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Geographical disparities in temporal trends of low birth weight in Saskatchewan from 2002/2003 to 2021/2022: insights from a joinpoint regression analysis. 2002/2003 年至 2021/2022 年萨斯喀彻温省出生体重不足时间趋势的地域差异:连接点回归分析的启示。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-11-01 Epub Date: 2024-10-15 DOI: 10.1017/S0021932024000336
Daniel A Adeyinka

Low birth weight (LBW) is an important public health indicator that is associated with various negative health outcomes in infants. To effectively implement interventions that would improve health outcomes in children, it is important to understand both the historical trends and current levels of LBW rates. In this study, trends and regional differences in LBW rates in Saskatchewan from 2002/2003 to 2021/2022 were assessed. A joinpoint regression analysis was conducted using historical LBW rates, obtained from the Canadian Institute for Health Information database. Data were analysed using average percent change and average annual percent change. Spatial patterns and trends were identified using a choropleth map. From a provincial and national rate of 5.2% in 2002/2003, the LBW rate in Saskatchewan increased to 6.5% in 2021/2022, approaching the national rate of 6.8%. Over the 20-year period, average annual changes for Canada were 1.4% and 1.0% for Saskatchewan. There was a turning point in the study: 2004/2005 for Canada and 2011/2012 for Saskatchewan. Initially, Saskatchewan had stable LBW rates, increasing yearly by 0.1%, while the national rate was 5.7%. However, in recent years, Saskatchewan's rate increased to 1.8% annually, surpassing the national rate of 0.9%. Geographical differences were also observed within Saskatchewan, with the Far North region having the highest LBW rate (9.2%), and the Central West region having the lowest rate (4.3%) in 2021/2022. The Central East, Regina Qu'Appelle, and southern Saskatchewan saw significant upwards trends in LBW rates between 2015/2016 and 2021/2022. There is an increasing trend in LBW rates in Canada and Saskatchewan, as well as geographical disparities within the province. The geographical disparities in LBW rates underscore the need for tailored interventions in high-risk regions in the province.

出生体重不足(LBW)是一项重要的公共卫生指标,与婴儿的各种不良健康后果有关。为了有效实施干预措施以改善儿童的健康状况,了解低出生体重率的历史趋势和当前水平非常重要。本研究评估了萨斯喀彻温省 2002/2003 年至 2021/2022 年期间低出生体重儿比率的趋势和地区差异。利用从加拿大卫生信息研究所数据库中获得的历史婴儿夭折率进行了连接点回归分析。数据采用平均百分比变化和平均年百分比变化进行分析。使用choropleth地图确定了空间模式和趋势。2002/2003 年,萨斯喀彻温省和全国的低体重儿比率为 5.2%,到 2021/2022 年,该省的低体重儿比率增至 6.5%,接近全国的 6.8%。在这 20 年间,加拿大的年均变化率为 1.4%,萨斯喀彻温省为 1.0%。研究中出现了一个转折点:加拿大为 2004/2005 年,萨斯喀彻温省为 2011/2012 年。起初,萨斯喀彻温省的低体重儿比率比较稳定,每年增加 0.1%,而全国的比率为 5.7%。然而,近年来,萨斯喀彻温省的婴幼儿夭折率上升到每年 1.8%,超过了 0.9% 的全国婴幼儿夭折率。2021/2022 年,萨斯喀彻温省内也出现了地域差异,其中远北地区的低体重儿比率最高(9.2%),而中西部地区的比率最低(4.3%)。在 2015/2016 年至 2021/2022 年期间,萨斯喀彻温省中东部、里贾纳-夸佩勒和南部地区的畸形产儿率呈显著上升趋势。加拿大和萨斯喀彻温省的畸形婴儿出生率呈上升趋势,省内也存在地域差异。婴儿夭折率的地域差异凸显了在该省高风险地区采取有针对性的干预措施的必要性。
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引用次数: 0
Unveiling disparities: a non-linear decomposition analysis of the gap in menstrual hygiene material use between adolescent women in Aspirational and the remaining districts of India. 揭示差距:对印度有抱负地区和其他地区的少女在经期卫生用品使用方面的差距进行非线性分解分析。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-11-01 Epub Date: 2024-10-14 DOI: 10.1017/S0021932024000312
Mahashweta Chakrabarty, Aditya Singh, Subhojit Let, Shivani Singh

