In most countries, men are more likely to be childless than women. Understanding how this inequality arises is important given the significance of parenthood for individuals’ lives. The objective of this study was to explore how three prominent explanations for sex inequalities in childlessness relate to the Sex Gap in Childlessness (SGC) in Sweden. The three explanations examined were sex ratio imbalance (more men than women), mismeasurement of fatherhood (inequalities in registration) and partnership differences (inequality in multi-partner fertility). Administrative register data for cohorts born in 1945–1974 were used. The population was restricted to men and women who were born in Sweden or arrived prior to the age of 15, and all registered childbearing partnerships were examined. To explore the possible significance of the three explanations, counter-factual standardization was used. Of the three explanations examined, the population sex ratio had the largest positive impact on the SGC, while multi-partner fertility had a negative impact. The results show that inequalities in the sex ratio can explain about 20–34% of the SGC depending on cohort. Inequalities in registration of fathers explain about 9–24% of the SGC depending on cohort. Finally, results show that women are slightly more likely to have multiple partners, and that this behaviour has a substantial minimizing effect on the SGC (minimizing it by 6–65%). To the authors’ knowledge this was the first paper to estimate the scope of the impacts of these three mechanisms on the SGC. Differences in multi-partner fertility have in many instances been used as an explanation for men’s higher childlessness. This study shows that women have slightly more childbearing partners than men, and that this actually leads to a smaller SGC in the studied population.

In a high fertility context, research on the relationship between parental investment, unwanted births and child nutritional outcomes is limited. The implications may be especially relevant for children coming from the most disadvantaged backgrounds and at increased risk of nutritional deprivation. This study assessed the association between maternal investment, unwanted births disaggregated into mistimed and unwanted children, and child nutritional outcomes in a poor population of Serbian Roma. Multiple Indicator Cluster Surveys rounds 5 and 6 data for Serbian Roma settlements were used to account for the association between two measures of maternal investment: weight at birth and parity, and mistimed and unwanted children, and children height-for-age z-score (HAZ), weight-for-age z score (WAZ) and weight-for- height z-score (WHZ). The sample included 130 children aged 0-24 months. The child variables were age, gender, and birth order, while maternal independent variables included age, literacy and access to improved toilet facility as proxies for socioeconomic status. Children born with low birth weight (lower maternal investment in utero) face a significant deficit in terms of their nutritional outcomes, measured by HAZ and WAZ. The effect was aggravated for height if the child was unwanted while there was a positive relationship between access to improved toilet facility and WHZ. Unwanted children were of higher birth order, with older, higher parity mothers than mistimed children. Many of the Roma children may be at risk of undernutrition, however, Roma children who received lower maternal investment in utero, unwanted and living in poorest households may face additional risk.

Sexual violence against women is commonly justified in sub-Saharan Africa (SSA) despite international commitments to halt it. This study investigated the association between healthcare decision-making capacity and the justification of sexual violence among women in SSA. We used current datasets of 30 sub-Saharan African countries published between January 2010 and December 2018. The sample included 259,885 women who were in sexual unions. We extracted and analysed the data with Stata version 14. Chi-square test and multilevel logistic regression models were used to analyse the data. Results for the regression analysis were presented as adjusted odds ratios (AOR) with their corresponding 95% confidence intervals (CIs). The results showed that women who decided on their healthcare alone had lower odds [AOR=0.93; CI=0.91–0.96] of justifying sexual violence compared to those who were not deciding alone. We also found that women aged 45-49 [AOR=0.85; CI=0.82-0.89], those with higher education [AOR=0.26; CI=0.24-0.29], cohabiting women (AOR=0.82, CI=0.80-0.85], richest women [AOR= 0.58; CI=0.56-0.60], women living in urban areas [AOR=0.74; CI=0.73-0.76], and Christians [AOR=0.52; CI=0.51-0.54] had lower odds of justifying wife beating if a woman refuses to have sex with her partner. On the contrary, women who engaged in agriculture had higher odds of justifying sexual violence than those who were not working [AOR=1.07; CI=1.04-1.09]. Groups that should be prioritised with anti-sexual violence initiatives are the poor, rural residents, and young women. It is also vital to institute policies and interventions focused on educating men about women’s right to make decisions, and why partner violence is unjust and intolerable.

