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.

The human sex ratio SR (proportion male) at birth has been reported to vary with many variables. The explanation of this variation is not established, but I have hypothesized that it is partially caused by the hormonal concentrations of both parents around the time of conception. The present note suggests how this hypothesis might accommodate recent sex ratio findings relating to ‘psychosexual restriction’, female genital cutting, sexes of prior sibs, finger length ratios, the autism spectrum disorder, parental occupation and maternal eating disorders. Tests of such suggestions are offered, and it is hypothesized that: (a) in women, Manning's R (the ratio of the lengths of the 2nd and 4th digits) is positively correlated with offspring sex ratio (proportion male); (b) women who have undergone female genital cutting (FGC) have high androgen levels; (c) offspring sex ratio correlates positively with ‘masculinity’ of parental occupation, the correlation being mediated by testosterone levels. It is noted that the lines of evidence for three hypotheses (James', Manning's and Baron-Cohen's) are mutually supportive.

This paper examines the association of the sociodemographic characteristics of women and the unobserved hospital factors with maternal mortality in Kenya using multilevel logistic regression. The data analysed comprise hospital records for 58,151 obstetric admissions in sixteen public hospitals, consisting of 182 maternal deaths. The results show that the probability of maternal mortality depends on both observed factors that are associated with a particular woman and unobserved factors peculiar to the admitting hospital. The individual characteristics observed to have a significant association with maternal mortality include maternal age, antenatal clinic attendance and educational attainment. The hospital variation is observed to be stronger for women with least favourable sociodemographic characteristics. For example, the risk of maternal death at high-risk hospitals for women aged 35 years and above, who had low levels of education, and did not attend antenatal care is about 280 deaths per 1000 admissions. The risk for similar women at low-risk hospitals is about 4 deaths per 1000. To complement results from the analysis of individual patient records, the paper includes findings from hospital staff reports regarding the maternal mortality situation at the hospitals.

This paper considers whether sex composition of existing children in Australian families is an important factor in parity progression. Using census data from 1981, 1986, 1991, 1996 and 2001, women are linked with their co-resident children, allowing investigation of family sex composition and its changing impact over time on the propensity to have another child. The study finds that parents are much more likely to have a third and fourth birth if existing children are all of the same sex, indicating a strong preference for children of both sexes. This increased propensity has added around three per cent to the fertility of recent cohorts. The paper concludes with a discussion of the potential impact of sex-selection technologies on fertility. The authors argue that future widespread use of reliable sex-selection technologies might act to increase fertility in the short term, but would lead to a long-term reduction in fertility.

Data from the Cebu Longitudinal Health and Nutrition Survey have been used to examine breast-feeding patterns in the Metropolitan Cebu region of the Philippines. The results show that there is extensive and early use of non-nutritive liquids, resulting in low levels of exclusive breast-feeding. The use of cross-sectional versus longitudinal data, the definition of exclusive breast-feeding, and movements in and out of the exclusively breast-fed category, are considered.

This paper investigates height and weight differences between the two Koreas by comparing national anthropometric data published by the South Korean Research Institute of Standard and Science with United Nations survey data collected inside North Korea in 2002. For socioeconomic reasons, pre-school children raised in the developing country of North Korea are up to 13 cm shorter and up to 7 kg lighter than children who were brought up in South Korea – an OECD member. North Korean women were also found to weigh up to 9 kg less than their Southern counterparts.

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.

This study examined the effects of biosocial variables on changes in nutritional status of rural Bangladeshi children, aged less than 2 years, pre- and post-1987 monsoon flooding. Nutritional status was measured by weight for age: variables included were age, sex, sickness during 2 weeks preceding the survey, intake of vitamin A capsules, socioeconomic status of household, and mother's education. A multivariate logistic regression analysis revealed an adverse effect of flood on nutrition and the effect was dependent on sex of child and intake of vitamin A. After the flood the proportion of severely malnourished children was significantly greater among those who had not taken vitamin A. For boys the proportion with severe malnutrition increased after the flood and the increase was greater than for girls; however, boys always had a lower risk of severe malnutrition than girls.

