The disadvantaged child: A product of the culture of poverty,his education,and his life chances

Abstract

This study concerns the fertility of Sherpa and Tibetan women living at altitudes over 3,400 meters in Nepal. The average completed fertility (4.77 live births) and estimated crude birth rate (31 to 33 per 1,000) are low relative to low altitude peasant populations as well as to high altitude Andean peasants. Environmental phenomena (hypoxia, iodine deficiency) may be associated with retarded menarchial age and high infant mortality; but the major factors causing the low fertility appear to be cultural rather than environmental. Traditional ceremonial requirements delay the age at marriage until the mid or late twenties. Religious practices promote male and female celibacy. Migrant females and women married to migrant males report reduced fertility, probably because of poor nutrition and health care. Nonmigrant women living in villages that participate extensively in the cash economy have greater access to the growing market economy, health care, and education and report higher numbers of live births and fewer child deaths.     

Household extension and reproductive behaviour in Taiwan

The inflence of household type on reproductive behavior is examined for a national probability sample of Taiwanese women. Data were derived from a 1980 national household survey of the labor force in Taiwan, focusing on 10,624 couples. Reproductive variables include measures of current and prospective fertility as well as cumulative fertility. In spite of remarkable social and economic development over the past 3 decades, extended families are still widely found in Taiwan. Women in extended households have only slightly higher fertility preferences and current fertility than women in nuclear families once marital duration is controlled. Although women in extended households marry earlier and receive more family help with child care than women in nuclear families, such factors are no longer considered sufficient to produce major differentials in reproductive behavior. Residence and husband's class of work are the strongest correlates of whether a household is currently extended or nuclear. In general, the husband's characteristics are more strongly related to family type than the wife's. Findings suggest that preferences for smaller families and low fertility need not await a transformation to a nuclear family structue.     

Household type and family size in Maharashtra, 1970

Abstract

Demographic transition theory expectations notwithstanding, empirical analyses have often observed higher fertility among nuclear than among extended households. A similar finding has been observed consistently at all stages of the reproductive career among a sample of households in Maharashtra, India, in 1970. Neither differential levels of natural fertility nor of family‐size preferences and use of fertility regulation, nor differential socioeconomic levels, can explain adequately the higher fertility of nuclear households. On the other hand, the evidence suggests that the direction of causation is reversed, that is, that household type is itself a function of fertility and other life‐cycle variables and also of space constraints on the household, and as such, is a better determinant of household type than a function of the latter.     

A period analysis of parity distribution among white and nonwhite women in the United States, 1940–1974

Abstract

The historical trends of childlessness and of one‐child, two‐child, and three‐or‐more‐child families among white and nonwhite women in the United States are studied in terms of period fertility tables. Given the age and parity of a woman, we can read from the fertility tables how her parity is expected to change at successive ages during the rest of her childbearing period, if she is subjected to the age‐parity‐specific fertility rates for a particular year. The fertility tables for white and nonwhite women are constructed for the years 1940, 19S0, 1960, 1970, and 1974. These tables show that among white women who have completed their childbearing (with period rates), the percentage with more than two children has decreased from 66 in 1960 to 27 in 1974, whereas the corresponding reduction among nonwhite women is from 67 to 48 per cent (Table 1, Case 1).     

Assessing the correlates of desired family size in Shaanxi,China

Abstract

This exploratory analysis of factors associated with Chinese women's fertility desires uses data on married women between the ages of 18 and 35 who live in Shaanxi Province, China. Analyses using an economic framework found that both rural and urban couples who intended to sign, or who had already signed, the one‐child certificate reported wanting significantly fewer children. However, in rural areas (where 80 per cent of the provincial population lives), education level, living arrangements, participation in an arranged marriage, attitudes regarding the ideal age for marriage, and knowledge of the reasons for the government's fertility policies appear to play a relatively larger role in shaping fertility preferences.     

Women's role orientations and expected fertility: Evidence from the Detroit area, 1978

Abstract

The paper investigates whether there is empirical evidence to support the hypothesis that women's attitudes toward traditionally female family roles affect their expected fertility net of the much‐discussed link between women's employment and fertility. Along with several socio‐demographic variables, the study uses a nonwork related attitude variable comprised of a motherhood role attitude measure and a housekeeping attitude measure. The study uses a probability sample of white, fecund, once‐married women under 35 living with their husbands in the Detroit Metropolitan Area in 1978. Findings suggest that nonwork related attitudes have a significant effect on fertility expectations net of labor force participation. They also suggest that general fertility surveys could benefit from including questions on nonwork related role orientations.     

