Effect of mother support groups on nutritional status in children under two years of age in Laisamis village, Kenya.

BACKGROUND: In tackling the ongoing malnutrition problem in many parts of Kenya, the government has initialized preventive actions such as mother support groups in order to improve health and nutrition among children. Few studies have evaluated the effectiveness of such intervention. OBJECTIVE: This study aimed at determining how mother support groups affect the nutrition status of children under 2 years of age. METHODS: 41 children participated. Anthropometric measurements were taken of the children once a month during 12 months. Medical history, nutrition status and socioeconomic factors were collected by interviews with the mothers. The children were divided into two groups depending on their mother's assigned group; mother support group or not. RESULTS: Nutritional status was significantly better among children in the mother support group (P=0.001). There were significantly more children with severe acute malnutrition among the children not in support group (P=0.040). The mean height (P=0.001) and mean weight (P=0.0281) were significantly higher among children in the non-support group. CONCLUSION: Mother support groups may have a beneficial effect on the nutritional status of children under 2 years of age. Cases of severe acute malnutrition seemed to be less prevalent in children whose mothers attend mother support groups.

Infertility experience and health differentials - a population-based comparative study on infertile and non-infertile women (the HUNT Study).

OBJECTIVE: Studies suggest that health complaints, distress and poor life satisfaction are associated with infertility experience. Research on health consequences of infertility experience in women has relied heavily on clinic-based samples. This population-based study investigates the association between infertility and health and life satisfaction. DESIGN: Cross-sectional population-based health study, conducted between 2006 and 2008. SETTING: All women in a county in Norway were invited. The current material is restricted to women aged 20-49 years. POPULATION: A total of 9200 women participated. METHODS: Health measures were compared between women with infertility experience (infertile women) and women without infertility experience (non-infertile women). Disparities in health and life satisfaction among the infertile women were assessed. MAIN OUTCOME MEASURES: Self-reported health, functional impairment, depression, anxiety, and life satisfaction. RESULTS: Some 15.4% of the women had experienced infertility. Infertile women reported poor self-reported health and functional impairment significantly more often than non-infertile women. Childless infertile women had significantly raised adjusted risks for health complaints and dissatisfaction with life compared with non-infertile women with a child, whereas infertile women with a child did not. Differences in health and life satisfaction emerged among the infertile women, but the differences were not significant. There were no significant differences in depression and anxiety between infertile and non-infertile women, or between the two groups of infertile women (with/without a child). CONCLUSIONS: The study confirms the adverse effect of infertility on health and life-satisfaction. The childless infertile women stand out as being vulnerable to the detrimental consequences of infertility.

Has fertility declined from mid-1990s to mid-2000s?

OBJECTIVE: To assess changes in self-reported fertility from the mid-1990s to the mid-2000s. DESIGN: The study is a retrospective population-based study. SETTING: The study applied a dataset from two cross-sectional surveys conducted in the mid-1990s and some 10 years later, inviting all women in a county in Norway. POPULATION: Women aged 50-59 years enrolled in either survey constituted two cohorts. Data on 4468 women in the first survey (Cohort 1940) and 4951 women in the latter survey (Cohort 1950) were collected by structured questionnaires. MAIN OUTCOME MEASURES: Prevalence of fertility, infertility with subcategories subfertility and involuntary childlessness, as well as childlessness was estimated and compared between the surveys. Possible sociodemographic and lifestyle predictors of fertility were assessed at different points in time. RESULTS: Fertility declined over the two successive surveys; 87.8% of the women in Cohort 1940 were fertile compared with 84.2% of the women in Cohort 1950 (p = 0.000). The prevalence of infertility increased over time due to an increase in subfertility from 7.8 to 10.6% (p = 0.000). The level of education increased with time, as did at-risk alcohol consumption and smoking, and these factors were adversely associated with fertility. The proportion of childless women increased across surveys (p = 0.004) but relatively fewer women were involuntarily childless in Cohort 1950 than in Cohort 1940 (p = 0.543). CONCLUSION: Fertility, measured at 10-year intervals, declined significantly. The decline in fertility was related to changes in subfertility. Adjustments for sociodemographic and lifestyle factors did not fully explain the decline in fertility.

Social inequalities in mortality in older women cannot be explained by biological and health behavioural factors -- results from a Norwegian health survey (the HUNT Study).

