Improving Women’s Education Improves Maternal Health: Evidence from Peru

Maternal mortality in Peru declined over 70 percent between 1990 and 2015. Women’s education levels rose during the same period. This brief by PRC faculty research associate Abigail Weitzman indicates that Peruvian women’s rising education levels contributed to falling maternal mortality rates by reducing the risk of maternal complications and increasing the use of modern contraception and reproductive healthcare.Population Research Cente

The Prevalence, Frequency and Social Ecology of Sexual Concurrency Among Young Adult Women

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156152/2/psrh12149.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156152/1/psrh12149_am.pd

The Impact of the Zika Epidemic on Women’s Reproductive Intentions and Behaviors in Brazil

This research brief reports on a focus group study that explores how and why the Zika virus affects reproductive processes in Brazil. The authors found that both reproductive intentions and behaviors changed as a result of the Zika epidemic among women from low and high socioeconomic status groups in two areas of Brazil. The authors argue that Brazilian health officials and policymakers should reduce barriers to contraceptive use, address longstanding disparities in reproductive health services that put low-income women at disproportionate risk of an unwanted pregnancy, legalize abortion, and show respect and support to women who actively pursue pregnancy during the Zika epidemic.Population Research Cente

Sibling mortality burden in low-income countries: A descriptive analysis of sibling death in Africa, Asia, and Latin America and the Caribbean.

In high-income countries, emerging research suggests sibling bereavement can have significant health and life course consequences for young people. Yet, we know far less about its burden in lower-income countries. Due to higher fertility and mortality in lower-income countries, the level, timing, intensity, and circumstances surrounding sibling mortality are likely to follow patterns distinct from those in higher-income settings. Thus, in this study, we offer a descriptive overview of sibling death in 43 countries across sub-Saharan Africa, South and Southeast Asia, and Latin America and the Caribbean. Specifically, we analyze Demographic and Health Survey data from nationally representative samples of 352,930 15- to 34-year-old women, born between 1985 and 2003, to document experiences of sibling death before age 25. On average, roughly one-third of individuals report a deceased sibling in these countries; estimates reach 40-50% of respondents in multiple African countries, particularly those that have experienced conflict and war. Although some sibling deaths occurred before the focal respondent was born, most bereaved individuals recalled a death during their lifetime-often in late childhood/early adolescence. High proportions of bereaved respondents report multiple sibling deaths, highlighting the clustering of deaths within families. Even so, bereaved individuals tend to come from large families and thus frequently have a comparable number of surviving siblings as people who never experienced a sibling die. Together, the results offer a window into global inequality in childhood experiences, and they attest to the need for research that explores the implications of sibling mortality for young people in world regions where the experience is concentrated

Confident, moderate, reluctant: Young women’s trajectories in their willingness to refuse unwanted sex

Unwanted sex is widely experienced by young women in the United States, and previous research has identified the factors associated with young women agreeing to have unwanted sex. However, much less is known about young women’s willingness to refuse sex. This brief, from PRC faculty research associate Abigail Weitzman and PRC graduate student trainee Allen Mallory, reports on a study that is the first of its kind to examine this willingness to refuse sex and explore how it evolves during the transition to adulthood. They find that young women follow three trajectories in their willingness to refuse unwanted sex: confident, moderate, and reluctant.Population Research Cente

Replication Materials for: Multi-Sited Analysis of Migration, Fertility, and Contraception in France

Drawing on research that takes a transnational perspective, we standardize and integrate data collected in France (the destination country in our study) and data collected in six high-fertility African countries (the senders). Descriptively we show that African migrants in our sample have higher children ever born (CEB) than native-French women, but lower CEB than women in corresponding origin countries, thus suggesting that socialization into pronatalist norms is an incomplete explanation for migrant fertility in the first generation. We go on to test alternative explanations for migrant fertility by conducting multivariate analyses with entropy balancing that weight migrants’ background characteristics to resemble women in both origin and destination countries. Results are supportive of both selection and adaptation perspectives, although we find little evidence of migration-related disruption of childbearing. In a secondary analysis, we conduct a multi-sited analysis of migration and contraceptive use by standardizing and integrating a sample of African migrants in France from six West and Central African countries in the Trajectoires et Origines survey with a sample of women living in the same six African countries in the Demographic and Health Surveys. Descriptive analyses indicate that the contraceptive use of migrants in the sample more closely aligns with native-French women than women from origin countries. In particular, migrants report dramatically higher use of long-acting reversible contraception and short acting hormonal methods of contraception and lower use of traditional methods of contraception compared to women in countries of origin. Though migrants differ from women in countries of origin on observed characteristics including education and family background, re-weighting women in origin countries to resemble migrants on these observed characteristics does little to explain differences in contraceptive use between the two groups. A third paper focuses on Turkish migrants to France. Descriptive analyses indicate that contraceptive use of migrant women from Turkey in France is more comparable to that of non-migrant women in France compared to non-migrant women in Turkey. To address migrant selectivity on observed characteristics in multivariate analyses, non-migrant groups in France and Turkey are re-weighted with entropy balancing to resemble migrants on observed characteristics. Multivariate results indicate that there are sizeable differences in contraceptive usage between Turkish migrants and non-migrant Turkish women, which undermines the hypothesis of selection on observables. Yet, there are no significant differences between migrants and non-migrant French women in contraceptive methods, thus supporting an adaptation perspective. Supplementary analyses highlight several pathways that could help explain these findings

