International Journal of Population Research The latest articles from Hindawi Publishing Corporation © 2015 , Hindawi Publishing Corporation . All rights reserved. Predictors of Contraceptive Adherence among Women Seeking Family Planning Services at Reproductive Health Uganda, Mityana Branch Wed, 15 Apr 2015 11:24:17 +0000 Poor adherence is one of the main causes of unintended pregnancies among women of reproductive age. The purpose of this study was to establish the predictors of contraceptive adherence. A total of 211 women were enrolled and interviewed while seeking family planning services at reproductive health Uganda facility. Binary logistic regression was used to analyze the association between adherence and the independent variables. Most of the respondents (83.4%) were currently using a hormonal contraceptive. Of the participants who were using contraceptives, 43% had discontinued use at some time for reasons other than pregnancy, 53.1% reported having short birth interval less than 2 years, and 7% reported having more children than desired. The predictors of poor contraceptive adherence included lower education level (OR 2.484, 95% CI 1.403–4.397) and lower self-efficacy (OR 1.698, 95% CI 1.959–3.004). Lack of male partner support (OR 2.014, 95% CI 1.140–3.557) and low education level (OR 2.103, 95% CI 1.196–3.699) were predictive of reporting short birth interval less than 2 years. The findings point to a number of predictors of contraceptive adherence that may have implications for designing and evaluating family planning programs. In the Ugandan context, studies to evaluate effective adherence improvement strategies are needed. Richard Muhindo, Joyce Nankumbi Okonya, Sara Groves, and Michelene Chenault Copyright © 2015 Richard Muhindo et al. All rights reserved. Inequality in the Utilization of Maternal Healthcare Services in Odisha, India Tue, 31 Mar 2015 14:20:28 +0000 Odisha, one of the socioeconomically disadvantaged states of India, registers high maternal deaths. The state features wide regional and sociodemographic diversity with the Koraput-Balangir-Kalahandi (KBK) districts, dominated by disadvantaged tribal population. This study aims to assess the level and pattern of maternal healthcare services utilization among different subgroups of women in Odisha with a special focus on the regional, economic, and educational inequality using the latest District Level Household and Facility Survey (DLHS-III, 2007-08). Descriptive statistics and bivariate and multivariate analysis were used to understand the pattern of utilization of maternal healthcare services among women by different background characteristics. Concentration curve and decomposition analysis were used to understand the inequalities in utilization of maternal healthcare services and contribution of different socioeconomic factors. Results reveal wide regional variation in the utilization of maternal healthcare services. The utilization of maternal healthcare services is more concentrated among affluent households. Economic inequality in safe delivery is high. Decomposition analysis shows education as the leading contributor in explaining maternal healthcare services utilization. Enhancing literacy among women and improving of health infrastructure and its quality in rural and disadvantaged regions may be prioritized to improve the maternal health in Odisha. Ranjan Kumar Prusty, Jitendra Gouda, and Manas Ranjan Pradhan Copyright © 2015 Ranjan Kumar Prusty et al. All rights reserved. Occurrence of Pregnancies among HIV Infected Indian Women: Does Knowledge about HIV Status Make a Difference? Tue, 24 Feb 2015 09:28:53 +0000 This is the first study to examine the behavioural effect of HIV on fertility among HIV infected women in India. Retrospective calendar data from ever-married HIV infected women between 15 and 45 years of age, attending a specialized HIV clinic in Pune, Western India , were analysed. Directly standardized overall and parity-specific pregnancy rates were compared among HIV infected women before and after coming to know about their HIV status. The age- and parity-standardized pregnancy rates and age-standardized parity-specific pregnancy rates were statistically significantly lower after knowing about HIV status as compared to before the HIV status was known. Analysis of parity-specific rates suggested lower likelihood of HIV infected women to progress to higher parity. The clear behavioural impact of HIV on fertility observed should be taken into account while estimating HIV infected pregnant women in the country. Ensuring access to information and services for PMTCT to HIV infected couples is essential to support informed reproductive decision making among them. Shrinivas Darak, Inge Hutter, Sanjeevani Kulkarni, Vinay Kulkarni, and Fanny Janssen Copyright © 2015 Shrinivas Darak et al. All rights reserved. Race, Socioeconomic Status, and Age: Exploring Intersections in Preterm Birth Disparities among Teen Mothers Thu, 12 Feb 2015 11:23:53 +0000 Few studies have examined disparities in adverse birth outcomes and compared contributing socioeconomic factors specifically between African-American and White teen mothers. This study examined