Male involvement in family planning results in improved reproductive health and gender outcomes for women. In India, the use of family planning methods remains largely female-dominated. Recent media reports have indicated a rapid decline in male sterilization use in the past few years. This study aimed to assess the trends in, patterns of and factors associated with the use of male sterilization and male spacing methods in India using data from four rounds of the National Family Health Survey, conducted from 1992 to 2016. Bivariate analysis was done to see the trends in, and patterns of, male sterilization and spacing methods, while multinomial logistic regression was used to understand the factors associated with male spacing methods and sterilization. The results show a marked decline in the prevalence of male sterilization from 1992–93 (3.5%) to 2015–16 (0.3%) in India. Of the 640 districts, only 21 had a more than 2% prevalence of male sterilization. Scheduled tribe couples were two times more likely to use male sterilization than other (upper/no caste) groups. Couples from the northern region were significantly more likely to use male sterilization (aOR: 1.68, 95% CI: 1.43–1.97) compared with those from the south. There was a regional disparity in male condom use, with a very small proportion of couples in the southern (1.1%), north-eastern (2.4%) and eastern (3.3%) regions using the method compared with couples from the northern region (9.7%). Couples from the northern (aOR: 8.89, 95% CI: 8.44–9.38), north-eastern (aOR: 11.37, 95% CI: 10.62–12.18), eastern (aOR: 6.96, 95% CI: 6.60–7.34), western (aOR: 4.65, 95% CI: 4.40–4.92) and central (aOR: 10.89, 95% CI: 10.35–11.46) regions were also significantly more likely to use male spacing methods than those from southern India. Therefore, a greater focus on increasing the use of male sterilization and condoms is required in India to reduce the gender disparity in the use of family planning methods.

This study tracked the longstanding effect of childhood adversities on health status over the course of a life. This study used the data from China Health and Retirement Longitudinal Study which was a nationally representative survey and documented the generation who had arrived in the middle- and old-age phase and experienced the difficult time in the early founding of PR China in their childhood. Results shown the significant associations between multiple forms of children adversities (economic distress, child neglect, child abuse, lack of friends, parental mental health problems) and health status in adolescence (from 0.068 to 0.102, p<0.01), and health status in mid and late adulthood, including self-rated general health problems (from 0.039 to 0.061, p<0.01), chronic conditions (from 0.014 to 0.120, p<0.01 except for lack of friends), body aches (from 0.016 to 0.062, p<0.01 except for child neglect), and depression (from 0.047 to 0.112, p<0.01). Meanwhile, results also shown an underlying pathway (i.e., health status in adolescence) linking childhood adversities and health status in mid and late adulthood. Results suggested that the experience of multiple forms of adversities in childhood represented a substantial source of health risk throughout life.

People who are overweight and obese suffer from significant health impacts that have increased globally. Concurrently, usage of information and communication devices such as television and mobile phones have also been growing, affecting people’s weight. This study examined the association between watching television and owning a mobile phone with overweight and obesity among reproductive-aged women in low- and lower-middle-income countries (LLMICs). Data of 21 LLMICs reported between 2015 and 2020 were collected from the Demographic and Health Surveys. Multivariate logistic regression was performed to determine the association into three pooled segments: a group of 21 countries, the World Bank income classification and the regional categorisation of the countries. The all-inclusive prevalence of overweight or obesity was found at 27.1% among 175,370 reproductive-aged women, and this prevalence varied among countries. Overall, the odds of being overweight or obese were 1.20 (adjusted odds ratio [AOR]=1.20, 95% confidence interval [CI]: 1.15–1.24), 1.40 (AOR=1.40, 95% CI: 1.35–1.44) and 1.18 (AOR=1.18, 95% CI: 1.03–1.35) times higher among those who watched television less than once a week, at least once a week and almost every day, respectively, compared with those who did not watch television. Besides, women’s mobile phone ownership is more likely to experience overweight or obesity (AOR=1.72, 95% CI: 1.67–1.77). Consistent results were found for the countries categorised according to the World Bank income and regional classification. Focus on sedentary behaviour, such as television watching and mobile phone use, of women and regional or country-specific innovative strategies and programs are of great immediate importance to decrease the prevalence of overweight and obesity.