Zika virus public health crisis and the perpetuation of gender inequality in Brazil

Background In 2015–2017, the Americas experienced a highly consequential epidemics for pregnancy and childbearing. Mainly transmitted by the mosquito Aedes aegypti, but also through sexual intercourse, the Zika virus poses the risk of congenital Zika syndrome to fetus, which includes microcephaly and other child development complications. When a public health crisis taps directly into reproductive health, typically a feminine realm, responses to the emergency may exacerbate deeply-rooted gender norms. This paper investigates the role of gender in two relational contexts: (a) the government-led response to the pandemic in terms of communication campaigns aimed at preventing Zika infections; and (b) an individual level of response to the emergency, concerning women’s negotiation with their sexual partners with regard to the prevention of Zika as well as pregnancies. Methods We conducted content analysis of 94 unique pieces from public health communication campaigns produced by governmental agencies with the goal of promoting Zika awareness. Print and online materials were collected from May 2016 to August 2017, and included TV ads, Internet Pop-ups, and pamphlets. We also analyzed transcripts from 16 focus groups conducted with reproductive-aged women (18–40) in Belo Horizonte and Recife, two large cities differently affected by the Zika outbreak. Women answered open-ended questions connected to the epidemic, in areas such as personal knowledge and experiences with the Zika virus, experiences of their friends and acquaintances, their primary information sources, their perceptions of public health efforts toward containing the outbreak, as well as women’s contraceptive use. Results Campaign pieces handling pregnancy and microcephaly were largely gendered. Pieces targeted women, placing on their shoulders the responsibility for protecting a potential fetus from the disease. Importantly, campaigns neglected addressing male’s participation on Zika prevention and contraceptive management, while failing to take into account Brazil’s large proportion of unplanned pregnancies. Women were placed in a double bind by being expected to prevent both pregnancy and Zika, in a context where gendered power imbalances often translate in women having little power/means for condom negotiation/avoiding unprotected sexual intercourse. Conclusion Government and individual responses to the epidemics reinforced gender roles, situating pregnant women as responsible for averting mosquito bites and microcephaly. Further, prevention campaigns largely excluded men. Since low-socioeconomic status women possessed fewer resources to preclude infection, we also found that beyond the gender divide, this subgroup faced more pronounced Zika prevention challenges as they found it harder to negotiate condom use with their sexual partners and often could not access other types of contraceptives resulting in unplanned pregnancies

Household sanitation facilities and women’s risk of non-partner sexual violence in India

Abstract Background Globally, one in ten individuals practice open defecation. Despite media speculation that it increases women’s risk of sexual violence, little empirical evidence supports the claims. We investigate the relationship between household sanitation facilities and women’s risk of non-partner sexual violence (NPSV) in India, where nearly half of the population lives without a pit or toilet. Methods We use the most recent NPSV data, from the National Family Health Survey-III, to estimate logistic regression models of the effects of household sanitation facilities (toilet, pit, or none) on NPSV in the last year among women who have resided in their current home for one year or more. These effects are estimated net of other socioeconomic factors, compared to effects of household sanitation facilities on child diarrhea, and, as a falsification test, compared to effects of household sanitation facilities on intimate partner sexual violence (IPSV) in the last year. Results Net of their socioeconomic status, women who use open defecation are twice as likely to face NPSV as women with a household toilet. This is twice the association between open defecation and child diarrhea. The results of our falsification test indicate that open defecation is not correlated with IPSV, thus disconfirming a simultaneous selection of women into open defecation and sexual violence. Conclusions Our findings provide empirical evidence that lacking household sanitation is associated with higher risk of NPSV

Variability in mental health reporting among refugees and migrants in need of protection: new evidence from a weekly panel survey

Abstract Background The global population of refugees and other migrants in need of protection (MNP) is swiftly growing. Prior scholarship highlights that MNP have poorer mental health than other migrant and non-migrant populations. However, most scholarship on MNP mental health is cross-sectional, leaving open questions about temporal variability in their mental health. Methods Leveraging novel weekly survey data from Latin American MNP in Costa Rica, we describe the prevalence, magnitude, and frequency of variability in eight indicators of self-reported mental health over 13-weeks; highlight which demographic characteristics, incorporation hardships, and violence exposures are most predictive of variability; and determine how variability corresponds to baseline mental health. Results For all indicators, most respondents (> 80%) varied at least occasionally. Typically, respondents varied 31% to 44% of weeks; for all but one indicator they varied widely—by ~ 2 of 4 possible points. Age, education, and baseline perceived discrimination were most consistently predictive of variability. Hunger and homelessness in Costa Rica and violence exposures in origin also predicted variability of select indicators. Better baseline mental health was associated with less subsequent variability. Conclusions Our findings highlight temporal variability in repeated self-reports of mental health among Latin American MNP and further highlight sociodemographic heterogeneity therein