intersections between neighborhood socioeconomic status (as defined by census-tract median household income), maternal age, and racial disparities in preterm birth (PTB) outcomes between African-American and White teen mothers in North Carolina. Using a linked dataset with state birth record data and socioeconomic information from the 2010 US Census, disparities in preterm birth outcomes for 16,472 teen mothers were examined through bivariate and multilevel analyses. African-American teens had significantly greater odds of PTB outcomes than White teens (OR = 1.38, 95% CI 1.21, 1.56). Racial disparities in PTB rates significantly varied by neighborhood income; PTB rates were 2.1 times higher for African-American teens in higher income neighborhoods compared to White teens in similar neighborhoods. Disparities in PTB did not vary significantly between teens younger than age 17 and teens ages 17–19, although the magnitude of racial disparities was larger between younger African-American and White teens. These results justify further investigations using intersectional frameworks to test the effects of racial status, neighborhood socioeconomic factors, and maternal age on birth outcome disparities among infants born to teen mothers. Sheryl L. Coley, Tracy R. Nichols, Kelly L. Rulison, Robert E. Aronson, Shelly L. Brown-Jeffy, and Sharon D. Morrison Copyright © 2015 Sheryl L. Coley et al. All rights reserved. Theories of Urban Dynamics Tue, 16 Dec 2014 00:10:09 +0000 This paper reviews the existing analysis framework for territorial dynamics and urban growth and proposes a taxonomy of interpretive theories as well as a critical review. Specifically, the paper aims to provide four innovations to existing knowledge in this field as follows: firstly, a clear presentation of how the data of population growth of each habitat type have appeared and their academic interpretations; secondly, a reclassification of interpretative theories into three groups: the counterurban, the post-fordist, and the cyclical theories; thirdly, with the ultimate goal to analyze the suitability of interpretations to the reality, a taxonomic proposal of habitat categories being made; fourthly, the final one refering to the balance of the theoretical to the empirical reality, in light of the data currently available, using the considered methodologies. That balance allows collecting positive elements of each theory and pointing to the possibility of developing a theory of synthesis. Manuel García Docampo Copyright © 2014 Manuel García Docampo. All rights reserved. Assessing Net Coverage for Young Children in the 2010 U.S. Decennial Census Tue, 18 Nov 2014 08:17:35 +0000 The U.S. Census Bureau’s Demographic Analysis shows that the population aged 0 to 4 experienced a net undercount rate of 4.6 percent in the 2010 Decennial Census. This is more than twice as high as any other age group. Despite the fact that the relatively high net undercount of young children was uncovered more than fifty years ago, this problem has received little systematic attention from demographers. To help fill that gap in the literature, this study examines the accuracy of the count of children in the 2010 Decennial Census. The initial focus on all children shifts to a focus on young children (aged 0 to 4) where the net undercount rate is the highest. Discussion highlights some of the potential explanations for the findings. William P. O’Hare Copyright © 2014 William P. O’Hare. All rights reserved. Explaining Sex Differentials in Child Mortality in India: Trends and Determinants Thu, 06 Nov 2014 09:36:16 +0000 This study has twofold objectives: (1) to investigate the progress in sex differentials in child mortality in India in terms of within and between group changes and (2) to identify the factors explaining the sex differentials in child mortality and quantify their relative contributions. We have used three rounds of the National Family Health Survey (NFHS) data, 1992 to 2006. Life table approach and Pyatt and Oaxaca decomposition models were used as methods of analyses. The results revealed that though sex differential in child mortality is still high in India, it declined during 1992 to 2006 (Gini index from 0.36 to 0.24). This decline was primarily led by a change in within inequality of female child mortality (Gini index from 0.18 to 0.14). Among the selected predictors, breastfeeding (40%), birth order (24%), antenatal care (9%), and mother’s age (7%) emerged as critical contributors for the excess female child mortality in India. From the findings of this study, we suggest that any efforts to do away with gender differences in child survival should focus more on within female child disparity across different population subgroups alongside male-female disparity. Implications are advanced. Shrikant Kuntla, Srinivas Goli, and Kshipra Jain Copyright © 2014 Shrikant Kuntla et al. All rights reserved. Disparities in Health Outcomes of Return Migrants in Mexico Tue, 28 Oct 2014 06:35:12 +0000 Objective. The epidemiological paradox posits that immigrants in USA experience better health outcomes than nonimmigrants with similar socioeconomic status. However, little is known about the