[The main problems in maternal-child health in Mexico]
Mexico around 1980 had a general mortality rate of 7.45/1000, a maternal mortality rate of 1.26/1000 live births, an infant mortality rate of 46.63/1000 live births, and a life expectancy at birth of 65 years. In Costa Rica and Cuba respectively, general mortality rates are 30 and 46% lower, maternal mortality rates are 21 and 60% lower, and infant mortality rates are 60 and 64% lower than in Mexico. Maternal mortality declined from 143.0 to 94.5/100,000 live births between 1970-80, but health coverage must be extended to eliminate some of the causes of death. The 6 major causes of maternal mortality from 1968-80 have been toxemia, hemorrhages in pregnancy or delivery, sepsis during delivery or the puerperium, abortion, delivery without mention of complications, and other complications, all of which can be controlled more adequately with better medical attention, especially in the prenatal period. On the national level, 80.5% of pregnant women receive medical care, but the proportion of high parity women receiving care is lower. 12% of pregnant women in urban areas get no medical attention compared to 32% in rural areas. 57% of urban women but only 26% of women in places with fewer than 2500 inhabitants have 5 prenatal visits or more. Prenatal care from the beginning of pregnancy is the best means of detecting and controlling complications, and is especially important for older women, multiparas, and women with little education in marginal suburban and rural areas. 29% of women in rural areas are assisted at delivery by nonprofessional personnel. Infant mortality considered to occur for exogenous causes fell from 74.2 to 38.8/1000 live births between 1960-80, indicating that health care has improved. Respiratory and intestinal ailments continue to be the 2 main causes of infant deaths. Perinatal mortality declined from 24.2 to 22.1/1000 live births between 1976-78, but a large proportion of such deaths could have been avoided with better prenatal care. 47.9% of infants in places of under 2500 inhabitants receive no medical care of any kind in their 1st month of life, compared to 24.7% in metropolitan areas. Infants of mothers under 20 and over 40 and of mothers of large families are least likely to receive medical attention in their 1st month. 85.6% of children of mothers with 7 or more years of schooling receive medical care exclusively from physicians, compared to 28.3% of children of illiterate mothers. Only 30% of children in Mexico are vaccinated against polio, diptheria-pertussis-tetanus, measles, and tuberculosis in their 1st year of life. Mortality among children aged 1-4 declined from 9.8/1000 in 1960 to 3.2 in 1980, due primarily to a slow improvement in socioeconomic conditions.
Data from the 2nd National Health and Nutrition Examination Survey (NHANES II) were analyzed to estimate the prevalence of oral contraceptive (OC) use in the US in 1976-80. Overall unadjusted prevalence of use was 16.7% for premenopausal females ages 12-54 years (19.2% for females ages 15-44 years). This rate ranged from a low of 1% in the 12-14-year age group to a high of 34% among women ages 20-24 years. Approximately 8.7 million females were using OCs during 1976-80. This figure is similar to the estimate of 8.9 million OC users during 1971-74 generated by NHANES I. Comparison of the results of the 2 NHANES indicates increases in OC use in the 1971-74 to 1976-80 period among females ages 12-14, 15-19, and 50-54 years and decreases for all 5-year age groups between 20-49 years. Overall age-adjusted prevalences indicated a 2% (95% CI, 0.2-3.8%) decline in use from the early to late 1970s. To observe trends in use by marital status, the NHANES estimates were compared to data from the 1973, 1976, and 1982 National Surveys of Family Growth (NSFG). Use increased during the 1970s in never married women, but declined sharply among currently married women and slightly among widowed, divorced, and separated women. Finally, use rates for NHANES II were age adjusted to the NHANES I population in order to compare trends in use by demographic characteristics (race, poverty level, rural-urban residence, size of place, and education level). An upward trend in use was noted between the 2 surveys for women with income below the poverty level (1.1% increase) and for those with an elementary school education level (6% increase). Use declined for all other demographic groups in 1971-82, with the sharpest decline (9.4%) occuring among women with some college education. The overall decline in OC use during the 1970s is considered to reflect concern about the increased risk of venous thromboembolism, myocardial infarction, and stroke for users age 30 years and over, especially smokers.
Impact of westernization and other factors on the changing status of Moslem women.
Reform in the status of women in Islam results from factors external to Islam -- initiation of the West, industrialization, and urbanization -- as well as from the internal factors of Moslem reformers, education, and the formation of a middle class. Against the background of the Middle East's traditional social pattern, it is crucial to determine how the position of women is being affected by the new influences from the West, how they are reacting to the new influences, where they are making progress or encountering obstacles, and how they feel and look towards the future. Westernization brought about a chain of related phenomena -- a decline of parental authority, a breakdown of the extended family, and a conscious initiation of Western family structures and social reforms. A few contemporary official reactions of the Moslem Arabs show great sensitivity to the opinions of the West, especially to the Western disapproval of the traditional Arab treatment of women. In attempting to prove how much progress the Arab world has made, they emphasize the changes in the family legal codes during the last 20 years, giving far greater privileges to women. The propaganda in the form of frequent speechs and pamphlets suggesting realization of political equality is a great exaggeration. The reason behind such an inaccurate account of the amount of change is the focus on a proportionately small minority of educated Arab women. Yet, the propaganda serves as an index of the aims and attitudes of the Arab leaders who are directing the present society. There exists a steady, if undramatic move towards emancipation among women of the Moslem Middle East. Equally true is that there is no evidence of a militant crusade for women's rights. A genuine desire does exist for "freedom from" some of the traditional restrictions, yet this does not involve any real challenge to the traditional conception of women's role as mother. It only represents a desire that the life of women should not be limited to this role. There are also indications that education is more than a symbol of new position. It is broadening the horizons and fostering concerns about larger problems of the nation and society. The introduction of Western communications in the Moslem Middle East, embodied in modern mass media, is a new impetus for the small but progressively growing indigenous feminist movements. Modernization and its underlying tensions and clashes with the traditional way of life in the Moslem Middle East is already working itself out through an increasing number of individual lives.
Turkey: pressures on employment, housing, education and health care.
High population growth rates in Turkey have exacerbated problems in the areas of employment, education, housing, and medical care. Rural unemployment has caused widespread migration to major cities, resulting in a deterioration of living conditions in these centers and increasing the demand for municipal services. Since 1940 population increases have consumed most of the rise in national income and hindered economic development. Employment opportunities have not kept pace with the excess supply of labor caused by population growth, especially in the modern industrial sector. Despite overall progress in increasing literacy, educational imbalances persist between regions, rural and urban areas, and males and females. Women with at least a primary school education have an average of 2.5 children compared with 5.2 children among illiterate women. Historically, large families have been encouraged by the Turkish government. From 1927-80, Turkey's population increased 350% to 45 million and is expected to reach 65-70 million by the year 2000. 38% of the population is currently under the age of 15 years, a fact that has implications for future population trends and economic development. The 1965 Population Planning Law gave responsibility for carrying out the country's family planning services to the Ministry of Health and Social Welfare. A 1983 law legalized abortion, which had been a major cause of maternal mortality, up to 10 weeks or longer if there is a risk to the infant or mother. 1600 physicians and 6800 other health personnel have been trained to provide contraceptive services. By 1981, 4 million people had been educated in family planning and maternal-child health. As a result of all these measures, a marked decrease in fertility has been noted since 1965.
Women's work and development in Latin America.
The discussion explores the problem of women's employment patterns under capitalist development in Latin America, first by analyzing the way in which women's work has been conceptualized within modernization theory. It then goes on to examine the 2 types of work in which most Latin American women are engaged -- domestic service and informal work such as selling produce and taking in laundry -- to provide evidence for challenging modernization theory and for developing a more useful approach. Subsequently, the discussion considers women's domestic and informal work within the context of capitalist development, which provides some insight into the broader structures shaping women's employment. Finally, the discussion proposes some reconceptualizations of women's work and development. Modernization theorists analyze women's work in the cities within a variety of constructs, interpreting it as a backward manifestation of traditional society, a reflection of women's inadequate training for the modern sector, an indication of women's primary orientation to the family, or as a phenomenon that is too tangential to warrant examination. The primary assumption is that modernization improves women's status and the conditions of their lives as it brings greater productivity, more advanced technology, and more highly differentiated institutions. Assumptions concerning women's absorption into the modern sector and the equalization of work roles between men and women are not borne out by actual employment trends, which reveal the persistent concentration of women in domestic work, informal jobs, and the lower-paying service jobs. Despite their predominance, domestic service and informal jobs are infrequently included in employment statistics and are virtually ignored in studies of development, yet these 2 types of work are the primary forms of work for Latin American women. Even when modernization theorists recognize the proliferation of informal and domestic service jobs, they see it as part of a progressive development stage, with displaced rural laborers becoming incorporated into the modern sector by way of informal jobs. In most Latin American countries, rural women become a permanent part of the services and the informal labor market when they move to the cities. There is little sign of their transition to industrial employment. In general, capitalist development marginalizes Latin American women, who in several important ways lose status. The range of pursuits considered women's work should include their activities within the infromal labor sector. Informal work is still virtually unexplored, especially as it relates to wage work in underdeveloped countries. Informal labor is not registered in the census, nor is it included in the gross national product. Yet, it is a major component of women's work. Domestic service and infromal jobs should be seen in relation to other forms of labor and to total social production.
The use of contraception among abortion applicants.
Applicants for therapeutic abortion at an outpatient unit of a general hospital in the capital city of Newfoundland were interviewed, and the contraception related findings are presented. The total number of therapeutic abortions performed in 1977 in the province was 493, of which 416 (84%) were performed in Grace General Hospital, where the study was conducted. The 416 women ranged in age from 14-45 years. 72% were under age 24. 41% had achieved only elementary school education. 65% came from the capital city and from the surrounding areas, within a radius of 100 miles. The rest of the women had traveled up to 700 miles or more to procure the service. Of the total of 416, 10, or 2%, claimed that they had no knowledge that there are ways to prevent conception. The 2nd group of 170 women (41%) knew that contraceptive methods did exist but for various reasons had never used any method at any time in their lives. The 3rd group of 236 (57%) consisted of those who had used some form of contraception. This group was further divided: 181 women (44%) had used birth control methods within the last 6 months or earlier but not at the time of conception; the rest had been consistent contraceptors but the method had failed. Of the 10 women who claimed they had absolutely no knowledge of contraception, 6 were below age 17, 7 were unmarried, and 5 were Roman Catholics. Approximately 1/3 of the 170 women who knew of contraceptive methods but did not use them were under age 16 and would have required parental consent to receive contraceptive counseling and/or prescriptions. For approximately 2/3 of this group, birth control methods were available and accessible since they were above the age of 17 and could have sought contraceptive counseling. The reasons this group of women gave for not using contraceptives fell under 3 main headings. 1/3 attributed it to ignorance and/or carelessness. Another 1/3 consisted of those who had not planned on having sexual intercourse. The rest consisted mainly of young women whose parental attitude had deterred them from seeking help with birth control. The 181 women who had used some form of contraception within the last 6 months or earlier but not at the time of conception were mainly over age 17. More than half of them were unmarried. Less than 1/3 had elementary school education, and half had high school or more education. The complaint of side effects caused by the method was the most common reason for non-use among this group. In most instances the method complained about was oral contraception. More than half of the consistent users were married and almost 3/4 had high school or better education. The contraceptive that appears to have had the highest failure rate among the consistent users was the condom. Almost 1/3 of the women claimed that they had depended on the condom. The oral contraceptive, the IUD, and irreversible methods such as tubal ligation and vasectomy had a failure rate of 2% each.
