The health and well-being of older women living alone in the United Kingdom and beyond: a scoping review.

In the United Kingdom (UK), women are more likely to live alone in later life. Social factors such as household composition have been shown to affect health and wellbeing as we age. The health and well-being of older women who live alone are of interest to researchers, care providers, health organizations, and policymakers. This article contributes to the literature by detailing a scoping review, establishing the current evidence in this field. The purpose and context of the review are given. The methodology and resulting data are described. Gaps in the literature and implications for practice and research are given.

Differences in the socio-demographic determinants of undernutrition in children aged <5 years in urban and rural areas of Bangladesh measured by the Composite Index of Anthropometric Failure.

OBJECTIVES: This study investigates the prevalence and determinants of undernutrition among children <5 years living in Bangladesh using the Composite Index of Anthropometric Failure (CIAF) and highlights the differences between urban and rural areas. STUDY DESIGN: Data are drawn from three cross-sectional Bangladesh Demographic Health Surveys conducted from 2007 to 2014. METHODS: A Chi-square test was used to assess the prevalence of <5 years child undernutrition. Logistic regression analysis was performed to identify various sociodemographic risk factors. RESULTS: The prevalence of undernutrition based on the CIAF was 52% among children <5 years in Bangladesh. The prevalence of undernutrition in children living in urban areas and rural areas were found to be 45% and 54%, respectively. As per the CIAF, undernutrition was highly prevalent among children in the older age group, children of uneducated and currently working mothers, those of underweight mothers, children of fourth and above in the birth order, children of fathers who were manual labourers, children of households who had no access to television and those in the poorest households whether in urban or rural areas. Children in the older age group, children of uneducated mothers, those with underweight mothers and those from the poorest households provided common key risk factors for undernutrition in both urban and rural areas. Children of fourth and above birth order and not watching television at all were additional risk factors of child undernutrition in rural areas. CONCLUSION: Half of the children in rural areas and two-fifths of them in urban areas are suffering undernutrition in Bangladesh, and several sociodemographic factors heighten the risks. Also, birth order and watching television were identified as the differential risk factors. This study therefore concludes that evidence-based interventions are needed to reduce the burden of undernutrition in children in the country.

EFFECT OF EARLY SEXUAL DEBUT ON HIGH SCHOOL COMPLETION IN SOUTH AFRICA.

Early sexual debut is of major concern because it is a correlate for health and economic shocks experienced in adulthood. In South Africa, this concern has provided impetus for research directed at the HIV and AIDS epidemic, teenage pregnancy and the effect of adolescent sexual behaviour on persistence in school. Of interest to the present study is high school completion, which is a well-established empirical barometer of adult socioeconomic opportunities. Using data from the five waves of the Cape Area Panel Study (CAPS), this paper examines the association between sexual behaviours initiated in pre- and early adolescence and high school completion rates. The CAPS study is a longitudinal survey that was designed to investigate young people's (aged 14-22 years) educational attainment and sexual behaviours in Cape Town, South Africa. The sample was constituted from 3213 individuals who had initiated sex during their teenage years and the analysis was undertaken when the youngest cohort was aged 21, an age at which they should have completed high school if they were on time. Logistic regression models were fitted separately for males and females. Overall, the results reveal that early sexual debut is correlated with long-term negative educational outcomes. Individuals who experience early sexual debut are less likely to complete high school than their counterparts who make their sexual debut later on in life. This effect is worse for Africans, who also disproportionately have an earlier sexual debut than other race groups. Apart from race however, the findings also reinforce the effect of other demographic factors on high school completion, namely, place of residence and family socioeconomic status as measured by parental education and household income. Hence, early sexual debut adds another layer of inequality and worsens the plight of Africans, females, those living in rural areas and those who come from low-income families.

Obstetric related residual morbidities among the women in Bangladesh.

PIP: This study determined the extent of obstetric-related residual morbidities among 500 postmenopausal women in an outpatient department of Narayangang and Dhaka medical college hospitals, Bangladesh. Findings revealed that about 31.4% suffered from obstetric-related gynecological diseases. Muslim women suffered more compared to their non-Muslim counterparts (41.8% vs. 36.4%). Parity was found to have a positive relationship with morbidity, and mothers with parity 5 or higher are at greater risk of suffering. In addition, child death was found to be associated with morbidity. It has also been observed that uterine prolapse was higher among Muslim than non-Muslim respondents (9.49% vs. 51%), among uneducated women, women with parity 5 or higher, and among mothers who have ever experienced a child's death. In the majority of cases, women preferred to deliver their babies at home with the assistance of relatives or dais. However, women who preferred to deliver at home with the assistance of untrained birth attendants were mostly found to suffer from uterine prolapse. The study results imply the need for preventive measures and for improving the sociodemographic, cultural and clinical conditions of postmenopausal women.^ieng

Access to "Jiggasha program: a family planning communication approach" and its exposure to the selected background characteristics.

