Volume 8, Number 36
22 September 2008

There will be a hiatus in publishing The Pop Reporter after the September 22 edition, due to funding constraints. We will keep you informed about future publishing plans as soon as possible.

ADOLESCENT HEALTH RESEARCH

Adolescent boys: who cares?
(Editorial; Global)
Bulletin of the World Health Organization. 2008 Sep;86(9):659-660.
Schmid GP | Dick B
Little attention has been paid to the complications of traditional male circumcision by most organizations. Globally, 30-34% of men are circumcised. Most of these circumcisions are performed for cultural or religious reasons during adolescence, outside formal health-care settings, without anaesthesia and in challenging traditional settings. Male circumcision provides partial protection for men against acquiring HIV infection through heterosexual sex. In those communities where the tradition of male circumcision occurs, it likely makes an important contribution to HIV prevention. However, working with traditional circumcisers to improve the safety of male circumcision remains a challenge. We must, therefore, explore ways to increase the provision of safe and humane male circumcision services to those who want to be circumcised in these settings.

Post-traumatic stress and psychiatric disorders in Palestinian adolescents following intifada-related injuries
(Abstract; subscription needed for full text; Middle East)
Social Science and Medicine. 2008 Oct;67(8):1199-1207.
Khamis V
This study was designed to assess the occurrence of post-traumatic stress disorder (PTSD) and psychiatric disorders (i.e., anxiety and depression) in Palestinian adolescents following intifada-related injuries. It was hypothesized that a combination of pre-trauma variables (e.g., age, geographic location), trauma-specific variables such as trauma recency, type of trauma (deliberately violent vs. accidental), and post-trauma variables (e.g., social support, coping strategies, belief in fate) would be predictive of these psychological sequelae. The participants were 179 boys who were injured during Al-Aqsa intifada and as a result sustained a permanent physical disability. They ranged in age from 12 to 18 years (M = 16.30, SD = 1.64). Questionnaires were administered in an interview format with adolescents at home. Approximately 76.5% of the injured victims qualify as having PTSD and that the disorder had a heterogeneous course, with excess risk for chronic symptoms and comorbidity with other psychiatric disorders such as anxiety and depression. Among all the predictors in the PTSD, anxiety and depression models, only geographical location, fatalism, and negative coping were significant predictors. In conclusion, post-traumatic reactions and psychiatric disorders in adolescents involved in armed conflict injuries can persist for several months. Given the apparent significant relationship between psychological sequelae of intifada-related injuries and certain predictors (i.e., negative coping style and fatalism), treatments such as trauma-focused cognitive behaviour therapy may yield positive results. Negative coping and fatalism should be addressed more directly during therapy.

FAMILY PLANNING RESEARCH

Influence of IUD perceptions on method discontinuation
(Abstract; subscription needed for full text; Middle East)
Contraception. 2008 Oct;78(4):290-293.
Alnakash AH
The study was conducted to assess how misbeliefs and fears about intrauterine contraceptive devices (IUDs) can influence the rate of early discontinuation of this method. This is a prospective survey conducted at the Family Planning Clinic at Al-Habibia Maternity Teaching Hospital (Baghdad, Iraq). Two hundred women presenting to the family planning clinic with requests for premature IUD removal were administered a structured questionnaire to ascertain demographic information and reasons for removal request. Careful and sympathetic questioning was essential in order to obtain correct information. The data were analyzed using descriptive and inferential statistics. Slightly over half of the women (52.8%) gave only one reason for requesting removal, while the remaining (47.5%) women had two or three complaints. Side effects were the principal reason for request for removal in both groups (45.7% and 42.6%). In the group that offered only one reason, IUD side effects, device-related issues, fears about the device and pregnancy or seeking pregnancy were the reported reasons. In the group that offered more than one reason, each had two or three complaints. IUD side effects and fears about the device were the most prevalent (42.6% and 41.8%, respectively); these fears and perceptions were reported more frequently among younger users and among those requesting early removal. Fears and misbeliefs about IUD contributed to discontinuation of use in almost half of the women requesting IUD removal. These elements were more common among younger women and, noticeably, among those who requested early removal.

