Armed conflicts and experience of intimate partner violence among women in Afghanistan: analysis of the 2015 Afghanistan DHS data.

OBJECTIVE: Armed conflicts and intimate partner violence (IPV) impose a burden on individual and societal well-being. Given the history of armed conflict in Afghanistan and the high prevalence of IPV, this study aims to examine the influence of armed conflicts on IPV among Afghan women. METHODS: Multilevel logistic regression models were applied to the 2015 Afghanistan Demographic and Health Survey (N=10 414 women aged 15-49). Armed conflict severity was measured using the conflict index issued by the Office for the Coordination of Humanitarian Affairs, IPV was measured by three types of violence, including emotional, physical and sexual violence. All analyses were conducted by using STATA V.15.1. RESULTS: Over 52% of women experienced at least one type of IPV, with 33.01%, 49.07%, and 8.99% experiencing emotional, physical, and sexual violence, respectively. The regression results show that armed conflicts were significantly and positively associated with the experience of all types of IPV. In addition, the association between armed conflicts and the experience of emotional IPV was positively moderated by women's attitudes towards IPV. CONCLUSION: Our findings suggest that women living in high-conflict regions were more prone to experience IPV, particularly women with positive attitudes towards IPV. Promoting progressive gender roles, women's empowerment, awareness of IPV and inclusion of women in conflict resolution will help deal with the issue of IPV.

Grandparenting and life satisfaction among Chinese elderlies: a study of possible mechanisms.

OBJECTIVE: This study examines the impact of caregiving on older people's life satisfaction, focusing on the role of caring for grandchildren. The study considers individual characteristics (aging attitudes) and situational factors (intergenerational support) and aims to identify the mediating roles of aging attitudes and intergenerational support in the relationship between caregiving and life satisfaction. METHOD: The study analyzed data from the 2014 China Longitudinal Aging Social Survey (CLASS), focusing on 5363 grandparents who reported providing care for their grandchildren in the 12 months before the survey. Life satisfaction was subjectively measured. The data was analyzed using multiple linear regression, propensity score matching, and mediation analysis. RESULT: The study found that grandparents who cared for their grandchildren have higher levels of life satisfaction. Self-aging attitudes, general aging attitudes, intergenerational economic support, intergenerational instrumental support, and intergenerational emotional support fully mediated the relationship between grandchild care and life satisfaction. CONCLUSION: This study demonstrates that caring for grandchildren is a vital activity for older people that helps them develop positive aging attitudes and strengthens intergenerational support, thereby improving their quality of life. Hence, the government, society, families, and communities should provide more social support to older adults caring for grandchildren. This would not only benefit the health of the older people themselves but also promote intergenerational harmony and family development.

Understanding, Experience, and Response Strategies to Sexual Harassment Among Chinese College Students.

Sexual harassment is a serious problem, and with a growing population of college students in China, the phenomenon is becoming prevalent. Using the 2010 data from the Third Survey on Chinese Women's Social Status, we examined relationships between understanding of sexual harassment and experience/response among Chinese college students. The results show that college students understand physical sexual harassment better (88%; unwanted sexual requests: 92%) than verbal and visual sexual harassment (54% and 70%, respectively). Understanding is higher among females than males, with a margin between eight to 21%. At a prevalence of 30%, the experience of verbal sexual harassment is the highest compared to other forms of harassment. Males were more likely to experience verbal and visual sexual harassment, while females were more likely to experience physical sexual harassment. In any event of sexual harassment, expressing dissatisfaction and stopping it is the response strategy that most resonates with respondents. It varied between 62% and 70% across forms of sexual harassment. Reporting to teachers or school authorities resonates least, varying between 0.30% and 2.28%. Understanding sexual harassment was strongly associated with a reduced likelihood of harassment. The equivalent odds ratios varied between 0.41 and 0.33 (p < .001), or 59-67% reduced likelihood across the forms of sexual harassment. Understanding sexual harassment was also strongly associated with an increased likelihood of not reacting passively or staying silent. Odds ratio varied between 1.99 and 3.86 (p < .001), about a minimum of twofold increased likelihood. Parents should strive to involve in their children's sex and sexual rights education, particularly during adolescence, to help them inculcate values against sexual harassment. Also, colleges and universities can bolster their curriculum with elective courses on sex education and regularly organize symposiums on sexual harassment to create a better understanding and awareness among students.

Maternal autonomy and childhood undernutrition: Analysis of 2018 Nigeria demographic and health survey.

Existing knowledge of how maternal autonomy relates to child undernutrition in Nigeria is few and limited to children under 24 months old. Nothing is known about how it affects older children. Therefore, this study investigated whether mothers' household autonomy affects children 24-59 months, as do children under 24 months old. We used data from 2018 Nigerian Demographic and Health Survey, which is a nationally representative survey. Samples include 3502 and 5463 children under 24 months and between 24 and 59 months old, respectively. Three anthropometry indexes were used to determine child undernutrition: weight-for-height, height-for-age, and weight-for-age, which indicate wasting, stunting, and underweight, respectively. Three domains of maternal autonomy: decision-making, financial-control, and mobility, were operationalized using responses from mothers. Results from logistic regression analysis show that in unadjusted models, maternal decision-making autonomy and mobility were associated with undernutrition in both samples. After adding covariates, only associations between maternal decision-making autonomy and underweight in children 24-59 months old retained statistical significance. Findings show that gendered social inequalities are linked to differences in child nutritional outcomes. Future studies could investigate how feeding practices mediate associations between maternal autonomy and childhood undernutrition.

