The hypothesis that the month-specific rate of return to ovarian cyclicity after childbirth is causally related to suckling pattern was tested for a population of New Mexican women recruited within the service area of New Mexico Highlands University and for a nationwide USA subpopulation of women recruited through membership of the Couple to Couple League (CCL). Survival analysis for time-dependent covariates was used, and significant predictors of the first postpartum menses were found. Important differences were detected in the suckling pattern for the two groups and a 5:2 differential was found in their respective rates of menstrual cycle recovery. Although the two groups were comparable perinatally, daily and time-windowed breast-feeding performance fell off at twice the rate for the New Mexico population when contrasted with the CCL sample. For both populations, the introduction of solid feeds was a strong and significant predictor of returning menstrual cyclicity, independent of suckling pattern.

This paper examines the reasons for the high level of unmet need for contraception in rural Egypt, using data from the individual survey and service availability module of the 1988Ð89 Egypt Demographic and Health Survey. Two broad sets of potential factors are considered: characteristics of a woman which influence her desire for children and thus her propensity to use contraception, and factors relating to the family planning service environment in which she lives. The results from a multivariate analysis show that certain individual characteristics, such as family composition and education, have a strong impact on the level of contraceptive use and on the proportion of total demand for spacing or limiting childbearing that is met by use of family planning. Unmet need, however, remains fairly constant across demographic and socioeconomic subgroups of the population. The largest variations in unmet need are regional, but elements of the family planning services, namely the provision of a community-based nurse who distributes family planning and female doctors at clinics, also play an important role.

This study in Bangladesh found that inter-cluster variation in the use of modern reversible methods of contraception was significantly attributable to the educational levels of the female family planning workers working in the clusters. Women belonging to clusters served by educated workers had a higher probability of being contraceptive users than those whose workers had only completed primary education. At the household level, important determinants of use were socioeconomic status and religion. At the individual level, the woman being the wife of the household head and having some education were positively related to her being a user. The model also found that inter-household variation was significantly greater than inter-cluster variation. Finally, the study concludes that after controlling for various covariates at all three levels, the clusters do not have significantly different levels of use of modern reversible methods of contraception. There are, however, some special areas where contraceptive use is dramatically low, and these contribute significantly to the observed inter-cluster variation.

This analysis investigates the determinants of contraceptive discontinuation in six developing countries, using data from Phase I surveys of the DHS programme. Cumulative probabilities of discontinuation at 24 months for reasons other than the desire for another child were examined. By this time, typically about 40% of couples have stopped use and most are subsequently at risk of an unwanted conception. Discontinuation of IUD use was found to be less common than for other methods, partly perhaps because cessation of use requires a deliberate decision to have the device removed.

The most important results are negative ones. Neither the schooling of couples nor their type of residence exerted appreciable influence on discontinuation. The policy and programme implications are discussed. Prior use of a method, fertility preferences and the related demographic factors of age and family size emerged as pervasive predictors of discontinuation.

This paper examines the biosocial basis of premarital sexual and reproductive behaviour among women in Sudan. It applies Udry's biosocial perspective, which attempts to reconcile the biological and sociological models of premarital sexual and reproductive behaviour. World Fertility Survey (WFS) data were used to study premarital first motherhood. Early puberty was found to be paramount in determining childbearing in a separate biological model, but also in a biosocial model constructed to take account of social controls. This finding suggests that social controls do not influence the biological predisposition to premarital sexual behaviour. However, given the limitations of the WFS data, conclusive evidence must await a more appropriately designed study of reproductive behaviour in Sudan.

In 1993, the Navrongo Health Research Centre launched a new demographic research system for monitoring the impact of health service interventions in a rural district of northern Ghana. The Navrongo Demographic Surveillance System uses automated software generation procedures that greatly simplify the preparation of complex database management systems. This paper reviews the Navrongo model for data collection, as well as features of the Navrongo system that have led to its replication in other health research projects requiring individual-level longitudinal demographic data. Demographic research results for the first 2 years of system operation are indicative of a pretransitional rural society with high fertility, exceedingly high mortality risks, and pronounced seasonal out-migration.

The relationship between mood states, urinary stress hormone output (adrenaline, noradrenaline and cortisol) and adequacy of the menstrual cycle was examined in 120 recorded non-conception cycles from 34 women. It was hypothesized that women with higher stress levels would be more likely to experience abnormal cycles and that within women higher stress levels would positively relate to follicular phase length and inversely relate to luteal phase length. There was a non-significant trend for women to report higher stress levels during oligomenorrhoeic and unclear cycles compared with normal cycles. Analysis of covariance indicated that there was no consistent relationship between the measures of stress used here and follicular or luteal phase length within women. There was also no consistent pattern of relationship between reported mood states and stress hormone excretion within women. Further research is warranted to understand the role of stress and subtle menstrual cycle abnormalities in female fertility.

Using data from a cross-sectional nutrition survey conducted in rural Ethiopia between March and April 1992, roughly a year after the end of one of the longest civil wars in modern human history, this study attempts to document the magnitude and correlates of childhood undernutrition in Ethiopia. Findings from the study reveal that, at the time of the survey, 59% of children in the country were exposed to long-term or chronic undernutrition (stunted); about 4% were suffering from acute problems (wasted); and about the same proportion were both stunted and wasted. Less than a third of the country's children had normal growth. The logistic–binomial regression results demonstrated the existence of significant clustering of risks of undernutrition within areas of residence and notable differentials by age of child, duration of breast-feeding, age at introduction of supplementary foods and number of under-five siblings. Significant variations were also noted by age of household head, per capita land holding, religious affiliation and prevalence of endemic diseases in an area.

The incidence of obesity, defined as the fraction of persons with BMIs exceeding 30·0, was examined in two birth cohorts of 40–50-year-old occupationally active inhabitants of the city of Wrocław, Poland. In both cohorts and both genders obesity increased monotonically with decreasing position on a three-level educational scale. During the 1986–1996 decade obesity increased dramatically among males with trade school education only; concomitant shifts were much smaller or absent in the college-educated groups. The contrast in obesity between the opposite ends of the educational scale has widened markedly in both genders; and the between-gender gap has declined somewhat.