Effects of the status of women on the first-birth interval in Indian urban society

Husbands' knowledge and involvement in sexual and reproductive health rights of women in Bahir Dar City, Northwest Ethiopia: a community-based study

Background

Sexual and reproductive health rights (SRHRs) are integral elements of the rights of everyone to the highest attainable standard of physical and mental health, but they are the most underdeveloped and least understood sphere of rights, especially in Africa, including the country of Ethiopia. The implementation of women's SRHRs is essential for achieving gender equality and promoting women's rights. Husbands' knowledge and involvement play a significant role in improving women's practice of their SRHRs. However, there is limited information/data about the level of husbands' knowledge and involvement in Northwest Ethiopia, including Bahir Dar City. Therefore, this study aimed to assess husbands' knowledge, involvement, and factors influencing their involvement in women's SRHRs.

Methods

Community-based cross-sectional study design was conducted from March 20 to April 5, 2023, in Bahir Dar City, Northwest Ethiopia, among 391 husbands. Multi-stage sampling and simple random sampling technique were applied to select kebeles and study participants, respectively. Participants were interviewed face-to-face using structured and pretested questionnaire. Binary logistic regression was applied to identify associated factors, and a p-value of <0.05 was a cutoff point to declare statistical significance.

Results

In this study, 50.6% (198/391) of the husbands had good knowledge about their wives' SRHRs and 44.2% (173/391) (95% CI, 39.3-49.1%) of the husbands were involved when their wives practiced their SRHRs. Access training/education about sexual health [AOR = 5.99; 95% CI (2.7-13.2)], husbands' advance educational level [AOR = 8.81; 95% CI (2.04-38)], good knowledge about SRHRs [AOR = 7.94; 95% CI (4.3-14.4)], low monthly income (<4,600 birr) [AOR = 9.25; 95% CI (4.2-20.5)], and had open discussion with family members and friends about SRHRs [AOR = 1.92; 95% CI (1.01-3.6)] were found to have significant association with husbands' involvement.

Conclusion

Husbands' level of knowledge on SRHRs of women and their involvement remain low. Therefore, responsible concerned bodies need to work on the strategies that help to improve men involvement and knowledge, and tackle the above-mentioned factors influencing their involvement.

Transition in the ages at key reproductive events and its determinants in India: evidence from NFHS 1992-93 to 2019-21

INTRODUCTION

Reproductive health events have changed fertility and family planning needs, depicting the changing life patterns of women and the population to which they belong. Understanding the pattern at which these events occur helps in understanding the fertility pattern, family formation and the idea about health essential needs for women. This paper attempts to see the variation in reproductive events (first cohabitation, first sex and first birth) over three decades and also to see potential contributing factors among the reproductive age group of women using secondary data from Data Source: All rounds of the National Family Health Survey (1992-93 to 2019-2021) have been utilized.

METHODS AND RESULTS

Cox Proportional Hazard Model illustrates that all regions have initiated their first birth later than women who belong to the east region similar pattern has been obtained for first cohabitation and first sex except for the central region. Multiple Classification Analysis (MCA) depicts the increasing pattern in the predicted mean age at first cohabitation, sex and birth for all demographic characteristics; the highest increment was found in SC women, Uneducated women and Muslim women. Kaplan Meier Curve demonstrates that women with no education, primary or secondary education are shifting towards higher educated women. Most importantly, the results of the multivariate decomposition analysis (MDA) revealed that education played the largest contribution among the compositional factors in the overall increase in mean ages at key reproductive events.

CONCLUSIONS

Though reproductive health has long been essential in women's lives, they are still very confined to specific domains. Over time the government has formulated several proper legislative measures relating to various domains of reproductive events. However, given that the large size and heterogeneity in social and cultural norms result in changing ideas and choices regarding the initiation of reproductive events, national policy formulation needs to be improved or amended.

Associated factors of first-birth interval among women in reproductive age, addressing maternal and child health

Background

The first-birth interval directly influences family size and maternal and child mortality. The objective of this study is to investigate factors associated with the time of the first-birth after the first marriage among women in Iran.

