This study is based on the 1983 Rural Health Survey of Ethiopia. Patterns and levels of child morbidity by age, sex, geographic region, and sanitary facilities are examined. Morbidity levels peak in the second year of life. Diarrhoeal diseases are of major importance, especially among infants and toddlers. Parasitic diseases, and respiratory diseases other than pneumonia, become increasingly important with age.

There are no significant sex differentials in morbidity except for higher rates of diarrhoeal diseases among female children. Geographic differentials are quite marked with particularly high morbidity levels from all disease types in the western mountainous regions of Ethiopia. Access to high quality drinking water, a latrine, and garbage disposal, are strongly related to reduced overall morbidity levels, though not necessarily to reduced diarrhoeal disease levels.

The relative performance of less developed countries in their health, demographic and economic sectors was assessed by means of comparative indices constructed with the help of a factor analysis. This approach reduces the problems usually associated with such indices, like the arbitrary weighting of their components.

A study in Bangladesh showed that couples who lost a child often stopped practising contraception in order to have another child. Logistic regression analysis revealed that contraceptive continuation was related to maternal age, parity, husband's education and the sex of the last child.

The female reproductive axis in mammals is a highly complex dynamic system which goes through different transient or absorbent states during the course of a life-time. Little is known about the mechanisms controlling this system during fetal life and at birth, although it has been shown in numerous species, including primates, that the whole machinery is already functioning (Brooks et al., 1990; Plant, 1986). After a delay ranging from a few days to a few weeks, according to the species, the reproductive axis becomes quiescent and activity apparently resumes only at the time of puberty. Here again understanding of the phenomenon is still limited (Ojeda, 1991).

This study based on the 1975–76 Bangladesh Fertility Survey showed that the mortality of sons, and not daughters, was associated with a lower rate of female contraceptive initiation of use and a higher rate of discontinuation.

In order to determine the validity of infant mortality estimates based on retrospective reporting, the Honduran Ministry of Health carried out a follow-up survey of women interviewed in a 1987 national survey. Women were interviewed approximately 14 months after the baseline survey and were asked about the outcomes of their pregnancies and the survival status of their young children. The overall infant mortality rate calculated from the follow-up survey was lower than that obtained from the baseline survey, due to the particularly low rate among the group of women who were pregnant at the time of the baseline survey. Possible explanations for this low rate are discussed.

Surveys of low-income women in Los Angeles County in 1985 and 1986 were used to examine the relative impact of child-bearing motivations versus life circumstances on the intention to have a(nother) child. Future child-bearing intentions are strongly related to current parity level regardless of marital status, race/ethnicity or economic status. Psychological motivating factors predict child-bearing intentions of nulliparous women, but not those of parous women. Multivariate analyses showed that motivation for parenthood and life circumstances combined predicted women's child-bearing intentions 88·6% of the time for nulliparous women, but 73·7% for parous women. These findings suggest that, in a low-income population, the onset of parenthood reduces the relationship between specific motivations for child-bearing and actual child-bearing intentions, and diminishes the ability to predict child-bearing intentions based on both attitudinal and social/structural factors.

Reported information on the duration of post-partum amenorrhoea usually shows considerable number preference, particularly at 6-monthly intervals. This paper presents a technique for smoothing such amenorrhoea data using a modified exponential curve. An attempt has also been made to estimate the average number of months a mother is expected to remain amenorrhoeic.

In a prospective study in Matlab, a rural area in Bangladesh, the relationship between a variety of covariates and childhood mortality was examined. Economic status of household, education of mother, sex of the children, health intervention programmes, age of mother, and live birth order of the children were identified as having a statistically significant impact on child survival when the effect of age was controlled. The effects of sex of the children, health programmes, age of mother, and birth order were found to be dependent on the age of the children, but the effect of mother's education was dependent on sex of the children.

There is a wide range of duration of post-partum amenorrhoea and resumption of ovulation between individuals, within an individual or between populations. Several extraneous variables, such as parity, mother's age, sex of the breast-fed baby, socioeconomic status and cultural level of the family, can be controlled; then the remaining variables will probably explain a part of the total variability in post-partum amenorrhoea duration but say nothing about the physiological process. In attempting to question physiological aspects of the return of fertility several observational studies have tended to favour one of the different factors which are supposed to play a major role in the regulation and have compared different levels of it, such as body composition of the mother (Frisch & McArthur, 1974), breast-feeding pattern (Jones, 1989) or the life style of the women. Life style can be related to women's physical activity in normal life (Ellison, 1991), the difference between urban and rural life (Carael, 1981) or the environment (Laurenson et al., 1985). Prolactin as a possible mediator of the central regulation has been carefully considered (Lunn, Austin & Whitehead, 1984; Howie et al., 1982). These studies were mainly observational rather than experimental, supplementing mothers during the lactating period or during the pregnancy. If this information is added to what is known of other animal species (Loudon, 1987) or animal experimentation (Plant et al., 1989; Williams et al., 1990a; Williams et al., 1990b), the combination of several of the main factors believed to have a major role in the human species can be clarified and the aetiology of the resumption of fertility in nursing women investigated.