Deformed nasal septa and relaxed selection

Abstract

Demographic studies undertaken in several Andean countries have found that women residing at high altitudes have significantly fewer live births than do their low altitude counterparts. This reduction has been explained as being due to various factors: the debilitating effects of hypoxia upon the reproductive system; the effects of sociocultural factors which vary with altitude and which affect reproductive behavior; and errors in data collection. In order to examine the validity of some of these hypotheses, the fertility of a group of 906 Bolivian women residing at low, medium, and high altitudes was examined. The women were selected from the lower socioeconomic strata and reported never having used any method of contraception. A detailed analysis of the fertility of these women showed no significant altitude‐related differences in the number of live births. However, as a result of significantly higher childhood mortality rates at altitude, there was a significant reduction in numbers of living children. The results of this study suggest that the collection and analysis of census data that ignores socioeconomic differences within a population or differences among census units in neonatal or early childhood mortality may bias or complicate the study of the impact of altitude on human fertility. Although the present research does not prove that hypoxic stress does not affect the reproductive system, the results suggest that if altitude does reduce fecundity, the reduction is not great and is likely to be shown only through studies of reproductive physiology.     

Selection intensities in menopausal and permanent contraceptor women of a rural population in India

Abstract

The opportunity for selection was estimated in the rural population of Visakhapat‐nam District, Andhra Pradesh, India. The index of total selection was found to be low. Selection in relation to birth control reveals that opportunity for selection is lower among the women who completed their fertility by family planning methods than in women who completed their fertility by attaining menopause. Further, the results showed that differential fertility and mortality make equal contributions to the total measure of selection in both groups.     

Age at first birth and family size: Evidence from a longitudinal study

Abstract

This paper examines the correlates of the relationship of age at first birth to completed parity, using data from a fifteen‐year longitudinal study. Particular emphasis is given to measures of orientation toward family roles which have been singled out in previous studies as a likely causal factor not yet examined. Women who had an early first birth went on to have larger families than women who postponed childbearing longer. Demographic factors, including premarital pregnancies, unwanted births, and fecundity differentials, did not appear to account for the observed relationship. The hypothesis that early socialization toward traditional female roles might account for the higher fertility of women who began childbearing early was not confirmed. Women with a first birth at a young age were not characterized by more traditional sex‐role behavior or attitudes nor did they express higher initial fertility preferences. They did more often increase their fertility preferences over the inter‐survey period.     

Correcting contraceptive failure rates for sample composition and sample selection bias

Abstract

There is reason to believe that in the short run marriages are becoming more stable in some Western African countries such as Cameroon. One of the crucial questions facing these countries is whether fertility rates can be expected to increase or decrease due in part to the increased stability of marriages. Analyzing 1978 Cameroon World Fertility Survey data and using a multivariate regression model which compares the fertility rate of women who have had at least one marital disruption with that of continuously married women, we studied the relationship between marital instability and fertility. The results show that fertility rates for women married more than once are significantly lower than those for continuously married women even before the end of their first marriage. Furthermore, marital disruption significantly reduces fertility rates after the dissolution of the first marriage. Finally, even after the length of reproductive time lost is controlled, there is an inverse relationship between the number of marriages and fertility. The results are discussed in the context of economic development, modernization, and urbanization.     

Fertility and patterns of labor force participation among married women

Abstract

Past research has shown that the labor market behavior of wives is discontinuous and affected by family events. Specifically, both cross‐sectional and panel data indicate that fertility decreases the period that a married woman spends working. Each birth appears to decrease labor force participation by one year or more. The present study attempts to specify these effects more completely. The variation in work patterns for each parity progression is examined to determine whether the fertility‐work effect is due to a few women who leave the labor force for an extended period during childbearing or due to a large number of women who have intermittent work histories. The analysis uses a national sample of women who were high school sophomores in 1955 and followed up as adults in 1970 and for whom retrospective data for each of the intervening years were obtained. Only married women with uncomplicated marital histories are included in the present study. We find dramatic evidence for two distinct types of response to childbearing. Women tend either to work almost continuously throughout the period or to drop out of the labor force for a very extended period of time after first birth.     

