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Mohammed M, Akuoko M. Subnational variations in electricity access and infant mortality: Evidence from Ghana. HEALTH POLICY OPEN 2022. [DOI: 10.1016/j.hpopen.2021.100057] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Havlíček J, Tureček P, Velková A. One but not two grandmothers increased child survival in poorer families in west Bohemian population, 1708–1834. Behav Ecol 2021. [DOI: 10.1093/beheco/arab077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Human childrearing is characterized by cooperative care and grandmothers are usually the most prominent alloparents. Nevertheless, it has been argued that limited resources may intensify competition among kin. The effect of grandmothers’ presence on child survival may thus crucially depend on the family’s socioeconomic status. We evaluate the impact of grandmothers’ presence on child survival using a large historical dataset from eighteenth to nineteenth-century western Bohemia (N = 6880) and assess the effects of socioeconomic status. We employed a varying effects model conditioned on relatedness between individuals because of possible genetically transmitted benefits. Proportional hazards showed that grandmothers had little or no impact on child survival in families of high and medium socioeconomic status (farmers and cottagers, respectively), whereas in families with the lowest socioeconomic status (lodgers), grandmothers’ presence increased the survival probability of children up to five years of age. The beneficial effect of grandmaternal care was strongest between the first and second years of life. Importantly, though, in families with low socioeconomic status, we also observed lower survival chances of children when both grandmothers lived in the same village. These findings suggest that the balance between kin cooperation in childrearing and competition over resources may depend on resource availability.
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Affiliation(s)
- Jan Havlíček
- Department of Zoology Faculty of Science, Charles University, Viničná 7, 128 44, Praha 2,Czech Republic
| | - Petr Tureček
- Department of Philosophy and History of Science, Faculty of Science, Charles University, Viničná 7, 128 44, Praha 2,Czech Republic
| | - Alice Velková
- Department of Demography, Faculty of Science, Charles University, Albertov 6, 128 00, Praha 2,Czech Republic
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Paul R, Rashmi R, Srivastava S. Differential in infant, childhood and under-five death clustering among the empowered and non-empowered action group regions in India. BMC Public Health 2021; 21:1436. [PMID: 34289824 PMCID: PMC8296729 DOI: 10.1186/s12889-021-11486-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 07/09/2021] [Indexed: 11/25/2022] Open
Abstract
Background With 8,82,000 deaths in the under-five period, India observed varied intra-state and inter-regional differences across infant and child mortality in 2018. However, scarce literature is present to capture this unusual concentration of mortality in certain families by examining the association of the mortality risks among the siblings of those families along with various unobserved characteristics of the mother. Looking towards the regional and age differential in mortality, this paper attempts to provide evidence for the differential in mortality clustering among infants (aged 0–11 months), children (12–59 months) and under-five (0–59 months) period among mothers from the Empowered Action Group (EAG) and non-EAG regions of India. Methods The study used data from the National Family Health Survey (2015–16) which includes all the birth histories of 475,457 women aged 15–49 years. Bivariate and multivariate analyses were used to fulfil the objectives of the study. A two-level random intercept Weibull regression model was used to account for the unexplained mother (family) level heterogeneity. Results About 3.3% and 5.9% of infant deaths and 0.8% and 1.6% of childhood deaths were observed in non-EAG and EAG regions respectively. Among them, a higher percentage of infant and child death was observed due to the death of a previous sibling. There were 1.67 times [95% CI: 1.55–1.80] and 1.46 times [CI: 1.37–1.56] higher odds of infant and under-five mortality of index child respectively when the previous sibling at the time of conception of the index child was dead in the non-EAG regions. In contrast, the odds of death scarring (death of previous sibling scars the survival of index child) were 1.38 times [CI: 1.32–1.44] and 1.24 times [CI: 1.20–1.29] higher for infant and under-five mortality respectively in the EAG regions. Conclusion The extent of infant and child mortality clustering and unobserved heterogeneity was higher among mothers in the non-EAG regions in comparison to their EAG region counterparts. With the growing situation of under-five mortality clustering in non-EAG states, region-wise interventions are recommended. Additionally, proper care is needed to ameliorate the inter-family variation in mortality risk among the children of both EAG and non-EAG regions throughout their childhood.