Methods

In this cross-sectional study, the first birth history of 1350 women aged 15–49 years was collected in Kerman (southern Iran) in 2018. To assess the predictor variables of the first-birth interval and calculate the adjusted hazard ratios, multivariate Cox regression was used. The P-value < 0.05 was considered as significant. The statistical analysis of data was performed using SPSS version 22.

Results

The average of the first-birth interval was 2.5 ∓ 0.8 years. Woman’s age at marriage (HR 1.48, 95% CI 1.32–2.48), husband’s age at marriage (HR 1.88, 95% CI 1.62–2.03), age at the first menstruation (HR 1.53, 95% CI 1.24–2.53), being rural residents (HR 2.041, 95% CI 1.26–2.95), and having engagement period (HR 1.85, 95% CI 1.52–3.05) were associated with short first-birth interval, and woman’s BMI (HR 1.72, 95% CI 1.54–2.77), woman’s university educational level (HR 1.47, 95% CI 1.35–2.57), husband’ s university educational level (HR 1.39, 95% CI 1.32–2.51), contraception use (HR 2.28, 95% CI 1.12–2.86) and income sufficiency (HR 2.25, 95% CI 1.12–2.96) were associated with long first-birth interval.

Conclusions

Being a rural resident is the most influential predictor of short first-birth interval and income sufficiency is the most influential predictor of long first-birth interval.

Total Fertility Rate, which is the average number of live births that would be born to a woman over her reproductive life if she experiences the current age-specific fertility rates throughout her lifetime. The fertility pattern can be measured by several indicators such as the first-birth interval (FBI) after marriage. FBI is defined as the duration of time spent by married couples to have their first child since the first day of marriage. Some studies have demonstrated that the length of FBI subsequently influences spacing and childbearing pattern of a family. The aim of this study is first to determine the mean of FBI and second to explore the associated factors of FBI in Kerman, southern Iran. We analyzed data for 1350 women 15–49 years old. The outcome variable was the first-birth interval (FBI). Results showed that the average of FBI was 2.5 years. There is a positive association between FBI and age of wives at marriage, first menace age, wives’ BMI, wives and husbands’ educational level, contraception use, age of husbands at marriage, residence place, income sufficiency, and having engagement period. The women and men who got married at older ages were more likely to report short FBI. It was indicated that Educated women and men and women who experience menstruation at a younger age are more likely to report longer FBI. The knowledge about importance of FBI should be more announced for couples by health services in order to help them manage their child-spacing and fertility. The government also should pay attention on FBI as an important index in determining the average age of country population.

Factors associated with contraceptive use among sexually active Nepalese youths in the Kathmandu Valley

Background

In Nepal, evidence is sparse regarding the use of contraception at first and current relationships among sexually active young people. This study examined the factors associated with modern contraceptive use at first and current sexual relationships.

Methods

A descriptive cross-sectional household survey conducted amongst young Nepalese men and women living in the urban areas of the Kathmandu valley. We used logistic regression to model the relationship between selected independent variables and outcome variables (use at first sexual intercourse and current use of modern contraception) among 492 ever sexually active youth aged 15–24 years.

Results

We found that the key factors associated with current non-use of modern contraceptives among sexually active youth age 15–24 were young age at first sexual contact and a relationship with someone other than a spouse, while significant factor associated with current use of contraception was religion, revealing that Hindu youths having lower odds of use compared to young people who belonged to other religions.

Conclusions

The findings suggest that contraception education should be intensified and directly towards those entering adolescence to encourage youths to adopt contraception at the time of their first sexual relationship. The influence of religion on use of modern contraception needs further exploration.