This study aimed to investigate the factors contributing to the gap in the use of hygienic materials during menstruation to collect blood among adolescent women between Aspirational and the remaining districts of India. The study sample consisted of 114805 adolescent women (20835 women from 112 Aspirational districts and 93970 women from 595 remaining districts) from the National Family Health Survey-5. Fairlie decomposition was used to identify and measure the factors contributing to the gap in the use of hygienic materials between Aspirational and the remaining districts of India. This study determined that the use of hygienic materials during menstruation varied significantly between Aspirational and the remaining districts. While only 37% of adolescent women used hygienic materials in Aspirational districts, almost 52% did so in the remaining districts. Seventy-five per cent of Aspirational districts (84 of 112 districts) reported less than 50% use of hygienic materials, which is lower than the national average and the average of the remaining districts. It was revealed that nearly 90% of the total explained gap between the two groups was accounted for by household wealth, place of residence, exposure to mass media, and education level. Wealth was the main contributor to the gap, explaining about 46% of the difference in hygienic materials use between Aspirational and the remaining districts, followed by the place of residence (18%), exposure to mass media (15%), and education level (11%). Findings suggest that targeted interventions to improve access to hygienic materials among adolescent women in Aspirational districts, particularly those in the northern states of Uttar Pradesh, Bihar, and Chhattisgarh, are necessary. Policy efforts should focus on women from poor households, improving access to education, and expanding mass media exposure in Aspirational districts to reduce the gap in menstrual hygiene practices among adolescent women in India.

本研究旨在调查导致印度励志县和其他县的少女在经期使用卫生材料采血方面存在差距的因素。研究样本包括第五次全国家庭健康调查(National Family Health Survey-5)中的 114805 名少女(其中 20835 名来自 112 个励志区,93970 名来自 595 个其他区)。费尔利分解法用于确定和衡量造成印度志向县和其他县在使用卫生用品方面存在差距的因素。这项研究确定,在经期使用卫生材料方面,励志区与其他地区之间存在显著差异。在励志地区,只有 37% 的少女使用卫生用品,而在其他地区,则有近 52% 的少女使用卫生用品。75%的励志地区(112 个地区中的 84 个)报告的卫生材料使用率低于 50%,低于全国平均水平和其他地区的平均水平。调查显示,两组之间的差距近 90%是由家庭财富、居住地、接触大众媒体的机会和教育水平造成的。财富是造成差距的主要原因,它解释了励志区与其他地区在卫生用品使用方面约 46%的差距,其次是居住地(18%)、大众媒体接触率(15%)和教育水平(11%)。研究结果表明,有必要采取有针对性的干预措施,改善有抱负地区,尤其是北方邦、比哈尔邦和恰蒂斯加尔邦北部地区的青少年女性获得卫生用品的情况。政策努力的重点应放在贫困家庭的妇女、改善受教育的机会以及扩大励志地区的大众媒体曝光率上,以缩小印度少女在经期卫生习惯方面的差距。
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引用次数: 0
Comment on 'Changing relationships between HIV prevalence and circumcision in Lesotho', and 'Age-incidence and prevalence of HIV among intact and circumcised men: an analysis of PHIA surveys in Southern Africa'. 就 "莱索托艾滋病毒感染率与包皮环切术之间关系的变化 "和 "未受包皮环切术和包皮环切术的男性中艾滋病毒的年龄发病率和感染率:对南部非洲 PHIA 调查的分析 "发表评论。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-09-01 Epub Date: 2024-05-20 DOI: 10.1017/S0021932024000208
Brian J Morris, Joya Banerjee

Two articles by Garenne (2023a,b) argue that voluntary medical male circumcision does not reduce human immunodeficiency virus transmission in Africa. Here we point out key evidence and analytical flaws that call into question this conclusion.