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Affiliation(s)
- Ronak Paul
- International Institute for Population Sciences, Mumbai, 400088, India
| | - Rashmi Rashmi
- International Institute for Population Sciences, Mumbai, 400088, India
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Adjei G, Darteh EKM, Nettey OEA, Doku DT. Neonatal mortality in the central districts of Ghana: analysis of community and composition factors. BMC Public Health 2021; 21:173. [PMID: 33478435 PMCID: PMC7819257 DOI: 10.1186/s12889-021-10156-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 01/01/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Communities and their composition have an impact on neonatal mortality. However, considering the smallest health administrative units as communities and investigating the impact of these communities and their composition on neonatal mortality in Ghana have not been studied. Therefore, this study aimed to investigate the effect of community-, household- and individual-level factors on the risk of neonatal mortality in two districts in Ghana. METHODS This was a longitudinal study that used the Kintampo Health and Demographic Surveillance System as a platform to select 30,132 neonatal singletons with 634 deaths. Multilevel cox frailty model was used to examine the effect of community-, household- and individual-level factors on the risk of neonatal mortality. RESULTS Regarding individual-level factors, neonates born to mothers with previous adverse pregnancy (aHR = 1.38, 95% CI: 1.05-1.83), neonates whose mothers did not receive tetanus toxoid vaccine (aHR = 1.32, 95% CI: 1.08-1.60) and neonates of mothers with Middle, Junior High School or Junior Secondary School education (aHR = 1.30, 95% CI: 1.02-1.65) compared to mothers without formal education, had a higher risk of neonatal mortality. However, female neonates (aHR = 0.61, 95% CI: 0.51-0.73) and neonates whose mother had secondary education or higher (aHR = 0.37, 95% CI: 0.18-0.75) compared to those with no formal education had a lower risk of mortality. Neonates with longer gestation period (aHR = 0.95, 95% CI: 0.94-0.97) and those who were delivered at home (aHR = 0.56, 95% CI: 0.45-0.70), private maternity home (aHR = 0.45, 95% CI: 0.30-0.68) or health centre/clinic (aHR = 0.40, 95% CI: 0.26-0.60) compared to hospital delivery had lower risk of mortality. Regarding the household-level, neonates belonging to third quintile of the household wealth (aHR = 0.70, 95% CI: 0.52-0.94) and neonates belonging to households with crowded sleeping rooms (aHR = 0.91, 95% CI: 0.85-0.97) had lower risk of mortality. CONCLUSION The findings of the study suggest the risk of neonatal mortality at the individual- and household-levels in the Kintampo Districts. Interventions and strategies should be tailored towards the high-risk groups identified in the study.
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Affiliation(s)
- George Adjei
- Department of Community Medicine, University of Cape Coast, Cape Coast, Ghana
| | - Eugene K. M. Darteh
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Obed Ernest A. Nettey
- University of Ghana, Regional Institute for Population Studies, Accra, Ghana
- Kintampo Health Research Centre, P.O. Box 200, Kintampo, Ghana
| | - David Teye Doku
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
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Junkka J, Karlsson L, Lundevaller E, Schumann B. Climate vulnerability of Swedish newborns: Gender differences and time trends of temperature-related neonatal mortality, 1880-1950. ENVIRONMENTAL RESEARCH 2021; 192:110400. [PMID: 33129863 DOI: 10.1016/j.envres.2020.110400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/23/2020] [Accepted: 10/25/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND In resource-poor societies, neonatal mortality (death in the first 28 days of life) is usually very high. Young infants are particularly vulnerable to environmental health risks, which are modified by socioeconomic factors that change over time. We investigated the association between ambient temperature and neonatal mortality in northern Sweden during the demographic transition. METHODS Parish register data and temperature data in coastal Västerbotten, Sweden, between 1880 and 1950 were used. Total and sex-specific neonatal mortality was modelled as a function of mean temperature, adjusting for age, seasonality and calendar time, using discrete-time survival analysis. A linear threshold function was applied with a cut point at 14.5 °C (the minimum mortality temperature). Odds ratios (ORs) with 95% confidence intervals (CIs) were computed. Further analyses were stratified by study period (1800-1899, 1900-1929, and 1930-1950). RESULTS Neonatal mortality was 32.1 deaths/1000 live births, higher in boys than in girls, and decreased between 1880 and 1950, with high inter-annual variability. Mean daily temperature was +2.5 °C, ranging from -40.9 °C to +28.8 °C. At -20 °C, the OR of neonatal death was 1.56 (CI 1.30-1.87) compared to the reference at +14.5 °C. Among girls, the OR of mortality at -20 °C was 1.17 (0.88-1.54), and among boys, it was 1.94 (1.53-2.45). A temperature increase from +14.5 to +20 °C was associated with a 25% increase of neonatal mortality (OR 1.25, CI 1.04-1.50). Heat- and cold-related risks were lowest between 1900 and 1929. CONCLUSIONS In this remote sub-Arctic region undergoing socio-economic changes, we found an increased mortality risk in neonates related to low but also to high temperature. Climate vulnerability varied across time and was particularly high among boys. This demonstrates that environmental impacts on human health are complex and highly dependent on the specific local context, with many, often unknown, contributing determinants of vulnerability.