The health of children in refuges for women victims of domestic violence: cross sectional descriptive survey

ObjectivesTo describe the health and developmental status of children living in refuges for women victims of domestic violence and to investigate their access to primary healthcare services.DesignCross sectional survey.SettingWomen''s refuges in Cardiff.Participants148 resident children aged under 16 years and their mothers.Results148/257 (58%) children living in refuges between April 1999 and January 2000 were assessed. Child health system data were incorrect (general practitioner and/or address) or unavailable for 85/148 (57%) children. Uptake of all assessments and immunisations was low. 13/68 (19%) children aged <5 years had delayed or questionable development on the Denver test, and 49/101 (49%) children aged 3-15 years had a Rutter score of >10 (indicating probable mental health problems). Concerns were expressed by mothers of 113/148 (76%) children. After leaving the refuge, 22 children were untraceable and 36 returned home to the perpetrator from whom the families had fled.ConclusionsThe children had a high level of need, as well as poor access to services. Time spent in a refuge provides a window of opportunity to review health and developmental status. Specialist health visitors could facilitate and provide support, liaison, and follow up.

What is already known on this topic

A pilot study showed poor uptake of immunisations and surveillance among children who live in refuges for women victims of domestic violenceQualitative studies suggest that these children are at risk of psychological ill health

What this study adds

Baseline health and demographic data show that children in refuges have a high level of unmet health need, particularly in relation to mental health difficultiesTheir families have poor access to health services     

Explaining the Role of Proximate Determinants on Fertility Decline among Poor and Non-Poor in Asian Countries

ObjectivesWe examined the overall contributions of the poor and non-poor in fertility decline across the Asian countries. Further, we analyzed the direct and indirect factors that determine the reproductive behaviour of two distinct population sub-groups.DesignData from several new rounds of DHS surveys are available over the past few years. The DHS provides cross-nationally comparable and useful data on fertility, family planning, maternal and child health along with the other information. Six selected Asian countries namely: Bangladesh, India, Indonesia, Nepal, Philippines, and Vietnam are considered for the purpose of the study. Three rounds of DHS surveys for each country (except Vietnam) are considered in the present study.MethodsEconomic status is measured by computing a “wealth index”, i.e. a composite indicator constructed by aggregating data on asset ownership and housing characteristics using principal components analysis (PCA). Computed household wealth index has been broken into three equal parts (33.3 percent each) and the lowest and the highest 33.3 percent is considered as poor and non-poor respectively. The Bongaarts model was employed to quantify the contribution of each of the proximate determinants of fertility among poor and non-poor women.ResultsFertility reduction across all population subgroups is now an established fact despite the diversity in the level of socio-economic development in Asian countries. It is clear from the analysis that fertility has declined irrespective of economic status at varying degrees within and across the countries which can be attributed to the increasing level of contraceptive use especially among poor women. Over the period of time changing marriage pattern and induced abortion are playing an important role in reducing fertility among poor women.ConclusionsFertility decline among majority of the poor women across the Asian countries is accompanied by high prevalence of contraceptive use followed by changing marriage pattern and induced abortion.     

睡眠障碍通过下丘脑-垂体-卵巢轴影响女性生育能力的临床研究

摘要 目的：探究睡眠障碍是如何通过下丘脑-垂体-卵巢轴影响女性生育能力的。方法：选择2018年10月至2021年10月于我院妇科内分泌科就诊的育龄期女性80例作为研究对象,根据匹兹堡睡眠质量指数量表（PSQI）评估结果,将所有研究对象按照是否存在睡眠障碍分为睡眠障碍组（n=34例）和非睡眠障碍组（n=46例）。对比分析两组PSQI评分,血清性激素水平,月经周期,生育能力,通过Pearson法分析睡眠障碍与女性生育能力的相关性。结果：（1）睡眠障碍组PSQI总分以及睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍和日间功能障碍各方面得分均显著高于对照组（P<0.05）;（2）睡眠障碍组卵泡刺激素（FSH）、黄体生成素（LH）较非睡眠障碍组升高,而雌二醇（E₂）水平低于非睡眠障碍组（P<0.05）;（3）两组月经周期比较,睡眠障碍组月经紊乱比例显著高于对照组（P<0.05）;（4）两组生育能力比较,睡眠障碍组生育能力显著低于对照组（P<0.05）。（5）睡眠障碍与FSH和LH均存在负相关性,和E₂存在正相关（P<0.05）。结论：睡眠障碍可减弱下丘脑-垂体-卵巢轴的驱动,导致卵泡刺激素释放缓慢,延长了月经周期,并导致黄体功能下降,增加了未受孕或者再次异位妊娠的发生率。     

