Fertility and reproductive health: examining links with the environment

Lake Victoria is the world’s second largest freshwater lake, and the lake and its surrounding watershed are a critical resource and for millions of people spread across five countries: Tanzania, Kenya, Uganda, Burundi, and Rwanda. The interconnection and interdependence between human activities and the environment call for a regional, integrated response to properly manage existing and emerging threats to the Lake Victoria Basin. Regional bodies tasked with cooperative governance on environment and development issues, however, do not have even basic demographic or health information for the Basin. The lack of this data is in part due to the challenges of matching a geographically designated watershed with the different administrative boundaries for which data are available from five different countries. This research will show how spatially derived data, census data, and survey data can be combined to increase access to data atthe geographic scale that matters for regional environment and development planners and will illustrate how this data can be used in the Lake Victoria Basin for project planning, communications, and advocacy.

Education is a major catalyst for human development, and regarded as the key to ensuring environmental sustainability. Existing studies suggest that education and family planning services correlate with each other in affecting fertility and population growth and composition which has important implications on climate change mitigation options and adaptation responses. The paper uses the IIASA multistate human capital projection model to simulate the Indian population growth under different education scenarios, and compare the outputs with the results of population projections under the scenarios of preventing unwanted fertility of Indian women through providing family planning and reproductive health services. Based on statistical analysis of national household survey data, we explore the different income and consumption patterns among Indian population by different education categories and by other demographic characteristics, such as age and household size. Adopting the NCAR integrated assessment model PET and use the results from previous two parts as input, we simulate future energy consumption and carbon emissions under different education scenarios and decompose the overall effects of education in India on emissions into the impacts through affecting population growth, economic growth, or consumption preferences.

Demographic responses to environmental pressures have long been hypothesized in classic population theory, though empirical analyses remain scarce and traditionally focus on aggregate units of analysis. In this paper we test the hypothesis that land degradation since the 1980s led to marriage postponement and fertility reduction in eight sub-Saharan West African countries in the early 2000s. Using georeferenced data from multiple Demographic and Health Surveys, combined with remotely sensed data on land degradation, we examine proximate determinants of fertility among rural women in response to decline or fluctuation in net primary productivity (NPP) over time. Results consistently show little to no effect of environmental determinants, particularly long-term land degradation, on a set of fertility related outcomes. This is in sharp contrast to the negative association between land degradation and fertility found at the aggregate level. However, recent fluctuations in NPP are negatively associated with age at first marriage, suggesting that early marriage among women may reflect household decisions to diversify and reduce risk. These results call into question the spatial and temporal scales at which demographic responses to environmental pressures occur, and the extent to which these are confounded by economic development.

Malawi and Kenya exhibit the challenges posed by climate change and population dynamics. Both countries experience high rates of population growth and rapidly rising urbanization, with large numbers of urban dwellers living in slums. , Their agricultural-based economies are undermined by erratic climatic conditions and water scarcity problems, leading to food insecurity. These challenges are exacerbated by climate change.

Given the strong links between population dynamics and climate change, addressing both issues using integrated responses would offer combined benefits. Key informant interviews conducted with stakeholders in both countries reveal a high level of awareness of the links, as well as the need for their integration. However, the issues are weakly linked at policy level, and programs to address them are implemented separately.

This paper examines the challenges of integrating population into climate change and development planning, and identifies opportunities to enhance integration in the context of both countries.

The concept of family in India has been changed with the increase in urbanization, industrialization and technological development. Initially the structure of family was created to preserve the common culture among the family members. Generally it is observed that fertility level and behavior of women is strongly shaped by the structure of family. Based on such a hypothesis present study is trying to examine the effect of family structure on reproductive behavior and health status of currently married women. Various studies have tried to analyze the fertility differential by type of family and concluded that higher number of children ever born in joint family. But the present study, which used the data from third round of National Family Health Survey, 2005-06, proved that although the use of fertility control method is high in nuclear family but fertility rate is still high. Study also reveals that women of joint family get benefited in terms of receiving health care services and assistance. Thus there is a need for in depth study to see the impact of family structure on women’s reproductive behavior and health status and to examine whether all families have homogeneous characteristics or this similarity is due to program implementation.