development of health problems over the life course for immigrants who return to their country of origin. Methods. The Mexican Migration Project provides detailed information on immigration, health, and socioeconomic status for 671 unauthorized migrants, 101 legal migrants, and 3,748 nonmigrants. Cox regression estimated the adjusted hazard of developing hypertension, diabetes/prediabetes, poor mental health, and heart and lung problems. Results. Legal immigrants to USA did not have a significantly higher risk of having a self-reported diagnosis of hypertension, diabetes, heart or lung problems, or poor mental health compared to nonmigrants. However, the hazard ratio for unauthorized deported immigrants ranged from 2.25 (CI: 1.29–3.93) for diabetes to 4.43 (CI: 2.33–8.40) for poor mental health compared to nonmigrants. Conclusions. Health problems occur several years earlier among unauthorized immigrants compared to individuals who never migrated. Poor access to healthcare services combined with USA lifestyle and working conditions after migration to the USA may contribute to an increased risk for the development of chronic health conditions later in life. Fernando A. Wilson, Jim P. Stimpson, and José A. Pagán Copyright © 2014 Fernando A. Wilson et al. All rights reserved. Population Projections for Sparsely Populated Areas: Reconciling “Error” and Context Sun, 14 Sep 2014 00:00:00 +0000 Population projections are increasingly utilised as tools for understanding and modelling the economic, social, and environmental futures of sparsely populated areas. This study examines issues around “fit for purpose” for the application of projections to remote contexts. We focus on projections made for the Northern Territory of Australia, a jurisdiction in the north of the country, to assess the relative accuracy of projections over time. The results conclusively demonstrate the reduced accuracy of remote population projections. Nevertheless, the exercise of comparing and contrasting the accuracy of projections provides a useful lens for understanding demographic and other issues which necessitate that approaches for developing and utilising projections can and should be different in sparsely populated areas. We provide examples of alternative approaches to projections and the analysis of errors which researchers and analysts in sparsely populated areas might apply to other jurisdictions. Andrew Taylor Copyright © 2014 Andrew Taylor. All rights reserved. Gender and Reproductive Outcomes: The Effects of a Radio Serial Drama in Northern Nigeria Sun, 14 Sep 2014 00:00:00 +0000 A large body of evidence has documented the effectiveness of mass-media communication programs in increasing family planning use and changing reproductive behavior. But the potential impact of these programs on the mediating role of gender norms has not been systematically assessed in Nigeria. Regionally representative cross-sectional end line data collected for the evaluation of a long-running entertainment-education radio serial drama program aired in northern Nigeria are examined for program effects on both reproductive and gender outcomes as well as the relative effect of gender on reproductive outcomes. The drama was popular, with 70% of the sample listening weekly. Results show that the drama positively impacted both sets of outcomes especially the reproductive outcomes. Results further indicate a strong relative effect of gender on reproductive issues. Fatou Jah, Scott Connolly, Kriss Barker, and William Ryerson Copyright © 2014 Fatou Jah et al. All rights reserved. Gender Disparity in Health and Food Expenditure in India among Elderly Wed, 27 Aug 2014 08:31:56 +0000 The present paper aims to shed light on the changing pattern of gender disparity in health and food expenditure over time among the elderly in India. National Sample Survey Organization (NSSO) data of the 55th (1999-2000) and the 64th (2007-2008) rounds on household consumer expenditure have been used for this study. Further, the paper examines whether change in the sex composition of the elderly in households contributes to a change in health and food expenditure. The findings indicate wide gender disparity in food and health care expenditure, with that of males being higher than that of their female counterparts; the gap, however, is narrowing with time. The compositional shift in sex among the elderly in households contributes significantly to the decline in household health and the increase in household food expenditure over time. Barsharani Maharana and Laishram Ladusingh Copyright © 2014 Barsharani Maharana and Laishram Ladusingh. All rights reserved. Estimation and Comparison of Immunization Coverage under Different Sampling Methods for Health Surveys Thu, 07 Aug 2014 07:19:50 +0000 Immunization currently averts an estimated 2-3 million deaths every year in all age groups. Hepatitis B is a major public health problem worldwide. In this study, the estimates of hepatitis B vaccine coverage are compared among three sampling plans namely, sampling and sampling method under cluster sampling and systematic random sampling schemes. The data has been taken from the survey “Comparison of Two Survey Methodologies