advanced search

<< Back To Home

CSU 13/2009: MALE CIRCUMCISION/ DRIVERS OF INFANT AND CHILD MORTALITY / FERTILITY DECLINES AND SOCIAL SECURITY

Monday, 23rd of March 2009

CSU 13/2009: MALE CIRCUMCISION/  DRIVERS OF INFANT AND CHILD MORTALITY / FERTILITY DECLINES AND SOCIAL SECURITY
 
  MALE CIRCUMCISION FOR HIV PREVENTION
 
 WHO and three other international agencies have created an Internet
 Clearinghouse on Male Circumcision and HIV Prevention, recently featured in
 the New York Times. The website, at http://www.malecircumcision.org/ aims
 to dispel myths about male circumcision and provide objective information
 on circumcision to both the public and to specialists in the field.
 
 READER FEEDBACK
 
 'I also wanted to congratulate Ellyn Ogden on receiving the Heroism Award.
 It represents very well deserved recognition of her important contribution
 in the field over the years.  Ellyn has ample reason to be really proud of
 her accomplishments.   And some readers may not be aware that Ellyn has
 flown millions of miles, bumped up and down dirt roads, and walked for
 hours in the field while also suffering severe back problems that required
 surgery and long periods of bed-rest and recuperation. . . .
 
 Ellyn is a shining example to all of us in the vaccine/immunization
 community.'
 
 Best regards, Robin.
 -----------------------------
 Robin Biellik, DrPH
 Geneva, Switzerland
 home: +41 22 367 20 02
 mobile: +41 78 890 45 77
 email: rbiellik@gmail.com
 
 
 DRIVERS OF INFANT AND CHILD MORTALITY/FERTILITY DECLINES AND SOCIAL
 SECURITY
 
 Tks to reader Roger Pearson for drawing to my attention the following
 journal articles, new and old, on the drivers of mortality and fertility. I
 have also included an encyclical excerpt, rarely cited, giving the Catholic
 view on birth spacing. If you want to space your children, the Pope won't
 discourage you!
 
 The paper by Boldrin and her colleagues is especially interesting because
 it makes social security, dating back to the 19th century in some
 countries, a major driver of fertility declines, not such often cited
 factors as 20th century introduction of new contraceptives.
 
 Good reading.
 BD
 
 
 MORTALITY AND BIRTH INTERVALS
 
 Rutstein SO., 'Effects of preceding birth intervals on neonatal, infant and
 under-five years mortality and nutritional status in developing countries:
 evidence from the demographic and health surveys,' Int J Gynaecol Obstet.
 2005 Apr;89 Suppl 1:S7-24.
 
 OBJECTIVE: This paper examines the association between birth intervals and
 infant and child mortality and nutritional status.
 
 METHODS: Repeated analysis of retrospective survey data from the
 Demographic and Health Surveys (DHS) program from 17 developing countries
 collected between 1990 and 1997 were used to examine these relationships.
 The key independent variable is the length of the preceding birth interval
 measured as the number of months between the birth of the child under study
 (index child) and the immediately preceding birth to the mother, if any.
 Both bivariate and multivariate designs were employed. Several child and
 mother-specific variables were used in the multivariate analyses in order
 to control for potential bias from confounding factors. Adjusted odds
 ratios were calculated to estimate relative risk.
 
 RESULTS: For neonatal mortality and infant mortality, the risk of dying
 decreases with increasing birth interval lengths up to 36 months, at which
 point the risk plateaus. For child mortality, the analysis indicates that
 the longer the birth interval, the lower the risk, even for intervals of 48
 months or more. The relationship between chronic malnutrition and birth
 spacing is statistically significant in 6 of the 14 surveys with
 anthropometric data and between general malnutrition and birth spacing in 5
 surveys. However, there is a clear pattern of increasing chronic and
 general undernutrition as the birth interval is shorter, as indicated by
 the averages of the adjusted odds ratios for all 14 countries.
 
 CONCLUSION: Considering both the increased risk of mortality and
 undernutrition for a birth earlier than 36 months and the great number of
 births that occur with such short intervals, the author recommends that
 mothers space births at least 36 months. However, the tendency for
 increased risk of neonatal mortality for births with intervals of 60 or
 more months leads the author to conclude that the optimal birth interval is
 between 36 and 59 months. This information can be used by health care
 providers to counsel women on the benefits of birth spacing.
 
 
 THE CATHOLIC VIEW ON BIRTH SPACING
 
 For those not yet familiar with it, here is the Catholic view on birth
 spacing, as set down by Pope Paul VI in his encyclical Humanae Vitae.
 
 'If therefore there are well-grounded reasons for spacing births, arising
 from the physical or psychological condition of husband or wife, or from
 external circumstances, the Church teaches that married people may then
 take advantage of the natural cycles immanent in the reproductive system
 and engage in marital intercourse only during those times that are
 infertile, thus controlling birth in a way which does not in the least
 offend the moral principles which We have just explained.'
 
 
 SOCIAL SECURITY AND FERTILITY
 
 This linkage is based on the observation that rising levels of pensions for
 the elderly are associated with lower fertility. Boldrin and colleagues try
 to explain why.
 
 Michele Boldrin, Mariacristina De Nardi, Larry E. Jones
 
 National Bureau of Economic Research Working Paper No. 11146
 Issued in February 2005
 The NBER Bulletin on Aging and Health provides summaries of publications
 like this.  You can sign up to receive the NBER Bulletin on Aging and
 Health by email.
 
 ---- Abstract -----
 The data show that an increase in government provided old-age pensions
 is strongly correlated with a reduction in fertility. What type of
 model is consistent with this finding? We explore this question using
 two models of fertility, the one by Barro and Becker (1989), and the
 one inspired by Caldwell and developed by Boldrin and Jones (2002). In
 the Barro and Becker model parents have children because they perceive
 their children's lives as a continuation of their own. In the Boldrin
 and Jones' framework parents procreate because the children care about
 their old parents' utility, and thus provide them with old age
 transfers. The effect of increases in government provided pensions on
 fertility in the Barro and Becker model is very small, and
 inconsistent with the empirical findings. The effect on fertility in
 the Boldrin and Jones model is sizeable and accounts for between 55
 and 65% of the observed Europe-US fertility differences both across
 countries and across time and over 80% of the observed variation seen
 in a broad cross-section of countries. Another key factor affecting
 fertility the Boldrin and Jones model is the access to capital
 markets, which can account for the other half of the observed change
 in fertility in developed countries over the last 70 years.
 
 http://www.nber.org/papers/w11146