This analysis examines the relationship between length of preceding birth interval and risk of intrauterine growth retardation using data on Swedish infants from the 1973 World Health Organization study of perinatal mortality. Results of a multivariate logit analysis demonstrate that the lower than average mean birth weight of infants born after short birth intervals cannot be completely attributed to their shorter mean gestation length. Infants born after birth intervals of 12 months or less are 30% more likely to be small for gestational age (SGA) than infants born 18–59 months after the previous birth, even when the effects of maternal age and parity are controlled. The results obtained here do not support maternal depletion as an explanation for the association between short birth intervals and elevated risk of SGA, since there is no evidence of an attenuation of the risk of SGA with increasing length of interval in the under 18 month birth interval range.

This paper examines the determinants of infant and child mortality variations in four near east countries using data from WFS surveys. The analysis considers biological correlates of mortality—mother's age, birth order, birth interval, and previous infant loss—and several social factors—mother's and father's education, mother's residence, father's occupation, and mother's work experience since marriage. A multivariate analysis using a logistic regression model is carried out to obtain the net effect of each factor on mortality. Separate models are constructed for infant mortality and childhood mortality and for each country.

The four countries show large variations in mortality, but this is persistently higher in female than male children. All four demographic characteristics affect mortality significantly, especially the length of the preceding birth interval. Among the socioeconomic variables, only rural–urban residence is influential.

Retrospective and prospective data collected in Cameroon were used to reassess hypotheses about how infant and early childhood mortality is affected by birth spacing and breast-feeding. These data show that: (a) a short preceding birth interval is detrimental for child survival in the first 4 months of life; (b) full and partial breast-feeding have direct protective effects on child survival in the first 4-6 months of life, with the effects of the former stronger than those of the latter; (c) early subsequent conception significantly increases mortality risks in the first 16 months of life of the index child. These findings are robust to various controls, e.g. study design, data defects, child's health conditions at/around birth, postnatal maternal and child recurrent illnesses, patterns of utilisation of health care services, and immunisation status of the child.

Contraceptive prevalence is a key variable estimated from Demographic and Health Surveys. But the prevalence estimated from reports of husbands differs widely from that estimated for wives. In this research, using data from six Demographic and Health Surveys of sub-Saharan Africa, reports from spouses in monogamous couples with no other reported sex partners in the recent period are examined. Agreement ranged from 47% to 82%, but among couples in which one or both reported use, the ‘both’ category represented less than half in all nations except Zimbabwe. Husbands generally had higher reports of condoms, periodic abstinence and pills but fewer reports of the IUD, injections and female sterilization. Either discussion of family planning with the spouse and/or higher socioeconomic status was associated with agreement in most of the surveys. Ambiguities in the survey question regarding current use need to be reduced, perhaps with an added probe question for non-permanent methods.

This study investigates the effects of the 1974–75 famine on differential fertility in a rural population of Bangladesh, using information on household socioeconomic status collected in the 1974 census, and registration data on births, deaths and migrations for the period 1974–77 from the Demographic Surveillance System of the International Centre for Diarrhoeal Disease Research, Bangladesh. Occupation of household head was taken as a measure of socioeconomic status. Total fertility rates were analysed for three periods: pre-famine, famine and post-famine. Overall fertility declined due to the famine by 34%, but this was compensated partially by a 17% increase in the post-famine period. Fertility of women of all ages and socioeconomic groups was affected by the famine, a more pronounced effect being observed among the poor. Fertility showed a higher post-famine recovery among women in the middle socioeconomic groups and in those aged 25–34 years.

Changes in body weight were examined for non-pregnant women in rural Nepal, using 183 anthropometric measures between the early winter and monsoon seasons in 1982, 1982–83, 1990–91 and 1993. The women gained weight when work loads decreased after the monsoon, but despite substantial changes in total energy expenditure, which were out of phase with changes in food intake, seasonal changes were small, averaging only up to 2.6% of initial body weight.

There were notable differences between individual women, changes in body weight ranging from-5·6 kg to 4·8 kg. Weight change was examined with respect to lactation status, age, body mass index, mid upper arm circumference and skinfolds as well as total energy expenditure and intake. Non-lactating women, very thin women and women aged under 25 years gained more weight than their counterparts, both before and after the monsoon. Data for a sub-sample in 1982–83 indicated that women who maintained high physical activity levels throughout the year were less prone to weight loss than women whose activity fluctuated between seasons. Initial energy reserves, age-related maturation factors, levels of physical activity and energy intake combine to produce the notable inter-individual variation in body weight changes observed in this population.

This paper examines secular changes in the influence of maternal age, parity and social class on perinatal mortality in Scotland. Despite changes in reproductive behaviour, improved access to maternity services and more effective perinatal care, the influence of maternal age and social class on perinatal mortality remained unchanged between 1960 and 1982. Although there were no significant changes in the traditional J-shaped association between parity and stillbirths, cross-sectional analysis shows that in the early 1980s the risk of both neonatal and perinatal deaths decreased as parity increased: this finding is consistent with the pattern of risks observed in longitudinal studies and retrospective surveys of reproductive histories. The stability of age, parity and social class effects thus suggests that little if any of the overall decrease in Scottish perinatal mortality can be attributed to a significant narrowing of relative risks in the obstetric population.