Safety of intrauterine contraceptive device (copper T 200 B) in women with cardiac disease
(Abstract; subscription needed for full text; Asia)
Contraception. 2008 Oct;78(4):315-318.
Suri V | Aggarwal N | Kaur R | Chaudhary N | Ray P
Women with cardiac disease have need for effective long-lasting reversible contraception. Women with cardiac disease are at increased risk for bacterial endocarditis. There is limited research regarding the use of intrauterine contraceptive devices (IUD) in women with cardiac disease. In a prospective study, the IUD copper (Cu T200B) was inserted in 40 women with cardiac disease. Infective endocarditis prophylaxis was given 1 h before IUD insertion. The IUD was inserted under aseptic conditions. Ten milliliters of venous blood was obtained for culture of aerobic and anerobic bacteria within 1 h of insertion of the copper T IUD. Women were contacted for follow-up at frequent intervals. There was no incidence of uterine perforation, hemorrhage or spontaneous expulsion of the IUD. All blood cultures were sterile. There were no cases of infective endocarditis. Four women (10%) had menorrhagia at the 6-month follow-up which responded to medical management. One woman had PID for which antibiotics were given. Five women had mild cramps and five had spotting after insertion of the IUD. Patient adherence was excellent as none returned for removal for reasons other than desire for another pregnancy. The Cu T200B IUD is a reasonably safe and effective method of temporary contraception in women with cardiac disease who are not receiving anticoagulant therapy.

Feasibility, acceptability, effect and cost of integrating counseling and testing for HIV within family planning services in Kenya
(Report; Sub-Saharan Africa)
[Washington, D.C.], Population Council, Frontiers in Reproductive Health, 2008 Jul. [47] p. (USAID Cooperative Agreement No. HRN-A-00-98-00012-)
Liambila W | Kibaru J | Warren C | Gathitu M | Mullick S
Integrating counseling and testing (CT) for HIV into family planning (FP) services potentially increases the range of services available for FP clients, many of whom are at risk of STIs including HIV in high prevalence settings. Systematic evidence about offering CT in FP settings has remained extremely limited, despite the widespread interest in this model of FP-HIV integration. FRONTIERS supported the Division of Reproductive Health (DRH) and the National AIDS and STI Control Program (NASCOP) of the Kenya Ministry of Health (MOH) to design, implement and compare two models of integrating CT for HIV within FP services in 23 health facilities in Nyeri and Thika Districts of Central Province, Kenya in terms of their feasibility, acceptability, cost and effect on the voluntary use of CT, as well as the quality of FP services. The study utilized a pre-post intervention design to obtain information from FP providers and their clients in 2006 to 2007. Data were collected through provider-client observations (554 at baseline and 530 at endline) and client exit interviews (552 at baseline and 530 at end line), pre and post intervention interviews and focus group discussions with health providers, and a health facility assessment of the readiness of facilities to offer HIV CT within FP services. Introduction and implementation involved: (a) holding sensitization meetings at national, provincial and district levels; (b) reviewing and developing training materials; (c) application of the Balanced Counseling Strategy (BCS) Plus approach; (d) modification of facility registers to record the required data; and (e) training of health providers. The MOH provided all required equipment and supplies, including HIV rapid test kits and FP commodities. Two models were pilot-tested. The "testing" model was implemented in Nyeri District, an area with relatively few VCT sites. In this model, FP clients were educated about HIV prevention generally, and CT in particular, and offered HIV CT during this consultation by the FP provider. The "referral" model was implemented in Thika district, an area with good accessibility to VCT services. In this model, FP clients were educated about HIV CT, and those interested were instead referred to a specialized CT service, either within the same facility or to another CT service (at another health facility or a stand-alone VCT center). The study demonstrated that both models were feasible and acceptable to providers and to clients as means of integrating and linking HIV prevention counseling, condom promotion and counseling and testing with FP services, and are effective in increasing quality of care and service utilization.