Non-communicable Diseases such as anaemia, hypertension and diabetes and their treatment may upsurge the risk of childbirth-related complications for both women and their babies. The present study is an attempt to assess the level and determinants of Anaemia, Hypertension and Diabetes among pregnant women using the fourth round of National Family Health Survey-4 (2015-16) data. Bivariate and logistic regression techniques have been used for data analysis. Study findings suggest that the prevalence of anaemia among pregnant women was found to be 25.9%, whereas the corresponding figure for hypertension and diabetes were 4.4% and 2.4%, respectively. Further, substantial socio-economic differentials have been observed in the prevalence of Anaemia, Hypertension and Diabetes among pregnant women. Results of regression analysis suggest that anaemia and hypertension were significantly higher among women in their third trimester [(OR = 2.10; p < 0.001) and (OR = 1.63; p < 0.001)], respectively, compared to women in the first trimester. Similarly, pregnant women in the age group 35-49 were at an elevated risk of hypertension (OR = 2.78; p < 0.001)) and diabetes (OR = 2.50; p < 0.001)) compared to women aged 15-24. Further, the risk of anaemia was found to be significantly lower among pregnant women from the richest quintile (OR = 0.71; p < 0.001) and women with higher educational level (OR = 0.72; p < 0.001) when compared to women from the poorest wealth quintile and women with no formal education respectively. Similarly, pregnant women from the richest quintile (OR = 1.68; p < 0.001) and women from other religion (OR = 1.75; p < 0.001) are significantly more likely to develop diabetes compared to women from the poorest quintile and women from the Hindu religion, respectively. In conclusion, early screening for predicting the risk of gestational anaemia, gestational diabetes, and gestational hypertension is critical in minimizing maternal and reproductive outcomes. The existing guidelines for Screening and Management of Gestational Diabetes, Gestational Hypertension need to be contextualized and modified according to a local need for effective treatment.

Schistosomiasis japonica remains a public health concern in many areas of the Philippines. Periodic Mass Drug Administration (MDA) to at-risk populations is the main strategy for morbidity control of schistosomiasis. Attaining MDA coverage targets is important for the reduction of morbidity and prevention of complications due to the disease, and towards achieving Universal Health Care. The study employed a qualitative case study design. Key informant interviews and focus group discussions were conducted to provide in-depth and situated descriptions of the contexts surrounding the implementation of MDA in two selected villages in known schistosomiasis-endemic provinces in Mindanao in the Philippines. Data analysis was done using the Critical Ecology for Medical Anthropology (CEMA) model coupled with the intersectionality approach. It was found that within various areas in the CEMA model, enabling as well as constraining factors have been encountered in MDA in the study settings. The interplay of income class, geographical location, gender norms and faith-based beliefs may have led to key populations being missed during the conduct of MDA in the study sites. The constraints faced by the target beneficiaries of MDA, as well as programme implementers, must be addressed to enhance service delivery and to control morbidity due to schistosomiasis. Improving compliance with MDA also requires a holistic, integrated approach to addressing barriers to participation, which are shaped by wider socio-political and power structures.

This study investigates regional variations in the factors associated with acceptance and actual experience of intimate partner violence (IPV) among married women in northern and southern Nigeria - two regions with distinct socio-cultural and economic differences. Data from the 2018 demographic and health survey are analysed to compare these two regions. The sample comprised married/living-with-partner women within the reproductive age of 15-49. Overall, a positive association exists between IPV experience and IPV acceptance, regardless of which is used as the outcome variable. Contrary to the notion that IPV is prevalent where its acceptance is high, this study finds that the reverse is true. IPV acceptance is significantly higher in the north than in the south (39.4% versus 14.7%), but the reverse is the case for the actual experience of IPV (20.1% versus 24.7%). Being employed and having access to the internet reduce the odds of IPV victimisation for women in the south, but increases the chances for northern women. Muslims in the north have significantly higher odds of IPV acceptance than their Christian counterparts in the same region, but the reverse is the case in the south. Regional differences also exist in the influence of decision-making, educational difference between spouses, and media exposure. While the cosmopolitan-success and conservative-failure hypothesis explains the regional differences in the acceptance of IPV, it fails to explain differences in the actual experience of IPV. The study provides alternative explanations for the regional differences in the experience of IPV and acceptance of it in Nigeria, and it points to the need for differing intervention programmes across regions. Notably, the study found that the association between justification of IPV and actual experience of it is bi-directional and suggests caution in making causal inferences.

