Journal of Biosocial Science最新文献

Millions of young girls in Nigeria have continued to suffer the negative consequences of early marriage such as discontinuation of education and restricting them from achieving their full potential. Successive Nigerian governments have therefore deployed different strategies over the years to mitigate the practice, particularly in the northern part of the country. This study analysed the changes in the pattern of child marriage across space-time in Nigeria using a dataset obtained from the Nigeria Demographic and Health Survey conducted between 2003 and 2018 at a consecutive interval of 5 years. A Bayesian spatio-temporal random effect model with inference based on integrated nested laplace approximation was considered. Whereas the findings demonstrate a reduction in the practice of child marriage over time everywhere in the country, the prevalence remains highest in States such as Kogi, Niger, Federal Capital Territory Abuja, Taraba, and Kaduna, all in the northern part of the country despite the policies, program and interventions by international organisations, Child Right Acts, and Non-governmental organisations. Over the fifteen years, only slight changes were recorded in the Southwest region. Furthermore, higher levels of education, urban residency, household wealth, being a Yoruba, or belonging to a Christian religious group were found to lower the chances of child marriage. State-specific strategic planning would be useful in deploying suitable local solutions to reduce child marriage in Nigeria.

Despite the growing literature on the impact of Covid-19 on antenatal care (ANC) and maternal/neonatal and child health outcomes globally, substantial knowledge gaps remain about the population-level impact in sub-Saharan Africa (SSA). Existing evidence on the ANC impact of Covid-19 in SSA is largely based on health facility or small-scale qualitative research, which are limited in providing population-level understanding. This paper examines the extent to which Covid-19 impacted ANC service utilisation and identifies what population sub-groups were most adversely impacted. It is based on a secondary analysis of the Madagascar Demographic and Health Survey (DHS), the first DHS in SSA released following the Covid-19 pandemic. Multilevel logistic regression analysis was used to estimate the net effect of Covid-19 on ANC and identify the most at-risk population sub-groups. The findings show that all ANC measures considered (no ANC, early ANC, adequate ANC visits) were significantly affected by Covid-19 (p<0.05). On average, Covid-19 was associated with a 42% increase in the odds of having no ANC, a 22% reduction in the odds of starting early ANC during the first trimester, and a 22% reduction in the odds of receiving adequate ANC (at least four visits, starting during the first trimester). Births to older mothers and to mothers with no education were disproportionately affected during Covid-19. Although youth aged 15-24 had poorer ANC compared to older women before the pandemic, the pattern was reversed during the pandemic. Also, the protective effect of education was stronger during than before the pandemic. These findings underscore the importance of Covid-19 impact mitigation strategies targeting the most at-risk groups (e.g. older mothers). Furthermore, essential information/education during pandemics should be in formats accessible to non-literate women. This paper advances understanding of the population-level impact of Covid-19 on ANC and emphasises the need for further research to better understand the population-level impact of Covid-19 across countries of SSA.

Head porterage, popularly known in Ghana as Kayayei, has been an old economic venture for young girls and women who migrate from the northern to the southern part of the country. Even though Head Porters view Kayayei as a source of livelihood, conditions such as the outbreak of the 2019 coronavirus disease (COVID-19) further worsened their sexual vulnerabilities, as well as their autonomy to make decisions on contraceptive use. Head Porters, as a term defined in this study, refers to women aged 15 years or older who carry loads from one point of the town to another for a fee. The study is qualitative and used both purposive and simple random sampling in recruiting 120 Head Porters for focus group discussions. The study was planned and implemented in three zones in Kumasi, the Ashanti Regional capital of Ghana, during the lockdown period (between March and April 2020). Factors such as access to contraceptives, self-reported sexual desire, and partner desire to use condoms, sexual demands, and the impact of the COVID-19 pandemic on contraceptive access were assessed. Sexual demands increased during the COVID-19 period, with most Head Porters indicating they used fewer condoms and contraceptives during the same period. The desire to use a condom was limited among both Head Porters and their partners, and access to contraceptives was hampered by fear of getting infected by COVID-19 from a health worker at family planning clinics. The COVID-19 pandemic significantly increased the sexual and economic vulnerabilities of Head Porters in Ghana and impacted their access to family planning services. Governmental and international organizations need to start developing intervention programs for vulnerable populations such as Head Porters before future disease outbreaks.

