Current research and policies on reproductive behaviours in many East African countries focus primarily on proxy indicators of women’s autonomy, and very little emphasis is placed on direct indicators of women’s autonomy. In this paper, data from the 2002 Eritrea Demographic and Health Survey (EDHS) are used to address some of the most frequently raised questions about the link between women’s autonomy and reproductive behaviour. The results from the multivariate logistic models show that although the relationship between women’s autonomy and reproductive preferences in Eritrea is complex, some clear, broad patterns exist that have implications for theory and policy. First, although the different dimensions of women’s autonomy influence the outcome variables differently in terms of magnitude and statistical significance, most of them have a strong connection; in particular, women’s final say in decisions regarding day-to-day household purchases and spousal communication are significant explanatory variables in fertility preferences and ever-use of modern contraception. Second, many background (proxy) variables, particularly household economic condition and employment, exert a strong and independent influence over fertility preferences and ever-use of contraception regardless of a woman’s autonomy. In their relationship to reproductive behaviours, therefore, employment and economic status cannot be considered as proxies for women’s autonomy in Eritrea. A complete explanation of the relationship between women’s autonomy and reproductive preferences must recognize the effects of both the background and direct autonomy indicators. Interventions are needed to improve women’s decision-making autonomy and strengthen their negotiating capacity on family planning if an increased desire to limit fertility is to be attained.

The resolution of parent–offspring conflict (POC) might sway in favour of the offspring if the parent relies on offspring-supplied information about need. Here, three hypotheses from a resolution model of POC were tested using data on sickness histories and mother–infant interactions from 24 Karo Batak women and their young children from two rural villages in North Sumatra, Indonesia. First, as predicted, offspring with greater need (measured as age and propensity to illness) tended to fuss more often. Second, as expected, observed fussiness predicted the number of suckling occurrences observed during sampling periods. Third, contrary to the prediction, the duration of fussing observed after breast-feeding occurrences was longer than the duration of the breast-feeding occurrences themselves. Parental decisions were made based on offspring-supplied information about need, but offspring failed to garner resources in excess of the parental optimum. This suggests that a POC interpretation is unnecessary to account for these results.

Health systems in developing countries infrequently implement and evaluate maternal death surveillance. This study identified under-reported and misclassified maternal deaths among women of reproductive age between 1999 and 2004 in a rural service unit in Vellore, India. In-depth interviews, semi-structured interviews and structured questionnaires were used to identify maternal deaths known to health care providers and community leaders who regularly come in contact with pregnant women. Eighteen under-reported and misclassified cases – or 50% of maternal deaths – were reported. These included 29% of abortion-related and 7% of domestic violence-related deaths. Based on this study’s fieldwork, the existing death surveillance system detected 100% of the maternal deaths reported by hospital staff; however, it missed most maternal deaths reported by community workers. The latter are more likely than deaths reported by hospital workers to result from abortion and family violence. The existing surveillance system should be augmented with a community-based death surveillance system. This comprehensive approach identified twice as many maternal deaths than previously recorded and could be applied in other settings. Appropriate public health interventions should be initiated to prevent maternal deaths in this community.

This study sought to determine which factors among the indicators of socioeconomic status have the most influence on physical, mental and social functions, and on subjective well-being, all of which are components of successful ageing. A representative random sample of 1825 persons aged 65 years or older was surveyed by face-to-face interview. Socioeconomic status was measured by educational level, family household income, personal income and property ownership. The factors measured were chronic diseases, activities of daily living (ADL) for physical functioning, history of mental disease, Mini-Mental Status Examination questionnaire (MMSE) scores for mental functioning, social activity participation per week for social functioning, and the Philadelphia Geriatric Center Morale Scale (PGCMS) for subjective well-being. Multiple logistic regression analyses were performed. Education level was the most important factor in physical and mental functioning, whereas personal income was the most important in social functioning. Educational level, household income and personal income were significantly associated with subjective well-being as assessed by PGCMS scores. Subjects who demonstrated successful ageing were more likely to have a higher education and higher personal income. The results point to the importance of focusing on disparities in each component of successful ageing, which may point to appropriate health-promotion strategies for eliminating inequality in successful ageing.