Using formal consensus methods to adapt World Health Organization Medical Eligibility Criteria for contraceptive use
(Abstract; subscription needed for full text)
Contraception. 2008 Oct;78(4):300-308.
Stephen G | Brechin S | Glasier A
Most contraceptive users are medically fit and can use any available method. Some medical conditions are associated with theoretical safety concerns when certain contraceptives are used. Nevertheless, most contraceptive clinical trials exclude subjects with chronic medical conditions, and direct evidence on which to base sound contraceptive prescribing is limited. The World Health Organization (WHO) Medical Eligibility Criteria provide recommendations on the safe use of contraception. This document is aimed at policymakers and program managers working in less developed countries in which the risks of pregnancy usually far outweigh the risks associated with contraceptive use. The Faculty of Sexual and Reproductive Healthcare used formal consensus methods to adapt the WHO document to reflect clinical practice and health care systems in the United Kingdom. This structured group consensus method adds authority, rationality and scientific credibility to the UK version, which makes best use of published evidence and captures collective expert knowledge. Not all clinicians will agree with the recommendations made in the UK version of the Medical Eligibility Criteria, but for the vast majority, they will be a valuable reference to guide clinical practice for women with many conditions that theoretically affect contraceptive use.

GENDER and HEALTH RESEARCH

Making schools inclusive: How change can happen. Save the Children's experience
(Report; Global)
London, United Kingdom, Save the Children, 2008. 62 p.
Pinnock H | Lewis I
"Making education more inclusive requires schools and education authorities to remove the barriers to education experienced by the most excluded children - often the poorest, children with disabilities, children without family care, girls, or children from minority groups." Also included in the text are examples of children from very remote areas, girls excluded from school, children from ethnic groups, children with language barriers, and children in countries affected by conflict.

Physical violence against intimate partners and related exposures to violence among South African men
(Abstract; subscription needed for full text; Sub-Saharan Africa)
CMAJ. Canadian Medical Association Journal / Journal de l'Association Medicale Canadienne. 2008 Sep 9;179(6):535-541.
Gupta J | Silverman JG | Hemenway D | Acevedo-Garcia D | Stein DJ
Despite high rates of intimate partner violence in South Africa, there have been no national studies of men's perpetration of violence against female partners. Data was analysed from the South Africa Stress and Health Study, a cross-sectional, nationally representative study, specifically examining data for men who had ever been married or had ever cohabited with a female partner. We calculated the prevalence of physical violence against intimate female partners and used logistic regression to examine associations with physical abuse during childhood and exposure to parental and community violence. A total of 834 male participants in the South Africa Stress and Health Study met the study criteria. Of these, 27.5% reported using physical violence against their current or most recent female partner during their current or most recent marriage or cohabiting relationship. Crude odds ratios (ORs) and 95% confidence intervals (CIs) indicated significant associations between perpetration of violence against an intimate partner and witnessing parental violence (OR 3.91, 95% CI 2.66-5.73) or experiencing physical abuse during childhood (OR 3.24, 95% CI 2.27-4.63), but not exposure to community violence (OR 1.29, 95% CI 0.88-1.88). The 2 significant associations persisted in adjusted analyses: OR 3.22 (95% CI 1.94-5.33) for witnessing parental violence and OR 1.73 (95% CI 1.07-2.79) for experiencing physical abuse during childhood. The author's found a high prevalence of physical violence perpetrated by men against their intimate partners. Men who experienced physical abuse during childhood or were exposed to parental violence were at the greatest risk.