Garenne(2023a,b)的两篇文章认为,自愿性包皮环切手术并不能减少非洲的人体免疫缺陷病毒传播。在此,我们指出了质疑这一结论的关键证据和分析缺陷。
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引用次数: 0
Beyond the margins: antenatal health and healthcare behaviours among homeless women in Kolkata Municipal Corporation, India. 超越边缘:印度加尔各答市无家可归妇女的产前保健和医疗行为。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-09-01 Epub Date: 2024-09-23 DOI: 10.1017/S0021932024000324
Margubur Rahaman, Kailash Chandra Das

Despite high childbearing rates among homeless women in India, the antenatal health and healthcare behaviours among such population remain poorly understood. To address this research gap, a mixed-methods approach was employed in the present study, involving interviews with a sample of 400 women aged 15-49 years, utilising time and location sampling techniques. Additionally, a purposeful sample of 52 women from the same age group participated in in-depth interviews. The respondents exhibited rampant socio-economic backwardness, including chronic homelessness (36%), no formal education (54%), engagement in rag picking (31%), and low income levels. About 56% of the women reported poor self-rated health (SRH), notably higher among those aged 35 and above and those living alone (68%). Poor SRH was also prevalent among the ever married (61%), ragpickers (61%), beggars (62%), chronic homeless individuals (62%), tobacco (60%) and alcohol consumers (61%), and those with chronic diseases (61%). Common health issues included depression or anxiety (56%) and iron deficiency anaemia (35%). The level of unmet healthcare needs was 41%, with significant variation across diseases. Lack of reproductive health rights and awareness, socio-cultural beliefs, stigma, socio-economic poverty, poor quality of public healthcare services, irregularity in charity-run healthcare, and time constraints hindered antenatal care visits. The study underscores the urgent need for population-centric programmes and policies aimed at promoting reproductive health to achieve Sustainable Development Goal 3 of 'Good health and wellbeing' by 2030.

尽管印度无家可归妇女的生育率很高,但人们对这类人群的产前健康和保健行为仍然知之甚少。为了填补这一研究空白,本研究采用了混合方法,利用时间和地点抽样技术,对 400 名 15-49 岁的妇女进行了访谈。此外,还对同一年龄段的 52 名妇女进行了有目的的深度访谈。受访者表现出严重的社会经济落后,包括长期无家可归(36%)、未受过正规教育(54%)、从事捡破烂(31%)和收入水平低。约 56% 的妇女自评健康状况(SRH)较差,其中 35 岁及以上和独居妇女的比例尤其高(68%)。已婚妇女(61%)、拾破烂者(61%)、乞丐(62%)、长期无家可归者(62%)、吸烟者(60%)和酗酒者(61%)以及慢性病患者(61%)的自我评定健康状况也普遍较差。常见的健康问题包括抑郁或焦虑(56%)和缺铁性贫血(35%)。未满足的医疗保健需求占 41%,不同疾病之间的差异很大。缺乏生殖健康权利和意识、社会文化信仰、耻辱感、社会经济贫困、公共医疗服务质量差、慈善机构提供的医疗服务不规范以及时间限制阻碍了产前检查。这项研究强调,迫切需要制定以人口为中心的计划和政策,以促进生殖健康,从而到 2030 年实现可持续发展目标 3 "良好的健康和福祉"。
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引用次数: 0
The association of solid fuel use in households for cooking with elevated blood pressure among reproductive-aged married women in Bangladesh. 孟加拉国已婚育龄妇女家庭使用固体燃料做饭与血压升高的关系。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-09-01 Epub Date: 2024-09-19 DOI: 10.1017/S0021932024000300
Nuruzzaman Khan, Syful Islam, Mostaured Ali Khan, Iqbal Kabir, Atika Rahman Chowdhury, Diba Paul, Hazrat Ali