PIP: This paper studies the effectiveness of "Jiggasha," an innovative communication approach for the promotion of family planning in Dhaka, Bangladesh. Data from the 1996 Jiggasha follow-up survey were used, which gathered information by interviewing a network sample of 1862 married women and a subsample of 608 men. The study used the sample constituted by women respondents and included data on socioeconomic and demographic characteristics of the respondents and their knowledge, attitude and practice relating to contraceptives. Findings showed that Jiggasha respondents have more access to radio than television. All respondents reported having a radio in their homes and they emphasized the importance of broadcasting more family planning messages via both electronic media. Only 16% of the women in the study setting were exposed to group meetings. Of the respondents reporting participation in group meetings, 38.25% joined in a Jiggasha meeting, 23.15% in a Grameen Bank group meeting, and 4.70% in a Bangladesh Rural Advancement Committee group meeting. Logistic regression analysis indicated more access to Jiggashas among women over 30 years of age than among the younger age groups. Religion and education levels of respondents have significant impact on access to Jiggashas. Husbands' approval plays an important role among the Jiggasha respondents in using family planning method. This study provides important information for policy-makers to make family planning program a success.^ieng

The determinants of first and subsequent births in urban and rural areas of Bangladesh.

PIP: This study identifies the determinants of the probability of having subsequent births among rural and urban women in Bangladesh. Data were obtained from the 1989 Bangladesh Fertility Survey among a 2-stage sample of 11,905 ever-married women aged 10-49 years. 8466 lived in rural areas; 3439 lived in urban areas. Analysis relied on tabular analysis, nonparametric survival analysis, and Cox proportional hazard regression models. The dependent variable is birth intervals in single months at different parities up to 144 months. Explanatory variables are demographic, socioeconomic, cultural, and decision-making ones and period effects. Findings reveal that different factors affected first births and higher order births. The subsequent births to women in rural areas were affected by more factors. Some variables consistently affected all subsequent births, while others had other impacts. For example, education increased the risk of having a first birth, but decreased the risk of subsequent births. Husband's education was a significant factor in first births and insignificant in higher order births. The period effect was significant for all births. Findings confirm that fertility is recent and stronger in urban areas and will continue to decline. Greater urbanization is likely to lower fertility. Risk of subsequent births was related to work experience. Religion was significant in higher order births in rural areas, but it was insignificant in urban areas. Residence in Dhaka resulted in a lower risk of a first birth compared with Chittagong region. Rural regions had lower risk of higher order births than Chittagong region. Son preference was not a significant factor.^ieng

Factors affecting the most recent fertility rates in urban-rural Bangladesh.

This paper reports on a study which has been undertaken using data from the 1989 Bangladesh Fertility Survey (BFS) to determine the significance of influences on the probability of birth in the year preceding the survey. In the survey a total of 11905 ever-married women of reproductive age were asked a battery of questions relating to fertility aspects of women. Variables selected in this study were grouped into demographic, socio-economic, cultural and decision-making variables. Findings from the study indicate that the mother's age, whether contraception has ever been used, the death of a child at any time, whether the woman has ever worked, religion, region of residence, and female independence are the important covariates for explaining recent fertility in Bangladesh. Models are developed for the probabilities of a woman giving birth in urban and rural areas, dependent on her demographic and socio-economic conditions. Also developed are models for contraceptive use in urban-rural Bangladesh. This modelling contributes to a better understanding of fertility changes in Bangladesh and the differentials between urban and rural fertility. It is indicated that a continued fertility decline is likely.

A hierarchical model of contraceptive use in urban and rural Bangladesh.

In this paper, a model is developed for examining the hierarchical effects of contraceptive use and its determinants in urban-rural Bangladesh by employing data from the 1989 Bangladesh Fertility Survey (BFS). In the survey, a total of 11,905 ever-married women of reproductive age were interviewed in urban and rural situations. An investigation has been carried out in this study using a set of demographic, socio-economic, cultural, and decision-making variables. A number of new findings emerge from this study. It has been found that contraceptive use has no significant variation between regions; however, a statistically significant variation exists between the blocks (census tracts) of Bangladesh. Findings also indicate that mother's parity, her education, family planning decisions, and female independence score are found to have a significant positive effect on the use of contraception in urban and rural Bangladesh, whereas child death has a significant negative influence. Religion and work experience of women are found to have little effect on contraceptive use. The findings of the study indicate priority points for policy purposes.