Decision-making and the pill: the consumer's view.
The 99 women who were interviewed about their attitudes toward the oral contraceptive (OC) pill were selected from those participants in the Oxford-Family Planning Association contraceptive study who had been recruited at 4 of the 17 family planning clinics in different parts of England and Scotland between 1968-74. The study aimed to address the following questions: how do these women perceive the benefits and risks of OCs and how does their perception of the balance between efficacy and health hazards affect their contraceptive choices. Over 3/4 of the women has used OC for a total duration of more than 4 years; only 2 women has used them for less than 12 months. Apart from occasional use of the sheath or withdrawal, the pill was the 1st regular method used by 70% of the women. In general the pill was chosen as the 1st regular method by these women because it was effective and simple to use. Despite the widespread satisfaction with the reliability and ease of use of the pill, it was clear from an examination of the Oxford-FPA study records that this group of women had changed their method of contraception fairly often for a variety of reasons. Excluding changes recorded as being due to "desire for pregnancy" or "resumption of contraception after delivery or termination," the average number of method changes per person was 3.3. Only 13 women had never used any of the other 3 most commonly used methods (excluding sterilization): IUD, diaphragm, or sheath. 6 women had used all 3 of these methods in addition to OC; 34 women had used 2, and 46 had used 1 other method. 21% of the women mentioned that they had suffered headaches or migraine, which they associated with OCs, and this had precipitated brand changes for 11% of women and changes to a different contraceptive method for 9% of the women. All but 19% of the women mentioned some problems associated with the pill during the course of the interview, and about half of the problems mentioned related to specific pill side effects, while half were general anxieties about the possible risks to their health as a consequence of taking OCs. 1/2 of the women expressed particular anxiety about the risk of cardiovascular disease; 12% mentioned that they were concerned about a risk of cancer. Of the 19 current users of OCs, only 9 envisaged staying on the pill in the long term. 80% of the women suffered side effects which they attributed to their use of OCs. Despite their very long average duration of use of OCs, very few remained committed to OC throughout their reproductive lives.
Singapore's 1980 Census disclosed success in lowering the birthrate, but it was an unequal reduction, i.e., the better educated the woman the less children she has. The educated woman has greater resources to provide her children with a better environment, nurturing, and care. A woman below age 40 with no educational qualificactions, on average, produces about 3 children although she has limited income and few resources to give her children the extra attention, help, and stimulation required. With primary edcuation, she produces about 2 children on average; with secondary education, 1 1/4; with upper secondary education, 1-1/3; with tertiary education, 1 1/4. These figures show how many children for each ever-married woman aged 10-39. Figures of the older women aged 35-39 showed that they have slightly more children. Adjusted for those women in the group who remain married, the mean figures are: no education, 3.5; primary, 2.7; secondary, 1.9; upper secondary, 2.0; and tertiary, 1.65. Those without education still have more than double the children of those with tertiary or secondary education, who have not reproduced themselves. These less disturbing figures form the basis of this discussion's argument. Before 1960, most girls had no education. The law permitted, and people practiced, polygamy. The pattern of procreation producing the next generation has been altered, first by educating everyone, second by giving women equal employment opportunities, and third by establishing monogamy since 1960. In their parents' generation, the able and not-so-able both had large families. For once this generation of children from uneducated paretns have received their education in the late 1960s and 1970s, and the bright ones make it to tertiary levels and will have less than 2 children per ever-married woman. They will not have large families like their parents. The results are going to be felt in Singapore in 1 generation, in 25 years. If Singapore continues to reproduce in a lopsided way, the country will be unable to maintain its present standards. Levels of compentency will decline, the economy falter, and the society will decline. The government has focused on better health, education, and housing to improve performance through better environment. Parents must be persuaded to do their part in family nurturing, and this is only possible in small families. Singapore must amend its policies and try to reshape its demographic configuration so that better educated women will have more children to be adequately represented in the next generation.
Fact sheets adapted from "Sexuality Education: a Guide to Developing and Implementing Programs".
This collection of fact sheets, adapted from "Sexuality Education: A Guide to Developing and Implementing Programs," presents information on the following: sexual knowledge and behavior of adolescents; adolescents' use of contraception; adolescent pregnancy; effects of adolescent childbearing; parent/child communication about sexuality; amount of sexuality education being offered; support for sexuality education; and effects of sexuality education programs. When asked when during a woman's monthly cycle she is most likely to become pregnant, only 37% of adolescents aged 15-17 and 49% aged 18-19 knew the correct answer. When asked to identify their initial source of information about sexuality, 37% cited peers, 22% literature, 17% their mothers, 15% their fathers, and 8% all other sources. Out of 29 million teenagers, about 7 million men and 5 million women are sexually active. The number of teenagers who are sexually active increased by 2/3 during the 1970s. The average age of 1st intercourse is 16.4 among whites and 15.5 among blacks. In 1979, of sexually active teenagers, 27% indicated they had never used any birth control method, 39% indicated they sometimes used a birth control method, and 34% indicated they consistently use a birth control method. Of the 70% of adolescents who used some birth control method at least occasionally, about 34% used oral contraceptives (OCs) or the IUD, about 20% used a condom, diaphragm, or foam; and about 16% used withdrawal, douche, or rhythm. In 1978, 1,142,000 teenage girls became pregnant. The pregnancy rate for all 15-19-year-old women increased by 13% between 1972-78. Pregnant teenagers have 4-5 times as many pregnancy complications as older women. Only 50% of teenage women who have given birth before age 18 complete high school, compared to 96% who have not given birth by age 20. Teenagers who have children when they are 18 or younger earn about 2/3 as much as those who wait until they are 20 or older. A number of studies suggest that improving communication about sexuality within families may reduce irresponsible sexual behavior and decrease unwanted pregnancies. Between 60-75% of students receive at least a small amount of sexuality education by the time they graduate from high school. Fewer than 10% of students participate in a comprehensive program lasting at least 40 hours. According to a 1978 Gallup Poll, 59% of teenagers in the US and 56% of adults favor making contraceptives available to male and female adolescents. Both Catholics and Protestants have equal support. About 90% of parents and teenagers believed that family planning clinics should provide contraceptives to teenagers. Programs that combined sexuality education and adolescent health services within the high school building have reduced birthrates by about half and have substantially reduced the dropout rate of student mothers.
Nutrition and fertility in Bangladesh: nutritional status of nonpregnant women.
In October 1975 a longitudinal study of over 2000 married women was initiated in Matlab, Bangladesh, to determine the association of fertility with nutritional status. This paper reports the results on nutritional status among nonpregnant women. The average weight and height of the study women was 40.4 kg and 147.9 cm. Weight fluctuated throughout the 2 1/2 year study period corresponding to seasonal food shortages. Maternal weight was consistently lower for older, higher parity women. Older women were also shorter than younger women, due to greater deficits in growth during childhood. Older, higher parity women had slightly lower hematocrits than younger women with an overall mean of 35%. Education level was associated positively with height, weight, and hematocrit. Muslims were taller and heavier then Hindus, reflecting their generally higher socioeconomic status. The decreasing nutritional status seen with increases in age and parity is the cumulative effect of the demands of subsequent pregnancies and lactation on maternal stores. The impact of higher education levels of the mother is likely to be reflected in her nutritional status because of the association of education with increased income. The pattern of changes in nutritional status in this study corresponds to seasonal patterns of rice availability associated with rain fall, rice prices, and wage rates. Women appear to gain weight during the postharvest season. However, they lose weight during the summer months, as food deficits as well as energy expenditure increase. Because of acquired immunity and less severe malnutrition, infection rates for adults are not likely to be as important a cause of worsened nutritional status as for children.
History and overview of Oyo State Community-Based (CBD) Programme. The pilot project.
This paper examines the objectives of community-based delivery of health care (CBD); project design; project direction; midwife orientation and training training and selection of community agents; community agent medical kits; logistics; and record forms. The need for low-cost family planning and maternal childhealth services in rural Nigeria is strikingly apparent. A primary objective of CBD delivery is the developing and testing of the feasibility of a safe, effective, low-cost, and potentially broadly replicable model for door-to-door delivery of basic MCH/FP services in rural Nigeria through local community agents. The project builds on the existing networks of government midwives and local health maternity centers. Services are limited but include primary care for emergencies, prenatal and postpartum check-ups, deliveries, and infant welfare clinics with the referral of cases involving high risks or complications to the nearest government hospital. Given a kit with drugs, contraceptives, and 1st-aid supplies, the community agents provide information/education on health, nutrition, and family planning for a nominal charge, from which the agents receive a small commission. The basic topics of midwife training were: the assessment of child and maternal health and proper use of contraceptives and medicaments; techniques for training agents; teaching methods for training agents; and techniques for supervising continuing training, and the resupply of the agents. Since most of the community agents are illiterate, in their training specially designed oral and audiovisual training techniques were employed. Pictographs were developed indicating the different illnesses, different aged patients, and different services given by the agents. Supplies for the project were procured both locally and from overseas through low-cost bulk purchase by AID and UNICEF.
The Oyo State Community-Based Distribution (CBD) project in Oyo State Nigeria was originally funded under a grant from USAID whose purpose is to discover new approaches in the delivery of health and family planning services, particularly to serve those without access to such services. Emphasis is placed on community-based services, involving the community members themselves in the program. The Community-Based Delivery (CBD) Health and Family Planning Project was designed to demonstrate and test the effectiveness of providing low-cost rural health and family planning services through trained community volunteers who are directly supervised by governmental health personnel. The project was expanded to 4 additional areas in Oyo State. The lessons learned are presented in this paper. The CBD project has rapidly and significantly increased the health services rendered to the rural population. Very positive and practical benefits resulted from integrating family planning with basic health services. There were great political and program advantages in utilizing traditional birth attendants in the CBD services. Dissemination of project information at the local level through both formal and informal channels and can have a major impact on project replication. The local university played an imortant role in initiating the CBD project, although there are some drawbacks to running a project from a university hospital. The community-based approach has encouraged health personnel to provide services to all people living in a particular area. Nonprofessional rural health personnel have made a major contribution to the CBD program. A primary value of CBD workers has been the linking/referral functions they have served with the government health services. Individual monetary incentives are not necessary to motivate CBD workers. Small service fees are an acceptable part of the CBD program. Illiterate workers can properly treat malaria and other common illnesses. Abstinence is practiced to ensure the health of the nursing child. Male interest in family planning was greater than expected.
The reporting system and service statistics: Oyo State CBD project.
