Volume 7, Number 46
3 December 2007

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ADOLESCENT HEALTH NEWS

Kenya: Youths asked to take HIV test
(News Article; Sub-Saharan Africa)
27 Nov 2007
Mwaniki, The Nation

Ghana: Ghanaian teenagers lack in-depth knowledge about contraceptives
(News Article; Sub-Saharan Africa)
23 Nov 2007
Public Agenda

ADOLESCENT HEALTH RESEARCH

Sexual harassment and abuse of adolescent schoolgirls in South India
(Abstract; subscription needed for full text; Asia)
Education, Citizenship and Social Justice. 2007 Nov;2(3):257-277.
Leach F | Sitaram S
This article reports on a small exploratory study of adolescent girls' experiences of sexual harassment and abuse while attending secondary school in Karnataka State, South India. In South Asia, public discussion of sexual matters, especially relating to children, is largely taboo, and the study uncovers a hidden aspect of schooling, which presents a further barrier to increasing girls' educational participation in India. Data from open-ended interviews and a participatory workshop in two schools revealed that girls were vulnerable to sexual harassment both within the school grounds (mostly by male pupils) and while travelling to and from school (by older boys and adult men), especially on public transport. For some girls, sexual harassment reduced their desire to continue their schooling, for others it increased their fear of being withdrawn if parents came to hear of any incident. Given the reluctance in patriarchal societies to address the abuse and exploitation of women and girls, the authors suggest that further research into this issue is urgently needed.

Sexual behaviour and contraceptive use among youth in the Balkans
(Abstract; subscription needed for full text; Europe)
European Journal of Contraception and Reproductive Health Care. 2007 Dec;12(4):309-315.
Delva W | Wuillaume F | Vansteelandt S | Claeys P | Verstraelen H
The objectives were to assess sexual and health seeking behaviour related to contraception among high school students in Bosnia (Sarajevo), the FYR of Macedonia (Skopje), and Serbia and Montenegro (Belgrade and Podgorica). A standardized questionnaire was self-administered by 2150 urban high school students. Multiple logistic regression analyses accounting for within-class correlation were applied to identify determinants of sexual behaviour, and the use of contraception and sexual and reproductive health (SRH) care. In this group of youth with a mean age of 16.7 years, 41.3% of the boys and 20.8% of the girls had already experienced sexual intercourse. Mean age at sexual debut differed between sexually active boys (15.5) and girls (16.3). A condom was used at first sex by 73.7% of the boys and by 69.0% of the girls. Condoms were consistently used during sexual intercourse with the current or last partner by 64.3% of the boys and 48.5% of the girls. Oral contraception was resorted to by 0.0% (Macedonia) to 10.6% (Bosnia) of sexually active girls. One third of sexually active girls and 18.0% of sexually active boys had ever refrained from seeking medical advice on SRH despite feeling the need for it, mainly because of feelings of shame, fear and insecurity. TV or radio and friends were mostly mentioned as useful sources of information on contraceptives. Age at sexual debut and the proportion of sexually active youth in these Balkan states do not differ from those in other parts of Europe. However, declining condom use after sexual initiation is not compensated by having recourse to other contraceptive methods, as seen in some West-European countries. The role of mass media in dissemination of information and tackling barriers to SRH care should be explored.

FAMILY PLANNING NEWS

Philippines: Parishioners embrace family planning method
(News Article; Asia)
27 Nov 2007
Indian Catholic

Pakistan: Workshop on reproductive health begins
(News Article; Asia)
30 Nov 2007
Associated Press of Pakistan, The Post

Yemen: 32% of married Yemeni women use birth control, study says
(News Article; Middle East)
28 Nov 2007
Mojalli AD, Yemen Times

USA: Male birth control pill discussed at futuristic medical conference
(News Article; Global)
29 Nov 2007
Pico P, KNSD/NBC News Channel