Bangladesh is experiencing a rapid increase in hypertension prevalence, particularly in socio-economically disadvantaged communities. The higher use of solid fuel in these communities could be one of the significant factors contributing to this trend, but evidence supporting this hypothesis is limited in Bangladesh. Therefore, this study aims to investigate the associations of household solid fuel use and its exposure level with systolic and diastolic blood pressure (DBP) and hypertension. We analysed 7,320 women's data from 2017/18 Bangladesh Demographic and Health Survey. We considered three outcome variables: (i) systolic blood pressure (BP) (continuous response), (ii) DBP (continuous response), and (iii) hypertension status (yes, no). Our primary exposures of interest were fuel type (clean vs solid) and the potential level of household air pollution exposure through solid fuel use (unexposed, moderately exposed, and highly exposed). We used a multilevel mixed-effects Poisson regression model with robust variance to determine association between exposure and outcome variables while adjusting for confounders. Of the total respondents analysed, approximately 82% used solid fuel for cooking. The age-standardised prevalence of hypertension was 28%. Respondents using solid fuel were found to be 1.44 times (95% confidence interval [CI], 1.04-1.89) more likely to develop hypertension compared to clean fuel users. Compared to women using clean fuel, the likelihood of hypertension was found to be 1.61 times (95% CI, 1.07-2.20) higher among the moderately exposed group and 1.80 times (95% CI, 1.27-2.32) higher among the highly exposed group. Similar associations were reported for systolic and DBP. The use of solid fuel increases the risk of becoming hypertensive and elevates systolic and DBP. Policies and programmes are necessary to increase awareness of the adverse effects of solid fuel use on health, including hypertension. Efforts should be made to reduce solid fuel use and ensure proper ventilation systems in households where solid fuel is used.

孟加拉国的高血压发病率正在迅速上升,尤其是在社会经济条件较差的社区。这些社区较多使用固体燃料可能是导致这一趋势的重要因素之一,但在孟加拉国支持这一假设的证据有限。因此,本研究旨在调查家庭固体燃料的使用及其暴露水平与收缩压、舒张压和高血压的关系。我们分析了 2017/18 年孟加拉国人口与健康调查中 7320 名妇女的数据。我们考虑了三个结果变量:(i) 收缩压(BP)(连续反应);(ii) 舒张压(DBP)(连续反应);(iii) 高血压状态(是,否)。我们关注的主要暴露因素是燃料类型(清洁燃料与固体燃料)以及通过使用固体燃料可能暴露于家庭空气污染的程度(未暴露、中度暴露和高度暴露)。我们使用多层次混合效应泊松回归模型和稳健方差来确定暴露与结果变量之间的关联,同时对混杂因素进行调整。在接受分析的所有受访者中,约 82% 的人使用固体燃料做饭。高血压的年龄标准化患病率为 28%。与使用清洁燃料的受访者相比,使用固体燃料的受访者患高血压的几率是后者的 1.44 倍(95% 置信区间 [CI],1.04-1.89)。与使用清洁燃料的妇女相比,中度暴露组患高血压的可能性是前者的 1.61 倍(95% 置信区间,1.07-2.20),高度暴露组患高血压的可能性是前者的 1.80 倍(95% 置信区间,1.27-2.32)。收缩压和舒张压也有类似的关联。使用固体燃料会增加罹患高血压的风险,并使收缩压和直流血压升高。有必要制定政策和计划,提高人们对使用固体燃料对健康(包括高血压)的不利影响的认识。应努力减少固体燃料的使用,确保使用固体燃料的家庭有适当的通风系统。
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引用次数: 0
'They will be like a person with a disease': a qualitative investigation of variation in contraceptive side-effect experiences in Central Oromia, Ethiopia. 他们会像生病的人一样":对埃塞俄比亚中奥罗莫地区避孕副作用体验差异的定性调查。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-09-01 Epub Date: 2024-09-20 DOI: 10.1017/S0021932024000294
Rose Stevens, Eshetu Gurmu, Ametelber Negash, Elizabeth Ewart, Alexandra Alvergne