AIMS: To assess mortality inequalities related to education, employment and marital status in older women, and whether educational and employment inequalities can be explained by biological, health behavioural or marital factors. METHODS: Data, collected by questionnaires and medical examinations, on 5607 Norwegian women aged > or =70 participating in the population-based Nord-Trøndelag health study in 1995-97, were linked with information from the Death Registry at Statistics Norway at 31.12.2004. Cox regression model was used to estimate hazard ratios (HR) of all-cause and cardiovascular mortality related to educational level and previous employment, and to marital status. RESULTS: Low level of education and never having been in paid work were significantly associated with elevated all-cause mortality. The associations remained significant upon adjustments for age, marital status, biological (systolic blood pressure, body mass index, total cholesterol) and health behavioural (smoking, physical activities) factors. Differences in cardiovascular mortality were related to low level of education and never having been in paid work, though the significant age-adjusted associations only remained significant for education upon adjustments for age, marital, biological and behavioural factors. A raised risk in cardiovascular mortality was found among women previously holding manual jobs (HR1.23, 95% CI 0.99-1.53). The graded association between education, employment and mortality showed a significant trend, except from the occupation gradient in cardiovascular mortality. Widowed and divorced women had an age-adjusted significantly raised all-cause and significant cardiovascular mortality risk compared with married women. CONCLUSIONS: The socioeconomic and marital differences in mortality in older women could not be explained by biological and behavioural factors, and remains a public health issue.

Socioeconomic inequalities in health in older women.

Socioeconomic status differentials in health are well documented. Less is known about the socioeconomic variation in health in older people, and in older women in particular. The aim of the study was to examine the association between socioeconomic status and health in older women in relation to two indicators of socioeconomic status and three measures of health, and further, to investigate whether socioeconomic differences in health increase or decrease with advancing age. Data from a cross-sectional population based health survey inviting all women ≥70 years were analysed; 6,380 women aged 70-103 years participated. Logistic regression was applied to analyse variation in health by socioeconomic status. Disadvantaged socioeconomic status (i.e. lower educational levels and previous manual or never been in paid work) was significantly associated with poorer health outcomes, whether measured as self-assessed health or depression. Limiting long-standing illness was significantly associated with never been in paid work. The associations were not attenuated by simultaneous adjustments for health behavioural factors, social support, and marital status. Additional adjustments for medical conditions did only alter the significant association between employment status and limiting long-standing illness. The analyses revealed that educational inequalities did not decrease with advancing age, whereas the results for employment varied across age groups. Our findings suggest an enduring relation between socioeconomic status and health in later life. The study adds to the understanding of the consistent associations between poorer health and social disadvantages at older age. We are not aware of any previous study showing the persistence of social inequalities in health upon adjustments for medical conditions.

Fertility in Norwegian women: results from a population-based health survey.

AIMS: Reproductive behaviour has changed during the most recent decades, with increased infertility and subfertility. This study evaluated fertility, estimated the prevalence of fertility problems, and assessed possible predictors for impaired fertility. METHODS: Eligible subjects were 9,983 menopausal women participating in two health surveys. Data were collected by comprehensive questionnaires. RESULTS: Of all women 89.3% were fertile, 4.8% were subfertile, 4.1% were voluntarily childless, and 1.8% were involuntaruly childless. Impaired fertility was associated with a higher level of education and excessive alcohol intake. There were significant differences in subfertility among the parous women, with increased subfertility with decreasing age. Among the nullipara, involuntary childlessness was more prevalent in the youngest age group, while voluntary childlessness increased with advancing age. CONCLUSIONS: Fertility problems were quite common, and have increased in younger age groups, though seemingly fewer women remained childless past their reproductive age in the youngest age group.

Socioeconomic factors and health in two generations of Norwegian women.

BACKGROUND: The effects of social determinants on health have been largely studied in men. There has also been a tendency to disregard historical context in studies of inequalities in health. OBJECTIVE: This study assessed the effects of social determinants on women's health, especially those associated with the radical changes in their lives in the past 50 years, such as increased opportunities for higher education and employment. METHODS: Data were examined from 2 health surveys of Norwegian women born either between 1926 and 1935 ("the housewife cohort") or between 1946 and 1955 ("the working mother cohort"), each cohort having experienced different historical periods of particular social transitions. RESULTS: Health had a social gradient in both the housewife cohort (N = 4546) and the working mother cohort (N = 6322), but somewhat dissimilarly. In both cohorts, self-rated health was poor with less education, lack of employment, and financial difficulties. Not having paid employment was associated with poor health in both cohorts, but contrary to our expectations, more so among the housewife cohort, in whom the association was stronger than in the working mother cohort. Women in managerial and manual occupations married to men higher on the occupational ladder assessed their health more favorably. This occupational position discrepancy suggested that women married to men in lower occupational positions assessed their health more negatively, in both cohorts, with the exception of professional women in the housewife cohort. CONCLUSION: Although socioeconomic influences on the 2 cohorts examined were considerably different, the fundamental social changes in women's lives in past decades were not reflected in major changes in the social patterning of women's health.