Research on health care behaviour in sub-Saharan Africa usually considers the mother as the reference in the household when a child is sick. The study of health care management within the family is a key issue for understanding therapeutic rationales. This study was conducted in the region of Fatick in Senegal among 902 children with malaria-related fever. The data were taken from a retrospective quantitative survey conducted in all compounds of the DSS (Demographic Surveillance Site) of Niakhar. The results show that child care-taking is fundamentally a collective process: in 70·9% of out-of-home resorts, the treatment decision was collective. The health care process of 68·1% of morbid episodes involved several individuals. The involvement of the mother, the father and other relatives in the collective management of health care followed different logics. Each care-giver had a specific and complementary function depending on gender norms, intergenerational relations and characteristics of the family unit. Family management of illness aims at optimizing financial and human resources given the economic, logistical and social constraints on health care. Nevertheless, collective management also favoured home-based care, prevented good treatment compliance and delayed the resort to health facilities. These results suggest that health education campaigns should focus on an early involvement of fathers in health care-giving and also on the strengthening of the autonomy of mothers. Mothers’ empowerment should give women more autonomy in their child’s treatment choice. Lastly, there is a need to develop community health facilities and establish shared funding at the community level.

Summary. With the rapid pace of the nutrition transition worldwide, understanding influences of child feeding practices within a context characterized by the co-existence of overweight and undernutrition in the same population has increasing importance. This qualitative study describes Brazilian mothers’ child feeding practices and their perceptions of their association with child weight status and explores the role of socioeconomic, cultural and organizational factors on these relationships. Forty-one women enrolled in the Family Health/Community Health Workers Programme were selected from rural, urban, coastal and indigenous areas in Ceara State, north-east Brazil, to participate in four focus group discussions. Content analysis identified fourteen emergent themes showing mothers’ child feeding practices in this setting were influenced by economic resources, mothers’ immediate social support networks (e.g. neighbours and family members) and participation in nutrition assistance programmes. Child malnutrition was the most common nutritional concern; nevertheless, mothers were aware of the negative health consequences of obesity but misunderstood its causes (e.g. foods filled with fat would make a person fat; others thought that birth control pills and stimulants given to children were causes of obesity); several reported their own struggles with overweight. Food assistance programmes emerged as an important influence on children’s dietary adequacy, especially among mothers describing dire economic situations. The findings have implications for targeting food assistance as well as health and nutrition education strategies in low-income families undergoing the nutrition transition in north-east Brazil.

Preference for children of either sex is considered a constraint on fertility decline as it induces many couples to keep adding on surviving children in the hope of having a desired sex composition of children. However, preferences for children of a particular sex may differ in relation to demographic and socioeconomic characteristics of women, traditional values and cultural practices, such as propagating a family name, providing economic advantages, and obtaining a medium of social and economic security in times of illness, unemployment and old age. Utilizing the Pakistan Integrated Household Survey (2001–02), this paper aims at investigating the existence of sex preference and examines sex preference differentials by different attributes of women in Pakistan. The results reveal that there is a desire to have another child in the presence of all children of one sex, either sons or daughters. The desire to have a son with only or mostly daughters, however, is stronger than the desire to have a daughter with only or mostly sons. This behaviour will retard fertility decline unless there is a shift in the desire to have children of both sexes in Pakistan.

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.

This study assessed the role of mother’s religious affiliation in child immunization status of surviving children 12 months of age and older in Nigeria, using data from the 2003 Nigeria Demographic and Health Survey (NDHS). Guided by two competing hypotheses – the ‘characteristics hypothesis’ and the ‘particularized theology hypothesis’ – variations in the risks of child immunization in Nigeria were examined using logistic regression analysis. The results indicate that religion plays a role in the risk of non-immunization; religion was not associated with the risk of partial immunization; however, religion was significantly associated with the reduced risk of full immunization.

In the Kingdom of Tonga, migration to overseas developed countries has prevailed. To elucidate the effects of migration on population dynamics, an interview survey was conducted in the migrant-sending community of Kolovai, in the outer region of Tongatapu Island. All births, deaths, marriages and in- and out-migrations that took place between 1983 and 2002 were recorded for all members of the ‘Kolovai population’, consisting of persons who had lived in this community for at least a one-year period during this 20 years. The ‘Kolovai population’ members, numbering 1184 (564 males and 620 females), were divided into three groups based on residence at the end of each year, i.e. Kolovai (called KK), other places in Tonga (KT) or overseas countries (KO). The KK population decreased from 774 in 1982 to 570 in 2002, owing mostly to an increase of 167 persons as the natural balance and a decrease of 324 persons as the balance of international migration. Comparison of total fertility rate (TFR) between KK and KO women revealed that the mean TFR of the former decreased from 3·460 in the earlier 10-year period (1983–1992) to 2·240 in the later 10-year period (1993–2002), while that of the latter was more than 3·5 in both 10-year periods. This difference was largely due to the decrease in the proportion married among KK women. If the current trends of international migration and fertility continue, the population of Kolovai will be reduced and its age composition will become cylinder-shaped in the near future.

