A Family planning survey in four Delhi villages

A family planning attitude survey was conducted in four villages near metropolitan Delhi. Information was obtained through questionnaires from 455 currently married females of reproductive age: Of the women interviewed, 50 per cent were aware of family planning, 19 per cent had knowledge of a method and only 3 per cent used birth control methods. The method most commonly practised was prolonged lactation. Of the women interviewed, 253 were willing to learn about family planning; they said there was little opposition from their family members. These women thought that a family should have four children, and spacing between them should be roughly four years.     

Aspects of the demographic situation in seventeen parishes in Shropshire 1711-60. An exercise based on parish registers

The area chosen for study was the Coalbrookdale coalfield, a fairly closely knit community north of the Severn at Ironbridge, and at that time undergoing industrialization, based on the Darby works in the Dale. It is believed to have been a fairly closed population, little affected by migration, and with little nonconformist influence. All the registers are available in printed form. There were few gaps of much significance, and they were filled by linear interpolation wherever possible. All information was recorded on standard forms and may be summarized as follows:

Baptisms show severe setbacks in 1728-9, 1741-2 and 1756-7. There is a marked excess of male baptisms. There was an increase in illegitimacy over the period, and observed levels were higher than, for instance, in recent French studies. The vast majority of children were those of local residents, a few from adjacent villages.

Marriages exhibit fewer fluctuations than baptisms. There were minor booms, in 1730 (following high mortality), and in 1756-7. The great majority of marriages were between people of the same parish. Only 11 per cent involved one or both partners not resident in the county. The proportion of marriages where one partner was not ‘of this parish’ actually falls towards the end. It is not known whether this was a real movement or due to attempts to enforce the Settlement Laws.

Burials show the most pronounced fluctuations. There were peaks of burials in 1728-9, 1741-2 and 1757-8. Children were counted separately, according to definitions used in previous studies. Over 40 per cent of all burials were those of children. Infants were counted where it was possible to check on the baptisms of buried children. In these villages about a third of the child burials were those of infants of about one year old or less. There is a tendency for child burials to rise over the period, but this may be due to more accurate registration later. Where marital status could be determined in three parishes, only 2·5 per cent of women buried were spinsters. The sex ratio of deaths is similar to that of baptisms. The ratio of male burials to females is highest in infancy and then falls. 98 per cent of those buried were ‘of this’ or of the adjoining parish.

Different fertility calculations were made giving ratios of either 5·18 or 5·43 baptisms per marriage in the related period.

The fifty years were marked by long-term growth, with three pronounced peaks of natural increase (1716-25, 1731-45, 1746-55). For the whole period there was an excess of either 40 or 46 baptisms over each roo burials.

An attempt was made to reconstruct total population at each point. A starting figure of about 11,500 people was established for 1676 from the Compton census, the hearth tax returns being found unsuitable. Various growth models were tried to see which would fit the observed facts. Constant growth rates were found unrealistic, but a formula was found which allowed for the wave-like movements during the observed period. It is shown that if baptisms ware inflated by 15 per cent to arrive at births, and burials by 10 per cent to find deaths (as in previous studies), it is possible to calculate a population of 11,500 in 1720 and roughly 20,000 in 1760, with intermediate figures tallying with the observed natural increase or desrease, and a plausible set of birth rates (between 30 and 42 per thousand) death rates (between 16·1 and 43·5 per thousand, the latter figure in 1729), and marriage rates between 4-6 (in years of disaster) up to 10·5 (in the recovery year 1730).     

Family planning in choiseul province,Solomon Islands

The results presented are from a rural prevalence survey on family planning in Choiseul Province, Solomon Islands. Married women aged 15–49 years with at least one living child and married men whose wife met the same criteria, provided data on knowledge, attitudes and practices of contraceptive use. Fifty one per cent of the female sample were using some form of contraception, 26 per cent reversible and 25 per cent non-reversible methods. Sixty-five per cent of men claimed that they or their spouse were using a method of family planning. Tubal ligation was the most common currently used method (25 per cent in the female survey). Desired family size was four for both males and females. Knowledge and approval of family planning was high, with 83 per cent of females and 81 per cent of males knowing of at least one method. Problems in accessing information and services for family planning include cultural and logistical constraints. Religious affiliation was the major variable affecting knowledge, use and approval of contraceptive methods. Nearly a quarter of the sample lived further than two hours travel time from the nearest health clinic supplying contraceptive methods. These clinics often have only an intermittent availability of supplies. A strong interest in family planning was demonstrated by both respondents and service providers.     

