypic level is in fact the result of underlying genetic and shared environmental influences that affect education, IQ and age of first birth in common.

In this work, the evolution of demographic and health patterns in a Basque rural population from Spain is analysed, as they relate to progress in demographic and epidemiological transition. For this purpose, parochial record data on 13,298 births and 9215 deaths, registered during the 19th and 20th centuries (1800–1990), were examined. The study area is a rural community called Lanciego, which is located at the southern end of the Rioja Alavesa area (Alava Province, Basque Country). In Lanciego, demographic transition began in the final decade of the 19th century, when a definite, irreversible trend began towards a reduction in mortality. The decrease in the birth rate came later than that in the death rate, and did not start until the 1930s. The post-transitional stage seemed to be reached in the 1970s, when the birth and death rates showed values below 20 per 1000. Other characteristics observed for the post-transitional stage in Lanciego are: (i) very low rates of infant mortality achieved at the expense of effective control of exogenous mortality; (ii) the mortality curve by ages changes from a U-shape (typical of populations with a high infant mortality rate and low life expectancy at birth) to a J-shape more characteristic of modern societies where longevity and life expectancy are considerably higher; (iii) a certain level of over-mortality among women in the senior age group (>65); and (iv) a significant proportion of mortality in recent times (1970–90) resulting from cardiovascular diseases and malignant neoplasms (post-transition causes). This last point is in contrast with observations from the first four decades of the 20th century, when infectious diseases and respiratory ailments were determining factors in mortality among this population. The data provided by the study of the variation over time in demographic and health patterns indicate that reducing the risk of mortality is one of the most important preconditions for fertility decline.

This paper aimed to assess the prevalence of known diabetes among Bahraini adults, and to determine associated social and lifestyle factors. A community-based survey was carried out on 514 adults aged 30–79 years. The overall prevalence of known diabetes was 9%. Using multivariate analysis, the risk of diabetes was found to be higher among older (50–79 years), female, illiterate, currently married, non-smoking people, those who did not walk regularly, overweight and obese people (BMI[ges ]25), those who had a history of hypertension and those who consumed fresh vegetables more than 3 times a week. However, only obesity was found to be significantly associated with diabetes (OR=1·83, CI 1·48–4·15).

This study, conducted on the Kenyan coast, assesses the effect of intra-household relations on maternal treatment-seeking. Rural and urban Mijikenda mothers’ responses to childhood fevers in the last 2 weeks (n=317), and to childhood convulsions in the previous year (n=43), were documented through survey work. The intra-household relations and decision-making dynamics surrounding maternal responses were explored through in-depth individual and group interviews, primarily with women (n=223). Responses to convulsions were more likely than responses to fevers to include a healer consultation (p<0·0001), and less likely to include the purchase of over-the-counter medications (p<0·0001). Mothers received financial or advisory assistance from others in 71% (n=236) of actions taken outside the household in response to fevers. In-depth interviews suggested that general agreement on appropriate therapy results in relatively few intra-household conflicts over the treatment of fevers. Disputes over perceived cause and appropriate therapy of convulsions, however, highlighted the importance of age, gender and relationship to household head in intra-household relations and treatment decision-making. Although mothers’ treatment-seeking preferences are often circumscribed by these relations, a number of strategies can be drawn upon to circumvent ‘inappropriate’ decisions, sometimes with implications for future household responses to similar syndromes. The findings highlight the complexity of intra-household relations and treatment decision-making dynamics. Tentative implications for interventions aimed at improving the home management of malaria, and for further research, are presented.

The inbreeding coefficient of a population, estimated from ecclesiastical Roman Catholic dispensations, results from the relative contribution of different degrees of relationships (uncle–niece, first cousin, etc.). The interpopulation comparisons of consanguinity patterns may be obscured by the fact that in 1918 the Roman Catholic Church norm regulating the closest marriageable kinship was modified, limiting the application for an ecclesiastical dispensation to relatives of third degree (second cousins) or closer. Depending on the length of the period before or after the change of regulation, coefficients and rates may differ. Deviation of frequencies for multiple marriages may also occur. The aim of the present paper is to determine how the chosen procedure based on ecclesiastical dispensations may affect results, regarding the inbreeding coefficient, the consanguinity rate, the structure of consanguinity and the close/remote kinship ratio. As a sample case, information from the Gredos mountain range (central Spain) has been used.

Time spent on subsistence activities was compared between rural sedentes and urban migrants of the Huli population in Papua New Guinea. Person-day observation data were collected for rural sedentes (441) in the Tari basin and for urban migrants in Port Moresby (175). The time spent on subsistence activities by males was longer in the urban area than in rural areas, while that by females was similar in both areas. Conspicuous gender inequality with respect to labour hours in rural areas seems to diminish when people move to urban areas, reflecting the different subsistence regime between rural and urban environments.

This paper presents the prevalence of and investigates predictors for specific perceived gynaecological morbidities in Pakistani women. A total of 717 women were identified from eight squatter settlements in Karachi, Pakistan. Detailed information on demographics, contraceptive use and gynaecological morbidities was elicited. The perceived prevalence of uterine prolapse was 19·1% and that of pelvic inflammatory disease 12·8%. The prevalence of uterine prolapse (adjusted odds ratio 1·8; 95% confidence interval 1·0–3·0) was significantly higher among women who married at younger ages (≤16 years), independent of education, socioeconomic status and parity. That of pelvic inflammatory disease was significantly higher among those under 21 years of age (adjusted odds ratio 2·3; 95% confidence interval 1·1–4·8), independent of education, socioeconomic status and parity. Young Pakistani women report an immense burden of reproductive ill health, especially those who began sexual activity at an early age.

In the July 2001 issue of the Journal of Biosocial Science Tina Moffat presents an interesting study from Nepal (Moffat, 2001). She refers to several studies, among them our study from Nepal’s neighbouring country Bhutan (Bøhler & Ingstad, 1996), to show that weaning practices are determined by different aspects of the environment, and thus cannot be made universal. However, she goes on to conclude that the recommendation of exclusive breast-feeding for 6 months may not be appropriate for the population she studied. This part of her conclusion is, in my view, far from sufficiently supported by her data.