Does psychosocial support buffer the effect of COVID-19 related stressors on mental health among Chinese during quarantine?

The effect of the COVID-19 related stressors on the mental health of both infected patients and the general public has been well established. However, knowledge is limited on how psychosocial support buffers the association. This study aimed to examine this buffering role in the context of China. We utilized cross-sectional data collected online in mid-March 2020, involving 585 respondents. Mental health status was determined through depression symptoms and loneliness. COVID-19 related stressors include three aspects: perceived severity, perceived threat to life and health, and perceived risk of COVID-19 infection. Psychosocial support included family and social supports. Analyses include ordinary linear regression. The finding showed that psychosocial support buffered the negative effect of loneliness in the context of perceived severity of COVID-19, but appeared to intensify the negative effect of depression symptoms in the context of perceived threat to life and health. However, there was no significant buffering effect on depression or loneliness in the context of the perceived risk of infection. The buffering effect of psychosocial support on COVID-19 related stressors is of mixed patterns. This study contributes to the emerging body of literature trying to understand how the COVID-19 impacts the mental health of individuals.

Sociocultural Determinants of Attitudes Toward Domestic Violence Among Women and Men in Afghanistan: Evidence from Afghanistan Demographic and Health Survey 2015.

Domestic violence (DV), also commonly referred to as intimate partner violence or spousal abuse, is a global public health issue that affects the physical, psychological, sexual, and reproductive health of women. We examined the sociocultural factors associated with the attitude toward DV perpetrated against women in Afghanistan. We used data from the 2015 Afghanistan Demographic and Health Survey, consisting of an ever-married sample of 29,461 women and 10,760 men aged 15 to 49 years. Our dependent variable, attitude toward DV, was determined from responses on acceptance of wife-beating in five scenarios, and the group of socio cultural factors was selected based on evidence from previous studies. Our main analytical method was logistic regression, using the survey design. Our findings indicated that factors such as an increase in years of education and living in a wealthier household reduce the likelihood of acceptance of DV among men and women. Ethnicity was also associated with the attitude toward DV, but the magnitude varied across ethnic groups and gender. Furthermore, an increase in age and living in the urban area were associated with nonjustification of DV among women, but not among men. On the other hand, frequent exposure to the media increases the likelihood of acceptance of DV among men, but not for women. The result of the present study suggests that there are economic, social, and cultural aspects to the attitude toward DV among men and women in Afghanistan. Therefore, policies designed at changing the socio cultural perception of the people are of importance in other to bring about a change in attitude, and even combat the prevalence of DV.

Decreasing Social Isolation to Enhance Mental Health among Older Adults in China: A Mediation Analysis of Aging Attitude.

A large body of literature has examined the relationship between social isolation and mental health in older adults. However, only a few studies have examined the mediating effects of aging attitudes on this relationship. This study investigated the impact of objective isolation (family isolation, friend isolation, and community isolation), and subjective social isolation (perceived isolation) on the mental health of Chinese older adults, and the mediating effect of aging attitudes. Mental health was assessed through depressive symptoms, using the Epidemiological Studies Depression Scale. The research sample comprising 7,024 elderly adults (60 years old), was obtained from the nationally representative 2014 Chinese Longitudinal Aging Social Survey. The regression analysis indicated that objective social isolation and subjective social isolation are independently related to mental health among older adults. Furthermore, in the mediation analysis, aging attitude was found to play a significant mediating role between social isolation and mental health. Our study concludes that though, objective and subjective social isolation are issues affecting mental health in older people, however, aging attitude also needs to be factored in that relationship as we have shown that there is a significant mediating effect.

Trends in the association between educational assortative mating, infant and child mortality in Nigeria.

BACKGROUND: Existing knowledge has established the connection between maternal education and child survival, but little is known about how educational assortative mating (EAM), relates to childhood mortality. We attempt to examine this association in the context of Nigeria. METHODS: Data was obtained from the 2008, 2013, and 2018 waves of the Nigeria Demographic and Health Survey, which is a cross-sectional study. The sample includes the analysis of 72,527 newborns within the 5 years preceding each survey. The dependent variables include the risk of a newborn dying before 12 months of age (infant mortality), or between the age of 12-59 months (child mortality). From the perspective of the mother, the independent variable, EAM, includes four categories (high-education homogamy, low-education homogamy, hypergamy, and hypogamy). The Cox proportional hazard regression was employed for multivariate analyses, while the estimation of mortality rates across the spectrum of EAM was obtained through the synthetic cohort technique. RESULTS: The risk of childhood mortality varied across the spectrum of EAM and was particularly lowest among those with high-education homogamy. Compared to children of mothers in low-education homogamy, children of mothers in high-education homogamy had 25, 31 to 19% significantly less likelihood of infant mortality, and 34, 41, and 57% significantly less likelihood of child mortality in 2008, 2013 and 2018 survey data, respectively. Also, compared to children of mothers in hypergamy, children of mothers in hypogamous unions had 20, 12, and 11% less likelihood of infant mortality, and 27, 36, and 1% less likelihood of child mortality across 2008, 2013 and 2018 surveys, respectively, although not significant at p < 0.05. Both infant and child mortality rates were highest in low-education homogamy, as expected, lowest in high-education homogamy, and lower in hypogamy than in hypergamy. Furthermore, the trends in the rate declined between 2008 and 2018, and were higher in 2018 than in 2013. CONCLUSION: This indicates that, beyond the absolute level of education, the similarities or dissimilarities in partners' education may have consequences for child survival, alluding to the family system theory. Future studies could investigate how this association varies when marital status is put into consideration.

