Influence of women's autonomy on infant mortality in Nepal

<p>Abstract</p> <p>Background</p> <p>Nepalese women lag behind men in many areas, such as educational attainment, participation in decision-making and health service utilization, all of which have an impact on reproductive health outcomes. This paper aims to examine the factors influencing infant mortality, specifically, whether women's autonomy has an impact on infant mortality in the Nepali context.</p> <p>Methods</p> <p>Data were drawn from the Nepal Demographic and Health Survey, 2006. The analysis is confined to 5,545 children who were born within the five years preceding the survey. Association between infant mortality and the explanatory variables was assessed using bivariate analysis. Variables were then re-examined in multivariate analysis to assess the net effect of women's autonomy on infant mortality after controlling for other variables.</p> <p>Results</p> <p>The infant mortality rate (IMR) in the five years preceding the survey was 48 deaths per one thousand live births. Infant mortality rate was high among illiterate women (56 per 1000 live births) and among those not involved in decision making for health care (54 per 1000 live births). Furthermore, infant mortality was high among those women who had more children than their comparison group, who had birth intervals of less than two years, who had multiple births, who were from rural areas, who were poor, whose source of water was the river or unprotected sources, and who did not have a toilet facility in their household.</p> <p>Results from logistic regression show that women's autonomy plays a major role in infant mortality after controlling other variables, such as mother's sociodemographic characteristics, children's characteristics and other household characteristics. Children from literate women had a 32 percent lower chance (OR = 0.68) of experiencing infant mortality than did children from illiterate women. Furthermore, infants of women who were involved in decision-making regarding their own health care had a 25 percent lower (OR = 0.75) chance of dying than did infants whose mothers who were not involved in healthcare decisions.</p> <p>Conclusion</p> <p>Infant mortality is high in Nepal. In this context, mother's literacy and involvement in healthcare decision making appear to be the most powerful predictors for reducing infant mortality. Hence, in order to reduce infant mortality further, ongoing female education should be sustained and expanded to include all women so that the millennium development goals for the year 2015 can be attained. In addition, programs should focus on increasing women's autonomy so that infant mortality will decrease and the overall well being of the family can be maintained and enhanced.</p

Stereo-Selectivity of Human Serum Albumin to Enantiomeric and Isoelectronic Pollutants Dissected by Spectroscopy, Calorimetry and Bioinformatics

1–naphthol (1N), 2–naphthol (2N) and 8–quinolinol (8H) are general water pollutants. 1N and 2N are the configurational enantiomers and 8H is isoelectronic to 1N and 2N. These pollutants when ingested are transported in the blood by proteins like human serum albumin (HSA). Binding of these pollutants to HSA has been explored to elucidate the specific selectivity of molecular recognition by this multiligand binding protein. The association constants (Kb) of these pollutants to HSA were moderate (104–105 M−1). The proximity of the ligands to HSA is also revealed by their average binding distance, r, which is estimated to be in the range of 4.39–5.37 nm. The binding free energy (ΔG) in each case remains effectively the same for each site because of enthalpy–entropy compensation (EEC). The difference observed between ΔCpexp and ΔCpcalc are suggested to be caused by binding–induced flexibility changes in the HSA. Efforts are also made to elaborate the differences observed in binding isotherms obtained through multiple approaches of calorimetry, spectroscopy and bioinformatics. We suggest that difference in dissociation constants of pollutants by calorimetry, spectroscopic and computational approaches could correspond to occurrence of different set of populations of pollutants having different molecular characteristics in ground state and excited state. Furthermore, our observation of enhanced binding of pollutants (2N and 8H) in the presence of hemin signifies that ligands like hemin may enhance the storage period of these pollutants in blood that may even facilitate the ill effects of these pollutants

Maternal health in resource-poor urban settings: how does women's autonomy influence the utilization of obstetric care services?

Background: Despite various international efforts initiated to improve maternal health, morethan half a million women worldwide die each year as a result of complications arising frompregnancy and childbirth. This research was guided by the following questions: 1) How doeswomen's autonomy influence the choice of place of delivery in resource-poor urban settings? 2)Does its effect vary by household wealth? and 3) To what extent does women's autonomy mediatethe relationship between women's education and use of health facility for delivery?Methods: The data used is from a maternal health study carried out in the slums of Nairobi, Kenya.A total of 1,927 women (out of 2,482) who had a pregnancy outcome in 2004–2005 were selectedand interviewed. Seventeen variable items on autonomy were used to construct women's decisionmaking,freedom of movement, and overall autonomy. Further, all health facilities serving the studypopulation were assessed with regard to the number, training and competency of obstetric staff;services offered; physical infrastructure; and availability, adequacy and functional status of suppliesand other essential equipment for safe delivery, among others. A total of 25 facilities weresurveyed.Results: While household wealth, education and demographic and health covariates had strongrelationships with place of delivery, the effects of women's overall autonomy, decision-making andfreedom of movement were rather weak. Among middle to least poor households, all threemeasures of women's autonomy were associated with place of delivery, and in the expecteddirection; whereas among the poorest women, they were strong and counter-intuitive. Finally, thestudy showed that autonomy may not be a major mediator of the link between education and useof health services for delivery.Conclusion: The paper argues in favor of broad actions to increase women's autonomy both asan end and as a means to facilitate improved reproductive health outcomes. It also supports thecall for more appropriate data that could further support this line of action. It highlights the needfor efforts to improve households' livelihoods and increase girls' schooling to alter perceptions ofthe value of skilled maternal health care

Technology as a disruptive agent: Intergenerational perspectives

YesThis study explores how British South Asian parents perceive their children’s technology consumption through their collectivist lenses and interdependent values. The findings for this qualitative study indicate that second and third generation South Asian parents acknowledge the benefits of children’s technology use; but largely perceive technology as a disruptive agent, whereby children are becoming isolated and increasingly independent within the household. The analysis aims to understand how parents view their children’s relationship with others as a result of technology consumption. Accordingly, this paper proposes an extension of the Construal of self conceptualisation and contributes a Techno-construal matrix that establishes a dyadic connection between technology consumption and cultural values. Overall, the study reveals that children display less inter-reliance and conformance typically associated with collectivist cultures, resulting from their technology use. Consequently, parents interpret their children’s shift from interdependence to more independence as a disruptive and unsettling phenomenon within the household