Intergenerational effects on health in developing countries

The relationship between family structure and child well-being has been little studied in lower income settings. In Botswana new household types have emerged with increases in female headship, non-marital childbearing and parental cooperation with other household members. This study examines the association between household structure and child health in Botswana, measured by physical health. The study pays more attention to the heterogeneity of the household membership. This involves a larger kin network beyond biological parents. Second, the study explores if contextual factors are associated with child health. Three measures of child health assessed are stunting, diarrhoea and acute respiratory infection. Data used are from the 2000 Multiple Indicator Survey (MICS), and the 2007 Botswana Family Health Surveys (BFHS). Simple and logistic multilevel models are used to control for confounding variables associated with child health. The study demonstrates the importance of shared household resources, processes, and family functioning that goes beyond biological parent families on child health outcomes.

The adverse health impact of solid fuel use such as firewood, coal and biomass is well established. Evidence from developing countries suggest that women disproportionately bear the health costs of using such fuel. Even though women stand to benefit immensely from a switch to cleaner fuel, few studies have examined women's role in enabling that change. Using individual level data on asset ownership in Karnataka households, we examine the link between women's asset ownership and the propensity of a household to use solid fuel. Along with improvements in child health outcomes and education, female ownership of assets has been shown to have a bearing on the intra-household status of women. We find that women's ownership of assets have a statistically significant, negative impact on the propensity of the household to use solid fuel.

Marriage has been chosen as a scapegoat for reducing burden of parents in Bangladesh. Thus often marriage takes place at early age, i.e., during childhood, which is known as ‘early marriage’. Premature marriage deprives the girls of the opportunity for personal development as well as their rights to health and wellbeing.
The objectives of this study were to identify the causes of early marriage for girls and determine the factors associated with early marriage. Findings revealed that mean age at marriage for rural area was 15.21 years and for urban area it was 17.13 years and for Bangladesh it stood at almost 16. These readings confirm early marriage still exists. About 72% of the respondents were married before they reach 18. The most important determinant of age at marriage was found that arranging marriage is perceived as the only socially acceptable way to have sex and child bearing.

Research and programs have traditionally sought to understand and influence maternal health by focusing on the knowledge, attitudes and practices of recently-pregnant women. Yet, women are often not the decision-makers. In this innovative study, we analyze data collected from women, their husbands, and their mothers-in-law to explore the relative influence of each household member on maternal health practices in rural Mali. The analysis modeled indices of eight cultural domains, including traditionality, gender roles, and power. Key outcomes are antenatal care frequency, antenatal care timing, place of delivery, and receipt of postnatal care. Husbands’ preferences and opinions were not significantly associated with any of the outcomes. In contrast, the preferences and opinions of mothers-in-law had strong effects on the maternal health behaviors of their daughters-in-law. These results indicate that interventions focusing only on women are insufficient to advance women’s reproductive health in patriarchal societies such as Mali.

This paper examines the intergenerational effects of maternal micronutrient supplementation with iron and folic acid on the outcome of low birthweight in India.

Using data from the nationally-representative 1998/9 and 2005/6 National Family Health Surveys of India, we assess the population-level effectiveness of iron and folic acid supplementation on low birthweight and birthweight, using multivariable logistic and linear regression models respectively.

We find that only two-thirds of women report taking iron and folic acid supplementation during pregnancy, of whom only one-quarter for the recommended duration. Maternal supplementation is significantly negatively associated with low birthweight, after adjustment for socioeconomic status (OR: 0.77; 95% CI 0.68-0.87), and further adjustment for antenatal care utilization (ANC) (OR: 0.82; 95% CI 0.72-0.94). This corresponded to a 41.28g (95% CI 2.32g-80.2g) increase in birthweight, which attenuated to 27.59g (95% CI -12.4g-67.6g) after adjustment for ANC.

These findings have important implications as India accounts for about 40% of the global burden of low birthweight. Improved implementation of this simple intervention may help reduce intergenerational transmission of poor health status, and reduce India’s burden of low birthweight, and its sequelae.

Introduction: Micronutrient malnutrition contributes substantially to the global burden of disease. Micronutrient malnutrition in preschool children is rampant in India. Objective: To assess the impact of multiple micronutrient fortified flour and nutricandy on growth and hemoglobin levels of preschool children (3-6 yrs) for a period of 60 days in urban slums of Vadodara, India. Methodology: Baseline and End line data was collected on socio-economic status, hemoglobin levels, dietary intake and anthropometric measurements. Preschool children (3-6 yrs) are supplemented with 80 gm of multiple micronutrient fortified flour and one nutricandy daily at the anganwadi center. Result: At the end of the intervention period, all subjects (both boys and girls) showed significant increment in weight and height. A significant rise of 5.3% in hemoglobin levels was seen (0.55 g/dl, p < 0.05) for all the subjects among the various age groups. The overall prevalence of anemia decreased from 68% to 44% after supplementation. Conclusion and Recommendation: Multiple micronutrient food supplementation led to a rise in growth, reducing the prevalence and severity of anemia among the preschool children. Thus, can be recommended as a short term strategy for improving hemoglobin levels in preschool children belonging to the low socioeconomic status.

Harmful Widowhood Practice (HWP) is an obnoxious inhuman treatment following the death of their husbands. They are the Umuadas - the daughters married outside their community, family members and community because of the prevalent cultural norms. The HWP is a common traditional practice in most African societies. In Nigeria, it is predominantly practiced in Igboland. The traditional HWPs are wife and assets inheritance including sexual cleansings. The study therefore examined the HWPs in Igboland, Nigeria
The study adopted qualitative method of data collection. Validated and structured interview guide was used for data collection. The 241 widows identified in 5 communities of OMC were randomly selected and interview for the study. Data collected were analysed using thematic approach
Findings of the investigation reveal harmful widow practices persisted in 5 communities of OMC and possibly apply to all parts of Nigeria due to Igbo world perception about deaths, its causes, marriage and umuadas ruthless behaviour in implementing widowhood practices. Efforts of change agents e.g. churches, NGOs & governments to curb the harmful cultural practices proved abortive due to inadequate legislation
HWP is common in Nigeria therefore for the achievement of MDGs in Africa government should provide legislation for the protection of widows

Using the data from the longitudinal survey “Well-being of Elderly in Anhui Province, China” conducted in 2001, 2003, and 2006 respectively, this study examines the impact of adult children’s out-migration on Chinese rural elders’ psychological well-being. The results show that, controlling the characteristics of the elders, the change of migrant sons has a negative effect on the elders' psychological well-being, especially for the older men, while, an increase in migrant daughters are associated with deterioration in psychological well-being of older women. Due to the gender roles and division in family, traditional living arrangement moderated the negative effect of adult children's out-migration on psychological well-being of older women. However, for older men, living with adult children implies an increase of demand, therefore, worsens their psychological well-being. These findings support an extension of economics of labor migration theory that incorporates the stress–health outcome framework.

This study examined gender differences in the influence of marital status and marital quality on life satisfaction. The roles of intergenerational support and perceived socioeconomic status in the relationship between marriage and life satisfaction were also explored. The analysis was conducted with data from the Chinese General Social Survey (CGSS) in 2006, representing 1,317 women and 1,152 men at least 25 years old. Chi-squared tests and logistic regression models were used in this process. Marriage, including marital status and relationship quality, has a protective function for life satisfaction. Marital status is more important for males, but marital quality is more important for females. The moderating roles of intergenerational support and perceived socioeconomic status are gender specific, perhaps due to norms that ascribe different roles to men and women in marriage.