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Pathways that determine the fertility of sedente and migrant Oraon populations of Eastern India: a structural equation modelling approach. HUM FERTIL 2023; 26:1202-1218. [PMID: 36715214 DOI: 10.1080/14647273.2022.2156302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/02/2022] [Indexed: 01/31/2023]
Abstract
Within local socio-ecological context, the fertility determinants of a population are mediated through complex interrelated physiological and behavioural pathways. We aimed to find out the direct and indirect determinants of fertility of sedente and migrant Oraon populations using Structural Equation Model (SEM). Bivariate analysis showed significant (p ≤ 0.05) sedente-migrant differences in socio-demographic, reproductive, contraceptive, and reproductive and sexual decision-making variables. Results of SEM showed migration status, age at first conception, contraceptive preference and reproductive and sexual decision making have direct but negative association (p ≤ 0.05), and age of the participants, under-five mortality and preference for male child have direct but positive association with fertility (p ≤ 0.05). These variables are also associated with fertility through certain mediated pathways (p ≤ 0.05) like ages at first conception with contraceptive preferences, reproductive and sexual decision-making ability (positive), under-five mortality and desired family size (negative). Educational status of the spouses showed indirect association (p ≤ 0.05) with fertility through four pathways: (i) contraceptive preferences; (ii) reproductive and sexual decision-making ability; (iii) ages at first conception (positive); and (iv) desired family size (negative). Hence, sedente and migrant participants reflected a sharp difference in the determinants of fertility owing to differential local socio-ecological attributes.
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Systematic review of multilevel models involving contextual characteristics in African demographic research. JOURNAL OF POPULATION RESEARCH 2023. [DOI: 10.1007/s12546-023-09305-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
AbstractMultilevel modelling has become a popular analytical approach for many demographic and health outcomes. The objective of this paper is to systematically review studies which used multilevel modelling in demographic research in Africa in terms of the outcomes analysed, common findings, theoretical rationale, questions addressed, methodological approaches, study design and data sources. The review was conducted by searching electronic databases such as Ebsco hosts, Science Direct, ProQuest, Scopus, PubMed and Google scholar for articles published between 2010 and 2021. Search terms such as neighbourhood, social, ecological and environmental context were used. The systematic review consisted of 35 articles, with 34 being peer-reviewed journal articles and 1 technical report. Based on the systematic review community-level factors are important in explaining various demographic outcomes. The community-level factors such as distance to the health facility, geographical region, place of residence, high illiteracy rates and the availability of maternal antenatal care services influenced several child health outcomes. The interpretation of results in the reviewed studies mainly focused on fixed effects rather than random effects. It is observed that data on cultural practices, values and beliefs, are needed to enrich the robust evidence generated from multilevel models.
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The Neglected Role of Domestic Migration on Family Patterns in Latin America and the Caribbean, 1950-2000. Stud Fam Plann 2023. [PMID: 37186233 DOI: 10.1111/sifp.12241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Urbanization has played a key role in shaping twentieth-century demographic changes in Latin America and the Caribbean (LACar). As a result, scholarly research on domestic migration and the family has primarily focused on fertility differentials by migration status in urban areas, finding a robust negative correlation between internal migration and fertility. This research has overlooked how this relationship varies across types of migration flows other than rural-to-urban migration and by women's age at migration and social class. Additionally, not enough attention has been paid to the family formation and dissolution trajectories underlying the lower fertility of rural migrants. I use a life-course inductive approach to examine these overlooked aspects among women from 10 LACar countries, including the three largest countries by population. Using retrospective information on women's childbearing and marital histories from the Demographic and Health Surveys, I build an eight-category typology of family paths and study the conditional distribution of this typology by women's age at migration, educational attainment, and origin/destination area. This examination demonstrates that social class is the primary source of differentiation across family formation and dissolution trajectories and that low-class young rural migrants played a crucial role in the demographic transformations that occurred in the region.
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Male Fertility and Internal Migration in Rural and Urban Sub-Saharan Africa. EUROPEAN JOURNAL OF POPULATION = REVUE EUROPEENNE DE DEMOGRAPHIE 2023; 39:10. [PMID: 36976350 PMCID: PMC10050504 DOI: 10.1007/s10680-023-09659-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/21/2023] [Indexed: 03/29/2023]
Abstract
Subnational differences in male fertility within sub-Saharan African countries have not been explored, nor the differences in male fertility according to migration status been sufficiently probed. We study divergences in rural and urban male fertility and investigate the relationship between male fertility and migration across 30 sub-Saharan African countries. We employ 67 Demographic and Health Surveys to estimate completed cohort fertility among men aged 50-64 according to migration status. Overall, we find that urban male fertility has declined faster than rural male fertility, widening the gap between the sectors. Rural-urban migrant men have lower fertility than their rural non-migrant counterparts. Men migrating within the rural sector have similarly high fertility as rural non-migrants, while urban-urban migrant men have even lower fertility than non-migrant urban men. Using country-fixed effects models, we find that among men with at least secondary education, differences in completed cohort fertility by migration status are widest. When we consider the timing of migration in relation to the timing of the birth of the last child, we observe that migrant men are a select group, having around two children less than non-migrant rural men. There is also evidence of adaptation to destination, though to a lesser extent. Furthermore, migration within the rural sector does not seem to be disruptive to fathering. These results indicate that rural-to-urban migration has the potential to delay rural fertility decline, and that urban male fertility is likely to decline further, especially as the proportion of urban-to-urban migration increases.
