Suchergebnisse

Intimate partner violence is a global public health concern that is widely under-reported. Socio-demographic factors of the interviewer may contribute to a reluctance to report violence. The introduction of the fieldworker survey to the 2015 Zimbabwe Demographic and Health Survey provides the first opportunity to test associations between interviewer characteristics and the reporting of intimate partner violence in the largest source of IPV data on intimate partner violence available for low- and middle-income countries. Three separate, multilevel logistic regression models were used to examine associations between the reporting of physical, sexual and emotional intimate partner violence and interviewer characteristics (age, sex and marital status, as well as differences in these indicators between interviewer and respondent), language of the interview and the interviewer's previous experience conducting the Demographic and Health Survey. Previous experience as a Demographic and Health Survey interviewer was associated with significantly lower odds (OR: 0.67) of reporting physical intimate partner violence. Researchers should consider using the fieldworker data set in future studies to control for potential interviewer error, account for the clustering of data by interviewer and increase the robustness of Demographic and Health Survey analyses. Understanding how interviewers may shape the reporting of intimate partner violence is a step towards accurately measuring its burden in low- and middle-income countries.

The aim of this paper is to examine how nationwide marriage equality and minority stressors are associated with perceptions of social inclusion using a national sample of partnered men who have sex with men (MSM)(n=498). A four-item scale measuring changes in perceived social inclusion due to the nationwide legalization of same-sex marriage was created. Respondents were categorized into four distinct political environments using results from the 2016 US Presidential election. Multilevel modeling was used to examine associations between political environment, minority stressors, and perceived social inclusion. Changes in perceived social inclusion due to marriage equality did not significantly differ between political environments. Higher levels of internalized, anticipated, and enacted stigma were all associated with fewer gains in perceived social inclusion. An interaction between political environment and external stigma was significant in the most politically conservative areas. The legalization of marriage equality has improved perceived social inclusion overall, but less so among men who experience more discrimination and live in conservative environments. Multilevel interventions to change social norms are needed to help decrease minority stressors and improve perceived social inclusion in politically conservative areas with elevated levels of discrimination.

AbstractUnmet need for modern contraception is a major public health concern in resource‐constrained countries. Recent research supports the application of social‐ecological theories to explain how characteristics of a woman's community shape modern contraception use. However, this research focuses largely on individual countries and uses a limited number of community‐level effects. We fitted three random‐effects logistic regression models to examine associations between 13 community‐level variables and the odds of reporting unmet need, unmet need for spacing, and unmet need for limiting for all parous, female respondents in 44 DHS surveys collected in 2010–2015 (n=528,101). Community variables explain significant variance in unmet need between communities. Associations between community variables and unmet need differ by urban and rural residence. The results highlight several commonalities in how the community shapes unmet need across resource‐constrained settings and may help in designing structural‐level interventions.

SummarySocietal gender inequality and a preference for male children has been shown to be detrimental to girls' health. This is despite females' innate biological advantage early in life. The negative effects of gender inequity on female health are most pronounced in resource-poor countries, where cultural norms supporting a preference for male children are strongest. However, most of what is known about gender inequality and child health comes from studies of singleton births. There is little evidence for how, or if, the disadvantages associated with gender bias and son preference extend to multiple births, a population inherently at risk for a number of health challenges. This analysis examines whether gender bias in health outcomes exists for twins. Data on live twin births from 38 Demographic and Health Surveys were compiled (n=11,528 individuals) and twins were categorized as girl/girl, girl/boy, boy/girl or girl/girl. Gender inequality was measured via the Gender Inequality Index. Multilevel logistic regression models examined associations between twin sex composition, gender inequality and eight outcomes of infant and child morbidity, mortality and mother's treatment-seeking behaviours. Twin pairs containing girls had significantly lower odds of first-year mortality. Higher country-level gender inequality was associated with higher odds of reporting diarrhoea and fever/cough, as well as an increased odds of post-neonatal mortality. Results suggest that the biological advantage for females may be stronger than son preference and gender inequality in the first year of life. Understanding these relationships has the potential to inform efforts to curb the influence of gender preference on the health of female children in resource-poor settings.