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Affiliation(s)
- Johan Junkka
- Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden
| | - Lena Karlsson
- Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden; Department of Sociology, Umeå University, 901 87, Umeå, Sweden
| | - Erling Lundevaller
- Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden
| | - Barbara Schumann
- Centre for Demographic and Ageing Research, Umeå University, 901 87, Umeå, Sweden; Department of Epidemiology and Global Health, Umeå University, 901 87, Umeå, Sweden.
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Karlsson L, Lundevaller EH, Schumann B. Season of birth, stillbirths, and neonatal mortality in Sweden: the Sami and non-Sami population, 1800-1899. Int J Circumpolar Health 2020; 78:1629784. [PMID: 31221048 PMCID: PMC6598521 DOI: 10.1080/22423982.2019.1629784] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Seasonal patterns of neonatal mortality and stillbirths have been found around the world. However, little is known about the association between season of birth and infant mortality of pre-industrial societies in a subarctic environment. In this study, we compared how season of birth affected the neonatal and stillbirth risk among the Sami and non-Sami in Swedish Sápmi during the nineteenth century. Using digitised parish records from the Demographic Data Base at Umeå University, we applied logistic regression models for estimating the association of season of birth with stillbirths and neonatal mortality, respectively. Higher neonatal mortality was found among the winter- and autumn-born Sami, compared to summer-born infants. Stillbirth risk was higher during autumn compared to summer among the Sami, whereas we found no seasonal differences in mortality among the non-Sami population. We relate the higher neonatal mortality risk among winter-born Sami to differences in seasonality of living conditions associated with reindeer herding.
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Affiliation(s)
- Lena Karlsson
- a Centre for Demographic and Ageing Research (CEDAR) , Umeå University , Umeå , Sweden.,b Department of Sociology , Umeå University , Umeå , Sweden
| | | | - Barbara Schumann
- a Centre for Demographic and Ageing Research (CEDAR) , Umeå University , Umeå , Sweden.,c Department of Epidemiology and Global Health , Umeå University , Umeå , Sweden
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Karlsson L, Lundevaller E, Schumann B. The association between cold extremes and neonatal mortality in Swedish Sápmi from 1800 to 1895. Glob Health Action 2019; 12:1623609. [PMID: 31232229 PMCID: PMC6598478 DOI: 10.1080/16549716.2019.1623609] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Accepted: 05/20/2019] [Indexed: 11/24/2022] Open
Abstract
Background: Studies in which the association between temperature and neonatal mortality (deaths during the first 28 days of life) is tracked over extended periods that cover demographic, economic and epidemiological transitions are quite limited. From previous research about the demographic transition in Swedish Sápmi, we know that infant and child mortality was generally higher among the indigenous (Sami) population compared to non-indigenous populations. Objective: The aim of this study was to analyse the association between extreme temperatures and neonatal mortality among the Sami and non-Sami population in Swedish Sápmi (Lapland) during the nineteenth century. Methods: Data from the Demographic Data Base, Umeå University, were used to identify neonatal deaths. We used monthly mean temperature in Tornedalen and identified cold and warm month (5th and 95th) percentiles. Monthly death counts from extreme temperatures were modelled using negative binomial regression. We computed relative risks (RR) with 95% confidence intervals (CI), adjusting for time trends and seasonality. Results: Overall, the neonatal mortality rate was higher among Sami compared to non-Sami infants (62/1,000 vs 35/1,000 live births), although the differences between the two populations decreased after 1860. For the Sami population prior 1860, the results revealed a higher neonatal incidence rate during cold winter months (<-15.4°C, RR = 1.60, CI 1.14-2.23) compared to infants born during months of medium temperature. No association was found between extreme cold months and neonatal mortality for non-Sami populations. Warm months (+15.1°C) had no impact on Sami or non-Sami populations. Conclusions: This study revealed the role of environmental factors (temperature extremes) on infant health during the demographic transition where cold extremes mainly affected the Sami population. Ethnicity and living conditions contributed to differential weather vulnerability.
