Ingrid Swenson

Factors influencing infant mortality in Vietnam.

Selected determinants of overall infant mortality in Vietnam were examined using data from the 1988 Vietnam Demographic and Health Survey, and factors underlying neonatal and post-neonatal mortality were also compared. Effects of community development characteristics, including health care, were studied by logistic regression analysis in a subsample of rural children from the 1990 Vietnam Accessibility of Contraceptives Survey. Infant neonatal and post-neonatal mortality rates showed comparable distributions by birth order, maternal age, pregnancy intervals, mothers education and urban-rural residence. Rates were highest among first order births, births after an interval of less than 12 months, births to illiterate mothers and to those aged under 21 or over 35 years of age. Logistic regression analysis showed that the most significant predictor of infant mortality was residence in a province where overall infant mortality was over 40 per 1000 live births. In the rural subsample, availability of public transport was the most persistent community development predictor of infant mortality. Reasons for the low infant mortality rates in Vietnam compared to countries with similar levels of economic development are discussed.

Relationships between pregnancy spacing, sex of infants, maternal age, and birth order, and neonatal and post‐neonatal mortality in Bangladesh

Abstract The relationships between length of the interpregnancy interval, outcome of the pregnancy preceding the interval, sex of the infants, pregnancy order, maternal age, and maternal history of previous child deaths and neonatal and postneonatal mortality were explored in a rural Bangladeshi population using a multiple regression analysis. Specific interactions between the interpregnancy interval, outcome of the pregnancy preceding the interval, sex of the infants, and history of previous child deaths were examined. An inverse relationship was observed between postneonatal mortality and the length of the interpregnancy interval when the pregnancy preceding the interval was a surviving infant. No such trend was observed for neonatal mortality. Post‐neonatal mortality rates among children whose mothers had experienced two or more previous child deaths were essentially the same as that for infants whose mothers had experienced 0–1 child deaths when the interpregnancy intervals were more than 24 months. A...

The Professionals Who Can't Quit

ly, however, nurses have not swelled the ranks of former smokers. As a profession, they run a poor third behind physicians and dentists. Only 36 percent of nurse-smokers have kicked the habit, in comparison with 64 percent of physicians and 61 percent of dentists(1,2). And the problem is not confined to the U.S. In England, where nurses have been admonished by their professional organizations to set a non-smoking example for the public, at least half the profession continues to use tobacco(3-5). The vast majority of U.S. nurses are, of course, women; and their smoking habits resemble those of the rest of their sex. Even though the smoking habit has declined among men, it has been on the increase among women-and a number of researchers have attempted to find out why. Fisher suggests that women smoke to satis-

Vietnamese infant and childhood mortality in relation to the Vietnam War.

OBJECTIVES There is obvious potential for war to adversely affect infant and childhood mortality through direct trauma and disruption of the societal infrastructure. This study examined trends in Vietnam through the period of the war. METHODS The 1988 Vietnam Demographic and Health Survey collected data on reproductive history and family planning from 4172 women aged 15 through 49 years in 12 selected provinces of Vietnam. The 13,137 births and 737 deaths to children younger than age 6 reported by the respondents were analyzed. RESULTS For the country as a whole, infant and childhood mortality dropped by 30% to 80% from the prewar period to the wartime period and was stable thereafter. In provinces in which the war was most intense, mortality did not decline from the prewar period to the wartime period but declined after the war, consistent with an adverse effect during the wartime period. CONCLUSIONS The data are limited by assignment of birth location on the basis of mothers current residence and by inadequate information on areas of war activity. Nonetheless, the data do not indicate a widespread, sizable adverse effect of the war on national infant and childhood mortality in Vietnam but suggest detrimental effects in selected provinces.

Selected determinants of fertility in Vietnam: age at marriage, marriage to first birth interval and age at first birth

Data from the 4172 women aged 15-49 interviewed in the 1988 Vietnamese Demographic and Health Survey were used to examine age at marriage, marriage to first birth intervals and age at first birth. Differences between urban and rural areas, northern and southern provinces and by education of the women were analysed. The majority of the women had their first birth before age 20, but women with secondary education had a significantly higher age at first birth than those with little or no education, and women from the north had a significantly higher age at first birth than women from the south. Rural women and those with little or no education married at significantly younger ages than urban women and those with secondary education; these education effects were confirmed in a rural subsample of women. Women from rural areas and from the north had significantly shorter marriage to first birth intervals than urban women and those from the south, but there were no significant effects related to education.

