The continuing conflict situation in Nigeria have created over 2 million displaced persons. In 2019, women and children accounted for about 80% of the internally displaced population in the country. Displacement increases the need for reproductive health services. This study explored the reasons for non-use of modern contraceptives among forcibly displaced Bakassi women in Akwa Ibom State, southern Nigeria. Focus group discussions were used to collect data from a convenience sample of 40 women of reproductive age (15–49 years) in two makeshift resettlement camps in the region in January and February 2020. Data were analysed using a qualitative inductive approach, with thematic organization and analysis of the transcribed responses from the focus group discussions. The findings revealed that many of the women were not using modern contraceptives at the time of the study, and the major reasons they gave for non-use were misconceptions, costs, religious beliefs, desire for more children and the inaccessibility and unavailability of contraceptive services. The use of family planning services can be a life-saving intervention in unstable, crisis environments. Programme implementation to address non-use of contraceptive services among women in crisis contexts should target social norm change, reproductive health education, empowerment programmes and health service provision.

The ‘livestock revolution’ has seen the lives and livelihoods of peri-urban peoples increasingly intertwine with pigs and poultry across Africa in response to a rising demand for meat protein. This ‘revolution’ heralds the potential to address both poverty and nutritional needs. However, the intensification of farming has sparked concern, including for antibiotic misuse and its consequences for antimicrobial resistance (AMR). These changes reflect a micro-biopolitical conundrum where the agendas of microbes, farmers, publics, authorities and transnational agencies are in tension. To understand this requires close attention to the practices, principles and potentials held between these actors. Ethnographic research took place in a peri-urban district, Wakiso, in Uganda between May 2018 and March 2021. This included a medicine survey at 115 small- and medium-scale pig and poultry farms, 18 weeks of participant observation at six farms, 34 in-depth interviews with farmers and others in the local livestock sector, four group discussions with 38 farmers and 7 veterinary officers, and analysis of archival, media and policy documents. Wide-scale adoption of quick farming was found, an entrepreneurial phenomenon that sees Ugandans raising ‘exotic’ livestock with imported methods and measures for production, including antibiotics for immediate therapy, prevention of infections and to promote production and protection of livelihoods. This assemblage – a promissory assemblage of the peri-urban – reinforced precarity against which antibiotics formed a potential layer of protection. The paper argues that to address antibiotic use as a driver of AMR is to address precarity as a driver of antibiotic use. Reduced reliance on antibiotics required a level of biosecurity and economies of scale in purchasing insurance that appeared affordable only by larger-scale commercial producers. This study illustrates the risks – to finances, development and health – of expanding an entrepreneurial model of protein production in populations vulnerable to climate, infection and market dynamics.

Aging is a multifactorial process influenced by both biological and sociocultural factors. The objective of this study was to identify current and past factors with an impact on the quality of aging in a sample of people 65 years of age or older born in the postwar period after the Spanish civil war. Socioeconomic, health, anthropometric, and food consumption data were collected in public Leisure Centers for the elderly in Madrid. The sample consists of 587 people (64.6% women), with a mean age of 71.8 ±5.3 years. Following the World Health Organization (WHO) guidelines regarding what is considered Healthy Aging, an index called the Index of Quality of Aging was calculated from four variables: the Mini Mental State Examination score, perception of health, satisfaction with life and the number of diseases that affect daily life. Another index called the Diet Inflammation Index was created based on the inflammatory or anti-inflammatory potential of different foods. The Index of Quality of Ageing was used as a dependent variable in linear regression models for men and women. Differences by gender were observed in the factors that influence the quality of aging. Education had a positive influence on men quality of ageing while it does not on women. In these, a relationship between the quality of the current diet and the quality of aging was observed.

‘Health and nutrition’ is one among the five areas covered by the Aspirational District Programme in India, which aims to achieve the Sustainable Development Goals (SDGs). The reduction of undernutrition in under-five children has remained a major focus of the SDGs, especially at the ages of 6–23 months as this affects child development. This study used National Family Health Survey 2015–16 data to examine appropriate feeding practices and their associations with undernutrition among children aged 6–23 months in the 124 aspirational districts of India. Multinomial logistic regression analysis was used to analyse the association between feeding practices and undernutrition, adjusting for covariates. A total of 13,851 children aged 6–23 months were included in the analysis. Child nutritional outcomes, and children receiving the recommended minimum dietary diversity (MDD), minimum meal frequency (MMF) and minimum acceptable diet (MAD), were poorer in the aspirational compared with non-aspirational districts. However, the proportions of children who continued to breastfed, i.e. currently breastfeeding and the proportion of children who were receiving appropriate breastfeeding, i.e. receiving complementary feeding, in addition to breast milk, were higher in the aspirational districts. Appropriate breastfeeding and MDD were found to be associated negatively with undernutrition. While the continuation of breastfeeding increased the odds of children being undernourished, appropriate breastfeeding lowered the odds. The significant predictors of undernourishment among the study children were the child being male, of higher birth order, older and of smaller than average birth size; mother’s lower educational level, mother’s lower BMI of mothers and being a teenage mother; and poor household drinking water, sanitation facilities and lower economic status. This study suggests that educating mothers, especially illiterate and poor mothers, about appropriate breastfeeding and dietary diversity could help prevent and reduce child undernutrition in the aspirational districts of India.