to Estimate Total Vaccination Coverage” sponsored by Indian Council of Medical Research, New Delhi. It is observed that the estimations of proportions of this vaccination coverage are significantly not different at 5% level of probability. Both sampling and sampling will be preferred to systematic sampling in estimation of hepatitis B vaccine coverage for this study population because of quick estimation and lesser cost. The cluster sampling is the most recommended method for such immunization coverage especially in a developing country. D. C. Nath and B. Patowari Copyright © 2014 D. C. Nath and B. Patowari. All rights reserved. Contraceptive Use in India: A Data Mining Approach Sun, 03 Aug 2014 09:00:31 +0000 This paper uses data mining approach to analyse patterns of contraceptive use in India by comparing contraceptive use among groups of women with distinct demographic, economic, cultural, and social characteristics. The analysis suggests that currently married, nonpregnant women aged 15–49 years in India can be classified into 13 mutually exclusive groups on the basis of six characteristics of women—surviving children, household standard of living, religion, women’s years of schooling, husbands’ education, and residence. Contraceptive use pattern in these 13 groups is essentially different and reflects the orientation of family planning efforts, especially, official family planning efforts in the country. The observed differences in the patterns of contraceptive use have important policy and programme implications in the context of universal access to family planning. Aalok Ranjan Chaurasia Copyright © 2014 Aalok Ranjan Chaurasia. All rights reserved. Beyond Networks: Health, Crime, and Migration in Mexico Thu, 24 Jul 2014 06:20:27 +0000 Two rounds of a longitudinal survey from Mexico, representative at the national, urban, rural, and regional level, are used to examine the determinants of local, domestic, and international migration. Aside from the typical covariates in the migration decision, this study considers health conditions, crime, and individual’s perspectives on life as explanatory variables. Coefficient estimates for most health variables do not offer significant support to the healthy migrant hypothesis. In terms of crime, the results suggest that females respond to worsening safety conditions in Mexico by migrating domestically, but not abroad. The decision to migrate domestically or abroad for males is not statistically correlated with increases in crime. Overall, having access to international migration networks continues to play a significant role in the decision to migrate to the US. Jose N. Martinez Copyright © 2014 Jose N. Martinez. All rights reserved. Emigration, Immigration, and Skill Formation: The Case of a Midstream Country Mon, 30 Jun 2014 09:45:17 +0000 This study theoretically investigates the economy of a small country that exports skilled labor to higher developed countries and simultaneously imports unskilled labor from lower developed countries. Compared with the free immigration case, if this country adopts an optimally controlled immigration policy by imposing income tax on immigrants to maximize national income, skills formation is negatively affected and the number of domestic unskilled workers increases. Moreover, under certain conditions, we can assert the counter-intuitive possibility that the wage rate of domestic unskilled workers may decrease but that of skilled workers may increase owing to the restriction of foreign unskilled workers. Kenji Kondoh Copyright © 2014 Kenji Kondoh. All rights reserved. Increasing Longevity and the New Demography of Death Tue, 24 Jun 2014 00:00:00 +0000 The world is ageing at both an individual and population levels and population ageing is truly a global phenomenon, the only notable region of exception being sub-Saharan Africa, which remains relatively young in demographic terms. At an individual level, life expectancies at birth have increased at the global level from 47 years in the mid-20th century to around 70 years today and are expected to rise to 76 years by the mid-21st century. At the population level, the proportion of the world’s population aged 60 years and over has increased from 8 percent in the mid-20th century to 12 percent, and by 2050, it is expected to reach 21 percent. In Europe, ageing has continued at a slower rate, but with the emergence of increasing numbers of centenarians. This paper outlines the transition using data from England and Wales from a demography of young death in the mid-19th century to a demography of survival in the 20th century and on to the new demography of old death in the 21st century. The paper provides evidence that it is likely that ages at death will continue to increase, with more and more people reaching extreme old age. At the same time, it is likely that life expectancies at birth will continue to rise, taking life expectancy at birth in England and Wales to 100 years or more by the end of the 21st century. The new 21st century demography of death will lead to annual numbers of deaths far in excess of previous maxima. George W. Leeson Copyright © 2014 George W. Leeson. All rights reserved. Measures