Recordkeeping is a problem for the management of a community-based health program. Analyzing the records to obtain feedback on how the program is doing is also a problem. 3 major problems in recordkeeing of CBD programs are: 1) illiterate workers cannot write or read records; 2) there is no place to keep records; 3) CBD workers are usually on their own and are generally unsupervised. The following are criteria for the CBD worker reporting sheet: all instructions must be in pictorial form, or in pictographs; the form must be fairly simple with a limited amount of information; the concepts used for reporting should be clear; extensive pretesting is needed to develop a good reporting form. Several problems were experienced with the initial reporting forms. The initial pictures were too small to be seen clearly. There were too many categories which resulted in confusion for the workers. Specific contraceptives were not distinguished. Workers did not always complete the forms at the time the service was rendered. The current form corrected some of these problems, but others still exist. The distinction between old and new cases is still a problem--most workers tend to mark all cases as new. CBD workers still do not always complete forms at the time of service rendition. The number of marks given for condoms, foam tablets, and treatments still at times indicates the number of condoms, or the number of days of a treatment. The CBD worker forms are collected at the monthly meeting after which they are summarized either by the Zone Field Director or by University College Hospital staff in Ibadan. The totals for each group of workers from 1 maternity's catchment area are prepared and then the different catchment areas are summarized for the zone.
Fertility and modern family planning in rural southwestern Nigeria.
This paper describes the role of modern family planning rural southwestern Nigeria. Traditional means of deliberate family planning, or childspacing are a part of the Yoruba culture. The effects on this tradition of modernization and westernization are analyzed. The data presented were drawn from a survey of women from 4 regions of Oyo State, conducted by the University of Ibadan, and administrered to 1990 women aged 15 to 50 who currently had a child under the age of 5. The Yoruba woman typically marries by age 20, begins childbearing immediately and continues to have children into her 40s. By age 45, the women interviewed had given birth to an average of 7.34 children. While the overall fertility is high, it is much below the biological maximum of 12 to 14 children. Deliberate spacing of pregnancies is practices through postpartum abstinence, typically 2 to 3 years for the traditional village women. Postpartum practices are changing with the advent of westernization, urbanization, and education. The period of abstinence is shortening. A significant interest in family planning was found, though awareness of modern methods was low, and the availability of services was minimal or nonexistent. Interest in childspacing is found among all ages and parity levels, though more interest in postponing the next birth is found among women over 35 or among those with 5 or more children. Interest in postponing the next birth is strongly positively correlated with education. Actual use of modern family planning lags far behind expressed desires. For the entire sample, 2.5% have ever used contraception. The most used methods are the oral pill, followed by Depo-prover injection and the IUD. The lack of family planning services and education in rural areas partly explains the low level of use of contraception. Attitudes toward modern family planning are generally negative (only 25% of the sample approved of it). Sex is viewed as basically for the purpose of producing children and is otherwise immoral.
Late marriage and the use of rhythm.
The hypothesis is advanced that high levels of rhythm use in some developing countries are partly explained by late female marriage. 8 ways are listed by which late marriage might have this effect, involving possible differences between early and late marriers in contraceptive goals, contraceptive competence, or contraceptive evaluation. Crossnational regressions show that rhythm use is in fact higher where marriage is later, even with access to other methods controlled. Across developing countries, the proportion Catholic does not affect rhythm use, although across developed countries its effect is strong. Analysis is also conducted of the choice of rhythm across households, using survey data for the Philippines, Turkey, Indonesia, Thailand, the Republic of Korea, Taiwan, Singapore, and the US. Late marriage is related to the choice of rhythm in each country except Turkey. 2 main explanations are supported by the analysis: that late marriers try to space births, for which purpose rhythm is preferred; and that late marriers are more educated (and therefore either more competent at rhythm or more sensitive to the perceived risks of other methods). A significant part of the effect of late marriage on rhythm remains unexplained, however. (author's)
Research on the determinants of fertility
This review of empirical findings concerns the extent to which a variety of explanatory variables, including biological variables, infant and child mortality, the role of women, education, and access to resources, have been shown to directly or indirectly explain observed variations in fertility. The chapter also includes an overview of time of the major projects conducting empirical research on fertility. Explanations of fertility can be sought at many levels: the level of the biology of a single birth or in terms of the general social and economic characteristics of an entire population. The chapter proceeds from the most immediate biological determinants of fertility to the general social and economic variables. In any discussion of fertility, it is useful to begin with a recognition of the role of intermediate variables. Davis and Blake (1956) provide a taxonomy of mutually exclusive intermediate variables which mediate between fertility and explanatory variables of a behavioral form. They suggest that there are 3 categories of variables that are necessary for successful reproduction: variables which define the probability of sexual intercourse, such as marriage age; variables which define the probability of a conception resulting from sexual intercourse, such as contraceptive use or the pattern of primary or secondary sterility; and variables which define the probability of a conception resulting in a live birth, such as spontaneous or induced abortion. From a research perspective, economists have adopted several strategies for dealing with the intermediate variables. Possibly the most common strategy is to selectively ignore the intermediate variables by restricting research to the marital fertility of individuals. This strategy allows an examination of contraception or abortion but ignores the determinants of age and marriage duration. Finally, it is possible to develop models explicitly recognizing the complete mechanisms through which fertility is affected by economic influences. Research findings concerning the following variables emphasized by economists in their research are considered: age; mortality; budget constraints; the status of women; direct costs and benefits of children. A 3rd category of variables relates to the environment within which family decision making is undertaken. There are 2 basic kinds of variables which come under this heading: variables relating to the political, social, and economic status of the community as a whole; and variables relating to specific policies and programs which are likely to have a direct or indirect influence on population or 1 of its components. A summary table gives key findings from the empirical literature. In general, the findings suggest that multivariate controls tend to reduce the influence of individual variables. There are reasons to raise questions about the direction of causality in almost all of the variables, i.e., in almost all cases authors have raised questions such as whether fertility may not influence the level of the variable in question, or whether the variable in question is not an intervening variable for some more fundamental determinant of fertility.
Prospects of the population by educational level in developing countries.
An attempt was made to project some educational characteristics of the population for selected developing countries regarding literacy and school attendance. The projected populations on medium variant for each country as prepared and published by the UN were used throughout. This projection of population attending school was attempted primarily for the developing countries of Argentina, Indonesia, Nepal, and Thailand. Because of some limitations imposed upon the basic data, only China, Indonesia, Mexico, Nepal, Philippines, and Thailand were chosen for the attempt to project literate population. The projections were uniformly based on the assumption that those levels of literacy and school attendance or enrollment in the future would approach those levels already attained in the urban levels at present. The rationale to support such an assumption was that those characteristics such as literacy or school attendance or enrollment would be improved in the course of time along with the process of urbanization of the whole population expected with advance in social and economic development of a country. In all instances of those countries selected, it was found that the proportions attending school increased rapidly for almost all sex-age segments of the population in recent years. Basically, extrapolating these trends, it may be safe to anticipate further increase of those proportions based on their increases in recent years, for example between 1970 and 1980 rounds of censuses, because the level of such proportions would soon reach 100% for the most of younger segments. Proportions attending school were larger for females than for males at ages 5, 6, and 7, whereas corresponding proportions were generally larger for males than for females at all other ages. In regard to literacy, in general the higher the level of literacy, the narrower the range of its variations between males and females. This fact implies that a pace of improving the literacy level is comparatively faster among the group of persons whose literacy was relatively lower. The results of these projections of educational characteristics should be compared with corresponding projections of economic activity, marital status distribution, households, and so forth to determine any noticeable contradictions involved and to assess the validity of a series of assumptions used in the projection of the population with specific characteristics.
Non-marital childbearing: diverging legal and social concerns.
Recent increased concern with out-of-wedlock childbearing has centered on the deleterious effects for the children involved. This concern revolves around the newborn infant experiencing a single-parent situation. However, the standard definition of illegitimacy reflects the legal concerns for the child, and thus, is quite restrictive. The vital registration system considers a child to be "legitimate" if it was conceived or born while the mother was legally married. By using a broader definition reflecting the social policy concerns, it is estimated that an additional 1 million births in the decade 1968-77 were born out-of-wedlock. Further, the broader social policy definition indicates that nonmarital fertility is more prevalent in the older, better educated strata of the population than the legal definition has implied. (author's)
This review of some of the issues and problems in the fields of international health, nutrition, and population/family planning, focuses on predominantly rural societies. In most countries in Sub-Saharan Africa, 70-90% of the people lack access to modern health services. Infant and childhood mortality rates are high, and maternal health has been essentially neglected. At the same time, the African region is now experiencing a a growth rate of 3%, meaning that the population will double in just 23 years. The majority of infant and childhood diseases are treatable with relatively simple interventions, including the provision of family planning services. For the last several years, the Center for Population and Family Health (CPFH) at Columbia University has been involved in a number of operations research activities focuses on the development of appropriate approaches to the delivery of services to rural population. Findings suggest that such projects are best developed in a relatively small project area with members of the community and of the local health care agency heavily involved. If the project is an integrated one, priorities should be determined and only a small number of interventions selected. An approach to training for such activities is to carry them out in short segments through phasing. Illiterate workers can be highly effective in relating to their peers in the village and should not be ruled out because their illiteracy prevents them from keeping records. A wide range of personnel--including nurses, midwives, and lay villagers--can carry out a wide variety of activities that were limited in the past to more highly trained workers. Effective projects and innovative program strategies can be developed and implemented utilizing speical groups such as women's organizations, cooperatives, and factory groups. Social marketing programs can also be effective in distributing key commodities and implementing program interventions. Small projects such as these, if successful, can have an impact on either national or state level programming. As more governments attempt to implement primary health and family programs, the importance of short-term applied operations research, including demonstration efforts, becomes increasingly evident.
Social mobility and fertility.
This review examines 4 possible causal links between social mobility and fertility: 1) fertility affects social mobility; 2) social mobility affects fertility; 3) fertility and social mobility simultaneously affect each other; and 4) social mobility and fertility are unrelated. Due to the lack of systematic theory guiding the research, conceptualizations and measures of social mobility and fertility vary markedly from study to study, leading to inconsistent findings. The review focuses on theoretical perspectives underpinning the research, causal operators proposed to interpret observed associations, and analytical methods used. The selectivity perspective is based on the contention that a family must be small in order to rise on the social scale. This has found little support, however. In fact, studies suggest that children induce slightly higher levels of status achievement and family responsibilities may stimulate the energy and ambition of some so that they achieve more than they would have done without a family. Most studies have concerned the hypothesis that social mobility affects fertility. 4 theoretical perspectives have emerged: status enhancement; relative economic status; social isolation; and stress and disorientation. At any time in a couple's reproductive life cycle the decision or actual experience of either social mobility or fertility may influence the decision or actual experience of the other variable. Mobility-fertility research has defined an individual's or couple's position in terms of income, education, or occupation with occupation used most often as a single index of social class and indexes of social mobility developed by comparing persons' changes in occupational position. A common theme in much of the research literature is that the existence of an effect of social mobility on fertility depends on the societal conditions of a given population. Most studies through the mid-60s used a common measurement method to assess whether a mobility effect existed. This method compared the reproductive behavior of the upwardly and/or downwardly mobile with that of the nonmobile at origin and/or destination.
Asian Americans: growth, change, and diversity.