Demographic studies in a Brazilian population of Arabian origin

Abstract

Marital distance, exogamy, inbreeding, admixture, and fertility were studied in 513 families of mixed and unmixed Arabian origin living in São José do Rio Preto, Brazil. The 212 unmixed Arabian families were divided into two subgroups: 83 couples married before migration and 129 couples married after migration. The exogamy index and marital distance were significantly higher for the couples married after migration, and the coefficients of inbreeding for both autosomal and sex‐linked genes were also higher for this subgroup. Admixture was studied in 301 families, most of which were comprised of an Arabian man married to a non‐Arabian woman. The frequency of mixed marriages has increased in recent years. The unmixed Arabian group has a significantly higher fertility, but it seems to be dependent upon cultural changes over the years.     

Differences in the Access to Sterilization between Women Living and Not Living with HIV: Results from the GENIH Study,Brazil

BackgroundIn many countries, young women of reproductive age have been especially affected by the HIV epidemic, which have fostered research to better understand how HIV infection influences and shapes women´s fertility and reproductive and sexual decisions. In Brazil, few studies have focused on the impact of the HIV epidemic on contraceptive choices among women living with HIV (WLHIV).ObjectiveThis study evaluates the impact HIV infection may have in the access to female sterilization in Brazil, using a time-to-event analysis.MethodsA cross-sectional quantitative study (GENIH study) was conducted between February 2013 and April 2014 in the city of São Paulo, comparing two probabilistic samples of 975 WLHIV and 1,003 women not living with HIV (WNLHIV) aged 18 to 49. Sexual and reproductive data was collected retrospectively in order to reconstruct women''s reproductive trajectories. Given the objectives of this study, the analysis was restricted to women with parity one or more and, in case of WLHIV, to those sterilized after HIV diagnosis and not infected through vertical transmission. The final sample analysis included 683 WNLHIV and 690 WLHIV. A series of multivariable-adjusted Cox models estimated the probability of being sterilized after HIV diagnosis, compared with WNLHIV. Models were adjusted for schooling, race/color, and stratified by parity at last delivery (1–2, 3+). Hazard ratios were calculated for female sterilization, and separately for interval and postpartum procedures (performed in conjunction with caesarean section or immediately after vaginal delivery). Additionally, information regarding unmet demand for female sterilization was also explored.FindingsNo statistical difference in the overall risk of sterilization between WLHIV and WNLHIV in the two parity-related groups is observed: HR = 0.88 (0.54–1.43) and 0.94 (0.69–1.29), respectively, among women with 1–2 children and those with three and more. However, significant differences regarding the impact of HIV infection at sterilization are observed depending on the timing and the type of sterilization procedure. The probability of obtaining an interval sterilization is significantly lower for WLHIV compared to those not living with HIV. The reverse occurs regarding postpartum sterilization. Although sterilization is mainly performed in conjunction with caesarean section in Brazil, it is evident that caesarean sections are not the sole factor increasing the risk of sterilization among WLHIV.ConclusionThe results indicate barriers in the access to services offering interval sterilization for WLHIV and certain facilitation in obtaining the procedure in conjunction with caesarean section. Health policy makers at local and national levels should promote institutional changes in order to facilitate access to interval sterilization and to confront the sensitive discussion of WLHIV’s eligibility for postpartum sterilization. It is also urgent to increase access to a wider range of contraceptive methods for WLHIV and promote dual method protection strategies. Moreover, since condom use may decrease in the future in the context of the preventive effect of antiretroviral therapy, promoting dual methods will expand the choices regarding the reproductive rights of women living with HIV.     

