This paper examines the impact of rural–urban migration on under-two mortality in India, using data from the 1992/93 Indian National Family Health Survey. Multilevel logistic models are fitted for mortality in three age groups: neonatal, early post-neonatal, and late post-neonatal and toddler. Migration status was not a significant determinant of mortality in any of the three age groups. Further analysis shows that a relationship between migration status and mortality exists when socioeconomic and health utilization variables are omitted from the models. The relationship between migration and mortality is thus explained by differences in socioeconomic status and use of health services between rural–urban migrant and non-migrant groups. The selectivity of rural–urban migrants on socioeconomic characteristics creates mortality differentials between rural–urban migrants and rural non-migrants. Problems faced by migrants in assimilating into urban societies create mortality differentials between rural–urban migrants and urban non-migrants. These results highlight the need to target migrants in the provision of health services, and demonstrate that rural areas continue to have the highest levels of infant–child mortality. Further research is needed to understand the health care needs of rural–urban migrants in order to inform the provision of appropriate health care.

The disease burden in both developed and developing countries is moving towards higher proportions of chronic diseases, and diseases such as cancers are now considered to be of public health concern. In sub-Saharan Africa, healthy behaviours such as fruit and vegetable consumption are recommended to reduce the chances of onset of chronic diseases. This paper examines the determinants of fruit and vegetable consumption in Ghana with particular emphasis on consumption by ecological zone. Data were from the 2008 Ghana Demographic and Health Survey (n=4916 females; n=4568 males). Univariate and multivariate analyses were performed using basic descriptive and Poisson regression. The main independent variable was ecological zone and the dependent variables were levels of fruit and vegetable consumption. The mean number of fruits and vegetables consumed in a week was higher among females (fruits: 7.5, 95% CI=7.3–7.7; vegetables: 8.1, 95% CI=7.8–8.3) than males (fruits: 6.2, 95% CI=6.0–6.4; vegetables: 7.9, 95% CI=7.7–8.2). There were significant differences in consumption by ecological zone. Respondents in the Savannah zone consumed less fruit than those in the Coastal and Forest zones, but the differences in fruit and vegetable consumption between the Coastal and Savannah zones were not consistent, especially for vegetable consumption. The findings suggest that one of the key interventions to improve fruit and vegetable consumption could lie in improving distribution systems since their consumption is significantly higher in the Forest zone, where the production of fruit and vegetables is more developed than in the Savannah and Coastal zones. The findings relating to household wealth challenge conventional knowledge on fruit and vegetable consumption, and rather argue for equal consideration of spatial differences in critical health outcomes.

In a previous pilot project (Rosenzweig & Adelman, 1976) the sex choice attitudes of married couples with university (graduate school) education were explored. The present study extends this work by investigating the sex-choice attitudes of high school and partially college-educated subjects. Once again, the basic decision-making unit of husband and wife was sampled. Differences in sex preferences and sex-choice attitudes, based on the size of the marital family (no child, one child), were systematically explored. A greater effort was made to determine the effect of additional information regarding new methods of fetal sex determination, contraception, and related topics on sex-choice attitudes. Questionnaires were completed before and after information had been provided. Discussion was encouraged between husband and wife but discouraged with others. Results indicated that the exercise of sex choice is favoured by the majority of subjects across all three educational groups. Most individuals would employ sex control to ensure a balance of the sexes in a limited, two-child family. Little desire was shown to choose first child sex but active choice of a second child of opposite sex from the first appears a strong probability. Male preference, while pronounced, was a much weaker influence on the desire to make choices than the balance principle. Selective intercourse and a sex-choice pill were acceptable methods of sex control, but both artificial insemination and fetal sex determination combined with selective early abortion were rejected. Added information had a measurable but only slight effect on attitudes. Public education as to the possibilities of sex choice and control will be gradual and sex control will probably be selectively employed in the near future. But general use of such procedures is not imminent. Once put into practice, however, sex choice will create new marital problems that may require professional counselling.

This study investigates the link between health-related variables and risks of divorce. The findings indicate that physical characteristics associated with poor health – namely, obesity and short stature – are not significantly related to risks of marital dissolution for either men or women. On the other hand, risk-taking behaviours – such as smoking and drug use – are strongly related to higher risks of divorce for both sexes. Overall, the results emphasize the need to accommodate health-related variables in the dominant economic and social psychological theories of marital dissolution.