For women who are trying to conceive, it is critical to assess their general knowledge regarding fertility and fertility-awareness practices to identify the fertile window and their agency to achieve pregnancy. The couple’s ability to deal with the infertility issue may be influenced by their beliefs and attitudes concerning infertility, which are based on social and cultural influences as well as their inner aspirations. As a result, it’s critical to examine infertile and fertile woman’s general knowledge of reproduction and infertility risk factors. It’s also crucial to learn about women’s attitudes toward infertility (social beliefs), as well as the repercussions of infertility and the practises they employ to avoid it. The present study includes 250 fertile and 250 infertile women. Data collection for infertile women was done from the Gynecology Outpatient Department (OPD). Participants from both groups i.e., infertile and fertile women have little knowledge about infertility but, infertile women have significantly higher knowledge than fertile women. Knowledge of the fertile period, as well as several potential causes of infertility, were found to be significantly higher in women with infertility problem rather than fertile women, indicating that the knowledge they have acquired is not attributable to education system, but rather to their experience gained during visits to medical practitioners. In addition to differences with respect to knowledge, infertile and fertile women differed in terms of both attitude (societal beliefs and social consequences of infertility) and practices. Better knowledge regarding infertility is likely to bring positive notes among women with infertility problems. Which will further improve the attitude and practices of society towards infertile women. Therefore, its crucial to introduce reproductive health education at high school or undergraduate level, to assist women in avoiding infertility and to help infertile women develop healthier attitudes regarding infertility treatment and coping techniques.

Nigeria accounts for a quarter of malaria cases worldwide, which can be prevented with the use of insecticide treated nets (ITN). While studies have documented mother-related characteristics influencing use of ITN, regional variations in the influence of those factors are not well known. This study investigated nine factors (age, place of residence, education, religion, wealth, number of children in the household, sex of child, age of child and previous experience of child mortality) as possible predictors of use of ITN for children and how the associations vary across northern and southern parts of the country. The study utilised the 2015 Nigeria Malaria Indicator Survey, which comprised 6524 mothers (4009 from the north and 2151 from the south) aged 15-49. Bivariate and multivariate logistic regression models were fitted. It was found that, less than half (47.9%) of the respondents reported no access to a mosquito net in the north compared to 70.8% in the south. More than half (51.4%) of the northern respondents used insecticide treated net (ITN) for the child compared to 27.1% of southern mothers. When the variables are fitted together in the same model, place of residence, mother’s age, mother’s education, wealth, religion, number of children in the household and previous experience of child mortality were associated with the use of ITN. Regional variations exist in the influence of mother’s age, number of children in the household and previous experience of child mortality. It was submitted that mother’s characteristics are more important than the child’s factors in the use of ITN, and that, contrary to the theory of poor utilisation of health-related facilities in the north compared to the south, residents in the former have access to and use ITN more than their counterparts from the latter.

Antenatal care (ANC) and facility delivery are essential maternal health services, but uptake remains low in north-western Nigeria. This study aimed to assess the psychosocial influences on pregnancy and childbirth behaviours in Nigeria. Data were from a cross-sectional population-based survey of randomly sampled women with a child under 2 years conducted in Kebbi, Sokoto and Zamfara states of north-western Nigeria in September 2019. Women were asked about their maternal health behaviours during their last pregnancy. Psychosocial metrics were developed using the Ideation Model of Strategic Communication and Behaviour Change. Predicted probabilities for visiting ANC four or more times (ANC4+) and giving birth in a facility were derived using mixed-effects logistic regression models adjusted for ideational and socio-demographic variables. Among the 3039 sample women, 23.6% (95% CI: 18.0–30.3%) attended ANC4+ times and 15.5% (95% CI: 11.8–20.1%) gave birth in a facility. Among women who did not attend ANC4+ times or have a facility-based delivery during their last pregnancy, the most commonly cited reasons for non-use were lack of perceived need (42% and 67%, respectively) and spousal opposition (25% and 27%, respectively). Women who knew any ANC benefit or the recommended number of ANC visits were 3.2 and 2.1 times more likely to attend ANC4+ times, respectively. Women who held positive views about health facilities for childbirth had 1.2 and 2.6 times higher likelihood of attending ANC4+ times and having a facility delivery, respectively, while women who believed ANC was only for sickness or pregnancy complications had a 17% lower likelihood of attending ANC4+ times. Self-efficacy and supportive spousal influence were also significantly associated with both outcomes. To improve pregnancy and childbirth practices in north-western Nigeria, Social and Behavioural Change programmes could address a range of psychosocial factors across cognitive, emotional and social domains which have been found in this study to be significantly associated with pregnancy and childbirth behaviours: raising knowledge and dispelling myths, building women’s confidence to access services, engaging spousal support in decision-making and improving perceived (and actual) maternal health services quality.