The success of the Community-Directed Treatment (ComDT) approach in the control of onchocerciasis and filariasis has caught the attention of other disease control programmes. In this study the ComDT approach was implemented and compared with the school-based approach for control of schistosomiasis and soil-transmitted helminthiasis among school-age children in Lushoto District, Tanzania. This was a qualitative study, consisting of in-depth interviews with village leaders, community drug distributors (CDDs) and schoolteachers, as well as focus group discussions with separate groups of mothers and fathers to assess the perceptions and experiences of the villagers on the implementation of the two approaches. It was found that the villagers accepted the ComDT approach and took the responsibility of selecting the CDDs, organizing and implementing their own method of distributing drugs to the school-age children in their villages. The ComDT approach was well received and was successfully implemented in the villages. Although the villagers pointed out the limitation in reaching the non-enrolled children in the school-based approach, they also expressed satisfaction with this approach. This study suggests that the ComDT approach is well accepted and can be implemented effectively to ensure better coverage of especially non-enrolled school-age children.

Secondary analysis of the trends and correlates of consanguinity in the Palestinian Territories was conducted using data from two separate surveys in 1995 and 2004. The analysis was conducted on ever-married women aged 15–54 who were asked about their relation to their husband in both surveys. A total of 16,197 women in 1995 and 4971 women in 2004 were successfully interviewed. Consanguinity was found to be widely practised in the Palestinian Territories with rates of total consanguinity reaching 45% of all marriages in 2004. Analysis was conducted with the data from the two surveys combined and this indicated that consanguinity was significantly decreasing with time after controlling for other variables. Age of the women, their age at marriage, region and locality type they lived in and their standard of living were all found to be significant predictors of consanguinity. The education level of the women was not found to be significant. After controlling for the survey year, women’s labour force status was also found to be a non-significant predictor of consanguinity. Although consanguinity was found to be significantly decreasing slowly with time after controlling for other variables, the future trends of consanguinity are not known due to the unstable political situation in the territories, which could have a direct effect on marriage patterns.

Some socioeconomic and demographic factors contributing to the use of condoms among bar maids were studied in selected urban areas in Tanzania. Bar maids were classified according to whether or not they use condoms, and logistic regression was used in the analysis. Of the demographic variables studied, age, marital status, education level, use of alcohol and wage rate showed a significant relationship at the 1% level between individual factors and use of condoms. The odds ratios show that girls aged 10–14 are over 18,000 times more likely not to use condoms compared with women aged 30 and above. Those who drink are 6·6 times (1/0·165) less likely to use condoms compared with those who do not drink. In other words, alcohol consumption can be a stimulus for an individual not to use condoms. It is clear that young girls who drink are at the highest risk of contracting HIV/AIDS in comparison with older females. A multiple logistic regression model shows all the aforementioned factors to be significant at the 1% level. A policy recommendation is made that the government should impose restrictions as far as employment of bar maids is concerned.

The aim of this study was to determine the degree to which general body fatness variation, presented by body mass index (BMI), the sum of the three skinfold thicknesses (TST) (triceps, subscapular, abdominal) and percentage of body fat (%FAT), can be explained by socioeconomic status (SES) and lifestyle. The cross-sectional, population-based survey was of 259 healthy working males aged 20–30 from the city of Cracow, Poland. Objective anthropometric measurements, bioelectrical impedance analysis, the results of motor fitness tests and social and lifestyle data from a questionnaire were analysed. The independent variables were: age, socioeconomic status (birthplace, place of residence until the age of 14, social class, educational level and the type of work done) and lifestyle elements (smoking habits, dietary habits, family obesity resemblance, sport activity in the past, leisure time physical activity and level of motor fitness). Three separate full models were created using stepwise straightforward regression with BMI, TST and %FAT as dependent variables. The highest autonomous influence on BMI and %FAT was ascribed to age and family obesity resemblance, whereas variation in TST was explained by level of motor fitness, age, city as a place of residence until the age of 14 and family obesity resemblance. Although the analysed variables explained only from 8% (BMI) to 13% (TST) of body fatness variation, indicating at the same time that most variations are explained by other variables, the impact of lifestyle family-shared factors on body fatness seems to be significant.