Vol 2, No 2 (2016)

Table of Contents

Articles

by Danan Gu, Runlong Huang, Kirill Andreev, Matthew E. Dupre, Yaer Zhuang, Hongyan Liu
198 Views, 202 PDF Downloads
This study examined the possible underestimation and age-trajectories of mortality at oldest-old ages in China’s 2000 and 2010 censuses. By linking logit-transformed conditional probabilities of dying from 13 countries with the highest data quality in the world, this study found that many Chinese provinces had underestimations of mortality at oldest-old ages when a relatively lenient criterion was applied. When a relatively strict criterion was applied, most provinces had a 30% or more underestimation in the probability of dying. We also investigated age trajectories of death rates after age 80 in these two censuses by applying the Kannisto model. Results showed that the age trajectories were distorted in most provinces after age 95. Overall, eastern-coastal provinces had higher data quality — in terms of low underestimation rates and less distorted age trajectories — whereas western China had provinces with problematic data. Females had greater rates of underestimation yet less distorted age-trajectories than males; and the 2010 census had greater rates of underestimation yet less distorted age-trajectories than the 2000 census. We conclude that appropriate adjustments with simultaneous applications of the Kannisto model are needed for direct estimates of mortality at oldest-old ages in the 2000 and 2010 censuses for China and for its provinces.
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Articles

by Mukesh Ranjan, Laxmi Kant Dwivedi, Rahul Mishra, Brajesh -
354 Views, 450 PDF Downloads
Higher infant mortality among tribal populations in India is well-documented. However, it is rare to compare factors associated with infant mortality in tribal populations with those in non-tribal populations. In the present paper, Cox proportional hazards models were employed to examine factors influencing infant mortality in tribal and non-tribal populations in the Central and Eastern Indian states using data from the District Level Household Survey-III in 2007-2008. Characteristics of mothers, infants, and households/communities plus a program variable reflecting the place of pregnancy registration were included in the analyses. We found that the gap in infant mortality between tribal and non-tribal populations was substantial in the early months after birth, narrowed between the fourth and eighth months, and enlarged mildly afterwards. Cox regression models show that while some factors were similarly associated with infant mortality in tribes and non-tribes, distinctive differences between tribal and non-tribal populations were striking. Sex of infants, breastfeeding with colostrum, and age of mother at birth acted similarly between tribes and non-tribes, yet factors such as state of residence, wealth, religion, place of residence, mother’s education, and birth order behaved differently. The program factor was non-significant in both tribal and non-tribal populations.
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Articles

by Mark Lyons-Amos
189 Views, 106 PDF Downloads
Multilevel modelling techniques such as random models or fixed effect are increasingly used in social sciences and demography to both account for clustering within higher level aggregations and evaluate the interaction between individual and contextual information. While this is justifiable in some studies, the extension of multilevel models to national level analysis — and particularly cross-national comparative analysis — is problematic and can hamper the understanding of the interplay between individual and country level characteristics. This paper proposes an alternative approach, which allocates countries to classes based on economic, labour market and policy characteristics. Classes influence the profiles of three key demographic behaviours at a sub-national level: marriage, cohabitation and first birth timing. Woman level data are drawn from a subset of the Harmonized Histories dataset, and national level information from the GGP contextual database. In this example, three country classes are extracted reflecting two Western patterns and an Eastern pattern, divided approximately along the Hajnal line. While Western countries tend to exhibit higher levels of family allowances albeit accounting for a lower share of spending which is associated with lower marriage and later fertility, Eastern countries generally show a higher share of spending but at lower absolute levels with lower cohabitation rates and early fertility.
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Articles

by Ramesh Babu Kafle
103 Views, 73 PDF Downloads
This paper examines declining fertility in a low development setting. Specifically, this paper analyzes transitions in age at first birth and of the length of birth intervals, the variations of the length of birth intervals by selected socioeconomic and demographic factors, and the determinants of the risk of higher order birth in Nepal by using the DHS data. There is very little change in the age at start of fertility schedule but the proportion of women progressing to the next higher order birth from the second, third and fourth births has declined over time. Increases in the median length of higher order birth intervals and decline in the ultimate proportions of women attaining higher order births drive declines in the pace of childbearing and overall fertility level. Controlling for other factors, higher order births are more likely among women who had given a previous birth before the survey period or women who had a female birth compared to women who did not have such births. Significantly, lower hazard ratio of the second birth is observed among women who are more educated, working in non-agriculture sector, from well-to-do households, with higher age at first birth, and whose first child survived during infancy.
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Articles

