This study examines local heterogeneity in the aptitude of Sardinian mothers towards late reproduction, and explores its temporal persistence and association with both post-reproductive longevity and propensity to consanguineous marriage. Data on women's fertility from 1961 and birth records for 1980–1996 from Vital Statistics were analysed by means of the following indicators: the incidence of old mothers at last childbirth, female mortality (1980–2001) at 80 years of age and over and the proportion of consanguineous marriages (1930–1969). A variable kernel-smoothing method was used to create interpretable representations of the true spatial structure of the indicators, and to highlight areas of higher than expected intensity. In particular, an area of reproductive and post-reproductive longevity was identified where the traits combine with a higher tendency to relatedness. Intriguingly, this area corresponds approximately to the geographically and historically well defined central-eastern zone, which was the refuge of Sardinians during past invasions, and overlaps the Ogliastra region, which has been widely studied for its genetic homogeneity.

This study explores the prevalence and factors associated with the utilization of maternal and child health care services among married adolescent women in India using the third round of the National Family Health Survey (2005–06). The findings suggest that the utilization of maternal and child health care services among adolescent women is far from satisfactory in India. A little over 10% of adolescent women utilized antenatal care, about 50% utilized safe delivery services and about 41% of the children of adolescent women received full immunization. Large differences by urban–rural residence, educational attainment, religion, economic status and region were evident. Both gross effect and fixed effect binary logit models yielded statistically significant socioeconomic and demographic factors. Women's education, wealth quintile and region are the most important determinants for the utilization of maternal and child health care services. Health care programmes should focus more on educating adolescents, providing financial support, creating awareness and counselling households with married adolescent women. Moreover, there should be substantial financial assistance for the provision of delivery and child care for married women below the age of 19 years.

Body mass index (BMI) is a good indicator of nutritional status in a population. In underdeveloped countries like Bangladesh, this indicator provides a method that can assist intervention to help eradicate many preventable diseases. This study aimed to report on changes in the BMI of married Bangladeshi women who were born in the past three decades and its association with socio-demographic factors. Data for 10,115 married and currently non-pregnant Bangladeshi women were extracted from the 2007 Bangladesh Demographic and Health Survey (BDHS). The age range of the sample was 15–49 years. The mean BMI was 20.85±3.66 kg/m2, and a decreasing tendency in BMI was found among birth year cohorts from 1972 to 1992. It was found that the proportion of underweight females has been increasing in those born during the last 20 years of the study period (1972 to 1992). Body mass index increased with increasing age, education level of the woman and her husband, wealth index, age at first marriage and age at first delivery, and decreased with increasing number of ever-born children. Lower BMI was especially pronounced among women who were living in rural areas, non-Muslims, employed women, women not living with their husbands (separated) or those who had delivered at home or non-Caesarean delivery.

Men's supportive stance is an essential component for making women's world better. There are growing debates among policymakers and researchers on the role of males in maternal health programmes, which is a big challenge in India where society is male driven. This study aims to look into the variations and determinants of maternal health care utilization in India and in three demographically and socioeconomically disparate states, namely Uttar Pradesh, West Bengal and Maharashtra, by husband's knowledge, attitude, behaviour towards maternal health care and gender violence, using data from the National Family Health Survey III 2005–06 (equivalent to the Demographic and Health Survey in India). Women's antenatal care visits, institutional delivery and freedom in health care decisions are looked into, by applying descriptive statistics and multivariate models. Men's knowledge about pregnancy-related care and a positive gender attitude enhances maternal health care utilization and women's decision-making about their health care, while their presence during antenatal care visits markedly increases the chances of women's delivery in institutions. From a policy perspective, proper dissemination of knowledge about maternal health care among husbands and making the husband's presence obligatory during antenatal care visits will help primary health care units secure better male involvement in maternal health care.