Determinants of Savings in Sukanya Samriddhi Account: Evidence from Tripura

The financial inclusion models that have been implemented successfully in various parts of India have not gained momentum in North East India. The inherent characteristics of the states in this region and the prominence of several informal financial systems are some of the reasons for the failure of the formal financial inclusion models. This study made an attempt to examine the determinants of savings under the Sukanya Samriddhi Account (SSA), a formal financial inclusion scheme advocated by the Government of India for the betterment of girl children. The study area comprised the eight districts of Tripura, one of the states of North East India. The data for the case study was collected through scheduled interviews with 225 respondents, who had a girl child below the age of 10 years. The results, arrived at through a statistical analysis, showed that the pivotal catalysts determining the decisions whether to invest in the SSA scheme were: gender, age, level of income, family size and income, financial literacy, uncertainty of income and planning for child’s education, marriage and house. The relevance of the finding of the study in terms of policy-making has been highlighted.

Devaki syndrome: a culture-bound psychological reaction in Indian Hindu women in response to repeated pregnancy loss?

Depression and anxiety are observed in pregnant women with previous foetal loss due to spontaneous abortions. Culture has important influence on the expression of psychopathology. We report two Hindu women during second trimester of pregnancy with symptoms of depression and anxiety along with identification with a mythological figure - Devaki, with extreme preoccupations with child Krishna and expecting a male child, which precipitated after a series of unfortunate foetal losses.

FEMALE EDUCATION AND ITS ASSOCIATION WITH CHANGES IN SOCIO-DEMOGRAPHIC BEHAVIOUR: EVIDENCE FROM INDIA

Education is a crucial factor in influencing the pattern and timing of marriage for women, and the changes in levels of female literacy will also change the dynamics of family formation. India has experienced consistent improvement in levels of female literacy; therefore, this study examined the association of women's education with the changes in their demographic behaviour in the Indian context. The central idea of the paper is to examine the differences in age at marriage and first birth, choice of marriage partner and the number of children ever born based on educational attainment of women. In addition, the study examined incongruence in years of schooling and discontinuation from school, for children based on education of the mother. The study utilized data from the third round of District Level Household and Facility Survey. The sample constituted 344,164 ever-married women aged 35 years and above with surviving children aged 5-20 years. The results imply that women with higher education are more likely to marry late and have fewer children compared with less educated women. Accordingly, increase in education of women also increases the probability of marrying men with better education than themselves. The study further observed that education of wife has a greater association with the number of children ever born than the education of husband. At the same time, incongruence in years of schooling and drop-out from school are both high for children of uneducated women. The study also found that the children from urban areas are more likely to drop out than their rural counterparts. In addition to education of the mother, number and composition of children in the family and economic condition of the household are some other factors that influence the educational attainment of children.

Women's empowerment and fertility: a review of the literature

Women's empowerment has become a focal point for development efforts worldwide and there is a need for an updated, critical assessment of the existing evidence on women's empowerment and fertility. We conducted a literature review on studies examining the relationships between women's empowerment and several fertility-related topics. Among the 60 studies identified for this review, the majority were conducted in South Asia (n = 35) and used household decision-making as a measure of empowerment (n = 37). Overall, the vast majority of studies found some positive associations between women's empowerment and lower fertility, longer birth intervals, and lower rates of unintended pregnancy, but there was some variation in results. In many studies, results differed based on the measure of empowerment used, sociopolitical or gender environment, or sub-population studied. This article is one of the first evaluations of the literature assessing the relationships between women's empowerment and fertility. We identify several key issues that merit further investigation.

The marginal valuation of fertility

Substantial theoretical and empirical evidence demonstrates that fertility entails economic, physiological, and demographic trade-offs. The existence of trade-offs suggests that fitness should be maximized by an intermediate level of fertility, but this hypothesis has not had much support in the human life-history literature. We suggest that the difficulty of finding intermediate optima may be a function of the way fitness is calculated. Evolutionary analyses of human behavior typically use lifetime reproductive success as their fitness criterion. This fitness measure implicitly assumes that women are indifferent to the timing of reproduction and that they are risk-neutral in their reproductive decision-making. In this paper, we offer an alternative, easily-calculated fitness measure that accounts for differences in reproductive timing and yields clear preferences in the face of risky reproductive decision-making. Using historical demographic data from a genealogically-detailed dataset from 19th century Utah, we show that this measure is highly concave with respect to reproductive effort. This result has three major implications: (1) if births are properly timed, a lower-fertility reproductive strategy can have the same fitness as a high-fertility strategy, (2) intermediate optima are far more likely using fitness measures that are strongly concave with respect to effort, (3) we expect mothers to have strong investment preferences with respect to the risk inherent in reproduction.