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Female Off-Farm Employment and Fertility Timing in Rural China. Front Public Health 2022; 10:790436. [PMID: 35433603 PMCID: PMC9009253 DOI: 10.3389/fpubh.2022.790436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Advanced maternal age is associated with fetal outcomes such as higher risks of birth defects and very low birth weight. Off-farm employment is an important factor in fertility transition in many developing countries. This study investigated the association between off-farm employment and fertility timing among Chinese rural women. Method Using data from the China Labor-force Dynamics Survey (CLDS), we employed the ordinary least squares and instrumental variable approaches to estimate the effect of female off-farm employment on fertility timing decisions as well as the differences in the effect across groups. Results The results show that off-farm employment participation is significantly associated with a later age at first birth, and the effect is stronger for women participating in wage employment than in off-farm self-employment. The delayed effects on fertility timing are also more pronounced for less-educated women and low-income families, implying a heterogeneous effect in terms of women's socioeconomic status. Conclusion Studies of the relationship between women's off-farm employment and fertility timing in rural areas of developing countries remain limited. This study provides important insights on this topic, and it lends support to efforts to design effective policies and practices to facilitate female employment, childbearing, and health promotion.
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Gendered and Stratified Family Formation Trajectories in the Context of Latin American Migration, 1950 to 2000. INTERNATIONAL MIGRATION REVIEW 2022. [DOI: 10.1177/01979183211067768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The interdependence of migration and family formation has been studied extensively, but studies that consider the embeddedness of this interdependence within gender and class relations are less common. Most existing research on family and migration treats gender and social class as separate determinants of family events or transitions, instead of analyzing how the intersections of both shape full family formation trajectories, defined as all partnership and childbearing statuses throughout an individual life course. We overcome this gap by using an intersectionality framework to analyze trajectories of family formation and migration collected by the Mexican and Latin American Migration projects (1982–2016). Using retrospective information, we reconstruct full family formation and dissolution trajectories (i.e., individuals’ marital statuses and number of children born from ages 15 to 39) for 16,000 individuals and apply sequence and cluster analysis to define a six-category typology of ideal family formation trajectories. Next, we associate this typology with individuals’ sex, age at migration (domestic, international), and educational attainment as a way to measure individuals’ social class position. Our results suggest that the relationship between migration and typical family trajectories depends on the intersection of individuals’ social class and gender. Previous studies have neglected this intersection by overly focusing on the “average” migrant's experience. Migration research must acknowledge and account for migrants’ heterogenous experiences and pay more attention to how intersecting social categories mediate the relationship between migration and other demographic processes.
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Nativity differentials in first births in the United States: Patterns by race and ethnicity. DEMOGRAPHIC RESEARCH 2022; 46:37-64. [PMID: 35210939 PMCID: PMC8863386 DOI: 10.4054/demres.2022.46.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND While recent decades have seen gradual convergence in ethno-racial disparities in completed fertility in the United States, differences in the age pattern of first births remain. The role of nativity has not been fully understood. OBJECTIVE This paper examines how first births vary by nativity, and how this variation contributes to more significant racial and ethnic differentials. METHODS Using data from the National Survey of Family Growth (1997-2017), we jointly estimate the correlates of the timing of first births and childlessness. We assess differences between immigrants and US-born and child-migrant women across ethno-racial groups. RESULTS The unique first-birth patterns among foreign-born women have a notable impact on Hispanics, reducing differences from Whites in the average age at first birth and contributing to more significant differentials in childlessness. The impact of immigrant women on White and Black first births is more modest in scope. CONTRIBUTION Our work shows the importance of nativity for ethnic/racial disparities in the timing and quantum of fertility in the United States. We demonstrate how the migrant population is more determinant for Hispanic fertility patterns than for Black or White. We conclude by elaborating on the implications of these results for future research as the immigrant population in the United States becomes ethnically and racially more diverse.
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Moving towards the centre or the exit? Migration in population studies and in Population Studies 1996-2021. Population Studies 2021; 75:27-45. [PMID: 34902286 DOI: 10.1080/00324728.2021.1942178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This paper examines the position of migration in population studies, focusing on the period 1996-2021. It considers the reasons why migration remains problematic for demographers, but also how approaches to migration have changed over the last 25 years. While it has arguably become more important to both demography and population studies because of the transition to low fertility and mortality, migration has metamorphosed into a complex field in its own right, almost independently from changes in demography. Both internal and international migration form the subject of this examination and four main themes are pursued: data and measurement; theories and approaches; migration and development; and migration and political demography. The papers published in the journal Population Studies are used to provide a mirror through which to view these changes over the last 25 years. This paper concludes by looking at likely future directions in migration studies, demography, and population studies.
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Urban Family Planning in Low- and Middle-Income Countries: A Critical Scoping Review. Front Glob Womens Health 2021; 2:749636. [PMID: 34816250 PMCID: PMC8593933 DOI: 10.3389/fgwh.2021.749636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022] Open
Abstract
Health agendas for low- and middle-income countries (LMICs) should embrace and afford greater priority to urban family planning to help achieve a number of the global Sustainable Development Goals. The urgency of doing so is heightened by emerging evidence of urban fertility stalls and reversals in some sub-Saharan African contexts as well as the significance of natural increase over migration in driving rapid urban growth. Moreover, there is new evidence from evaluations of large programmatic interventions focused on urban family planning that suggest ways to inform future programmes and policies that are adapted to local contexts. We present the key dimensions and challenges of urban growth in LMICs, offer a critical scoping review of recent research findings on urban family planning and fertility dynamics, and highlight priorities for future research.
