Research Article
Relevance of students’ demographic characteristics, sources of information and personal attitudes towards HIV testing for HIV knowledge: evidence from a post-conflict setting
- Marija Milic, Jelena Dotlic, Jasmina Stevanovic, Milan Parlic, Katarina Mitic, Desmond Nicholson, Aleksandra Arsovic, Tatjana Gazibara
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- Published online by Cambridge University Press:
- 28 January 2020, pp. 1-19
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Although studies on HIV knowledge have previously been conducted in central Serbia and southern Kosovo, none has included the Serbian population residing in the northern part of the Kosovo province. The aim of this study was to assess HIV-related knowledge and to estimate factors contributing to a higher HIV-related knowledge level among Serbian university students in the Kosovo province. A cross-sectional study including 1017 first- and fourth-year students enrolled at the University of Pristina temporarily seated in Kosovska Mitrovica was carried out during the academic year 2013–2014. The students completed a 31-item questionnaire comprising demographic data, HIV transmission knowledge and attitude towards HIV testing. Data were statistically analysed. Students demonstrated good knowledge of HIV (average 32.8 ± 3.3 out of a maximum 42). Only 5% of the students reported having been tested for HIV. Factors associated with being more knowledgeable about HIV were studying health-related disciplines (β = −0.09; 95% confidence interval [CI] −0.13, 0.00), using the internet as a source of information about HIV (β = −1.09; 95% CI −1.65, −0.52), having a positive attitude towards HIV testing (β = −0.43; 95% CI −0.59, −0.26), having a low self-perceived risk for HIV infection (β = 0.41; 95% CI 0.23, 0.56) and the position that one would keep the same level of contact with an HIV-positive person after learning their HIV status (β = 0.38; 95% CI 0.21, 0.55). Setting up specialized classes on this topic at high schools and universities could help to increase the awareness of HIV infection and promote HIV testing and a positive attitude towards HIV-positive persons.
Contraceptive use in Eswatini: do contextual influences matter?
- Clifford Odimegwu, Garikayi B. Chemhaka
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- Published online by Cambridge University Press:
- 13 January 2020, pp. 20-37
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This study sought to investigate the determinants of current use of modern contraceptives beyond the individual level in Eswatini (formerly Swaziland). Previous studies have overlooked the role of community characteristics such as socioeconomic development, women’s empowerment and fertility norms in shaping contraceptive use. Hierarchical structured subsample data of 4112 sexually experienced women from the 2007 Eswatini Demographic Health Survey were analysed using multilevel logistic regression to identify factors contributing to community/cluster variations in women’s current use of modern contraceptives. Less than half (44.2%) of the sexually active women were using modern contraceptive methods in 2007. At the community level, the odds of contraceptive use decreased for rural women (AOR = 0.82, 95% CI: 0.68–0.98) and among women residing in communities with high-fertility norms (AOR = 0.77, 95% CI: 0.66–0.89). After adjusting for both individual- and community-level factors, no community-level variables considered for the study were significantly associated with contraceptive use. The findings highlight in all four models, from the empty to full model, that there is a small and decreasing significant variation in women’s contraceptive use across communities (MOR, 1.37–1.17). In 2007, the findings suggest individual rather than community factors account for some contextual variability in contraceptive use. The study proposes the use of ethnographic techniques to unravel community factors that promote modern contraceptive use in Eswatini.
Gender inequality and sexual height dimorphism in Chile
- Héctor Castellucci, Carlos Viviani, Giorgio Boccardo, Pedro Arezes, Ángelo Bartsch, Marta Martínez, Verónica Aparici, Johan F.M. Molenbroek, Sara Bragança
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- Published online by Cambridge University Press:
- 17 January 2020, pp. 38-54
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Chile has experienced significant improvements in its economy; thus, a secular trend in height has been observed in its population. Gender equality has also improved hand in hand with active policies addressing the gender gap in several dimensions (work, education, health) and overall economic improvement. This study examined changes in sexual height dimorphism in four samples of Chilean male and female working-age subjects and attempted to establish associations with gender equality and welfare. Sexual height dimorphism was calculated and compared with gender equality and overall welfare indicators between 1955 and 1995. Sexual height dimorphism reduction was seen to be strongly associated with greater gender equality and some general welfare indicators, such as the infant mortality rate. Gross domestic product per capita was not associated with sexual height dimorphism, but it showed significant associations with gender equality indicators. Overall, the gender gap has been reduced in Chile, which can be observed through improvements in gender equality indicators and a reduction in height dimorphism, mainly in areas associated with women’s health. However, gender equality is still far behind in terms of female labour participation and women in political power, which require attention and further improvements.
