This paper reports the results of a June 1980 survey of 1069 children in Changsha, Hunan Province. The data have been unavailable previously either in Chinese or in English. In general, they suggest that comparisons of single children with children from multiple-child families in China regarding quality of life, intellectual development, and behavioural traits are similar to comparisons conducted in the United States and other western countries. As in many western studies, single children in China appear to have a better quality of life than children with siblings. Regarding intellectual development, single children in China perform better than those with siblings, a finding which is consonant with the family intactness model of Falbo. Single children in Changsha are little different from ones from multiple-child families on various aspects of behaviour, and are more co-operative and less hostile. These findings are the opposite of those of the Shanghai study, the other major analysis of single children in China; the Shanghai survey indicated that single children were not as well-behaved as those with siblings, a finding that caused some concern among Chinese social scientists. To the extent that the findings of the Changsha study, and not those of the Shanghai study, reflect the situation of single children in China, this could mean that the one-child family planning campaign may not be having a negative impact on children's behaviour.

The relationship between sleep habits and psychosomatic health complaints was investigated by a questionnaire study in 148 bank workers in Tokyo. Daily bedtime was more flexible than daily rising time, and both mean bedtime and rising time tended to be earlier with increasing age. Multiple logistic regression analysis showed that psychosomatic health complaints of sleep disturbances, fatigue, digestive troubles, and depressive mood were significantly associated with sleep habits and perceived mental stress.

Bangladesh society is profoundly gender stratified, and yet male roles in reproductive health processes have not been rigorously investigated. This study examines the association between men’s reproductive health knowledge, attitude and behaviour and their wives’ subsequent reproductive behaviour using longitudinal data from the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). A total of 4969 matched husband-and-wife data from a 1998 survey and women’s contraceptive use history data following this survey are used. Results show a significant association between husbands’ fertility preferences and current use of any family planning method. When wives’ background characteristics, and husbands’ background and socioeconomic characteristics are controlled for, the predicted probability of using a method of contraception among non-educated wives whose husbands want more children is 0·49 compared with 0·64 for those whose husbands do not want more children. However, the net effect of husbands’ preference for additional children diminishes as wives’ level of education increases. Among wives who had completed high school, the predicted probability of using a method of contraception is 0·70 for those whose husbands want more children compared with 0·69 for those whose husbands do not want more children.

The existence of very low rates of fertility among non-contracepting human populations has intrigued researchers in demography and reproductive ecology. Long inter-birth intervals, driven primarily by the lactational amenorrhoea associated with breast-feeding, have been shown to be important determinants of low natural fertility in several populations. Other reports have suggested that sterility brought about by sexually transmitted diseases (STDs) might also explain low fertility in some populations, especially in Africa. This report presents an analysis of 1981 Indian census data that documents low natural fertility in Ladakh, a high-altitude region of the Himalaya in north India. In Ladakh, there is evidence for low rates of marriage among women that may be attributable to the practice of polyandry, but also high rates of primary and secondary sterility within marriage, resulting in low completed parities for post-reproductive age married women. Age-specific fertility rates derived from the number of current births are also unexpectedly low. Hypotheses to explain very low fertility in Ladakh are considered from among the likely proximate determinants and evaluated using two supplementary sources of information derived from fieldwork in Ladakh in the early 1990s. The most likely explanations for low marital fertility include sterility from STDs, high rates of fetal loss, and possibly nutritional contraints on ovarian hormone status.

One hundred and fifty-two randomly selected pregnant women were examined and followed up by interviews and psychological tests during pregnancy and after parturition. The present paper is focused upon factors which determine the woman's preference for the sex of her expected child. It was shown that women who already have one or more children generally wanted the expected child to be of the opposite sex to her youngest child. Thus, the main part of the study was limited to eighty-one nulliparous women.

Associations were found between the woman's preference for the sex of the child and several factors such as the sex of her own siblings and her position among them, her education, intelligence and degree of field-dependence indicating immaturity and lack of autonomy.

Several of the findings presented refute the common supposition that nulliparous women generally want to give birth to a son, and that the arrival of a son is more satisfactory. Women wishing for a son were found to be somewhat more field-dependent than other women and somewhat more often reported that they had experienced a range of mental symptoms before the current pregnancy. Women wishing for a boy also reported more mental symptoms during the post-partum period. Moreover, those women who gave birth to a son reperted more symptoms at this time than those who gave birth to a daughter, and paradoxically the most affected were those who had wished for a son and had had their wishes fulfilled. The arrival of a daughter therefore seems to be equally satisfactory to the mother, at least as measured by the criteria used in this investigation.

India is the highest contributor to child anaemia among developing countries. To see the latest picture of child anaemia in India, data for 6- to 59-month-old children were taken from the fourth round of the National Family Health Survey conducted in 2015–16 (NFHS-4). The study sample consisted of 1,37,347 children. The dependent variable was the anaemia status of the child. The objectives of the study were to assess (i) the distribution of anaemia prevalence by child age group, (ii) the prevalence of child anaemia by zone and state and (iii) the relation of child anaemia prevalence with social, demographic and economic variables, including maternal nutritional status and low birth weight. The study found that in India in 2015–16, 56% of 6- to 59-month-old children were anaemic – a decrease of only 13.5 percentage points since the NFHS-3 study conducted in 2005–06. It is well known that iron supplementation is necessary for child growth and brain development. This study suggests that, in addition, the socioeconomic conditions of households in India need to be improved to prevent child anaemia. Low birth weight and low maternal nutritional status are also responsible for the high prevalence of anaemia among children in India.