by Haiyan Zhu, Qiushi Feng, Danan Gu
132 Views, 97 PDF Downloads

Interviewer-rated health (IRH) and self-rated health (SRH) have strong and independent predictive power for mortality, but their relative predictive power has not been examined among subpopulations. Because individuals from different subpopulations have distinct views, understandings, and judgments about health that influence their criteria and referents for SRH, we examine whether IRH is a valid predictor of mortality within subpopulations, which may provide added value for understanding its association with mortality. Using data from the 2005 and 2008 waves of the Chinese Longitudinal Healthy Longevity Survey, this study modeled associations of SRH and IRH with mortality in various subgroups among 12,583 older adults in China. We found that IRH is a robust predictor of mortality, independent of SRH, across major demographic and socioeconomic subpopulations after adjusting for a wide range of covariates. The predictive power of IRH for mortality was generally more robust than that of SRH in most subpopulations. Our findings suggest that IRH could be a good complement to SRH among subgroups of the Chinese older population.

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Articles

by Abha Gupta, Pushpendra Kumar, Olalemi Adewumi Dorcas
180 Views, 325 PDF Downloads

It is widely evidenced that low socio-economic status is significantly associated with poor health, but inequalities caused by social and economic factors are poorly quantified. This paper attempts to measure contributions of selected factors to the differences in full antenatal care (ANC) utilization in the state of Jharkhand, India, based on the third wave of District Level Household and Facility Survey (DLHS-3) data in 2007–2008. Full ANC is defined as having a minimum of three antenatal visits, at least two tetanus toxoid injections and receiving folic acid tablets for at least 90 days or more during the last pregnancy. Multivariate and decomposition statistical techniques were employed to examine the factors associated with utilization of ANC services and their contributions to inequalities in utilization. Results show that the factors with the largest contribution to utilization of ANC services were poor economic status of women (37.53%), mass media exposure (30.71%), and residence in a rural area (15.56%). The relative contributions of region, mothers’ education, age, and birth order of the women in generating inequalities were small. Therefore, to improve maternal health and to reduce socio-economic gaps in the state, more focus is needed on vulnerable sections of society and regions where the effects of government health programs hardly reach.

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Articles

by Atreyee Sinha, Aparajita Chattopadhyay
160 Views, 115 PDF Downloads
Spousal violence emerged as a major public health concern over the past few decades as its consequences on the health of victims are profound. Infliction of violence during pregnancy is even more detrimental as it might cause serious injuries to women and their unborn children. Violence during pregnancy can restrict access to proper health care and affect the health of mother and child. However, the role of spousal violence on utilization of pregnancy care services is not well explored in India where both fertility and spousal violence are high. In the present study, we used data of selected North and South Indian states from the National Family Health Survey (2005–2006) to examine the relationship between experience of spousal violence by young married women and utilization of maternal and child health care services. A marked regional variation was observed in MCH care utilization and levels of violence, where the South Indian states performed better than the North. Spousal violence was a significant factor determining MCH care use. Women who had experienced any form of physical/sexual violence were less likely to receive full ante natal care than non-abused women and the association was stronger in the South. Women experiencing any physical/sexual violence were also less likely to avail institutional delivery in the North. Emotional violence had similar constraining effects on MCH care use in the South. Integration of violence screening and counselling with MCH programs could be helpful to address the needs of abused pregnant women and provide essential care.
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Articles

by Priyanka Dixit, Laxmi Kant Dwivedi
139 Views, 200 PDF Downloads

As institutional delivery centers usually have much better modern facilities and hygienic conditions in India, utilization of institutional delivery services could improve maternal and child health. The objective of this paper is to address the issue of whether women were consistent in delivering births in an institutional care center over successive pregnancies in India and investigate the factors associated with consistent utilization of institutional delivery. We applied multivariate multilevel models that allow for a strong dependence between successive outcomes at the same unit to the third round of the National Family Health Survey in 2005-2006. Results show that region and place of residence, woman’s education, wealth index, having experienced the loss of a child, ever having terminated a pregnancy, and birth order are significant predictors of place of delivery for all three recent births among ever-married women. Our results further show that previous utilization of institutional delivery was an important predictor of utilization for subsequent institutional deliveries. Policies aimed at improving the wide or persistent utilization of institutional delivery in India should focus on first-time mothers targeting disadvantaged women who are from rural areas, poor families, illiterate, Muslim, and scheduled castes.

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