Household- and community-level determinants of low-risk Caesarean deliveries among women in India
- Pradeep Kumar, Preeti Dhillon
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- Published online by Cambridge University Press:
- 30 January 2020, pp. 55-70
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Caesarean section delivery rates in India have doubled from 9% in 2005–06 to 17% in 2015–16, increasing the clinical and economic burden on the health care system. This study applied multilevel models to assess the role of household- and community-level factors in Caesarean section (CS) deliveries among low-risk women in India using data from Round 4 of the National Family Health Survey (NFHS-4) conducted in 2015–16. The sample size was 59,318 low-risk women who had their last birth in an institution during the 5 years preceding the survey. These women were nested in 57,279 households, which were nested in 22,183 communities, which were further nested in 640 districts in India. Around 21% of the low-risk women and 24% of all women who had delivered in an institution had undergone CS. The CS rates among low-risk women were extremely high in private institutions (40%) and in southern India (43%). The explanatory variables age, education of women, household wealth and number of antenatal visits were significantly positively associated, while women’s parity was negatively associated, with CS delivery among low-risk women. The multilevel analysis suggested that the likelihood of a low-risk woman opting for CS was influenced by a similar decision of another woman from the same household (37%) and/or community (18%). Furthermore, women with low-risk pregnancies from higher educated communities were less likely (OR 0.92) to undergo CS. There is therefore a need for a community-level awareness programme on the risks and benefits of low-risk CS and vaginal delivery, particularly in the southern region of India.
Time trends in mid-upper-arm anthropometry from 1982 to 2011 in male children and adolescents from Kolkata, India
- Magdalena Żegleń, Łukasz Kryst, Parasmani Dasgupta, Rana Saha, Rituparna Das, Sukanta Das
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- Published online by Cambridge University Press:
- 19 February 2020, pp. 71-81
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The aim of this study was to investigate inter-generational changes in selected mid-upper-arm measurements of boys from Kolkata, India. The analysis was based on the anthropometric measurements of two cohorts of Bengali boys aged 7–16 from middle-class families, in 1982–83 and 2005–11. The two cohorts were compared in terms of their mid-upper-arm circumference (MUAC) and mid-upper-arm area (MUAA), mid-upper-arm muscle area (MUAMA), mid-upper-arm fat area (MUAFA) and Arm Fat Index (AFI). The significances of the differences were determined using two-way ANOVA. All features differed significantly between the examined cohorts and all showed a general positive secular trend. In most cases, the biggest differences were noted for 14- and 16-year olds and the smallest for the youngest boys. The contemporary boys seemed to have more favourable overall developmental conditions, probably related to socioeconomic progress in India over recent decades.
The realization of fertility intentions in the context of childbearing postponement: comparison of transitional and post-transitional populations
- Jiřina Kocourková, Anna Šťastná
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- Published online by Cambridge University Press:
- 10 March 2020, pp. 82-97
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Childbearing postponement is a key demographic change that has been experienced by most European countries. It leads to a late-fertility pattern, with women realizing their reproductive plans preferentially after the age of 30. This may result in a lower fertility level. Since the ideal family size has not changed in most European countries, it has been argued that the end of the postponement transition further depends on the extent to which the lower fertility of younger women is compensated for by an increase in that of older women. Thus, the completion of the transition depends not only on the formation of a late childbearing pattern, but also on the capability of women to realize their reproductive plans if they commence childbearing later in their lives. This study employed a new approach to assess postponement transition based on analysis of the realization of the fertility intentions of women at later childbearing ages using survey panel data. A method that enables the differentiation between transitional and post-transitional cohorts was applied. The investigation was based on a comparison of the postponement transition in Czechia and France, the former being a post-communist and the latter a Western European country. It was found that despite having a similar pattern of fertility timing, Czechia and France underwent differing phases of postponement transition. The Czech population was identified as being transitional since only the ‘transition’ cohorts had completed their fertility during the period under study. These cohorts did not show a significant increase in realization of fertility intentions in later age. In contrast, the post-transitional French population is characterized by higher completed cohort fertility rates amongst women who entered motherhood at the age of 30 and over and by the significantly higher realization of fertility intentions for women aged 30–34 years.
Body structure, muscular strength and living conditions of primary school children in Warsaw
- Anna Siniarska, Joanna Nieczuja-Dwojacka, Małgorzata Grochowska, Sławomir Kozieł
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- Published online by Cambridge University Press:
- 20 February 2020, pp. 98-107
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The aim of this study was to determine whether the living conditions of school children affects their body structure and muscular strength. Data were taken from 400 girls and 341 boys aged 7–15 years attending nine primary schools in Warsaw in 1997. A questionnaire was completed, anthropological measurements made and two muscular strength tests conducted. The questionnaire asked questions on the children’s level of education, their parents’ professions and monthly incomes, the number of persons in the family and the number of rooms in the family’s apartment/home. Body height, body weight, chest and arm circumferences, grip strength and vertical jump height were measured and used to calculate body mass index, Marty’s Index and the Sargent Vertical Jump Index. Statistical tests included Student’s t-test, Principal Component Analysis (PCA) and multiple regression analysis. Body height, chest circumference, Sargent Vertical Jump Index and grip strength were significantly greater in the boys than the girls. Two factors, namely ‘socioeconomic status’ (F1) and ‘family size’ (F2), describing living conditions, were isolated after PCA. Boys from bigger families (F2) were shorter, with lower weights and BMIs, smaller chest and arm circumferences and greater grip strengths than those from smaller families, whereas girls from families of lower socioeconomic status (F1) weighed less and had greater BMIs and arm circumferences than those from higher socioeconomic status families. The results suggest that boys seem to be more ‘ecosensitive’ than girls.