HIV/AIDS and STIs RESEARCH

Making HIV prevention programmes work
(Abstract; subscription needed for full text; Global)
Lancet. 2008 Sep 6-12;372(9642):831-844.
Bertozzi SM | Laga M | Bautista-Arredondo S | Coutinho A
Even after 25 years of experience, HIV prevention programming remains largely deficient. We identify four areas that managers of national HIV prevention programmes should reassess and hence refocus their efforts- improvement of targeting, selection, and delivery of prevention interventions, and optimisation of funding. Although each area is not wholly independent from one another, and because each country and epidemic context will require a different balance of time and funding allocation in each area, we present the current state of each dimension in the global HIV prevention arena and propose practical ways to remedy present deficiencies. Insufficient data for intervention effectiveness and country-specific epidemiology has meant that programme managers have operated, and continue to operate, in a fog of uncertainty. Although priority must be given to the improvement of prevention methods and the capacity for the generation and use of evidence to improve programme planning and implementation, uncertainty will remain. In the meantime, however, we argue that prevention programming can be made much more effective by use of information that is readily available.

Male circumcision for HIV prevention: A prospective study of complications in clinical and traditional settings in Bungoma, Kenya
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Bulletin of the World Health Organization. 2008 Sep;86(9):669-677.
Bailey RC | Egesah O | Rosenberg S
Male circumcision reduces the risk of HIV acquisition by approximately 60%. Male circumcision services are now being introduced in selected populations in sub-Saharan Africa and further interventions are being planned. A serious concern is whether male circumcision can be provided safely to large numbers of adult males in developing countries. This prospective study was conducted in the Bungoma district, Kenya, where male circumcision is universally practised. Young males intending to undergo traditional or clinical circumcision were identified by a two-stage cluster sampling method. During the July-August 2004 circumcision season, 1007 males were interviewed 30-89 days post- circumcision. Twenty-four men were directly observed during and 3, 8, 30 and 90 days post-circumcision, and 298 men underwent clinical exams 45-89 days post-procedure. Twenty-one traditional and 20 clinical practitioners were interviewed to assess their experience and training. Inventories of health facilities were taken to assess the condition of instruments and supplies necessary for performing safe circumcisions. Of 443 males circumcised traditionally, 156 (35.2%) experienced an adverse event compared with 99 of 559 (17.7%) circumcised clinically (odds ratio: 2.53; 95% confidence interval: 1.89-3.38). Bleeding and infection were the most common adverse effects, with excessive pain, lacerations, torsion and erectile dysfunction also observed. Participants were aged 5 to 21 years and half were sexually active before circumcision. Practitioners lacked knowledge and training. Proper instruments and supplies were lacking at most health facilities. Extensive training and resources will be necessary in sub-Saharan Africa before male circumcision can be aggressively promoted for HIV prevention. Two-thirds of African men are circumcised, most by traditional or unqualified practitioners in informal settings. Safety of circumcision in communities where it is already widely practised must not be ignored.

Voluntary counselling and testing uptake and HIV prevalence among tuberculosis patients in Jogjakarta, Indonesia
(Abstract; subscription needed for full text; Asia)
Transactions of the Royal Society of Tropical Medicine and Hygiene. 2008 Oct;102(10):1003-1010.
Mahendradhata Y | Ahmad RA | Kusuma TA | Boelaert M | Van der Werf MJ
We aimed to establish HIV prevalence and uptake of unlinked anonymous testing and voluntary counselling and testing (VCT) among tuberculosis (TB) patients in Jogjakarta, Indonesia. We introduced unlinked anonymous HIV testing for TB patients attending directly observed treatment, short-course services between April and December 2006. Patients were additionally offered VCT services. Of 1269 TB patients who were offered unlinked anonymous testing, 989 (77.9%; 95% CI 75.6-80.1%) accepted. HIV prevalence was 1.9% (95% CI 1.6-2.2%). HIV infections were less frequently diagnosed among TB patients who attended a public health centre [odds ratio (OR) 0.15; 95% CI 0.03-0.70] rather than public hospital. They were more frequent in TB patients with a university education background (OR 5.16; 95% CI 1.01-26.63) or a history of HIV testing (OR 57.87; 95% CI 9.42-355.62). Of the 989 patients who accepted unlinked anonymous testing, only 133 (13.4%; 95% CI 11.5-15.7%) expressed interest in VCT. Of these, 52 (39.1%; 95% CI 31.2-47.6%) attended VCT, but interest was higher among students and those offered VCT by public health centres. The HIV prevalence in Jogjakarta is higher than expected and needs to be monitored cautiously. Unlinked anonymous HIV testing is well accepted and can be implemented with modest additional efforts.

