Subnational inequalities of early marriage and fertility among Chinese females from 1990 to 2010 / 北京大学学报(医学版)

OBJECTIVE@#To analyze the inequality of early marriage and adolescent fertility with respect to local economic development among Chinese females aged 15-19 years from 1990 to 2010.@*METHODS@#Aggregated data were extracted from the Chinese National Census from 1990 to 2010. We calculated the ever-married rate and fertility rate of female adolescents aged 15-19 years. Using gross domestic product (GDP) per capita as an indicator for socio-economic status of a province, we calculated the slope index of inequality (SII) and the concentration index (CI) to analyze the subnational inequalities of early marriage and adolescent fertility. Weighted linear regression models were also established to assess the associations between GDP per capita and the ever-married rate/fertility rate.@*RESULTS@#The ever-married rate for Chinese female adolescents aged 15-19 years decreased from 4.7% in 1990 to 1.2% in 2000, and rebounded to 2.1% in 2010. From 1990 to 2000, the fertility rate decreased from 22.0 per 1 000 to 6.0 per 1 000, and further decreased to 5.9 per 1 000 in 2010. In 1990, the socio-economic inequalities of the ever-married rate and fertility rate for female adolescents aged 15-19 years were not statistically significant (P for SII or CI>0.05). The values of SII revealed that, in 2000 and 2010, female adolescents with the lowest GDP per capita had an ever-married rate 2.4% (95%CI: 0.4-4.4) and 2.3% (95%CI: 0.3-4.2) higher than those with the highest GDP per capita, respectively. In the meantime, in 2000 and 2010, female adolescents with the lowest GDP per capita had a fertility rate 12.9 per 1 000 (95%CI: 5.4-20.5) and 9.3 per 1 000 (95%CI: 4.6-14.0) higher than those with the highest, respectively. In 2000 and 2010, the CIs for marriage were -0.32 (P=0.02) and -0.17 (P=0.03), respectively, and the CIs for childbirth were -0.37 (P<0.01) and -0.26 (P<0.01), respectively. In 2000, the ever-married rate and the fertility rate were estimated to increase by 1.4% (95%CI: 0.1-2.7) and 7.9 per 1 000 (95%CI: 2.9-12.8) with 100% increase in GDP per capita, respectively; in 2010, the numbers were 1.5% (95%CI: 0.1-2.9) and 6.7 per 1 000 (95%CI: 3.2-10.1), respectively.@*CONCLUSION@#Subnational socio-economic inequality of early marriage and adolescent fertility existed in 2000 and 2010. Female adolescents residing in less-developed areas were more likely to engage in early marriage and childbirth. Reducing income inequality and increasing education investment for poverty-stricken areas seem to be effective measures to reduce this inequality.

Comparison of Health status among married and unmarried girls of late adolescent age in an urban slum of Delhi

Background: Late adolescent girls are being forced into marriage and the burden of marital responsibilities, most notably partner’s sexual demands and childbearing and child-rearing, led to significant emotional distress and depression. Thus, early marriage for girls might have profound impact on their health status. Aims & Objectives: To study impact of early marriage on health status of married girls of late adolescent age and to compare them with unmarried girls of same age. Material & Methods: A comparison study was conducted among girls of late adolescent age in an urban slum of North East Delhi. One sixty study participants were included in each group. A pretested interview schedule was used for collecting details such as knowledge on reproductive health, physical parameters and anemic status. Chi square tests were used and odds ratio was calculated. Results: Majority of married girls, 102(63.8%) had middle school education while 93(58.1%) of unmarried girls had high school education. The mean (SD) age of marriage of married adolescent girls was 17(±) years while their husband age at time of marriage was 21.6(±) years. Levels of hemoglobin were low in both groups 87.5% in married girls and 98.75% in unmarried girls. Conclusion: Early marriage was found to have impact on menstruation, reproductive health and nutritional status of adolescent girls.

Differentials and Correlates of Infants Mortality in Nigeria: A Comparative Survival Analysis between North East and South West Nigeria.