for Human Reproduction Should Be Linked to Both Men and Women Tue, 10 Jun 2014 00:00:00 +0000 We introduce the two-sex net reproduction rate (2SNRR) and the two-sex total fertility rate (2STFR)—two demographic indicators that reflect the number of children born, given age specific fertility and mortality of the adults. The main quality of these indicators is that they measure the childbearing behaviour of both women and men. The indicators have intuitive value, since they tell us to what extent adults are replaced by children. While the traditional net reproduction rate (NRR) describes general replacement trends among women only, the 2SNRR is an indicator of a population’s growth potential, irrespective of sex. We demonstrate the use of the indicators with data from Bejsce parish in Poland for the period 1800–1967 and with data from UN projections for China for future years. We discuss the consequences for our understanding of fertility trends when sex ratios deviate from normal levels. Nico Keilman, Krzysztof Tymicki, and Vegard Skirbekk Copyright © 2014 Nico Keilman et al. All rights reserved. An Exploratory Study of the Nature and Extent of Nonsuicidal Self-Injury among College Women Thu, 05 Jun 2014 12:41:21 +0000 This study assessed the extent and nature of nonsuicidal self-injury (NSSI) among 165 students attending an all-women’s college. Associations between NSSI behaviors and demographics, borderline personality disorder (BPD), posttraumatic stress disorder (PTSD), and attachment styles were investigated. Statistically significant relationships between the severity of NSSI and demographic characteristics and BPD and PTSD were explored using bivariate analysis. Within this population, presence of NSSI behavior was significantly associated with age, years in college, nonheterosexual orientation, BPD, PTSD, and preoccupied attachment styles. There were also marginally significant associations with race and financial status. Severity of NSSI behaviors was significantly associated with age, years in college, BPD pathology, and primary parent’s level of education. A logistic regression analysis was developed that predicted NSSI behavior with 67% accuracy based on these findings. This study has implications for clinical practice. Efrosini D. Kokaliari Copyright © 2014 Efrosini D. Kokaliari. All rights reserved. Variations in Desired Family Size and Excess Fertility in East Africa Tue, 27 May 2014 06:51:41 +0000 This contribution studies the variation in desired family size and excess fertility in four East African countries by analyzing the combined impact of wealth, education, religious affiliation, and place of residence. The findings show an enormous heterogeneity in Kenya. Wealthy and higher educated people have fertility desires close to replacement level, regardless of religion, while poor, uneducated people, particularly those in Muslim communities, have virtually uncontrolled fertility. Rwanda is at the other extreme: poor, uneducated people have the same desired fertility as their wealthy, educated compatriots, regardless of their religion—a case of “poverty Malthusianism.”. The potential for family planning is high in both countries as more than 50% of the women having 5 children or more would have preferred to stop at 4 or less. Tanzania and Uganda have an intermediate position in desired family size and a lower potential for family planning. Generally, the main factor that sustains higher fertility is poverty exacerbated by religious norms among the poor only. Dieudonné Ndaruhuye Muhoza, Annelet Broekhuis, and Pieter Hooimeijer Copyright © 2014 Dieudonné Ndaruhuye Muhoza et al. All rights reserved. Male Involvement in Family Planning: Challenges and Way Forward Mon, 26 May 2014 08:13:42 +0000 Public health officials have advocated the involvement of men as a strategy for addressing the dismal performance of family planning (FP) programmes. This study was therefore designed to explore the challenges and determine way forward to male involvement in FP in Olorunda Local Government Area, Osogbo, Nigeria. This cross-sectional study involved the use of a four-stage sampling technique to select 500 married men and interviewed them using semistructured questionnaire. In addition, four focus group discussions (FGDs) were also conducted. Mean age of respondents was 28.5 ± 10.3 years. Some (37.9%) of the respondents’ spouse had ever used FP and out of which 19.0% were currently using FP. Only 4.8% of the respondents had ever been involved in FP. Identified barriers to male involvement included the perception that FP is woman’s activity and was not their custom to participate in FP programme. More than half of the FGD discussants were of the view that men should provide their wives with transport fare and other resources they may need for FP. The majority of the respondents had never been involved in family planning with their wives. Community sensitization programmes aimed at improving male involvement in FP should be provided by government and nongovernmental agencies. Ademola Adelekan, Philomena Omoregie, and Elizabeth Edoni Copyright © 2014 Ademola Adelekan et al. All rights reserved. Developing an Estimate of Supported