Number and percentage of live births, by month of birth, 1991 to most recent year.

Definition:The crude birth rate is the annual number of live births per 1,000 population.Method of measurementThe crude birth rate is generally computed as a ratio. The numerator is the number of live births observed in a population during a reference period and the denominator is the number of person-years lived by the population during the same period. It is expressed as births per 1,000 population. Method of estimation:Data are taken from the most recent UN Population Division's "World Population Prospects". Other possible data sources:Population censusHousehold surveysPreferred data sources:Civil registration with complete coverageExpected frequency of data dissemination:Biennial (Two years)Data collected March 5, 2021 from: https://www.who.int/data/maternal-newborn-child-adolescent-ageing/indicator-explorer-new/mca/crude-birth-rate-(births-per-1000-population)

Baltimore City Child Health

An Exploration of 2010 Birth, Prenatal Visit, Lead Exposure and Teen Birth Rates

By City of Baltimore [source]

About this dataset

This Baltimore City Child and Family Health Indicators dataset provides us with crucial information that can support the health and well-being of Baltimore City residents. It contains 13 indicators such as low birth weight, prenatal visits, teen births, and more. This data is sourced from the Maryland Department of Health & Mental Hygiene (DHMH), Baltimore Substance Abuse Systems (BSAS), theBaltimore City Health Department, and the US Census Bureau. Through this data set we can gain a better understanding of how Baltimore City citizens’ health compares to other areas and how it has changed over time. By investigating this dataset we are given an opportunity to create potential strategies for providing better care for our community. With discoveries from these indicators, together as a city we can bring about lasting change in protecting public health within Baltimore

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How to use the dataset

This dataset provides valuable information about the health and wellbeing of children and families in Baltimore City in 2010. The data is organized by CSA (Census Statistical Area) and includes stats on term births, low birth weight births, prenatal visits, teen births, and lead testing. This dataset can be used to analyze trends in children's health over time as well as identify potential areas that need more attention or resources.

To use this dataset: - Read through the data dictionary to understand what each column represents.
- Choose which columns you would like to explore further.
- Filter or subset the data as you see fit then visualize it with graphs or maps to better understand how conditions vary across neighborhoods in Baltimore City.
- Consider comparing the data from this year with prior years if available for deeper analysis of changes over time.
- Look for correlations among columns that could help explain disparities between neighborhoods and create strategies for improving outcomes through policy interventions or other programs designed specifically for those areas needs

Research Ideas

• Mapping health disparities in high-risk areas to target public health interventions.
• Identifying neighborhoods in need of additional resources for prenatal care, infant care, and lead testing and create specific programs to address these needs.
• Creating an online dashboard that displays real time data on Baltimore City’s population health indicators such as birth weight, teenage pregnancies, and lead poisoning for the public to access easily

Acknowledgements

If you use this dataset in your research, please credit the original authors. Data Source

License

License: CC0 1.0 Universal (CC0 1.0) - Public Domain Dedication No Copyright - You can copy, modify, distribute and perform the work, even for commercial purposes, all without asking permission. See Other Information.

Columns

File: BNIA_Child_Fam_Health_2010.csv | Column name | Description | |:---------------|:----------------------------------------------------------| | the_geom | Geometry of the Census Statistical Area (CSA) (Geometry) | | CSA2010 | Census Statistical Area (CSA) (String) | | termbir10 | Total number of term births in 2010 (Integer) | | birthwt10 | Total number of low birth weight births in 2010 (Integer) | | prenatal10 | Total number of prenatal visits in 2010 (Integer) | | teenbir10 | Total number of teen births in 2010 (Integer) | | leadtest10 | Total number of lead tests conducted in 2010 (Integer) |

Acknowledgements

If you use this dataset in your research, please credit the original authors. If you use this dataset in your research, please credit City of Baltimore.

A computerized data set of demographic, economic and social data for 227 countries of the world. Information presented includes population, health, nutrition, mortality, fertility, family planning and contraceptive use, literacy, housing, and economic activity data. Tabular data are broken down by such variables as age, sex, and urban/rural residence. Data are organized as a series of statistical tables identified by country and table number. Each record consists of the data values associated with a single row of a given table. There are 105 tables with data for 208 countries. The second file is a note file, containing text of notes associated with various tables. These notes provide information such as definitions of categories (i.e. urban/rural) and how various values were calculated. The IDB was created in the U.S. Census Bureau''s International Programs Center (IPC) to help IPC staff meet the needs of organizations that sponsor IPC research. The IDB provides quick access to specialized information, with emphasis on demographic measures, for individual countries or groups of countries. The IDB combines data from country sources (typically censuses and surveys) with IPC estimates and projections to provide information dating back as far as 1950 and as far ahead as 2050. Because the IDB is maintained as a research tool for IPC sponsor requirements, the amount of information available may vary by country. As funding and research activity permit, the IPC updates and expands the data base content. Types of data include: * Population by age and sex * Vital rates, infant mortality, and life tables * Fertility and child survivorship * Migration * Marital status * Family planning Data characteristics: * Temporal: Selected years, 1950present, projected demographic data to 2050. * Spatial: 227 countries and areas. * Resolution: National population, selected data by urban/rural * residence, selected data by age and sex. Sources of data include: * U.S. Census Bureau * International projects (e.g., the Demographic and Health Survey) * United Nations agencies Links: * ICPSR: http://www.icpsr.umich.edu/icpsrweb/ICPSR/studies/08490

In the year 1975 the death rate has been higher than the birth rate for the first time since the end of the war. This means that our country has now the same problem as the Federal Republic of Germany and the German Democratic Republic namely a declining population. A decline in the birth rate is a phenomenon that could be observed in many industrialised countries since the 60s. This resulted in questions and problems that concern many areas of the economic an social development. The need for kindergartens, class rooms, apartments and workplaces has to be evaluated anew constantly as well as the necessary number of foreign workers or the financial burden for the contributors to the public pension scheme. In the developing countries on the other hand, it is the population boom in connection with the unemployment rate and the shortage of food that causes immense problems - which in return has an impact on the rich countries. Therefore, worldwide measures are taken understand the factors that influence the population growth and the birth rate so that decisions can be made for the future. The International Statistic Institute conducts, commissioned by the United Nations, a World-Fertility-Survey (WFS) in numerous countries; the up until now largest research on fertility and its conditions. The title birth-biography implies that this special survey collects information that cannot be gained from the existing birth statistic; the reports from the registrar’s offices to the Central Statistical Office cannot be merged with data from previous reports and also can not be evaluated together. To a limited extent, special question on children born alive had already been posed in the Mikrozensus in 1971 (Mikrozensus MZ7102). Since the number of answers was quite high, important partial results had already been gained. This special survey also concentrates on question on regional and social origin, occupation of the women in connection with the birth of their children and previous marriages. It is also noted if and at what age a child died. This is necessary for research on social conditions of infant mortality which is still quite high in Austria.

United States US: Fertility Rate: Total: Births per Woman data was reported at 1.800 Ratio in 2016. This records a decrease from the previous number of 1.843 Ratio for 2015. United States US: Fertility Rate: Total: Births per Woman data is updated yearly, averaging 2.002 Ratio from Dec 1960 (Median) to 2016, with 57 observations. The data reached an all-time high of 3.654 Ratio in 1960 and a record low of 1.738 Ratio in 1976. United States US: Fertility Rate: Total: Births per Woman data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s USA – Table US.World Bank: Health Statistics. Total fertility rate represents the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children in accordance with age-specific fertility rates of the specified year.; ; (1) United Nations Population Division. World Population Prospects: 2017 Revision. (2) Census reports and other statistical publications from national statistical offices, (3) Eurostat: Demographic Statistics, (4) United Nations Statistical Division. Population and Vital Statistics Reprot (various years), (5) U.S. Census Bureau: International Database, and (6) Secretariat of the Pacific Community: Statistics and Demography Programme.; Weighted average; Relevance to gender indicator: it can indicate the status of women within households and a woman’s decision about the number and spacing of children.

