There are a number of reasons for anticipating that contact by women in developing country settings with modern maternal–child health (MCH) services will lead to increased use of family planning services. Indeed, the expectation of such a relationship underlies the integrated service delivery strategy that has been adopted on a more or less global basis. However, the available empirical evidence in support of this proposition is inconclusive. This study re-examines this issue in Morocco. Household survey data and data on the supply environment for health and family planning services gathered in 1992 are analysed in the study. A full-information maximum likelihood estimator is used to control for the possible endogeneity of health care and contraceptive choices. The findings indicate a substantial and apparently causal relationship between the intensity of MCH service use and subsequent contraceptive use. Policy simulations indicate that sizeable increases in contraceptive prevalence might be realized by increasing the coverage and intensity of use of MCH services.

All available data for thirteen Pacific Island nations are used in a comparative analysis of suicide levels and characteristics. Age, sex and method of suicide are examined in detail. Global comparison shows Pacific rates are amongst the highest reported. Female youth rates exceed male rates in Western Samoa and amongst Fiji Indians. Method of suicide (paraquat ingestion) is instrumental in determining high rates in Western Samoa, especially in females. The broad causal theme is societal transition. Commonality and diversity are discussed.

The hypothesis that the month-specific rate of return to ovarian cyclicity after childbirth is causally related to suckling pattern was tested for a population of New Mexican women recruited within the service area of New Mexico Highlands University and for a nationwide USA subpopulation of women recruited through membership of the Couple to Couple League (CCL). Survival analysis for time-dependent covariates was used, and significant predictors of the first postpartum menses were found. Important differences were detected in the suckling pattern for the two groups and a 5:2 differential was found in their respective rates of menstrual cycle recovery. Although the two groups were comparable perinatally, daily and time-windowed breast-feeding performance fell off at twice the rate for the New Mexico population when contrasted with the CCL sample. For both populations, the introduction of solid feeds was a strong and significant predictor of returning menstrual cyclicity, independent of suckling pattern.

The hypothesis that measures of sub-adult mortality rates in natural fertility populations are associated with subsistence practices in a selected cross-cultural sample (n=39) was tested. After controlling for both distance from the equator and the general likelihood of cultural similarities between genetically closely related cultures using phylogenetic comparative methods, it was found that dependence on extractive modes of subsistence (hunting, gathering and fishing) was a significant positive correlate of total child mortality (15q0). Both increases in dependence on foraging and permanent settlement were associated with increases in child mortality between pairs of historically related cultures. The results indicated little association between infant mortality (1q0) and either dependence on foraging or settlement.

A study has been made of the probabilities of marriage of females and males aged 15–49 (either as a whole or in 5-year age groups) in two Outer Hebridean islands, Harris and Barra. The results were compared with ages of marriage and with the frequencies of permanent celibacy. The marriages took place between 1861 and 1990.

Median ages of marriage rose to maxima in the 1930s and 1940s, then fell steeply, levelling out latterly. Permanent celibacy was consistently high among females, but rose from much lower levels in males to maxima in the 1970s and 1980s. It is concluded that in these populations age at marriage and the extent of permanent celibacy are largely independent of one another.

In both islands the overall probabilities of females marrying fell until the 1920s, and then rose. The last decades showed stability (Barra) and a fall (Harris). Males showed only slight falls to about 1910; data were absent for between 1911 and 1960, but subsequently there was little rise in probability.

These overall changes seemed to be associated with reciprocal variations in probabilities in the younger and older age groups. Declining overall probabilities were associated with declines in younger and increases in older age-group probabilities, and vice versa.

Non-parametric correlations between median ages of marriage and probability of marriage were negative and generally significant for the 15–19 age group. Among the older age groups coefficients were generally positive.

There was some evidence of an association between probability of marriage and sex ratio in any group of potential mates. The effect appeared more marked among 15- to 19-year-old females.

Local factors which might explain at least part of the decline in nuptiality for the greater part of the period under study include the decline in the fishing industry and the ‘land hunger’ which existed until the late 1920s. This decline is interpreted as a ‘Malthusian’ response to economic and social conditions, but it coexisted with a ‘neo-Malthusian’ strategy, in the shape of declining marital fertility. The ‘Malthusian’strategy seems to have been largely abandoned around the 1950s, but it may have reappeared during the 1980s.