Intimate partner violence is widespread worldwide. While assumed to impact women’s ability to use contraceptive methods, few data are available to support this claim. In this study, eight focus group discussions were conducted to guide questionnaire development and to provide contextual information. Participants were women who were currently using the pill and women who had used the pill previously. In addition, 300 women were interviewed who initiated oral contraceptive pill use between December 1995 and April 1996. Participants were interviewed 3–6 months later to investigate the role intimate partner violence played in covert pill use and pill discontinuation. Special study procedures for asking women questions about violence were employed. Nineteen per cent of the women interviewed were using the pill covertly. The odds of covert pill use were four times higher in El Alto and La Paz than in Santa Cruz. Women who used the pill covertly were more likely to have experienced method-related partner violence (OR=21.27) than women whose partners knew of their pill use. One-third of the women had discontinued pill use at the time of the interview. In the final multivariate analysis, having experienced side-effects (OR=2.37) was a significant predictor of pill discontinuation and method-related partner violence was marginally predictive (OR=1.91; 95% CI 1.0–3.66). While efforts are ongoing to incorporate men into family planning programmes, some male partners oppose, and in some situations violently oppose, contraceptive use. The needs of women with these types of partners must not be overlooked.

A sample of 842 rural women from Morocco (Amizmiz, Marrakech) was used to examine the relationship between a number of biosocial variables and fertility patterns. For women still in their reproductive years there were significant correlations between family size and woman's age, age at marriage and years of marriage. Among women with completed families, those with early age at marriage ceased childbearing about 10 years before reaching menopause, while women who married later continued to bear children until the end of their fertile life.

Using nationally representative data, it is shown that marital unions are relatively stable in Nigeria. Remarriage rates are high so little time is lost between unions. Consequently, the fertility of women who have experienced marital disruption is only slightly lower than for those in stable unions. Their slightly lower parity may be a function of a high incidence of reproductive impairment, which is a major reason for divorce and separation in Nigeria.

It has been suggested that parish-based reconstitution studies may underestimate the true age at marriage because they do not normally include data for emigrants who may be expected to behave differently from individuals who remain in their natal parishes. This study uses data from C18-19th parish registers of north-west Germany to estimate the difference in age at marriage between leavers and stayers. The difference is not significant for males; although that for females is significant, it is small and the consequence of failing to include migrants is likely to be negligible for most studies. However, it is shown that there is also an independent effect on age at marriage that is due to the woman's natal social (economic) status; historical demographic studies that ignore this dimension may risk confounding two different effects.

This study evaluated the strength of the independent effects of social position (expressed by educational level) and number of childbirths on body mass index (BMI) variation of Polish adult females. The material comprised 2045 pre-menopausal women aged 35–50, who were healthy and occupationally active inhabitants of the city of Wrocław, Lower Silesia, Poland. Two-way analysis of variance (ANOVA) revealed that both educational level (F=34·7; p=0·0001) and parity (F=5·6; p=0·001) exerted independent significant effects on BMI. The mean BMI of women who had attended basic vocational or trade school at the very most (27·0 kg/m2) was greater than that of women who had completed secondary school education or had graduated from university (25·3 kg/m2). However, it is worthy of note that there were no social differences in BMI values between childless women. Nevertheless, an increasing number of childbirths was essentially related to increasing female BMI in each social group, and this tendency was most marked among women of lower social position. Regardless of educational level, the highest prevalence of obesity (BMI exceeding 30 kg/m2) was found among females with at least three children (15·6% and 26·4% of women from higher or lower social groups, respectively).

This paper is based on a study aimed at understanding the perceptions of men to induced abortion and contraceptive use within marriage in rural Zimbabwe. Two qualitative methods were combined. Men were found to view abortion not as a reproductive health problem for women. Instead, they described abortion as a sign of illicit sexual activity and contraceptive use as a strategy married women use to conceal their involvement in extramarital sexual activity. Men felt anxious and vulnerable for lack of control over women. In the absence of verbal communication on sexual matters, women and men resort to what are called here ‘hide-and-seek’ strategies, where women acquire and use contraceptives secretly while men search for evidence of such use. It is concluded that promoting women’s sexual and reproductive health requires both short- and long-term strategies. The short-term strategy would entail providing women with reproductive technology they can use without risking violence. The long-term strategy would entail understanding men’s concerns and the way these are manifested. In turn this requires the use of methodologies that encourage dialogue with research participants, in order to capture their deep meanings and experiences.

