The impact of women's social position on fertility in developing countries

This paper examines ideas about possible ways in which the extent of women's autonomy, women's economic dependency, and other aspects of their position vis-à-vis men influence fertility in Third World populations. Women's position or “status” seems likely to be related to the supply of children because of its links with age at marriage. Women's position may also affect the demand for children and the costs of fertility regulation, though some connections suggested in the literature are implausible. The paper ends with suggestions for future research.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45660/1/11206_2005_Article_BF01124382.pd

Understanding the impact of gendered roles on the experiences of infertility amongst men and women in Punjab

<p>Abstract</p> <p>While infertility is a global challenge for millions of couples, low income countries have particularly high rates, of up to 30%. Infertility in these contexts is not limited to its clinical definition but is a socially constructed notion with varying definitions. In highly pronatalistic and patriarchal societies like Pakistan, women bear the brunt of the social, emotional and physical consequences of childlessness. While the often harsh consequences of childlessness for Pakistani women have been widely documented, there is a dearth of exploration into the ways in which prescribed gender roles inform the experiences of childlessness among Pakistani women and men. The aim of this study was to explore and compare how gender ideologies, values and expectations shape women’s and men’s experiences of infertility in Pakistan. Using an interpretive descriptive approach, in-depth interviews were conducted with 12 women and 8 men experiencing childlessness in Punjab, Pakistan from April to May 2008. Data analysis was thematic and inductive based on the principles of content analysis. The experience of infertility for men and women is largely determined by their prescribed gender roles. Childlessness weakened marital bonds with gendered consequences. For women, motherhood is not only a source of status and power, it is the only avenue for women to ensure their marital security. Weak marital ties did not affect men’s social identity, security or power. Women also face harsher psychosocial, social, emotional and physical consequences of childlessness than men. They experienced abuse, exclusion and stigmatization at the couple, household and societal level, while men only experienced minor taunting from friends. Women unceasingly sought invasive infertility treatments, while most men assumed there was nothing wrong with themselves. This study highlights the ways in which gender roles and norms shape the experiences associated with involuntary childlessness for men and women in Punjab, Pakistan. The insight obtained into the range of experiences can potentially contribute to deeper understanding of the social construction of infertility and childlessness in pronatalistic and patriarchal societies as well as the ways in which gender ideologies operationalise to marginalise women.</p

Risk of COVID-19 after natural infection or vaccinationResearch in context

Summary: Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health

Risk of COVID-19 after natural infection or vaccinationResearch in context

Background: While vaccines have established utility against COVID-19, phase 3 efficacy studies have generally not comprehensively evaluated protection provided by previous infection or hybrid immunity (previous infection plus vaccination). Individual patient data from US government-supported harmonized vaccine trials provide an unprecedented sample population to address this issue. We characterized the protective efficacy of previous SARS-CoV-2 infection and hybrid immunity against COVID-19 early in the pandemic over three-to six-month follow-up and compared with vaccine-associated protection. Methods: In this post-hoc cross-protocol analysis of the Moderna, AstraZeneca, Janssen, and Novavax COVID-19 vaccine clinical trials, we allocated participants into four groups based on previous-infection status at enrolment and treatment: no previous infection/placebo; previous infection/placebo; no previous infection/vaccine; and previous infection/vaccine. The main outcome was RT-PCR-confirmed COVID-19 >7–15 days (per original protocols) after final study injection. We calculated crude and adjusted efficacy measures. Findings: Previous infection/placebo participants had a 92% decreased risk of future COVID-19 compared to no previous infection/placebo participants (overall hazard ratio [HR] ratio: 0.08; 95% CI: 0.05–0.13). Among single-dose Janssen participants, hybrid immunity conferred greater protection than vaccine alone (HR: 0.03; 95% CI: 0.01–0.10). Too few infections were observed to draw statistical inferences comparing hybrid immunity to vaccine alone for other trials. Vaccination, previous infection, and hybrid immunity all provided near-complete protection against severe disease. Interpretation: Previous infection, any hybrid immunity, and two-dose vaccination all provided substantial protection against symptomatic and severe COVID-19 through the early Delta period. Thus, as a surrogate for natural infection, vaccination remains the safest approach to protection. Funding: National Institutes of Health