The relationship between fetal wastage and pregnancy spacing in Bangladesh.

Data from Matlab, Bangladesh, was used to study the relationship between early fetal wastage or stillbirth and pregnancy spacing. The population under study is characterized by prolonged lactation, minimal nutrition, and high fertility and mortality. A binary regression analysis was used to adjust for certain maternal factors, i.e., pregnancy order, maternal age, history of previous pregnancy and child loss, and outcome of the immediately preceding pregnancy. Adjusted rates showed significantly greater risk of second trimester fetal wastage for pregnancies conceived less than 12 months after the preceding pregnancy termination; the risk relationship was not apparent for 3rd trimester fetal deaths. This is surprising due to increased fetal weight gain and presumed nutrient demand during the third trimester. The greatest risk was among pregnancies conceived less than 12 months following a livebirth, breastfed infant. Among mothers with a history of 2 or more pregnancy losses, the risk of early fetal wastage and stillbirth was increased. Lactation may be a causal factor.

Variations in Vietnamese marriages, births and infant deaths by months of the Julian calendar and years of the Vietnamese and Chinese astrological calendars

The timing of births and marriages in Vietnam appears to have some statistically significant relationships with the signs of the Chinese and Vietnamese astrological calendars. Years considered to be good years have significantly more births and marriages than years that are not considered as desirable. Births and marriages also have some significant variations with seasons of the year. Infant deaths do not appear to have any significant relationships with the astrological signs although infant mortality has some significant relationships with seasons of the year. The findings indicate that there is some purposeful planning for marriages and births to coincide with optimal times defined in the astrological calendars.

A comparison of the knowledge and attitudes about smoking among nurses who never smoked, those who have successfully stopped smoking and those who currently smoke

A smaller percentage of nurses than physicians or dentists smoked in 1959, while in 1972 a higher percentage of nurses smoked than did either of the other two professional groups (Garfmkel, 1976). Although the study documented that smaller percentages of all professionals smoked in 1972 than in 1959, the dechne was less for nurses than for physicians and dentists. In 1975 a survey of health professionals reported that the percentage of nurses who smoke increased from 37% in 1967 to 39% in 1975, as compared to 29% of all U.S. women in 1975. However, 23% of the nurses who smoked were smoking low tar and nicotine cigarettes, as compared to 17% of the general U.S. female population who smoked @HEW, 1975). In spite of the fact that U.S. nurses, physicians, dentists and pharmacists in the 1975 survey strongly agreed that they had a definite role as examplars for their clients, nurses lagged behind other professionals in quitting the smoking habit (DHEW, 1979). Of nurses who have smoked, only 36% have quit, whereas 64% of the physicians and 61% of the dentists who had smoked quit @HEW, 1979). In a 1978 survey 24.3% of nurse respondents had stopped smoking, but 34.5% were current smokers (Belanger et al., 1978). Another study found that 25.9% of the female nurses smoked, as compared to 19.5% of other professional women (physicians and dentists). Nurses, more frequently than other professional women in the study, stated that they found it difficult to quit smoking (Garfimkel, 1976). This same study also reported that a smaller percentage of female physicians smoked than did their male counterparts.

COLLABORATIVE RESEARCH: PROCESS AND MEASUREMENT

Conducting research is a time consuming, demanding activity. Collaboration has been suggested as one way to maximize research productivity, but It Is understood that collaboration has costs as well as benefits. Individual researchers and administrators need to be able to predict how productive collaboration will be. The authors propose multidimensional measures of the collaborative process, the benefits and costs, and evaluate one case example. Using the proposed measures should give the reader a better understanding of collaborative research.

Contraceptive use in Vietnam: The effect of individual and community characteristics

Data from the 1988 Vietnamese Demographic and Health Survey and the 1990 Vietnam Study of Accessibility of Contraceptives were used in this analysis to determine how selective individual and community characteristics influenced the use of modern methods of contraception in Vietnam. Although there were no significant differences in the use of contraceptives between women with a primary education and those with a higher educational attainment, the illiterate women with no formal education were significantly less likely to use modern methods of contraception. Women living in provinces with high infant mortality rates were significantly less likely to use modern methods of contraception than women in low-infant-mortality provinces. Independent of other individual and community characteristics, there were no significant differences in the use of contraception between urban and rural women.