Infants’ motivation to engage with the social world depends on the interplay between individual brain’s characteristics and previous exposure to social cues such as the parent’s smile or eye contact. Different hypotheses about why specific combinations of emotional expressions and gaze direction engage children have been tested with group-level approaches rather than focusing on individual differences in the social brain development. Here, a novel Artificial Intelligence-enhanced brain-imaging approach, Neuroadaptive Bayesian Optimisation (NBO), was applied to infant electro-encephalography (EEG) to understand how selected neural signals encode social cues in individual infants. EEG data was acquired from 42 6- to 9-month-old infants looking at images of their parent’s face, analysed in real-time and selected by a Bayesian Optimisation algorithm to identify which combination of gaze and emotional expression of the parent’s face produces the strongest brain activation in the child. This individualised approach supported the theory that the infant’s brain is maximally engaged by communicative cues with a negative valence such as direct gaze and angry facial expressions. Moreover, we evaluated whether results also capture individual differences in behaviour. We found that infants attending preferentially to faces with direct gaze had increased positive affectivity and decreased negative affectivity compared to infants preferentially attending to faces with averted gaze. This work supports the idea that infants’ attentional preferences for social cues are heterogeneous and lays the foundation for the development of neuroimaging-informed personalized experiments to study diversity in neurodevelopmental trajectories of social skills.Babies are born with a drive to interact with other people. Within a year, this drive takes them from a passive newborn to a smiling, talking toddler. Our goals shape how sociable we are and who we socialise with across the lifespan, and are thus fundamental to social psychology (Over, 2016). However, the reasons why babies choose to interact remains a mystery. Measuring motivation is difficult because it is generated by the child, whilst traditional experimental methods measure passive responses to stimuli produced by the experimenter. Our transformative approach to studying infant social motivation is inspired by innovations in advertising. In the last twenty years, advertising has been revolutionised by the use of artificial intelligence (AI). Rather than the traditional model of creating generic campaigns based on what creatives thought consumers wanted, on the internet advertisers can now identify what exactly motivates individual customers by trying out different adverts and measuring an individual customers reaction to them. For example, if you click on an advert for a holiday in Mauritius, you will then see adverts for holiday resorts on other websites that you later visit. We aim to use the principles of this approach to determine what motivates babies to interact with other people. Study 1: Identify brain signals and networks related to social motivation. As a first step, we need to identify readouts of core social reward networks in the brain; measuring the brain (rather than behaviour) allows us to measure social motivation using the same signals across development. We can measure these networks very precisely using functional magnetic resonance imaging (fMRI), but this is not suitable for babies who are awake. Functional Near-Infrared Spectroscopy (fNIRS) is an alternative imaging method that is very similar to fMRI but that can be used with babies who are awake. We will use a combination of fNIRS and fMRI to identify brain signals of the brain networks that are involved in the core social reward networks, which we can then measure with fNIRS alone in Studies 2 and 3. Study 2: Identify the social cues infants find maximally rewarding. We will use social tasks that use eye tracking methodology. This technology follows exactly where infants look at on a screen, with infants looking behaviour even triggering visual events on the screen (e.g., if infants look towards a face, this will trigger a social reward such as a smiling or talking face). As the infant watches the screen and completes the tasks, the algorithm will be able to learn which tasks produce a larger brain signal from the social reward networks. This then allows us to determine which type of social interaction is particularly rewarding for the infants and how this may change as babies grow up. For example, very young babies may be particularly interested in eye gaze and smiling, but as they grow into toddlers and begin to talk, language may be more interesting for them. Study 3: Develop tools for using our approach within real-life interaction. Screen based social tasks are extremely useful, but watching social stimuli on a screen is very different from the dynamic nature of interacting with people. Here, we will measure infants brain responses whilst they interact with a social partner. As the infant interacts with their partner, the algorithm will identify the type of social cues that they find particularly rewarding. The algorithm will then prompt the trained social partner to engage in these maximally rewarding social interactions (such as eye contact, smiling or touch). This will provide a demonstration of how our tools can be used within a custom intervention design for children with conditions that affect social motivation, like autism. Taken together, our work is designed to produce new tools to transform our understanding of why babies socialise with other people, and to help vulnerable children to reach their full potential.

HAN VAN DER HORST is a baby boomer born in 1949 into a Catholic working-class family, whose father himself had not had the opportunity to continue his studies. Han describes the environment and fears in which he grew up, focusing on the pursuit of educational opportunities in a changing time after World War II. Han took the bus every day for six years to a boys' college in Rotterdam. Due to his father's limited income, he could not afford a moped, which posed a problem in reaching girls' grammar schools. Han decides to study history at the University of Amsterdam, because of the city and the Provo movement. He was able to study in Amsterdam thanks to a study allowance consisting of a scholarship and interest-free loan. As a reward for his high school diploma, Han previously received the opportunity from his parents to participate in a youth exchange. Participation in the youth exchange cost one hundred and twenty-five guilders, which was now within the family's reach. The narrator chose Esslingen, Germany, because of his familiarity with the German language. He wondered if he would be singled out because of his origins. The exchange was mixed, which was unusual at the time. In 1967, at the age of 18, he went on a fourteen-day trip to Esslingen in Germany with a diverse group and then became host to his German host for a fortnight. Han took part in a youth exchange without much European thought, although such ideas were promoted in information leaflets and newspaper articles. They were received by the Esslingen municipal council and had organized daily excursions as part of Germany's reputation recovery. The narrator remembers speeches about friendship between peoples and European cooperation. They visited interesting places in the city and surroundings. Han van der Horst's father could not go into hiding during the war and had to go to Germany, where he did heavy physical work and experienced a bombing. It seems that during the youth changes after the Second World War, the war itself did not play a major role among the young people from Schiedam. Han indicates that Germans tended to apologize, but the Dutch did not like that. They had come to Germany to celebrate. After the exchange, the hosts and hostesses traveled back to the Netherlands with the narrator. Han's German host then stayed at the narrator's home in the flat for fourteen days. They also came into contact with groups from other cities, including a group from Sweden. After fourteen days the exchange came to an end, and Han van der Horst left for Amsterdam, although he did not yet live there and remained a railway student for three years. At that time, around 1970, European unity and the EEC (European Economic Community) were not prominent in everyday consciousness, especially for non-specialists. Han notes that the focus within his social circle, or "bubble", was mainly on broader themes such as international solidarity and the struggle for revolution. Han shared that interest with Giuliano from Udine, where he would participate in an exchange program the following year. Giuliano's parents knew each other from the resistance and were members of various left-wing political parties. Giuliano was friends with Anna, whose parents were liberal partisans. In essence, the Han says that personal experiences with youth exchanges, but especially world events, ultimately influenced his life and mentality. Han van der Horst says that he is not afraid of the unknown. This position is emphasized with an explicit "Point!". At the same time, he notes that nowadays, possibly due to factors such as the Internet, the fear of the unknown is actually increasing, and he considers this a dangerous trend.