This study investigates the consequences of female rural-urban migration with respect to their education, career, and relationship and family formation in the Netherlands. The study is based on four birth cohorts of Dutch women born in 1970-1973 in rural areas, comparing those who had migrated to urban areas before the age of 25 with those who had remained behind. Outcomes were measured at age 42. The data were derived from administrative registers available at Statistics Netherlands. The results show that female migration to cities served to increase women’s resources: they were more often university educated and had better paid jobs, in line with the idea of cities as socioeconomic escalators. The city also functioned as a relationship market with a relative abundance of men with resources. Both lower and university educated city women were more likely to be in a relationship with a highly educated man compared to their rural peers. However, lower educated women had an increased probability of being single at age 42 when they lived in cities at age 25. This was not the case for university educated women. In conclusion, for lower educated women urban migration may entail risks as well as benefits, especially with respect to family formation. University educated women on the other hand benefited both in terms of their own socioeconomic outcomes and in terms of their partners’ resources.

There is growing evidence on the negative effects of perceived discrimination on health outcomes and their interactions with indicators of socioeconomic status. However, less has been studied on whether income and education lead individuals of a different race to encounter different discriminatory experiences in their lifetime. Using data from the national survey of the Midlife Development in the United States—MIDUS 1 (1995-1996) and MIDUS Refresher (2011-2014)—on eight measures of perceived lifetime discrimination, this study compares discriminatory experiences of Black and White persons in two time periods. We applied generalized structural equation models and generalized linear models to test multiplicative effects of income and education by race on lifetime discrimination. In both periods, we find substantive disparities between White and Black people in all types of lifetime discrimination, with Black people reporting much higher levels of discrimination. Such disparities exacerbated in the top cohorts of society, yet these associations have changed in time, with White individuals reporting increasing levels of discrimination. Results show that, for Black people in the mid-1990s, perceived discrimination increased as education and income increased. This finding persisted for education by the early 2010s; income effects changed as now both, low- and high-income Black people, reported the highest levels of discrimination. These findings highlight a policy conundrum, given that increasing income and education represent a desirable course of action to improve overall discrimination and health outcomes. Yet, we show that they may unintendingly exacerbate racial disparities in discrimination. We also show that the U.S. is moving toward a stagnation period in health outcomes improvement, with racial disparities in discrimination shrinking at the expense of a deterioration of whites’ lifetime discriminatory experiences. Our results highlight the need for a multi-systems policy approach to prevent all forms of discrimination including those due to historical, institutional, legal, and sociopolitical structures.

The prevalence of anaemia and its continuous growth, especially among women, is a global health concern. The present study aims to examine the prevalence of anaemia and its determinants in the North Eastern region of India. The study used secondary data from the National Family Health Survey 2015-2016 on women of reproductive age group in India. The data were adjusted for sampling weight, stratification and cluster sampling design for analysis. Binary logistic regression and multivariable regression analysis were performed to determine factors associated with anaemia. Of the 65941 participants, 25993 (40%) had anaemia. High prevalence of mild or moderate anaemia was found among women with following socio-demographic characteristics: residing in the rural area (41.20%), having no education (43.07%), belonging to the low-income family (43.39%), having a well as source of drinking water (46.29%), using the traditional method of contraception (44.55%), underweight (42.18%) and those who had first delivery before 20 years of age (40.66%). Logistic regression (adjusted odds ratio) showed that women in the following categories were more likely to develop anaemia: in the age-group of 35-49 years, with no education, with poor wealth, having low nutrition levels; using traditional contraception and women who ate pulses or fish once a week. Alarming rates of anaemia (two in every five), found in the study, need effective strategies for fortification of iron supplement among women. Generation of mass awareness in this regard by utilizing the ongoing adolescent, maternal, child health and nutrition programmes will help in reducing the incidence of anaemia among women.

