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The social bases of declining infant mortality: lessons from a nineteenth-century Italian town.
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The implications of the demographic transition theory for fertility change in Nigeria.
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Delayed marriages in Pakistan.
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Women and AIDS in Zimbabwe: the making of an epidemic.
As the AIDS epidemic in Africa assumes major proportions, the need to understand the social context in which heterosexual transmission occurs takes on urgent importance. In this article we explore how the intersection of traditional culture with the colonial legacy and present-day political economy has influenced family structure and sexual relations, and particularly the social position of women. Drawing on Zimbabwe's historical experience, we show how land expropriation, rural impoverishment, and the forcible introduction of male migrant labor fostered new patterns of sexual relations, characterized by multiple partners. Traditional patriarchal values reinterpreted in European law resulted in further subjugation of women as even limited rights to ownership were withdrawn. For many women, sexual relations with men, either within marriage (for the majority) or outside, become inextricably linked to economic and social survival. In this setting, all sexually transmitted diseases became rampant, including genital ulcer, which facilitates transmission of the human immunodeficiency virus (HIV). Intervention programs to halt the spread of AIDS need to take into the account the epidemic's historical roots and social nature. For example, efforts to reduce risk of HIV transmission should seek to expand women's limited options, both technically (e.g., by providing alternatives to condoms) and socially (e.g., by promoting employment).
Use of pacifiers and breastfeeding duration.
Pacifiers are widely used in many developing countries. Although their use is not recommended for breastfeeding infants, there have been no published reports on the association between pacifier use and risk of early weaning. In a study of 354 infants in Brazil, mothers were asked about pacifier use at age 1 month, duration of breastfeeding, and introduction of other foods. Among 249 children still breastfed at 1 month, the risk that a child would be weaned at any age between 1 and 24 months was higher in pacifier users than in non-users (hazard ratio 3.0, 95% CI 2.0-4.6). The association remained even after adjustment for the child's age, sex, birthweight, socioeconomic status, and age at introduction of bottle-feeding.
Community health workers and primary health care in Honduras.
Community participation and utilization of community health workers (CHWs) are essential components of the primary health care model. The success of CHWs is dependent on their training and subsequent community support. Community-prepared nurses are ideal CHW educators. A training program for CHWs was implemented in Honduras emphasizing the principles of adult learning and problem-based learning. Following a 4-month program of training a primary health care clinic was opened and managed by CHWs for a population over 10,000. Approximately 80% of local health problems were managed by the CHWs proving that well-trained CHWs can have a significant impact on the delivery of health care.
Impact of health education on mothers' knowledge of preventive health practices.
A prospective community-based intervention study was conducted in a slum area of Karachi, Pakistan, with the objective of evaluating the impact of health education on the knowledge of mothers. One hundred and fifty households were studied in the intervention and the same in the non-intervention group. The post intervention knowledge scores of the mothers showed a significant difference of P < 0.05. Nearly 50.7% mothers in the intervention group knew of at least four diseases against which vaccination is given as compared to the non-intervention group (P < 0.05). Similarly, mothers in the intervention group were more aware about the advantages of breast feeding, signs of dehydration, measures for prevention of measles and tuberculosis as compared to the non-intervention group (P < 0.05). Finally, a comparison was made between the pre- and post-intervention scores between the two groups. The score in the non-intervention group changed from 11.5 to 16.1 (P > 0.05) as compared to the intervention group in which it changed from 10.2 to 32.2 (P < 0.05).
A question of dignity. Impact of rapid population growth on developing countries.
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Difficulties in conducting participatory action research to prevent diarrhoea in a slum area of Bangkok.
Childhood diarrhoea is a major cause of childhood morbidity and mortality in Thailand. During April 1988-April 1990, a study was conducted to evaluate participatory action research as a method of intervening on unhygienic practices in two communities in the Klong Toey slum of Bangkok (intervention group) and compared these practices in two other communities of the same slum where there was no intervention (control group). The following variables were compared in two groups: hygiene behaviour and factors associated with participation of community leaders and mothers with children aged less than five years. Two hundred and twenty-one mothers of the original 606 (36%) were still available at the end of the study. It was found that the mothers in the intervention groups were more likely to wash their hands before feeding and use cupboards and covered containers for keeping food. Several factors negatively affected community participation: matters concerning the slum culture and organization, community leadership, family problems, occupational problems, and physical environment of the community. The conclusions of the study are limited because of the considerable proportion of the subjects that was lost to follow-up. The study points at some of the methodological issues when conducting research in challenging and difficult to reach communities that have important health problems.
Urban concentration and sectoral income distribution.
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[Thoughts on the spatial distribution of population].
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The prevalence and demographic characteristics of consanguineous marriages in Pakistan.
Consanguineous marriages are strongly preferred in much of West and South Asia. This paper examines the prevalence and sociodemographic correlates of consanguineous unions in Pakistan using local and national data. Information from 1011 ever-married women living in four multi-ethnic and multi-lingual squatter settlements of Karachi, the main commercial centre of the country, are compared with data from the national 1990/91 Pakistan Demographic and Health Survey (PDHS), based on information provided by 6611 women. Both sets of results indicate that approximately 60% of marriages were consanguineous, over 80% of which were between first cousins. The mean coefficients of inbreeding (F) in the present generation were 0.0316 and 0.0331 for the Karachi and PDHS data respectively. In both surveys the prevalence of consanguineous unions appeared to be unchanged over the past three to four decades. Consanguineous unions were more common among women who were illiterate or had only primary level education, were first or second generation migrants from rural areas of Pakistan or, in the PDHS, lived in rural areas, and whose parents were also consanguineously married.
Urbanization in Taiwan, 1964-1975.
"This paper examines levels and rates of urbanization in Taiwan and its ability to absorb a growing labor supply in its urban centers. Urban growth is concentrated in the Northern region and in large urban places. By 1975, half of Taiwan's population was located in places of 50,000 or more and 80 percent of the total population growth between 1964 and 1975 occurred in urban areas. Despite substantial urban growth and an even more rapid labor force growth, workers were absorbed into 'urban' industries and occupations. Based on this ability to absorb, Taiwan does not appear to be overurbanized and seems to fit the Western model." This paper was originally presented at the 1980 Annual Meeting of the Population Association of America (see Population Index, Vol. 46, No. 3, Fall 1980, p. 373). (summary in CHI)
[The population of cities and towns in the USSR (1970-1979)].
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Changes in the functions of Soviet cities with growth.
"A sample of Soviet cities (the largest 100 cities in the RSFSR) is used to develop a model relating city size, city function and the city's force of attraction (in-migration rates)....[It is found that] city growth...is accompanied by a change in functional structure and an increase in the importance of some functions at the expense of others....A change in functional structure, in turn, produces a change in the city's force of attraction, resulting in either an increase or a decline of in-migration."