Short Birth Interval (SBI) is one of the main causes of adverse maternal and child health outcomes. A 33-month birth-to-birth interval between two successive live births should be followed to minimize the risk of adverse maternal and child health. This study aimed to examine the prevalence of SBI and the associated factors in rural India. Information on 98,522 rural mothers from the fourth round of National Family Health Survey data was analyzed. Bivariate statistics, logistic regression, Moran’s I, and Cluster and Outlier Analysis have been used to assess the prevalence and spatial pattern of SBI in rural India. Results revealed that about half of the mothers in rural India had experienced SBI. Rural Indian mothers whose child was not alive (OR = 1.76, 95% CI = 1.63–1.90), were not using any contraceptive methods (OR = 1.42, 95 % CI = 1.37–1.48) and not breastfeeding (OR = 2.73, 95% CI = 2.50–2.97) were more likely to experience SBI. On the other hand, rural mothers from the middle, richer and richest wealth quintiles (OR = 0.91, 95% CI = 0.86–0.97; OR = 0.84, 95% CI = 0.80–0.92; OR = 0.60, 95% CI = 0.55–0.66) and of age over 30 years (OR = 0.38., 95% CI = 0.36–0.39) were less likely to experience SBI. Analysis of spatial patterns revealed clear east-west differences in the prevalence of SBI. There was strong clustering of high values of SBI in most districts across the central, northern, western, and southern regions. The study suggests the need to introduce appropriate interventions and programs focused on reducing the prevalence of SBI in rural India.

Hypertension is considered one of the most persistent public health issues and the single largest contributor to avoidable morbidity and mortality in India. This study aims to investigate the prevalence and risk factors of hypertension in youths (15-29 years) by gender and rural-urban place of residence. Data from the fourth round of the National Family and Health Survey – 2015-16 (n = 395,207) was utilised for the study. After estimation of the stratified prevalence of hypertension by various characteristics, multivariable logistic regression analysis was conducted to assess the correlates of hypertension. The results revealed that the prevalence of hypertension in youths at the national level varied from 9.16% (Meghalaya) to 3.34% (Delhi). The stratified analysis suggests pronounced gender differences in the prevalence of hypertension among youth with insignificant rural-urban differences, although the prevalence was higher in urban areas. Overall, the prevalence of hypertension was found higher for male youths living in urban areas (7.82%) and females in rural areas (5.08%). Concurrently, results from regression analysis also suggest higher odds of hypertension for males residing in urban areas for a variety of demographic, socioeconomic, and health-risk factors. Advancing age, having no education, living in the northeast region, being overweight/obese and high blood glucose level was significantly associated with a greater likelihood of hypertension for both the gender and place of residence. Public health awareness regarding blood pressure needs to be tailored differently for both males and females considering the place of residence. The study suggests that more research should focus on blood pressure/hypertension among children, adolescents and youth since they point towards adult blood pressure patterns.

