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This study examined the relationship between orphanhood status, living arrangements and sexual debut. The study is important in the context of southern Africa, where a substantial number of children live apart from their parents because the parent is dead or living elsewhere, and where female adolescents face disproportionate sexual and reproductive health risks. Data for female adolescents were taken from Demographic and Health Surveys conducted in seven southern African countries. Unadjusted and adjusted hazard ratios of sexual debut were estimated using Cox Proportional Hazard models. The results from multivariate analyses showed that non-co-residence with biological parents was significantly associated with higher risk of sexual debut in five of the seven countries. Using pooled data, the results showed that father absence was associated with higher risk of sexual debut - whether the father was deceased or living elsewhere. Interventions to delay sexual debut among female adolescents should seek to promote father-adolescent co-residence and improve access to education. [ABSTRACT FROM AUTHOR]

There are substantial regional disparities in under-five mortality in Nigeria, and evidence suggests that both individual- and community-level characteristics have an influence on health outcomes. Using 2008 Nigeria Demographic and Health Survey data, this study (1) examines the effects of individual- and community-level characteristics on infant/child mortality in Nigeria and (2) determines the extent to which characteristics at these levels influence regional variations in infant/child mortality in the country. Multilevel Cox proportional hazard analysis was performed on a nationally representative sample of 28,647 children nested within 18,028 mothers of reproductive age, who were also nested within 886 communities. The results indicate that community-level variables (such as region, place of residence, community infrastructure, community hospital delivery and community poverty level) and individual-level factors (including child's sex, birth order, birth interval, maternal education, maternal age and wealth index) are important determinants of infant/child mortality in Nigeria. For instance, the results show a lower risk of death in infancy for children of mothers residing in communities with a high proportion of hospital delivery (HR: 0.70, p<0.05) and for children whose mothers had secondary or higher education (HR: 0.84, p<0.05). Although community factors appear to influence the association between individual-level factors and death during infancy and childhood, the findings consistently indicate that community-level characteristics are more important in explaining regional variations in child mortality, while individual-level factors are more important for regional variations in infant mortality. The results of this study underscore the need to look beyond the influence of individual-level factors in addressing regional variations in infant and child mortality in Nigeria. [ABSTRACT FROM PUBLISHER]

Although desired family size is often different from actual family size, the dynamics of this difference are not well understood. This paper examines the patterns and determinants of the difference between desired and actual number of children (unmet fertility desires) among women aged 15–49 years using pooled data from the 1990, 1999 and 2003 Nigeria Demographic and Health Surveys (NDHSs). The results show that more than two-thirds of the sample have unmet fertility desires (18.1% have more while 52.4% have fewer than desired). It was found that early and late childbearing increased the odds of unmet fertility desires. Also, women with low levels of education, from poor households, rural residents as well as those who had experienced child death were at a higher risk of unmet fertility desires in the multivariate context. The study highlights the policy and programme implications of the findings. [ABSTRACT FROM AUTHOR]