FAMILY PLANNING RESEARCH

Longitudinal association between hormonal contraceptives and bacterial vaginosis in women of reproductive age
(Abstract; subscription needed for full text; Global)
Sexually Transmitted Diseases. 2007 Dec;34(12):954-959.
Riggs M | Klebanoff M | Nansel T | Zhang J | Schwebke J | Andrews W
This study examined whether hormonal contraceptive use is associated with diagnosis of bacterial vaginosis (BV) over 1 year. A total of 3077 women of reproductive age were recruited from gynecologic and family planning clinics for a 1-year prospective longitudinal study. Data collected over 5 visits included demographics, health and hygiene behaviors, and gynecological exams. Gram stains were used to quantify vaginal flora. There was a decreased risk of overall BV prevalence among oral contraceptive users (odds ratio, OR 0.76; confidence interval, CI 0.63-0.90) and among those using hormonal injection/implant (OR 0.64; CI 0.53-0.76). An increased risk for BV prevalence (OR 1.38; CI 1.11-1.71) and incidence (OR 1.43; 1.02-2.07) was observed among those subjects who had tubal ligation. Greater remission of BV was found among those using hormonal injection or implant (OR 1.67; CI 1.23-2.27) whereas less remission occurred among those subjects who had tubal ligation (OR 0.56; CI 0.39-0.80). Hormonal contraceptive use is associated with a decreased risk of BV.

Contraceptive efficacy and side effects of Implanon
(Abstract; subscription needed for full text; Europe)
European Journal of Contraception and Reproductive Health Care. 2007 Dec;12(4):362-365.
Gezginc K | Balci O | Karatayli R | Colakoglu MC
The objective was to determine the efficacy and side effects of Implanon used for long-term contraception. Prospective study of 80 patients who used Implanon for long-term contraception between January 2004 and January 2006; side effects, efficacy and removals were recorded. Amenorrhoea, infrequent bleeding and frequent bleeding were reported by 33 (41.25%), 19 (23.75%) and 14 patients (17.5%), respectively. Non-menstrual side effects comprised breast tenderness in 15 patients (18.75%), acne in eight (10%), headache and dizziness in three (3.75%); depressive mood disorders, pelvic pain and loss of libido were mentioned each by two of the women (2.5%). During the study period, Implanon was removed from 20 participants. No problem was encountered during its placement or removal. Patients considering use of Implanon must be carefully selected and informed about its expected side effects before placement.

Sexual intercourse and current contraceptive use among university students in Finland
(Abstract; subscription needed for full text; Europe)
European Journal of Obstetrics, Gynecology and Reproductive Biology. 2007 Nov;135(1):104-110.
Virtala AM | Kunttu K | Huttunen TA | Virjo IO
The objective was to ascertain the current frequency of sexual intercourse, the current use of contraceptives, the ever use of emergency contraception, and the ever experience of condom failure among Finnish university students. The study population consisted of Finnish undergraduate university students (19-34 years of age) in 2004. The randomly selected sample comprised 5030 subjects. The data were collected by postal questionnaire, the response rate being 62.7%. Data were presented with frequency distributions and cross-tabulations. Chi-square test was used. Frequencies for women and men were presented and tested separately. A total of 80% of students were currently practicing sexual intercourse. Approximately half of the female students currently used hormonal contraception and one-third used a condom. Almost half of the men currently used a condom. The simultaneous use of condom and hormonal contraception was rare. Condom failure was common. The ever use of emergency contraception appeared to be associated with condom failure. Of Finnish university students 80% were sexually active and hormonal contraceptives were the most popular method of contraception among female students. The use of the condom should be practiced more often for prevention of sexually transmitted diseases.

GENDER and HEALTH NEWS

Namibia: Gender violence in the spotlight again
(News Article; Sub-Saharan Africa)
21 Nov 2007
Windhoek, The Namibian

South Africa: Ground-breaking sexual offences bill approved
(News Article; Sub-Saharan Africa)
20 Nov 2007
Khumalo G | Feni Z, BuaNews

Cameroon: Justice Minister pledges law against female circumcision
(News Article; Sub-Saharan Africa)
20 Nov 2007
Yufeh, Brenda

Sierra Leone: For women, war's over but violence goes on
(News Article; Sub-Saharan Africa)
26 Nov 2007

Africa: Joining the fight against gender-based violence
(News Article; Sub-Saharan Africa)
26 Nov 2007
UN IRIN