This paper examines contraceptive method use at different stages of the reproductive life course. Previous research on contraceptive practice in developed countries typically applies age as a proxy for reproductive history. While age is an essential and useful life course measure for understanding contraceptive use, investigations of contraceptive practice should also consider parity and fertility intentions, as they may be more accurate measures of reproductive life course stage. Analysis is based on data collected in the 2005 Household, Income and Labour Dynamics in Australia (HILDA) survey, a nationally representative sample of women of reproductive age (18–44). For women at risk of pregnancy, the most commonly used methods are easily reversed methods such as the oral contraceptive pill (30%) and condom (23%), medium-term methods such as the intrauterine device and implantation (5%) and permanent methods (7% tubal ligation and 9% vasectomy of partner). Logistic regression models are used to investigate the use of four popular contraceptive methods by parity, age and fertility intentions controlling for socio-demographic factors. The main findings indicate that the use of these methods varies substantially by the stage of a woman's reproductive life course: age, parity and fertility intentions are all associated with method use.

Stigma and discrimination within health care settings remain a public health challenge across diverse cultural environments and may have deleterious effects on mental and physical health. This study explores the causes, forms and consequences of HIV-related stigma and discrimination among migrant sub-Saharan African women living with HIV in Belgium. A qualitative study was conducted with 44 HIV-positive sub-Saharan African migrant women between April 2013 and December 2014 in health care settings in Belgium. Data were analysed using thematic content analysis. Twenty-five of the women reported overt stigma and discrimination and fifteen reported witnessing behaviours that they perceived to be stigmatizing and discriminatory in health care settings. The themes that emerged as to the causes of stigma and discrimination were: public perceptions of migrants and HIV, fear of contamination and institutional policies on HIV management. Reported forms of stigma and discrimination included: delayed or denied care, excessive precautions, blame and humiliation. The consequences of stigma and discrimination were: emotional stress, inconsistent health-care-seeking behaviour and non-disclosure to non-HIV treating personnel. Stigma and discrimination in health care settings towards people with HIV, and more specifically towards HIV-positive sub-Saharan African migrant women, impedes sustainable preventive measures. Specialized education and training programmes for non-HIV health care providers require in-depth investigation.

The present paper examines the association between the type of household and maternal health in India using data from the National Family Health Survey 1998–99. The indicators of maternal health used in the analysis are contraceptive use, visit to obtain antenatal care in the first trimester, safe delivery and nutritional status of women measured in terms of body mass index (BMI). Binary and multinomial logistic regressions are used to establish associations. The type of household is coded into three categories, viz. nuclear household, joint household with in-laws and joint household without in-laws. The other independent variables used in the analysis are age, children ever born, work status, education of women, religion, caste, standard of living, exposure to mass media, women’s autonomy and presence of others at the time of interview. The findings clearly suggest that type of household is significantly associated with the utilization of the above-mentioned services that positively affect maternal health. Women in nuclear households are more likely to utilize these services compared with women in joint households. However, an association between type of household and BMI was not found.

The relationships between selected demographic and socioeconomic variables and current use status of contraception were examined using logistic regression technique. Information on current contraceptive use was provided by 3156 out of 4488 currently married women aged 15–49 interviewed in the 1988 Ghana Demographic and Health Survey. Respondents' approval of family planning emerged as the most important predictor of current contraceptive use, followed by discussion of family planning with partner and level of education. As a policy measure, information, education and communication programmes on family planning should be intensified, particularly in rural areas. Female education, at least up to secondary level, should be given top priority.

An experiment was designed to test the effect of a synthetic hypothetical human female pheromone on sexual behaviour. Sixty-two married couples participated for 3 menstrual months. No effect was found.

Do girls fall in love with an image of their father? This study tested the hypothesis that, in choosing a partner, people tend to replicate the physical and mental attributes of their opposite-sex parent more than of the same-sex parent. A sample of 314 women, mostly in their late teens and describing themselves as ‘in love’, supplied details of their boyfriends and parents. A tendency for the boyfriend's eye colour to match that of the father more than of the mother was found, as well as a tendency for girls to replicate the age and dominance relationships of the parental partnership in their own relationship. These effects were very small and of marginal significance.