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Migrant health penalty: evidence of higher mortality risk among internal migrants in sub-Saharan Africa. Glob Health Action 2021; 14:1930655. [PMID: 34134611 PMCID: PMC8550177 DOI: 10.1080/16549716.2021.1930655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Despite the greater attention given to international migration, internal migration accounts for the majority of movements globally. However, research on the effects of internal migration on health is limited, with this relationship examined predominantly in urban settings among working-age adults, neglecting rural populations and younger and older ages. Objectives: Using longitudinal data from 29 mostly rural sub-Saharan African Health and Demographic Surveillance Systems (HDSS), this study aims to explore life-course differences in mortality according to migration status and duration of residence. MethodsCox proportional hazards models are employed to analyse the relationship between migration and mortality in the 29 HDSS areas. The analytical sample includes 3 836,173 people and the analysis spans 25 years, from 1990 to 2015. We examine the risk of death by sex across five broad age groups (from ages 1 to 80), and consider recent and past in- and return migrants. Results: In-migrants have a higher risk of mortality compared to permanent rural residents, with return migrants at greater risk than in-migrants across all age-groups. Female migrants have lower survival chances than males, with greater variability by age. Risk of dying is highest among recent return migrant females aged 30–59: 1.86 (95% CI 1.69–2.06) times that of permanent residents. Only among males aged 15–29 who move to urban areas is there evidence of a ‘healthy migrant’ effect (HR = 0.62, 95% CI 0.51–0.77). There is clear evidence of an adaptation effect across all ages, with the risk of mortality reducing with duration following migration. Conclusions: Findings suggest that adult internal migrants, particularly females, suffer greater health disadvantages associated with migration. Policy makers should focus on improving migrant’s interface with health services, and support the development of health education and promotion interventions to create awareness of localised health risks for migrants.
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Fertility Differences Between Migrants and Stayers in a Polygamous Context: Evidence from Senegal. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2021. [DOI: 10.1007/s12134-020-00802-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AbstractThis study takes a ‘country-of-origin’ or dissimilation perspective to compare the timing of births and completed fertility of international migrants and of those who stay at origin. In order to disentangle selection effects determining differential fertility behaviour of migrants, other mechanisms explaining migrant fertility (disruption, interrelation of events) are also examined. Furthermore, we take into consideration the prevalence of polygamy in Senegal to enhance our knowledge of migrant fertility in this specific context. For the empirical analysis, we use longitudinal data collected in the framework of the MAFE-Senegal project (Migrations between Africa and Europe), which includes retrospective life histories of non-migrants in Senegal and migrants in France, Italy and Spain. We estimate discrete time hazard models and Poisson regressions for male and female respondents separately to analyse the timing of first and higher-order births as well as completed fertility. The results show a strong disruptive effect of migration on childbearing probabilities for men and women, clearly related to the geographic separation of partners due to the out-migration of the man. Increased birth risks in the first year upon arrival could be observed for migrant women following their husbands to Europe, suggesting an interrelation of migration and fertility events. Regarding completed fertility, migrants have significantly fewer children by the age of 40 compared to their non-migrant counterparts, which among men is largely driven by a strong negative effect of polygamous migrants.
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Does Emancipation Matter? Fertility of Chinese International Migrants to the United States and Nonmigrants during China’s One-child Policy Period. INTERNATIONAL MIGRATION REVIEW 2021. [DOI: 10.1177/0197918321994789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article investigates the impact of international migration to the United States on the level and timing of Chinese migrants’ fertility. We compare Chinese women who did not leave the country (non-migrants) and were subject to restrictive family policies from 1974 to 2015 to those who moved to the United States (migrants) and were, thus, “emancipated” from these policies. We theoretically develop and empirically test the emancipation hypothesis that migrants should have a higher fertility than non-migrants, as well as an earlier timing of childbearing. This emancipation effect is hypothesized to decline across birth cohorts. We use data from the 2000 US census, the 2005 American Community Survey, the 2000 Chinese census, and the 2005 Chinese 1 percent Population Survey and discrete-time event history models to analyze first, second, and third births, and migration as joint processes, to account for selection effects. The results show that Chinese migrants to the United States had substantially higher childbearing probabilities after migration, compared with non-migrants in China, especially for second and third births. Moreover, our analyses indicate that the migration process is selective of migrants with lower fertility. Overall, the results show how international migration from China to the United States can lead to an increase in migrant women’s fertility, accounting for disruption, adaptation, and selection effects. The rapidly increased fertility after migration from China to the United States might have implications on other migration contexts where fertility in the origin country is dropping rapidly while that in the destination country is relatively stable.
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The effect of spousal separation and reunification on fertility: Chinese internal and international migration. DEMOGRAPHIC RESEARCH 2020. [DOI: 10.4054/demres.2020.43.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Visualising Immigrant Fertility -- Profiles of Childbearing and their Implications for Migration Research. JOURNAL OF INTERNATIONAL MIGRATION AND INTEGRATION 2020. [DOI: 10.1007/s12134-020-00762-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractDifferent measures of fertility have strengths and limitations when used to describe the fertility of immigrants, and no single measure captures every aspect of this complex phenomenon. This paper introduces a novel visual framework that shows life course profiles of immigrant childbearing in a multifaceted way. It develops the well-known cohort fertility curve—showing the average number of children ever born over the life course—and adds lines for immigrant women arriving at different ages, using their average number of children born on arrival as a starting point. These immigrant fertility profiles can illustrate a number of important aspects of childbearing simultaneously, including children born before arrival, fertility after arrival and completed fertility at the end of childbearing. In addition to showing numbers of children born (i.e. fertility quantum), the slopes of each profile indicate the tempo of fertility and how this changes by age and duration of residence. The fertility profiles of different immigrant groups can be plotted in the same graph, and can be compared and contrasted with non-immigrant groups—at origin as well as destination—through the augmentation of each visualisation. Using Nordic register data, we illustrate how these fertility profiles can be used to expand our knowledge of immigrant childbearing and to investigate various hypotheses of migrant fertility, giving a novel overview of the relationships between fertility measures such as period and quantum, before and after arrival.