Contraceptive side effects are consistently given as the main reason why women are dissatisfied with contraception or choose not to use it. However, why some women suffer more from side effects remains unknown. Through inductive analysis of in-depth interviews and focus group discussions with 40 contraceptive users and 3 key informants in Central Oromia, Ethiopia, we explored women's rationales for variation in side-effect experiences. The data first reveal the wide diversity in type and severity of side-effect experiences reported by users of contraception. Second, we found that women's rationales for why some individuals suffer more side effects from contraception invoke economic and physical hardship (food insecurity and heavy workloads), as well as interindividual differences in biology (one's blood must 'fit' with contraception). Finally, the analysis revealed the tension many women face in trying to negotiate the trade-off between the consequences of these side effects and those of an unwanted pregnancy. The results show the value of using a biosocial approach, which centres women's voices and experiences, for informing the measurement of contraceptive side effects within population health surveys and clinical trials. Additionally, the findings help gain an understanding of how an individual's social, biological, and cultural contexts drive variation in when and why different side effects manifest.

避孕药的副作用一直被认为是妇女对避孕不满意或选择不使用避孕药的主要原因。然而,为什么有些妇女遭受的副作用更多,这仍然是个未知数。通过对埃塞俄比亚中奥罗米亚州 40 名避孕药具使用者和 3 名主要信息提供者的深入访谈和焦点小组讨论进行归纳分析,我们探讨了妇女在副作用体验方面存在差异的原因。数据首先揭示了避孕药具使用者所报告的副作用经历在类型和严重程度上的巨大差异。其次,我们发现,妇女在解释为什么有些人在避孕时会遭受更多副作用时,会提到经济和身体上的困难(粮食不安全和繁重的工作),以及生物学上的个体差异(一个人的血液必须 "适合 "避孕)。最后,分析揭示了许多妇女在试图权衡这些副作用和意外怀孕的后果时所面临的紧张关系。研究结果表明,在人口健康调查和临床试验中,采用以妇女的声音和经验为中心的生物社会方法来衡量避孕药具的副作用是有价值的。此外,研究结果还有助于了解个人的社会、生理和文化背景是如何导致不同副作用在何时以及为何出现的。
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引用次数: 0
Geographic inequities in neonatal survival in Nigeria: a cross-sectional evidence from spatial and artificial neural network analyses. 尼日利亚新生儿存活率的地域不平等:通过空间和人工神经网络分析得出的横截面证据。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-09-01 Epub Date: 2024-09-19 DOI: 10.1017/S0021932024000282
Daniel A Adeyinka, Nazeem Muhajarine

This study was conducted to provide empirical evidence of geographical variations of neonatal mortality and its associated social determinants with a view to improving neonatal survival at the subnational level in Nigeria. With a combination of spatial analysis and artificial intelligence techniques, this study analysed data from the 2016/2017 Nigeria Multiple Indicator Cluster Survey. The analysis focused on the neonatal period of a weighted national representative population of 30,924 live births delivered five years before the survey commencement. Global Moran's I index and local indicator of spatial autocorrelation cluster maps were used to determine hot and cold spots. A multilayer perceptron neural network was used to identify the key determinants of neonatal mortality across the states and geopolitical zones in Nigeria. The overall neonatal mortality rate was 38 deaths per 1000 live births. There is evidence of geographic clustering of neonatal mortality across Nigeria (worse in the North-Central and North-West zones), majorly driven by poor maternal access to mass media (which plays a critical role in promoting positive health behaviours), short birth interval, a higher position in a family birth order, and young maternal age at child's birth. This study highlights the need for a policy shift towards implementing state and region-specific strategies in Nigeria. Gender-responsive, culturally, and regionally appropriate reproductive, maternal, and child health-targeted interventions may address geographical inequity in neonatal survival.

