Authors: Elizabeth Frankenberg, Wayan Suriastini and Duncan Thomas
Title: Can expanding access to basic healthcare improve children's health status? Lessons from Indonesia's 'midwife in the village' programme
In the 1990s, the Indonesian government placed over 50,000 midwives in communities throughout the country. We examine how this expansion in health services affected children's height-for-age.
To address the problem that midwives were not randomly allocated to communities, the estimation exploits the biology of childhood growth, the timing of the introduction of midwives to communities, and rich longitudinal data. The evidence indicates that the nutritional status of children fully exposed to a midwife during early childhood is significantly better than that of their peers of the same age and cohort in communities without a midwife.
The former are also better off than children assessed at the same age from the same communities but who were born before the midwife arrived. Within communities, the improvement in nutritional status across cohorts is greater where midwives were introduced than where they were not.
This result is robust to the inclusion of community fixed effects.
Keywords: Child Health, Health Programmes, Community, Less Developed Countries, Indonesia
Authors: Gunnar Andersson and Kirk Scott
Title: Labour-market status and first-time parenthood: The experience of immigrant women in Sweden, 1981-97
This paper investigates the impact of labour-market attachment on first births of foreign-born women in Sweden. The study uses a longitudinal, register-based dataset consisting of the entire population of immigrants from ten nations and a five-per-cent random sample of natives.
The effects of earned income are evident, with increased income levels increasing the probability of becoming a mother for all observed nationalities. The effects of various forms of participation and non-participation in the labour force do not vary greatly between immigrants and the Swedish-born. Among all subgroups, we find a higher propensity to begin childbearing among those who are established in the labour market. Contrary to popular belief, receiving welfare benefits clearly reduces first-birth intensity for immigrants but not for natives.
The similarity in patterns across widely different national groups supports the notion that various institutional factors affecting all subgroups are crucial in influencing childbearing behaviour.
Keywords: Fertility, Immigration, Immigrants, Labour-Market Status, Labour-Force Participation, Sweden
Authors: Nadezhda Aleshina and Gerry Redmond
Title: How high is infant mortality in Central and Eastern Europe and the Commonwealth of Independent States?
This paper examines the measurement of infant mortality in the countries of Central and Eastern Europe and the Commonwealth of Independent States (CIS). There are worrying indications that official infant mortality counts, based on administrative data, may understate the true gravity of the problem in 15 countries in the region, including 11 out of 12 CIS countries, and four countries in South Eastern Europe.
In the case of 8 CIS countries in the Caucasus and Central Asia plus Romania, the evidence is strongest, not least because surveys that allow independent estimation of infant mortality have been carried out there. In the case of the remaining six countries, the evidence is more circumstantial, and based on inconsistencies within the official data themselves, combined with information on how live births are defined.
However, we find also that surveys are rather blunt instruments, and that the confidence intervals that surround estimates from these surveys are often large
Keywords: Infant Mortality, Eastern Europe, Central Asia, Live Birth, Administrative Data, Survey Data
Author: Brienna Perelli-Harris
Title: The path to lowest-low fertility in Ukraine
The phenomenon of lowest-low fertility, defined as total fertility below 1.3, is now emerging throughout Europe and is attributed by many to postponement of the initiation of childbearing. Here an investigation of the case of Ukraine, where total fertility-1.1 in 2001-is one of the world's lowest, shows that there is more than one pathway to lowest-low fertility.
Although Ukraine has undergone immense political and economic transformations in the past decade, it has maintained a young age at first birth and nearly universal childbearing. Analyses of official national statistics and the Ukrainian Reproductive Health Survey show that fertility declined to very low levels without a transition to a later pattern of childbearing. Findings from focus-group interviews are used to suggest explanations of the early-fertility pattern.
These include the persistence of traditional norms for childbearing and the roles of men and women, concerns about medical complications and infertility at a later age, and the link between early fertility and early marriage.
Keywords: Fertility, Lowest-Low Fertility, Postponement of Childbearing, Ukraine, Soviet Union, Eastern Europe
Authors: Matthijs Kalmijn, Paul M. de Graaf and Jacques P. G. Janssen
Title: Intermarriage and the risk of divorce in The Netherlands: The effects of differences in religion and in nationality, 1974-94
A textbook hypothesis about divorce is that heterogamous marriages are more likely to end in divorce than homogamous marriages. We analyze vital statistics on the population of The Netherlands, which provide a unique and powerful opportunity to test this hypothesis.
All marriages formed between 1974 and 1984 (nearly one million marriages) are traced in the divorce records and multivariate logistic regression models are used to analyze the effects on divorce of heterogamy in religion and national origin. Our analyses confirm the hypothesis for marriages that cross the Protestant-Catholic or the Jewish-Gentile boundary.
Heterogamy effects are weaker for marriages involving Protestants or unaffiliated persons. Marriages between Dutch and other nationalities have a higher risk of divorce, the more so the greater the cultural differences between the two groups. Overall, the evidence supports the view that, in The Netherlands, new group boundaries are more difficult to cross than old group boundaries.
Keywords: Divorce, Ethnicity, Heterogamy, Intermarriage, Marriage, Nationality, Religion
Author: Alysa Levene
Title: The estimation of mortality at the London Foundling Hospital, 1741-99
The high mortality of foundlings across Europe has long been established by historical demographers but methods of quantification have not permitted comparison with rates in the populations beyond the foundling hospitals. This study investigates mortality rates at the London Foundling Hospital in the eighteenth century in a way that addresses the issue.
The study finds that although foundling mortality was extremely high at certain periods in the hospital's history, there is evidence for a decline towards the end of the century, in common with national and local rates. This suggests that the causes of the mortality fall were common even to infants born in disadvantaged circumstances, and brought up away from their mothers.
Several possible reasons for the fall in mortality are considered, including improved nutrition among mothers, a shift in the disease environment, and changes in such habits as gin drinking.
Keywords: Infant Mortality, Foundling Hospital, London, Left-Truncation, Childcare, Nutrition
Authors: Pekka Martikainen, Tuija Martelin, Elina Nihtilä, Karoliina Majamaa and Seppo Koskinen
Title: Differences in mortality by marital status in Finland from 1976 to 2000: Analyses of changes in marital-status distributions, socio-demographic and household composition, and cause of death
Being currently not married is more common today than 25 years ago. Over this period relative differences in mortality by marital status have increased in several countries, mainly as a result of a sharp decline in mortality among the married.
Using Finnish census data linked with death certificates, we show that these increases are not explained by the non-married population becoming more marginalized in socio-economic status or household composition.
However, the increases in marital-status differences in mortality from accidental, violent, and alcohol-related causes of death in the 30-64 age group indicate that changes in the health-related behaviour of the non-married population may play a role. The public-health burden associated with not being married has also grown. At the end of the 1990s about 15 per cent of all deaths above the age of 30 would not have occurred if the non-married population had had the same age-specific mortality rates as the married population.
Keywords: Marital Status, Mortality, Cause of death, Socio-Demographic Composition, Household Composition, Finland