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Immigrant Fertility in Comparative Perspective: South Africa and the United States. Demography 2020; 57:297-322. [DOI: 10.1007/s13524-019-00852-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Abstract
Because immigrant fertility is situated within two societies, the resultant childbearing patterns reflect a culmination of selectivity into migration alongside blended experiences of origin-destination contexts around fertility norms. We analyze the ways that national origin shapes patterns of childbearing within fertility covariates. We use data from Statistics South Africa and the United States Census Bureau harmonized in the Integrated Public Use Microdata Series, International for a disaggregated analysis of the odds of a birth in the past year among the three most prominent immigrant groups compared with native-born women in each receiving country. Interacted logistic regression analyses and margins results demonstrate significant nativity-based differences in the odds of childbearing across age, previous childbearing, and marital status, but not across educational attainment. We attribute variation in the covariates of fertility across nativities to demographic composition and the contexts of migration unique to each group.
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Examining internal migration effects on short versus long interbirth intervals in Cotonou, Benin Republic. BMC Pregnancy Childbirth 2019; 19:375. [PMID: 31646982 PMCID: PMC6813098 DOI: 10.1186/s12884-019-2529-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/23/2019] [Indexed: 11/10/2022] Open
Abstract
Background The literature on migration-fertility relationship uses various measures of fertility, such as fertility rates, actual fertility and family size preferences. This study introduces a different measure—interbirth intervals over women’s reproductive years—to examine how internal migration is associated with short interbirth intervals (less than 24 months) and long interbirth intervals (greater than 60 months) in Cotonou, the largest city of Benin Republic. Methods The paper uses primary data on 2852 live births to 1659 women aged 15–49 years from the 2018 Fertility and Migration Survey in Cotonou. Competing-risks models were fitted for the analysis. Results Nineteen percent of live births were of short interbirth intervals and 16% were of long interbirth intervals. The prevalence of short interbirth intervals was higher among migrants who spent less than 5 years in Cotonou (29%) than among non-migrants (19%) and earlier migrants (18%). Non-migrants had the highest proportion of long interbirth intervals (19%). Within the first 5 years following the migration to Cotonou, migrants had higher subhazard ratio (SHR) of short interbirth intervals (SHR: 1.71, 95% CI: 1.33–2.21) and lower SHR of long interbirth intervals (SHR: 0.64, 95% CI: 0.47–0.87) than non-migrants. This association holds after controlling for socioeconomic characteristics—but with a slightly reduced gap between migrants who spent less than 5 years in Cotonou and non-migrants. Afterwards and irrespective of women’s socioeconomic backgrounds, migrants who spent 5 or more years in Cotonou and non-migrants had similar risks of short and long interbirth intervals. Finally, from 5 years of stay in Cotonou, migrants for reasons other than school or job were less likely to experience short interbirth intervals (SHR: 0.65, 95% CI: 0.46–0.98 for migrants who spent 5–10 years in Cotonou, and SHR: 0.74, 95% CI: 0.54–1.02 for migrants who spent more than 10 years in Cotonou) than non-migrants. Conclusion Family planning programmes should mainly target migrants in the early years after their arrival in Cotonou. Moreover, non-migrants need to be sensitised on the adverse health outcomes of long interbirth intervals.
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Nutrition transition, overweight and obesity among rural-to-urban migrant women in Kenya. Public Health Nutr 2019; 22:3200-3210. [PMID: 31159907 DOI: 10.1017/s1368980019001204] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To assess the effect of rural-to-urban migration on nutrition transition and overweight/obesity risk among women in Kenya. DESIGN Secondary analysis of data from nationally representative cross-sectional samples. Outcome variables were women's BMI and nutrition transition. Nutrition transition was based on fifteen different household food groups and was adjusted for socio-economic and demographic characteristics. Stepwise backward multiple ordinal regression analysis was applied. SETTING Kenya Demographic and Health Survey 2014. PARTICIPANTS Rural non-migrant, rural-to-urban migrant and urban non-migrant women aged 15-49 years (n 6171). RESULTS Crude data analysis showed rural-to-urban migration to be associated with overweight/obesity risk and nutrition transition. After adjustment for household wealth, no significant differences between rural non-migrants and rural-to-urban migrants for overweight/obesity risk and household consumption of several food groups characteristic of nutrition transition (animal-source, fats and sweets) were observed. Regardless of wealth, migrants were less likely to consume main staples and legumes, and more likely to consume fruits and vegetables. Identified predictive factors of overweight/obesity among migrant women were age, duration of residence in urban area, marital status and household wealth. CONCLUSIONS Our analysis showed that nutrition transition and overweight/obesity risk among rural-to-urban migrants is apparent with increasing wealth in urban areas. Several predictive factors were identified characterising migrant women being at risk for overweight/obesity. Future research is needed which investigates in depth the association between rural-to-urban migration and wealth to address inequalities in diet and overweight/obesity in Kenya.