The 1980 US census counted 3.5 million Asian Americans, up from 1.4 million in 1970. Asian Americans made up just 1.5% of the total US population of 226.5 million as of April 1, 1980, but this was the 3rd largest racial or ethnic minority after blacks and Hispanics. Asians increased far more during the 1970s (141%) than blacks (17%) or Hispanics (39%). This Bulletin examines the characteristics of Asian Americans, how their numbers have grown, where they live, how different groups vary in age structure, childbearing, health, and longevity. It reports on the kinds of households Asian Americans form and how they fare with regard to education, occupation, and income. Asian Americans are now often perceived as the model minority. As a whole, they are better educated, occupy higher rungs on the occupational ladder, and earn more than the general US population and even white Americans. This Bulletin presents the 1st comprehensive look at many important facts about Asian Americans and how the groups differ. Special tabulations of data collected in the 1980 census are provided. The 1980 census data are the latest available to give a true picture at the national level of Asian Americans and the various groups among them. The Bulletin examines the current numbers of Asian Americans and how this population is defined. The major Asian American groups are Chinese (21%), Filipinos (20%), Japanese (15%), Vietnamese (21%), Koreans (11%), and Asian Indians (10%). Except for the latest-arrived Vietnamese, the fertility of the 6 groups is lower than the white average. The following areas are also discussed: mortality and health; families and households; education; Asian youth; employment; income and poverty; and future prospects.
Maternal sociomedical characteristics and birth weights of firstborns.
In order to examine the higher risks associated with adolescent pregnancy, pregnancy outcome and sociomedical characteristics were examined in a sample of 1844 black and white primiparous females who received prenatal care. White females were more frequently married and more likely to live with their husbands than with their parents. Black females were better educated and more interested in obtaining further education. White women smoked significantly more cigarettes. There were no differences in contraceptive use in black and white females. Number of prenatal visits was least freqent among adolescent black females. With the exception of a higher incidence of vaginal infections among black females, there were no significant differences in general health status. There were no differences in birth weights between the 1stborns of black and white adolescents, but adult white females had significantly heavier 1stborns than blacks. Nonetheless, no differences were found in prevalence of low birth weight-for-gestational age neonates between black and white females. Results of the multivariate analysis suggest that infrequent prenatal visits, maternal diabetes, and cigarette-smoking are the most important factors in increasing the likelihood of intrauterine growth retardation among the primiparous women in this study. Neither age nor other indicators of socioeconomic status (such as marital status, education, residence or family structure) seem to be significantly associated risk factors. Contrary to expectations, gynecological age (chronological age minus menarcheal age), a putative measure of reproductive maturity, was also not associated with the quality of pregnancy outcome. In conclusion, these results underscore the importance of prenatal care in affecting the quality of pregnancy outcome.
Economic and demographic interrelationships in sub-Saharan Africa.
In most of Africa the process of structural change accompanying increasing industrialization has barely begun, and features of African land tenure and family organization that encourage high fertility remain largely intact. Because of unequal spatial distribution of the population, industrial development is constrained by insufficient markets; and income-earning opportunities in the vast sparsely populated regions are few. Long-fallow agriculture makes extensive use of the labor of women and children. This feature and common property practices make the status of men dependent upon family size. Young female age at marriage, large age differences between spouses, polygyny, unequal work burdens between the sexes, and low female educational levels keep the status of women low. Land reforms that give property to men may further erode the status of women. Since fathers pass most or all of the burden of family support onto mothers, men's motivation for family limitation is weak, and optimistic anticipations in the early years after independence made parents confident that they could support large families. However, income trends, nonagricultural employment opportunities, and expectations have changed for the worse in most of Africa. These changes are likely to make many Africans inclined to delay the next birth or terminate childbearing. But it is generally believed that contraceptive use, whether by modern or traditional means, is very low in Africa. African men are in a better position to avoid their sexual partners pregnancy than the women themselves are, as long as women's status is low and family planning services rare. It would be useful to have more systematic studies of how land shortages and privatization of land affect age at marriage and male and female attitudes toward family size. To complement such information, research is needed on prospects for the practice of fertility limitation, deliberate as well as unintended.
Factors affecting the choice of nonpermanent contraceptive methods among married women.
Data from the 1976 US National Survey of Family Growth were used to examine the effect of sociodemographic factors on choice of nonpermanent contraceptive methods among white, fecund, married women aged 15-44 who intend no additional births. A multivariate analysis revealed that age of the respondent had a strong negative relationship to the effectiveness of contraceptive chosen. Being Catholic had a negative effect on the effectiveness of contraceptive chosen, but significant interaction occurred between age and parity and between age and education. 1 explanation may be that increased age may result in reduced perception of risk that an unwanted birth will occur. Another explanation is that concerns about health risks associated with the pill or IUD use may lead to use of other methods among older women. The most probable explanation of the observed relationship is a cohort effect. Older women who began marital contraception at an earlier point in time have continued to use the same methods as were initially available early in their marriage. The lack of a significant association between parity and the effectiveness of contraceptive method chosen based on multivariate analysis is most likely due to the high correlation between parity and age. The lack of a significant effect of education on choice of method may be explained by the nearly universal access to all methods of contraception for married women. Further research on the same lines is strongly urged to shed light on current behavior patterns.
A note on the determinants of breastfeeding durations in an African country.
This paper utilizes data from the 1977-78 Kenya Fertility Survey, 1 component of the World Fertility Survey, to analyze the determinants of breastfeeding durations for women 15 to 50 years old who had their last-but-1 live birth between 3 and 15 years prior to the interview. Comparisons are made with the findings fro m the World Fertility Surveys in 8 other developing countries in Asia and Latin America. Findings indicate that literacy, urban residence, secondary school education, and modern employment reduce the duration of breastfeeding in Kenya. In addition, the subgroups of women who appear to be curtailing breastfeeding are growing in proportional size or are composed of women may be innovators or leaders. A continuation of this pattern into the future may increase levels of infant morbidity and mortality and, in the absence of increased modern contraceptive practice, may increase the societal level of fertility. The death of the infant curtails the period of breastfeeding. Although there is a pronounced preference for male children in Kenya, this preference does not lead to differential durations of breastfeeding by sex of child. About 10% of Kenyan women used contraception in the last closed interval. Parity and age explain less than 1% of the variation in duration of breastfeeding in Kenya. Kenyan women are among the least likely to have attended secondary school, to have worked since marriage, and to have used modern contraception. The most traditional groups of Kenyan women, those who are Muslim or who are in polygamous unions, breastfeed for the longest durations. The Kenya Fertility Survey suggests that the subgroup of women with some secondary school education is growing considerably. Kikuyu women may be regarded as innovators in many respects. In addition to having shorter breastfeeding durations, they are the least likely to be in polygamous unions or to want more children, and they are the most likely to be using contraception.
The effect of female education on marital fertility in different size communities of Mexico.
Based on a very large sample of married women aged 15 to 49 from the 1970 census of Mexico, the effect of literacy and education on the number of children ever born in different size communities is investigated. While cumulative marital fertility tends to be inversely related to community size, the overall shape of the education-fertility relationship is generally similar in rural, semi-urban, small urban, and large urban localities. These results combined with those for literacy do not support the hypothesis of an urbanization or a literacy threshold at which women's schooling begins to reduce family size. Literate wives have slightly more children than illiterate wives in rural areas, but in more urbanized regions this differential inverses and seems to widen with each increase in size of the community. Fertility is slightly higher at 1 to 3 years of primary school than at no education; it declines slightly at 4 to 5 years primary, and then declines substantially at complete primary, secondary, and preparatory/university levels. A statistically significant but small interaction between education and residence on cumulative marital fertility is noted. The overall greater impact of female education on cumulative marital fertility in urban as compared to semi-urban as compared to rural communities of Mexico is primarily due to the proportion of married women with fertility depressing educational backgrounds rather than to a markedly different effect of education, per se, on fertility. The results emphasize the country-wide importance of completion of the entire 6-year primary cycle.
Risk factors of breast-feeding among filipino women.
At a time when women's participation in developing countries and their breastfeeding practice are the objects of promotional campaigns, findings on the relationship between the 2 are required for formulating policies. A woman's participating in modernizing influences will, to a large extent, affect her child feeding practice. Urban-rural residence (under study, separated from other related factors), rural-to-urban migration (specifically female-dominated in the Philippines), education, which can have 2 opposite effects on breastfeeding, and employment, have been defined as modernizing influences. In this study, log linear analysis is used on information from the 1973 National Demographic Survey of the Philippines to study presence and effects of breastfeeding. The sample characteristics shown are predominating rural origins, educational trends consisting of increasing female participation, and low workforce participation (based on a 23 hour per week criterion). Employment outside (but not inside) the home and duration and the actual fact of urban residence negatively affect breastfeeding practice. Education's effects are also negative, especially among the youngest mothers. These factors have similar affects on breastfeeding duration. College education in particular explains a precipitous drop over time in the proportion still breastfeeding. The 2 most important affectors, college education and employment, do not involve a great proportion of women at present, but do potentially, and a pro-breastfeeding development policy will need to address the problem of an increasing population at risk. Use of higher educational institutions to promote breastfeeding among educated women, using the media in urbanizing populations, and the possible promotion of cottage industries, day care, and maternity leave, could all be elements of policies to help offset the effects of otherwise negative development trends.
Breast-feeding in Manila, Philippines: preliminary results from a longitudinal study.
Longitudinal data collected over a 2-year period (1982-84) on 152 1st and 2nd parity mothers who were delivered in a charity maternal hospital in Manila, Philippines, indicate the reasons for never breastfeeding and for early termination of breastfeeding. 2 groups were studied, one on the basis of the woman's intentions to breastfeed, and one on the basis of parity. They were studied through initial hospital interviews and follow-up home visits. Some of the general characteristics of the study group were fairly high educational levels, a previous infant mortality rate about 45/1000, low standards of living, and a history of low duration of breastfeeding. Reasons for not commencing and for ceasing breastfeeding during the 1st 3 months are diverse e.g. incompatibility with work, negative attitudes, false beliefs such as the transmission of the mother's physical tiredness through milk, and medical complications requiring separation from the mother. Mixed feeding was found convenient by many. The very small minority who were found to bottle feed properly would need to spend 21% of the group's mean annual income on formula; most mothers used less than ideal but cheaper bottle feeding procedures. Breastfeeding clearly helped reduce diarrheal incidence, although its total incidence was quite low, while bottle feeding clearly acted against birth spacing. The findings of this study appear to argue in favor of educational compaigns to counteract false beliefs, policy reviews for hospital obstetrics, and vigourous breastfeeding promotion for the sake of family planning and the economic viability of families.
Breast-feeding and fertility among Philippine women: trends, mechanisms and impact.
In pre-transitional societies, contraceptive practice is usually low or absent and prolonged breastfeeding has been identified as the major factor in keeping marital fertility below the biological maximum, so that the length of birth intervals is the strongest determinant of completed family size. Declining breastfeeding prevalence often threatens to shorten birth interval length. Breastfeeding is widespread in the Philippines, (estimates range from 83% to 87%) but it has declined slightly and its duration is not as long as in other Asian countries. Prevalence and duration appear greater among younger women, and lower in urban groups and better educated women. Ethnic groups are also important determinants. Postpartum amenorrhea averages about 8.0 months. The correlation of increased amenorrhea with breastfeeding presence is comparable to other countries' correlations, and breastfeeding clearly prolongs amenorrhea. Multiple regression analysis shows that full breastfeeding delays amenorrhea longer (0.550 months/month of breastfeeding) than partial breastfeeding (0.005 months). The latter conferred protection only until the 6th month, after which protection declined, both in menstruating and non-menstruating women. An analysis of the proximate determinants of fertility show that breastfeeding reduces the potential fertility of Philippine women by 4.4 children, contraceptive use by 3.9, and monmarriage by 3.8, making breastfeeding the single most important reducer. This trend is declining in metropolitan areas and among more educated women. Breastfeeding may be relied on to postpone and not prevent childbearing, and appears to be threatened by the increase and type of demands made on mothers by modern conditions. Compensatory effects of increased contraceptive use and delayed marriage appear to be showing promise. Practical guidelines for promoting breastfeeding in family planning need developing.