Prospective study of birth interval dynamics in rural Bangladesh

A group of 209 married, fecund women in rural Bangladesh were studied prospectively for 24 months from 1969 to 1971 to define some of the biological and sociological factors relating to fertility performance. These women were selected from a larger study population of 112,000 that had been followed with a daily house-to-house vital registration programme since 1966. The selected women were interviewed bi-weekly and were asked questions about menstruation, pregnancy, lactation, husband's occupational absences, and monthly urine tests for pregnancy were taken. The results for 193 non-contracepting women revealed that the seasonal pattern of births previously observed in this population could be associated with a corresponding seasonal pattern of conceptions and that this was due to a seasonal trend in fecundability. The highest conception rates were in the coolest months of the year. Post-partum lactational amenorrhoea was very prolonged, averaging 17 months for women with a surviving child. The appearance of the first post-partum menstrual flow (onset of ovulation) also had a seasonal trend which could not be adequately explained. The median waiting time to conception, once menstruation had resumed was eight months. This interval was influenced by seasonal fluctuations, as well as by the age of women and by husbands' absences. The foetal wastage rate was 15·0 per 100 conceptions, with 62 per cent of the foetal losses occurring during the second month of gestation. Overall, the average birth interval was 33 months, with the prolonged lactational amenorrhoea accounting for almost 45 per cent of this interval.      

我国农村社会保障发展路径的研究综述

目前学术界对我国农村社会保障的研究相对集中在探索农村社会保障的发展道路上。大多数学者认为我国城乡二元结构的特殊格局决定了城市社会保障和农村社会保障之间存在较大的差异,无法在短期内实现完全意义的城乡社会保障体系一体化,目前只能通过一种过渡性的制度安排,在完全割裂的城乡二元社会保障制度之间构建衔接模式;构建农村社会保障制度必须考虑我国农村经济发展水平低且很不平衡的国情;农村社会保障基金的筹集渠道包括财税支持,土地收入,集体或乡镇企业补贴,农民个人交费等。     

Dynamics of contraceptive use and breastfeeding during the post-partum period in Peru and Indonesia

This paper examines the interaction between contraceptive use and breastfeeding in relation to resumption of intercourse and duration of amenorrhea post-partum. We used data from the month-by-month calendar of reproductive events from Demographic and Health Surveys (DHS) in Peru and Indonesia. The analyses show that breastfeeding women were less likely than non-breastfeeding women to have resumed sexual intercourse in the early months post-partum in both countries. In Peru, but not in Indonesia, breastfeeding women had a significantly lower odds than non-breastfeeding women of adopting contraception. Although the likelihood of contraceptive adoption was highest in the month women resumed menstruation in both countries, about ten per cent of subsequent pregnancies occurred to women before they resumed menses. These results emphasize the importance of integrating breastfeeding counselling and family planning services in programmes serving post-partum women, as a means of enabling those who wish to space their next birth to avoid exposure to the risk of a pregnancy that may precede the return of menses.     

Population dynamics and drought: A village in Niger

Summary The paper reports the results of demographic research in a rural village of about 1500 Hausaspeaking farmers in southern Niger, during the winter of 1973-74. The research site lies at the heart of the Sahel-sudanic zone just to the south of the Sahara, where drought, and in some areas, famine have exacted a heavy human, animal, and economic toll since 1968. The study was designed to measure and explain the change in the size and structure of the population during the years 1969-73. Social anthropological field techniques were used to ensure full and accurate reporting by community residents on all census topics. Data on rainfall and crop yields, on health and sanitary conditions, and on the political economy, social organization, and culture of the village were gathered in order to interpret the demographic situation The analysis of this data yields the following conclusions: 1. The population of the village appears younger (mean age: 15 years) and growing faster (mean doubling time: 23 years) than reported for Niger as a whole in 1972. 2. Contrary to what the researchers expected, the crude death rate, while relatively high to begin with, actually declined during the drought period (mean: 14.81); the crude birth rate remained very high (mean: 46.01), and the crude rate of increase rose from 1969 to 1973. 3. There was virtually no family out-migration from the target village during the drought, although the number of adult males participating in seasonal migrations to large West African towns rose from 35 per cent in 1969-70 to 75 per cent in 1973-74. 4. Problems of food production and distribution were acute, but thanks to the availability of donated foods, these were sufficiently short-lived during this drought cycle to make no discernible impact on population, although prolonged protein/calorie malnutrition among the very young may affect future fecundity.     