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Influence of internal migration on the use of reproductive and maternal health services in Nepal: An analysis of the Nepal Demographic and Health Survey 2016. PLoS One 2019; 14:e0216587. [PMID: 31071179 PMCID: PMC6508582 DOI: 10.1371/journal.pone.0216587] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 04/25/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Internal migration has been an integral part of socioeconomic transformation in a country. Migrants are a vulnerable group for access to the reproductive and maternal health services. Very little is known regarding the role of internal migration on the use of reproductive and maternal health services in Nepal. This study examines the effect of internal migration on the use of reproductive and maternal health services in Nepal. METHODS The data for this study were extracted from the 2016 Nepal Demographic and Health Survey (2016 NDHS). The study population is women age 15-49. The sample population is different for modern contraceptive use than for Antenatal care (ANC) visits and place of delivery. The sample population for modern contraceptive use is restricted to the 8,811 (weighted) women who are currently married. The total analytic sampled population for ANC visits and place of delivery is 3,220 (weighted) women. The study used descriptive and logistic regression analysis, with three outcome measures: current use of modern contraception; at least four ANC visits; and place of delivery. RESULTS Sixty-eight percent women were internal migrants. Forty-four percent of eligible women reported current use of modern contraception, 71% of women made at least four ANC visits, about 9% of women made 8 or more ANC visits and 58% of women delivered in a health facility. Our findings show that modern contraceptive use is significantly higher among urban non-migrant women and urban-to-urban migrants. Urban-to-urban migrant women and rural-to-urban migrant women have significantly higher odds of attending at least four ANC visits for the most recent birth compared with rural-to-rural migrant women. Women who moved between urban areas, women who moved from an urban to a rural area, women who moved from a rural area to an urban area and urban non-migrants are significantly more likely to deliver in a health facility compared with women who moved between rural areas. CONCLUSION The differentials of use of reproductive and maternal health services by migration status may need consideration during program planning to improve women's reproductive and maternal health services in Nepal.
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The Impact of Neighborhood Environment on Women's Willingness to Have a Second Child in China. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 56:46958019833232. [PMID: 30854908 PMCID: PMC6413426 DOI: 10.1177/0046958019833232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In recent years, the Chinese government has changed the one-child policy that was implemented more than 3 decades ago and has began encouraging couples to have 2 children. However, this cannot quickly change people's reproductive concepts after more than 30 years of low fertility rate and birth control. In this context, the aim of our study was to assess the effect of neighborhood environment on Chinese women's fertility-willingness for a second child. Our results show that there is a statistically significant relationship between neighborhood environment and women's fertility-willingness for a second child. Women living in affluent neighborhoods with better living environments have lower fertility-willingness for a second child than those in poor neighborhoods. However, childcare institutions (such as kindergartens) provide shared childcare and improve women's fertility-willingness. We suggest that to encourage more couples to have a second child, it is necessary to increase the number of neighborhood kindergartens. In addition, local governments must improve the social welfare of migrant households and loosen the requirements for migrant households to obtain local hukou, which will allow migrant children to enjoy local public services, especially education services.
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Abstract
This study examines young people's intentions to migrate abroad in Kyrgyzstan, focusing in particular on differences between Asian and European-origin ethnic groups. The multivariate analyses of recent survey data show that even after controlling for socioeconomic characteristics and social embeddedness Europeans are significantly more inclined to migrate than Asians. Whereas no gender differences in migration intentions among either group are detected, marriage, childbearing, and social capital exhibit distinct ethnic-specific effects. Although economic considerations are prevailing stimuli for migration in both groups, the results point to the formation of two dominant ethnic-specific migration preference types – for temporary migration among Asians and permanent migration among Europeans.
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Abstract
Despite its importance in studies of migrant health, selectivity of migrants-also known as migration health selection-has seldom been examined in sub-Saharan Africa (SSA). This neglect is problematic because several features of the context in which migration occurs in SSA-very high levels of HIV, in particular-differ from contextual features in regions that have been studied more thoroughly. To address this important gap, we use longitudinal panel data from Malawi to examine whether migrants differ from nonmigrants in pre-migration health, assessed via SF-12 measures of mental and physical health. In addition to overall health selection, we focus on three more-specific factors that may affect the relationship between migration and health: (1) whether migration health selection differs by destination (rural-rural, rural-town, and rural-urban), (2) whether HIV infection moderates the relationship between migration and health, and (3) whether circular migrants differ in pre-migration health status. We find evidence of the healthy migrant phenomenon in Malawi, where physically healthier individuals are more likely to move. This relationship varies by migration destination, with healthier rural migrants moving to urban and other rural areas. We also find interactions between HIV-infected status and health: HIV-infected women moving to cities are physically healthier than their nonmigrant counterparts.
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The effect of internal migration, individual and contextual characteristics on contraceptive use among Nigerian women. Health Care Women Int 2017. [PMID: 28644720 DOI: 10.1080/07399332.2017.1345908] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
We investigated the relation of internal migration to contraceptive use and adjusted for individual and contextual (community) characteristics. Multilevel logistic regression models were fitted to nationally representative data of 28,876 women from 884 communities in Nigeria. Only about one out of every 10 women (10.4%) currently used a contraceptive method. Contraceptive prevalence according to the migration status were rural-urban (12.5%), urban-rural (13.8%), rural nonmigrants (6.2%) and urban nonmigrants (17.1%). The relationship between internal migration and contraceptive use was fully explained by individual and community characteristics. Programs aimed at increasing contraceptive prevalence should address contextual challenges alongside socioeconomic factors.