Employed women in Barbados: a demographic profile, 1946-1970
This monograph, based on data from population censuses from 1946, 1960, and 1970, analyzes demographic factors associated with female labor force participation in Barbados. The general worker rate among women had declined in the post-World War II period from 58.3% in 1946 to 45.6% in 1970; however, the rate for men showed a similar decline in this period, from 92.0% to 80.7%. The dissimilarity index of the age composition of male and female workers was only 4.8 in 1970, and the pattern of female age-specific worker rates at ages below 50 years is gradually approaching that of males. Female worker rates by education continue to be lower than those for males, yet are increasing for women in the higher educational categories. In 1970, 66% of working women were mothers. Younger working and nonworking women reveal lower levels of fertility than older women, although nonworking women tend to reveal higher fertility levels at all ages than their working counterparts. Labor force participation rates decline with parity. Among mothers, 1970 worker rates rose gradually to a peak of 52% at age 25-29 years, then assumed a plateau-like shape until age 45-49 years before beginning a gradual decline. In contrast, among nonmothers, the curve rises from 40% at ages 15-19 years to a peak of 72% at age 25-29 and then drops to 48% for women at the end of the age span. Completed family size in 1970 was 3.5 among working women and 4.0 among nonworking women. Barbadian women continue to be employed primarily in clerical, sales, and services occupations, although there is a trend toward increased female employment in community and business services. Needed are future studies on the micro level aimed at providing data on specific groups such as female heads of household, women in the professions, and nonworking women. Such studies could identify the supply and demand factors in female employment and assess the effect of women's employment on the household.
Unemployment experience of demographic groups.
This paper studies the probability of being hit by unemployment and the amount of unemployment for those who are hit using a subsample of a 5% representative sample of the adult Danish population followed over the 1979-80 period. The probability of being hit and the amount of unemployment for those hit by unemployment are related to the degree of compensation offered by unemployment insurance, to lagged unemployment experience, and to a number of other background variables. Longitudinal data ideally contain a dating of transitions between labor market states, i.e., unemployed, employed, and nonparticipation. From this dating of transitions, it is straightforward to calculate durations of spells in different states. The data in this paper are of a more crude nature as the share of the year spent in unemployment is used, called the degree of unemployment, instead of the duration of unemployment spells. Technically the degree of unemployment is calculated on a weekly basis as the ratio between benefit hours and potential working hours. The annual degree of unemployment is simply calculated as the average weekly degree during the year. The preliminary results presented apply to a sample of 9275 cases of which 2735 were observations with a positive degree of unemployment. A strong positive history dependence was found both in the probit estimations for the probability of being hit by unemployment and in selectivity-corrected OLS regressions explaining the amount of unemployment for those who are hit. Rather few significant coefficients to the different background variables were found. Consequently, much of the individual variation in the amount of unemployment for those who were hit were either explained by true history dependence or related to unmeasured individual factors. A positive effect was found from the benefit-wage ratio on the probability of being hit by unemployment for prime age and older workers. A negative or insignificant effect was found from the benefit-wage ratio on the amount of unemployment. This result came as a surprise in light of the predominantly positive effects reported in the literature. It is argued that this apparent contradiction may be resolved because the standard result applies to duration analyses in single spell samples while the results here apply to the amount of unemployment during a year. Thus, policy recommendations based on results from single spell duration analyses should be viewed cautiously.
Data derived from the 1970 US Census indicate that fertility declines with increasing education level. In this paper, the author uses a method she developed earlier for decomposing the difference between rates into several components. Specifically, the difference in average number of children between groups dichotomized on the basis of wife's education is decomposed in terms of 6 other socioeconomic factors--husband's education, husband's occupation, wife's age at marriage, race, wife's labor force status, and family income. The fertility of wives who were not high school graduates was compared to that of high school graduates, and then a similar comparison was made between wives with high school education only and those with college education. All 6 factors examined were found to contribute positively to the overall reduction in number of children when wives advanced from non-high school graduate status to high school graduate status. On the other hand, comparisons between wives with 4 years of high school and those with a college education indicates that the .158 difference between their average number of children increases if the averages are controlled for differences in husband's education, race, or family income. For a more meaningful comparison of the effects of the 6 factors, all were considered simultaneously. Together these factors explained 51.3% of the difference in average number of children between those with and without a high school education, with husband's education making the largest (15.1%) contribution. In terms of college educated versus high school educated wives, the 6 factors explained 72.3% of the fertility difference, with wife's age at marriage making the largest (63.9%) contribution.
Results from the 1979 census of Jordan concerning the population of the East Bank are presented. Census organization and methods are first described. The data are presented in six sections, which concern personal characteristics including sex, age, religion, nationality, urban-rural residence, household, place of birth, and place of previous residence; education; economic activity; nuptiality; fertility; and characteristics of non-Jordanians. (ANNOTATION)
[Population and housing census, 1980. Vol. 3: families and households]
Results from the 1980 census of Norway concerning families and households are presented. "The publication contains data on the households' demographic composition, education, housing conditions, employment, income and socio-economic status. In some tables and figures a comparison is made between comparable characteristics from the population census in 1970." Most of the data are presented at the national level. (summary in ENG) (EXCERPT)
[First general population census: public information]
Results from the 1980 census of Mozambique are presented. Data are included on population size and density, rural and urban population, population by age and sex, population growth, educational status and literacy, economic activity, and households and families. (ANNOTATION)
[Micro-census: annual results, 1982]
Results are presented from the 1982 micro-census of Austria. Some comparative statistics for 1979 to 1981 are also provided. Data are included on resident population by age, sex, marital status, educational status, type of community, and state; female population aged 15 and over by age, social status, labor force participation, presence and number of children, and educational status; labor force characteristics, including employment status and occupation; private households; families; and housing. (ANNOTATION)
[Micro-census: annual results, 1983]
Results are presented from the 1983 micro-census of Austria. Some comparative statistics for 1980 to 1982 are also provided. Data are included on resident population by age, sex, marital status, educational status, type of community, and state; female population aged 15 and over by age, social status, labor force participation, presence and number of children, and educational status; labor force characteristics, including employment status and occupation; private households; families; and housing. (ANNOTATION)
[Changes by year of mortality and sociocultural indexes, Japan: 1921-1925 to 1975]
The relationship between mortality and various sociocultural phenomena in Japan is examined using a range of analytical techniques. Changes in mortality rates from the 1920s to 1975 are shown to be influenced by sociocultural changes. Among the variables considered are education, economy, urbanization, industrialization, and health. Differences in the degree of influence of certain factors on male and female mortality rates are noted. (summary in ENG) (ANNOTATION)
The spiral of suicide and social change in Sri Lanka
Increases in the suicide rate in Sri Lanka during the period 1955-1974 are noted, and possible explanations are suggested. Using data from official sources, the authors conclude that "the rising suicide rate may be related to the growing competition for education and careers, high unemployment, internal migration, and the increasing age at marriage, all of which contribute to the fundamental dislocation of a once more stable and predictable society." (EXCERPT)
An attempt is made to estimate the extent of recent emigration from Argentina and to describe the characteristics of the emigrants, including sex, age, educational status, marital status, and occupation, and their countries of residence. Data are from a variety of sources, including official national sources and published secondary sources from selected countries. The volume and characteristics of this emigration are described, with the focus on the period 1960-1980. (ANNOTATION)
A demographic profile of the U.S. population under age 17 is presented. Changes since 1950 and expected changes through the year 2000 in the child population by three-year age group are described. Consideration is also given to educational status and living arrangements. The data are from official sources. (ANNOTATION)
[The immigrant woman in Venezuela]
Data from a 1981 survey of migration in Venezuela and from other sources are analyzed to estimate the total number of female immigrants and their place of birth, reason for migrating, age, marital status, family status, education, economic activity, occupation, and integration. (ANNOTATION)
An old-age security incentive for children in the Philippines and Taiwan.
Comparable analyses in the Philippines and Taiwan can be useful in assessing the general validity of the old-age security hypothesis, which states that the expectation of relying on children in one's old age promotes the desire for large families in traditional societies. The hypothesis presumes that there are social norms that support parental claims for care in old age and presumes that the perceived cost of having many children is either nonexistent or made worthwhile by the expected benefits. Finally, it presumes that a relationship between old-age support expectations and desired family size is common to "traditional" societies, irrespective of cultural or historical background. Although the Philippines and Taiwan are very close geographically, their traditional family systems and historical backgrounds lead one to expect the hypothesis to be incorrect in the Philippines but correct in Taiwan. A useful feature of this analysis is that both countries have traditional and modern sectors, allowing a test of the traditional-modern hypothesis while holding culture constant. The analysis uses nationally representative samples of wives of childbearing age in the Philippines (1975) and Taiwan (1976). The Philippines sample of 1691 wives under age 45 represents a response rate of 93%. A number of demographic, socioeconomic, and family variables should be controlled when testing for an independent effect of old-age security expectation on fertility preferences. Exploratory multiple regression was used to guide selection from the full set of available control variables, a subset important for the proper specification of an additive model. Before other variables were controlled, expected reliance on children appeared to have a positive effect on fertility preferences in both the Philippines and Taiwan, and the effect appeared stronger in Taiwan. In terms of ideal family size, the difference between expecting to rely on children "not at all" versus "a great deal" was 0.4 in the Philippines and 0.9 in Taiwan. When other factors were controlled, the difference between expecting to rely on children "not at all" versus "only a little" failed to have a significant effect on any measure of fertility preferences in either the Philippines or Taiwan. The difference between expecting to rely "a great deal" instead of a "little" had a substantial effect on all measures of fertility preferences. In sum, findings for the Philippines and Taiwan were consistent with the 1st part of the old-age security hypothesis, but findings regarding the 2nd part of the hypothesis, describing a loss of importance in more modern settings, were less clear.
Internal migration and socio-economic environment: a new look at the problem.
Results are presented from an analysis of the relationship between socioeconomic environment and population mobility in Italy between 1972 and 1981. Data are from official sources, including the 1971 census. The variables considered include labor force participation, occupations, age structure, housing, educational status, and provincial population density and distribution. Consideration is given both to out-migration by province and to internal migration for Italy as a whole. (summary in FRE) (ANNOTATION)
Female education and fertility in rural Sierra Leone: a test of the threshold hypothesis.
This study tests the female education threshold hypothesis which posits that there is a critical level of educational attainment beyond which fertility begins to decline from traditional high levels. Using data from a sample of 2000 currently married women of child bearing ages 15-49 in rural Sierra Leone, a non linear regression analysis reveals a threshold value of 6 years of schooling for rural women. Women below and above the threshold value exhibit the expected positive and negative coefficients on fertility respectively. Although the coefficients are not statistically significant at the 5% level, they are consistent for broad age groups 15-24, 25-34, 35-49, which shows that the observed results are not an artifact of intercohort differences. The initial effect of improvement in female education is likely to be fertility increase; only education beyond the threshold level will depress fertility. Female education should be a priority, but decisions about elementary versus secondary and formal versus informal education still need to be made. (author's modified)
Knowledge and attitudes of family planning in Khartoum Province, Sudan.