The rate of consanguineous mating in north Jordan was 63·7% with an average inbreeding coefficient of 0·0283. First cousin marriages were the most predominant type (58·5%); villagers showed higher levels than city dwellers. The level of female education did not influence consanguinity rate.

Parallel analyses of recent data from the United States, Thailand, Belgium, and Japan all confirm the finding that female age and not male age is the more important contributor to the decline in frequency of marital intercourse during the childbearing ages. The most probable explanation is the decline in female (but not male) androgen levels during the age span examined.

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.

The contribution of adolescents' childbearing to total fertility rates in many sub-Saharan African countries is higher than in other parts of the world. In this paper, data collected from 897 female adolescents aged 15–19 years are analysed to investigate patterns and determinants of entry into motherhood in two informal settlements in Nairobi, Kenya, using Kaplan–Meier estimates and Cox regression models. About 15% of these adolescents have had a child. The findings show that marriage, being out of school and having negative models in peer, family and school contexts are associated with early childbearing among females aged 15–17 years. For adolescents aged 18–19 years, school attendance considerably delays entry into motherhood while marriage hastens its timing. Furthermore, older adolescents with high levels of social controls (parental monitoring or perceived peer orientation to or approval of prosocial behaviours) and individual controls (high religiosity and positive orientation to schooling) are likely to delay childbearing. Programmes aiming to reduce risky sexual behaviours that could lead to childbearing among adolescents should be introduced very early, and before the onset of sexual activity. Also, the findings underscore the need to identify and address the risky factors and reinforce the protective ones in order to improve sexual and reproductive health outcomes of adolescent girls in Nairobi slum settlements.

This is the report of a 5-year follow-up survey of 350 couples married in Hull in 1965–66 and first interviewed shortly after marriage. It is based on the results of a second set of interviews conducted in 1970–71. The couples' initial intentions on family-building and birth-spacing are compared with their fertility experience during the first 5 years of marriage. Changes in patterns of contraceptive usage during the period are explored and both family-building and contraceptive practice are examined in relation to those variables which were found to influence the original intentions as expressed in the first interview.

Social stratification is an important mechanism of human organization that helps to explain health differences between demographic groups commonly associated with socioeconomic gradients. Individuals, or group of individuals, with similar health profiles may have had different stratification experiences. This is particularly true as social stratification is a significant non-measurable source of systematic unobservable differences in both SES indicators and health statuses of disadvantage. The goal of the present study was to expand the bulk of research that has traditionally treated socioeconomic and demographic characteristics as independent, additive influences on health by examining data from the United States. It is hypothesized that variation in an index of multi-system physiological dysregulation – allostatic load – is associated with social differentiation factors, sorting individuals with similar demographic and socioeconomic characteristics into mutually exclusive econo-demographic classes. The data were from the Longitudinal and Biomarker samples of the national Study of Midlife Development in the US (MIDUS) conducted in 1995 and 2004/2006. Latent class analyses and regression analyses revealed that physiological dysregulation linked to socioeconomic variation among black people, females and older adults are associated with forces of stratification that confound socioeconomic and demographic indicators. In the United States, racial stratification of health is intrinsically related to the degree to which black people in general, and black females in particular, as a group, share an isolated status in society. Findings present evidence that disparities in health emerge from group-differentiation processes to the degree that individuals are distinctly exposed to the ecological, political, social, economic and historical contexts in which social stratification is ingrained. Given that health policies and programmes emanate from said legal and political environments, interventions should target the structural conditions that expose different subgroups to different stress risks in the first place.

In this study, the determinants of contraceptive use and method choice are examined based on various variables, classified as individual, cultural, fertility and contextual. The data used came from the 1993 Turkish Demographic and Health Survey. The main finding is that there exists a positive association between the educational level of both spouses and the use of contraceptive methods in Turkey. After all individual, cultural, fertility and contextual variables are controlled, a woman's education is a stronger predictor of method use and method choice than that of her husband. Increasing the educational level of women may be the most effective means of advancing family planning acceptance and increasing the demand for contraceptive services in Turkey. The study also shows that, to a great extent, contraceptive use and choice of modern method depend on the sex of a couple’s living children, implying some preference for sons, although generally women prefer to have children of both sexes.