The Sudan Demographic and Health Survey (SDHS) was conducted in two phases between November 15, 1989 and May 21, 1990 by the Department of Statistics of the Ministry of Economic and National Planning. The survey collected information on fertility levels, marriage patterns, reproductive intentions, knowledge and use of contraception, maternal and child health, maternal mortality, and female circumcision. The survey findings provide the National Population Committee and the Ministry of Health with valuable information for use in evaluating population policy and planning public health programmes. A total of 5860 ever-married women age 15-49 were interviewed in six regions in northern Sudan; three regions in southern Sudan could not be included in the survey because of civil unrest in that part of the country. The SDHS provides data on fertility and mortality comparable to the 1978-79 Sudan Fertility Survey (SFS) and complements the information collected in the 1983 census. The primary objective of the SDHS was to provide data on fertility, nuptiality, family planning, fertility preferences, childhood mortality, indicators of maternal health care, and utilization of child health services. Additional information was coUected on educational level, literacy, source of household water, and other housing conditions. The SDHS is intended to serve as a source of demographic data for comparison with the 1983 census and the Sudan Fertility Survey (SFS) 1978-79, and to provide population and health data for policymakers and researchers. The objectives of the survey are to: assess the overall demographic situation in Sudan, assist in the evaluation of population and health programmes, assist the Department of Statistics in strengthening and improving its technical skills for conducting demographic and health surveys, enable the National Population Committee (NPC) to develop a population policy for the country, and measure changes in fertility and contraceptive prevalence, and study the factors which affect these changes, and examine the basic indicators of maternal and child health in Sudan. MAIN RESULTS Fertility levels and trends Fertility has declined sharply in Sudan, from an average of six children per women in the Sudan Fertility Survey (TFR 6.0) to five children in the Sudan DHS survey flTR 5.0). Women living in urban areas have lower fertility (TFR 4.1) than those in rural areas (5.6), and fertility is lower in the Khartoum and Northern regions than in other regions. The difference in fertility by education is particularly striking; at current rates, women who have attained secondary school education will have an average of 3.3 children compared with 5.9 children for women with no education, a difference of almost three children. Although fertility in Sudan is low compared with most sub-Saharan countries, the desire for children is strong. One in three currently married women wants to have another child within two years and the same proportion want another child in two or more years; only one in four married women wants to stop childbearing. The proportion of women who want no more children increases with family size and age. The average ideal family size, 5.9 children, exceeds the total fertility rate (5.0) by approximately one child. Older women are more likely to want large families than younger women, and women just beginning their families say they want to have about five children. Marriage Almost all Sudanese women marry during their lifetime. At the time of the survey, 55 percent of women 15-49 were currently married and 5 percent were widowed or divorced. Nearly one in five currently married women lives in a polygynous union (i.e., is married to a man who has more than one wife). The prevalence of polygyny is about the same in the SDHS as it was in the Sudan Fertility Survey. Marriage occurs at a fairly young age, although there is a trend toward later marriage among younger women (especially those with junior secondary or higher level of schooling). The proportion of women 15-49 who have never married is 12 percentage points higher in the SDHS than in the Sudan Fertiliy Survey. There has been a substantial increase in the average age at first marriage in Sudan. Among SDHS. Since age at first marriage is closely associated with fertility, it is likely that fertility will decrease in the future. With marriages occurring later, women am having their first birth at a later age. While one in three women age 45-49 had her first birth before age 18, only one in six women age 20-24 began childbearing prior to age 18. The women most likely to postpone marriage and childbearing are those who live in urban areas ur in the Khartoum and Northern regions, and women with pest-primary education. Breastfeeding and postpartum abstinence Breastfeeding and postpartum abstinence provide substantial protection from pregnancy after the birth uf a child. In addition to the health benefits to the child, breastfeeding prolongs the length of postpartum amenorrhea. In Sudan, almost all women breastfeed their children; 93 percent of children are still being breastfed 10-11 months after birth, and 41 percent continue breastfeeding for 20-21 months. Postpartum abstinence is traditional in Sudan and in the first two months following the birth of a child 90 percent of women were abstaining; this decreases to 32 percent after two months, and to 5 percent at~er one year. The survey results indicate that the combined effects of breastfeeding and postpartum abstinence protect women from pregnancy for an average of 15 months after the birth of a child. Knowledge and use of contraception Most currently married women (71 percent) know at least one method of family planning, and 59 percent know a source for a method. The pill (70 percent) is the most widely known method, followed by injection, female sterilisation, and the IUD. Only 39 percent of women knew a traditional method of family planning. Despite widespread knowledge of family planning, only about one-fourth of ever-married women have ever used a contraceptive method, and among currently married women, only 9 percent were using a method at the time of the survey (6 percent modem methods and 3 percent traditional methods). The level of contraceptive use while still low, has increased from less than 5 percent reported in the Sudan Fertility Survey. Use of family planning varies by age, residence, and level of education. Current use is less than 4 percent among women 15-19, increases to 10 percent for women 30-44, then decreases to 6 percent for women 45-49. Seventeen percent of urban women practice family planning compared with only 4 percent of rural women; and women with senior secondary education are more likely to practice family planning (26 percent) than women with no education (3 percent). There is widespread approval of family planning in Sudan. Almost two-thirds of currently married women who know a family planning method approve of the use of contraception. Husbands generally share their wives's views on family planning. Three-fourths of married women who were not using a contraceptive method at the time of the survey said they did not intend to use a method in the future. Communication between husbands and wives is important for successful family planning. Less than half of currently married women who know a contraceptive method said they had talked about family planning with their husbands in the year before the survey; one in four women discussed it once or twice; and one in five discussed it more than twice. Younger women and older women were less likely to discuss family planning than those age 20 to 39. Mortality among children The neonatal mortality rate in Sudan remained virtually unchanged in the decade between the SDHS and the SFS (44 deaths per 1000 births), but under-five mortality decreased by 14 percent (from 143 deaths per 1000 births to 123 per thousand). Under-five mortality is 19 percent lower in urban areas (117 per 1000 births) than in rural areas (144 per 10(30 births). The level of mother's education and the length of the preceding birth interval play important roles in child survival. Children of mothers with no education experience nearly twice the level of under-five mortality as children whose mother had attained senior secondary or nigher education. Mortality among children under five is 2.7 times higher among children born after an interval of less than 24 months than among children born after interval of 48 months or more. Maternal mortality The maternal mortality rate (maternal deaths per 1000 women years of exposure) has remained nearly constant over the twenty years preceding the survey, while the maternal mortality ratio (number of maternal deaths per 100,000 births), has increased (despite declining fertility). Using the direct method of estimation, the maternal mortality ratio is 352 maternal deaths per 100,000 births for the period 1976-82, and 552 per 100,000 births for the period 1983-89. The indirect estimate for the maternal mortality ratio is 537. The latter estimate is an average of women's experience over an extended period before the survey centred on 1977. Maternal health care The health care mothers receive during pregnancy and delivery is important to the survival and well-being of both children and mothers. The SDHS results indicate that most women in Sudan made at least one antenatal visit to a doctor or trained health worker/midwife. Eighty-seven percent of births benefitted from professional antenatal care in urban areas compared with 62 percent in rural areas. Although the proportion of pregnant mothers seen by trained health workers/midwives are similar in urban and rural areas, doctors provided antenatal care for 42 percent and 19 percent of births in urban and rural areas, respectively. Neonatal tetanus, a major cause of infant deaths in developing countries, can be prevented if mothers receive tetanus toxoid vaccinations.

This map shows the average number of children born to a woman during her lifetime. Data from Population Reference Bureau's 2017 World Population Data Sheet. The world's total fertility rate reported in 2017 was 2.5 as a whole. Replacement-Level fertility is widely recognized as 2.0 children per woman, so as to "replace" each parent in the next generation. Countries depicted in pink have a total fertility rate below replacement level whereas countries depicted in teal have a total fertility rate above replacement level. In countries with very high child mortality rates, a replacement level of 2.1 could be used, since not every child will survive into their reproductive years. Determinants of Total Fertility Rate include: women's education levels and opportunities, marriage rates among women of childbearing age (generally defined as 15-49), contraceptive usage and method mix/effectiveness, infant & child mortality rates, share of population living in urban areas, the importance of children as part of the labor force (or cost/penalty to women's labor force options that having children poses), and religious and cultural norms, among many other factors. This map was made using the Global Population and Maternal Health Indicators layer.