Data on contraceptive knowledge and attitudes, collected in a 1977 fertility survey undertaken in the Khartoum Province of the Sudan by the Sudan Family Planning Association, was presented. The data, collected from an urban sample of 1474 wives and 1036 husbands and a rural sample of 494 wives and 264 husbands was analyzed primarily by constructing percent distributions. Knowledge of contraception was fairly high. Among rural respondents, 99% of the wives and 97% of the husbands were aware of birth control. Respective figures for the urban sample were 99% and 98%. Among the 2753 respondents who knew of at least 1 method of birth control, all except 7 rural husbands were familiar with OCs. More than 3/4 of the rural women knew about injectables, IUDs, and lactation. 86% of the rural women were also aware of female sterilization; however, only 26% knew about male sterilization. Among the rural women, knowledge of diaphragms, condoms, rhythm, abstinence, and withdrawal ranged from 32%-50%. Knowledge of specific methods tended to be slightly higher among urban women than among rural women; however, only 44% of the urban women compared to 88% of the rural women were aware of lactation as a birth control method. Urban wives were similar to rural women in that the proportion aware of female sterilization (90%) was higher than the proportion aware of male sterilization (41%). In urban areas, husbands were somewhat less knowledgeable about specific methods than wives, and this same pattern was observed among rural respondents. Urban men tended to be more knowedgeable about birth control than rural men. Despite the relatively high knowledge levels, the use of birth control was disapproved of by many of the respondents. Among the rural wives, 36% disapproved of birth control, 49% approved of birth control, 12% approved of it only under certain circumstances, and 3% had no opinion. Respective figures for urban women were 29%, 56%, 12%, and 3%. Respective figures for rural men were 52%, 23%, 22%, and 3%, and for urban men they were 47%, 30%, 22%, and 1%. In both urban and rural areas, the level of approval was highest among educated women, recently married women, and women of high socioeconomic status. In urban areas, women who grew up in urban environments were more likely to approve of birth control than women with rural backgrounds. For both urban and rural men, the level of approval was highest among recently married men and among men with high socioeconomic status. Among rural women who approved of birth control only under certain circumstances, 83% approved of using birth control when maternal health was endangered, 42% approved its use to prevent births under adverse economic conditions, 29% approved its use to limit family size, and 38% approved its use for spacing births. Respective figures for urban women were 56%, 42%, 37%, and 34%. The respondents were asked why they approved or disapproved of family planning. Major reasons for disapproving of birth control were that it was contrary to religious beliefs and harmful to maternal health. Major reasons for approving the use of birth control were that it made it possible to give better care to each child, it eased the financial burden on the family, and it contributed toward maternal health. The reasons given by male and female respondents were very similar. The major findings were presented in a set of 8 tables.
A comment on J. Akin et al., "The determinants of breastfeeding in Sri Lanka."
A reanalysis of World Fertility Survey data on breastfeeding in Sri Lanka calls into question 2 conclusions reached in a 1981 study of breastfeeding determinants in Sri Lanka. In the 1981 study, incorrect conclusions were reached because the analysis was restricted to only the 1st 15 months of breastfeeding duration and because of multicollinearity among regressor variables. At 15 months, 2/3 of the women still breastfed. In the present investigation, the analysis was extended to the 48th month. At 48 months only a small proportion of mothers continued to breastfeed. The results of the regression analysis based on the 48-month period agreed with the results of the 1981 study in regard to the effects of parity, education, and residence on breastfeeding duration and disagreed with the 1981 study in regard to the effects of contraceptive use and age of the mother on breastfeeding duration. In the 1981 study, contraceptive use was negatively related to breastfeeding duration. In the current study, the relationship was negative for short breastfeeding durations and positive for longer breastfeeding durations. During the early phase of breastfeeding, contraceptive use may simply be a proxy for social status. At breastfeeding durations of a year or more, the use of contraception may indicate a serious commitment to breastfeeding, i.e., the women want to avoid pregnancies which would interfere with their breastfeeding activities. The 1981 study found that parity was positively related to breastfeeding; but, paradoxically, that the age of the mother had a negative impact on breastfeeding duration. This inconsistency was due to multicollinearity among regressor variables. The current analysis demonstrated that the mean duration of breastfeeding increased with both maternal age and with parity.
Women's ages at marriage in recent cohorts in Asia: a comparative study of individual co-variates.
This paper presents models of the effects of covariates on the mean and standard deviation of the age at marriage among women in a range of cohorts in 9 Asian and Pacific countries represented in the World Fertility Survey. After reviewing the advantages of estimation using a model by Coale and McNeil over proportional hazards and OLS regression approaches, Coale-McNeil results are presented for alternative specifications involving combinations of dependent variables (especially the mean of the observed schedule versus the mean of the observed schedule and the standard deviation) and independent variables (education alone, childhood residence alone, and both simultaneously). Models estimating the mean of the observed schedule while the standard deviation is fixed are most parsimonious, yet for some countries and cohorts useful information regarding origin age of the observed distribution and the pace at which 1st marriages occur is lost by fixing the standard deviation. With regard to effects of the 2 covariates examined, both have independent effects that are consistent across countries, but the net effects of educational level are greatest. On balance, the Coale-McNeil model seems to fare well with a wide range of marriage patterns and produces estimates of the mean age at marriage that are superior to those based on regression, particularly because in the later application one is confronted with awkward decisions regarding age cutoffs. However, use of the Coale-McNeil model and associated software also involves some difficult tradeoffs. The dependence of results on the (frequency arbitrary) level set for the proportion ultimately marrying was considered elsewhere. Here, the authors note the choice between parsimony and detail that underlies the decision whether to fix the level of standard deviation. (author's modified)
Data from the 1975 Bangladesh Fertility Survey were used to analyze the relationship between female education, labor force participation, and age at marriage on the 1 hand and fertility and use of contraception on the other hand. It was hypothesized that the 3 aspects of women's status would be positively associated with contraceptive use and negatively correlated with fertility. Education emerged as the variable most strongly correlated with contraceptive use; current use of contraception ranged from 8% among those with no education to 42% among women with a secondary education or above. A similar pattern was noted between age at marriage and contraceptive use. Current use increased from 11% among women married below the age of 15 years to 32% among those who married at age 22 years or above. On the other hand, current use of contraception was only 2 percentage points higher among women who had ever worked (14%) than among those who had never worked (12%). Age at marriage was found to be the most important variable explaining fertility behavior. Women who married under the age of 15 years had an average of 4.22 children compared to 1.77 among those who married at 20-21 years of age and 2.65 among those marrying at age 22 years or above. The number of children ever born declined from 4.15 among women with no education to 1.96 among those with at least a secondary school education. Labor force participation did not exert as strong an effect on fertility: women who had ever worked had an average of 4.24 children compared with 3.85 among those who had never worked. The general associations noted in this study were stronger among urban than rural women. These results point to a need to improve women's status, particularly female education, and also to raise the age at marriage to obtain more widespread use of contraception and lower fertility levels.
[Perinatal mortality risk factors in a case-control study]
This work describes a cross-sectional case-control study conducted in a marginal area of the city of Leon, Guanajuato, Mexico, to identify risk factors for perinatal mortality. 104 deaths identified in the civil register as occurring during 1982 in the study area were each matched to 2 controls selected from the same district and with birth dates within 30 days of the case. Perinatal mortality was defined as occurring between the 27th week of pregnancy and the 7th day after birth. 39 factors were stuided, including 10 socioeconomic factors, 6 maternal factors such as weight, height, and smoking, 10 factors concerning obstetrical history, 4 factors related to pathology during pregnancy, 6 factors referring to labor and delivery, and 2 concerning medical attention. In the univariate analysis, 18 factors were significant: unmarried or illiterate mother, maternal age under 17 or over 35, more than 7 previous births, previous perinatal death, less than 30 weeks or more than 200 weeks between pregnancies, hypertension, hemorrhage in the 2nd half of pregnancy, morning edema of pregnancy, no prenatal care, and birth attended by midwife. Some factors were eliminated because they were found to be dependent on a 2nd factor, and factors linked to perinatal events were also eliminated. A final model achieved after discriminant function analysis included 8 risk factors for perinatal mortality: 1) less than 30 weeks between pregnancies 2) more than 200 weeks between pregnancies 3) hypertension during pregnancy 4) maternal age under 18 5) maternal age over 35 6) unmarried mother 7) previous fetal deaths and 8) no prenatal care.
Fertility and family formation. Some trends among Danish female cohorts born between 1932 and 1967.
Focusing on Denmark, this paper presents a few descriptive graphs concerning the annual number of live births between 1901 and 1982 and cumulative fertility rates at selected ages of the female cohorts born between 1901-62. Contour plots of the various cumulative incidence rates and fertility hazards are displayed further. The paper discusses a number of marital fertility differentials and mentions parity-specific fertility of all women (i.e., aggregated over marital status) and of single women. It also considers some cohort changes in formation and dissolution of marriage, and points out some wider perspectives for research in Danish fertility. Second births occurred with almost the same intensity as first-births, at least if all women are considered. The proportions of women staying childless up to given ages have been subject to continued increase, and there is a clear tendency to postpone childbirth to the more mature ages. The study disclosed the existence of continued great differences in cohort fertility within, and between, the formal married states considered. Women entering the childbearing ages after 1968 and being married have a much lower fertility in the observable age span than the cohorts born prior to 1950. At the same time the fertility of unmarried women has increased from age 22 among the cohorts born after 1940-41. Frequently made observations in the literature are that education, childbirth, and occupational employment are interacting processes covering long and overlapping segments of the life cycle of the individual female. Moreover, efficient and easily applicable contraceptive methods are readily available for the woman and her sexual partner, and the right of terminating a pregnancy by induced abortion before the 29th week has been established by law since 1973. Little objective knowledge exists on how social, economic, and cultural change relate to family formation. 2 complementary avenues could be followed to enhance the present level of knowledge and understanding: a file consisting of data on childbirth, survivorship, change of formal marital status, and alteration of postal address, altogether at the level of individuals, could be extracted from the computerized National Population Register established in 1968; and resort may be taken to recurrent sample-based retrospective fertility surveys of the World Fertility Survey type.
The formation of family size ideals.
