This paper reviews the literature examining the relationship between women’s empowerment and contraceptive use, unmet need for contraception and related family planning topics in developing countries. Searches were conducted using PubMed, Popline and Web of Science search engines in May 2013 to examine literature published between January 1990 and December 2012. Among the 46 articles included in the review, the majority were conducted in South Asia (n=24). Household decision-making (n=21) and mobility (n=17) were the most commonly examined domains of women’s empowerment. Findings show that the relationship between empowerment and family planning is complex, with mixed positive and null associations. Consistently positive associations between empowerment and family planning outcomes were found for most family planning outcomes but those investigations represented fewer than two-fifths of the analyses. Current use of contraception was the most commonly studied family planning outcome, examined in more than half the analyses, but reviewed articles showed inconsistent findings. This review provides the first critical synthesis of the literature and assesses existing evidence between women’s empowerment and family planning use.

Birth weight is used as a proxy for the general health condition of newborns. Low birth weight leads to adverse events and its effects on child growth are both short- and long-term. Low birth weight babies are more common in twin gestations. The aim of this study was to assess the effects of maternal and socio-demographic risk factors at various quantiles of the birth weight distribution for twin gestations using quantile regression, a robust semi-parametric technique. Birth records of multiple pregnancies from between 1991 and 2005 were identified retrospectively from the birth registry of the Christian Medical College and hospitals in Vellore, India. A total of 1304 twin pregnancies were included in the analysis. Demographic and clinical characteristics of the mothers were analysed. The mean gestational age of the twins was 36 weeks with 51% having preterm labour. As expected, the examined risk factors showed different effects at different parts of the birth weight distribution. Gestational age, chroniocity, gravida and child’s sex had significant effects in all quantiles. Interestingly, mother’s age had no significant effect at any part of the birth weight distribution, but both maternal and paternal education had huge impacts in the lower quantiles (10th and 25th), which were underestimated by the ordinary least squares (OLS) estimates. The study shows that quantile regression is a useful method for risk factor analysis and the exploration of the differential effects of covariates on an outcome, and exposes how OLS estimates underestimate and overestimate the effects of risk factors at different parts of the birth weight distribution.

Information on future intention to use contraceptives is a potential programme indicator for family planning services. Using three consecutive rounds of Ethiopian Demographic and Health Survey (EDHS) data collected in 2000, 2005 and 2011, this study examined whether the sex composition of living children and future desire for additional children were associated with the intention to use contraceptives among Ethiopian women aged 15–49 years who were not using any method of contraception at the time of the survey. The pooled multivariate binary logistic regression analysis indicated that between 2000 and 2011, the intentions of non-users to use contraceptives in the future increased significantly. Women who had at least one child (with an equal number of boys and girls, more boys than girls or more girls than boys) who did not want any more children, and those who were unsure about their desire for additional children, showed an increased intention to use contraceptives in the future, compared with those with an equal number of boys and girls who expressed a desire for additional children. Women with no children and who did not want children, or those who were unclear about their future desire, showed a lower intention to use contraceptives, compared with women with an equal number of boys and girls who wanted a child in the future.

This study investigated the effect of family planning on the levels of women’s anaemia and child undernutrition at the aggregate level using the compiled databases of the World Bank, UNICEF and the Economist Intelligence Unit. Correlation scatter matrix plots and multivariate OLS regression models were employed to assess the effect of family planning on women’s anaemia and child nutritional status across countries. At the aggregate level, the bivariate correlation estimates found that the Contraceptive Prevalence Rate (CPR) was negatively associated with women’s anaemia (r=−0.62, p<0.01), child underweight (r=−0.57, p<0.01) and child stunting (r=−0.63, p<0.01). The results of the OLS regression showed that the independent effect of CPR on women’s anaemia (β=−0.35, p<0.01), child underweight (β=−0.13, p<0.01) and child stunting (β=−0.18, p<0.05) was negative, even after controlling for child marriage, female literacy, per capita GDP, poverty ratio, health expenditure and food security. The synthesis of these findings with the existing literature based on micro-data suggests pathways through which family planning influences the nutritional status of women and children. Family planning helps in avoiding shorter birth intervals, unintended pregnancy and unsafe abortion, which would otherwise result in nutrient depletion among mothers and further increase the risk of undernutrition in their children.

The sex differences on the WISC-III are reported for the thirteen subtests, the Verbal and Performance IQs, the four Index IQs and the Full Scale IQs in Sudan and the United States. The sex differences are closely similar in the two samples with a correlation of 0.878 (p<0.001) for the thirteen subtests. Males obtained significantly higher Full Scale IQs in the two samples of 0.23d and 0.11d, respectively.