In a period of 30 years, Brazil experienced successive development changes, becoming from a low-income country, with a large portion of rural population and a complex health system, a middle-income country, urbanized, with a unified health system. Life expectancy at birth increased five years per decade, due to the reduction of deaths from infectious diseases and success in controlling HIV/AIDS and fertility rates decreased from five children per woman to less than two. However, still remains huge inequalities in sexual and reproductive health rights, including sexual activity without coercion, reproductive choice, contraception, safe pregnancy and motherhood, as well as the consequences of abortion. The objective of this study is to characterize and analyze the reproductive behaviours and health situation of the population living in areas of socio-environmental risk, guided by the importance of understanding the different needs of the most vulnerable social groups. The Social Inclusion and Exclusion Index, calculated for risk áreas, ilustrates the inequalities that the average indicators of Santos hide, unveiling the curtain is possible to discover in all its crudeness the naked city, the wealth of the few and the misery of the many steep hills, the abandoned historical center and the west area of the endless palafittes.

Malnutrition remains the world's most serious health problem and the single biggest contributor to maternal/child mortality. Improved nutrition before and during pregnancy means better health for the mother. It is on that note that the present study attempts to identify different types of food items in the study area, examine the food types that are commonly consumed and relate consumption with childbirth outcome in Ogoja and Obudu local Government Areas of Cross River State, Nigeria. The study area included two Local Government Areas of Northern Cross River State, Nigeria. Data for this study came from a community-based, cross-sectional survey of women conducted in 2007–2010 in the two LGAs of Cross River State. The results shows that a majority of food items found in the study are carbohydrate and are consumed by pregnant women. The consumption of these food items imparted negatively on childbirth outcome. Women who consumed proteinous food had better child birth outcome compared to those who consumed other types. Availability was at the foundations of nutritional consumption. Making available certain food and their consumption

Do Population-Health-Environment (PHE) initiatives work? It offers to combine solutions to population-environment (PE) together with health-environment (HE) for the global conservation of natural resources in developing countries. In doing so, PHE recognizes the importance of considering “conservation, health, and family planning interventions” in the management of some of the world’s most impoverished as well as ecologically rich environments (Hahn et al. 2011). In this paper I probe the potential effectiveness of integrated PHE investments for conservation outcomes. The evaluation was conducted in 2007 in WWF high priority marine and terrestrial conservation sites with PHE programs in Philippines, Nepal, India, Mozambique, Madagascar, Kenya, Cameroon and the Central African Republic. I interviewed 754 individuals: WWF staff, health and environment partners and local men and women in individual and focus-group interactions. Quantitative and qualitative results indicate diverse, and in some cases dramatic, improvements in maternal and child health and conservation measures that appeared to synergized by the integrative PHE approach. Results also point toward the importance of investing in livelihoods in tandem with PHE interventions.

The health problems due to consumption of arsenic-contaminated water are a serious public health concern in West Bengal. There is extensive documentation of reproductive and fetal developmental effects due to arsenic exposure in animal species with only a handful examining the same in case of human pregnancy outcomes. This paper examines the adverse pregnancy outcomes (in terms of live births, stillbirths, spontaneous abortions and preterm births) of women both in the exposed (drinking arsenic-contaminated water at the level of ≥0.05 mg/L for at least five years) and non-exposed groups (drinking arsenic-safe water at the level of ≤0.01 mg/L). A cross-sectional case-control study was conducted in Murshidabad district, West Bengal. Eligible participants included ever-married women of reproductive age 15-49 years and who previously had at least one pregnancy. In the exposed and non-exposed groups, respectively, 87 percent and 94 percent of the pregnancies ended as live births; the difference was statistically significant (z = 3.2; p = 0.002). Adverse pregnancy outcomes measured as spontaneous abortion, stillbirth and preterm birth rates were 73.4, 62.3, and 81.8 per 1000 live births, respectively, among the exposed group and 34.0, 24.0, and 37.2 per 1000 pregnancies, respectively, among the non-exposed group.

India accounts for 23 % of the global burden of maternal deaths. According to biomedical causes, more than 70 percent of these deaths are from direct obstetric complications. However, there exists ambiguity and variability in existing literature on magnitude of socio-economic inequality in obstetric morbidity prevalence which makes it difficult to set priorities in health policy. This study aims to assess how far self-reporting obstetric morbidity misleads in measuring socio-economic inequality in India and whether using sophisticated inequality measures such as regression based inequality decomposition will help to overcome the problem. The study has used data from NFHS-3 and employed regression based decomposition analysis. Bivariate results reveal that self-reporting obstetric morbidity from NFHS-3 data is misleading in measurement of socio-economic differentials; however decomposition analysis shows that the prevalence of obstetric complications is greater among disadvantaged groups with a negative contribution of education. Thus we can overcome the problem of measuring socio-economic inequality to some extent. But, a logical explanation of the results inferred for health policy interventions is vital, as decomposition analysis has also failed to overcome the problem of self-reporting morbidities by illiterate women.