GENDER and HEALTH RESEARCH

Women's status, institutional barriers and reproductive health care: A case study in Yunnan, China
(Abstract; subscription needed for full text; Asia)
Health Policy. 2007 Dec;84(2-3):284-297.
Tian L | Li J | Zhang K | Guest P
Yunnan is one of the poorest and most remote provinces in China. The reproductive health status of the population is poor. The aim of the study was to identify factors contributing to poor reproductive health and major barriers in accessing reproductive health information and care and to inform interventions to increase access to and the quality of care in service delivery. The study was based on qualitative data collected from structured and unstructured interviews with health program managers, service providers, clients, and community members in three counties. Focus group discussions, field observations, reviews of the records of medical facilities and thematic analysis were used in the study. Gender inequality and the fragmented health system were some of the barriers in accessing the services. Incorrect diagnosis, over treatment and IUD insertion with un-sterilised tools may have contributed to the persistent high rate of reproductive tract infections (RTI) in the study settings. The improvement of reproductive health thus hinges critically upon the elevation of women's status. All health sectors within China's health system need to be better integrated and institutionally induced gender inequality ought to be reduced so that all in the population, particularly the vulnerable, will have equal and adequate access to reproductive health care.

Human papillomavirus infections in Cuban women with cervical intraepithelial neoplasia
(Abstract; subscription needed for full text; Central America and the Caribbean)
Sexually Transmitted Diseases. 2007 Dec;34(12):974-976.
Soto Y | Mune M | Morales E | Goicolea A | Mora J
The aims of the current study were to detect different HPV types in Cuban patients with different grades of cervical intraepithelial neoplasia (CIN) and to assess the association between HPV infection and other risk factors involved in the development of cervical cancer in Cuban women. We analyzed 60 samples from women with a previous diagnosis of abnormal cytology (15 CIN-1, 36 CIN-2, and 9 CIN-3), who were referred to the Gynecology and Obstetrics Department at Eusebio Hernandez Maternity Hospital in Havana, Cuba, by their primary clinics. Epidemiologic data were obtained from standardized questionnaires. The questionnaire was designed to provide information on sexual and reproductive behavior (reproductive and gynecological history, sexual history, and the age of the first intercourse), socioeconomic conditions, cigarette smoking, and oral contraceptive use. During the first visit to the hospital an informed consent was obtained from each patient. For HPV detection, ectocervical and endocervical scrapings were used; Pap smears were also analyzed. Every patient underwent colposcopic examination, which included two schematic drawings of the reactions of the acetic acid and Lugol solution. This method allowed the detection of leucoplastic lesions, atypical transformation zones, cervicitis, colpitis, and condylomatous lesions.

Violence against women in intimate relationships: Explanations and suggestions for interventions as perceived by healthcare workers, local leaders, and trusted community members in a northern district of Vietnam
(Abstract; subscription needed for full text; Asia)
Scandinavian Journal of Public Health. 2007 Nov;35(6):640-647.
Jonzon R | Vung ND | Ringsberg KC | Krantz G
This study explored professionals' and trusted community inhabitants' explanations of the violence between intimate partners and their suggestions for preventive activities. It was performed in a rural district in northern Vietnam. A total of 20 men and 20 women were strategically selected for focus-group discussions and the analyses followed the procedure for qualitative thematic content analysis. It was pointed out that violence against women was not discussed openly in the community and women subjected to violence kept silent and avoided seeking help in order not to reveal what was happening in the family. The informants perceived the violence as an interplay between individual and family-related factors and sociocultural norms and practices where Confucian ideology exerted a strong influence. When it came to prevention, there was a strong belief in educating the people and in enforcing policy and law. As described by the informants, traditional attitudes to gender roles and women's power disadvantage are found to be behind most of the explanations for intimate partner violence. Collaboration between sectors at local level, between the health sector and other bodies, and with community leaders as spokesmen would help to improve openness and reduce society's tolerance of violence against women. The mass media also have an important role to play.

HIV/AIDS and STIs NEWS

Nepal: It's okay to talk about sex on the radio
(News Article; Asia)
28 Nov 2007
PlusNews

China AIDS rate slows, main transmission now sex
(News Article; Asia)
Washington Post. 2007 Nov 29;
Blanchard B

Uruguay launches anti-HIV campaign targeting women, youths
(News Article; South America)
29 Nov 2007
Xinhua News

Kenya: HIV/Aids hurting education, says Saitoti
(News Article; Sub-Saharan Africa)
29 Nov 2007
AllAfrica/ East African Standard

Nigeria: Onaiyekan condemns discrimination of Aids victims
(News Article; Sub-Saharan Africa)
27 Nov 2007
AllAfrica/ Leadership