Coming to terms with complexity: A call to action for HIV prevention
(Abstract; subscription needed for full text; Global)
Lancet. 2008 Sep 6-12;372(9641):845-859.
Piot P | Bartos M | Larson H | Zewdie D | Mane P
A quarter of a century of AIDS responses has created a huge body of knowledge about HIV transmission and how to prevent it, yet every day, around the world, nearly 7000 people become infected with the virus. Although HIV prevention is complex, it ought not to be mystifying. Local and national achievements in curbing the epidemic have been myriad, and have created a body of evidence about what works, but these successful approaches have not yet been fully applied. Essential programmes and services have not had sufficient coverage; they have often lacked the funding to be applied with sufficient quality and intensity. Action and funding have not necessarily been directed to where the epidemic is or to what drives it. Few programmes address vulnerability to HIV and structural determinants of the epidemic. A prevention constituency has not been adequately mobilised to stimulate the demand for HIV prevention. Confident and unified leadership has not emerged to assert what is needed in HIV prevention and how to overcome the political, sociocultural, and logistic barriers in getting there. The author's discuss the combination of solutions which are needed to intensify HIV prevention, using the existing body of evidence and the lessons from our successes and failures in HIV prevention.

Antiretroviral therapy and early mortality in South Africa
(Research Article; Sub-Saharan Africa)
Bulletin of the World Health Organization. 2008 Sep;86(9):678-687.
Boulle A | Bock P | Osler M | Cohen K | Channing L
The objective of this study is to describe province-wide outcomes and temporal trends of the Western Cape Province antiretroviral treatment (ART) programme 5 years since inception, and to demonstrate the utility of the WHO monitoring system for ART. The treatment programme started in 2001 through innovator sites. Rapid scaling-up of ART provision began early in 2004, located predominantly in primary-care facilities. Data on patients starting ART were prospectively captured into facility-based registers, from which monthly cross-sectional activity and quarterly cohort reports were aggregated. Retention in care, mortality, loss to follow-up and laboratory outcomes were calculated at 6-monthly durations on ART. By the end of March 2006, 16 234 patients were in care. The cohort analysis included 12,587 adults and 1709 children. Women accounted for 70% of adults enrolled. After 4 and 3 years on ART respectively, 72.0% of adults (95% confidence interval, CI: 68.0-75.6) and 81.5% (95% CI: 75.7-86.1) of children remained in care. The percentage of adults starting ART with CD4 counts less than 50 cells/microl fell from 51.3% in 2001 to 21.5% in 2005, while mortality at 6 months fell from 12.7% to 6.6%, offset in part by an increase in loss to follow-up (reaching 4.7% at 6 months in 2005). Over 85% of adults tested had viral loads below 400 copies/ml at 6-monthly durations until 4 years on ART. The location of care in primary-care sites in this programme was associated with good retention in care, while the scaling-up of ART provision was associated with reduced early mortality.

MATERNAL AND CHILD HEALTH RESEARCH

Children's school participation and HIV/AIDS in rural Malawi: The role of parental knowledge and perceptions
(Research Article; Sub-Saharan Africa)
Demographic Research. 2008 Sep 12;19(45):1603-1634.
Grant MJ
Studies of the relationship between HIV/AIDS and children's educational attainment largely focus on the direct impacts of parental illness and death, overlooking the potential indirect impact that parental knowledge and perceptions of their HIV status may have on children's school enrollment. Drawing on both quantitative and qualitative evidence from Malawi, this paper finds that women's real and perceived anticipation of future health shocks has a positive impact on their children's educational attainment. Interventions that target health uncertainty, such as HIV testing programs, may make a significant contribution to maintaining children's educational attainment in communities affected by HIV/AIDS.