Although the recent Pakistan Demographic and Health Survey (DHS) show that two-thirds of marriages in Pakistan are consanguineous, the sociocultural determinants of such marriages remain largely unexplored. This paper examines the relative importance of the three commonly perceived reasons for such marriages: religious, economic and cultural. The analysis is based on qualitative data collected in 1995 from multi-ethnic and multi-religious communities in Karachi, the largest city of Pakistan. Results show that consanguineous marriages are preferred across all ethnic and religious groups to a varying degree, and that parents continue to be the prime decision-makers for marriages of both sons and daughters. The major reasons for a preference for consanguineous marriages are sociocultural rather than any perceived economic benefits, either in the form of consolidation of family property or smaller and less expensive dowries. Among Muslims, following religious traditions is the least commonly cited reason for such marriages. Despite the reported sociocultural advantages of consanguineous marriages, such unions are perceived to be exploitative as they perpetuate the existing power structures within the family.

This study examines wife–husband preference for children and subsequent fertility for a period of 5 years in the treatment and comparison areas of Matlab, Bangladesh. The two data sets used were: the In-depth Survey (1984) and the Demographic Surveillance System (1984–89). In the case of wives' preferences for children, subsequent childbearing was 13·8% higher than desired in the treatment area and 44·7% higher than desired in the comparison area. After controlling for all variables in the model, the likelihood of giving birth was 1·78 times higher for wives who wanted no more children, but whose husbands did want more, compared with couples where neither husband nor wife wanted more children. For couples where the wife wanted more, but the husband did not want more children, the likelihood of giving birth was 0·63 times that of couples where both the husband and wife wanted more children. This finding suggests that to enhance the decline in fertility in these two areas of Matlab, it will be necessary to motivate both wives and husbands to cease childbearing.

This paper examines the reasons for the high level of unmet need for contraception in rural Egypt, using data from the individual survey and service availability module of the 1988Ð89 Egypt Demographic and Health Survey. Two broad sets of potential factors are considered: characteristics of a woman which influence her desire for children and thus her propensity to use contraception, and factors relating to the family planning service environment in which she lives. The results from a multivariate analysis show that certain individual characteristics, such as family composition and education, have a strong impact on the level of contraceptive use and on the proportion of total demand for spacing or limiting childbearing that is met by use of family planning. Unmet need, however, remains fairly constant across demographic and socioeconomic subgroups of the population. The largest variations in unmet need are regional, but elements of the family planning services, namely the provision of a community-based nurse who distributes family planning and female doctors at clinics, also play an important role.

It has been suggested that altering the pace of reproduction would improve the health of women and children. For formulating intervention policies, it is important to know whether on its own such a strategy is likely to lead to risk reduction. This paper analyses mortality risk in sibships to explore the relationship between family formation factors and other household characteristics that identify women whose families are at higher risk. The analysis allows for the fact that reproductive behaviour may be modified by the family's prior experience of child death, using simultaneous equations methods to purge the model of the ‘feedback’ effects of death on the endogenous variable, childbearing pace. The strong relationship between reproductive pace and average risk in a family appears to be due to the association of both with other differences between households. Other aspects of family formation patterns are good indicators of which families are likely to experience excess risks to their children. These factors are associated with maternal education, but measure characteristics of the family or mother that educational attainment does not fully capture. They indicate that high-risk mothers are likely to have less control over many aspects of their lives. The pace of family building does not lead to excess average family risk, but may result, at least in part, from the concentration of risk in families with other characteristic patterns of family formation and few resources. The paper argues for a broader conception of household influences on child health and the health-related behaviour of parents.

Beliefs about child illness were investigated using semi-structured interviews with mothers and providers in four rural Guatemalan communities. The two most common forms of child illness in Guatemala – diarrhoea and respiratory disease – were focused upon. These illnesses are particularly difficult to prevent and treat, especially with the rudimentary health services available in rural areas of developing countries. Comparisons with other ethnographic studies in Guatemala suggest that some traditional models of illness causation identified in these earlier investigations are relatively unimportant in the communities studied here. This finding, in conjunction with frequent responses related to hygiene and water, suggests that traditional explanations may be co-existing with biomedical views of illness causation to a greater degree today than in the past.