Aims: Infant mortality rate (IMR) is not only used as a demographic measure, but also as an important health indicator of a society as well as a measure of its living standard worldwide. The Nigeria Demographic and Household Survey (NDHS) declared a wide difference in the IMR among geographical zones in Nigeria with widest gap between the North East (NE) and South West (SW). This study assessed the differences in IMR viz-a-viz socio-demographic, sexual and reproductive factors and also determined factors affecting the IMR in the two zones. Place of Study: Rural and Urbanlocations across the NE and SW Nigeria Study Design: We used a nationally representative cross sectional data from the NDHS 2008 survey.Our analysis was based on the 23,995 and 11,546 births during five years preceding data collection from women aged 15-49 years in NE and SW Nigeria respectively. Methods: We censored the children who have not had their first birthday as of the day of interview and estimated the IMR with Life tables using West Models. Other analysis were carried out with descriptive statistics, bivariate and multivariate cox regression models at 5% significance level. Results: About 3 of every four NE children are from rural areas compared with 47.4% in SW, while nearly 78% of NE children are from mothers without formal education the rate was 20.9% in the SW. The IMR among children from teenager mothers was 121 and 82 per 1000 live births in NE and SW respectively, 87 for urban NE, 52 for urban SW, 115 for rural NE, and 66 for rural SW. In the NE, children from rural areas were about 30% times more likely than children from urban areas to die before their first birthday (HR=1.3 95% CI:1.1-1.6)while in the SW they were 40% times more likely to die (HR=1.6 95% CI:1.1-2.4). Children from wealthiest homes in the NE had lower IMR than children from wealthiest homes in the SW (37 vs 55) but wealth quintiles were not significant to IMR in the SW. Conclusion: The prevailing trend of early marriage, non-education, delayed initiation of breastfeeding, unsafe drinking water, unemployment and poverty among others should be averted so as to improve child survival in the Nigeria especially in the North East.

'Medical Knowledge' and 'Tradition' of Colonial Korea: Focused on Kudo's "Gynecology"-based Knowledge / 의사학

This article attempts to illuminate the ways in which Kudo's medical knowledge based on 'gynecological science' constructed the cultural 'traditions' of colonial Korea. Kudo appears to have been quite an influential figure in colonial Korea in that his writings on the relationship between women's crime, gynecological science and the Choson society granted a significant amount of intellectual authority. Here, I examine Kudo's position within colonial Korea as a producer and propagator of medical knowledge, and then see how women's bodies were understood according to his gynecological knowledge. It also traces the ways in which Kudo's gynecological knowledge represents Choson society and in turn invents the 'traditions' of Chosn. Kudo's knowledge of "gynecology" which had been formed while it traveled the states such as Japan, Germany and France served as an important reference for his representation of colonial Korean society. Kudo was a proponent of biological evolution, particularly the rules of 'atavism' put forth by the criminal anthropologist Cesare Lombroso, and argued that an unique social environment caused 'alteration of sexual urges' and primitive cruelty in Choson women. According to Kudo, The social environment was none other than the practice of 'early marriage,' which went against the physiology of women. To Kudo, 'early marriage' was an old 'tradition' of Choson and the cause of heinous crimes, as well as an unmistakable indicator of both the primitiveness and savageness of Chosn. While Lombroso considered personal factors such as stress as the cause of women's crimes, Kudo saw Choson women's crimes as a national characteristic. Moreover, he compared the occurrence rate of husband murders by provinces, based on which he categorized the northern population of Choson as barbaric Manchurian and the southern population as the superior Japanese, a combination of racism and scientific knowledge. Kudo's writings provide an insight into the appropriation of Western medical theories and criminal anthropological knowledge by a non-Western colony as well as the ambivalence and contradictions underlying Japanese empire as in the use of concepts like 'difference' and 'unity.' According to today's standards, Kudo's physiological arguments can hardly avoid being called pseudo science, which confirms that the power and authority of science standing on 'objectivity' and 'universality' are actually dependent on social contexts that are constantly being readjusted. In the end, the cultural 'traditions' of a nation/state often taken for granted are social constructions born out of transnational crossing points of knowledges, and on the basis of these constructs are the concepts of differences between nations/states. And one of the core references for these differences in colonial Korea was Western science/medical knowledge.

A study on teenage pregnant mothers attending primary health centers of Kempegowda Institute of Medical Sciences, Bangalore.

Data were collected from 78 teenage pregnant mothers (15-19 years) out of 1446 pregnant mothers who attended the primary health centers situated in the field practice area of the rural health center, Kengeri of Kempegowda Institute of Medical Sciences, Bangalore, between May and July 2009 to study the factors associated with teenage pregnancies and awareness regarding family planning. This was a descriptive study. Out of 78 teenage pregnant mothers, 57 (73%) were Hindus and 45 (57.7%) belonged to joint families. 76 (97.4%) teenage pregnant mothers were housewives, i.e. 55 (70.5%) of the spouses of the teenage pregnant mothers were laborers, in majority, i.e. 40 (51.3%) teenage pregnant mothers' age at marriage and the age at first pregnancy were 18 years. The mean age at marriage increased significantly with an increase of the educational status of the teenage pregnant mothers (F value = 7.08%, P< 0.002). The mean age at first pregnancy was also increased with an increase of the education status of both the teenage pregnant mothers and their spouse. The most common reason for early marriage and early pregnancy was traditional practices and family pressure among 50 (64%) and 45 (57.7%) teenage pregnant mothers, respectively. 49 (63%) teenage pregnant mothers were not aware of any family planning methods.