Supporting orphans and vulnerable children affected by AIDS: Using community-generated definitions to explore patterns of children's vulnerability in Zambia
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS Care. 2008 Sep;20(8):894-903.
Schenk KD | Ndhlovu L | Tembo S | Nsune A | Nkhata C
This study explores how communities in Zambia characterize vulnerable children in the context of HIV; demonstrates how estimates of vulnerability vary depending on definitions; and discusses the implications of these estimates for program delivery. Baseline research conducted in 2005 included cross-sectional community-based household surveys at six locations using multi-stage random sampling (totalling 1,503 households, reporting on 5,009 children) and participatory qualitative research (focus group and in-depth interviews) with adults and youth at four locations. Between 14 and 27% of children in the sample had experienced a parental death (2-5% maternal orphans, 7-13% paternal orphans, 4-10% double orphans). In addition, other characteristics that communities associated with children's vulnerability were prevalent: 26-34% had been taken into another household, 15-27% were living in female-headed households, and 11-28% were living in a household with someone who is chronically ill. Overall, 58-73% of children had one or more community-defined characteristics of vulnerability. This study highlights the need to carefully consider the meaning of "vulnerability" when targeting programmes to support children affected by HIV and AIDS. Local community input is vital to inform context-specific criteria for distributing programme resources. If used, eligibility criteria should be context-specific yet flexible to evolving community realities. In settings such as rural Zambia where levels of HIV-related vulnerability are high, it may be more efficient to target at the level of communities rather than assess individual households.

Declining HIV prevalence among young pregnant women in Lusaka, Zambia
(Research Article; Sub-Saharan Africa)
Bulletin of the World Health Organization. 2008 Sep;86(9):697-702.
Stringer EM | Chintu NT | Levy JW | Sinkala M | Chi BH
HIV prevention has been ongoing in Lusaka for many years. Recent reports suggest a possible decline in HIV seroincidence in Zambia and some neighbouring countries. This study aimed to examine trends in HIV seroprevalence among pregnant and parturient women between 2002 and 2006. The authors analysed HIV seroprevalence trends from two Lusaka sources: (i) antenatal data from a city-wide programme to prevent mother-to-child HIV transmission, and (ii) delivery data from two anonymous unlinked cord-blood surveillances performed in 2003 and again in 2005-2006, where specimens from greater than 97% of public-sector births in each period were obtained and analysed. Between July 2002 and December 2006, the Lusaka district tested 243,302 antenatal women for HIV; 54 853 (22.5%) were HIV infected. Over this period, the HIV seroprevalence among antenatal attendees who were tested declined steadily from 24.5% in the third quarter of 2002 to 21.4% in the last quarter of 2006 (P less than 0.001). The cord-blood surveillances were conducted between June and August 2003 and again between October 2005 and January 2006. Overall HIV seroprevalence declined from 25.7% in 2003 to 21.8% in 2005-2006 (P = 0.001). Among women less than or= 17 years of age, seroprevalence declined from 12.1% to 7.7% (P = 0.015). HIV seroprevalence appears to be declining among antenatal and parturient women in Lusaka. The decline is most dramatic among women less than or= 17 years of age, suggesting a reduction in sero-incidence in this important age group.

Estimating child mortality due to diarrhoea in developing countries
(Research Article; Global)
Bulletin of the World Health Organization. 2008 Sep;86(9):710-717.
Boschi-Pinto C | Velebit L | Shibuya K
The major objective of this study is to provide estimates of diarrhoea mortality at country, regional and global level by employing the Child Health Epidemiology Reference Group (CHERG) standard. A systematic and comprehensive literature review was undertaken of all studies published since 1980 reporting under-5 diarrhoea mortality. Information was collected on characteristics of each study and its population. A regression model was used to relate these characteristics to proportional mortality from diarrhoea and to predict its distribution in national populations. Global deaths from diarrhoea of children aged less than 5 years were estimated at 1.87 million (95% confidence interval, CI: 1.56-2.19), approximately 19% of total child deaths. WHO African and South-East Asia Regions combined contain 78% (1.46 million) of all diarrhoea deaths occurring among children in the developing world; 73% of these deaths are concentrated in just 15 developing countries. Planning and evaluation of interventions to control diarrhoea deaths and to reduce under-5 mortality is obstructed by the lack of a system that regularly generates cause-of-death information. The methods used here provide country-level estimates that constitute alternative information for planning in settings without adequate data.