Fisher (1930) presented both theoretical and empirical results concerning genetic influences on fertility. Since then, only sparse research has been done on the genetics of fertility, although more sophisticated methodogy and data now exist than were available to Fisher. This paper presents a behavioural genetic analysis of age at first intercourse, accounting for genetic, shared environmental, and selected non-shared environmental influences. The data came from the nationally representative National Longitudinal Survey of Youth (NLSY). A newly developed kinship linking procedure was used that identifies links for cousins, half-siblings, full-siblings and twins in the NLSY. The results suggest a genetic influence in the overall dataset, and also among whites and in male–male and opposite-sex pairs. Genetic influences were extremely small or non-existent for blacks and for female–female pairs. Shared environmental influences were small for most subsets of the data, but moderate for female–female pairs. Two specific non-shared environmental influences – self-esteem and locus of control – were ruled out as accounting for any meaningful variance, although other general sources of non-shared environmental influence appear potentially important. Analysis of selected samples from upper and lower tails suggested that genetic influences are important in accounting for both early and late non-virginity. These findings are consistent with work reported by Miller et al. (1999), who used molecular genetic methods. Generally, these findings support the existence of genetic influences and implicate non-shared environmental influences as being important determinants of the timing of loss of virginity among US adolescents and young adults.

This study in Bangladesh found that inter-cluster variation in the use of modern reversible methods of contraception was significantly attributable to the educational levels of the female family planning workers working in the clusters. Women belonging to clusters served by educated workers had a higher probability of being contraceptive users than those whose workers had only completed primary education. At the household level, important determinants of use were socioeconomic status and religion. At the individual level, the woman being the wife of the household head and having some education were positively related to her being a user. The model also found that inter-household variation was significantly greater than inter-cluster variation. Finally, the study concludes that after controlling for various covariates at all three levels, the clusters do not have significantly different levels of use of modern reversible methods of contraception. There are, however, some special areas where contraceptive use is dramatically low, and these contribute significantly to the observed inter-cluster variation.

A study of the abnormal sex ratio at birth in China reveals that it is not an entirely new phenomenon that emerged since the 1980s, but is simply more visible at present. Deliberate intervention to determine the sex of children has existed in the past few decades, at least in certain groups. Apart from modern medical methods, traditional Chinese medical practice is shown to be highly accurate in identifying the sex of a fetus. This may lead to sex-selective abortion and an abnormal sex ratio at birth. The possible causes of the abnormal sex ratio at birth include not only the real imbalance due to the disturbance of social factors, but also a spurious one attributable to the under-counting of female births. The real magnitude of the imbalance has been exaggerated by statistical error. The phenomenon is a complicated one reflecting the comprehensive socioeconomic setting. Among these factors, the stage of the fertility transition is one of the most decisive.

Endogenous ultradian rhythms with a periodicity of 2–3 hours operate separately in the right and left hemispheres of the human brain and modulate physiological functions, perception and cognition. Since sensory pathways from either hand terminate in the contralateral hemisphere, ultradian rhythms of the right and left brain can be monitored by variations in the tactile discrimination of the left and right hand, respectively. Thirteen right-handed German males were tested every 15 minutes for 8 hours. Time series of the tactile error rate determined for the right and left hands oscillate with significantly different ultradian periodicities. Whereas cycles in tactile discrimination of the right hand (left hemisphere) have a periodicity of about 2 hours, tactile discrimination of the left hand (right hemisphere) is modulated by longer periods of about 3 hours. This is interpreted in terms of the overall functional asymmetry of the human brain. Since the left brain is the specialized locus for verbal processing and the right brain for visual–spatial processing, lateralized ultradian rhythms operating in the hemispheres may provide a distinct frame for long-term timing of neuronal processes underlying semantic and spatial mapping of the environment. This is particularly important for interpreting biosocial behavioural rhythms seen in humans living under natural conditions.

This analysis investigates the determinants of contraceptive discontinuation in six developing countries, using data from Phase I surveys of the DHS programme. Cumulative probabilities of discontinuation at 24 months for reasons other than the desire for another child were examined. By this time, typically about 40% of couples have stopped use and most are subsequently at risk of an unwanted conception. Discontinuation of IUD use was found to be less common than for other methods, partly perhaps because cessation of use requires a deliberate decision to have the device removed.