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Abstract
The rapid population growth of many African cities has important implications for population health, yet little is known about factors contributing to increasing population, such as the fertility of internal migrants. We examine whether in-migrants to Kinshasa have different fertility patterns than lifetime Kinshasa residents, and identify characteristics of migrants that may explain differences in fertility. We also use detailed migration histories to examine whether fertility differs by features of migration. We use representative data from the PMA2020 Project for 2197 women in Kinshasa, including 340 women who moved to Kinshasa. We examine differences between migrants and non-migrants in fertility and other fertility-related characteristics. We also examine whether fertility differs by duration of residence in Kinshasa, number of lifetime moves, age at first migration, urban/rural classification of birthplace, and the distinction between intra-Kinshasa migration and migration to Kinshasa.. Migrants have significantly higher fertility than permanent Kinshasa residents, but the difference is relatively small in magnitude. This higher fertility appears due in part to patterns of contraceptive use among migrants. There is noteworthy heterogeneity among migrants: higher fertility among migrants is associated with longer duration in Kinshasa, more lifetime moves, urban-Kinshasa migration, older age at first migration, and moving to Kinshasa from outside (as opposed to intra-Kinshasa migration).
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The dangers of using 'negative durations' to estimate pre- and post-migration fertility. Population Studies 2016; 70:359-363. [PMID: 27697002 DOI: 10.1080/00324728.2016.1221442] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
To keep childbearing that occurs before and after migration separate from each other, many analysts apply a technique that uses 'negative durations' to estimate the childbearing risks that migrants have before they migrate. This strategy can lead to incorrect results and should be abandoned. In this research note, we use data for births and internal migration in Sweden to highlight how the two types of behaviour can be kept apart conceptually and analytically without use of 'negative durations'. The procedures used can easily be generalized to any similarly linked pair of behaviours.
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Socialization, Adaptation, Transnationalism, and the Reproductive Behavior of Sub-Saharan African Migrants in France. POPULATION RESEARCH AND POLICY REVIEW 2015. [DOI: 10.1007/s11113-015-9360-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Impact of migration on fertility and abortion: evidence from the household and welfare study of Accra. Demography 2015; 51:2229-54. [PMID: 25381146 DOI: 10.1007/s13524-014-0339-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Over the last few decades, total fertility rates, child morbidity, and child mortality rates have declined in most parts of sub-Saharan Africa. Among the most striking trends observed are the rapid rate of urbanization and the often remarkably large gaps in fertility between rural and urban areas. Although a large literature has highlighted the importance of migration and urbanization within countries' demographic transitions, relatively little is known regarding the impact of migration on migrants' reproductive health outcomes in general and abortion in particular. In this article, we use detailed pregnancy and migration histories collected as part of the Household and Welfare Study of Accra (HAWS) to examine the association between migration and pregnancy outcomes among women residing in the urban slums of Accra, Ghana. We find that the completed fertility patterns of lifetime Accra residents are remarkably similar to those of residents who migrated. Our results suggest that recent migrants have an increased risk of pregnancy but not an increased risk of live birth in the first years post-move compared with those who had never moved. This gap seems to be largely explained by an increased risk of miscarriage or abortion among recent migrants. Increasing access to contraceptives for recent migrants has the potential to reduce the incidence of unwanted pregnancies, lower the prevalence of unsafe abortion, and contribute to improved maternal health outcomes.
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Mortality selection in the first three months of life and survival in the following thirty-three months in rural Veneto (North-East Italy) from 1816 to 1835. DEMOGRAPHIC RESEARCH 2014. [DOI: 10.4054/demres.2014.31.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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New insights into the fertility patterns of recent Polish migrants in the United Kingdom. JOURNAL OF POPULATION RESEARCH 2014. [DOI: 10.1007/s12546-014-9125-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Convergence in fertility of South Africans and Mozambicans in rural South Africa, 1993-2009. Glob Health Action 2013; 6:19236. [PMID: 23364078 PMCID: PMC3556705 DOI: 10.3402/gha.v6i0.19236] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Revised: 09/26/2012] [Accepted: 10/10/2012] [Indexed: 11/23/2022] Open
Abstract
Background Although there are significant numbers of people displaced by war in Africa, very little is known about long-term changes in the fertility of refugees. Refugees of the Mozambican civil war (1977–1992) settled in many neighbouring countries, including South Africa. A large number of Mozambican refugees settled within the Agincourt sub-district, underpinned by a Health and Socio-demographic Surveillance Site (AHDSS), established in 1992, and have remained there. The AHDSS data provide a unique opportunity to study changes in fertility over time and the role that the fertility of self-settled refugee populations plays in the overall fertility level of the host community, a highly relevant factor in many areas of sub-Saharan Africa. Objectives To examine the change in fertility of former Mozambican self-settled refugees over a period of 16 years and to compare the overall fertility and fertility patterns of Mozambicans to host South Africans. Methods Prospective data from the AHDSS on births from 1993 to 2009 were used to compare fertility trends and patterns and to examine socio-economic factors that may be associated with fertility change. Results There has been a sharp decline in fertility in the Mozambican population and convergence in fertility patterns of Mozambican and local South African women. The convergence of fertility patterns coincides with a convergence in other socio-economic factors. Conclusion The fertility of Mozambicans has decreased significantly and Mozambicans are adopting the childbearing patterns of South African women. The decline in Mozambican fertility has occurred alongside socio-economic gains. There remains, however, high unemployment and endemic poverty in the area and fertility is not likely to decrease further without increased delivery of family planning to adolescents and increased education and job opportunities for women.