To examine the association of environmental factors (including housing) with respiratory infections and diarrhoea in children under 5 years of age, a cross-sectional study of 403 families was conducted in a squatter settlement of Karachi. In the 2-week period before the survey prevalence of diarrhoea and respiratory infections was 14·4% and 15·0% respectively. The factors significantly associated (p>0·05) with diarrhoea in households in the multivariate analysis were: number of children under 5, regular cleaning of sewers, storage of water in small utensils and cooking inside a one room house. Five households risk factors were identified for respiratory infections: the number of children under 5, poor housing structure, increased household density, humidity inside the house less than the humidity outside house, and frequent cooking inside the house. These results suggest that children under 5 years of age in lower income areas are at additional risk to health because of poor environmental conditions.

The role of family health-seeking behaviour in under-five-year child mortality was explored through the combined approach of examining health-seeking behaviour regarding treatment generally, and in specific in relation to illness before death. A population-based case control study was carried out during the period 1993–1994 using 222 deaths from diarrhoea and acute respiratory illness (ARI) in children under five years of age in six slums of Karachi as cases, and 419 controls matched on age, disease (diarrhoea and ARI) and slum. Factors significantly associated (p<0·05) with child mortality in the multivariate analysis were: mothers changing healers quickly, using a traditional healer or an unqualified doctor and mothers to whom doctors did not explain the treatment, even when maternal education was controlled for. Seeking effective medical services is highly influential on whether the child survives or succumbs to ARI or diarrhoea. As mothers are the first providers of care, an attempt should be made to try and improve their skills through health education so that they can use simple and effective treatments for minor illnesses. They should also be taught to recognize potentially life-threatening conditions, to seek care early and to persist with treatment.

Fertility rates in Pakistan have remained consistently high over the past three decades. While numerous studies have examined sociodemographic determinants, the role of biological factors, and particularly consanguinity, has received little attention, even though marriage between close biological relatives continues to be the norm in Pakistan. Reproductive behaviour among women in consanguineous (first cousin) and non-consanguineous unions was compared, using data from a 1995 study of multi-ethnic communities in Karachi and the 1990–91 Pakistan Demographic & Health Survey (PDHS). The results show that, although female age at first marriage has been gradually rising in both study samples, women in consanguineous unions married at younger ages and were less likely to use modern contraceptive methods. In the Karachi sample, women in first cousin unions experienced a higher mean number of pregnancies and also reported a higher mean number of children ever born (CEB). However, their mean number of surviving children did not differ from those born to women in non-consanguineous unions, implying higher prenatal and/or postnatal losses in couples related as first cousins. On the other hand, the PDHS showed both lower CEB values for women in consanguineous marriages and a lower number of surviving children. Given the continuing popularity of consanguineous marriage, these findings have important implications for future fertility reduction in Pakistan.

This was a cross-sectional study carried out on 462 pregnant women attending antenatal care in Ibadan, Nigeria. The study's aims were to assess the level of participation of Nigerian men in pregnancy and birth, the attitude of the women and likely targets for improved care delivery. Three hundred and forty-nine women (75.5%) were aware that husbands could participate in childbirth. Most women did not think it was their husbands' place to attend antenatal clinic (48.3%) or counselling sessions (56.7%). Nearly all husbands (97.4%) encouraged their wives to attend antenatal clinic – paying antenatal service bills (96.5%), paying for transport to the clinic (94.6%) and reminding them of their clinic visits (83.3%). Three hundred and thirty-five husbands (72.5%) accompanied their wives to the hospital for their last delivery, while 63.9% were present at last delivery. More-educated women were less likely to be accompanied to the antenatal clinic, while more-educated men were likely to accompany their wives. Yoruba husbands were less likely to accompany their wives, but Yoruba wives with non-Yoruba husbands were 12 times more likely to be accompanied. Women in the rural centre were less likely to receive help with household chores from their husbands during pregnancy, while educated women were more likely to benefit from this. Monogamous unions and increasing level of husbands' education were associated with spousal presence at delivery. It appears that male participation is satisfactory in some aspects, but increased attendance at antenatal services and delivery would be desirable.