The most important results are negative ones. Neither the schooling of couples nor their type of residence exerted appreciable influence on discontinuation. The policy and programme implications are discussed. Prior use of a method, fertility preferences and the related demographic factors of age and family size emerged as pervasive predictors of discontinuation.

The dopaminergic system in the brain seems to play an important role in the regulation of sexual behaviour. The relationship between genes for the D1, D2 and D4 dopamine receptors and age at first sexual intercourse (AFSI) was examined in a sample of 414 non-Hispanic, European–American men and women. A significant association was observed between a DRD2 allele and AFSI and an even stronger association when the DRD2 allele was interacted with a DRD1 allele. A constrained regression model was constructed predicting AFSI using sex and a group of nine psychosocial variables as predictors. Adding the DRD2 and the DRD2-by-DRD1 predictors to this model increased the explained variance by 23 and 55%, respectively. Although these findings suggest a stronger association among males than among females, further research will be necessary to clarify this question, as well as to establish whether the observed association holds in other racial/ethnic groups.

Lateralized ultradian rhythms oscillating separately in the right and left hemispheres of the human brain can be monitored by variations in the tactile discrimination of either hand. A previous study in male German subjects has shown that the tactile error rates determined for the right and left hands oscillate with significantly different periodicities. In the present study, a group of Kenyan Maasai shepherds was tested while the subjects were leading herds on daily feeding routes. The Maasai exhibit considerable ultradian rhythms of about 2 hours in tactile error rates of either hand, but in contrast to the German subjects there is no significant difference between the right and left side. While an individual is en route, his hemispheres proceed through alternating states in matching segments of the path. Ultradian rhythms thus ‘scan’ not only the time of day but also the space, and might provide an intrinsic time-frame for neuronal processes of cognitive mapping.

This paper examines the biosocial basis of premarital sexual and reproductive behaviour among women in Sudan. It applies Udry's biosocial perspective, which attempts to reconcile the biological and sociological models of premarital sexual and reproductive behaviour. World Fertility Survey (WFS) data were used to study premarital first motherhood. Early puberty was found to be paramount in determining childbearing in a separate biological model, but also in a biosocial model constructed to take account of social controls. This finding suggests that social controls do not influence the biological predisposition to premarital sexual behaviour. However, given the limitations of the WFS data, conclusive evidence must await a more appropriately designed study of reproductive behaviour in Sudan.

The status of women, which is relative and multidimensional, has an important bearing on any long-term reduction in fertility. In Indian society, where cohabitation and childbearing are socially sanctioned only after marriage, the length of the first-birth interval affects the completed family size by influencing the spacing and childbearing pattern of a family. This study examines the influence of certain aspects of the status of married women – education, employment, role in family decision making, and age at marriage – along with three socioeconomic variables – per capita income of the family, social position of the household, and the caste system – on the duration of the first-birth interval in an urban Hindu society of the north-east Indian state of Assam. The data were analysed by applying life table and hazard regression techniques. The results indicate that a female's age at marriage, education, current age, role in decision making, and the per capita income of the household are the main covariates that strongly influence the length of the first-birth interval of Hindu females of urban Assam. Of all the covariates studied, a female's education appears to be a key mediating factor, through its influence on her probability of employment outside the home and thereby an earned income and on her role in family decision making. Unlike other Indian communities, the effect of the caste system does not have a significant effect on first-birth timing in this urban Hindu society.

The effect of nutrition on fertility and its contribution thereby to population dynamics are assessed in three social groups (elite, tradesmen and subsistence) in a marginal, pre-industrial population in northern England. This community was particularly susceptible to fluctuations in the price of grains, which formed their basic foodstuff. The subsistence class, who formed the largest part of the population, had low levels of fertility and small family sizes, but women from all social groups had a characteristic and marked subfecundity in the early part of their reproductive lives. The health and nutrition of the mother during pregnancy was the most important factor in determining fertility and neonatal mortality. Inadequate nutrition had many subtle effects on reproduction which interacted to produce a complex web of events. A population boom occurred during the second half of the 18th century; fertility did not change but there was a marked improvement in infant mortality and it is suggested that the steadily improving nutritional standards of the population, particularly during crucial periods in pregnancy (i.e. the last trimester), probably made the biggest contribution to the improvement in infant mortality and so was probably the major factor in triggering the boom.