How the internet increases modern contraception uptake: evidence from eight sub-Saharan African countries

Background Sub-Saharan African (SSA) countries have the highest worldwide levels of unmet need for modern contraception. This has led to persistently high fertility rates in the region, rates which have had major adverse repercussions on the development potential there. Family planning programmes play a key role in improving the uptake of modern contraception, both by fostering women’s health and by lowering their fertility. Increasing awareness of contraception benefits is a major component of such programmes. Here, we ask whether internet access can bridge the gap between women’s need for modern contraception and women’s uptake of the same. Methods We use a compendium of data for 125 242 women, aged 15–49, from the Demographic Health Survey, Akamai and International Communication Union data, covering eight SSA countries, for the period 2014–2019. We apply a Two-Stage Least Square model, using as instruments for individual internet exposure the distance to the main server in the country and whether the backbone network in the country has been connected to at least one submarine cable. Results Internet exposure, measured as women access the internet at least monthly (almost daily), is associated with a positive, 11.4% (95% CI 10.6% to 12.2%) (53.8% (95% CI 13.4% to 94.1%)), increase in modern contraception uptake. Education is an important moderator. Poorly educated women benefit the most from internet exposure. Discussion Internet exposure appears to have significantly increased the uptake of modern contraception among sub-Saharan women. The poorly educated appear particularly to benefit. There are two mechanisms at play: the internet increases women’s knowledge of contraception; and, in parallel, fosters their empowerment

Does bribery increase maternal mortality? Evidence from 135 Sub-Saharan African regions

About 295,000 women died globally during and following pregnancy and childbirth in 2017. Two-thirds of these deaths occurred in Sub-Saharan Africa. By linking individual and regional data from 135 regions in 17 Sub-Saharan African countries over the period 2002–2018 this study explores how bribery affects maternal mortality in Sub-Saharan Africa. Our results show that the percentage of people who had first-hand experience in bribery is significantly and positively associated with pregnancy related deaths. We find that a 10 p.p. increase in the prevalence of bribery is associated with up to 41 [95% CI: 10–73] additional deaths for every 1,000 pregnancy-related deaths. However, the healthcare system quality appears to be an important moderator. To reduce maternal mortality, policy makers should not only increase investments in healthcare, they need also to implement measures to combat corruption.</jats:p

A Geography of Cohabitation in the Americas, 1970-2010

In this chapter, we trace the geography of unmarried cohabitation in the Americas on an unprecedented geographical scale in family demography. We present the percentage of partnered women aged 25-29 in cohabitation across more than 19,000 local units of 39 countries, from Canada to Argentina, at two points in time, 2000 and 2010. The local geography is supplemented by a regional geography of cohabitation that covers five decades of data from 1960 to 2010. Our data derive primarily from the rich collection of census microdata amassed by the Centro Latinoamericano y Caribeño de Demografía (CELADE) of the United Nations and from the IPUMS-international collection of harmonized census microdata samples (Minnesota Population Center, Integrated public use microdata series, international: Version 6.3 [Machine-readable database]. University of Minnesota, Minneapolis, 2014). Our analyses unveil a substantial amount of spatial heterogeneity both within and across countries. Despite the spectacular rise in cohabitation, its regional patterning has remained relatively unchanged over the last decades, which points to the presence of geo-historical legacies in the present patterns of unmarried cohabitation

Generational interdependencies in families: The MULTILINKS research programme

Background: We identify four research themes where MULTILINKS, a programme of research on intergenerational family ties funded through the Seventh Framework of the European Commission, has brought new and unique insights. Key premises of the MULTILINKS approach involved an emphasis on (1) both young and old in families, (2) the ways in which social policies structure interdependencies in families, and (3) the influence of historical, economic and cultural contexts. Methods: Our overview includes research done in the context of the MULTILINKS programme at large as well as the papers in this special collection. Results: Firstly, by combining macro and micro perspectives on intergenerational family constellations across Europe it has been possible to provide a more nuanced view than is common in conventional portrayals of family change. Secondly, by extending research to Eastern European countries, the programme has not only identified crucial regional differences in co-residential arrangements and intergenerational exchanges in families, but also shown that explanations of well-being differentials are similar in Eastern and Western Europe. Thirdly, by focusing on legal and policy frameworks regarding the division of care and financial responsibilities for the young and old between the family and the state, it has been possible to distinguish patterns in the degree to which national policies strengthen or weaken generational interdependencies in families. Fourthly, research conducted in the context of the MULTILINKS programme has demonstrated the usefulness of paying attention to preferences about family members' responsibilities for each other. Conclusion: Recognition of the key premises of MULTILINKS has led to challenging, critical insights on intergenerational family ties

Information and vaccine hesitancy: Evidence from the early stage of the vaccine roll-out in 28 European countries.

The success of mass vaccination programs against SARS-CoV-2 hinges on the public's acceptance of the vaccines. During a vaccine roll-out, individuals have limited information about the potential side-effects and benefits. Given the public health concern of the COVID pandemic, providing appropriate information fast matters for the success of the campaign. In this paper, time-trends in vaccine hesitancy were examined using a sample of 35,390 respondents from the Eurofound's Living, Working and COVID-19 (LWC) data collected between 12 February and 28 March 2021 across 28 European countries. The data cover the initial stage of the vaccine roll-out. We exploit the fact that during this period, news about rare cases of blood clots with low blood platelets were potentially linked to the Oxford/AstraZeneca vaccine (or Vaxzeveria). Multivariate regression models were used to analyze i) vaccine hesitancy trends, and whether any trend-change was associated with the link between the AstraZeneca vaccine ii) and blood clots (AstraZeneca controversy), and iii) the suspension among several European countries. Our estimates show that vaccine hesitancy increased over the early stage of the vaccine roll-out (0·002, 95% CI: [0·002 to 0·003]), a positive shift took place in the likelihood of hesitancy following the controversy (0·230, 95% CI: [0·157 to 0·302]), with the trend subsequently turning negative (-0·007, 95% CI: [-0·010 to -0·005]). Countries deciding to suspend the AstraZeneca vaccine experienced an increase in vaccine hesitancy after the suspensions (0·068, 95% CI: [0·04 to 0·095]). Trust in institutions is negatively associated with vaccine hesitancy. The results suggest that SARS-CoV-2 vaccine hesitancy increased steadily since the beginning of the vaccine roll-out and the AstraZeneca controversy and its suspension, made modest (though significant) contributions to increased hesitancy