The relationship between parents' stated sex preferences for children and actual parental behaviour towards sons and daughters is examined among the Mukogodo, a group of traditional pastoralists in rural Kenya. Although their cultural values are male-centred and they tend to express a preference for sons, Mukogodo parents actually appear to be more solicitous of daughters, and the Mukogodo have a strongly female-biased childhood sex ratio. Studies of stated sex preferences should therefore be coupled with attempts to assess actual parental investment in sons and daughters.

Although the role of testosterone in the aetiology of social dominance is often suggested, surprisingly few studies have addressed the relationship between sex steroid hormones and dominance as a personality trait. In this paper, the relationship between testosterone and dominance is studied in a sample of adolescent boys and girls, taking into account the moderating role of gender ideology and same-sex peer group orientation. A direct association between free testosterone (FT) and dominance was found in girls but not in boys. In boys, masculine ideology moderated the relationship between FT and dominance, while in girls the relationship between FT and dominance was moderated by same-sex peer group affiliation.

Tuberculosis (TB) researchers and clinicians, by virtue of the social disease they study, are drawn into an engagement with ways of understanding illness that extend beyond the strictly biomedical model. Primers on social science concepts directly relevant to TB, however, are lacking. The particularities of TB disease mean that certain social science concepts are more relevant than others. Concepts such as structural violence can seem complicated and off-putting. Other concepts, such as gender, can seem so familiar that they are left relatively unexplored. An intimate familiarity with the social dimensions of disease is valuable, particularly for infectious diseases, because the social model is an important complement to the biomedical model. This review article offers an important introduction to a selection of concepts directly relevant to TB from health sociology, medical anthropology and social cognitive theory. The article has pedagogical utility and also serves as a useful refresher for those researchers already engaged in this genre of work. The conceptual tools of health sociology, medical anthropology and social cognitive theory offer insightful ways to examine the social, historical and cultural dimensions of public health. By recognizing cultural experience as a central force shaping human interactions with the world, TB researchers and clinicians develop a more nuanced consideration of how health, illness and medical treatment are understood, interpreted and confronted.

Many mothers in low-income countries, particularly in rural areas, nurse their children for 1–2 years on the average. The main purpose of this practice is, of course, to provide the newborn child with the nutrition necessary for its survival. Prolonged breast-feeding, however, also has a birth-spacing effect and postpones the next pregnancy by inhibiting ovulation and by delaying resumption of the menstrual cycle. Suckling of the infant is important for this suppression of the menstrual cycle because it leads to the release of prolactin, which not only plays an important role in milk production but also inhibits the release of gonadotrophins which initiate resumption of the menstrual cycle. For further details about these endocrinological aspects of lactation see, for example, Rolland et al. (1975); Thomson, Hytten & Black (1975) and Buchanan (1975).

The proposed method of bleeding pattern analysis avoids the problem of defining the menstrual cycle. The difficulty of maintaining a cyclical approach becomes acute when methods of fertility regulation are used which are known to disrupt seriously previously experienced bleeding patterns.

By using eight simple measures relating to the pattern of bleeding over a fixed period of time, it is possible to present sensitive indicators previously available but not used. These indicators will permit a more meaningful comparison of data obtained from different groups of women or for the same woman over time. The eight measures relate to the number, average duration and variability of bleeding episodes taking place within a defined period of time; the variability of the bleeding-free interval; the average duration and variability of the bleeding episode and its succeeding bleeding-free interval; and the number of days on which bleeding has occurred.

Agreement was reached by the Workshop participants regarding the terms to be used, the definition of these terms, the statistical approach to be adopted and the analytical procedures to be followed in the analysis of bleeding patterns. It is hoped that this alternative approach to bleeding pattern analysis will assist researchers, clinicians and other investigators in the collection, analysis and interpretation of menstrual bleeding patterns.

An example of this approach is given in the following paper by D. Mayes. This example is based on data in the form of diary cards made available to the Family Planning Research Unit, Exeter University, by John Guillebaud of the Churchill Hospital, Oxford.