The 1996 Nepal Family Health Survey (NFHS) is a nationally representative survey of 8,429 ever- married women age 15-49. The survey is the fifth in a series of demographic and health surveys conducted in Nepal since 1976. The main purpose of the NFHS was to provide detailed information on fertility, family planning, infant and child mortality, and matemal and child health and nutrition. In addition, the NFHS included a series of questions on knowledge of AIDS. The primary objective of the Nepal Family Health Survey (NFHS) is to provide national level estimates of fertility and child mortality. The survey also provides information on nuptiality, contraceptive knowledge and behaviour, the potential demand for contraception, other proximate determinants of fertility, family size preferences, utilization of antenatal services, breastfeeding and food supplementation practices, child nutrition and health, immunizations, and knowledge about Acquired Immune Deficiency Syndrome (AIDS). This information will assist policy-makers, administrators and researchers to assess and evaluate population and health programmes and strategies. The NFHS is comparable to Demographic and Health Surveys (DHS) conducted in other developing countries. MAIN RESULTS FERTILITY Survey results indicate that fertility in Nepal has declined steadily from over 6 births per woman in the mid-1970s to 4.6 births per woman during the period of 1994-1996. Differentials in fertility by place of residence are marked, with the total fertility rate (TFR) for urban Nepal (2.9 births per woman) about two children less than for rural Nepal (4.8 births per woman). The TFR in the Mountains (5.6 births per woman) is about one child higher than the TFR in the Hills and Terai (4.5 and 4.6 births per woman, respectively). By development region, the highest TFR is observed in the Mid-western region (5.5 births per woman) and the lowest TFR in the Eastern region (4.1 births per woman). Fertility decline in Nepal has been influenced in part by a steady increase in age at marriage over the past 25 years. The median age at first marriage has risen from 15.5 years among women age 45-49 to 17.1 years among women age 20-24. This trend towards later marriage is supported by the fact that the proportion of women married by age 15 has declined from 41 percent among women age 45-49 to 14 percent among women age 15-19. There is a strong relationship between female education and age at marriage. The median age at first marriage for women with no formal education is 16 years, compared with 19.8 years for women with some secondary education. Despite the trend towards later age at marriage, childbearing begins early for many Nepalese women. One in four women age 15-19 is already a mother or pregnant with her first child, with teenage childbearing more common among rural women (24 percent) than urban women (20 percent). Nearly one in three adolescent women residing in the Terai has begun childbearing, compared with one in five living in the Mountains and 17 percent living in the Hills. Regionally, the highest level of adolescent childbearing is observed in the Central development region while the lowest is found in the Western region. Short birth intervals are also common in Nepal, with one in four births occurring within 24 months of a previous birth. This is partly due to the relatively short period of insusceptibility, which averages 14 months, during which women are not exposed to the risk of pregnancy either because they are amenorrhoeic or abstaining. By 12-13 months after a birth, mothers of the majority of births (57 percent) are susceptible to the risk of pregnancy. Early childbearing and short birth intervals remain a challenge to policy-makers. NFHS data show that children born to young mothers and those born after short birth intervals suffer higher rates of morbidity and mortality. Despite the decline in fertility, Nepalese women continue to have more children than they consider ideal. At current fertility levels, the average woman in Nepal is having almost 60 percent more births than she wantsthe total wanted fertility rate is 2.9 births per woman, compared with the actual total fertility rate of 4.6 births per woman. Unplanned and unwanted births are often associated with increased mortality risks. More than half(56 percent) of all births in the five-year period before the survey had an increased risk of dying because the mother was too young (under 18 years) or too old (more than 34 years), or the birth was of order 3 or higher, or the birth occurred within 24 months of a previous birth. Nevertheless, the percentage of women who want to stop childbearing in Nepal has increased substantially, from 40 percent in 1981 to 52 percent in 1991 and to 59 percent in 1996. According to the NFHS, 41 percent of currently married women age 15-49 say they do not want any more children, and an additional 18 percent have been sterilized. Furthermore, 21 percent of married women want to wait at least two years for their next child and only 13 percent want to have a child soon, that is, within two years. FAMILY PLANNING Knowledge of family planning is virtually universal in Nepal, with 98 percent of currently married women having heard of at least one method of family planning. This is a five-fold increase over the last two decades (1976-1996). Much of this knowledge comes from media exposure. Fifty-three percent of ever-married women had been exposed to family planning messages on the radio and/or the television and 23 percent have been exposed to messages through the print media. In addition, about one in four women has heard at least one of three specific family planning programmes on the radio. There has been a steady increase in the level of ever use of modern contraceptive method over the past 20 years, from 4 percent of currently married women in 1976, to 27 percent in 1991 and 35 percent in 1996. Among ever-users, female sterilization and male sterilization are the most popular methods (37 percent), indicating that contraceptive methods have been used more for limiting than for spacing births. The contraceptive prevalence rate among currently married women is 29 percent, with the majority of women using modern methods (26 percent). Again, the most widely used method is sterilization (18 percent, male and female combined), followed by injectables (5 percent). Although current use of modern contraceptive methods has risen steadily over the last two decades, the pace of change has been slowest in the most recent years (1991-1996). Current use among currently married non-pregnant women increased from 3 percent in 1976 to 15 percent in 1986 to 24 percent in 1991 and to 29 percent in 1996. While female sterilization increased by only 3 percent from 45 percent of modern methods in 1986 to 46 percent in 1996, male sterilization declined by almost 50 percent from 41 percent to 21 percent over the same period. The level of current use is nearly twice as high in the urban areas (50 percent) as in rural areas (27 percent). Only 18 percent of currently married women residing in the Mountains are currently using contraception, compared with 30 percent and 29 percent living in the Hills and Terai regions, respectively. There is a notable difference in current contraceptive use between the Far-western region (21 percent) and all the other regions, especially the Central and Eastern regions (31 percent each). Educational differences in current use are large, with 26 percent of women with no education currently using contraception, compared with 52 percent of women who have completed their School Leaving Certificate (SLC). In general, as women's level of education rises, they are more likely to use modem spacing methods. The public sector figures prominently as a source of modem contraceptives. Seventy-nine percent of modem method users obtained their methods from a public source, especially hospitals and district clinics (32 percent) and mobile camps (28 percent). The public sector is the predominant source of sterilizations, 1UDs, injectables, and Norplant, and both the public and private sectors are equally important sources of the pill and condoms. Nevertheless, the public sector's share of the market has fallen over the last five years from 93 percent of current users in 1991 to 79 percent in 1996. There is considerable potential for increased family planning use in Nepal. Overall, one in three women has an unmet need for family planning14 percent for spacing and 17 percent for limiting. The total demand for family planning, including those women who are currently using contraception, is 60 percent. Currently, the family planning needs of only one in two women is being met. While the increase in unmet need between 1991 (28 percent) and 1996 (31 percent) was small, there was a 14 percent increase in the percentage of women using any method of family planning and, over the same period, a corresponding increase of 18 percent in the demand for family planning. MATERNAL AND CHILD HEALTH At current mortality levels, one of every 8 children born in Nepal will die before the fifth birthday, with two of three deaths occurring during the first year of life. Nevertheless, NFHS data show that mortality levels have been declining rapidly in Nepal since the eighties. Under-five mortality in the period 0-4 years before the survey is 40 percent lower than it was 10-14 years before the survey, with child mortality declining faster (45 percent) than infant mortality (38 percent). Mortality is consistently lower in urban than in rural areas, with children in the Mountains faring much worse than children living in the Hills and Terai. Mortality is also far worse in the Far-western and Mid-western development regions than in the other regions. Maternal education is strongly related to mortality, and children of highly educated mothers are least likely to die young. For example, infant mortality is nearly

Abstract: In a sequence of black and white animated drawings, the voice-over of a little girl tells in a simple and cheerful way her experience with having a younger brother affected by autism. Details: The voice-over of a little girl accompanies a sequence of black-and-white animated drawings that depict the story of how a little girl acknowledges her younger brother’s condition as an autistic child. Her innocent and spontaneous voice conveys the simplicity in which she experiences having a younger brother with autism, her efforts to understand him, and to build a relationship with him. She starts by describing him as a baby and having regular behaviours like every other baby: he ate, cried, and did not sleep much at night. Once he grew, though, he was almost isolated from the rest of the world. In fact, the drawings depict him as surrounded by a white circle that separates him from the black background and from his sister. She says that she tries to make him laugh, but he does not react. He just keeps looking upwards, “towards the sky”. She makes a list of some situations, such as loud noises or activities he does not like, that trigger a bad reaction in him and comments that when it happens, it is not fun. She also says that their parents need to carefully cut his hair when he sleeps to not make him mad that sometimes he moves his arms as if he wanted to fly, while people on the street give him a weird look. She says that he went to a lot of doctors and that their parents say that he is not like everyone else, and that is why she likes him. Because of his “strange behaviours,” she describes her brother as “coming from the moon,” even though she knows he was born on Earth. The first clue is that he likes rounded and shiny objects. In fact, the only time in which he does not look up is when he sees a manhole on the street. He also only likes to crawl up the stairs, not to descend them. She reveals that she would like to be a fairy to make everything he wants come true and to take him down from the moon to the earth. She also reveals that she invented a special language to communicate with him, play with him and make him laugh. The end scene shows them both running around and laughing, surrounded by a bigger white circle that she managed to enter. In the end, she hums a song while a text written by an adult speaks metaphorically about the “child from the moon” and wonders about what the right way is to approach him.