This study examines women's attitude towards intimate partner violence among 331 Bangladeshi women in five selected disadvantaged areas of Dhaka city. This study used a shorter version of the Inventory of Beliefs about Wife Beating (IBWB) to measure women's attitude towards intimate partner violence. The results revealed that the mean score on the wife-beating scale of 15 items was 7.81 (SD=4.893). Significant amounts of the variance (42.9%) in women's attitude towards intimate partner violence can be attributed to respondent's education (B=−0.60, p<0.001), husband's education (B=−1.251, p<0.01), exposure to mass media (B=−1.251, p<0.01), respondent's current age (B=0.081, p<0.05), age at marriage (B=0.215, p<0.01), intimate partner violence victimization within the last 12 months (B=−1.533, p<0.001) and women receiving micro-credit (small-scale loan or financial assistance) (B= −2.214, p<0.001). The paper concludes with a discussion of the implications of the findings.

This study sampled 8432 singleton first live births from Taiwan's 2005 Birth Registration Database to determine if there were more pre-term or low birth weight deliveries among aboriginal women than there were among Han Chinese women, and if the ‘weathering’ hypothesis applied to aboriginal women in Taiwan. Although the aboriginal women were socially disadvantaged and engaged in more unhealthy behaviours, including smoking, drinking, chewing betel quid and exposure to second-hand smoke, the evidence did not support the hypothesis that these teenaged minority women would have better birth outcomes, as has been demonstrated among teenage African-American women in the United States. Behaviours and not ethnicity were risk factors for teenage aboriginal mothers, who started deleterious health behaviours earlier than did their older counterparts. Teenage mothers had more adverse outcomes regardless of ethnicity and aboriginal mothers had more risky behaviours in all age groups. The prevalence of detrimental health behaviour among teenage mothers in Taiwan is of concern, particularly for aboriginal teenage mothers.

This study describes Finnish university students' knowledge and attitudes towards HIV and AIDS, homosexuality and sexual risk behaviour. Finnish-speaking students were randomly selected from all registered students at two universities in Finland (N=9715, n=950). The data were collected by using a modified version of the State University of New York at Buffalo School of Nursing AIDS Study Questionnaire on sexual risk behaviour developed by Held and Chng. The total response rate was 35% (n=333). The data were analysed using quantitative statistical methods. Normally distributed data were analysed by t-test and one-way ANOVA, with Bonferroni corrections. Non-normally distributed data were analysed using the Mann-Whitney U-test and Kruskal-Wallis test, followed by a post-hoc test. The majority of students were familiar with HIV and AIDS, including its mode of transmission. However, there were still some misconceptions concerning HIV and AIDS. The oldest students and women had a more positive attitude towards people living with HIV and AIDS (PLWHA). Of patients with HIV or AIDS, intravenous drug users were perceived most negatively. Male students had more homophobic attitudes. Students who reported that religion had an important role in their lives had significantly stricter attitudes towards sexual risk behaviour. Students' knowledge correlated positively with general attitudes towards HIV and AIDS. Knowledge about HIV and AIDS will lead to more positive attitudes towards HIV and AIDS as a disease, towards those infected as well as homosexual people. There is a need to focus on preventive health care and sexual health promotion by educating young people and changing their attitudes towards sexual risk behaviour.

This paper demonstrates that although modern BMIs in the US have increased, 19th century BMIs in Philadelphia were lower than elsewhere within Pennsylvania, indicating that urbanization and agricultural commercialization were associated with lower BMIs. After controlling for stature, blacks consistently had greater BMI values than mulattos and whites; therefore, there is no evidence of a 19th century mulatto BMI advantage in the industrializing North. Farmers' BMIs were consistently heavier than those of non-farmers.

This paper presents the results of a longitudinal intervention study carried out in the Davao del Norte province of the Philippines. The intervention, tested through a quasi-experimental design, consisted of training of family planning service providers in information exchange and training of their supervisors in facilitative supervision. The training intervention significantly improved providers' knowledge and quality of care received by clients. Moreover, good quality care received by clients at the time of initiating contraception use increased the likelihood of contraceptive continuation and decreased the likelihood of both having an unintended pregnancy and an unwanted birth. However, comparison of women in the experimental group with those in the control group did not show any significant effect of provider-level training intervention on these client-level outcomes. The reasons for this conundrum and the implications for quality of care are discussed.