A minority of ultra-Orthodox (Charedi) Jews choose not to be vaccinated, and their refusal has assumed significant importance from a variety of perspectives. Clinicians often encounter patients whose beliefs are different from their own. Vaccine hesitancy within the US Charedi Jewish community is a factor contributing to outbreaks of disease, reflecting a growing mistrust between communities and arms of the State played out on the terrain of bodies and societies. Clinicians need to be aware of and understand this broader context as a foundation of empathetic listening and epistemic humility that might lead to improved health for the Charedi community based on reinforced trust.

Birth cohort studies provide invaluable data on topics across the lifecourse, including health, education, socioeconomic conditions, and well-being. As a result, they are an important resource for biosocial researchers to answer numerous complex research questions. However, despite being positioned as representative of their national or regional context, cohort studies often fail to capture the experience of marginalised groups.One such group is sexual and gender minority (or LGBTQ+) people who, until very recently, have been largely invisible in birth cohorts. This is despite huge social and attitudinal changes in the last fifty years and clear evidence of the social, political, economic, and health and well-being disparities experienced compared to heterosexual cisgender people. However, due to small numbers, opportunities for quantitative analysis are limited and result in the neglect of LGBTQ+ data even when it is captured.This article presents a brief overview of how queer lives have (and have not) been captured by standard data collection and analysis techniques in the British birth cohort studies. Then, using a cohort born in 1970, the authors explore the possibilities of person-centred mixed-method pen portraits to improve understanding of this group's life trajectories.

In recent years, there have been increasing calls for the development and growth of the biosocial as a paradigm through which to tackle complex problems. The use of birth cohorts, mixed methods frameworks, and interdisciplinary work are common in biosocial research. However, these practices are also theoretically and practically complex due to epistemic, methodological, and academic challenges - particularly for early career researchers (ECRs) who face time constraints, funding limitations, and disciplinary expectations.This paper draws on lessons from the experiences of ECRs in biosocial research by reflecting on theoretical heterogeneity, the necessity of translation and negotiation across disciplines and methodologies, and the practicalities of funding, collaboration, and dissemination. Throughout, the paper discusses strategies to overcome common challenges and provide suggestions for fellow ECRs and those interested in biosocial ECR training and development. The paper highlights the importance of strong networks with senior biosocial researchers and peers, the value of practical support, and the importance of formal and informal learning opportunities. The authors call for the enthusiasm for biosocial research to be matched with investment in the development and support for ECRs.

This reflection explores the transformative power of critical theory through a quality improvement (QI) project creating culturally relevant dietary resources for Pacific Islander communities in Washington State, USA. Food injustice and lack of food sovereignty are examined as manifestations of modern-day colonialism perpetuated by capitalist-driven social structures. The methodology employed critical reflection, defined as the process of examining assumptions and power relations that shape practice, central to critical theory. Iterative group discussions aimed to understand the impact of individual and collective assumptions, power dynamics, and oppression on the project's conceptualization, implementation, and evaluation.Specific recommendations are integrated into the discussion to aid those replicating similar protocols, emphasizing actionable steps such as engaging with the community at all project stages. The research team, composed of osteopathic medical students and a critical theory expert, engaged in reflexivity to understand how social locations and lived experiences influenced perceptions. Despite the goal of fostering cultural inclusivity, limitations in engaging the Pacific Islander community throughout the project lifecycle highlighted the need for cultural humility and participatory action methodology.This study underscores the importance of understanding the history and socio-political context of marginalized communities to avoid perpetuating colonial practices and trauma. It emphasizes the necessity for medical schools to incorporate sociological theories into curricula to promote compassionate, culturally appropriate care and research. By critically examining positionality and engaging in transformative learning, the group advocates for systemic changes towards a more equitable global healthcare system.Through critical reflection, the group has come to understand how lived experiences have shaped perceptions of oppression, which are entrenched within and perpetuated by social institutions. Actionable items from these reflections are presented to help future practitioners and educators apply cultural humility, community empowerment, and critical theory in QI projects.