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Abstract
Birth seasonality responds to a variety of environmental and socio-cultural factors. The present study was carried out to quantify the trends in seasonal variation in birth rate in seven districts in the Kayes region of Mali between 2007 and 2010 and to attempt to link climatic- and agricultural-cycle-dependent factors with birth seasonality. Lagged regression analysis based on time series analysis techniques was used to investigate seasonality of births registered in health facilities and its association with climate, labour migration, agriculture workload, malaria infection and food supply. There was a clear bimodal pattern in month-to-month institutional delivery rate variation, and this seasonal pattern repeated each year over the study period. The data showed that rates of health-facility-attended deliveries were high at the end of the dry season (April-June), fell rapidly in the first half of the rainy season, rose again during the later part of the rainy season (August-October) and fell to their lowest values after the rains. The first peak observed in spring (April-June) corresponded to conception nine months earlier during the rainy season (between July and September), while the second peak observed in the third quarter of the year (August-October) corresponded with conception at the beginning of the dry season right after the harvest period (between November and January). Between these peaks was an abrupt trough in July. The findings support a causal process through which climate change influences conception/birth seasonality in two direct and indirect pathways. On one side climate change influences conception/birth seasonality from the effects on fetal loss (changes in annual rainfall leading to changes in malaria incidence) and on the other side by affecting fecundability (changes in agricultural cycles leading to changes in food production, agricultural workload and socio-cultural events, which in turn influence energy balance and sexual behaviour). Labour migration, which is closely linked with the agricultural cycle, influences sexual intercourse and thus marital fertility. Finally, the model emphasizes an eco-systemic approach to the study of birth seasonality.
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Review of research on residential mobility during pregnancy: consequences for assessment of prenatal environmental exposures. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2012; 22:429-38. [PMID: 22617723 PMCID: PMC3543155 DOI: 10.1038/jes.2012.42] [Citation(s) in RCA: 170] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 10/03/2011] [Accepted: 10/05/2011] [Indexed: 05/17/2023]
Abstract
Studies on environmental exposures during pregnancy often have limited residential history (e.g., at delivery), potentially introducing exposure misclassification. We reviewed studies reporting residential mobility during pregnancy to summarize current evidence and discuss research implications. A meaningful quantitative combination of results (e.g., meta-analysis), was infeasible owing to variation in study designs. Fourteen studies were identified, of which half were from the US. Most were case-control studies examining birth defects. Residential history was typically assessed after delivery. Overall mobility rates were 9-32% and highest in the second trimester. Mobility generally declined with age, parity, and socioeconomic status, although not consistently. Married mothers moved less frequently. Findings were dissimilar by race, smoking, or alcohol use. On the basis of the few studies reporting distance moved, most distances were short (median often <10 km). Results indicate potential misclassification for environmental exposures estimated with incomplete residential information. This misclassification could be associated with potential confounders, such as socioeconomics, thereby affecting risk estimates. As most moves were short distances, exposures that are homogenous within a community may be well estimated with limited residential data. Future research should consider the implications of residential mobility during pregnancy in relation to the exposure's spatial heterogeneity and factors associated with the likelihood of moving and distance moved.
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Is there an urban advantage in child survival in sub-saharan Africa? Evidence from 18 countries in the 1990s. Demography 2012; 48:531-58. [PMID: 21590463 DOI: 10.1007/s13524-011-0019-2] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Evidence of higher child mortality of rural-to-urban migrants compared with urban nonmigrants is growing. However, less attention has been paid to comparing the situation of the same families before and after they migrate with the situation of urban-to-rural migrants. We use DHS data from 18 African countries to compare child mortality rates of six groups based on their mothers' migration status: rural nonmigrants; urban nonmigrants; rural-to-urban migrants before and after they migrate; and urban-to-rural migrants before and after they migrate. The results show that rural-to-urban migrants had, on average, lower child mortality before they migrated than rural nonmigrants, and that their mortality levels dropped further after they arrived in urban areas. We found no systematic evidence of higher child mortality for rural-to-urban migrants compared with urban nonmigrants. Urban-to-rural migrants had higher mortality in the urban areas, and their move to rural areas appeared advantageous because they experienced lower or similar child mortality after living in rural areas. After we control for known demographic and socioeconomic correlates of under-5 mortality, the urban advantage is greatly reduced and sometimes reversed. The results suggest that it may not be necessarily the place of residence that matters for child survival but, rather, access to services and economic opportunities.
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Abstract
Labor migration profoundly affects households throughout rural Africa. This study looks at how men's labor migration influences marital fertility in a context where such migration has been massive while its economic returns are increasingly uncertain. Using data from a survey of married women in southern Mozambique, we start with an event-history analysis of birth rates among women married to migrants and those married to nonmigrants. The model detects a lower birth rate among migrants' wives, which tends to be partially compensated for by an increased birth rate upon cessation of migration. An analysis of women's lifetime fertility shows that it decreases as the time spent in migration by their husbands accrues. When we compare reproductive intentions stated by respondents with migrant and nonmigrant husbands, we find that migrants' wives are more likely to want another child regardless of the number of living children, but the difference is significant only for women who see migration as economically benefiting their households. Yet, such women are also significantly more likely to use modern contraception than other women. We interpret these results in light of the debate on enhancing versus disrupting effects of labor migration on families and households in contemporary developing settings.