In the Terai region, despite its ecological richness, the people have long suffered from a deficiency of micronutrients such as vitamin A, iron and zinc. The aim of this study was to investigate dietary and nutritional intakes among people in the Terai region of Nepal. The results were compared by sex and ethnicity. Food consumption surveys (one-day weighed records) were conducted among 114 people (55 Mushar and 59 Tharu). Nutritional intakes were calculated using Nepali food composition and other tables. The diet in the Terai region was characterized by a large amount of rice consumed with a tiny amount of curry or dal as a side dish. Intakes of vitamin A, iron, riboflavin and selenium were less than 50% of the recommended daily allowance irrespective of ethnicity or sex (with the exception of iron intake among Tharu males). Intakes of thiamine, riboflavin, niacin, phosphorus and zinc were higher among the Tharu than the Mushar, while intakes of selenium and iodine were higher among the Mushar than the Tharu. The nutritional significance of these differences was slight. Protein intake (per kg body weight) was lower in females than in males, while the energy-adjusted micronutrient intakes did not differ by sex. Intakes of vitamin A, iron, riboflavin and selenium were deficient among the participants. Intervention projects such as the introduction of kitchen gardens or fish farming may be effective, but will increase the degree of inequality between the two ethnic groups.

This paper describes the biological fitness of an urban population of Havana city, Plaza de la Revolución, which has the lowest fertility and the highest demographic ageing in Cuba. The aim is to assess the biological fitness of this community through the indexes of action opportunity of natural selection, to determine its evolutionary pattern and the influence of its socio-cultural peculiarity. Demographic data were obtained from the reproductive histories of 1200 women between the ages of 55 and 64. Data concerning mortality and surviving offspring from the first embryonic stages until age of reproduction were also collected. In order to measure the level of biological fitness two indexes were used: the Crow index of action opportunity of natural selection and the corrected index proposed by Johnston and Kensinger, which takes into account prenatal mortality. This corrected index was calculated including and excluding induced abortions in order to evaluate the contribution of these to biological fitness. When only postnatal mortality was considered, the results showed an evolutionary pattern similar to that of developed countries, based on low mortality and fertility. However, when prenatal mortality was taken into account, biological fitness decreased and the corrected index of natural selection was 4.5 times higher than when miscarriages and fetal deaths were not considered. Moreover, this corrected index was 2.65 times higher when induced miscarriages were considered, indicating the large decrease in biological fitness as a result of the current reproductive behaviour of frequent induced abortion.

The nutritional status of under-five children is a sensitive sign of a country's health status as well as economic condition. This study investigated the differential impact of some demographic, socioeconomic, environmental and health-related factors on the nutritional status among under-five children in Bangladesh using Bangladesh Demographic and Health Survey 2007 data. Two-level random intercept binary logistic regression models were used to identify the determinants of under-five malnutrition. The analyses revealed that 16% of the children were severely stunted and 25% were moderately stunted. Among the children under five years of age 3% were severely wasted and 14% were moderately wasted. Furthermore, 11% of the children were severely underweight and 28% were moderately underweight. The main contributing factors for under-five malnutrition were found to be child's age, mother's education, father's education, father's occupation, family wealth index, currently breast-feeding, place of delivery and division. Significant community-level variations were found in the analyses.