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Affiliation(s)
- Lena Karlsson
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
- Department of Sociology, Umeå University, Umeå, Sweden
| | - Erling Lundevaller
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
| | - Barbara Schumann
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
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Zang E, Campbell C. Males' Later-Life Mortality Consequences of Coresidence With Paternal Grandparents: Evidence From Northeast China, 1789-1909. Demography 2018; 55:435-457. [PMID: 29492799 DOI: 10.1007/s13524-018-0653-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In this study, we investigate the effect of early-life coresidence with paternal grandparents on male mortality risks in adulthood and older age in northeast China from 1789 to 1909. Despite growing interest in the influence of grandparents on child outcomes, few studies have examined the effect of coresidence with grandparents in early life on mortality in later life. We find that coresidence with paternal grandmothers in childhood is associated with higher mortality risks for males in adulthood. This may reflect the long-term effects of conflicts between mothers and their mothers-in-law. These results suggest that in extended families, patterns of coresidence in childhood may have long-term consequences for mortality, above and beyond the effects of common environmental and genetic factors, even when effects on childhood mortality are not readily apparent.
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Affiliation(s)
- Emma Zang
- Sanford School of Public Policy, Duke University, Durham, NC, USA.
| | - Cameron Campbell
- Division of Social Science, The Hong Kong University of Science and Technology, Hong Kong, China.,School of History and Culture, Central China Normal University, Wuhan, China
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Indigenous Infant Mortality by Age and Season of Birth, 1800-1899: Did Season of Birth Affect Children's Chances for Survival? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 15:ijerph15010018. [PMID: 29295484 PMCID: PMC5800118 DOI: 10.3390/ijerph15010018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 12/01/2017] [Accepted: 12/20/2017] [Indexed: 11/17/2022]
Abstract
This paper focuses on the influence of season of birth on infant mortality among the Sami and non-Sami populations in northern Sweden during the nineteenth century. The source material is a set of data files from the Demographic Data Base at Umeå University, making it possible to combine age at death (in days), month of death, and month of birth over the course of the entire century. Cox regression models reveal that for the first week of life, season of birth had no influence on the risk of mortality. For the Sami, the results showed that being born during winter was related to a higher risk of neonatal mortality, and being born during summer was related to a higher risk of mortality after six months of age. Furthermore, for the Sami, the neonatal mortality showed a U-shaped pattern with a minimum in June–August, whereas the corresponding pattern among the non-Sami was flatter. The findings shed light on vulnerability in two populations sharing the same environment, but diverging in terms of social, economic, and cultural factors.
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Abstract
Advanced maternal age is associated with negative offspring health outcomes. This interpretation often relies on physiological processes related to aging, such as decreasing oocyte quality. We use a large, population-based sample of American adults to analyze how selection and lifespan overlap between generations influence the maternal age-offspring adult health association. We find that offspring born to mothers younger than age 25 or older than 35 have worse outcomes with respect to mortality, self-rated health, height, obesity, and the number of diagnosed conditions than those born to mothers aged 25-34. Controls for maternal education and age at which the child lost the mother eliminate the effect for advanced maternal age up to age 45. The association between young maternal age and negative offspring outcomes is robust to these controls. Our findings suggest that the advanced maternal age-offspring adult health association reflects selection and factors related to lifespan overlap. These may include shared frailty or parental investment but are not directly related to the physiological health of the mother during conception, fetal development, or birth. The results for young maternal age add to the evidence suggesting that children born to young mothers might be better off if the parents waited a few years.
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Willführ KP, Gagnon A. Are stepparents always evil? Parental death, remarriage, and child survival in demographically saturated Krummhörn (1720-1859) and expanding Québec (1670-1750). BIODEMOGRAPHY AND SOCIAL BIOLOGY 2013; 59:191-211. [PMID: 24215259 DOI: 10.1080/19485565.2013.833803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Parental death precipitates a cascade of events leading to more or less detrimental exposures, from the sudden and dramatic interruption of parental care to cohabitation with stepparents and siblings in a recomposed family. This article compares the effect of early parental loss on child survival in the past in the Krummhörn region of East Frisia (Germany) and among the French Canadian settlers of the Saint Lawrence Valley (Québec, Canada). The Krummhörn region was characterized by a saturated habitat, while the opportunities for establishing a new family were virtually unlimited for the French Canadian settlers. Early parental loss had quite different consequences in these dissimilar environments. Event history analyses with time-varying specification of family structure are used on a sample of 7,077 boys and 6,906 girls born between 1720 and 1859 in the Krummhörn region and 31,490 boys and 33,109 girls whose parents married between 1670 and 1750 in Québec. Results indicate that in both populations, parental loss is associated with increased infant and child mortality. Maternal loss has a universal and consistent effect for both sexes, while the impact of paternal loss is less easy to establish and interpret. On the other hand, the effect of the remarriage of the surviving spouse is population-specific: the mother's remarriage has no effect in Krummhörn, while it is beneficial in Québec. In contrast, the father's remarriage in Krummhörn dramatically reduces the survival chances of the children born from his former marriage, while such an effect is not seen for Québec. These population-specific effects appear to be driven by the availability of resources and call into question the universality of the "Cinderella" effect.