The Garo tribe, one of a major indigenous communities of Meghalaya, India, relies heavily on their traditional health practices. This research investigates the healthcare-seeking behaviour of Garo women, their health concerns, their indigenous medical knowledge, and their reasons for preferring traditional over modern medicines. Conducted in East Garo Hills, Meghalaya, quantitative data (N = 96) were randomly collected from Garo women aged 15-49 through interviews to understand their health-seeking behaviour. Following a preliminary analysis, qualitative data (N = 12) were gathered through in-depth interviews to identify common illnesses, dimensions of traditional medicines, and reasons for dependency on them. Thematic analysis was performed using Atlas Ti. The result shows that almost 84% of Garo women (N = 86) seek treatment from Ojha (traditional healer) for achik (traditional) medicine, with only 6% using modern health facilities and 10% relying on herbal home remedies. Garo women rely on their age-old traditional remedies for health issues, irrespective of their educational or economic status. From the qualitative findings, this study explores the Garo tribe's unique traditional medicine, known as 'achik medicine', prepared through local herbs and plants, and is disseminated by traditional healers, or 'ojhas', whose knowledge is generational. Moreover, every Garo household possesses medicinal plants, and all are knowledgeable about their use. Major health issues faced by Garo women are menstrual disorders, post-delivery weakness, fever with severe headache and jaundice. Reasons for using achik medicines are more effectiveness than modern medicines, cultural identity, preference for natural remedies, efficiency of Ojhas, availability, accessibility, and affordability of Ojhas. Meanwhile, the reasons for using limited use of modern healthcare facilities are poor quality of service and remote location. This study underscores the importance of preserving indigenous knowledge systems and respecting cultural heritage while ensuring the well-being of marginalised communities. Additionally, it highlights the need to improve modern healthcare quality and public transportation in the region.

Marriage with teenage girls is an important health and social challenge, which is caused by various factors. Considering that no research has been done to show the reasons for men's desire to marry teenage girls, this research was conducted with the aim of identifying the reasons why men marry teenage girls in western Iran. This qualitative research was conducted with the conventional content analysis approach among 37 men in western Iran who married to girls under the age of 18. Targeted, theoretical, and snowball sampling methods were used to reach the participants. To collect data, semi-structured interviews were used both in-person (20 people) and online (17 people). Data analysis was done with Graneheim and Lundman approach and checking the accuracy and strength of the results with Guba and Lincoln criteria. One core category, 9 subcategories, and 88 initial codes were obtained from the data analysis. The core category, foresight along with desired upbringing, included the subcategories of getting sure of purity, to bring up the girl, seeking sexual pleasure, dominating the wife, low expectations, appropriate fertility, encouragement of social organizations and families, following models, and cultural beliefs. The reasons for men marrying teenage girls are rooted in personality traits, family encouragement, and the cultural and social context of the society. Marriage with teenage girls can be prevented by intervening at different levels and taking measures such as training and raising men's awareness about the consequences of marrying teenage girls, changing men's cultural and gender beliefs, raising the awareness of parents and social organizations about the adverse effects of child marriage, and establishing appropriate laws.

Covert contraceptive use is a strategy to avoid unintended pregnancy. However, evidence regarding the multilevel factors linking past experiences of unintended pregnancy with covert contraceptive use is limited. The objective of this study was to identify the compositional and contextual factors associated with covert contraceptive use among women with a prior unintended pregnancy. Framed by the socio-ecological model, a cross-sectional study was conducted using data from Round 5 of the Performance Monitoring and Accountability 2020 project in Nigeria. Non-pregnant women aged 15-49 years who reported a previous mistimed or unwanted pregnancy were included (N = 1631). Multilevel logistic regression models with random intercepts were specified to investigate the relationship between covert contraceptive use and compositional and contextual factors. Approximately 4.54% (95% CI = 3.28-6.25) of women reported covert contraceptive use. At the individual level, having less than secondary education (aOR = 5.88, 95% CI = 1.20-28.72) and being single (aOR = 11.29, 95% CI = 2.93-43.56) were associated with higher odds of covert contraceptive use. There was no significant association between covert contraceptive use and the type of unintended pregnancy (mistimed: aOR = 3.13, 95% CI = 0.88-11.13). At the community level, living in a community with average poverty levels (aOR = 6.18, 95% CI = 1.18-32.55) and high exposure to family planning mass media (aOR = 6.84, 95% CI = 1.62-29.11) were associated with higher odds of covert contraceptive use. Measures of variation showed significant variation in covert contraceptive use across communities. Further research is warranted to better understand the underlying mechanisms in these observed associations and variations in covert contraceptive use among women following the experience of an unintended pregnancy. Additionally, there is a need to design family planning strategies that integrate community-level structures.