Kenya: Chief executives undergo HIV test
(News Article; Sub-Saharan Africa)
27 Nov 2007
Mwai E, AllAfrica / East African Standard

HIV/AIDS and STIs RESEARCH

Missed opportunities for participation in prevention of mother to child transmission programmes: Simplicity of nevirapine does not necessarily lead to optimal uptake, a qualitative study
(Abstract; subscription needed for full text; Sub-Saharan Africa)
AIDS Research and Therapy. 2007 Nov 22;4(1):27.
Nkonki LL | Doherty TM | Hill Z | Chopra M | Schaay N
The objective of this study was to examine missed opportunities for participation in a prevention of mother-to-child transmission (PMTCT) programme in three sites in South Africa. A rapid anthropological assessment was used to collect indepth data from 58 HIV-positive women who were enrolled in a larger cohort study to assess mother-to-child HIV transmission. Semi-structured interviews were conducted with the women in order to gain an understanding of their experiences of antenatal care and to identify missed opportunities for participation in PMTCT. 15 women actually missed their nevirapine not because of stigma and ignorance but because of health systems failures. Six were not tested for HIV during antenatal care. Two were tested but did not receive their results. Seven were tested and received their results, but did not receive nevirapine. Health Systems failure for these programme leakages ranged from non-availability of counselors, supplies such as HIV test kits, consent forms, health staff giving the women incorrect instructions about when to take the tablet and health staff not supplying the women with the tablet to take. HIV testing enables access to PMTCT interventions and should therefore be strengthened. The single dose nevirapine regimen is simple to implement but the all or nothing nature of the regimen may result in many missed opportunities. A short course dual or triple drug regimen could increase the effectiveness of PMTCT programmes.

Education attainment and the risk of HIV-1 infections in rural Kilimanjaro region of Tanzania, 1991-2005: A reversed association
(Abstract; subscription needed for full text; Sub-Saharan Africa)
Sexually Transmitted Diseases. 2007 Dec;34(12):947-953.
Mmbaga EJ | Leyna GH | Mnyika KS | Hussain A | Klepp KI
Previous studies found educated individuals to have higher risk of human immunodeficiency virus (HIV)-1 infection in Africa. A reverse in this association was predicted. We investigated the change in this association from 1991 to 2005 in a rural population in Tanzania. Two cross-sectional surveys were conducted in 1991 (N = 1152, response rate 76.4%) and 2005 (N = 1528, 73.0%). Consenting individuals aged 15 to 44 years living in Oria village were interviewed and gave blood for HIV-1 testing. Primary [adjusted odds ratio (AOR), 2.7; 95% confidence interval (CI): 1.3-20.0] and secondary/higher education (AOR, 4.5; 95% CI: 1.4 -24.9) were associated with increased risk of HIV-1 infection in 1991. A reversed association was observed in 2005 where reduced odds of infection were associated with primary (AOR, 0.5; 95% CI: 0.2-0.8) and secondary/higher education (AOR, 0.4; 95% CI: 0.3-0.9). This was most pronounced among educated men. Corresponding reduction in risk behaviors were observed. Increased odds of reporting ever use of condom (AOR, 2.8; 95% CI: 1.1-7.3) and 70% reduction in reporting greater than or equal to 2 sexual partners in the past year was observed among educated women. Educated men reported 60% reduction in the odds of reporting greater than or equal to 2 sexual partners in the past month preceding the last survey. A reversed association between education attainment and HIV-1 infection was observed in this population between 1991 and 2005. Education seems to have an empowering role in women. Decreased risk among educated men may have an impact on HIV-1 transmission. Improving education sector in rural areas might be instrumental in the fight against the HIV epidemic.

Finding peace (kwam sa-ngob jai): A Buddhist way to live with HIV
(Abstract; subscription needed for full text; Asia)
Journal of Holistic Nursing. 2007 Dec;25(4):228-235.
Ross R | Sawatphanit W | Suwansujarid T
This study examines the Buddhist beliefs and practices of Thai HIV-positive postpartum women as ways to live with their infection. Seven HIV-positive postpartum, Buddhist, Thai women were interviewed. Principles of hermeneutic phenomenology guided the study. All women in the study practiced spiritual activities based on their understanding of three central Buddhist beliefs: karma, the Five Precepts, and the Four Noble Truths. These beliefs played a major role in helping them to deal with their infection. Meditating, praying, and doing good deeds are examples of spiritual activities they practiced. All participants maintained that their beliefs and practices allowed them to feel peaceful and that their ultimate goal in life is to find peace (Kwam Sa-ngob Jai). Understanding patients' spiritual beliefs and practices can help nurses to positively promote better nurse-patient relationships. Nurses should encourage patients' spiritual practices as being grounded in their belief system.