The island-wide family planning programme in Taiwan: Analysis of the accomplishments of the past eight years

Abstract Taiwan's island-wide family planning programme is the showcase of similar programmes in the developing world. In the past eight years, between 1964 and 1971, a cumulative total of 935,000 married women accepted the Lippes loop, 236,000 accepted the pill, and 116,000 couples accepted condoms. The prevalence rates of loop and pill users at the end of 1971 are estimated at 18·7 per cent and 3-6 per cent respectively. The programme had been recruiting more younger women of lower parity to practise family planning which is desirable, but a fact of concern is that a large proportion of the acceptors had had at least one son, and had accepted the methods to stop, rather than to space births. The 'life expectancy' of loop and pill, the two major contraceptives recommended in the programme, have been shorter than expected, 31·4 months without and 49·9 months with re-insertion for the loop, and only 10·5 months without re-taking for the pill. The concepts of 'half-life (retention)' and 'half-life (impact)', developed by the author, were applied in the analysis to obtain the values of 18·6 months and 25·7 months respectively for the loop, and 5·8 months and 9·2 months respectively for the pill all for the first segment. Only nine per cent of the total current loop wearers were aged 40-44 in 1964, but the proportion had increased substantially, to 20·5 per cent, in 1971. This 'ageing' of current users tends to minimize the demographic impact of the programme which is a factor of concern. Methods to overcome this and other problems should be explored for the final success of the programme.     

Pakistan: FPAP projects reflect integrated approach

The Family Planning Association of Pakistan has conducted a number of projects reflecting the government's integrated approach to family planning. The youth project aims at alerting young people to the need for family planning. A full-scale feasibility scan was conducted prior to implementation of the project to determine the best way to reach people. Volunteers were recruited among college students. The project's strategy for 1979 included organization of a youth leadership national workshop and oratorical contest on the topic, "Whatever your cause, it is a lost cause without population planning." Other FPAP projects include a group of "better living projects" which aim to educate young mothers in child care and family nutrition. Projects in the organized sector include a program at the Pakistan Mint, where a motivation center and clinic are set up. Training projects concentrate on fieldworkers and traditional birth attendants (dais). A 3-day course for dais includes reorientation on septic deliveries, child care, maternity care, and record keeping. In the cities, FPAP has a network of multipurpose centers in slum areas, where adult education and income generating activities are integrated with family planning.     

Prospective study of birth interval dynamics in rural Bangladesh

Abstract A group of 209 married, fecund women in rural Bangladesh were studied prospectively for 24 months from 1969 to 1971 to define some of the biological and sociological factors relating to fertility performance. These women were selected from a larger study population of 112,000 that had been followed with a daily house-to-house vital registration programme since 1966. The selected women were interviewed bi-weekly and were asked questions about menstruation, pregnancy, lactation, husband's occupational absences, and monthly urine tests for pregnancy were taken. The results for 193 non-contracepting women revealed that the seasonal pattern of births previously observed in this population could be associated with a corresponding seasonal pattern of conceptions and that this was due to a seasonal trend in fecundability. The highest conception rates were in the coolest months of the year. Post-partum lactational amenorrhoea was very prolonged, averaging 17 months for women with a surviving child. The appearance of the first post-partum menstrual flow (onset of ovulation) also had a seasonal trend which could not be adequately explained. The median waiting time to conception, once menstruation had resumed was eight months. This interval was influenced by seasonal fluctuations, as well as by the age of women and by husbands' absences. The foetal wastage rate was 15·0 per 100 conceptions, with 62 per cent of the foetal losses occurring during the second month of gestation. Overall, the average birth interval was 33 months, with the prolonged lactational amenorrhoea accounting for almost 45 per cent of this interval. From the Department of Population Dynamics, Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland 21205.     

Navigating the AIDS Epidemic in Rural Malawi

This article provides a perspective on rural Malawi during the unsettled times following the recognition by village residents that AIDS is a profound danger. The primary data are observational field journals in which local ethnographers wrote their recollections of conversations about AIDS that they overheard or participated in during the course of their daily lives. In their networks of friends, relatives, and neighbors, rural Malawians are publicly discussing a range of strategies of prevention. These strategies range from the abstinence, fidelity, and consistent condom use prescribed by international and national experts to innovative strategies of partner selection, divorce, and renewed religious commitment. The article also considers the effectiveness of these strategies and speculates about the applicability of the findings to other populations.     

Consistency of ancestry reporting between parents and children in the 1986 census

A question on ancestry was asked for the first time in the 1986 Population Census. This paper examines the consistency of the responses about ancestry reported for parents and their children. The level of consistency was more than 90 per cent when both parents were of the same ancestry; when parents were of different or mixed ancestries, the level of consistency was lower. It was estimated that about 75 per cent of all dependent children had an ancestry response consistent with that of the parent or parents with whom they lived.     

