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Early childbearing poses several potential risks to maternal and child health. This paper empirically analyses the association between teenage pregnancy and child nutritional status, maternal and child anaemia in three countries (Nigeria, India and Bangladesh) that account for the highest proportion of teenage births and/or total number of malnourished teenage mothers and children. Data were sourced from nine waves of Demographic and Health Surveys conducted in Bangladesh, India, and Nigeria from 2005–2018, covering a sample of 27,705 children from Bangladesh, 266,308 children from India and 54,719 children from Nigeria. Our outcome measures of maternal and child nutrition include (i) a composite measure of anthropometric failure for children (CIAF), (ii) maternal anaemia, (iii) childhood anaemia, and (iv) anaemia in maternal–child pairs. Using multivariate regression analysis, we examine the associations between early childbirth, child nutrition, and maternal and child anaemia, controlling for an array of household‐level socioeconomic and demographic characteristics. Across all three countries, the prevalence of CIAF (childhood anthropometric failure) is significantly higher among children born to women aged below 17 at first birth. We further find that early pregnancy and childbearing are associated with significantly higher rates of severe/moderate anaemia among both mothers and children in Bangladesh and Nigeria. In the three countries studied, the proportions of teenage mothers with vulnerable socioeconomic status and suboptimal pre‐conception care are relatively high, which raises the risk of maternal and child morbidity as well as mortality. [ABSTRACT FROM AUTHOR]

Background Violent conflicts are observed in many parts of the world and have profound impacts on the lives of exposed individuals. The limited evidence available from specific country or region contexts suggest that conflict exposure may reduce health service utilization and have adverse affects on health. This study focused on identifying the association between conflict exposure and continuum of care (CoC) services that are crucial for achieving improvements in reproductive, maternal, newborn, and child health and nutrition (RMNCHN). Methods and findings We combined data from 2 sources, the Demographic Health Surveys (DHS) and the Uppsala Conflict Data Program's (UCDP) Georeferenced Event Dataset, for a sample of 452,192 women across 49 countries observed over the period 1997 to 2018. We utilized 2 consistent measures of conflict-incidence and intensity-and analyzed their association with maternal CoC in 4 key components: (i) at least 1 antenatal care (ANC) visit; (ii) 4 or more ANC visits; (iii) 4 or more ANC visits and institutional delivery; and (iv) 4 or more ANC visits, institutional delivery, and receipt of postnatal care (PNC) either for the mother or the child within 48 hours after birth. To identify the association between conflict exposure and components of CoC, we estimated binary logistic regressions, controlling for a large set of individual and household-level characteristics and year-of-survey and country/province fixed-effects. This empirical setup allows us to draw comparisons among observationally similar women residing in the same locality, thereby mitigating the concerns over unobserved heterogeneity. Around 39.6% (95% CI: 39.5% to 39.7%) of the sample was exposed to some form of violent conflict at the time of their pregnancy during the study period (2003 to 2018). Although access to services decreased for each additional component of CoC in maternal healthcare for all women, the dropout rate was significantly higher among women who have been exposed to conflict, relative to those who have not had such exposure. From logistic regression estimates, we observed that relative to those without exposure to conflict, the odds of utilization of each of the components of CoC was lower among those women who were exposed to at least 1 violent conflict. We estimated odds ratios of 0.86 (95% CI: 0.82 to 0.91, p < 0.001) for at least 1 ANC; 0.95 (95% CI: 0.91 to 0.98, p < 0.005) for 4 or more ANC; and 0.92 (95% CI: 0.89 to 0.96, p < 0.001) for 4 or more ANC and institutional delivery. We showed that both the incidence of exposure to conflict as well as its intensity have profound negative implications for CoC. Study limitations include the following: (1) We could not extend the CoC scale beyond PNC due to inconsistent definitions and the lack of availability of data for all 49 countries across time. (2) The measure of conflict intensity used in this study is based on the number of deaths due to the absence of information on other types of conflict-related harms. Conclusions This study showed that conflict exposure is statistically significantly and negatively associated with utilization of maternal CoC services, in each component of the CoC scale. These findings have highlighted the challenges in achieving the Sustainable Development Goal 3 in conflict settings, and the need for more concerted efforts in ensuring CoC, to mitigate its negative implications on maternal and child health., Author(s): Anu Rammohan 1, Astghik Mavisakalyan 2, Loan Vu 1,3, Srinivas Goli 4,5,* Introduction In the last 15 years, the concept of continuum of care (hereafter CoC) has emerged as [...]

In this paper, using the "2005-2006 National Family Health Survey" dataset from India, we study the likelihood of a school-age child working, combining work with schooling or being idle, rather than attending school full time. Our analysis finds that with the inclusion of household chores in the child labour definition, boys are significantly more likely than girls to be full-time students and significantly less likely to be working, being idle or combining school and work. There are also significant regional differences, with children from the north-eastern states significantly more likely to be in the idle category rather than in school. The likelihood of being in the idle category is also significantly higher for older children, children with pre-school age siblings, urban children, Muslims and children from Scheduled Tribes. Finally, parental education, household wealth and land ownership are significantly and negatively correlated with the likelihood that the child is working, but land ownership does increase the risk of a child combining work and schooling.