The second National Family Health Survey (NFHS-2), conducted in 1998-99, provides information on fertility, mortality, family planning, and important aspects of nutrition, health, and health care. The International Institute for Population Sciences (IIPS) coordinated the survey, which collected information from a nationally representative sample of more than 90,000 ever-married women age 15-49. The NFHS-2 sample covers 99 percent of India's population living in all 26 states. This report is based on the survey data for 25 of the 26 states, however, since data collection in Tripura was delayed due to local problems in the state. IIPS also coordinated the first National Family Health Survey (NFHS-1) in 1992-93. Most of the types of information collected in NFHS-2 were also collected in the earlier survey, making it possible to identify trends over the intervening period of six and one-half years. In addition, the NFHS-2 questionnaire covered a number of new or expanded topics with important policy implications, such as reproductive health, women's autonomy, domestic violence, women's nutrition, anaemia, and salt iodization. The NFHS-2 survey was carried out in two phases. Ten states were surveyed in the first phase which began in November 1998 and the remaining states (except Tripura) were surveyed in the second phase which began in March 1999. The field staff collected information from 91,196 households in these 25 states and interviewed 89,199 eligible women in these households. In addition, the survey collected information on 32,393 children born in the three years preceding the survey. One health investigator on each survey team measured the height and weight of eligible women and children and took blood samples to assess the prevalence of anaemia. SUMMARY OF FINDINGS POPULATION CHARACTERISTICS Three-quarters (73 percent) of the population lives in rural areas. The age distribution is typical of populations that have recently experienced a fertility decline, with relatively low proportions in the younger and older age groups. Thirty-six percent of the population is below age 15, and 5 percent is age 65 and above. The sex ratio is 957 females for every 1,000 males in rural areas but only 928 females for every 1,000 males in urban areas, suggesting that more men than women have migrated to urban areas. The survey provides a variety of demographic and socioeconomic background information. In the country as a whole, 82 percent of household heads are Hindu, 12 percent are Muslim, 3 percent are Christian, and 2 percent are Sikh. Muslims live disproportionately in urban areas, where they comprise 15 percent of household heads. Nineteen percent of household heads belong to scheduled castes, 9 percent belong to scheduled tribes, and 32 percent belong to other backward classes (OBCs). Two-fifths of household heads do not belong to any of these groups. Questions about housing conditions and the standard of living of households indicate some improvements since the time of NFHS-1. Sixty percent of households in India now have electricity and 39 percent have piped drinking water compared with 51 percent and 33 percent, respectively, at the time of NFHS-1. Sixty-four percent of households have no toilet facility compared with 70 percent at the time of NFHS-1. About three-fourths (75 percent) of males and half (51 percent) of females age six and above are literate, an increase of 6-8 percentage points from literacy rates at the time of NFHS-1. The percentage of illiterate males varies from 6-7 percent in Mizoram and Kerala to 37 percent in Bihar and the percentage of illiterate females varies from 11 percent in Mizoram and 15 percent in Kerala to 65 percent in Bihar. Seventy-nine percent of children age 6-14 are attending school, up from 68 percent in NFHS-1. The proportion of children attending school has increased for all ages, particularly for girls, but girls continue to lag behind boys in school attendance. Moreover, the disparity in school attendance by sex grows with increasing age of children. At age 6-10, 85 percent of boys attend school compared with 78 percent of girls. By age 15-17, 58 percent of boys attend school compared with 40 percent of girls. The percentage of girls 6-17 attending school varies from 51 percent in Bihar and 56 percent in Rajasthan to over 90 percent in Himachal Pradesh and Kerala. Women in India tend to marry at an early age. Thirty-four percent of women age 15-19 are already married including 4 percent who are married but gauna has yet to be performed. These proportions are even higher in the rural areas. Older women are more likely than younger women to have married at an early age: 39 percent of women currently age 45-49 married before age 15 compared with 14 percent of women currently age 15-19. Although this indicates that the proportion of women who marry young is declining rapidly, half the women even in the age group 20-24 have married before reaching the legal minimum age of 18 years. On average, women are five years younger than the men they marry. The median age at marriage varies from about 15 years in Madhya Pradesh, Bihar, Uttar Pradesh, Rajasthan, and Andhra Pradesh to 23 years in Goa. As part of an increasing emphasis on gender issues, NFHS-2 asked women about their participation in household decisionmaking. In India, 91 percent of women are involved in decision-making on at least one of four selected topics. A much lower proportion (52 percent), however, are involved in making decisions about their own health care. There are large variations among states in India with regard to women's involvement in household decisionmaking. More than three out of four women are involved in decisions about their own health care in Himachal Pradesh, Meghalaya, and Punjab compared with about two out of five or less in Madhya Pradesh, Orissa, and Rajasthan. Thirty-nine percent of women do work other than housework, and more than two-thirds of these women work for cash. Only 41 percent of women who earn cash can decide independently how to spend the money that they earn. Forty-three percent of working women report that their earnings constitute at least half of total family earnings, including 18 percent who report that the family is entirely dependent on their earnings. Women's work-participation rates vary from 9 percent in Punjab and 13 percent in Haryana to 60-70 percent in Manipur, Nagaland, and Arunachal Pradesh. FERTILITY AND FAMILY PLANNING Fertility continues to decline in India. At current fertility levels, women will have an average of 2.9 children each throughout their childbearing years. The total fertility rate (TFR) is down from 3.4 children per woman at the time of NFHS-1, but is still well above the replacement level of just over two children per woman. There are large variations in fertility among the states in India. Goa and Kerala have attained below replacement level fertility and Karnataka, Himachal Pradesh, Tamil Nadu, and Punjab are at or close to replacement level fertility. By contrast, fertility is 3.3 or more children per woman in Meghalaya, Uttar Pradesh, Rajasthan, Nagaland, Bihar, and Madhya Pradesh. More than one-third to less than half of all births in these latter states are fourth or higher-order births compared with 7-9 percent of births in Kerala, Goa, and Tamil Nadu. Efforts to encourage the trend towards lower fertility might usefully focus on groups within the population that have higher fertility than average. In India, rural women and women from scheduled tribes and scheduled castes have somewhat higher fertility than other women, but fertility is particularly high for illiterate women, poor women, and Muslim women. Another striking feature is the high level of childbearing among young women. More than half of women age 20-49 had their first birth before reaching age 20, and women age 15-19 account for almost one-fifth of total fertility. Studies in India and elsewhere have shown that health and mortality risks increase when women give birth at such young ages?both for the women themselves and for their children. Family planning programmes focusing on women in this age group could make a significant impact on maternal and child health and help to reduce fertility. INFANT AND CHILD MORTALITY NFHS-2 provides estimates of infant and child mortality and examines factors associated with the survival of young children. During the five years preceding the survey, the infant mortality rate was 68 deaths at age 0-11 months per 1,000 live births, substantially lower than 79 per 1,000 in the five years preceding the NFHS-1 survey. The child mortality rate, 29 deaths at age 1-4 years per 1,000 children reaching age one, also declined from the corresponding rate of 33 per 1,000 in NFHS-1. Ninety-five children out of 1,000 born do not live to age five years. Expressed differently, 1 in 15 children die in the first year of life, and 1 in 11 die before reaching age five. Child-survival programmes might usefully focus on specific groups of children with particularly high infant and child mortality rates, such as children who live in rural areas, children whose mothers are illiterate, children belonging to scheduled castes or scheduled tribes, and children from poor households. Infant mortality rates are more than two and one-half times as high for women who did not receive any of the recommended types of maternity related medical care than for mothers who did receive all recommended types of care. HEALTH, HEALTH CARE, AND NUTRITION Promotion of maternal and child health has been one of the most important components of the Family Welfare Programme of the Government of India. One goal is for each pregnant woman to receive at least three antenatal check-ups plus two tetanus toxoid injections and a full course of iron and folic acid supplementation. In India, mothers of 65 percent of the children born in the three years preceding NFHS-2 received at least one antenatal