Religious and cultural influences on contraception

OBJECTIVE

To elucidate the religious and cultural influences that may affect the acceptance and use of various methods of contraception, including emergency contraception.

METHODS

Literature searches were conducted to identify religious teachings related to family, sexual relations, and family planning for Christianity, Judaism, Islam, Hinduism, Buddhism, and Chinese religious traditions. Religious scholars from each of the major religions were consulted for additional information regarding how various subgroups within that religion may interpret and apply religious teachings in specific circumstances.

RESULTS

Religious and cultural factors have the potential to influence the acceptance and use of contraception by couples from different religious backgrounds in very distinct ways. Within religions, different sects may interpret religious teachings on this subject in varying ways, and individual women and their partners may choose to ignore religious teachings. Cultural factors are equally important in couples' decisions about family size and contraception.

CONCLUSION

When new immigrants are faced with the challenges of acclimating to a new society and a new way of life, they may anchor strongly to traditional religious and cultural expectations regarding family, sexuality, and fertility. While health care providers must be cautious not to attribute stereotypical religious, social, and cultural characteristics to women seeking advice about contraception, they do need to recognize that different value systems may influence contraception decision-making in couples of different faiths. This increased cultural awareness needs to be tempered by the understanding that each patient encounter is unique. The values that an individual woman holds may not be in keeping with the official teachings of her religion or the cultural norms reported by other members of the same culture.

Women's education and the timing of marriage and childbearing in the next generation: evidence from rural Bangladesh

In traditional settings where early marriage and early childbearing persist, decisions about age at marriage are often made by parents, and mothers-in-law tend to have considerable influence in hastening the initiation of childbearing. This study analyzes data from a 2002 survey in six villages in rural Bangladesh to test the hypothesis that daughters of women with more education marry later and that daughters-in-law of more educated women initiate childbearing at a slower rate. Using Cox proportional hazard models, we find significant associations between the educational level of mothers and the age at marriage of their daughters and between the educational level of mothers-in-law and the timing offirst birth among their daughters-in-law, although the association between the former attenuates when controlling for other variables. We also find that these associations do not appear to be mediated by the senior women's level of empowerment. We conclude that in rural Bangladesh there is a significant relationship between female education in one generation and the timing of marriage and childbearing in the next.

Early childhood nutrition, education and fertility milestones in Guatemala

Data on fertility milestones were collected in 1994 and linked to information collected in a trial conducted in eastern Guatemala between 1969 and 1977, to examine whether early childhood nutrition was associated with the timing of fertility milestones. In the original trial, two pairs of villages were randomly allocated to receive either a high energy, high protein supplement (Atole) or a low energy, no-protein supplement (Fresco). Mean age at follow-up was 23.47 y (n = 240). About 62% of women had experienced first birth (median age at first birth = 19.83 y). The median intervals from menarche to first intercourse and from first intercourse to first birth were 5.67 and 0.95 y; they were 1.68 and 0.06 y shorter, respectively, for the Atole group than for the Fresco group. Women who had received Atole in utero and/or during early childhood experienced earlier milestones even after adjusting for socioeconomic status (SES), education and age at the prior event. Median age at first birth was 1.17 y earlier for the Atole group. Better growth during early childhood (not severely stunted) led to earlier milestones (median age at first birth was 1.04 y earlier), primarily among women with illiterate fathers. Completion of primary school significantly delayed fertility milestones; the median age at first birth was 4.27 y later for those who completed primary school compared with those who did not (P < 0.05). In sum, improved nutrition during early childhood results in earlier fertility milestones, but the effects of schooling in delaying fertility milestones are greater in magnitude. Intervention programs that improve early childhood nutrition should be accompanied by investments in education that ensure that girls complete primary school.