This study aimed to evaluate the proportion of contraception users among Lebanese youth, and the extent of knowledge and perception on birth control; and to raise awareness and sensitise young adults to sexual health, which remains taboo in Lebanon. The 30-item questionnaire was broadcasted to students in private and public universities in Lebanon, through social media and it collected information on contraception use and student knowledge. Over 30% of responders were medical students, and 41% have ever used contraceptives (mostly women); among which, 52.1% for contraception versus 47.9% for medical reasons. According to responders, the pill ranked high in terms of effectiveness (72.4% of responders perceive the pill as effective), followed by the male condom (69.1%) and the hormonal intrauterine device (29.6%). Some would not use contraception in the future, for religious reasons (30.8%) or for fear of complications (46.2%); indeed, around a third of contraceptive users (all female) have experienced adverse effects. Finally, students expressed concern about long-term complications of contraceptive use (pulmonary embolism/phlebitis, breast/endometrial/ovarian cancer, stroke, depression and myocardial infarction). Though less frequent than in the Western world, contraception use in Lebanon is non-negligible and gaps in university students’ knowledge on contraception were identified; which should prompt sexual education and family planning initiatives in Lebanon.

In the latter part of the third stage, India is in demographic transition with declining fertility and mortality. This marked decline in death rates is driven by improvements in health conditions due to medical progress and better living conditions. The conventional measures of ageing do not account for the significant improvements in health and life expectancy, thus leading to a tendency to overestimate the impact of population ageing when these indicators are used. The old-age threshold in the conventional measures of ageing depends on chronological age. The present study estimated the multi-dimensional old-age thresholds (MOAT) based on the remaining life expectancy (RLE), self-rated health, activities of daily living (ADL), handgrip strength, and cognition in India and selected states. The standard population was derived for each dimension for 50 and over in states using the WHO Study on Global AGEing and Adult Health data. Keeping the dimensional characteristics as of the standard population, the estimated MOAT for India was 67 years where Maharashtra stands at the top (68.6), followed by, West Bengal (66.5) and Karnataka (66). A 64 year old woman was similar to 68.8 year old man, and a 66 year old rural person was equivalent to 68 year old urban person. The study suggests implications of MOATs on reducing the burden of ageing and increment in retirement age.

Globally, despite the decline in under-five mortality rate from 213 per 1000 live births in 1990 to 132 per 1000 live births in 2018, the pace of decline has been slow, and this can be attributed to poor progress in child survival interventions, including those aimed at reducing children’s exposure to household pollution. This study examined the influence of neighbourhood poverty and the use of solid cooking fuels on under-five mortality in Nigeria. Data for the study comprised a weighted sample of 124,442 birth histories of childbearing women who reported using cooking fuels in the kitchens located within their house drawn from the 2018 Nigeria Demographic and Health Survey. Descriptive and analytical analyses were carried out, including frequency tables, Pearson’s chi-squared test and multivariate analysis using a Cox proportional regression model. The results showed that the risk of under-five mortality was significantly associated with mothers residing in areas of high neighbourhood poverty (HR: 1.44, CI: 1.34–1.54) and the use of solid cooking fuels within the house (HR: 2.26, CI: 2.06–2.49). Government and non-governmental organizations in Nigeria should initiate strategic support and campaigns aimed at empowering and enlightening mothers on the need to reduce their use of solid cooking fuels within the house to reduce harmful emissions and their child health consequences.

Many of the studies on the sex ratio at birth (SRB) are based on a small number of cases over a short period of time. Taking a multivariate approach to a dataset consisting of nearly 199 million birth records in the United States from 1968 to 2019, we present a detailed analysis of several possible factors that might affect the sex ratio at birth (SRB) and its patterns of variation. We found that race/ethnicity is the variable with the strongest influence on this index. Parental age, birth order and solar radiation also have a bearing on the SRB, albeit only to a moderate degree. The historical evolution of the SRB among Black and American Indian and Alaska Native populations remains unexplained.

Communities urbanize when the net benefits to urbanization exceed rural areas. Body mass, height, and weight are biological welfare measures that reflect the net difference between calories consumed and calories required for work and to withstand the physical environment. Individuals of African-decent had greater BMIs, heavier weights, and shorter statures. Urban farmers had lower BMIs, shorter statures, and lower weight than rural farmers. Over the late 19th and early 20th centuries, urban and rural BMIs, height, and weight were constant, and rural farmers had greater BMIs, taller statures, and heavier weights than urban farmers and workers in other occupations.