Rural residents account for the bulk of poverty in developing countries. This paper evaluates the impact of Indonesia's Dana Desa program (Village Fund Program or VFP) on rural poverty and female labour force participation. The VFP, introduced in 2014, was an ambitious national-level village governance program which transferred administrative responsibility and financial resources to Indonesia's 79,000 plus rural villages, providing them with the autonomy to invest in rural infrastructure, human capital, and job creation programs. Using nationally representative data from before and after the program, we show that the implementation of the VFP was associated with an improvement in rural household's consumption expenditure among households, particularly among agricultural households. Female labour force participation in rural areas increased by about 10 percentage points and there is also evidence of a sectoral shift away from agricultural employment towards jobs in the service sector. This improvement in labour force participation is associated with poverty reduction among rural households. [ABSTRACT FROM AUTHOR]

In this paper we examine the influence of gender, sibling characteristics and birth order on the schooling attainment of school-age Egyptian children. We use multivariate analysis to simultaneously examine three different schooling outcomes of a child having "no schooling", "less than the desired level of schooling", and an "age-appropriate level of schooling". Estimation results show strong evidence of gender, birth order and sibling characteristics on schooling attainment, with female and rural children particularly disadvantaged. Interestingly, our results show adverse effects on the schooling outcomes of first-born male children. Finally, we show that an improvement in parental education has large, positive and significant effects on the schooling attainment of children. (Contains 3 endnotes and 5 tables.)

The consequences of early childbearing on the growth and nutritional status of women in India has not been quantified in previous studies. Our study aimed to fill this gap by analysing the association between early marriage and early childbearing on nutritional status of Indian women, with a focus on Bihar and Andhra Pradesh, the two states accounting for the highest proportion of women marrying and giving first birth before 18 years of age. Our findings revealed that a substantial number of women were married before 18 years and thereby exposed to early pregnancy. Furthermore, a significantly higher proportion of women in the 'thin' category were married before 18 years, both in the Indian sample (33 %, p < 0.001) and in the selected states, Andhra Pradesh (31 %, p < 0.001) and Bihar (43 %, p < 0.001), compared to those women married at higher ages. Similarly, across all our samples women whose first birth was before age 18 years also had a significantly higher probability of being in the 'thin' category across all our samples. This pattern was also observed for associations between early childbirth and anemia levels. We conclude that the net effect of the early age at marriage and age at first birth on nutritional status is significant. Our results underline the need for preventing early marriages and the consequent high adolescent pregnancies in India, particularly in high prevalence states. This will help to improve nutritional status and health care utilisation among women, thereby, prevent maternal and child mortality and thus, achieve the MDGs 4-5. Electronic supplementary material The online version of this article (doi:10.1007/s10995-015-1700-7) contains supplementary material, which is available to authorized users., Author(s): Srinivas Goli[sup.1] , Anu Rammohan[sup.2] , Deepti Singh[sup.3] Author Affiliations: (1) Population Studies, Centre for the Study of Regional Development (CSRD), School of Social Sciences (SSS), Jawaharlal Nehru University [...]

Against the backdrop of the alarming rise in Caesarean section (C-section) births in India, this study aimed to examine the association between C-section births, fertility decline and female sterilization in the country. A cross-sectional design was used to investigate the association between C-section delivery and subsequent reproductive behaviour in women in India. Data were from the National Family Health Survey (NFHS-4). The study sample comprised 255,726 currently married women in the age group of 15–49 years. The results showed a strong positive relationship between C-section births and female sterilization. The predicted probabilities (PP) from the multivariate regression model indicated a higher chance of female sterilization in women with C-section births (PP = 0.39, p <0.01) compared with those with non-C-section births (PP = 0.20, p <0.01). Both state-level correlation plots and Poisson regression estimates showed a strong negative relationship between C-section births and mean children ever born (CEB). Based on the results, it may be concluded that the use of C-sections and sterilization were strongly correlated in India at the time of the NFHS-4, thus together contributing to fertility decline. A strong negative association was found between the occurrence of C-sections and CEB. The increased and undesired use of C-section births and consequent female sterilization is a regressive socio-demographic process that often violates women's rights. Fertility decline should happen through informed choice of family planning and must protect the reproductive rights of women. [ABSTRACT FROM AUTHOR]

In this study, we empirically analyse whether in utero exposure to the Ramadan fasting period is negatively associated with child nutrition. The data for the analyses come from a retrospective assessment of 759,799 children from 103 Demographic and Health Surveys (DHS) across 56 countries during 2003–2020. Considering the month-long Ramadan exposure as a natural experiment, we implement an intent-to-treat framework, comparing stunting and underweight among children aged 0–5 years who were exposed to Ramadan fasting at any time in utero with those who were not exposed. Our findings do not show significant evidence to conclude that in utero exposure to the Ramadan fasting period is negatively associated with child nutrition. On the contrary, except for stunting in Muslim children who had in utero exposure to Ramadan fasting during the first months of pregnancy, we find no significant association between in utero exposure to Ramadan fasting and child stunting and underweight. Our main results are robust to multiple robustness checks. [ABSTRACT FROM AUTHOR]