Increasing women’s knowledge about maternal health is an important step towards empowering them and making them aware of their rights and health status, allowing them to seek appropriate health care. In Yemen, the ongoing conflict has hampered the delivery of health information to women in public health facilities. This study examined rural women’s knowledge of, and attitude towards, maternal and child health in Yemen and identified the factors associated with good maternal health knowledge. The study was conducted between August and November 2018. A sample of 400 women aged 15–49 years who had delivered in the 6 months prior to the survey were systematically selected from selected public health facilities in Abyan and Lahj. Women were interviewed using a structured questionnaire to gather data on their demographic and economic characteristics, obstetric history and responses to health knowledge and attitude questions. Women’s knowledge level was assessed as poor or good using the mean score as a cut-off. Chi-squared test and multiple logistic regression analysis were used to identify statistically significant factors associated with good maternal health knowledge. The percentage of women who had good knowledge was 44.8% (95% CI: 39.8–49.8). Women’s attitude towards maternal health was negative in the areas of early ANC attendance, managing dietary regime and weight during pregnancy, facility delivery, PNC visits, cord care and mother and child health management. Women with primary education, whose husbands had received no formal education, who had their first ANC visit from the second trimester of pregnancy and who had fewer than four ANC visits were more likely to have poor health knowledge. Conversely, those with higher household income and only one child were more likely to have good maternal health knowledge. Overall, women’s knowledge on maternal and child health care in rural areas of Yemen was low. Strategies are needed to increase rural women’s knowledge on maternal and child health in this conflict-affected setting.

The study investigates the statistical relationship between male circumcision and HIV prevalence in Africa, in the context of the Voluntary Medical Male Circumcision (VMMC) campaigns in place since 2008. Data from the Population-based HIV Impact Assessment (PHIA) surveys conducted in African countries in 2017-2018 were utilized. Six countries with high HIV prevalence, low traditional circumcision and large VMMC programs were selected: Eswatini, Lesotho, Malawi, Namibia, Zambia, Zimbabwe. The statistical analysis investigated the relative risk (RR) of HIV prevalence by circumcision status (circumcised vs intact) among men age 20-59, and the age-incidence of HIV in the two groups among men age 20-49, defined as the linear-logistic slope of the relationship between prevalence and age. Results show that the standardized RR was not different from 1 at older ages (50-59): RR = 0.923, 95% CI = 0.769-1.108, P = 0.390. Furthermore, the age-incidence was at least as high or higher among the circumcised groups than among the intact groups. The standardized RR was lower than 1 at younger ages, and this could be explained by selection biases. HIV prevalence at age 40-59 (27.3%) was also the same in the four groups of circumcision status (intact, traditional, medical, unknown). Results matched earlier observations made in South Africa that circumcised and intact men had similar levels of HIV infection. The study questions the current strategy of large scale VMMC campaigns to control the HIV epidemic. These campaigns also raise a number of ethical issues.

India has a very high prevalence of female sterilisation compared to other countries in the world, with a prevailing situation of very low level of information about contraceptive options given to women. It is well established in demographic research that, there exists a strong association between knowledge of contraceptive methods and type of contraception chosen. Present study uses data from 3 consecutive rounds of National Family Health Survey (3, 4 & 5). The sample contains currently married women who started using the current method 5 years prior to each round of survey. Multilevel Logistic Regression and Fairlie Decomposition Model are used to analyse the effect of information given to respondents and decision-making power regarding contraceptive methods on choice of female sterilisation. Women, who are informed about available methods, have lower chance (45.8%, 37.5% & 40% for NFHS 3, 4 & 5 respectively) to opt for sterilisation after controlling all other factors. If woman is the sole decision maker for contraceptive choice, the chance of sterilisation reduces than cases where decision is taken only by husband or jointly. Information about other methods also contributes towards reducing the chance of female sterilisation over the time. Information about contraceptive methods is found to be a major factor in controlling choice of temporary or permanent method. Thus, major focus for the policy makers should be to make information regarding contraceptives more accessible for women.