Catastrophic household expenditure on caesarean deliveries in India

The objectives of our study were to examine the (1) trends and patterns of caesarean deliveries in India and; (2) differentials in catestrophic household expenditure on caesarean deliveries. The paper used data from 71st round of the National Sample Survey, India. The analysis included 14,310 women, hospitalised for delivery during the last 365 days preceding the survey. The proportion of caesarean sections among institutional deliveries in India was 2.5% in 1992–1993, which increased to 23.9% in 2014. In private facilities, 47.8% deliveries were conducted through caesarean section, while in public facilities, this proportion was 8%. OOPE per delivery was US$157 which was 64.9% of the total cost of maternal health care. OOPE varied by type of delivery; US$283 for caesarean and US$77 for non-caesarean delivery. About 60% of households incurred the expenditure on caesarean section exceeding 40% of their capacity to pay. The incidence of catastrophic delivery expenditure declined with increased education and per-capita expenditure. Caesarean delivery in private facilities and a hospital stay of more than 48 h increased the chances of catastrophic expenditure. Interventions and regulations are necessary for both public and private sector to check unwarranted caesarean deliveries and hospital stays to reduce catastrophic expenditure.

     

Reply to Wachter

Although twins constitute only about 2.4 per cent of total births in less developed countries, they account for about 12 per cent of neonatal deaths and about nine per cent of infant deaths. Twin mortality in less developed countries has almost never been analysed systematically. We examine survival among twins as contrasted with that among singleton births by using 2692 twin observations pooled from 26 standardized Demographic and Health Surveys. Weakened by gestational and other biological complications, twins seem to be more vulnerable to detrimental demographic and household socio-economic influences than singletons. Twinning tends to amplify, or at least retain, whatever group differences exist among singleton births.     

Older adults in sub-Saharan Africa living with children and grandchildren

Using data from Demographic and Health Surveys, we examine the composition of households containing older adults in 24 countries of sub-Saharan Africa, with a focus on those living with children and grandchildren. Overall, 59 per cent live with a child and 46 per cent with a grandchild. Men are more likely to live in nuclear households and women in extended households and alone. Regression analyses show that individual-level determinants of household composition differ by sex. For example, living with children and grandchildren is tied to living with a spouse for men, but for women the effect is either not significant or in the opposite direction. Households with an older adult and a grandchild, but no adult children, are common. Usually the adult child lives elsewhere, though about 8 per cent of older adults live with a grandchild who has at least one deceased parent. Older adults are more likely to be living with double-orphans in countries with high AIDS-related mortality.     

Seeking Help From Health and Welfare Services Among Elderly Single Women

The current research is a pilot study that included 87 single women who responded to an announcement placed in one of the national newspapers and then filled out interview questionnaires. The study hypothesized three groups of variables for predicting elderly single women's appeals for help from health and welfare services: (a) demographic variables, (b) intrapersonal variables, and (c) interpersonal variables. The research tools were (a) a demographics questionnaire constructed specifically for this study; (b) a personal assessment of single life: chosen or unchosen, including a question regarding what single people think about bachelorhood/spinsterhood; (c) an approach to the institution of bachelorhood/spinsterhood; (d) self-evaluation questionnaire; (e) a sense of mastery over life questionnaire; (f) informal support networks questionnaire; and (g) an assessment of the appeal to health and welfare services for help. A special questionnaire was constructed, which included a list of health and welfare services. The research findings indicate connections among all the research variables. All the research hypotheses were confirmed. Special attention should be given to this one tenth and more of the elder population. It might improve the lives of those women and save Western governments a lot of money.     

Fertility in Kenya and Uganda: a comparative study of trends and determinants

Between 1980 and 2000 total fertility in Kenya fell by about 40 per cent, from some eight births per woman to around five. During the same period, fertility in Uganda declined by less than 10 per cent. An analysis of the proximate determinants shows that the difference was due primarily to greater contraceptive use in Kenya, though in Uganda there was also a reduction in pathological sterility. The Demographic and Health Surveys show that women in Kenya wanted fewer children than those in Uganda, but that in Uganda there was also a greater unmet need for contraception. We suggest that these differences may be attributed, in part at least, first, to the divergent paths of economic development followed by the two countries after Independence; and, second, to the Kenya Government's active promotion of family planning through the health services, which the Uganda Government did not promote until 1995.     

Sexual violence at first intercourse against women in Moshi, northern Tanzania: prevalence, risk factors, and consequences

To explore the relationship between sexual violence at first intercourse and later sexually transmitted infections (STIs) in Moshi, Tanzania, we analysed data from a representative household survey that comprised face-to-face interviews with 1,835 women and tests for six STIs on biological samples from 1,235 of these women. Overall, 10.9 per cent report forced first intercourse and 15.3 per cent report unwanted first intercourse. Unadjusted analysis shows a relationship between forced first intercourse and STIs (OR: 1.72, 95 per cent CI: 1.19-2.51). Life-course variables mediate this relationship. Significant predictors of having an STI include older age, more sexual partners, and a partner who has children with other women. Coerced first intercourse appears to be associated with changes in the life course of women and with a heightened risk of contracting an STI.