Intimate partner violence and exclusive breastfeeding of infants: analysis of the 2013 Nigeria demographic and health survey.

BACKGROUND: Existing knowledge on the relationship between intimate partner violence (IPV) and exclusive breastfeeding (EBF) in the context of Nigeria is minimal and limited to a lifelong measure of IPV experience. An abuse experienced a long time ago may not have as much negative effect as that encountered at a more proximal time to the breastfeeding phase. To this effect, we examined this relationship with maternal IPV experienced around the time of pregnancy and postpartum. METHOD: We analyzed data from the 2013 Nigeria Demographic and Health Survey. The sample includes 2668 breastfeeding mothers having a child aged under 6 months. The outcome variable was EBF or mixed-feeding (24 h recall). The exposure variables were: the maternal experience of psychological, physical, and sexual intimate partner violence. Also, there was an experience of any form of IPV and frequency score of intimate partner violence. Analysis includes chi-square and t-test bivariates, complete case and imputed logistic regressions for binary outcome. RESULTS: In the imputed analysis, compared to mothers who experienced no IPV, those who experienced IPV had a 26% reduced likelihood of EBF practice (AOR 0.74; 95% CI 0.55, 1.00). Also, a unit dose of maternal IPV experience was associated with a 5% reduced likelihood of EBF practice (AOR 0.69; 95% CI 0.49, 0.98). Among the three forms of IPV, physical IPV had the highest effect size. Physical IPV was associated with a 37% reduced likelihood of EBF practice (AOR 0.63; 95% CI 0.44, 0.90), while psychological IPV was associated with a 34% reduced likelihood of EBF practice (AOR 0.66; 95% CI 0.47, 0.92), when compared to the respective reference groups. On the other hand, those who reported sexual IPV were just as likely to breastfeed as those who did not (AOR 0.94; 95% CI 0.62, 1.41). CONCLUSIONS: In this study, maternal IPV is associated with EBF practice. Policies aimed at promoting EBF should also be framed to combat IPV against pregnant women and nursing mothers.

Mothers' Healthcare Autonomy, Maternal-Health Utilization and Healthcare for Children under-3 Years: Analysis of the Nigeria DHS Data (2008-2018).

This study was designed to simultaneously examine if mothers' personal healthcare autonomy within the household, and the level of their maternal-healthcare utilization, translates into better preventive (complete immunization) and curative (treatments for diarrhoea, fever and acute respiratory infection) efforts on morbidities in child healthcare. We analysed data pooled from three consecutive waves of the Nigeria Demographic and Health Survey: the surveys of 2008, 2013 and 2018. Using a multilevel logistic regression, we estimated the odds ratio for each of the outcome variables while adjusting for covariates. Findings revealed that mothers' health autonomy is positively associated with child immunization and treatment of morbidities (except diarrhoea), a relationship moderated by the frequency of mothers' exposure to media. Additionally, mothers' healthcare utilization is positively associated with complete immunization, and all forms of morbidity treatment (except diarrhoea). Although the relationship between mothers' healthcare-utilization and child immunization is not dependent on family wealth, however, the relationship between mothers' healthcare utilization and treatment of morbidity is dependent. Policy effort should be geared towards stimulating mothers to seek appropriate and timely child healthcare and future studies could consider looking into the mediating role of paternal support in this relationship.

Supply and Demand-Related Decisive Factors in the Utilization of Non-Medical Community Healthcare Services among Elderly Chinese.

There is little research on the utilization of non-medical community healthcare services among the elderly, compared with that of medical community healthcare services. From the perspective of both supply and demand, based on the survey data from Shaanxi province, this study examined supply-related factors (including service supply, service quality, service charge and service accessibility) and demand-related factors (including service need, individual financial status, family care support and knowledge of service) affecting the utilization of non-medical community healthcare services among the elderly in China by using Poisson regression. The findings show that service supply, service quality, service need and knowledge of service are positively associated with the utilization of non-medical community healthcare services among elderly Chinese, but the other factors identified in previous studies are not significant predictors for the utilization of the services among the elderly in the context of China. To our knowledge, this is the first study to examine both supply-related factors and demand-related factors affecting the utilization of non-medical community healthcare services among elderly Chinese.