Globally, diarrhoea is the third leading cause of death for under five-children. Women’s empowerment can significantly reduce under-five mortality due to diarrhoea. This study investigated the association between women’s empowerment and childhood diarrhoea in Benin using data from the 2017/18 Benin Demographic and Health Survey. A total of 7979 currently married women were included in the study. A logistic regression model was used to control for possible confounders. The prevalence of diarrhoea among children under five years of age was 13.6%. About 36.3% of the currently married women decided either alone or together with their husband on their own health, purchase of large household items and visiting family/relatives. Close to 65.4% of currently married women disagreed with all five reasons to justify wife-beating. The children of mothers who had decision-making power were less likely to have diarrhoea (aOR = 0.74, 95% CI: 0.57–0.96) than the children of mothers who had no decision-making power. Moreover, the children of mothers who disagreed with all five reasons to justify wife-beating (aOR = 0.79, 95% CI: 0.65–0.96) were less likely to have diarrhoea than the children of mothers who accepted wife-beating as a part of life. Women’s age, educational level, wealth index and region were associated with childhood diarrhoea in Benin. The role of women’s empowerment, as determined by decision-making power and wife-beating attitude, was found to be significantly associated with the risk of childhood diarrhoea in Benin, after adjusting for other variables. Therefore, it is essential for policymakers in Benin to reinforce strategies and interventions focusing on women’s empowerment to avert childhood mortality caused by diarrhoea. This includes improving household economic status, women’s education and decision-making power and enhancing awareness of women’s human and democratic rights.

The role of household structure, especially the mother-in-law (MIL) influencing daughter-in-law’s maternal health care (MHC) seeking behaviour, has been a continuing debate due to the former’s advantageous position in the household. This study assesses the association of household structure and particularly the presence of MIL with MHC utilisation in India using the National Family Health Survey-4 data (2015-16). The sample of women aged 15-49 years who have given birth during the last five years preceding the survey (n=184,641) was considered for analysis. The outcome variables were full-antenatal care, institutional delivery, and postnatal care. Binary logistic regression was used to check the adjusted effects of the household structure on MHC utilisation. The analyses were done with STATA (version 13) with a significance level of 5%. Adjusting the effects of socio-demographic and economic characteristics, women from non-nuclear households with MIL had higher odds of full-antenatal care (OR= 1.04, CI= 0.99-1.08) and institutional delivery (OR=1.05, CI=1.01- 1.10) than their counterparts from nuclear households. Women from non-nuclear households without MIL had lower chances of postnatal care (OR=0.98, CI=0.96-1.00) than those from nuclear households. The study unearths a very weak association between the presence of MIL in the household and MHC services utilisation of the daughter-in-law, a notable change from the earlier literature often portraying MIL as a barrier.

Parental and pregnancy characteristics can affect proportions and tissue composition of the child’s bodyand thereforecan influence their present and future health, as well as overall wellbeing. The aim of this study was to examine the differences between selected parental and birth-related parameters among preschool (3-7 years of age) children of varying adiposity status (n=541 girls and n=571 boys).The research was carried out in 20 randomly selected kindergartens in Krakow (Poland). Thickness of 6 skinfolds (biceps, triceps, subscapular, suprailiac, abdominal and calf) was measured. Sum of skinfolds was calculated and participants were divided into low, normal or high body fat groups. Birth-related characteristics were obtained using a questionnaire filled out by the children’s parents. Children of mothers who gained the most gestational weight were characterised by high adiposity. Preschoolers with the highest birth weight, body length and head circumference had the greatest adiposity. Children of relatively younger mothers had higher body fat, in comparison to the rest of the study group. Parents of preschoolers in the high adiposity category were characterised by a greater body mass, compared to the parents of children in other body fat groups and that boys with the highest adiposity relatively more often had a close relative with obesity. Children in varying adiposity categories differed in terms of some birth-related factors. Particular attention should be paid to familial and parental characteristics, because they may influence the child’s predisposition to excess adiposity deposition later in life.

This study uses Trivers-Willard hypothesis to explain the differences in daughters’ and sons’ educational outcomes by parental background. According to the Trivers-Willard hypothesis (TWH), parental support and investments for sons and daughters display an asymmetrical relationship according to parental status because of the different reproductive advantage of the sexes. It predicts that high-status parents support sons more than daughters, and low-status parents support daughters more than sons. In modern societies, where education is the most important mediator of status, the TW hypothesis predicts that sons from high-status families will achieve higher educational outcomes than daughters. Using cohorts born between 1987 and 1997 from the reliable full population Finnish register data that contain the data of over 600.000 individuals, children’s educational outcomes were measured using data on school dropout rate, academic grade point average (GPA), and general secondary enrollment in their adolescence. OLS and sibling fixed-effect regression that permitted an examination of opposite-sex siblings’ educational outcomes within the same family were applied. Sons with high family income and parental education, compared to daughters of the same family, have lower probability of dropping out of school and are more likely to enroll into academic secondary school track. In families with low parental education or income daughters have lower probability for school dropout and enroll more likely to academic school track related to sons of the same family. The effect of family background by sex can be interpreted to support TWH in dropout and academic school track enrollment but not in GPA.