Fertility Desires among Men and Women Living with HIV/AIDS in Nairobi Slums: A Mixed Methods Study

Objectives

Fertility desires require new understanding in a context of expanding access to antiretroviral therapy for people living with HIV/AIDS in Sub-Saharan Africa. This paper studies the fertility desires and their rationales, of slum-dwelling Kenyan men and women living with HIV/AIDS who know their serostatus, but have different antiretroviral therapy treatment statuses. It addresses two research questions: How do people living with HIV/AIDS consider their future fertility? What factors contribute to an explanation of fertility desires among people living with HIV/AIDS.

Methods

A mixed methods study (survey [n = 513] and in-depth interviews [n = 41]) with adults living with HIV/AIDS living in Nairobi slums was conducted in 2010. Regression analyses assess independent relationships between fertility desires and socio-demographic factors. Analyses of in-depth interviews are used to interpret the statistical analyses of fertility desires.

Results

Our analyses show that fertility desires are complex and ambivalent, reflecting tensions between familial and societal pressures to have children versus pressures for HIV (re-)infection prevention. More than a third (34%) of men and women living with HIV expressed future fertility desires; however, this is significantly lower than in the general population. Factors independently associated with desiring a child among people living with HIV/AIDS were age, sex, number of surviving children, social support and household wealth of the respondent.

Discussion

Increasing access to ART is changing the context of future childbearing for people living with HIV/AIDS. Prevailing values mean that, for many people living with HIV/AIDS, having children is seen as necessary for a “normal” and healthy adult life. However, the social rewards of childbearing conflict with moral imperatives of HIV prevention, presenting dilemmas about the “proper” reproductive behaviour of people living with HIV/AIDS. The health policy and service delivery implications of these findings are explored.     

Socioeconomic inequalities in breast cancer survival in Reunion Island: The contribution of stage at diagnosis as a mediator

IntroductionAlthough breast cancer survival has improved in France, it appears that women living in deprived areas are more likely to die from breast cancer. However, no study has yet examined socioeconomic inequalities in breast cancer survival in La Réunion. Our objective was to examine whether socioeconomic inequalities in breast cancer survival exist in Reunion Island and whether stage at diagnosis could partly explain these differences.MethodsA population-based cohort study of all women on Reunion Island with primary breast cancer diagnosed between 2008 and 2016 was conducted. Each woman was assigned a deprivation index based on her area of residence at diagnosis. Net survival by deprivation group and stage at diagnosis was estimated by the non parametric Pohar Perme method. The role of stage (indirect effect) was assessed using a mediation analysis extended to the relative survival framework.ResultsAt five years, net survival was significantly lower in women living in the most deprived areas than in women living in the least deprived areas (81 % (95 % CI 77–86) and 91 % (95 % CI 89–94), respectively, p < 0.0001), and mediation analysis showed that the contribution of stage at diagnosis to these survival differences was 43 %.DiscussionOur result shows that although measures to promote earlier diagnosis are important, they would only reduce socioeconomic inequalities in breast cancer survival by 43 %. To further investigate these inequalities, future research should explore the role of unmeasured mediators, such as comorbidities and treatment received, as well as the impact of specific interventions that might address the differences in mediator distribution.     

农户生活消费对环境影响的空间差异及其原因——基于张掖市2010年调查数据

农户是农村最主要的行为主体,其生活消费对环境有重要影响,然而农户的生活消费模式等因素的差异导致对环境的影响在空间上存在差异,为了缓解农户生活消费对环境的压力,需要研究其消费对环境影响的空间差异。基于张掖市2010年调查数据和统计资料研究了农户生活消费对环境影响空间差异,并分析了原因,研究结果显示:(1)张掖市2010年人均生态足迹为1.056hm2/人,人均生态承载力为1.705hm2/人,人均生态盈余0.649hm2/人;(2)从生态足迹的构成看,当地的生活消费主要是以生物资源和化石能源消耗为主,占总生态足迹的81%,而建筑用地和水域消耗最少,占总生态足迹的1.2%。;(3)张掖市五县(区)农户生活消费对环境的影响总体差异较小,Gini系数为0.309。但是区域间的差异远远大于区域内的差异,区域间的差异为0.442,占总差异的71.1%,区域内的差异为0.18,占总差异的28.9%。其中,甘州区农户生活消费对环境影响差异最大,Theil指数为0.078;(4)农户消费模式、家庭规模和人均年收入增多,将加剧农户对环境的压力,劳动力受教育程度、社会资本存量和非农化程度提高,将在一定程度上减缓农户对环境的影响。