PIP: In this paper, a model is developed for examining the hierarchical effects of contraceptive use and its determinants in urban-rural Bangladesh by employing data from the 1989 Bangladesh Fertility Survey (BFS). In the survey, a total of 11,905 ever-married women of reproductive age were interviewed in urban and rural situations. An investigation has been carried out in this study using a set of demographic, socioeconomic, cultural, and decision-making variables. A number of new findings emerge from this study. It has been found that contraceptive use has no significant variation between regions; however, a statistically significant variation exists between the blocks (census tracts) of Bangladesh. Findings also indicate that maternal parity, maternal education, family planning decisions, and female independence score are found to have a significant positive effect on the use of contraception in urban and rural Bangladesh, whereas child death has a significant negative influence. Religion and work experience of women are found to have little effect on contraceptive use. The findings of the study indicate priority points for policy purposes.

Influences of selected socioeconomic and demographic variables on fertility in Bangladesh.

"The data used in this study are from the 1989 Bangladesh Fertility Survey (1989 BFS), which was conducted...by the National Institute of Population Research and Training (NIPORT)....A two-stage probability sample design was used for the survey.... It has been found that female age at marriage has a significant direct negative influence on fertility. Thus, raising the age at marriage by implementing a minimum-age marriage law is likely to lower fertility on a national scale. Duration of breast-feeding is also found to have a significant direct negative effect on fertility....Fetal loss appears to have a significant direct positive effect on fertility...which means that mothers who have experienced fetal loss are found to have higher fertility.... Maternal mortality is also high in Bangladesh. Therefore, it is essential to provide primary health care, particularly maternal and child health care, for surviving children."

Urban and rural fertility in Bangladesh: a causal approach.

Fertility models are constructed from the 1989 Bangladesh Fertility Survey (BFS) employing path analysis. These models are developed and interpreted for urban and rural situations. As a proxy for fertility, the number of children ever born is used, and age, religion, age at marriage, parental childhood residence, and education are considered as explanatory variables. The contribution that these variables give to explaining the 1989 Bangladeshi fertility is compared to the explanatory variables that Ahmed (1981) found suitable for Bangladeshi fertility in 1975. We find that in 1989, compared to 1975, childhood background and education of the mother and age at marriage exert a greater influence on urban fertility, and religion no longer has a significant effect. In the rural case, the effect of religion on fertility has increased since 1975, as has education and age at marriage.

PIP: Path analysis was used to determine the influence of socioeconomic and demographic variables on fertility. Data was obtained from the 1989 Bangladesh Fertility Survey (BFS) on 11,905 ever married women: 8466 rural women and 3439 urban women. Findings were compared with Ahmed's analysis of 1975 BFS data. The number of children ever born (CEB) was examined in terms of the influences of age, religion, childhood place of residence, and educational background. In the urban model CEB was significantly influenced by women's age, education, and childhood background. Religion indirectly influenced CEB through women's age at marriage and education. Women's age did not indirectly significantly influence CEB. In the rural model CEB was directly and significantly influenced by women education, marriage age, religion, and age. Education had a smaller influence in the rural setting and indirectly influenced marriage age but to a lesser extent than in an urban setting. In the rural setting women's age did have an indirect affect on fertility through educational status. Childhood background influenced the education of women in rural areas. In the rural setting age and religion had stronger impacts than in urban areas. In urban areas the indirect influence of age on women's education was stronger. The findings suggest that urbanization is an appropriate explanation for fertility decline in that it reduced fertility and increased educational levels. Between 1975 and 1989 religion had a diminished affect on urban fertility, and women's education and marriage age increased in their impact on fertility over time. In rural areas religion's impact increased over the 14-year period, but women's education and marriage age decreased the impact of increased religious influence.

Factors affecting fertility in a rural area of Bangladesh.

"The purpose of this paper is to examine the effects of selected socioeconomic and demographic factors on fertility in a rural area of Bangladesh. It has been revealed that age at first marriage and coital frequency have direct significant effects while ever use of contraception and duration of breast-feeding have direct positive significant effects on total parity. Total effects of wife's education and age at first marriage on fertility are found to be negative while those of religion and household income on fertility are found to be positive."

A study on socio-economic and intermediate variables on fertility.

"In this paper an attempt has been made to examine fertility differentials of currently married rural women [in Bangladesh] by their socioeconomic (viz, education of women, land ownership and family type) and demographic (viz, age at the first marriage, duration of breast feeding and duration of post partum amenorrhoea for the child) characterisation. This study is based on data collected from 995 currently married women of childbearing age. It has been found that women's (i) level of education (ii) age at first marriage (iii) duration of breastfeeding and (iv) duration of post-partum amenorrhoea, are inversely related with fertility. Joint family shows higher fertility than that of nuclear family and land ownership reveals [a] U-shaped relationship with fertility."

Fertility differentials in rural Bangladesh.

"Data from two sources in rural Bangladesh have been used in this study to examine the differentials in fertility by selected socio-economic and demographic factors. Results [indicate] that age at first marriage, education of spouses and availability of electricity in the household...have [an] inverse relationship with fertility. Higher fertility is observed for Muslim women than for non-Muslims. It has been found that fertility is the lowest to those women whose husbands are service holders and the highest for agriculture."