The limits of behaviour change theory: Condom use and contexts of HIV risk in the Kolkata sex industry
(Abstract; subscription needed for full text; Asia)
Culture, Health and Sexuality. 2008 Jan;10(1):27-41.
Evans C | Lambert H
This paper uses ethnographic data from a sex workers' HIV project in India to consider the appropriateness of individual, social/group and structural theories of health behaviour when applied to HIV-prevention initiatives. Existing theories are critiqued for their modernist representation of behaviour as determined by individual rational decision-making processes or by external structural forces, with inadequate recognition being given to the roles that human agency, subjective meaning and local context play in everyday actions. Analysis of sex workers' accounts of their sexual practices suggests that existing theories of health behaviour can only partially account for sexual behaviour change retrospectively and that they have limited predictive value with respect to the outcomes of individual sexual encounters. Our data show that these outcomes were, in fact, highly context dependent, while possibilities for action were ultimately strongly constrained by structural forces. Findings suggest that interventions need to adopt an integrated, structurally-oriented approach for promoting safer sexual practices in sex work settings. Recognising that no one model of health behaviour is likely to be adequate in explaining or predicting behaviour change encourages responsiveness to local people's agency, recognises the different (health- and non-health-related) registers of risk with which people operate and encourages flexibility according to local contingencies and contexts.

MATERNAL AND CHILD HEALTH NEWS

South Africa: New PMTCT protocol in two weeks
(News Article; Sub-Saharan Africa)
30 Nov 2007
Thom A, Health-e

China: New moms need more time to breastfeed
(News Article; Asia)
24 Nov 2007
Hong C, China Daily

Nigeria: How to battle rising maternal deaths
(News Article; Sub-Saharan Africa)
29 Nov 2007
Agha E, This Day

MATERNAL AND CHILD HEALTH RESEARCH

Efficacy of human rotavirus vaccine against rotavirus gastroenteritis during the first 2 years of life in European infants: Randomised, double-blind controlled study
(Abstract; subscription needed for full text; Europe)
Lancet. 2007 Nov 24;370(9601):1757-1763.
Vesikari T | Karvonen A | Prymula R | Schuster V | Tejedor JC
The authors aimed to assess the efficacy of the oral live attenuated human rotavirus vaccine Rotarix (RIX4414) for prevention of rotavirus gastroenteritis in European infants during their first 2 years of life. 3994 study participants were enrolled from six countries and were randomly assigned two oral doses of either RIX4414 (n=2646) or placebo (n=1348), which were coadministered with the first two doses of specific childhood vaccinations. Follow-up for gastroenteritis episodes was undertaken from 2 weeks post-dose two through the two consecutive rotavirus seasons following vaccinations (combined efficacy follow-up period; mean duration 17 months [SD 1.6]). The primary endpoint was vaccine efficacy against rotavirus gastroenteritis of any severity during the first efficacy follow-up period (2 weeks post-dose two to the end of the first rotavirus season). Stool specimens obtained during gastroenteritis episodes were tested for rotavirus by ELISA and typed by RT-PCR. Episodes scoring 11 or greater on the 20-point Vesikari scale were classified as severe. Analysis was according to protocol. This study is registered with ClinicalTrials.gov, number NCT00140686 (eTrack102247). 120 infants were excluded from the according-to-protocol analysis. During the first efficacy follow-up period (mean duration 5.7 months [SD 1.2]), 24 of 2572 infants allocated RIX4414 versus 94 of 1302 given placebo had rotavirus gastroenteritis episodes of any severity, resulting in a vaccine efficacy of 87.1% (95% CI 79.6-92.1; p less than 0.0001). For the combined efficacy follow-up period, vaccine efficacy against severe rotavirus gastroenteritis was 90.4% (85.1-94.1; p less than 0.0001), for admission owing to rotavirus gastroenteritis 96.0% (83.8-99.5; p less than 0.0001), and for rotavirus-related medical attention 83.8% (76.8-88.9; p less than 0.0001), and significant protection against severe rotavirus gastroenteritis by circulating G1, G2, G3, G4, and G9 rotavirus types was shown. In a European setting, two doses of RIX4414 coadministered with childhood vaccines provided high protection against any and severe rotavirus gastroenteritis, with an overall reduction of admissions for gastroenteritis over two consecutive rotavirus epidemic seasons.