This study examined the nutritional status of mothers in one of the most populous food-insecure zones in southern Ethiopia, the Sidama zone. The study used primary data collected from 1094 households with a child under 24 months located in ten kebeles (the smallest administrative district). Households were selected using multi-stage probability sampling techniques. The mothers' nutritional status was estimated using both body mass index (BMI) and mid-upper-arm circumference (MUAC). The results from the BMI analysis revealed that 28.1% of the women were malnourished (BMI <18.5) and 67.5% were normal (BMI 18.5 to <25.0), while the remaining small proportion (4.5%) fell in the overweight or obese categories. Similarly, the computation of maternal nutritional status by MUAC analysis showed that 31.4% of the women were malnourished (MUAC <22). Further analysis of the main predictors of maternal malnutrition using logistic regression showed that three individual-level variables and three household-level variables predicted maternal malnutrition: woman's age, duration of breast-feeding, literacy status, marital form, land size and intra-household food distribution. The study concludes that maternal malnutrition is a serious problem in the study area and that there are contextual risk factors that could be addressed to partially tackle the problem.

Using recent pooled data from the World Health Organization Global Infobase and the World Factbook compiled by the Central Intelligence Agency of the United States, this study assesses the relation between income inequality and obesity prevalence among 31 OECD countries through a series of bivariate and multivariate linear regressions. The United States and Mexico well lead OECD countries in both obesity prevalence and income inequality. A sensitivity analysis suggests that the inclusion or exclusion of these two extreme cases can fundamentally change the findings. When the two countries are included, the results reveal a positive correlation between income inequality and obesity prevalence. This correlation is more salient among females than among males. Income inequality alone is associated with 16% and 35% of the variations in male and female obesity rates, respectively, across OECD countries in 2010. Higher levels of income inequality in the 2005–2010 period were associated with a more rapid increase in obesity prevalence from 2002 to 2010. These associations, however, virtually disappear when the US and Mexico have been excluded from the analysis. Findings from this study underscore the importance of assessing the impact of extreme cases on the relation between income inequality and health outcomes. The potential pathways from income inequality to the alarmingly high rates of obesity in the cases of the US and Mexico warrant further research.

Obesity has been linked to several physiological and psycho-social diseases, decreases in cognitive function, poor levels of scholastic achievement, low socioeconomic status and delayed onset of maturity. This study investigates the association between obesity and both academic performance and reasoning ability in 394 male and 398 females students between the ages of 6 and 12 from Lisbon, Portugal. It also assesses how this relationship may be influenced by chronological age, maturity and socioeconomic status. The results suggest that: 1) reasoning ability is independent of socioeconomic status and level of maturity; 2) no differences in reasoning ability exist between groups of different BMI; 3) academic performance is moderated by chronological age in boys, and by maturity in both genders; 4) obesity is not associated with academic performance. It is concluded that reasoning ability and academic performance are not associated with obesity, and that inter-individual differences in academic performance in boys may be explained by differences in their level of maturity.

A number of authors have identified multiple concurrent sexual partnerships by both men and women to lie at the root of the HIV/AIDS epidemic in sub-Saharan Africa. This study applies multilevel models to Demographic and Health Survey data collected during 2003–2008 in 20 sub-Saharan African countries to examine the influence of social and cultural context on involvement with multiple sexual partnerships in the region, above and beyond the effects of individual characteristics. The findings provide support for the ecological argument that health behaviours are shaped and determined by societal conditions, in addition to the effects of individual and household characteristics. Involvement with multiple sex partners is most prevalent in societies in which sexual norms are widely permissive and where polygyny is common. Individual autonomy is substantial and attitudes towards sexuality are more liberal among men and women who live in communities in which sexual norms are widely permissive. Men and women who are most likely to have multiple sex partners in the sub-Saharan region are those who initiated sexual activity earlier and those who have the individual attributes (e.g. young age, urban residence, education, media exposure and working for cash and away from home) that bring to them more rights and/or decision-making autonomy, but not necessarily more financial resources and economic security (mostly among women). On the other hand, involvement with multiple partners is determined by cultural norms (i.e. permissive sexual norms) and social change (i.e. mass education, expansion of cash employment). The findings suggest a number of opportunities for more effective policy and programmatic responses to curb the prevalence of multiple partnerships in sub-Saharan Africa.