The biraderi (brotherhood) is a long-established, widely prevalent dimension of social stratification in Pakistani communities worldwide. Alongside consanguinity, it offers a route for cementing social solidarities and so has strong socio-biological significance. A detailed breakdown of biraderi affiliation among participants in an ongoing birth cohort study in the northern English city of Bradford is presented. There is historical resilience of intra-biraderi marriage, but with a secular decline in prevalence across all biraderi and considerable reductions in some. While a majority of marriages in all biraderi are consanguineous the prevalence varies, ranging from over 80% to under 60%. In consanguineous unions, first cousin marriages account for more than 50% in five of the fifteen biraderi and >40% in six others. Within-biraderi marriage and consanguinity enhance genetic stratification, thereby increasing rates of genomic homozygosity and the increased expression of recessive genetic disorders. The trends reported constitute putative signals of generational change in the marital choices in this community.

Based on evolutionary reasoning, Trivers & Willard (1973) predicted status-biased sex composition and parental investment with son-preferencing effects in higher, and daughter-preferencing effects in lower status groups. Previous research shows mixed results. This study uses event-history methods and Swedish register data to study one possible mechanism in isolation: do parents in different status groups vary in their proclivities to continue fertility based on the sex composition of previous offspring? The results show no support for the Trivers–Willard hypothesis on a wide range of different status indicators. Future research on the stated hypothesis should focus on physiological rather than behavioural mechanisms.

This paper addresses the overall performance and inequalities in the immunization of children in Vietnam. Descriptive and logistic analysis of cross-national demographic and health data was used to examine inequality in immunization, identify the most vulnerable groups in immunization coverage, and identify the gap in coverage between hard-to-access people and the remainder of the population. The gap in the coverage was found to occur primarily in vulnerable groups such as the poor minority or poor rural children. No evidence was found of a difference in immunization coverage because of sex or birth order. However, the age of children showed a significant influence on the rate of immunization. Mother’s education and regular watching of television had a significant influence on child immunization. In order to improve child immunization coverage in Vietnam, efforts should be concentrated on poor children from minority groups and those living in rural areas, especially remote ones. Community development, investment for immunization and re-organization of immunization services at the grassroots level are also key factors to remove the barriers to immunization for vulnerable populations in Vietnam.

Age at menarche has been shown to be an important indicator for diseases such as breast cancer and ischaemic heart disease. The aim of the present study was to document secular trends in age at menarche and their association with anthropometric measures and socio-demographic factors in university students in Bangladesh. Data were collected from 995 students from Rajshahi University using a stratified sampling technique between July 2004 and May 2005. Trends in age at menarche were examined by linear regression analysis. Multiple regression analysis was used to assess the association of age at menarche with adult anthropometric measures and various socio-demographic factors. The mean and median age of menarche were 13.12±1.16 and 13.17 years, respectively, with an increasing tendency among birth-year cohorts from 1979 to 1986. Menarcheal age was negatively associated with BMI (p<0.01), but positively associated with height (p<0.05). Early menarche was especially pronounced among students from urban environments, Muslims and those with better educated mothers. Increasing age at menarche may be explained by improved nutritional status among Bangladeshi populations. Early menarche was associated with residence location at adolescence, religion and mother's education.

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.

Botswana is one of the sub-Saharan countries where actual fertility has declined. This study examines the fertility preferences of both men and women and shows that fertility intentions have a significant influence on future fertility behaviour. Fertility preferences are relatively low and there is no significant difference between those of men and women. Men's preference for sons influences desired family size and eventual fertility. For women as well as men, child survival is an important factor. Women's income is also influential.

The private sector in health care in Vietnam has been increasingly competing with the government in primary health care services. However, little is known about the use of skilled birth attendance or about choice of public and private sectors among those who opt for skilled attendants. Using data from the Vietnam 2002 Demographic and Health Survey, this study examines factors related to women’s decision-making of whether to have a skilled birth attendant at a recent childbirth, and if they did, whether it was a public or private sector provider. The study indicates that the use of the private sector for delivery services was significant. Women’s household wealth, education, antenatal care and community’s wealth were positively related to skilled birth attendance, while ethnicity and order of childbirth were negatively related. Order of childbirth was positively associated with skilled birth attendance in the private sector. Among service environment factors, increased access to public sector health centres was associated with an increased likelihood of skilled birth attendance in general, but a lowered chance of that in the private sector. Further studies are needed to assess the current situation in the private sector, the demand for delivery services in the private sector, and its readiness to provide quality services.

In its recently adopted Global Strategy on Infant and Young Child Feeding, the World Health Assembly called for urgent action in addressing the barriers to optimal feeding practices. This paper examines mothers’ concerns about milk insufficiency as a major contributor to suboptimal infant feeding decisions, using survey data from periurban areas of two Bolivian cities. Mothers in the lowland modernizing city of Santa Cruz were more likely than mothers in the highland traditional city of Cochabamba to express concern about insufficient milk, and also less likely to feed their infants according to international recommendations. Furthermore, perceived milk insufficiency was particularly common among mothers of infants younger than 6 months of age – an age at which infants are particularly vulnerable to the adverse effects of breast-feeding cessation and complementary feeding initiation. The paper concludes with policy, programme and research recommendations to address the critical problem of perceived insufficient breast milk.