This paper evaluates exposure to mass media family planning (FP) messages among the Garo, an indigenous community in Bangladesh. A sample of 223 currently married Garo women were selected purposively from two districts where most of the Garo population live. The analysis demonstrated that television was the most significant form of mass media to disseminate FP messages among the recipients – more so than radio and newspapers. About 80·6% of the respondents had heard of FP messages through television, while for the radio and newspapers the percentages were 55·3% and 22·7% respectively. The contraceptive prevalence rate is much higher (79·5%) in the study area than the national level (55·8%). A linear logistic regression model was employed to identify the confluence of different demographic and socioeconomic characteristics on mass media FP messages. Regarding exposure to FP messages, four independent variables out of six had significant effects on the exposure to FP messages through any one of the types of media, i.e. radio, television and newspapers. These independent variables were age, level of education, occupation and number of children.

This paper demonstrates that although modern BMIs have increased, 19th century Middle-Atlantic black and white BMIs were in the normal range; neither underweight nor obese individuals were common. Farmers’ BMIs were consistently heavier than non-farmers. Philadelphia residents’ BMIs were lower than elsewhere within Pennsylvania, indicating that urbanization and agricultural commercialization were associated with current biological living standards in urbanized areas.

After a decade of fertility decline, Ghana’s fertility and the level of unmet need for contraception stalled in mid-transition in the late 1990s. Although the literature acknowledges this, the geographical patterns in unmet need have not been adequately documented. Spatial analysis of unmet need can reveal differences in usage and provision of contraceptive commodities, thereby pointing to geographical areas where contraceptive programmes should be strengthened. This study examines the geographical variation of the risk of mistimed and unwanted pregnancies between rural communities and also between urban communities of the three ecological zones of Ghana. The study also investigates if geographical differences in the risks of mistimed and unwanted pregnancies changed during the period when unmet need stalled at the national level. A multilevel regression model was applied to pooled data from the 1998 and 2003 Ghana Demographic and Health Surveys to examine the determinants of the risk of unintended pregnancies, while controlling for clustering of outcomes within communities. The results show that between the two surveys, there was no significant change in the levels of risk of mistimed and unwanted pregnancy. However, geographical heterogeneity in the risk of mistimed and unwanted pregnancy was observed, after controlling for relevant predictors. This showed concentration of mistimed pregnancies in some rural communities relative to others, and variation in the risk of unwanted pregnancies between urban communities. The results give a clear indication that bridging the inequality gap in contraceptive use requires programmes that are area-specific.

In Lesotho, the risk of mother-to-child-transmission (MTCT) of HIV is substantial; women of childbearing age have a high HIV prevalence rate (26·4%), low knowledge of HIV status and a total fertility rate of 3·5 births per woman. An effective means of preventing MTCT is to reduce unwanted fertility. This paper examines the unmet need for contraception to limit and space births among HIV-positive women in Lesotho aged 15–49 years, using the 2004 Lesotho Demographic and Health Survey. HIV-positive women have their need for contraception unmet in almost one-third of cases, and multivariate analysis reveals this unmet need is most likely amongst the poor and amongst those not approving of family planning. Urgent action is needed to lower the level of unmet need and reduce MTCT. A constructive strategy is to improve access to family planning for all women in Lesotho, irrespective of HIV status, and, more specifically, integrate family planning with MTCT prevention and voluntary counselling and testing services.

Results are reported for mean IQs on the WAIS-R in Sudan in 1987 and 2007. There was a gain of 4·05 Full Scale IQ points over the 20-year period, representing a gain of 2·05 IQ points a decade. The Verbal IQ showed a loss of 1·65 IQ points, while the Performance IQ showed a gain of 7·2 IQ points. These results are broadly consistent with those in economically developed countries in showing that mean IQ on the WAIS-R has increased in Sudan, and the Performance IQ has increased more than the Verbal IQ.