POPULATION/FERTILITY/DEMOGRAPHY RESEARCH

On postponement and birth intervals
(Abstract; subscription needed for full text; Global)
Population and Development Review. 2008 Sep;34(3):483-510.
Timaeus IM | Moultrie TA
Much of the literature on fertility transition presumes that birth control is practiced either to limit family size or to space births. This article argues that women also use birth control to postpone pregnancy. Postponement is not synonymous with spacing. It arises when women delay their next birth for indefinite periods for reasons unrelated to the age of their youngest child, but without deciding not to have any more children. Postponement has a distinctive impact on the shape of birth-interval distributions that differs from the impacts of family size limitation, birth spacing, or a mixture of the two behaviors. Some populations, such as that in South Africa, have developed fertility regimes characterized by birth intervals far longer than can be accounted for by birth spacing. Postponement of further childbearing that eventually becomes permanent may be an important driver of the transition to lower fertility in sub-Saharan Africa.

Eager to leave? Intentions to migrate abroad among young people in Kyrgyzstan
(Abstract; subscription needed for full text; Asia)
International Migration Review. 2008 Autumn;42(3):620-651.
Agadjanian V | Nedoluzhko L | Kumskov G
This study examines young people's intentions to migrate abroad in Kyrgyzstan, focusing in particular on differences between Asian and European-origin ethnic groups. The multivariate analyses of recent survey data show that even after controlling for socioeconomic characteristics and social embeddedness Europeans are significantly more inclined to migrate than Asians. Whereas no gender differences in migration intentions among either group are detected, marriage, childbearing, and social capital exhibit distinct ethnic-specific effects. Although economic considerations are prevailing stimuli for migration in both groups, the results point to the formation of two dominant ethnic-specific migration preference types -for temporary migration among Asians and permanent migration among Europeans.

Sources of error and bias in methods of fertility estimation contingent on the P/F ratio in a time of declining fertility and rising mortality
(Abstract; subscription needed for full text; Global)
Demographic Research. 2008 Sep 16;19(46):1635-1662.
Moultrie TA | Dorrington R
Almost all commonly used indirect fertility estimation methods rely on the P/F ratio. As originally conceived, the ratio compares cumulated cohort fertility with cumulated period fertility on the basis of three, fairly strong, assumptions. The intention of this paper is to interrogate what happens to the results produced by the P/F ratio method as each of these three assumptions is violated, first independently, and then concurrently. These investigations are important given the generally poor quality of census data collected in developing countries, particularly sub-Saharan Africa, and the radically altering demographic conditions associated with a generalised HIV/AIDS epidemic in the region.

Global demographic convergence? A reconsideration of changing intercountry inequality in fertility
(Abstract; subscription needed for full text; Global)
Population and Development Review. 2008 Sep;34(3):519-537.
Dorius SF
This research challenges the notion that the second half of the twentieth century was a period of global demographic convergence. To be sure, fertility rates fell substantially during the period, but with considerable un-evenness. The declines in total fertility across population-weighted countries were sufficiently disproportionate that intercountry fertility inequality, estimated using standard measures of inequality, did not begin to decline until at least 1995. Regression analysis also shows that only very recently did lagging countries begin to catch up with countries that began the transition to low fertility earlier. Contrary to findings on changing intercountry health inequality, sub-Saharan Africa has had a greater impact on changes in fertility inequality than China. The trend in fertility inequality, where convergence is a relatively new phenomenon, stands in contrast to trends in inequality in other domains, such as income, education, and health.

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