Christine McMurray

Neonatal mortality and maternal health care in Nepal: searching for patterns of association.

This study explores the factors associated with neonatal mortality and maternal health care in Nepal. The subjects were 4375 births reported in the 1996 Nepal Family Health Survey. Maternal and child health care was found to have a significant association with neonatal mortality, although preceding birth interval and sex of child had stronger effects. Four aspects of maternal care were found to be highly associated with region, household ownership of assets, mothers education and fathers education. This indicates that accessibility, affordability and availability of maternal health care are important factors to consider in future research on neonatal mortality.

MEASURING EXCESS RISK OF CHILD MORTALITY: AN EXPLORATION OF DHS I FOR BURUNDI, UGANDA AND ZIMBABWE

This paper proposes a new method of measuring excess risk of child mortality in cross-sectional surveys, which is applied to DHS I data for Burundi, Uganda and Zimbabwe. The expected child mortality experience is estimated for each mother on the basis of childs age, mothers age at childs birth and her parity, and compared with her observed experience. Mothers who exceed their expected child mortality experience and also had more than one child die are considered to have excess child mortality. Zimbabwe had the greatest concentration of child deaths as measured by a simple ratio of mothers to deaths, but when observed experience was compared with expected it had less than half as many excess deaths as Uganda and Burundi. In all three countries mothers education had a strong negative association with the risk of excess child mortality, and in Zimbabwe and Burundi there were significant regional differences.

Culture, Catholics and Condoms Population Planning in the Pacific

A critical problem facing many of the small island nations of the Pacific is the growing imbalance between population and resources. Families of five or more children are typical of traditional Pacific lifestyles, but in the majority of Pacific countries average population growth rates now exceed average economic growth rates, and there are growing rural-urban inequalities in access to services and wage employment opportunities. Some Pacific countries have used migration to offset natural population increase and earn remittances to supplement national income, but that strategy has several disadvantages, including a tendency to support high fertility. This article argues that despite efforts made by some Pacific countries to reduce their population growth rates, such strategies are unlikely to succeed unless families and communities can be convinced that future benefits from having smaller families will exceed the known advantages of a large family size. Recent initiatives to slow the rate of population increase in the atoll nation of Kiribati are examined and their prospects of success are evaluated in the light of Kiribati culture and prevailing attitudes.

Fertility and family planning in Papua New Guinea a comment.

This paper comments on the use of contraceptives by the rural and urban women of Papua New Guinea. Agyei found that modern methods of contraception (pill injection loop condom) were currently used by 13% of rural and 20% of urban Papua New Guinea women. This is substantially more than the estimate given in the final draft of the National Health Plan 1986-90 of 7% of women of childbearing age using any method. An explanation for this difference could be that the official estimate is based on service statistics which understate contraceptive use. Another is that Agyeis single stage sample design may have over-represented current users. Because some provinces were not included in his sample more details of the selection of 65 cluster units are needed. Unpublished tabulations from the 1980 sample census indicate that only 5% of the urban women aged 15-49 were employed in professional and technical occupations compared with 10% in professional occupations alone in Agyeis sample. Agyeis unemployed category must refer to persons with no occupation or to persons not employed. It is not indicated whether either the rural or urban sample includes the census category rural village. The 1971 census found that 73% of all women aged 15 and over had never attended school while the 1980 census found that 83% of all Papua New Guinea females aged 5 years and over and not at school had no education. In Agyeis sample only 37% of rural women and 23% of urban women had no education. Overall there appears to be some indication that Agyeis sample may overrepresent women with some education and with higher status occupations. This could explain why Agyeis usage rates are substantially higher than other estimates.