This study is based on the 1983 Rural Health Survey of Ethiopia. Patterns and levels of child morbidity by age, sex, geographic region, and sanitary facilities are examined. Morbidity levels peak in the second year of life. Diarrhoeal diseases are of major importance, especially among infants and toddlers. Parasitic diseases, and respiratory diseases other than pneumonia, become increasingly important with age.

There are no significant sex differentials in morbidity except for higher rates of diarrhoeal diseases among female children. Geographic differentials are quite marked with particularly high morbidity levels from all disease types in the western mountainous regions of Ethiopia. Access to high quality drinking water, a latrine, and garbage disposal, are strongly related to reduced overall morbidity levels, though not necessarily to reduced diarrhoeal disease levels.

This study analysed the recent changes and patterns of information received about contraceptive methods by contraceptive users in India – an important indicator of quality of care in family planning services. Data were taken from the third and fourth rounds of National Family and Health Surveys (NFHS) conducted in India during 2005–06 and 2015–16. The Method Information Index (MII) was used to capture the information received by respondents on three aspects of contraceptive method use: information about the side-effects of the method, what to do if they experienced any complication from using the method and information received about other methods of contraception. A separate analysis of information received by users about the permanency of sterilization was also carried out. Logistic regression models were applied to assess the independent effects of users’ background characteristics and their states and union territories of residence on method information received by them. The value of the MII nearly doubled from about 16% in 2004–05 to 31% in 2015–16, indicating a marked increase in the information received by contraceptive users in India over the period between 2005–06 and 2015–16. In addition, the percentage of sterilized women who received information about the permanency of the method also increased, from 67% to 80%, over the period. While considerable progress has been made in the last decade, there is still plenty of scope for improvement in the information received by contraceptive users to advance a voluntary approach to family planning.

Data from 375 Ethiopian mothers show lactations of between 25 and 30 months in the majority, very prolonged even by African standards. Maternal nutritional status, as shown by body weights, was low due to very low food energy intakes. With frequent suckling already raising prolactin levels, these very low energy intakes may also result in yet more prolactin secretion. New pregnancies are delayed and birth intervals extended beyond normal African standards by all these factors.

Using data collected from the 2008 survey of Internal Migration and Health in China, this study examines the impact of late childhood nutrition intakes on a wide range of indicators of adult health. The results show that respondents who consume rich nutrients (meat, fish, milk, etc.) less frequently during late childhood have worse health outcomes when they grow up. They are more likely to rate their health as ‘fair/poor’, report a greater number of chronic diseases, have a higher incidence of acute illness, perceive greater numbers of physical pains/discomforts and to suffer more from insomnia and depression. With respect to objective biometrics, respondents who have less access to rich nutrients at age 14 tend to attain a shorter stature, gain more weight as an adult, and are more likely to become obese or have low lung capacity. Taken together, the evidence in support of a harmful impact of late childhood undernutrition on adult health is stronger and more consistent for subjective health indicators than for the objective biometrics examined in this study. Moreover, the results also indicate that the long-term health impact of late childhood nutrition deprivation is especially detrimental for females in China.

A life table analysis is made of the duration of breast-feeding and postpartum amenorrhoea in Orissa, India, taking one variable at a time using data from a baseline survey of fertility and mortality (BSFM) conducted on the lines of the World Fertility Survey. Then a multivariate (proportional hazard) analysis showed that socioeconomic factors including residence, caste status and education influence the breast-feeding and post-partum amenorrhoea periods. There was no effect of maternal age on the length of breast-feeding, but mean length of post-partum amenorrhoea varied with age. The durations of breast-feeding and post-partum amen orrhoea are strongly related.

The influence of religion on health remains a subject of considerable debate both in developed and developing settings. This study examines the connection between the religious affiliation of the mother and under-five mortality in Mozambique. It uses unique retrospective survey data collected in a predominantly Christian area in Mozambique to compare under-five mortality between children of women affiliated to organized religion and children of non-affiliated women. It finds that mother's affiliation to any religious organization, as compared with non-affiliation, has a significant positive effect on child survival net of education and other socio-demographic factors. When the effects of affiliation to specific denominational groups are examined, only affiliation to the Catholic or mainstream Protestant churches and affiliation to Apostolic churches are significantly associated with improved child survival. It is argued that the advantages of these groups may be achieved through different mechanisms: the favourable effect on child survival of having mothers affiliated to the Catholic or mainstream Protestant churches is probably due to these churches' stronger connections to the health sector, while the beneficial effect of having an Apostolic mother is probably related to strong social ties and mutual support in Apostolic congregations. The findings thus shed light on multiple pathways through which organized religion can affect child health and survival in sub-Saharan Africa and similar developing settings.