本研究旨在提供新生儿死亡率的地域差异及其相关社会决定因素的实证证据,以期改善尼日利亚国家以下各级的新生儿存活率。本研究结合空间分析和人工智能技术,分析了 2016/2017 年尼日利亚多指标类集调查的数据。分析的重点是调查开始前五年出生的 30,924 名加权全国代表性活产婴儿的新生儿期。全局莫兰 I 指数和局部空间自相关聚类图指标用于确定热点和冷点。使用多层感知器神经网络确定尼日利亚各州和地缘政治区新生儿死亡率的主要决定因素。新生儿总死亡率为每 1000 例活产死亡 38 例。有证据表明,尼日利亚各地新生儿死亡率存在地域聚集现象(中北部和西北部地区更严重),主要原因是产妇接触大众传媒的机会较少(大众传媒在促进积极的健康行为方面发挥着关键作用)、生育间隔较短、在家庭生育顺序中的位置较高以及婴儿出生时产妇年龄较小。这项研究强调,尼日利亚有必要转变政策,实施针对各州和各地区的战略。针对不同性别、文化和地区的生殖、孕产妇和儿童健康干预措施可以解决新生儿存活率的地域不平等问题。
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引用次数: 0
Assisted reproductive technology (ART) is not an independent risk factor for breech presentation among singleton term births in Vienna, Austria. 辅助生殖技术(ART)不是奥地利维也纳单胎足月分娩中臀先露的独立风险因素。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-09-01 Epub Date: 2024-03-27 DOI: 10.1017/S0021932024000130
L Bartsch, M Hämmerle, S Putschögl, B Hartmann, S Kirchengast

Assisted reproductive technologies (ARTs) such as in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) are still discussed critically, as there is no consensus on whether these treatments could be the cause of risk factors for obstetric problems such as breech presentation. The aim of this study was to test the association between ART and breech presentation among 11920 singleton term births taking place in Vienna from 2010 to 2020. In this single-centre medical record-based study, data concerning the conception mode (spontaneous versus IVF or ICSI), child presentation, birth mode, newborn sex and size as well as age, height, weight, and reproductive history of the mother were included. Three hundred twenty-six newborns (2.7%) were conceived by IVF or ICSI, and 527 newborns (4.4%) were delivered in breech presentation. Breech presentation occurred in 7.6% of IVF/ICSI children but only in 4.3% of spontaneously conceived children (P = 0.019). ART increased the crude risk of breech presentation significantly (OR = 1.67; 95% CI 1.71 - 2.38). After adjusting for maternal age, height, number of previous births, smoking, and newborn sex, however, ART had no longer a significant impact on the risk of breech presentation. In contrast, breech presentation was significantly associated with higher maternal age as well as a lower number of previous births, but not with ART. This study shows that the adverse outcomes of IVF and ICSI pregnancies may not be due to the ART treatment alone but might also be due to the mostly higher age and lower parity of the mothers using ART.