Moldova's first Demographic and Health Survey (2005 MDHS) is a nationally representative sample survey of 7,440 women age 15-49 and 2,508 men age 15-59 selected from 400 sample points (clusters) throughout Moldova (excluding the Transnistria region). It is designed to provide data to monitor the population and health situation in Moldova; it includes several indicators which follow up on those from the 1997 Moldova Reproductive Health Survey (1997 MRHS) and the 2000 Multiple Indicator Cluster Survey (2000 MICS). The 2005 MDHS used a two-stage sample based on the 2004 Population and Housing Census and was designed to produce separate estimates for key indicators for each of the major regions in Moldova, including the North, Center, and South regions and Chisinau Municipality. Unlike the 1997 MRHS and the 2000 MICS surveys, the 2005 MDHS did not cover the region of Transnistria. Data collection took place over a two-month period, from June 13 to August 18, 2005. The survey obtained detailed information on fertility levels, abortion levels, marriage, sexual activity, fertility preferences, awareness and use of family planning methods, breastfeeding practices, nutritional status of women and young children, childhood mortality, maternal and child health, adult health, and awareness and behavior regarding HIV infection and other sexually transmitted diseases. Hemoglobin testing was conducted on women and children to detect the presence of anemia. Additional features of the 2005 MDHS include the collection of information on international emigration, language preference for reading printed media, and domestic violence. The 2005 MDHS was carried out by the National Scientific and Applied Center for Preventive Medicine, hereafter called the National Center for Preventive Medicine (NCPM), of the Ministry of Health and Social Protection. ORC Macro provided technical assistance for the MDHS through the USAID-funded MEASURE DHS project. Local costs of the survey were also supported by USAID, with additional funds from the United Nations Children's Fund (UNICEF), the United Nations Population Fund (UNFPA), and in-kind contributions from the NCPM. MAIN RESULTS CHARACTERISTICS OF RESPONDENTS Ethnicity and Religion. Most women and men in Moldova are of Moldovan ethnicity (77 percent and 76 percent, respectively), followed by Ukrainian (8-9 percent of women and men), Russian (6 percent of women and men), and Gagauzan (4-5 percent of women and men). Romanian and Bulgarian ethnicities account for 2 to 3 percent of women and men. The overwhelming majority of Moldovans, about 95 percent, report Orthodox Christianity as their religion. Residence and Age. The majority of respondents, about 58 percent, live in rural areas. For both sexes, there are proportionally more respondents in age groups 15-19 and 45-49 (and also 45-54 for men), whereas the proportion of respondents in age groups 25-44 is relatively lower. This U-shaped age distribution reflects the aging baby boom cohort following World War II (the youngest of the baby boomers are now in their mid-40s), and their children who are now mostly in their teens and 20s. The smaller proportion of men and women in the middle age groups reflects the smaller cohorts following the baby boom generation and those preceding the generation of baby boomers' children. To some degree, it also reflects the disproportionately higher emigration of the working-age population. Education. Women and men in Moldova are universally well educated, with virtually 100 percent having at least some secondary or higher education; 79 percent of women and 83 percent of men have only a secondary or secondary special education, and the remainder pursues a higher education. More women (21 percent) than men (16 percent) pursue higher education. Language Preference. Among women, preferences for language of reading material are about equal for Moldovan (37 percent) and Russian (35 percent) languages. Among men, preference for Russian (39 percent) is higher than for Moldovan (25 percent). A substantial percentage of women and men prefer Moldovan and Russian equally (27 percent of women and 32 percent of men). Living Conditions. Access to electricity is almost universal for households in Moldova. Ninety percent of the population has access to safe drinking water, with 86 percent in rural areas and 96 percent in urban areas. Seventy-seven percent of households in Moldova have adequate means of sanitary disposal, with 91 percent of households in urban areas and only 67 percent in rural areas. Children's Living Arrangements. Compared with other countries in the region, Moldova has the highest proportion of children who do not live with their mother and/or father. Only about two-thirds (69 percent) of children under age 15 live with both parents. Fifteen percent live with just their mother although their father is alive, 5 percent live with just their father although their mother is alive, and 7 percent live with neither parent although they are both alive. Compared with living arrangements of children in 2000, the situation appears to have worsened. FERTILITY Fertility Levels and Trends. The total fertility rate (TFR) in Moldova is 1.7 births. This means that, on average, a woman in Moldova will give birth to 1.7 children by the end of her reproductive period. Overall, fertility rates have declined since independence in 1991. However, data indicate that fertility rates may have increased in recent years. For example, women of childbearing age have given birth to, on average, 1.4 children at the end of their childbearing years. This is slightly less than the total fertility rate (1.7), with the difference indicating that fertility in the past three years is slightly higher than the accumulation of births over the past 30 years. Fertility Differentials. The TFR for rural areas (1.8 births) is higher than that for urban areas (1.5 births). Results show that this urban-rural difference in childbearing rates can be attributed almost exclusively to younger age groups. CONTRACEPTION Knowledge of Contraception. Knowledge of family planning is nearly universal, with 99 percent of all women age 15-49 knowing at least one modern method of family planning. Among all women, the male condom, IUD, pills, and withdrawal are the most widely known methods of family planning, with over 80 percent of all women saying they have heard of these methods. Female sterilization is known by two-thirds of women, while periodic abstinence (rhythm method) is recognized by almost six in ten women. Just over half of women have heard of the lactational amenorrhea method (LAM), while 40-50 percent of all women have heard of injectables, male sterilization, and foam/jelly. The least widely known methods are emergency contraception, diaphragm, and implants. Use of Contraception. Sixty-eight percent of currently married women are using a family planning method to delay or stop childbearing. Most are using a modern method (44 percent of married women), while 24 percent use a traditional method of contraception. The IUD is the most widely used of the modern methods, being used by 25 percent of married women. The next most widely used method is withdrawal, used by 20 percent of married women. Male condoms are used by about 7 percent of women, especially younger women. Five percent of married women have been sterilized and 4 percent each are using the pill and periodic abstinence (rhythm method). The results show that Moldovan women are adopting family planning at lower parities (i.e., when they have fewer children) than in the past. Among younger women (age 20-24), almost half (49 percent) used contraception before having any children, compared with only 12 percent of women age 45-49. MATERNAL HEALTH Antenatal Care and Delivery Care. Among women with a birth in the five years preceding the survey, almost all reported seeing a health professional at least once for antenatal care during their last pregnancy; nine in ten reported 4 or more antenatal care visits. Seven in ten women had their first antenatal care visit in the first trimester. In addition, virtually all births were delivered by a health professional, in a health facility. Results also show that the vast majority of women have timely checkups after delivering; 89 percent of all women received a medical checkup within two days of the birth, and another 6 percent within six weeks. CHILD HEALTH Childhood Mortality. The infant mortality rate for the 5-year period preceding the survey is 13 deaths per 1,000 live births, meaning that about 1 in 76 infants dies before the first birthday. The under-five mortality rate is almost the same with 14 deaths per 1,000 births. The near parity of these rates indicates that most all early childhood deaths take place during the first year of life. Comparison with official estimates of IMRs suggests that this rate has been improving over the past decade. NUTRITION Breastfeeding Practices. Breastfeeding is nearly universal in Moldova: 97 percent of children are breastfed. However the duration of breast-feeding is not long, exclusive breastfeeding is not widely practiced, and bottle-feeding is not uncommon. In terms of the duration of breastfeeding, data show that by age 12-15 months, well over half of children (59 percent) are no longer being breastfed. By age 20-23 months, almost all children have been weaned. Exclusive breastfeeding is not widely practiced and supplementary feeding begins early: 57 percent of breastfed children less than 4 months are exclusively breastfed, and 46 percent under six months are exclusively breastfeed. The remaining breastfed children also consume plain water, water-based liquids or juice, other milk in addition to breast milk, and complimentary foods. Bottle-feeding is fairly widespread in Moldova; almost one-third (29 percent) of infants under 4 months old are fed with a bottle with

