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Traditional belief and practice among the Pokot people of Kenya with particular reference to mother and child health: 1. The Pokot people and their environment.

In order to provide effective and sympathetic health care in a community, it is essential to have a detailed understanding of the culture. This is particularly true when one is concerned with the health of mothers and their children. The Pokot people of Kenya have developed a social structure and cultural practices which aim to optimize the chance of survival of the community in an often difficult and hostile environment. When examined in detail, some of these practices are seen to be beneficial, while others are associated with significant morbidity and mortality, especially in the area of mother and child health. In recent times, Pokot society has been in a phase of transition, influenced by new opportunities of educational, economic and social interaction, particularly since the completion of a tarmac road through the district in 1983. While many of these changes are undoubtedly beneficial to the community, they have been associated with a disintegration of traditional Pokot society and accompanied by changing patterns of existing diseases, as well as the opportunity for introduction and dissemination of diseases which were previously absent from or rarely encountered in the area.

Adolescent

Social structure and U.S. inter-state fertility differentials in 1900.

This paper investigates the importance of agricultural land shortages versus modernization of the society in influencing inter-state differentials in fertility in 1900, when the United States was in mid-transition. Urbanization and manufacturing characteristics of states were the strongest correlates of variations in the index of total fertility because urban-industrialism depressed both the probability of marriage and marital fertility. Other modern characteristics of American states were also important in understanding variations in marital fertility. Low labor force employment of children and farm mechanization, integrally related characteristics, seemed to depress levels of marital fertility in many parts of the United States, independent of the urban-industrial system. Agricultural land opportunity had little overall effect on marital fertility; however, it was quite important in understanding variations in patterns of marriage.

Adolescent

Population structure of the Indian people: some microevolutionary aspects.

Some aspects of population structure, namely village endogamy, marital distance and consanguinity in India are discussed. These parameters show social and geographic variation. The role of culture is of great importance in determining the mating pattern of a population. In the Indian situation, group endogamy in general does not cause inbreeding. Consanguinity is a cultural phenomenon of long-standing tradition, and so far there is no strong indication of a temporal change.

Biological Evolution

Trends in fertility patterns of women in rural Zimbabwe.

To study changes over time in reproductive health and living conditions of women in a rural setting in Zimbabwe, 12 villages were selected at random in the Gutu district, Masvingo province. During two study periods in 1992 and 1993, 1,213 women of fertile age (15-44 years) were interviewed and examined. Median age at menarche was 15 years, with a decrease of 0.4 years from the oldest to the youngest age group. There has been no increase in the mean height of women, indicating no change in determinants of nutritional status of girls in childhood and adolescence. Younger women still marry at a median age of 19 years but prefer smaller families. Level of education is the main determinant for age at marriage and preferred family size. A low prevalence of primary (1%) as well as secondary infertility (4%) was found in spite of the currently reported high prevalence of sexually transmitted diseases in Zimbabwe.

Adolescent

Phenotypic consequences of nonrandom migration in the Jirels of Nepal.

The phenotypic structure of human populations is shaped by a number of factors such as population size and marital migration. This paper examines the impact of migration on the between-village phenotypic differentiation of the Jirels, a tribal group of eastern Nepal. Data on stature and five cranial measurements for 526 individuals (males and females) are utilized to illustrate the patterns of phenotypic variation. A permutation method is used to generate the phenotypic consequences of random migration constrained to observed levels of movement. The results suggest that Jirel migration is nonrandom and that it produces higher levels of phenotypic differentiation than would result from a random migration process.

Adult

Sociologic aspects of adolescent fertility and childbearing among Hispanics.

This paper reviews several sociologic factors associated with fertility and childbearing among Hispanic teens. The influences of acculturation, patterns of prenatal care and pregnancy outcome among Hispanic adolescents are discussed. Statistics related to birth weight, to onset of prenatal care, and marital status of the mother are also reviewed by age and ethnicity. Suggestions on how to enhance health care access among Hispanic teens are provided.

Acculturation

Variation in fertility between different types of local area.

Trends in fertility at the national level have been described in a recent article in the Population Review series. This article examines variations in the pattern of fertility experienced in different kinds of area within England and Wales. For this purpose use is made of the new ONS classification of local authorities into 11 groups and 29 clusters of areas with similar socio-economic characteristics. The classification was developed from statistics collected in the 1991 Census of Population. Although proportions of residents aged 0-4, 5-14, and 25-44 were among the 37 Census variables used to define groups and clusters of similar areas, the analysis did not make direct use of any measure of fertility related to ages of women at childbirth.

Adolescent

Family formation patterns among migrant women in Sydney.

A demographic survey among a probability sample of 980 married migrant women was carried out in Sydney in 1988. The sample included 507 Lebanese, 250 Turkish and 223 Vietnamese women. The study revealed differences in family formation patterns within and between the three groups and between them and the general population. Family size had declined among all three groups compared with their family of origin, and it was clear that the younger women would not achieve the same family sizes as the older women. Migrant women tended to marry earlier than the general population and to start their families earlier. While they showed a strong preference for their children to marry within their own ethnic and religious group, nearly one-third said it was up to the choice of the individual. Overall, the future family size of younger migrant women is expected to converge towards the Australian norm. Migrant families are in a state of transition between two cultures which needs to be recognised by health and family planning service providers.