辅助生殖技术(ART),如体外受精(IVF)和卵胞浆内单精子显微注射(ICSI),目前仍在激烈讨论中,因为这些治疗方法是否会导致臀先露等产科问题的风险因素,还没有达成共识。本研究旨在检测 2010 年至 2020 年维也纳 11920 例单胎足月分娩中 ART 与臀先露之间的关系。在这项基于病历的单中心研究中,纳入了有关受孕方式(自然受孕与体外受精或卵胞浆内单精子显微注射)、胎儿先露、分娩方式、新生儿性别和体型以及母亲年龄、身高、体重和生育史的数据。有 326 名新生儿(2.7%)通过体外受精或卵胞浆内单精子显微注射受孕,527 名新生儿(4.4%)臀位分娩。7.6%的体外受精/卵胞浆内单精子显微注射新生儿出现臀位,而只有 4.3%的自然受孕新生儿出现臀位(P = 0.019)。ART 显著增加了臀先露的粗略风险(OR = 1.67; 95% CI 1.71 - 2.38)。然而,在对产妇年龄、身高、前次分娩次数、吸烟和新生儿性别进行调整后,抗逆转录病毒疗法对臀先露的风险不再有显著影响。相反,臀先露与高龄产妇和低生育次数显著相关,但与抗逆转录病毒疗法无关。这项研究表明,试管婴儿和卵胞浆内单精子显微注射妊娠的不良后果可能不仅仅是抗逆转录病毒疗法造成的,也可能是由于使用抗逆转录病毒疗法的母亲大多年龄较大、奇偶数较低。
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引用次数: 0
Exploring the link between household structure and women's household decision-making autonomy in Mauritania. 探索毛里塔尼亚家庭结构与妇女家庭决策自主权之间的联系。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-09-01 Epub Date: 2024-05-27 DOI: 10.1017/S0021932024000221
Florence Wullo Anfaara, Daniel Amoak, Nancy Osei Kye, Yujiro Sano, Roger Antabe

Governments in sub-Saharan African countries aim to increase married women's household decision-making autonomy as it remains a critical determinant of desirable health behaviours such as healthcare utilisation, antenatal care visits, and safer sex negotiation. However, very few studies explore how household structure (i.e., monogamous or polygamous) is associated with married women's household decision-making autonomy. Our paper seeks to address this gap. Using the 2019-20 Mauritania Demographic and Health Survey, a nationally representative dataset, and applying logistic regression analysis, we explore how married women's household structure is associated with their household decision-making autonomy. We find that 9% of married women are in polygamous marriages, while 63% and 65% are involved in decision-making about their health and large household purchases, respectively. Additionally, 76% and 56% are involved in decision-making about visiting family or relatives and household expenditures. After accounting for socio-economic and demographic factors, we find that compared to women from monogamous households, those from polygamous households are less likely to participate in decision-making about their health (OR=0.65, p < 0.001), making large household purchases (OR=0.65, p < 0.001), visiting family or relatives (OR=0.72, p < 0.001), and household expenditure (OR=0.58, p < 0.001). Based on our findings, we recommend the urgent need to review and re-evaluate policies and approaches seeking to promote gender equality and women's autonomy in Mauritania. Specifically, it may be critical for intervention programmes to work around reducing power imbalances in polygamous household structures that continue to impact married women's household decision-making autonomy adversely. Such interventions should centre married women's socio-economic status as a central component of their empowerment strategies in Mauritania.

撒哈拉以南非洲国家政府的目标是提高已婚妇女的家庭决策自主权,因为这仍然是利用医疗保健、产前护理就诊和安全性行为协商等理想健康行为的关键决定因素。然而,很少有研究探讨家庭结构(即一夫一妻制或一夫多妻制)与已婚妇女的家庭决策自主权有何关联。我们的论文试图弥补这一空白。利用具有全国代表性的数据集--2019-20 年毛里塔尼亚人口与健康调查,并运用逻辑回归分析,我们探讨了已婚妇女的家庭结构与其家庭决策自主权之间的关系。我们发现,9% 的已婚妇女处于一夫多妻制婚姻中,而分别有 63% 和 65% 的已婚妇女参与了有关其健康和大宗家庭采购的决策。此外,分别有 76% 和 56% 的妇女参与了探亲访友和家庭支出的决策。在考虑了社会经济和人口因素后,我们发现与来自一夫一妻制家庭的妇女相比,来自一夫多妻制家庭的妇女参与健康决策(OR=0.65,p < 0.001)、家庭大额采购(OR=0.65,p < 0.001)、探亲访友(OR=0.72,p < 0.001)和家庭支出(OR=0.58,p < 0.001)的可能性较低。根据我们的研究结果,我们建议迫切需要审查和重新评估旨在促进毛里塔尼亚性别平等和妇女自主的政策和方法。具体来说,一夫多妻制家庭结构中的权力失衡继续对已婚妇女的家庭决策自主权产生不利影响,因此,干预计划必须围绕减少这种权力失衡开展工作。此类干预措施应以已婚妇女的社会经济地位为中心,将其作为毛里塔尼亚赋权战略的核心组成部分。
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引用次数: 0
Who is Anaemic in India? Intersections of class, caste, and gender. 谁在印度贫血?阶级、种姓和性别的交叉。
IF 1.5 3区 社会学 Q2 DEMOGRAPHY Pub Date : 2024-07-01 Epub Date: 2024-06-04 DOI: 10.1017/S0021932024000245
Bikash Das, Mihir Adhikary, Smriti Rekha Singha, Daksha Parmar