Uttar Pradesh (UP), with more than 220 million people, is the most populous state in India. Despite a high unmet need for modern family planning methods, the state has experienced a substantial decline in fertility. India has also seen a decline during this period which can be attributed to the increased prevalence of modern methods of family planning, particularly female sterilisation, but in UP, the corresponding increase was marginal. At the same time, Traditional Family Planning Methods (TMs) increased significantly in UP in contrast to India, where it was marginal. The trends in UP raise questions about the drivers in fertility decline and question the conventional wisdom that fertility declines are driven by modern methods, and the paper aims to understand this paradox. Fertility trends and family planning practices in UP were analysed using data from different rounds of National Family Health Surveys (NFHS) and the two UP Family Planning Surveys conducted by the UP Technical Support Unit to understand whether the use of TMs played a role in the fertility decline. As per NFHS-4, the prevalence of TM in India (6%) was less than half that of UP (13%). The UP Family Planning Survey in 25 High Priority Districts estimated that 22% of women used TMs. The analysis also suggested that availability and accessibiility of modern contraceptives might have played a role in the increased use of TMs in UP. If there are still couples who make a choice in favour of TMs, they should be well informed about the risks associated with the use of traditional methods as higher failure rate is observed among TMs users.

In the U.S., approximately 11% of infants are born small for gestational age (SGA). While there are many known behavioral risk factors for SGA births, there are still many factors yet to be explored. The purpose of this study was to investigate the maternal early menarche (< 12 years old)- SGA birth association. Data were retrieved from the 2011-2017 National Survey of Family Growth, and multivariate logistic regression was used to evaluate the association. Approximately 4% of mothers reported having an SGA infant and 24% of mothers reported early age at menarche. After controlling for maternal age, race/ethnicity, and annual household income, early menarche was associated with 3% increased odds of SGA, although this finding was not statistically significant (adjusted odds ratio: 1.03, 95% CI: 0.70, 1.53). Additional research is needed on the long-term birth outcomes and health consequences of early menarche.

This study evaluates a large (N > 366,000) sample of young women (15-18 years) from 64 lower- and middle-income countries for associations between height, household wealth, and schooling outcomes, with a focus on secondary school attendance. A pooled sample and regional samples (Latin America, South/Southeast Asia, East Africa, and West Africa) are evaluated. A dual purpose is to evaluate both associations between height and schooling, and potential height-wealth interactions such that height associations to schooling vary over levels of wealth. Ordered probit analysis indicates positive marginal probabilities from height on secondary school attendance in all samples, with diminishing probabilities in the Latin America and South/SE Asia samples, and flat/increasing probabilities in the African samples. For South/SE Asia and taller women in Latin America, height associations are stronger at lower household wealth. For both African samples and shorter women in Latin America, height associations are stronger at higher wealth. The findings suggest that the height-schooling relationship may derive from the influence from early-life health, and may also be affected by differences in health and education environments as suggested by variations across regions and height-wealth interactions within regions.

Against the backdrop of the alarming rise in Caesarean section (C-section) births in India, this study aimed to examine the association between C-section births, fertility decline and female sterilization in the country. A cross-sectional design was used to investigate the association between C-section delivery and subsequent reproductive behaviour in women in India. Data were from the National Family Health Survey (NFHS-4). The study sample comprised 255,726 currently married women in the age group of 15–49 years. The results showed a strong positive relationship between C-section births and female sterilization. The predicted probabilities (PP) from the multivariate regression model indicated a higher chance of female sterilization in women with C-section births (PP = 0.39, p<0.01) compared with those with non-C-section births (PP = 0.20, p<0.01). Both state-level correlation plots and Poisson regression estimates showed a strong negative relationship between C-section births and mean children ever born (CEB). Based on the results, it may be concluded that the use of C-sections and sterilization were strongly correlated in India at the time of the NFHS-4, thus together contributing to fertility decline. A strong negative association was found between the occurrence of C-sections and CEB. The increased and undesired use of C-section births and consequent female sterilization is a regressive socio-demographic process that often violates women’s rights. Fertility decline should happen through informed choice of family planning and must protect the reproductive rights of women.