Using family size ideals, this paper examines how Finnish families form plans concerning family size. Ideals at 3 different stages of life were compared to form ideal types, which are assumed to measure the varying development of family size ideals in families. Resources for well-being are assumed to be associated with the family's ability to plan family size. Thus, the different ideal types are described according to resource variables found to be significant in the differeng age groups. 13 types were formed on the basis of congruence or incongruity between the ideal at the beginning of the marriage and desired and expected family size. It was assumed at first that the types measured what they appeared to measure. On this basis, it was felt that 4 main types could be differentiated: ideals have remained the same at all stages; the original ideal has been corrected and this corrected ideal has been realized; the couple has been prevented from realizing their ideal; and the couple has been unsucessful in realizing their ideal. The final typology formed on the basis of the temporal development of family size ideals was composed of the following types: families whose ideals were congruent, 949 or 39.1%; families who realized a corrected ideal, 567 or 23.4%; families prevented from realizing their idea, 467 or 19.2%; and families unsuccessful in realizing their ideal, 444, 18.3%. The data of this cross-sectional study composed of 19-45 year old women set limits, to begin with, on the study of how ideals developed over time. The ideals did not follow each other in the same temporal sequences in all the families. The women, who were at different stages of life at the time of the interview, were asked to state all the goals at the same time. Thus the actual life situation of the interviewee could not help having an intentional or unintentional effect on the stated ideals. Because the analysis describing the development of family ideals over time included only those interviewees who had given an ideal number of children for all 3 life stages, only 44% of the original data could be included. The picture of the formation of family size ideals in families and the resources for welfare associated with it, made by comparing the family size ideals of people at various stages of life, conformed to expectations. Among families who had completed their childbearing phase, those who had been unsuccessful in reaching their ideal differed from those who had acted according to plan, in that their resources for welfare were weaker. The family's welfare was weaker in this type; the wife was more rarely employed and the municipality where they lived was less developed and in a more sparsely settled region than among the types who acted according to a plan among the ideal-congruent or the prevented types. The development of family size ideals over time provided above all a demonstration of how problematic it is to study the formation of ideals when cross-section research is used, which includes interviewees at different stages of life.
Demographic perspectives on Saudi Arabia's development.
Demographic movements likely to be taking place in Saudi Arabia were hypothesized on the basis of general knowledge. The discussion reports on population size, general Arab demographic patterns, general determinants of fertility, Arab fertility patterns, Saudi fertility patterns, mortality in general, mortality in the Middle East, mortality in Saudi Arabia, Saudi Arabian population growth, immigration, the changing composition of the work force, and third plan targets. Some doubt exists as to the size of Saudi Arabia's population, but there is little question that the total is growing rapidly. This expansion is taking place through stepped up immigration and a relatively high natural growth of indigenous Saudis, but statistics on population size, structure, and on the number of births and deaths leaves the magnitude of a number of important demographic trends in doubt. Yet, considerable evidence exists that several of the Arab countries in the region with fairly good demographic data are likely to have similar demographic patterns. In depth analysis of the demographic dynamics of these countries, particularly Jordan and Kuwait, identified several common elements bearing on several key parameters. Using what Saudi data is available and making comparisons with these neighboring countries, one can, based on expected levels of birth and death rates, indirectly infer the natural growth of Saudi Arabia's population. With several notable exceptions, Saudi Arabia's demographic patterns show a marked similarity to those experienced in the region as a whole. The average rate of population growth in both Saudi Arabia and the Arab region is about 3% a year and in both instances fertility rates are high. The demographic structure of these countries is characterized by the youthfulness of the population. In most of the Arab countries, the population aged 15 years or under accounts for over 48% of the population. The rate of the economically active population is low, ranging from 22% to 32% of the total population, with the female participation rate varying from 3.5% to 18.5%. In the nonagricultural sector, the average activity rate of women over the age of 15 usually does not exceed 6%. Arab countries are also characterized by their high infant mortality rates. In 1975 these rates ranged from 60 to 200/1000. Illiteracy rates for the group, as a whole, are also high, and they are significantly higher among women than among men. A multipurpose survey conducted in Saudi Arabia during 1976 and 1977 reported a live birthrate of 54.2/1000. This is somewhat above the UN figure of 49.5 for the country and over the average for Arab countries of 46.6 for 1975. The mortality rate for the Saudi population is 14.1/1000. If one accepts the birth and death rates indicated by the multipurpose survey, the population is growing at a national rate of 3% or more per year.
1983 Taiwan-Fukien demographic fact book, Republic of China.
This statistical abstract for the Taiwan Fukien area contains 91 detailed tables on age composition, educational status, economic characteristics, marital status, fertility, mortality, marriages, and divorces. Appendices include abridged life tables by sex and statistics on households, population size, population growth, and natural increase.
The beginnings of family limitation in the three towns of the Sudan.
This study examines the beginnings of fertility decline in the Three Towns of the capital of the Sudan: Khartoum, Khartoum North, and Omdurman. In 1975, 2673 married women, aged 15-59, completed a survey on basic demographic and socioeconomic variables and birth control practices. Part 2 of the survey, containing more detailed questions on birth control, was administered to respondents who had used some method of birth control. Large families are desirable in traditional Sudanese society: total marital fertility is 7.3. Wives who demonstrate 2 major indicators of modernization: 1) education, and 2) accompanying their husbands to public entertainment also achieve the lowest fertility. Other modernizing variables significant in decreasing fertility are: 1) working outside the home, 2) the occupation of wife's father, 3) a wife who eats meals with her husband, and 4) a wife who visits friends with her husband. One intermediate variable, age at marriage, is found to reduce fertility. Completed family size is 7.8 for women married earlier than age 15, and 4.4 for women married after age 20. Age at marriage is directly influenced by education. The intermediate variable use of family planning methods does not contribute to declining fertility when compared to the 2 major modernizing variables. In Sudan, where more than 1 in 5 women are currently using some family planning method, contraception is used to space rather than to limit births. 97% of respondents know at least one modern method of contraception, the pill. Women who demonstrate modernizing behavior, such as more education, owning luxury goods, and eating meals with their husbands, know more methods. In urban settings, the availability of the pill without prescription may promote contraception more than intensive family planning programs. Women's education and the modernization that accompanies education are changing traditional family relationships in the Three Towns and causing lower fertility.
Curriculum development in population education.
The 6th volume of a bibliography series on population education issues and problems, this bibliography with abstracts describes 70 publications on curriculum development for population education programs. Separate chapters cover curriculum development in the formal education system, in nonformal educational systems, in specific subject areas, in the Asia and Pacific region, national experiences with programs, and evaluation and research. The bibliography cites publications that show how countries put population education into their school curriculum, what problems they face, and the solutions they developed to deal with these problems. The abstracts highlight changing trends in population edcuation. Publications from 1969 to 1984 are included.
New developments in nutrition education.
This is an edited collection of some of the papers presented at the University of London Institute of Education conference on New Developments in Nutrition Education, held in July 1983. The conference was organized in recognition of the need to improve the quality and effectiveness of in-and out-of-school nutrition education in both developing and developed countries. The papers include such topics as nutritional disorders and the general need for improvement of nutritional education. More specifically, the need for nutritional education in primary schools is stressed because many people with poor nutrition also never receive schooling beyond the primary level. Many papers address the importance of the training of nutrition teachers and researchers, while others point to the need for a greater effort to evaluate nutrition projects once they have begun. Non-formal approaches and the use of mass media in nutritional education are explored in other papers. The monograph concludes with a look toward nutrition in the future.
Women's work and fertility: is there a negative relationship?
This paper expands on studies examining dichotomous relationships between employed and non-employed females and their relative fertilities, discussing types of employment. An initial look at employed females in Korea appears to show a higher fertility and expected and desired fertility, and a low use of contraception and abortion. Controlling for more factors yields that those who work at home, are employed or earn income have lower fertility. After adjustments are made for wife's education and marital duration, nonfarm workers show lower fertility for many aspects. In a further subdivision of traditional and modern (based on more formal relationships) sector jobs, modern sector workers showed lower and farm workers higher fertility than non-employed females. Longer modern or traditional sector work negatively affected fertility. Breakdown of working sectors shows the effects of place of residence and income: urban, white collar, and higher income women have lower fertility. Divorce and subfecundity do not appear to be hidden affectors of fertility for working women. The hypothesis that a negative relationship will exist between work and fertility only for work incompatible with childcare is not supported by this data. A better comprehension of employment factors on fertility in Korea will require a better understanding of sex role norms.
This article examines the chances of survival of children, their way of life an their health in countries around the world. Statistics of the number of children show constant number in developed countries, but an ever increasing rate in developing countries. Having children is the only way the poor can increase their capital. Large families mean a rapid population increase. Some countries have a population growth rate of over 3%, some cities growing at a rate of 7% or more. This results in a dramatic effect on children. UNICEF has identified several priorities essential for child survival and development: oral rehydration, immunization, breast feeding and growth monitoring. Other important priorities are family planning through child spacing, food supplements to priority groups and female literacy. Each of these is briefly discussed, as well as improving health care. Oral rehydration is the main form of treatment for diarrhea and mothers should be taught how to prepare oral rehydration solution and how to administer it. Diptheria, tetanus, whooping cough, tuberculosis, polio, and measles are responsible for 5 million deaths of children in the South which can be prevented by immunization. A study involving 200 babies in India clearly showed the advantages of raw breast milk in preventing infection. A major disadvantage of artifical or formula feeding is that women rapidly become pregnant again. Another pregnancy results in less contact with the 1st infant. Brain growth occurs mainly before birth and during the first 2 years of life and therefore should be a priority period in child care. Poor maternal health results in low birth weight infant. Physician training is important in influencing physicians to detect disease and also to provide preventive and promotive health care. Improving health care will not, however, drastically reduce mortality since income and income distribution are major contributing factors to the problem.
The number of children per woman is between 6 and 7 children in Black Africa. Infertility and poor fertility existing in certain regions of Africa only appear in results concerning central Africa. 6-10% of births occur in women between the ages of 40 and 50. It must be noted that the goal of the majority of societies in Black Africa is to have numerous descendants. Factors of fertility in Africa examined are: precocious marriage, a long period of exposure to the risk of pregnancy, birth spacing and pathological infertility. The paper also discusses modern contraception and birth control, the improvement of sanitation conditions as part of the battle against infertility and infant mortality, combating infertility, decreasing infant mortality and governmental attitudes toward fertility control. Despite the efforts of several private and governmental agencies to promote family planning, progress in Africa has been modest. In the majority of Black African countries, women do not have access to contraception. In rural areas, the absence of an administrative infrastructure prevents diffusion of information and access to contraception. Improving general health conditions has 2 consequences on fertility: it reduces infertility due to diseases that cause sterility and it reduces infant mortality which affects birth intervals. So far birth control has only been successful among the very educated women. However, a great potential for more users exists.
Preventive and promotive health care frees the poor from ill-health to enable them to work, educates them, and enables them to use resources better. A rural health and development program operates in Tamil Nadu, South India, serving 100,000 people in 83 agricultural villages, 3/4 of whom live below the Indian poverty line. Administered by the Rural Unit for Health and Social Affairs (RUHSA) of the Christian Medical College, Vellore, the project objectives were to decrease infant and age-specific toddler mortality by 25%, birth rates by 30%, increase birth intervals, increase facilities and personnel for better access, improve antenatal care, and immunization and economic status, establish womens' clubs, nursery schools, and youth organizations, achieve general personnel awareness, and establish village advisory committees. An evaluation study chose 3 villages within the service area: a headquarters, peripheral service center, and a village with a modicum of services, and 3 comparable villages outside, all of similar economic modes, customs, and language. 352 families with children under 5 were surveyed in total, and data were gathered on child mortality. Child deaths are distinctly related to land holding, income, caste, and mother's education in both project and comparison villages, but a lower relationship to poverty indicators exists for the project villages. A survey of older respondents indicates project villages had child mortality rates similar to nonproject villages previous to the project's initiation. The most significant health activities were under-5s' clinics, antenatal care, immunization care, and safe water provision. 134 of 178 project village households took advantage of antenatal care clinics. Only 80/174 comparison village households did. Figures for adequate immunization were 132/178 and 58/174 respectively.