Seroprevalence of hepatitis B and C viral co-infections among children infected with human immunodeficiency virus attending the paediatric HIV care and treatment center at Muhimbili National Hospital in Dar-es-Salaam, Tanzania
(Research Article; Sub-Saharan Africa)
BMC Public Health. 2007 Nov 22;7(1):338.
Telatela SP | Matee MI | Munubhi EK
With increased availability of antibiotics and antifungal agents hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are becoming a cause for significant concern in HIV infected children. We determined the seroprevalence and risk factors for HBV and HCV among HIV infected children aged 18 months to 17 years, attending the Paediatric HIV Care and Treatment Center (CTC) at Muhimbili National Hospital (MNH) in Dar-es-Salaam, Tanzania. Investigations included; interviews, physical examination and serology for HBsAg, IgG antibodies to HCV and alanine aminotransferase (ALT) levels. HIV serostatus and CD4 counts were obtained from patient records. 167 HIV infected children, 88 (52.7%) males and 79 (47.3%) females were enrolled. The overall prevalence of hepatitis co-infection was 15%, with the seroprevalence of HBV and HCV being 1.2% and 13.8%, respectively. Hepatitis virus co-infection was not associated with any of the investigated risk factors and there was no association between HBV and HCV. Elevated ALT was associated with hepatitis viral coinfection but not with ART usage or immune status. The high seroprevalence (15%) of hepatitis co-infection in HIV infected children attending the Paediatrics HIV CTC at the MNH calls for routine screening of hepatitis viral co-infection and modification in the management of HIV infected children.

Short duration of skin-to-skin contact: Effects on growth and breastfeeding
(Abstract; subscription needed for full text; Asia)
Journal of Paediatrics and Child Health. 2007 Dec;43(12):831-836.
Boo NY | Jamli FM
The aim was to compare weight gain and head growth in very-low-birthweight (VLBW, less than 1501 g) infants with or without exposure to short duration of skin-to-skin contact (STSC) during their stay in a neonatal intensive care unit. Stable VLBW infants were randomised into either STSC or control group. Parents of the STSC group were encouraged to provide STSC for at least 1 h daily. One hundred and forty-six infants were randomised, but only 126 were enrolled (STSC group: n = 64; Controls: n = 62). Infants in the STSC group had better mean weekly increase in head circumference (1.0 cm (SD = 0.3) vs. 0.7 cm (SD = 0.3); P less than 0.0001) and higher breastfeeding rate at discharge (29.7% vs. 14.5%; P = 0.04). Although the mean duration of maternal education was longer in STSC (13.0 vs. 12.1 years; P = 0.04) than in controls, linear regression analysis showed that the significant predictors associated with weekly head growth were exposure to STSC (unstandardised coefficient: 0.2; 95% confidence intervals (CI): 0.1, 0.3; P less than 0.0001) and head circumference of infants at the time of enrolment (unstandardised coefficient: -0.05; 95% CI: -08, -0.03; P less than 0.0001); the number of years of maternal education was not a significant predictor. Logistic regression analysis showed that the only significant predictors of successful breastfeeding at discharge were receiving expressed breast milk at enrollment (adjusted OR: 4.1; 95% CI: 1.4, 11.7; P = 0.009) and receiving expressed breast milk during intervention period (adjusted OR: 8.3; 95% CI: 2.8, 24.4; P less than 0.0001); exposure to STSC and maternal education were not significant predictors. Exposure to short duration of STSC may promote head growth in VLBW infants.