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Affiliation(s)
- Kai P Willführ
- a Max Planck Institute for Demographic Research , Rostock , Germany
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Alternatives to the grandmother hypothesis: a meta-analysis of the association between grandparental and grandchild survival in patrilineal populations. HUMAN NATURE-AN INTERDISCIPLINARY BIOSOCIAL PERSPECTIVE 2012; 22:201-22. [PMID: 22388808 DOI: 10.1007/s12110-011-9114-8] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We conducted a meta-analysis of 17 studies that tested for an association between grandparental survival and grandchild survival in patrilineal populations. Using two different methodologies, we found that the survival of the maternal grandmother and grandfather, but not the paternal grandmother and grandfather, was associated with decreased grandoffspring mortality. These results are consistent with the findings of psychological studies in developed countries (Coall and Hertwig Behavioral and Brain Sciences 33:1-59, 2010). When tested against the predictions of five hypotheses (confidence of paternity; grandmothering, kin proximity, grandparental senescence, and local resource competition), our meta-analysis results are most in line with the local resource competition hypothesis. In patrilineal and predominantly patrilocal societies, the grandparents who are most likely to live with the grandchildren have a less beneficial association than those who do not. We consider the extent to which these results may be influenced by the methodological limitations of the source studies, including the use of retrospective designs and inadequate controls for confounding variables such as wealth.
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‘Incorrect, loose and coarse terms’: classifying nineteenth-century English-language causes of death for modern use. An example using Tasmanian data. JOURNAL OF POPULATION RESEARCH 2011. [DOI: 10.1007/s12546-011-9065-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Adhikari R, Sawangdee Y. Influence of women's autonomy on infant mortality in Nepal. Reprod Health 2011; 8:7. [PMID: 21504609 PMCID: PMC3101134 DOI: 10.1186/1742-4755-8-7] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 04/19/2011] [Indexed: 11/23/2022] Open
Abstract
Background Nepalese women lag behind men in many areas, such as educational attainment, participation in decision-making and health service utilization, all of which have an impact on reproductive health outcomes. This paper aims to examine the factors influencing infant mortality, specifically, whether women's autonomy has an impact on infant mortality in the Nepali context. Methods Data were drawn from the Nepal Demographic and Health Survey, 2006. The analysis is confined to 5,545 children who were born within the five years preceding the survey. Association between infant mortality and the explanatory variables was assessed using bivariate analysis. Variables were then re-examined in multivariate analysis to assess the net effect of women's autonomy on infant mortality after controlling for other variables. Results The infant mortality rate (IMR) in the five years preceding the survey was 48 deaths per one thousand live births. Infant mortality rate was high among illiterate women (56 per 1000 live births) and among those not involved in decision making for health care (54 per 1000 live births). Furthermore, infant mortality was high among those women who had more children than their comparison group, who had birth intervals of less than two years, who had multiple births, who were from rural areas, who were poor, whose source of water was the river or unprotected sources, and who did not have a toilet facility in their household. Results from logistic regression show that women's autonomy plays a major role in infant mortality after controlling other variables, such as mother's sociodemographic characteristics, children's characteristics and other household characteristics. Children from literate women had a 32 percent lower chance (OR = 0.68) of experiencing infant mortality than did children from illiterate women. Furthermore, infants of women who were involved in decision-making regarding their own health care had a 25 percent lower (OR = 0.75) chance of dying than did infants whose mothers who were not involved in healthcare decisions. Conclusion Infant mortality is high in Nepal. In this context, mother's literacy and involvement in healthcare decision making appear to be the most powerful predictors for reducing infant mortality. Hence, in order to reduce infant mortality further, ongoing female education should be sustained and expanded to include all women so that the millennium development goals for the year 2015 can be attained. In addition, programs should focus on increasing women's autonomy so that infant mortality will decrease and the overall well being of the family can be maintained and enhanced.
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Affiliation(s)
- Ramesh Adhikari
- Geography and Population Department, Mahendra Ratna Campus, Tribhuvan University, Kathmandu, Nepal.
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Sear R, Coall D. How much does family matter? Cooperative breeding and the demographic transition. POPULATION AND DEVELOPMENT REVIEW 2011; 37:81-112. [PMID: 21280366 DOI: 10.1111/j.1728-4457.2011.00379.x] [Citation(s) in RCA: 133] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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