Housing Needs for Persons with Serious Mental Illnesses Sun, 27 Apr 2014 13:15:19 +0000 A rich body of literature attests to the importance of affordable accommodation and support services necessary, appropriate, and acceptable to persons disabled by a mental illness. However, there is a little which provides a means for housing and service planners to determine the gap between available supportive housing and need. Such understandings are needed to prepare strategies and develop the resources needed to accommodate persons with a disabling mental illness in the community. While housing studies that examine shelter needs of the homeless acknowledge that a sizable proportion has a disabling mental illness, these numbers underestimate need in the cohort that experiences disabling mental illnesses. This underestimate exists because many of those who are disabled by mental illness and in need of supportive housing are among the hidden homeless: doubled-up, couch-surfing, and temporarily sheltered by friends and family. Thus, little is known about the size of this cohort or their supportive shelter needs. The present analysis examines two approaches and offers one methodology as most feasible and parsimonious which can approximate housing need and may be extrapolated to other urban locations. Jeannette Waegemakers Schiff, Rebecca Schiff, and Barbara Schneider Copyright © 2014 Jeannette Waegemakers Schiff et al. All rights reserved. Gender Socialization: Differences between Male and Female Youth in India and Associations with Mental Health Sun, 27 Apr 2014 08:09:53 +0000 This paper describes patterns of gender socialization among youth in India and evaluates how these patterns are associated with their mental health. Data come from the Youth in India: Situation and Needs Study (), a subnationally representative survey conducted during 2006–2008. Descriptive results underscored the gendered nature of socialization experiences, showing that male and female youth inhabit different social worlds. Female youth expressed more gender-egalitarian attitudes than male youth but reported greater restrictions to their independence than male youth. Male youth recognized more gender-discriminatory practices within their households than did the female youth. Poisson models revealed that female youth experienced more mental health problems when their households engaged in practices that favoured males over females, even as these same practices were associated with fewer mental health problems among male youth. Family violence and restrictions to independence were associated with mental health problems for both male and female youth. When males and females engaged in behaviours contravening sex-specific gender norms, there were corresponding increases in mental health problems for both sexes. Together, these findings suggest that gender inequality permeates family life in India, with corresponding consequences for the mental well-being of male and female youth. Usha Ram, Lisa Strohschein, and Kirti Gaur Copyright © 2014 Usha Ram et al. All rights reserved. The Association between a History of Parental Addictions and Arthritis in Adulthood: Findings from a Representative Community Survey Sun, 23 Mar 2014 15:07:13 +0000 Aims. To examine the relationship between a history of parental addictions and the cumulative lifetime incidence of arthritis while controlling for age, sex, race, and four clusters of risk factors: (1) other adverse childhood experiences, (2) adult health behaviors (i.e., smoking, obesity, inactivity, and alcohol consumption), (3) adult socioeconomic status and (4) mental health. Materials and Methods. Secondary analysis of 13,036 Manitoba and Saskatchewan respondents of the population-based 2005 Canadian Community Health Survey. Sequential logistic regression analyses were conducted. Findings. After controlling for demographic characteristics, including age, gender, and race, respondents who reported a history of parental addictions had significantly higher odds of arthritis in comparison to individuals without (; 95% CI 1.38–1.80). Adjustment for socioeconomic status, adult health behaviors, and mental health conditions had little impact on the parental addictions and arthritis relationship. The association between parental addictions and arthritis was substantially reduced when adverse childhood experiences (; 95% CI 1.15–1.53) and all four groups of risk factors collectively (; 95% CI = 1.12–1.51) were included in the analyses; however, the relationship remained statistically significant. Conclusions. A robust association was found between parental addictions and cumulative lifetime incidence of arthritis. This link remained even when controlling for four groups of potential risk factors. Esme Fuller-Thomson, Jessica P. Liddycoat, and Maria Stefanyk Copyright © 2014 Esme Fuller-Thomson et al. All rights reserved. Patterns and Determinants of Essential Newborn Care Practices in Rural Areas of Northern Ghana Tue, 11 Mar 2014 09:25:26 +0000 Background. This study was designed to understand the patterns and determinants of three essential newborn care practices: safe cord care, optimal thermal care, and neonatal feeding practices. Methods. A