POPULATION/FERTILITY/DEMOGRAPHY NEWS

Malta 34th in UN human development index
(News Article; Europe)
28 Nov 2007
Lindsay D, Independent Online

South Africa: Pitter-patter of fewer tiny feet
(News Article; Sub-Saharan Africa)
29 Nov 2007
Laing R, The Times

Russia: The birth rate in Primorye grows
(News Article; Asia)
29 Nov 2007
Vladivostok Times

POPULATION/FERTILITY/DEMOGRAPHY RESEARCH

Rural-urban migration and child survival in urban Bangladesh: Are the urban migrants and poor disadvantaged?
(Abstract; subscription needed for full text; Asia)
Journal of Biosocial Science. 2008 Jan;40(1):83-96.
Islam MM | Azad KM
This paper analyses the levels and trends of childhood mortality in urban Bangladesh, and examines whether children's survival chances are poorer among the urban migrants and urban poor. It also examines the determinants of child survival in urban Bangladesh. Data come from the 1999-2000 Bangladesh Demographic and Health Survey. The results indicate that, although the indices of infant and child mortality are consistently better in urban areas, the urban-rural differentials in childhood mortality have diminished in recent years. The study identifies two distinct child morality regimes in urban Bangladesh: one for urban natives and one for rural-urban migrants. Under-five mortality is higher among children born to urban migrants compared with children born to life-long urban natives (102 and 62 per 1000 live births, respectively). The migrant-native mortality differentials more-or-less correspond with the differences in socioeconomic status. Like childhood mortality rates, rural-urban migrants seem to be moderately disadvantaged by economic status compared with their urban native counterparts. Within the urban areas, the child survival status is even worse among the migrant poor than among the average urban poor, especially recent migrants. This poor-non-poor differential in childhood mortality is higher in urban areas than in rural areas. The study findings indicate that rapid growth of the urban population in recent years due to rural-to-urban migration, coupled with higher risk of mortality among migrant's children, may be considered as one of the major explanations for slower decline in under-five mortality in urban Bangladesh, thus diminishing urban-rural differentials in childhood mortality in Bangladesh. The study demonstrates that housing conditions and access to safe drinking water and hygienic toilet facilities are the most critical determinants of child survival in urban areas, even after controlling for migration status. The findings of the study may have important policy implications for urban planning, highlighting the need to target migrant groups and the urban poor within urban areas in the provision of health care services.

The way forward
(Abstract; subscription needed for full text; Global)
Lancet. 2007 Nov 24;370(9601):1791-1799.
AbouZahr C | Cleland J | Coullare F | Macfarlane SB | Notzon FC
Good public-health decision-making is dependent on reliable and timely statistics on births and deaths (including the medical causes of death). All high-income countries, without exception, have national civil registration systems that record these events and generate regular, frequent, and timely vital statistics. By contrast, these statistics are not available in many low-income and lower-middle-income countries, even though it is in such settings that premature mortality is most severe and the need for robust evidence to back decision-making most critical. Civil registration also has a range of benefits for individuals in terms of legal status, and the protection of economic, social, and human rights. However, over the past 30 years, the global health and development community has failed to provide the needed technical and financial support to countries to develop civil registration systems. There is no single blueprint for establishing and maintaining such systems and ensuring the availability of sound vital statistics. Each country faces a different set of challenges, and strategies must be tailored accordingly. There are steps that can be taken, however, and we propose an approach that couples the application of methods to generate better vital statistics in the short term with capacity-building for comprehensive civil registration systems in the long run.

Stochastic forecast of the population of Poland, 2005 -- 2050
(Research Article; Europe)
(You need Adobe Acrobat Reader to access this document)
Demographic Research. 2007 Nov 20;17(11):301-338.
Matysiak A | Nowok B
Forecasting the population of Poland is very challenging. Firstly, the country has been undergoing rapid demographic changes. In the 1990s, they were influenced by the political, economic, and social consequences of the collapse of the communist regime. Since 2004 they have been shaped by Poland's entry into the European Union. Secondly, the availability of statistics for Poland on past trends is strongly limited. The resulting high uncertainty of future trends should be dealt with systematically, which is an essential part of the stochastic forecast presented in this paper. The forecast results show that with the probability of 81.8% the Polish population will decline during the next decades and Poland will face significant ageing as indicated by a rising old-age dependency-ratio. There is a probability of 50% that in 2050 the population will number between 25.7 and 36.5 million compared to 38.2 in 2004 and that there will be at least 64 persons aged 65+ per 100 persons aged 19-64.

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Volume 7, Number 46 3 December 2007