Adult

Use of obstetric services in rural Nigeria.

The pattern and determinants of maternal service utilization were studied in a rural Nigerian community. The study sample consisted of 488 randomly selected women who had a childbirth or an abortion between May 1987 and September 1989. Although 93% registered for prenatal care in a health care institution, only 51% delivered in a health institution while 49% delivered at home mainly under the care of traditional birth attendants. Factors found to be most consistently associated with the use of health institutions for delivery were maternal education and occupation, religion, and occupation of the husband. Maternal age, parity and marital status and place of the residence were not significantly associated with the choice between home and institutional delivery. Logistic regression analysis was used to determine the odds ratio and to quantify the weight of these independent variables found to be significantly associated with the place of delivery as the outcome variable.

Adult

Child spacing and two child policy in practice in rural Vietnam: cross sectional survey.

OBJECTIVE: To explore the reproductive pattern of women in rural Vietnam in relation to the existing family planning policies and laws. DESIGN: Cross sectional survey with question-naires on reproductive history. SETTING: Tien Hai, a district in Red River Delta area, where the population density is one of the highest in Vietnam. SUBJECTS: 1132 women who had at least one child under 5 years of age in April 1992. MAIN OUTCOME MEASURES: Birth spacing and probability of having a third child. RESULTS: The mean age at first birth was 22.2 years. The average spacing between the first and the second child was 2.6 years. Mothers with a lower educational level, farmers, and women belonging to the Catholic religion had shorter spacing between the first and second child and also a higher probability of having a third child. In addition, women who had no sons or who had lost a previous child were more likely to have a third child. CONCLUSION: Most families do not adhere to the official family planning policy, which was introduced in 1988, stipulating that each couple should have a maximum of two children with 3-5 years' spacing in between. More consideration should be given to family planning needs and perceptions of the population, supporting the woman to be in control of her fertility. This may imply improved contraceptive services and better consideration of sex issues and cultural differences as well as improved social support for elderly people.

Age Factors

Temporal variation in the mating structure of Sanday, Orkney Islands.

Pedigree and vital statistics data from the population of Sanday, Orkney Islands, Scotland, were used to assess temporal changes in population structure. Secular trends in patterns of mate choice were analysed for three separate birth cohorts of spouses: 1855-1884, 1885-1924 and 1925-1964. The degree to which mating was random or assortative with respect to both genealogical and geographic distance was determined by comparing average characteristics of all potential mates of married males with those of actual wives. We integrated this procedure, originally developed by Dyke (1971), into a three-fold investigation of population structure: (1) comparison of random and non-random components of relatedness as measured from pedigree data; (2) an analysis of marital distance distributions for actual and potential mates of married males; and (3) the relationship between genealogical relatedness and geographic distance. As population size decreased from 1881 to the present, total kinship and spatial distances between spouses increased. Whereas the random component of relatedness increased over time, consanguinity avoidance was sufficient to decrease the total coefficient of kinship over time. Part of the increase in consanguinity avoidance was associated with isolate breakdown, as distances between island-born spouses, as well as the total amount of off-island migration, increased from the mid-nineteenth century to the present. Mate choice was influenced by geographic distance for all time periods, although this effect diminished over time. Since decreases in population size, concomitant with increases in consanguinity avoidance and community exogamy, have probably occurred quite frequently in small human populations, as well as in rural Western communities in the past century, observed secular trends illustrate the potential for change in population structure characteristic of isolate breakdown.

Consanguinity

Genetic microdifferentiation in the Semai Senoi of Malaysia.

Blood samples, demographic and cultural data were collected from seven settlements of Semai Senoi, a swidden farming ethnic group of Malaysia. Three genetic loci (ABO blood group, hereditary ovalcytosis, and hemoglobin) were analyzed in a total sample of 546 individuals. These data indicate a considerable degree of genetic microdifferentiation in this area of the Semai distribution. Parent-offspring birthplace data (analyzed by means of a migration matrix) and settlement histories show that settlements are not strongly isolated. Genetic differences in the study area demonstrate a reasonable correspondence with migration and the history of the settlements. Genetic convergence also occurs through the addition of migrant groups to established populations leading to new patterns of marriage between donor and recipient groups. The genetic structure of the total Semai population through time thus comprises a mosaic of shifiting allele frequencies in a series of semi-isolated local populations.

ABO Blood-Group System

A comparison of definable traits in women requesting reversal of sterilization and women satisfied with sterilization.

More women of reproductive age are being sterilized. Some of these women regret the decision and subsequently request a reversal of sterilization, whereas others do not. This study was undertaken to develop a profile of easily definable traits of 159 women who requested a reversal of sterilization and compare it with that of 160 women who apparently were satisfied with sterilization. Statistically significant differences were found. Remarriage was the most common cause for regret among women in the group which requested reversal of sterilization. Women in this group married younger, completed their family earlier, and were sterilized at a younger age. These women had significantly fewer live children and had undergone more therapeutic abortions (p less than 0.005).

Abortion, Therapeutic