community-based cross-sectional study was carried out on a sample of 404 lactating mothers who have delivered a live baby at home within the past one year prior to the study. Results. Overall, the prevalence of essential newborn practices on safe cord care and optimal thermal care was exceptionally low. Of the 404 newborns, only 0.2% (1) had safe cord care, 5.2% (21) optimal thermal care, and 50.2% (203) were considered to have had adequate neonatal feeding. In logistic regression analysis, the main predictors of good neonatal feeding were maternal age, timing of the first antenatal care (ANC), and maternal knowledge of newborn danger signs. Women who could mention at least 4 danger signs of the neonate were 4 times more likely to give good neonatal feeding to their babies (AOR = 4.7, Cl: 2.43–9.28), . Conclusion. Evidence from this study strongly suggests that the expected essential newborn care practices are not available to a substantial number of the newborns. Efforts should therefore be made by the Ghana Health Service (GHS) to expand essential newborn care interventions beyond institutional level into the communities. Mahama Saaka and Mariam Iddrisu Copyright © 2014 Mahama Saaka and Mariam Iddrisu. All rights reserved. Neonatal Death and National Income in Developing Countries: Will Economic Growth Reduce Deaths in the First Month of Life? Sun, 02 Feb 2014 14:05:34 +0000 The relationship between national income and child mortality has been understood for many years. However, what is less well known is whether the association differs for neonatal mortality compared to postneonatal and early childhood deaths. Our study extends knowledge by analysing the relationship between gross national income (GNI) and neonatal, postneonatal, and early child mortality. The study draws on mortality estimates from Demographic and Household Surveys and World Bank data for GNI. It uses multivariate multiple regression analysis to examine the relationship between GNI and neonatal, postneonatal, and early child mortality rates (NMR, PNMR, and ECMR) using cross-sectional data from 65 countries and trend data from 49 countries. No significant relationship can be found between NMR and GNI for cross-sectional data once adjusted for region. The trend data confirms that increases over time in GNI are associated with lower reductions in NMR than other component rates. Thus, economic growth alone may have a weaker effect on reducing neonatal deaths than for older age groups; achieving improvements in neonatal mortality requires investment in maternal and new born health services alongside growth. Sarah Neal and Jane Falkingham Copyright © 2014 Sarah Neal and Jane Falkingham. All rights reserved. Changes in Fertility Decline in Rwanda: A Decomposition Analysis Thu, 16 Jan 2014 13:17:14 +0000 After having stalled in the 1990s, fertility in Rwanda resumed its downward trajectory between 2005 and 2010. The total fertility rate declined from 6.1 to 4.6 and modern contraceptive use increased. However, it is unclear which determinants lay behind the previous stall and the recent strong drop in fertility. This paper contributes to an ongoing debate on the impact of social upheavals on fertility decline. We use a decomposition analysis, focusing on the change in characteristics and reproductive behaviour of women and their contributions to levels of fertility during 1992–2000 and 2000–2010. Results show that due to widowhood and separation the proportion of women who were married decreased between 1992 and 2000, but their fertility increased in the same period due to replacement fertility and an unmet need for family planning. After 2000, postponement of marriage and lower infant mortality contributed to lower fertility, but the most important effect is the overall lower fertility due not only to improved family planning provision but perhaps also to the sensitizing campaigns of the Rwandan government. Pierre Claver Rutayisire, Pieter Hooimeijer, and Annelet Broekhuis Copyright © 2014 Pierre Claver Rutayisire et al. All rights reserved. Women’s Education, Family Planning, or Both? Application of Multistate Demographic Projections in India Thu, 09 Jan 2014 13:53:30 +0000 Is education the best contraceptive? Using the multistate human capital projection model, our analysis shows that the projected changes in India population vary depending on investments in education and helping women reduce unwanted fertility rates, that investments in both education and helping women in each education category—but particularly less educated women—meet their wanted fertility will have the largest impacts on India’s population projections, and that the impact from investment in reducing unwanted fertility will be much more immediate and significant than only investments in education. Our analysis also reveals that an increasing education transition rate in India will not only help to achieve a population age structure that is favorable for economic growth, but also result in a larger share of skilled labor force that help to achieve higher economic growth rate. More importantly, investment in girls’ education and achieving gender equality in education will be the most