The 2008 Sierra Leone Demographic and Health Survey (SLDHS) is the first DHS survey to be held in Sierra Leone. Teams visited 353 sample points across Sierra Leone and collected data from a nationally representative sample of 7,374 women age 15-49 and 3,280 men age 15-59. The primary purpose of the 2008 SLDHS is to provide policy-makers and planners with detailed information on Demography and health. This is the first Demographic and Health Survey conducted in Sierra Leone and was carried out by Statistics Sierra Leone (SSL) in collaboration with the Ministry of Health and Sanitation. The 2008 SLDHS was funded by the Sierra Leone government, UNFPA, UNDP, UNICEF, DFID, USAID, and The World Bank. WHO, WFP and UNHCR provided logistical support. ICF Macro, an ICF International Company, provided technical support for the survey through the MEASURE DHS project. MEASURE DHS is sponsored by the United States Agency for International Development (USAID) to assist countries worldwide in obtaining information on key population and health indicators. The purpose of the SLDHS is to collect national- and regional-level data on fertility and contraceptive use, marriage and sexual activity, fertility preferences, breastfeeding practices, nutritional status of women and young children, childhood and adult mortality, maternal and child health, female genital cutting, awareness and behaviour regarding HIV/AIDS and other sexually transmitted infections, adult health, and other issues. The survey obtained detailed information on these topics from women of reproductive age and, for certain topics, from men as well. The 2008 SLDHS was carried out from late April 2008 to late June 2008, using a nationally representative sample of 7,758 households. The survey results are intended to assist policymakers and planners in assessing the current health and population programmes and in designing new strategies for improving reproductive health and health services in Sierra Leone. MAIN RESULTS FERTILITY Survey results indicate that there has been little or no decline in the total fertility rate over the past two decades, from 5.7 children per woman in 1980-85 to 5.1 children per woman for the three years preceding the 2008 SLDHS (approximately 2004-07). Fertility is lower in urban areas than in rural areas (3.8 and 5.8 children per woman, respectively). Regional variations in fertility are marked, ranging from 3.4 births per woman in the Western Region (where the capital, Freetown, is located) to almost six births per woman in the Northern and Eastern regions. Women with no education give birth to almost twice as many children as women who have been to secondary school (5.8 births, compared with 3.1 births). Fertility is also closely associated with household wealth, ranging from 3.2 births among women in the highest wealth quintile to 6.3 births among women in the lowest wealth quintile, a difference of more than three births. Research has demonstrated that children born too close to a previous birth are at increased risk of dying. In Sierra Leone, only 18 percent of births occur within 24 months of a previous birth. The interval between births is relatively long; the median interval is 36 months. FAMILY PLANNING The vast majority of Sierra Leonean women and men know of at least one method of contraception. Contraceptive pills and injectables are known to about 60 percent of currently married women and 49 percent of married men. Male condoms are known to 58 percent of married women and 80 percent of men. A higher proportion of respondents reported knowing a modern method of family planning than a traditional method. About one in five (21 percent) currently married women has used a contraceptive method at some time-19 percent have used a modern method and 6 percent have used a traditional method. However, only about one in twelve currently married women (8 percent) is currently using a contraceptive method. Modern methods account for almost all contraceptive use, with 7 percent of married women reporting use of a modern method, compared with only 1 percent using a traditional method. Injectables and the pill are the most widely used methods (3 and 2 percent of married women, respectively), followed by LAM and male condoms (less than 1 percent each). CHILD HEALTH Examination of levels of infant and child mortality is essential for assessing population and health policies and programmes. Infant and child mortality rates are also used as indices reflecting levels of poverty and deprivation in a population. The 2008 survey data show that over the past 15 years, infant and under-five mortality have decreased by 26 percent. Still, one in seven Sierra Leonean children dies before reaching age five. For the most recent five-year period before the survey (approximately calendar years 2003 to 2008), the infant mortality rate was 89 deaths per 1,000 live births and the under-five mortality rate was 140 deaths per 1,000 live births. The neonatal mortality rate was 36 deaths per 1,000 live births and the post-neonatal mortality rate was 53 deaths per 1,000 live births. The child mortality rate was 56 deaths per 1,000 children surviving to age one year. Mortality rates at all ages of childhood show a strong relationship with the length of the preceding birth interval. Under-five mortality is three times higher among children born less than two years after a preceding sibling (252 deaths per 1,000 births) than among children born four or more years after a previous child (deaths 81 per 1,000 births). MATERNAL HEALTH Almost nine in ten mothers (87 percent) in Sierra Leone receive antenatal care from a health professional (doctor, nurse, midwife, or MCH aid). Only 5 percent of mothers receive antenatal care from a traditional midwife or a community health worker; 7 percent of mothers do not receive any antenatal care. In Sierra Leone, over half of mothers have four or more antenatal care (ANC) visits, about 20 percent have one to three ANC visits, and only 7 percent have no antenatal care at all. The survey shows that not all women in Sierra Leone receive antenatal care services early in pregnancy. Only 30 percent of mothers obtain antenatal care in the first three months of pregnancy, 41 percent make their first visit in the fourth or fifth month, and 17 percent in have their first visit in the sixth or seventh month. Only 1 percent of women have their first ANC visit in their eighth month of pregnancy or later. BREASTFEEDING AND NUTRITION Poor nutritional status is one of the most important health and welfare problems facing Sierra Leone today and particularly afflicts women and children. The data show that 36 percent of children under five are stunted (too short for their age) and 10 percent of children under five are wasted (too thin for their height). Overall, 21 percent of children are underweight, which may reflect stunting, wasting, or both. For women, at the national level 11 percent of women are considered to be thin (body mass index

The dataset was collected to analyse changes in the growth pattern of children across the late nineteenth and twentieth century. Importantly for studying child growth, the ship recorded the heights and weights of the boys at admission to and discharge from the ship providing longitudinal measures of growth for a very large number of boys. Longitudinal measures allow us to directly observe children’s growth rather than inferring growth by comparing the differences in height between different children at different ages. There are also a number of individual characteristics available for the boys including birth place, last place of residence, parents’ occupation, orphan status, etc. This project will explore how improvements in nutrition, sanitation, and medical knowledge during Britain's long-run health transition from 1850 onwards influenced children's growth pattern in terms of height, weight and BMI. Studying children's growth pattern (velocity of growth and shape of the growth curve) rather than their height at a specific age is a significant methodological innovation. Adaptive theories of human development and growth stress how exposure to poor nutrition or disease, especially in utero, does not merely affect the child's current height but also the timing of the pubertal growth spurt, their velocity of growth and the length of the growing period: in other words, their growth pattern. This project will extend existing knowledge of children's growth in Britain in three ways: first, by reconstructing boys' longitudinal growth measurements from training ship records spanning the century and a half from 1865 onwards; second, by producing and analysing new growth profiles from historical sources; and third, by placing the change in Britain's growth pattern in international context using growth profiles (the average height and weight of children across a number of ages) collected from 1850 to the present from around the world. Four new datasets will be produced and deposited in the UK Data Archive as a part of the project: three individual-level datasets with the heights and weights of children and a dataset with growth profiles for a wide range of countries around the world from 1850 to the present. The data produced will supply a longer-run perspective on the immediate and intergenerational factors influencing children's growth patterns in Britain and internationally and indicate how the shift from an unhealthy to healthy growth pattern took place. The data will also assemble new evidence on historical BMI growth curves and child obesity rates, providing historical context for the current child obesity crisis. The project's findings are particularly relevant to the current discussion about a post-2015 development framework to replace the Millennium Development Goals and to understanding the childhood obesity crisis and will inform health interventions and development policy goals for improving the health of children in both the developing and developed worlds. The data were transcribed from the register books kept by the training ship Indefatigable about the boys that they trained. The registers have been split into those where no privacy restrictions hold because all individuals are dead, and those where privacy restrictions hold because individuals may still be alive. Detailed description of the transcription methods and process is provided in the documentation.

IntroductionStunting is still a major public health problem all over the world, it affecting more than one-third of under-five children in the world that leads to growth retardation, life-threatening complication and accelerate mortality and morbidity. The evidence is scarce on prevalence and associated factors of stunting among under-five children in Sub-Saharan Africa for incorporated intervention. Therefore this study aimed to investigate the prevalence and determinants of stunting among under-five children in Sub-Saharan Africa using recent demographic and health surveys of each country.MethodsThis study was based on the most recent Demographic and Health Survey data of 36 sub-Saharan African countries. A total of 203,852(weighted sample) under-five children were included in the analysis. The multi-level ordinal logistic regression was fitted to identify determinants of stunting. Parallel line (proportional odds) assumption was cheeked by Brant test and it is satisfied (p-value = 0.68) which is greater than 0.05. Due to the nested nature of the dataset deviance was used model comparison rather than AIC and BIC. Finally the adjusted odds ratio (AOR) with 95% CI was reported identify statistical significant determinants of stunting among under-five children.ResultsIn this study, the prevalence of stunting among under-five children in Sub-Saharan Africa 34.04% (95% CI: 33.83%, 34.24%) with a large difference between specific countries which ranges from 16.14% in Gabon to 56.17% in Burundi. In the multi-level ordinal logistic regression good maternal education, born from mothers aged above 35 years, high household wealth status, small family size, being female child, being female household head, having media exposure and having consecutive ANC visit were significantly associated with lower odds of stunting. Whereas, living from rural residence, being 24–59 month children age, single or divorced marital status, higher birth order and having diarrhea in the last two weeks were significantly associated with higher odds of stunting.ConclusionStunting among under-five children is still public health problem in Sub-Saharan Africa. Therefore designing interventions to address diarrhea and other infectious disease, improving the literacy level of the area and increase the economic level of the family to reduce the prevalence of stunting in the study area.