Prevalence and clustering of diarrhoea within households in India: some evidence from NFHS-4, 2015–16
- Bevin Vijayan, Mala Ramanathan
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- Published online by Cambridge University Press:
- 04 March 2020, pp. 108-120
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Diarrhoeal disease is one of the major causes of morbidity and mortality in children and is usually measured at individual level. Shared household attributes, such as improved water supply and sanitation, expose those living in the same household to these same risk factors for diarrhoea. The occurrence of diarrhoea in two or more children in the same household is termed ‘diarrhoea clustering’. The aim of this study was to examine the role of improved water supply and sanitation in the occurrence of diarrhoea, and the clustering of diarrhoea in households, among under-five children in India. Data were taken from the fourth round of the National Family and Health Survey (NFHS-4), a nationally representative survey which interviewed 699,686 women from 601,509 households in the country. If any child was reported to have diarrhoea in a household in the 2 weeks preceding the survey, the household was designated a diarrhoeal household. Household clustering of diarrhoea was defined the occurrence of diarrhoea in more than one child in households with two or more children. The analysis was done at the household level separately for diarrhoeal households and clustering of diarrhoea in households. The presence of clustering was tested using a chi-squared test. The overall prevalences of diarrhoea and clustering of diarrhoea were examined using exogenous variables. Odds ratios, standardized to allow comparison across categories, were computed. The household prevalence of diarrhoea was 12% and that of clustering of diarrhoea was 2.4%. About 6.5% of households contributed 12.6% of the total diarrhoeal cases. Access to safe water and sanitation was shown to have a great impact on reducing diarrhoeal prevalence and clustering across different household groups. Safe water alone had a greater impact on reducing the prevalence in the absence of improved sanitation when compared with the presence of improved sanitation. It may be possible to reduce the prevalence of diarrhoea in households by targeting those households with more than one child in the under-five age group with the provision of safe water and improved sanitation.
Does use of solid fuels for cooking contribute to childhood stunting? A longitudinal data analysis from low- and middle-income countries
- Ashish Kumar Upadhyay, Swati Srivastava, Vinod Mishra
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- Published online by Cambridge University Press:
- 03 March 2020, pp. 121-136
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Using longitudinal data from the first and second waves of the Young Lives Study (YLS) in Ethiopia, India (Andhra Pradesh), Peru and Vietnam, conducted in 2002 and 2006–07, and a repeated measures mixed model, this study examined the effect of the use of solid fuels for cooking on childhood stunting among children aged 5–76 months. The analysis showed that in all four populations, the average height-for-age z-score (HAZ score) was much lower among children living in households using solid fuels than among children in households using cleaner fuels for cooking. The average HAZ score was lower among children living in households that used solid fuels in both waves of the YLS compared with those whose households used solid fuels in only one of the two waves. A significant reduction was noted in the average HAZ score between the two waves in all countries except Ethiopia. The results of the repeated measures mixed model suggest that household use of solid fuels was significantly associated with lower HAZ scores in all populations, except Ethiopia. The findings also indicate that the reduction in the HAZ scores between waves 1 and 2 was not statistically significant by the type of cooking fuel after controlling for potential confounding factors. The study provides further evidence of a strong association between household use of solid fuels and childhood stunting in low- and middle-income countries using longitudinal data. The findings highlight the need to reduce exposure to smoke from the combustion of solid fuels, by shifting households to cleaner cooking fuels, where feasible, by providing cooking stoves with improved combustion of solid fuels and improved venting, and by designing and implementing public information campaigns to inform people about the health risks of exposure to cooking smoke.
Women’s socioeconomic status and choice of birth control method: an investigation for the case of Turkey
- Deniz Karaoğlan, Dürdane Şirin Saraçoğlu
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- Published online by Cambridge University Press:
- 11 March 2020, pp. 137-156
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This study investigated whether woman’s education, labour market status and the status within the household have any impact on their birth control behaviour in Turkey. Empirical analyses were implemented using the 2013 Demographic and Health Survey dataset, which includes information on women’s socioeconomic status and their current choice of contraceptives: whether they used any method, and if so, what method they used. Using a bivariate probit model with selection to control for any possible selection bias, the results suggest that whether a woman uses any birth control method, and whether the woman chooses modern methods over traditional methods, are primarily explained by education level and urban/rural residence, and that the determinants of contraceptive use vary across college-educated and non-college-educated women. The results also indicate that non-employed women are less likely to use any birth control method compared with women with regular, full-time jobs. However the effect was statistically insignificant.