Scaling-up of skilled attendants and facility-based services is necessary for improving maternal and child care in developing countries but their effectiveness is crucially influenced by the uptake of such services. This study set out to establish the pattern and uptake of maternity services and associated factors against the backdrop of rapid urbanization in Nigeria. A cross-sectional study of socio-demographic and obstetric characteristics of mothers attending the Bacille Calmette-Guérin (BCG) immunization clinics in inner-city Lagos was conducted from July 2005 to December 2007, and their association with non-hospital delivery and use of unskilled attendants was determined by multiple logistic regression analyses. Of the 6465 participants, over half (51.4%) delivered outside hospital facilities and 81.8% of this group had no skilled attendants at delivery. Non-hospital delivery or the presence of unskilled attendants at delivery was associated with teenage mothers, Muslim religion, low or middle social class and use of herbal drugs in pregnancy. Additionally, non-hospital delivery was associated with ethnicity (Yoruba tribe), lack of tertiary education or full-time employment, accommodation with shared sanitation facilities and multiparity. The results suggest that availability of and access/proximity to hospital facilities or skilled attendants is no guarantee of uptake of maternity services. Efforts aimed at improving maternal and child health in developing countries should take cognisance of the socio-demographic and cultural underpinnings of maternal health-seeking behaviour of urban mothers beyond the provision of facility-based services or strengthening of the existing health care systems.

Using a cross-sectional sample of 1147 urban adolescents, aged between 14 and 20 years, the variability of some menstrual cycle indicators was related to weight loss. Nearly 40% of the adolescents tried to lose weight and the results showed that attempting to lose weight is significantly associated with increased prevalence of menstrual irregularity and menstrual pain. This finding is independent of body mass index.

Who are the men and women who are single in their mid-30s? This study, which uses life history data for a British cohort born in 1946, shows that an important minority are ‘handicapped’ and these adults are cared for primarily by their families, in particular by elderly parents. Celibates tend to be more introverted, ambitious and to have older marrying parents than their ever-married peers. Single women differ from single men. The women are more likely to be of higher ability, to be graduates and to be in high status occupations whilst single men are more likely to be members of the lowest social class or unemployed. The great majority of single people live either with their parents or on their own.

This paper critically analyses from a political sociology standpoint the international conceptualization of war-affected populations as traumatized and in need of therapeutic interventions. It argues for the importance of looking beyond the epidemiological literature to understand trauma responses globally. The paper explores how the imperative for international psychosocial programmes lies in developments within donor countries and debates in their humanitarian sectors over the efficacy of traditional aid responses. The aim of the paper is threefold. First, it discusses the emotional norms of donor states, highlighting the psychologizing of social issues and the cultural expectations of individual vulnerability. Second it examines the demoralization of humanitarianism in the 1990s and how this facilitated the rise of international psychosocial work and the psychologizing of war. Third, it draws attention to the limitations of a mental health model in Croatia, a country which has been receptive to international psychosocial programmes. Finally it concludes that the prevalent trauma approaches may inhibit recovery and argues for the need to re-moralize resilience.

This study uses data from thirteen Demographic and Health Surveys to examine effects of female migration on fertility in African cities. Contrary to expectations, migration from villages and towns in the 1980s and 1990s reduced total fertility rates in African cities by about one birth, from an estimated average of 5·55 in the absence of migration to 4·59. New arrivals experience much lower fertility in their first few years in cities than long term residents of similar age and parity. This results from the initial unmarried status of most migrants, high levels of spousal separation among new arrivals who are married, dramatic increases in use of modern methods of contraception after 2 years in cities, and continuation of traditionally long durations of postpartum abstinence. Accomodation of additional migrants thus appears consistent with efforts to reduce fertility in cities. Moreover, prospects for increased contraceptive prevalencein Africa may depend heavily on changes in population distribution that influence the demand for children, specifically movement to cities.

As India rapidly urbanizes, within urban areas socioeconomic disparities are rising and health inequality among urban children is an emerging challenge. This paper assesses the relative contribution of socioeconomic factors to child health inequalities between the less developed Empowered Action Group (EAG) states and more developed South Indian states in urban India using data from the 2005–06 National Family Health Survey. Focusing on urban health from varying regional and developmental contexts, socioeconomic inequalities in child health are examined first using Concentration Indices (CIs) and then the contributions of socioeconomic factors to the CIs of health variables are derived. The results reveal, in order of importance, pronounced contributions of household economic status, parent's illiteracy and caste to urban child health inequalities in the South Indian states. In contrast, parent's illiteracy, poor economic status, being Muslim and child birth order 3 or more are major contributors to health inequalities among urban children in the EAG states. The results suggest the need to adopt different health policy interventions in accordance with the pattern of varying contributions of socioeconomic factors to child health inequalities between the more developed South Indian states and less developed EAG states.