All 8th-form schoolgirls from the municipality of Odense in Denmark were asked at what age they reached menarche, and 886 girls (97·6%) gave this information. There is no evidence for seasonality in the time of birth but for far more girls than expected menarche occurred during winter or summer and fewer than expected during spring and autumn. This pattern appears primarily in girls living in the suburbs and was not seen in those living in central Odense. The seasonality appears to be brought about by differences in mean age at menarche according to time of the year at birth.

This study used path analysis to assess the chances of survival of babies in a neonatal intensive care unit in Lansing, Michigan, USA. Two paths to neonatal survival were identified and the variables accounted for 20% of the variance in gestational age. The first path showed that prior infant losses were negatively correlated with gestational age while in the second path, gestational age showed negative relationships with pre-pregnancy weight and household job worries.

Whilst it is generally accepted that breast-feeding lowers the likelihood of conception, this relationship is not straightforward and there appears to be a wide variation in the effectiveness of the association between individual mother-infant pairs. Up to about 6 months post-partum breast-feeding probably can be used as a family planning method, with up to 98% effectiveness if behavioural guidelines are adhered to (Consensus, 1988). But beyond this time significant variations appear between different countries, and even different communities within countries, which make any overall recommendation impossible. To understand the reasons for variation in the duration of lactational infecundity it is necessary to understand the mechanisms involved, but knowledge of these processes is still far from complete. There are, nevertheless, enough data to indicate that suckling and maternal milk output are intimately linked with the return of fecundity.

Analysis of British National Child Development Study data corroborates the long held views that first born children tend to get more medical surveillance than those of later birth order, and that there is a direct relationship between achieved family size and social status.

This study uses data from the Ghana Demographic and Health Survey (GDHS) of 1988 to examine factors determining the continued low levels of contraceptive use in Ghana. The women currently using efficient contraception are those who have sexual intercourse regularly, who discuss family planning with their partner, whose husbands approve of the use of family planning, and who live in the northern sector of the country. The finding that husband's approval is an important determinant of efficient contraceptive use has significant policy implications for Ghana and other African countries, to motivate both husbands and wives to share fertility control responsibilities.

The effect of lactation on menstrual cycles, ovulation and conception was studied in a group of non-contracepting Amerindian Mopan Mayan women. Anthropological observations of relevant events were made over a 21-month period. Blood samples were assayed to determine the plasma concentrations of prolactin, luteinising hormone, follicle stimulating hormone, human chorionic gonadotrophin, placental lactogen, oestrogen, progesterone and cortisol. The data show that: frequent and prolonged breast-feeding was associated with a marked increase in plasma prolactin concentrations to levels similar to those in lactating Gaing but higher than those in lactating Scottish women; ovulatory menstrual cycles and pregnancy occurred during frequent lactation; in lactating menstruating women there was an inverse correlation between fat weight and months post-partum. These data suggest that other factors as well as suckling account for the effects of lactation on fecundity.

Data from the 1982 Sri Lanka Contraceptive Prevalence Survey are used to identify women who wish to stop childbearing; they differ in socioeconomic status from their counterparts who want more children. Educated women are more likely to be motivated to cease childbearing than non-educated women; Christian or Sinhalese/Buddhist women are more willing to stop childbearing than Moor/Muslim or Tamil/Hindu women. The relationships between sex composition of existing children and women's fertility desires indicate that although moderate son preference exists it does not affect their contraceptive behaviour. Among those who want no more children, 15% are at risk of unwanted pregnancy because they do not practise contraception. Again better education and being Christian or Sinhalese/Buddhist reduced the risk of unwanted pregnancy. Women whose husbands disapproved of contraception had over four times higher risk of unwanted pregnancy than women whose husbands approved.

The paper reviews methods, and their difficulties, in the measurement of the daily energy expenditure of rural women under field conditions in developing countries. Since all methods need to be validated against a reference method which is usually based on indirect calorimetry, examples of the use of this technique are given. The energy costs of most agricultural and daily tasks of rural women in developing countries have been measured. Large intra- and inter-individual variations in the cost of a single activity occur, so repeated measurements are needed to obtain a valid mean energy cost for a specific activity for a homogeneous group of individuals.

Much work remains to be done on the assessment of the duration and the intensity of the physical activity of the rural adolescent and adult female population. Studies indicate that the workload of most rural women in developing countries is excessive and frequently associated with acute poverty.

Urinary cortisol excretion rates were determined from three urine samples given over 2 days, a rest day and a working day, by 51 men and 50 women. Each subject also completed a questionnaire relating to life style factors and to perceived levels of stress, busyness and happiness on each day. In men, an association between raised cortisol and high levels of stress was found. In women, high levels of busyness were associated with low cortisol excretion rates. The subjective experiences measured accounted for around 10–20% of cortisol variation in this naturalistic setting.