Health transition review 

About: Health transition review is an academic journal. The journal publishes majorly in the area(s): Population & Acquired immunodeficiency syndrome (AIDS). It has an ISSN identifier of 1036-4005. Over the lifetime, 259 publications have been published receiving 9383 citations.

Women's Education, Child Welfare and Child Survival: A Review of the Evidence

Abstract: J. C. Caldwells 1979 paper on Nigeria suggested several pathways whereby the mothers education might enhance child survival. The World Fertility Survey (WFS) program considerably increased knowledge about the links between maternal education and child survival during the 1980s. Some of the areas improved by maternal education included cleanliness health services utilization child quality and the empowerment of women. Life events of the mother also exerted child survival effects: e.g. prenatal care vaccination for tetanus and type of assistance at delivery. Large differences according to maternal education were found for prenatal care in Bolivia and Egypt but there was much less difference in Kenya according to Demographic and Health Surveys (DHS) data. Educated women were much more likely to be attended by a trained person at delivery. Tetanus immunization differentials were small for Egypt and Kenya but substantial for Bolivia. Several multivariate analyses for 25 DHS surveys indicated that the odds of dying before age 2 for a child born to a mother with 7 or more years of education were only 42.5% compared with the children of uneducated mothers. The association of child survival with maternal education was weaker in sub-Saharan African countries possibly attributable to greater female autonomy child fostering and extreme hardship. Another analysis covering 17 DHS surveys and ages 1-24 months found that neonatal mortality was less sensitive to maternal education than mortality in the next 23 months. Stunting in early life was strongly related to maternal education but not as strongly as mortality at age 1-24 months. Maternal education was also strongly associated with immunization coverage and children of uneducated mothers were far less likely to be immunized. In addition diarrhea was at least 20% higher among children of uneducated mothers while more educated mothers were more likely to utilize health services for childhood diseases.

Utilization of maternal health-care services in Peru: the role of women's education.

Abstract: The hypothesis that maternal education influences use of maternal health care services in Peru was analyzed by 4 logistic regression models using data from the Peruvian Demographic and Health Survey of September-December 1986. Peru has one of the highest child-mortality rates in the region with extreme variation across regions of the country ranging from 34/1000 in Lima to 110/1000 in the Andean mountains. The conceptual framework for this study was the health-seeking model of Kroger who proposed that utilization depends on predisposing factors including education characteristics of the illness and of the health-care system. This study analyzed 1925 births the last births to 4999 ever-married women in the 5 years before the survey. The 2 dependent variables were sources of prenatal care and assistance at delivery. 60.1% of the women had formal prenatal care and 54.9% had formal delivery assistance for their last birth. The bivariate effects of maternal schooling were strongly associated with use of health care with relative odds of 47.47 for delivery assistance and 25.37 for prenatal care. Controlling for the womans childhood background in Model 2 reduced the odds to 13.6 and 19.69 respectively. In model 3 access to care reduced relative odds to 8.33 for prenatal care and 10.70 for delivery assistance. Taking into account the household socioeconomic status in Model 4 reduced significance of the results. The results indicated that maternal education has a profound effect on seeking medical care but in Peru the lack of access to care in the outlying rural areas supersedes maternal education.

Sexual decision-making and negotiation in the midst of AIDS: youth in KwaZulu-Natal South Africa.

Abstract: The most recent national survey conducted in South Africa identified an 18.2% prevalence of HIV infection in KwaZulu/Natal province 26% higher than the level of infection during the preceding year. With half of KwaZulu/Natals population aged 19 years or younger 2.6 million people are of an age where they have recently begun or will soon begin sexual activity exacerbating the situation with regard to HIV. 24 Black African men aged 18-26 of mean age 24 who had been involved in sexual relationships with adolescent girls which had resulted in pregnancy and subsequent parenthood within the previous 3 years and 39 Black African primigravida women aged 15-19 of mean age 18 attending antenatal clinics were interviewed in a study of sexual negotiation and decision-making among Black South African youth in the context of AIDS. All study participants were unmarried. Communication between partners was poor and young women seemed powerless to enforce their preferences in sexual situations. AIDS was not a significant factor in any aspect of sexual decision-making. Sociocultural factors and the state of the HIV pandemic in South Africa are discussed in relation to the study findings.

Determinants of maternal care in a region of South India

Abstract: A cross-sectional survey was conducted during 1993 in urban and rural areas of Karnataka State, India. The survey included 3595 currently married women aged under 35, who had at least one child under five. Nine out of ten women had at least one antenatal consultation during their most recent fertile pregnancies. Most consultations were with doctors and there was minimal use of the services provided by paramedical staff of the primary health care system. Of all respondents, 38 per cent (57% urban and 29% rural) delivered in a hospital, and a majority of institutional deliveries were in private hospitals. Surgical interventions were made in more than one-third of hospital deliveries. There was a marked imbalance between antenatal and postnatal care as fewer than one-fifth of the mothers had a postnatal checkup. The educational level, economic status and religion of the mother are significant predictors of use of maternal health services. The relationship of problems during pregnancy and delivery with subsequent health-related behaviour is also examined. One of the dominant themes of the International Conference on Population and Development held in Cairo in September 1994 was reproductive health. This has been defined as a state in which People have the ability to reproduce and regulate their fertility; women are able to go through pregnancy and childbirth safely; the outcome of pregnancy is successful in terms of maternal and infant survival and well being; and couples are free to have sexual relations free of the fear of pregnancy and of contracting disease (Fathalla 1988). Maternal health services have a potentially critical role to play in the improvement of reproductive health. There is little doubt that access to skilled assistance and well equipped health institutions during delivery can reduce maternal mortality and morbidity and improve pregnancy outcomes. The effectiveness of routine antenatal and postnatal care is less certain. However, a few hospital based studies (Melrose 1984; Boes 1987a, b) and some community * The Ford Foundation provided financial support for the study, which is gratefully acknowledged. We would also like to record the hard and diligent work of Dr N.S.N. Rao in the organization and supervision of field work and the able assistance provided by Mr N.S. Sanath Kumar and Mr S. Ramaswamy in data processing. The interviewers, who collected data under rigorous field conditions, deserve our appreciation and commendation. Thanks are also due to the Karnataka health and ICDS officials for their full support and co-operation in the conduct of this study.

Elements for a theory of the health transition

Abstract: This article presents the basic elements for developing a theory of the health transition. Such elements include the definition of concepts the specification of a framework on the determinants of health status the analysis of the mechanisms through which health change occurs in populations the characterization of the attributes that allow us to identify different transition models and the enumeration of the possible consequences of the transition. The propositions are presented with a sufficient level of generality as to make them applicable to different contexts; at the same time an attempt is made to provide them with the necessary specificity to account for different national experiences thus opening a space for future comparative research efforts. The geographic scope is worldwide. (EXCERPT)