Anaemia severely impacts physical and mental abilities, raises health risks, and diminishes the quality of life and work capacity. It is a leading cause of adverse pregnancy outcomes and maternal mortality, especially in developing nations like India, where recent data on anaemia from National Family and Health Survey (NFHS-4) (2015-16) and NFHS-5 (2019-21) indicate a tremendous rise. Anaemia is a marker of poor nutrition and health, and socio-economic factors such as gender norms, race, income, and living conditions influence its impact. As a result, there are disparities in how anaemia affects different segments of society. However, existing research on health inequity and anaemia often employs a single-axis analytical framework of social power. These studies operate under the assumption that gender, economic class, ethnicity, and caste are inherently distinct and mutually exclusive categories and fail to provide a comprehensive understanding of anaemia prevalence. Therefore, the study has adopted the theoretical framework of intersectionality and analysed the NFHS-5 (2019-21) data using bivariate cross-tabulations and binary logistic regression models to understand how gender, class, caste, and place of residence are associated with the prevalence of anaemia. The results suggest that the women of Scheduled Tribes (ST) and Scheduled Castes (SC) share a disproportionate burden of anaemia. This study confirms that economic class and gender, geographical location, level of education, and body mass index significantly determine the prevalence of anaemia. The ST and SC women who are economically marginalised and reside in rural areas with high levels of poverty, exclusion, and poor nutritional status have a higher prevalence of anaemia than other population groups. Thus, the study suggests that intersections of multiple factors such as caste, class, gender, and place of residence significantly determine 'who is anaemic in India'.

贫血严重影响身心能力,增加健康风险,降低生活质量和工作能力。贫血是导致不良妊娠结局和孕产妇死亡的主要原因,尤其是在印度等发展中国家,全国家庭与健康调查(NFHS-4)(2015-16 年)和全国家庭与健康调查(NFHS-5)(2019-21 年)中有关贫血的最新数据显示,贫血人数急剧上升。贫血是营养不良和健康状况不良的标志,性别规范、种族、收入和生活条件等社会经济因素都会对其产生影响。因此,贫血对社会不同阶层的影响存在差异。然而,现有关于健康不平等和贫血的研究往往采用社会权力的单轴分析框架。这些研究假定性别、经济阶级、种族和种姓是固有的截然不同且相互排斥的类别,因而无法全面了解贫血症的流行情况。因此,本研究采用了交叉性理论框架,并使用二元交叉表和二元逻辑回归模型对 NFHS-5(2019-21 年)数据进行了分析,以了解性别、阶级、种姓和居住地如何与贫血患病率相关联。结果表明,在册部落(ST)和在册种姓(SC)的妇女承受着不成比例的贫血负担。这项研究证实,经济阶层和性别、地理位置、教育水平和体重指数在很大程度上决定了贫血症的发病率。在册部落和在册种姓妇女在经济上被边缘化,居住在贫困、排斥和营养状况较差的农村地区,她们的贫血患病率高于其他人群。因此,这项研究表明,种姓、阶级、性别和居住地等多重因素的交叉在很大程度上决定了 "谁在印度贫血"。
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引用次数: 0
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Journal of Biosocial Science
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