Abstract

Save the Children developed an early stimulation program that delivers actionable messages to mothers and other caregivers that show them how to interact and play with young children. The program also delivers a Child Development Card and two picture books, and instructions on how to use the card and the books to provide children with early learning opportunities. The program is low cost and potentially scalable because it builds on an existing delivery platform, and trains current community health care providers to deliver additional messages on early childhood stimulation practices.

Geographic coverage

Bangladesh is divided into seven major administrative regions called divisions, and the study takes place in three of Bangladesh’s seven divisions: Barisal (a southern district), Chittagong (a district in the southeast), and Sylhet (a district in the northeast). Within these three divisions, the study is located in three districts: Barisal (in the division of Barisal), Chittagong (in the division of Chittagong) and Moulvibazar (in the division of Sylhet). Districts are subdivided into subdistricts, or upazilas. Within these three districts, the study is located in three upazilas: Muladi (in the district of Barisal), Satkania (in the district of Chittagong), and Kalaura (in the district of Moulvibazar). Upazilas are subdivided into unions, and the study takes place in 30 unions: 4 unions in Muladi, 16 unions in Satkania, and 10 unions in Kalaura.

Analysis unit

Households Individuals

Universe

Households with children between 3 and 18 months of age residing in the catchment area of participating community clinics at the time of baseline data collection.

Kind of data

Sample survey data [ssd]

Sampling procedure

Sampling of Households The study sample frame was generated from community clinic health assistant records, which had the advantage of being the centralized government document of record containing the population frame for all households with children under five years of age. The health assistant dataset included data for all three upazilas of interest. Of a total of 41 unions located in the three upazilas, 11 unions were excluded from the sampling frame. Six of these had incomplete data, and five were excluded because they had only one community clinic and the study design required each union to have at least two clinics. The final sample included 78 community clinics, located in 30 unions.

Within the selected unions and community clinics, eligible households included those with children aged between 3 and 18 months who resided in selected community clinics' catchment areas during the baseline data collection period (November 2013-January 2014).We randomly sampled 33 households from each community clinic's catchment area to participate in the study. The sample was restricted to households with children aged three months or older because the main developmental assessment tool chosen for the evaluation (the Bayley-III; Bayley, 2006) had not been previously validated on children under the age of three months in Bangladesh. Furthermore, because the Bayley-III test is only valid for children up to the age of 42 months, we restricted the upper age limit of participating children to 18 months or younger at the time of baseline data collection in order to collect valid endline data 24 months later.

Replacement The community clinic health assistant records were not up to date, so the team developed rules for replacing households that were found to be ineligible or "out-of-scope," as well as households that refused to participate. We randomly selected 20 additional replacement households from within each community clinic and included them in a separate list, with each household randomly sorted from 1 to 20. If one of the 33 households originally selected was found to be ineligible or refused to participate, the field interviewer replaced it with the first household from the 20-household replacement list, and continued replacing households in order thereafter.

Overall, the majority of replacements were required because households were identified as ineligible, and only a few replacements were needed for households that refused to participate in the study (N = 39, or 1.5 percent of the sample). Households were ineligible if they did not fit the target sample description: "Households with children from 3-18 months of age that live in the selected community clinics' catchment areas during the period of the baseline data collection." This included: (a) households that had permanently left the catchment area (N = 300); (b) households with incorrect location information in the birth records (N = 291); (c) households with children who were ineligible due to inaccurate birth dates (N =173); and (d) households that were temporarily absent from the catchment area (N =159). For all 39 cases of refusal, the data collectors completed a non-complier questionnaire that captured some basic characteristics of this group to compare with the compliers.

Mode of data collection

Face-to-face [f2f]

Research instrument

Instruments AIR, ICDDR,B, and Data International Ltd. worked with Save the Children, the World Bank, and the evaluation advisory board to develop the study instruments. The team developed the data collection instruments by drawing from existing national and international tools aligned with the evaluation's outcomes of interest. The core indicators included child development outcomes, anthropometric measures, and parenting stimulation questions, although the final instrument contained many more relevant indicators. Where possible, indicators were measured using questions and approaches that had already been field tested in Bangladesh to ensure that they were appropriate for the local context and the target populations. We also designed the instruments to be of a manageable length in order to avoid interviewer or respondent fatigue and ensure high-quality data. On average, the final survey instruments took 30 minutes to complete.

Endline data collection tools resembled the instruments used at baseline. As discussed above, some instruments were modified slightly based on lessons learned during baseline data collection and monitoring data collection. The non-compliance survey was not administered at endline. Two new measures were added during endline: the Wolke Behavioral Rating Scale, which measures children's behavior during the Bayley-III; and a focus group protocol, with fathers and mothers grouped separately.

The Multiple Indicator Cluster Survey (MICS) is a household survey programme developed by UNICEF to assist countries in filling data gaps for monitoring human development in general and the situation of children and women in particular. MICS is capable of producing statistically sound, internationally comparable estimates of social indicators such as the Millennium Development Goals (MDGs) indicators. It is a flexible tool that is reasonably inexpensive and relatively quick to implement. Background MICS was originally developed in response to the 1990 World Summit for Children to measure progress towards an internationally agreed set of goals. The first round of MICS was conducted around 1995 in more than 60 countries. A second round of surveys was conducted in 2000 (around 65 surveys), and resulted in an increasing wealth of data to monitor the situation of children and women. For the first time it was possible to monitor trends in many indicators and set baselines for other indicators. Purpose Information on around 20 of the 48 MDG indicators will be collected in the current round of MICS, offering the largest single source of data for MDG monitoring. The current round of MICS is thus focused on providing a monitoring tool for the Millennium Development Goals (MDGs), the World Fit for Children (WFFC), as well as for other major international commitments, such as the United Nations General Assembly Special Session (UNGASS) on HIV/AIDS and the Abuja targets for malaria. Content MICS questionnaires are designed in a modular fashion that can be easily customized to the needs of a country. They consist of a household questionnaire, a questionnaire for women aged 15-49 and a questionnaire for children under the age of five (to be administered to the mother or caretaker). HOUSEHOLD: Household Listing, Education, Water and Sanitation, Household Characteristics, and Child Labour. WOMEN: Child Mortality, Tetanus Toxoid, Maternal and Newborn Health, Marriage, Contraception, and HIV/AIDS. CHILDREN: Birth Registration and Early Learning, Vitamin A, Breastfeeding, Care of Illness, Immunization, and Anthropometry. The surveys are typically carried out by government organizations, with the support and assistance of UNICEF and other partners. Technical assistance and training for the surveys is provided through a series of regional workshops, covering questionnaire content, sampling and survey implementation; data processing; data quality and data analysis; report writing and dissemination.

Romania RO: Fertility Rate: Total: Births per Woman data was reported at 1.580 Ratio in 2016. This stayed constant from the previous number of 1.580 Ratio for 2015. Romania RO: Fertility Rate: Total: Births per Woman data is updated yearly, averaging 1.910 Ratio from Dec 1960 (Median) to 2016, with 57 observations. The data reached an all-time high of 3.660 Ratio in 1967 and a record low of 1.270 Ratio in 2002. Romania RO: Fertility Rate: Total: Births per Woman data remains active status in CEIC and is reported by World Bank. The data is categorized under Global Database’s Romania – Table RO.World Bank: Health Statistics. Total fertility rate represents the number of children that would be born to a woman if she were to live to the end of her childbearing years and bear children in accordance with age-specific fertility rates of the specified year.; ; (1) United Nations Population Division. World Population Prospects: 2017 Revision. (2) Census reports and other statistical publications from national statistical offices, (3) Eurostat: Demographic Statistics, (4) United Nations Statistical Division. Population and Vital Statistics Reprot (various years), (5) U.S. Census Bureau: International Database, and (6) Secretariat of the Pacific Community: Statistics and Demography Programme.; Weighted average; Relevance to gender indicator: it can indicate the status of women within households and a woman’s decision about the number and spacing of children.