Very little is known, at national and state levels, about how much information women in India are receiving about the method of contraception they are using. The purpose of this study was to fill this gap in knowledge. A Method Information Index (MII) was calculated from the responses of women who started using a modern contraceptive method five years prior to interview, and who were still using it at the time of interview, in the third National Family Health Survey conducted in India in 2005–06. The women were asked whether at the time they initiated contraceptive use they were told about other methods they could use, the side-effects of their selected method and what to do if they experienced these side-effects. The MII values (percentages of women who responded ‘yes’ to all three questions) were calculated for each category of women’s characteristics to show the relationship between MII and each characteristic. Mixed-effect logistic regression models were used to assess the independent effect of each variable after controlling for the effects of other variables on MII. The results indicate that contraceptive users in India in 2005–06 were receiving very little information about the method they were using: only 15.6% of contraceptive users reported receiving information on all three items. This low level was prevalent across different socioeconomic strata and across all the major states. There were a few exceptions, but the level was still quite low. Clearly, there is plenty of scope to improve the content of information exchanged between service providers and clients in order to ensure the rights of women to receive services of good quality, as well as improve informed choice and continuity of contraceptive use. Such a focus on improving quality of services is likely to help the Ministry of Health and Family Welfare in making its stated transition from a ‘population control centric’ to a ‘reproductive rights based’ approach to family planning in India.

There is contradictory evidence of having fewer live births and higher embryonic mortality among high-altitude populations than their counterparts at lower altitude. This study explores the geospatial differences in selection intensities among human populations living in different ecological settings. Reproductive data from post-menopausal women were collected from 75 women from near Shimla, Himachal Pradesh, at an altitude of 2150 m above sea level and 100 women from Jind, Haryana, at an altitude of 227 m. Secondary data were taken from 85 women from the Kinnaur district of Himachal Pradesh at an average altitude of 3420 m. A comparison of the study data was made with similar data from different populations living in the western and eastern Himalayas. The total selection intensity index based on Johnston and Kensinger’s index was highest in Shimla and lowest in Kinnaur. The fertility selection component was highest in Shimla and lowest in Kinnaur. The prenatal mortality contribution to the total selection was highest in Shimla (30.76%) and lowest in Kinnaur (2.14%), while the contributions of normalized postnatal mortality were 16.39% and 57.80% in Shimla and Kinnaur, respectively. The fertility component of selection was higher than the mortality component in Shimla, while in the other two places the reverse was observed. Hypoxic conditions at high altitude seem to have little effect on the fertility and embryonic mortality rates of indigenous people. The geospatial differences in the selection intensities may be due to differences in ethnic, behavioural ecology, environmental, cultural and socioeconomic factors.

The long-term high sex ratio at birth (SRB) is a serious issue in China. In this study, changes in SRB were decomposed into variations in SRB by birth order and compositional changes in female births by birth order. With SRB data from China’s surveys and censuses, and SRB data from South Korea’s vital registration and censuses from 1980–2015, the trend and decomposition results in SRB were compared between China and South Korea, and the decomposition results for urban and rural SRBs, and for provinces, are presented. In both China and South Korea the rise in the SRB was driven by a rise in the SRB at all birth orders, which was only partly counteracted by the change in the distribution of births by order. The overall rise in the SRB ended when there was a decline in the SRB at second birth or above in South Korea. In China the total effect of variations in SRB of all birth orders increased more for the rural population than for the urban population before 2000, resulting in a higher total SRB for rural than urban population. After 2000, the total effect of variations in SRB of all birth orders lowered the total SRB for the rural population, whereas the effect of compositional change increased the total SRB, leading to a very slight rise in the total SRB for the rural population. At the province level, there was no spatial autocorrelation for the changes in total SRB by province, the total effect of variations in SRB of all birth orders or the effect of compositional change. The effect of variations in SRB by birth order accounted for the majority of changes in total SRB in most provinces.

Portugal has one of the highest rates of childhood overweight and obesity in Europe. However, little is known about the health of ethnic minorities living in its capital city, Lisbon. The Cape Verdean community in Lisbon tend to have low educational levels, material deprivation and struggle with discrimination and racism, factors that would probably be associated with a higher prevalence of overweight and obesity. Data for the Cape Verdean population were collected in three different time periods by three different research teams in 1993, 2009 and 2013 and included children aged 6–12 years living in the Cova da Moura neighbourhood of the Greater Lisbon Metro Area. The Portuguese national survey was conducted between 2009 and 2010 at public and private schools in mainland Portugal and included height, weight, skinfolds and arm and waist circumferences. From these survey data body mass index (BMI) and prevalence of stunting (chronic malnutrition – low height-for-age) and underweight (low weight-for-age) were calculated according to reference values proposed by Frisancho (2008). Overweight and obesity prevalence values were defined based on the references established by the International Obesity Task Force. The results show significant differences in height between Cape Verdean and Portuguese boys and girls. Generally, Cape Verdeans’ growth falls within the healthy range of international growth references across all of the survey data collected. Cape Verdean rates for combined overnutrition (overweight and obesity) in 2013 (9.8% for boys and 16.7% for girls) were lower than those of the Portuguese (33% for boys and 31.7% for girls). Logistic regression models showed that Cape Verdean children had a lower risk of being overweight or obese when accounting for breast-feeding, birth weight, maternal education and occupation. Despite living in a deprived neighbourhood these Cape Verdean children seemed to have grown more healthily than Portuguese ancestry children. The challenge for policymakers will be to support improvement of the poverty-related living conditions of this community without creating a risky environment for increasing prevalence of overweight and obesity.