Despite a significant drop in maternal mortality in Bangladesh, unsafe abortion remains a critical maternal health issue that could be reduced by promoting menstrual regulation (MR). This study aimed to investigate the prevalence and determinants of MR use among ever-married women as well as to identify the socioeconomic inequalities in MR use in Bangladesh. The latest Bangladesh Demographic and Health Survey (BDHS) 2017-18 data were used in this study. We used a sub-sample of 12,586 ever-married women aged 15 to 49 years for this study. To identify the determinants of MR, multilevel (mixed-effect) binary logistic regression analysis was used while accounting for potential between-clusters variations. The weighted prevalence of MR was 7.64% (95% CI: 7.19 - 8.12). Women of aged 20-29 years (AOR: 2.50, 95% CI: 1.46, 4.30) and ≥ 30 years (AOR: 4.17, 95% CI: 2.39, 7.26), from urban areas (AOR: 1.24, 95% CI: 1.04, 1.47), having one or two children (AOR: 1.96, 95% CI: 1.25, 3.09) and ≥ 3 children (AOR: 2.26, 95% CI: 1.40, 3.65), who used traditional contraceptive method (AOR: 1.39, 95% CI: 1.12, 1.73), and from Barishal division (AOR: 1.44, 95% CI: 1.08, 1.93) were more likely to have MR. Women were less likely to have MR if they were from Chittagong (AOR: 0.62, 95% CI: 0.46, 0.84) and Mymensingh (AOR: 0.51, 95% CI: 0.36, 0.73) divisions. MR use was found to be higher among higher socioeconomic status (SES) groups as the concentration index (CIX) value was positive and the Lorenz curve lay below the line of equality (CIX: 0.095, p<0.001). Health policy and intervention design should prioritize minimizing socioeconomic inequities concerning MR services.

In recent years, studies show that obesity has become an important health condition, especially among adults. The first aim of this study is to examine socio-demographic and behavioural factors on body mass index distribution of male and female adults over 20 years old in Turkey. The second aim is to determine the body mass index disparity by gender and the socio-demographic and behavioural factors that might wider or narrow it. This study adopts unconditional quantile regression and decomposition methods, and the data set covers the Turkish Health Surveys for 2014, 2016, and 2019. The findings document that high level of body mass index are associated with being married, aging, and physical inactivity. Interestingly, employment status has different contributions on the body mass index of males and females. The results also claim a body mass index gap among males and females as a result of differences in some potential socio-demographic and behavioural factors, and the gap gets higher at the upper and lower quantiles of BMI distribution. This study may provide a clear understanding for policymakers on how to design efficacious obesity policies considering the differences in the effect of socio-demographic and behavioural factors on the distribution of body mass index across females and males. The results suggest that the Ministry of Health should specifically target different groups for males and females and should reduce the differences in socio-demographic and behavioural determinants between females and males to prevent and reduce obesity prevalence in Turkey.

Childhood obesity/overweight is a worldwide concern and its prevalence is increasing in many countries. The first aim of this study is to analyse the trends in overweight and obesity among children under the age of five in Turkey based on the new World Health Organization (WHO) standards, using data from the ‘five-round of the Turkey Demographic and Health Surveys’ (TDHSs). The second aim is to examine whether or not the maternal/household and individual-level factors are associated with overweight/obesity using TDHS 2003, 2008, and 2013 datasets. A total sample of 14,231 children under the age of five were extracted from the TDHS in 1993, 1998, 2003, 2008, and 2013 to determine the prevalence of the trend. Pooled data from 8,812 children were included in the analysis to examine factors associated with overweight/obesity. Taking into account the clustered data structure, multilevel logistic regression models were utilised. In 1993, 1998, 2003, 2008, and 2013 the prevalence of overweight children was 5.3%, 4.9%, 10.0%, 11% and 11.6%, respectively. The factors that were independently associated with overweight/obesity were as follows: living in single-parent households (adjusted odds ratio (aOR) = 2.27, 95%CI = 1.21–4.26), compared to living in dual-parent households; having an obese mother (aOR = 4.25, 95%CI = 1.73–10.44), overweight mother (aOR = 3.15, 95%CI = 1.29–7.69), and a normal-weight mother (aOR = 2.70, 95%CI = 1.11–6.59) compared to having an underweight mother; being aged between 13–24 months (aOR = 1.72, 95%CI = 1.30 to 2.27), compared to being aged 0-12 months; male gender (aOR = 1.30, 95%CI = 1.11 to 1.53); being stunted (aOR = 2.18, 95%CI = 1.74 to 2.73); high birth weight (aOR = 1.55, 95%CI = 1.08 to 2.23) compared to low birth weight. In addition, overweight was higher in children of mothers who had completed primary school (aOR = 1.21, 95%CI = 1.01 to 1.59) than children of mothers who had not completed primary school. These findings reveal that, over the years, there has been a substantial increase in obesity/overweight among children which demonstrates the importance of evaluating the overweight indicators at the maternal/household level.