effective measure to increase India’s population education level and improve its overall values of human capital. Leiwen Jiang and Karen Hardee Copyright © 2014 Leiwen Jiang and Karen Hardee. All rights reserved. From (Un)Willingness to InvolveMENt: Development of a Successful Study Brand for Recruitment of Diverse MSM to a Longitudinal HIV Research Sun, 29 Dec 2013 18:01:27 +0000 Background. HIV continues to be a major concern among MSM, yet Black MSM have not been enrolled in HIV research studies in proportionate numbers to White MSM. We developed an HIV prevention research brand strategy for MSM. Methods. Questionnaires and focus groups were conducted with 54 participants. Descriptive statistics and chi-square analyses were performed and qualitative data were transcribed and content analyzed to identify common themes. Results. Formative research results indicated that younger Black MSM (18–29 years) were less likely to think about joining prevention studies compared to older (≥30 years) Black MSM (, ). Qualitative and quantitative results indicate four prominent themes related to brand development: (1) communication sources (message deliverer), (2) message (impact of public health messaging on perceptions of HIV research), (3) intended audience (underlying issues that influence personal relevance of HIV research), and (4) communication channels (reaching intended audiences). Conclusion. The findings highlight the importance of behavioral communication translational research to effectively engage hard-to-reach populations. Despite reservations, MSM in our formative study expressed a need for active involvement and greater education to facilitate their engagement in HIV prevention research. Thus, the brand concept of “InvolveMENt” emerged. Paula M. Frew, Victoria A. Williams, Eve T. Shapiro, Travis Sanchez, Eli S. Rosenberg, Vincent L. Fenimore, and Patrick S. Sullivan Copyright © 2013 Paula M. Frew et al. All rights reserved. Maternal Mortality and Female Literacy Rates in Developing Countries during 1970–2000: A Latent Growth Curve Analysis Sun, 22 Dec 2013 09:24:34 +0000 Background. The gross longitudinal relationship between female literacy and maternal mortality ratios has not been adequately investigated even though the knowledge of the relationship is crucial for designing maternal mortality reduction programs through female literacy campaigns and improvements. The objective of the study was to examine the dynamic relationship between female literacy and mortality ratios. A longitudinal study design spanning three decades, 1970–2000, was used. Country level data on 143 nations belonging to six geographical regions for the duration 1970–2000 were secured from websites hosted by global agencies such as World Bank and the United Nations were utilized. Maternal mortality ratios (1970–2000) ranged from 147 to 271 across the six regions. The longitudinal relationship between female literacy rates and maternal mortality ratios was examined using a latent growth curve approach. The study found that rates of change in female literacy and maternal mortality ratios are negatively related. Steady rates of increase in female literacy were associated with declining maternal mortality ratios as well. We find that female literacy programs are of immense value in reducing maternal mortality ratios given their ability to yield sustained reductions in mortality levels in developing countries. Vijayan K. Pillai, Arati Maleku, and FangHsun Wei Copyright © 2013 Vijayan K. Pillai et al. All rights reserved. Smoking Cessation in Long-Term Conditions: Is There “An Opportunity in Every Difficulty”? Sun, 08 Dec 2013 09:36:22 +0000 Introduction. Smoking plays a causal role in several long-term conditions and worsens their outcomes. Focusing on six such conditions, we present a narrative review of seminal studies on the prevalence and impact of continued tobacco use on these conditions; the effectiveness of cessation interventions; the extent to which patients receive these interventions, and barriers to providing and taking up these interventions. Methods. A conceptual framework was used to identify questions for a series of focused literature reviews. Findings were synthesized and the literature was examined to identify themes common across these conditions. Results. Smoking prevalence is either similar or higher in patients with established long-term conditions compared to the general population. Continued smoking accelerates disease progression, worsens outcomes, and risks poor treatment compliance or further complications. There is strong evidence for the effectiveness of cessation interventions in achieving smoking abstinence. Despite this, only a small proportion of patients receive such interventions. Important barriers to uptake include concerns about weight management and drug safety, higher nicotine dependency and codependency, comorbidity, and misperceptions about the benefits of cessation. Conclusion. The benefits of offering smoking cessation in patients with long-term conditions are far too great for it to remain of a low priority. Kamran Siddiqi, Omara F. Dogar, and Najma Siddiqi Copyright © 2013 Kamran Siddiqi et al. All rights reserved.