Son preference has been considered as a determinant of women's risk of intimate partner violence (IPV) experience in India, although quantitative evidence from large nationally representative studies testing this relationship is limited. This study examines the association between husband's son preference, sex composition of children and risk of physical and sexual IPV victimization among wives. Information was collected for 26,284 couples in the nationally representative 2005–2006 National Family Health Survey of India. The exposures were husband's son preference measured as husband's desire for one or more sons greater than the number of daughters and sex composition of the household: only sons, only daughters and mixed. Outcome included past year physical and/or sexual IPV. The results showed that husband's reported son preference (RR: 1.05; 95% CI: 0.98–1.13) and sex composition of children were not associated with risk for IPV victimization in the models adjusted for socio-demographic factors. The findings from this first population-based study of socio-cultural norms around son preference and married Indian women's risk for IPV victimization indicate that cultural preference for sons does not influence women's risk for IPV victimization.

This study explores the relationship between poverty and vulnerability to HIV infection in Ethiopia using primary (quantitative and qualitative) and secondary data from two sub-cities of Addis Ababa. The data show that sexual experience is influenced by diverse factors such as age, gender, economic status and education level. Household economic status and migration explain the nature of sexual experience and level of vulnerability to HIV infection. Poor uneducated women in poor neighbourhoods are more likely to engage in risky sexual encounters despite awareness about the risk of HIV infection as they operate in an environment that provides the ‘path of least resistance’ (Lindegger & Wood, 1995, p. 7). This article argues that poverty provides a situation where early sexual initiation, ‘transactional sex’ and an inability to negotiate for safer sex are associated with low income, lack of education and increased vulnerability to HIV infection. This vulnerability is simultaneously contested and accepted as a commitment to even sacrifice one's life for the sake of one's loved ones. As a modest contribution to the ‘structural violence’ approach, which emphasizes social inequalities based on gender, class, ethnicity and race and inequalities in terms of exposure to risk and access to health care (Massé, 2007), this article challenges the ‘African promiscuity’ discourse, which ‘does not permit policymakers to think beyond sex’ (Stillwaggon, 2006, p. 156), and encourages researchers and policymakers to ask the right questions to understand the complexity of HIV/AIDS and seek solutions to the pandemic.

Consanguineous marriage is traditional and respected in most communities of North Africa, the Middle East and West Asia, including Bahrain, with intra-familial unions accounting for 20–50+% of all marriages. Significant secular changes in consanguinity rates have been reported in recent decades in different populations. Among parents of 14,237 newborns in Bahrain in 2008–2009, the total consanguinity and first cousin marriage rates over a period of four months in 2008 were 10.9% and 6.9% respectively, while during all of 2009 the rates were 11.4% and 6.8% respectively. The study confirms that over a ten-year period first cousin marriage rates in Bahrain have declined from 24% to nearly 7%. Although advice against cousin marriages was not attempted at any stage in the comprehensive community genetics programmes in Bahrain, increasing the literacy of the public and of the health care providers on prevention strategies for genetic diseases could have contributed to this decline in consanguinity rate in Bahrain.

To date, very few studies have examined what contributes to unwanted and mistimed births in the Philippines. In a country where women have higher educational levels than their male counterparts, and their status is among the highest in Asia, it is expected that unwanted births will be low. The evidence, however, points to the contrary as 44% of births reported in the last five years were unintended. Using the 2003 Philippines National Demographic and Health Survey, this article focuses on married women who are currently pregnant and those who had given birth in the last five years. Multinomial logistic regression is employed to ascertain the risks of a recent birth/pregnancy being unwanted, mistimed or wanted. Regardless of women's status, having a final say in household and sexual matters with husbands lowers the risk of unwanted births but not mistimed births, calling into question the use of status variables such as education and wealth as indicators of women's autonomy. The success of implementing family planning programmes and policies in reducing unintended pregnancies underscores the importance of understanding how women are able (or unable) to make decisions surrounding their reproductive intentions.