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Internal migration and health: premarital sexual initiation in Nigeria. Soc Sci Med 2011; 72:1284-93. [PMID: 21435767 DOI: 10.1016/j.socscimed.2011.02.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 11/02/2010] [Accepted: 02/06/2011] [Indexed: 11/28/2022]
Abstract
The high rates of youth migration to urban and economic centers, in the context of persistent poverty and devastating HIV/AIDS burden, have raised intricate social policy challenges in developing countries. Using the 2008 Nigeria Demographic and Health Survey data, descriptive statistics, Kaplan-Meier survival curves and discrete-time hazard regression models, this study examines the patterns of internal migration and sexual initiation among never-married Nigerian youth aged 15-24. We find that migrants generally show stronger association than non-migrants, and urban-rural and rural-rural migrants particularly show the strongest independent association with premarital sexual initiation. Other significant covariates are age, religion, ethnic origin, educational attainment, independent living arrangement, formal employment and exposure to the mass media. The findings highlight the direct importance of youth migration in understanding and addressing the challenges of premarital sexual behavior and the need for behavior change policies and programs to be sensitive to the complex contextual nuances across youth groups in one country.
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Abstract
This paper provides insights into the relationship between migration and fertility in urban China. Data collected in five major Chinese cities during the China Urban Labor Survey of 2001 is used to compare the fertility patterns of rural-to-urban migrants with permanent urban residents. The analysis takes a life course perspective, taking into account the timing of major life events when estimating the impact of migration on fertility. These results suggest that migrants generally have higher fertility than native urban residents, but that the fertility patterns of migrants vary significantly by the relative timing of marriage and migration, and by educational attainment.
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Migration and child health inequities in Nigeria: a multilevel analysis of contextual- and individual-level factors. Trop Med Int Health 2010; 15:1464-74. [PMID: 20958894 DOI: 10.1111/j.1365-3156.2010.02643.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the role of rural-urban migration in the risks of under-five death; to identify possible mechanisms through which migration may influence mortality; and to determine individual- and community-level relationships between migration status and under-five death. METHOD Multilevel Cox regression analysis was used on a nationally representative sample of 6029 children from 2735 mothers aged 15-49 years and nested within 365 communities from the 2003 Nigeria Demographic and Health Survey. Hazard ratios with 95% confidence intervals were used to express the measures of association between the characteristics, and intra-class coefficients were used to express the measures of variation. RESULTS Children of rural non-migrant mothers had significantly lower risks of under-five death than children of rural-urban migrant mothers. The disruption of family and community ties, low socio-economic position and vulnerability, and the difficulties migrants face in adapting into the new urban environment, may predispose the children of rural-urban migrants to higher mortality. CONCLUSION Our results stress the need for community-level and socio-economic interventions targeted at migrant groups within urban areas to improve their access to health care services, maternal education, as well as the general socio-economic situation of women.
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Abstract
This article uses life history calendar (LHC) data from coastal Ghana and event history statistical methods to examine inter-regional migration for men and women, focusing on four specific migration types: rural-urban, rural-rural, urban-urban, and urban-rural. Our analysis is unique because it examines how key determinants of migration- including education, employment, marital status, and childbearing-differ by sex for these four types of migration. We find that women are significantly less mobile than men overall, but that more educated women are more likely to move (particularly to urban areas) than their male counterparts. Moreover, employment in the prior year is less of a deterrent to migration among women. While childbearing has a negative effect on migration, this impact is surprisingly stronger for men than for women, perhaps because women's search for assistance in childcare promotes migration. Meanwhile, being married or in union appears to have little effect on migration probabilities for either men or women. These results demonstrate the benefits of a LHC approach and suggest that migration research should further examine men's and women's mobility as it relates to both human capital and household and family dynamics, particularly in developing settings.
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Marriage, childbearing, and migration in Kyrgyzstan: Exploring interdependencies. DEMOGRAPHIC RESEARCH 2010. [DOI: 10.4054/demres.2010.22.7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Spousal separation, selectivity and contextual effects: exploring the relationship between international labour migration and fertility in post-Soviet Tajikistan. DEMOGRAPHIC RESEARCH 2009. [DOI: 10.4054/demres.2009.21.32] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Abstract
This study investigates the effects of forced migration on child survival and health in Angola. Using survey data collected in Luanda, Angola, in 2004, just two years after the end of that country's prolonged civil war, we compare three groups: migrants who moved primarily due to war, migrants whose moves were not directly related to war, and non-migrants. First, we examine the differences among the three groups in under-five mortality. Using an event-history approach, we find that hazards of child death in any given year were higher in families that experienced war-related migration in the same year or in the previous year, net of other factors. To assess longer-term effects of forced migration, we examine hazards of death of children who were born in Luanda, i.e., after migrants had reached their destinations. We again observe a disadvantage of forced migrants, but this disadvantage is explained by other characteristics. When looking at the place of delivery, number of antenatal consultations, and age-adequate immunization of children born in Luanda, we again detect a disadvantage of forced migrants relative to non-migrants, but now this disadvantage also extends to migrants who came to Luanda for reasons other than war. Finally, no differences across the three groups in child morbidity and related health care seeking behavior in the two weeks preceding the survey are found. We interpret these results within the context of the literature on short- and long-term effects of forced migration on child health.
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