A growing and substantial body of research suggests that female sex workers play a disproportionately large role in the transmission of HIV in many parts of the world, and they are often referred to as core groups by epidemiologists, mathematical modellers, clinicians and policymakers. Male sex workers, by contrast, have received little attention and it is not known whether it is helpful to conceptualize them as a core group. This paper draws upon ethnographic research documenting social and sexual networks in London and looks at the position of five male sex workers within a network comprising 193 men and seven women (as well as 1378 anonymous sexual contacts and 780 commercial contacts). In so doing, it suggests that there is no evidence to show that male sex workers are more or less likely to acquire or transmit HIV in the course of commercial sex compared with other types of sexual relationships. In addition, men engaging in non-commercial sex all reported having unprotected sex in a variety of contexts and relationships and there is no evidence to suggest that men who are not sex workers play less of a role in the transmission of HIV. In short, these data suggest that it would be inappropriate to conceptualize male sex workers as a core group. This is not to suggest that public policy should continue to overlook male sex workers. New and inventive approaches are required to reach out to a vulnerable but diverse group of men, selling sex for a variety of reasons; even if these men are no more vulnerable to acquiring and/or transmitting HIV than other men and women that form part of their network.

What is the most appropriate measure of impaired fertility for understanding its social consequences in sub-Saharan Africa? The dearth of subjective measures in surveys in the region has prevented comparisons of subjective and objective measures. Perceived difficulties conceiving may have a greater impact than objective measures for social outcomes such as divorce, stigmatization and distress. This study compares 12- (clinical) and 24- (epidemiological) month measures from biomedicine and 5- and 7-year measures from demography with a subjective measure of impaired fertility using correlations, random effects models and test–retest models to assess relationships between measures, their association with sociodemographic characteristics and the stability of measures across time. Secondary panel data (1998–2004) from 1350 Ghanaian women aged 15–49 of all marital statuses are used. Longer waiting times to identification of impaired fertility required by demographic measures result in more stable measures, but perceived difficulties conceiving are most closely aligned with clinical infertility (r=0.61; p<0.05). Epidemiological infertility is also closely aligned with the subjective measure. A large proportion of those identified as having impaired fertility based purely on waiting times are successful contraceptors. Where subjective measures are not available, epidemiological (24-month) measures may be most appropriate for studies of the social consequences of impaired fertility. Accounting for contraceptive use is important in order to avoid false positives. Future research should consider a variety of measures of perceived difficulties conceiving and self-identified infertility to assess which is most valid; in order to accomplish this, it is imperative that subjective measures of infertility be included in social surveys in sub-Saharan Africa.

As part of a longitudinal study of diet and dental caries, 405 Northumberland children initially aged 11–12 years recorded the time of going to bed on 3 consecutive days on 5 occasions over a 23-month period. The bedtimes were recorded in a personal diary and checked at private interview. Mean bedtime for the 212 females changed from 21 hr 44 min at age 11 years 7 months to 22 hr 11 min at age 13 years 3 months. Bedtime for the 193 males was, on average, 9 min later than that for the females. There was a consistent relation between bedtime and social class, with social class IV + V children going to bed, on average, 14 min later than social class I + II children. When the average age of the children was 13 years 3 months, 13% of them went to bed at or after 23.00 hr, and they were latest to bed on Saturday when their average bedtime was 22 hr 59 min.

In genetics, a consanguineous marriage means union between couples who are related as second cousins or closer. The present cross-sectional study was carried out in order to illustrate the prevalence and types of consanguineous marriages in the Shi'a population living in widespread territories in Lebanon including the Bekaa Valley, the south of Lebanon and the southern suburb of Beirut. Data on types of marriages were collected using a simple questionnaire. The total number of couples in the study was 1203. Consanguineous marriage was classified by the degree of relationship between couples. The overall frequency of consanguinity was found to be 28.4%, with first cousin marriages (21.3%) being the most common type followed by first cousins once removed (5.5%), then double first cousins (0.8%). The frequencies of second cousin and beyond second cousin marriages were the same at 0.4% of all the marriages. The mean inbreeding coefficient (α) was estimated at about 0.0161 for the population. There were no significant differences between the three studied territories for frequencies of different types of marriages (p>0.1), nor were there significant differences between the rural and urban areas (p>0.1).

This study examines the factors affecting age at first marriage—place of residence, education, premarital work status, religion, husband's childhood residence, education and occupation. Women's education appears to be the strongest determinant of variation in marriage age, and all the other factors show statistically significant influences.

A survey of 232 households of the Mosuo minority group in Yunnan Province, People's Republic of China, suggested that polyandrous matriarchy did not raise the birth rate per household, but lowered the community birth rate by restricting many women's chances of marrying. The results imply that tolerance by the national government of polyandry within certain minority groups (e.g. Mosuos and Tibetans) will not prevent but may aid the attainment of zero population growth by China in the twenty-first century.

The influence of number and date of pregnancies, births, and spontaneous and induced abortions on body shape, age at menopause and menopausal symptoms have been studied for 110 postmenopausal Viennese women. A significant correlation between fertility and age at menopause was not found, but several menopausal symptoms showed statistically significant correlations with fertility. With a higher number of pregnancies the individual symptoms became more severe.