Intercity variations in returns to migration.
This study focuses on 1) whether socioeconomic returns to migration vary across places of destination, and 2) whether this variation reflects labor supply and demand differentals and/or other characteristics of places of destination. The results analyze the data from 113 Standard Metropolitan Statistical Areas (SMASs) from the 1970 census, and 35 SMSAS in 1976, and address the question of whether the socioeconomic returns of migrants are enhanced or reduced by choice of destination. Previous studies point to a number of factors that influence interarea variation in wages and income levels, such as industrial structure, city size, cost of living, and environmental and social/cultural amenities; of these, city size is often identified as being the most important factor. Migrants are in a more favorable position if the demand for labor is high and if there are a limited number of potential workers in the area to fill particular kinds of positions. The educational level of a migrant has a statistically significant effect on both his occupational status and his annual earnings. Specifically, the socioeconomic returns of migrants who have completed at least one year of college are more sensitive to changing labor market conditions than those migrants who have completed no college education. Moreover, changes in socioeconomic returns between 1970 and 1976 are not related to changing labor market conditions.
Urban poverty in Malaysia: its profile and impact of programmes implemented towards its eradication.
The aim of this study is to analyze the current profile of poverty in poor areas in 4 metropolitan centers in peninsular Malaysia, and the impact of programs for uplifting living standards of residents in these areas. Relative income measure stresses real relative economic inequality: useful poverty theory should take relationships to the larger society into account. There has been considerable study of urban poverty in Malaysia, a recognition of a need for poverty eradication programs, and an understanding of mechanisms governing their impact, e.g. organizational factors and household participation. Selection of a sample of households to be studied is outlined: the result is a sample population of 1948 ethnically diverse households in several cities. A profile of socioeconomic conditions in urban poverty areas is given, as measured by subdivided economic indicators of economic, educational, health, public services, and fertility statuses, and level of general satisfaction with the poverty eradication program. Detailed studies of the data are made for each ethnic group. The organization and impact of programs are examined: the accessibility of daily services to households, the efficiency of service delivery, and the accessibility of nondaily household services have a considerable effect on the programs' impact. A conclusion outlines policy implications under general categories of economics, education, health, fertility, and public service access. Definitions of poverty lines and the enumeration of poverty areas, income generation projects, school attendance and housing projects will all need to receive special attention. Installations should maintain good community relationships, and the staff should include individuals linguistically proficient in the main dialects of the urban poor. An appendix to this study is a copy of the questionnaire.
[The end of the decade on women and its impact on development in Rwanda]
This paper outlines steps taken by Rwanda to promote the improved status of women during the International Decade of Women from 1975 to 1985. The manifesto of the 1959 Social Revolution affirmed the quality of women and their right to vote, among other rights. An initial meeting of 200 Rwandan women in 1975. Caused some consternation among the authorities, but the same year saw female personnel in the armed forces. Rwanda is in a good position internationally, having been the 1st African nation to ratify the international convention on the elimination of all descrimination against women. 97% of Rwandan women are employed in the agricultural sector, which is central to the economy, and which is likely because of land ownership and topographic realities to continue to be subsistence oriented. In addition to domestic duties, which include distant transportation of water, the norm is for a woman to work twice as many hours daily as a man, yet not be a principal decision maker in agricultural committees. Only 4.9% of girls had finished primary school in 1978, and 74.4% were illiterate. In an environment of a generalized educational shortage, only 27 secondary schools exist for girls, 49 for boys. Girls are trained principally for professions such as secretaries and midwives; only 4.9% of the student body in agronomy programs in the university is female. Women are notably absent in the decision-making process in the home and all other institutions. There is an acute need for female-oriented health care programs such as maternal child health and family planning. Planning for the improved status of women will benefit from more action outside of women's committees.
This study examines 3 years of panel data (1977, 1978, 1979) on responses of 2111 women from Matlab thana in rural Bangladesh to test a procedure for measuring underlying motivation to practice family planning. The logic of the analysis is related to the observation that many characteristics of women correlate in some way with contraceptive use, and each variable thus reflects motivation to some degree. The analysis uses maximum likelihood logit regression to examine the net effect of 8 predisposing variables on the prediction of behavior and to illustrate the underlying complexity of family planning motivation. The aim is to test whether a single survey can be used to construct a scale that reliably predicts behavior. Described 1st are the data and the model; presented next are bivariate relationships for characteristics of users with prevalence of use at 3 successive points in time. The independent variables studied include desire for more children, number, age and sex of living children, maternal age, husband's education and occupation and wife's education. Results indicate that among non-users who said they wanted no more children, 34.2% were users in round 2 (1978) and 42.3% in round 3 (1979). The data, however, suggest that current behavior in round 1 was a better predictor than attitudes: among 1979 users, the proportion of subsequent users was 72.0% in 1978 and 64.3% in 1979 as opposed to 20.5 and 26.0 among 1977 non-users in 1978 and 1979, respectively. The bivariate relationships suggest that characteristics of users and non-users differed markedly throughout the study period, but that differentials diminished with time. By 1979, users and non-users were more similar than in 1977 when the project had just begun. Results suggest that variables such as living children and living sons strongly affect attitudes, which, in turn, affect ultimate use. Variables such as socioeconomic status had a direct effect on motivation that was independent of stated attitudes. While results show that each effect was significant, no single variable reliably predicted use of contraception. Since coefficients are additive, however, results permit examination of the combined predictive power of a set of characteristics. For example, among contracepting women in 1977 who were educated, who intended to use in the future, and wanted no more children, 98% were using in 1979. Results thus suggest that questions in knowledge, attitude and practice (KAP) surveys elicit responses that measure different aspects of the motivation to contraception. For purposes of analysing KAP data, it is appropriate to use multidimensional scaling to produce a composite index for predicting which individuals will ultimately use contraception when services are made readily available.
In October 1977, a Family Planning and Health Services Project (FPHSP) was introduced in 70 villages in a rural area of Bangladesh in Matlab, Comilla district, to test the hypothesis that a latent demand for contraception exists which can be fulfilled with comprehensive family planning and selected maternal and child health services. An additional 79 villages served as comparison villages. Pre-project treatment-comparison area differentials for the socioeconomic and demographic characteristics of the population studies were, for the most part, inconsequential: the age composition of women, family size, and structure of dwelling units, and occupational categories are similar in treatment and comparison areas. Only the religious composition varies appreciably and this, in turn, correlates with the type of education. Of the total number of married women of reproductive age, 15.3% are Hindus while the rest are Muslims. However, there is a higher proportion of Hindus in the treatment area than in the comparison area--19.7 versus 11.0%, respectively. While the religious differentials are not likely to directly affect the results of the FPHSP, there may be indirect effects through the correlation of religion with the source of education. The preponderance of Hindu women in treatment areas tends to decrease the overall proportion of the population exposed to religious education at "Maktab," a Muslim institution. One could hypothesize that Maktab education fosters more conservative views on family planning. Since there are more Muslims in comparison areas and they, in turn, have a higher Maktab component one can hypothesize that the adoption rate in the comparison area is affected by the high prevalence of Maktab educated women. Educational type and religion therefore bear careful consideration in the interpretation of FPHSP results.
[The potential of young adults]
The characteristics of the population aged 15-24 in Indonesia are outlined. Information is included on educational status, unemployment, economic sector of employment, and occupation. The need to integrate more effectively the potential of the young population into the development process is stressed. (summary in ENG) (ANNOTATION)
Nuptiality pattern in rural Bangladesh
This study of nuptiality patterns in rural Bangladesh is based on Demographic Surveillance System (DSS) data from 159 villages and a total population of almost 175,000. Households were visited weekly during the study period 1975-1979 for the purpose of registering vital statistics, including marriages. Detailed information is presented on distribution of the population by age, sex, and marital status; seasonality of marriages; age at first marriage by sex; age difference between husbands and wives; and differentials in age at first marriage by education and by occupation of husband. Age at first marriage of females is found to have risen continuously between 1975 and 1979.
Age at marriage differentials in Ghana (West Africa): a multivariate analysis
An analysis of age at first marriage and its determinants is presented for rural Ghana. Data are from a 1972 DANFA Comprehensive Rural Health and Family Planning Project survey that included interviews with 778 husbands and 857 wives. Multivariate techniques are used to evaluate the following factors: age at menarche, education, occupation, religion, ethnicity, monogamous or polygamous marriage, marriage arranged by family or chosen by couple, and number of previous marriages. Results of the analysis show number of previous marriages to be significantly correlated with age at first marriage for both husbands and wives, monogamous or polygamous marriage to be a determinant for husbands, and age at menarche, education, occupation, and ethnicity to be determinants for wives.
Basic automated birth yearbook: North Carolina residents, 1984 (microfiche edition).
This report, on microfiche, which is often referred to as "The Baby Book," contains statistical tables by region and county for 1984 for North Carolina numbers and percentages of resident live births, classified by selected infant and maternal characteristics. Maternal characteristics include maternal age, marital status, race, education, month prenatal care began, number of prenatal visits, and previous fetal deaths. Infant characteristics include birth order, birth weight, Apgar score at 5 minutes, and congenital malformations. (author's modified)
Contributions of migrants to local labor force changes in different-sized nonmetro places.
Using a 1979 statewide survey of registered voters in Kentucky, this study focuses on the consequences of the migration turnaround for the human capital of nonmetropolitan places. Specifically analyzed are 2 questions: 1) do migrants differ from nonmigrants in different types of nonmetropolitan places, and 2) are there differences in the socioeconomic characteristics of migrants to different types of nonmetropolitan places. The human capital variables included in this study are age, education, occupation, and income. Past research indicates that, in general, migrants have higher educational attainment and socioeconomic status than nonmigrants. While exploring variations in the types of nonmetropolitan places of destination chosen by immigrants, it is necessary to examine the socioeconomic differences among these migrants and how this turnaround affects the local labor force. Results show that: 1) regardless of origin, migrants of nonmetropolitan counties are most likely to move to small places in nonadjacent nonmetropolitan counties; 2) migrants of small nonmetropolitan places have a higher educational, occupational, and income level than residents; 3) nonmetropolitan inmigrants from metropolitan areas appear to be older and to have higher educational and occupational status than nonmetropolitan inmigrants from other nonmetropolitan areas; and 4) migrants from other nonmetropolitan areas are younger than migrants from metropolitan areas, and they have a lower level of education. While these results are significant to a single state at a single point in time, they suggest the following: 1) there are significant socioeconomic differences among migrants to different types of nonmetropolitan places; 2) migrants to adjacent nonmetropolitan places report higher mean socioeconomic scores than migrants to nonadjacent nonmetropolitan places; 3) within these categories, size of nonmetropolitan destination is positively associated with socioeconomic status. The implications of these findings show that small nonmetropolitan places are receiving migrants with significantly higher socioeconomic status than the residents of those places. Overall, in the 1970s Kentucky's migration contributed to a redistribution of human capital such that the smallest nonmetropolitan places have experienced gains from