Quantifying quality: The impact of measures of school quality on children's academic achievement across diverse societies.

Recent decades have seen a rapid acceleration in global participation in formal education, due to worldwide initiatives aimed to provide school access to all children. Research in high income countries has shown that school quality indicators have a significant, positive impact on numeracy and literacy-skills required to participate in the increasingly globalized economy. Schools vary enormously in kind, resources, and teacher training around the world, however, and the validity of using diverse school quality measures in populations with diverse educational profiles remains unclear. First, we assessed whether children's numeracy and literacy performance across populations improves with age, as evidence of general school-related learning effects. Next, we examined whether several school quality measures related to classroom experience and composition, and to educational resources, were correlated with one another. Finally, we examined whether they were associated with children's (4-12-year-olds, N = 889) numeracy and literacy performance in 10 culturally and geographically diverse populations which vary in historical engagement with formal schooling. Across populations, age was a strong positive predictor of academic achievement. Measures related to classroom experience and composition were correlated with one another, as were measures of access to educational resources and classroom experience and composition. The number of teachers per class and access to writing materials were key predictors of numeracy and literacy, while the number of students per classroom, often linked to academic achievement, was not. We discuss these results in the context of maximising children's learning environments and highlight study limitations to motivate future research. RESEARCH HIGHLIGHTS: We examined the extent to which four measures of school quality were associated with one another, and whether they predicted children's academic achievement in 10 culturally and geographically diverse societies. Across populations, measures related to classroom experience and composition were correlated with one another as were measures of access to educational resources to classroom experience and composition. Age, the number of teachers per class, and access to writing materials were key predictors of academic achievement across populations. Our data have implications for designing efficacious educational initiatives to improve school quality globally.

Examining relations between performance on non-verbal executive function and verbal self-regulation tasks in demographically-diverse populations.

Self-regulation is a widely studied construct, generally assumed to be cognitively supported by executive functions (EFs). There is a lack of clarity and consensus over the roles of specific components of EFs in self-regulation. The current study examines the relations between performance on (a) a self-regulation task (Heads, Toes, Knees Shoulders Task) and (b) two EF tasks (Knox Cube and Beads Tasks) that measure different components of updating: working memory and short-term memory, respectively. We compared 107 8- to 13-year-old children (64 females) across demographically-diverse populations in four low and middle-income countries, including: Tanna, Vanuatu; Keningau, Malaysia; Saltpond, Ghana; and Natal, Brazil. The communities we studied vary in market integration/urbanicity as well as level of access, structure, and quality of schooling. We found that performance on the visuospatial working memory task (Knox Cube) and the visuospatial short-term memory task (Beads) are each independently associated with performance on the self-regulation task, even when controlling for schooling and location effects. These effects were robust across demographically-diverse populations of children in low-and middle-income countries. We conclude that this study found evidence supporting visuospatial working memory and visuospatial short-term memory as distinct cognitive processes which each support the development of self-regulation.

Leverage the power of ritual to improve community health worker efficacy and public health outcomes: Lessons from Bihar, India.

Biomedical health interventions now have global reach and interact in complex and often poorly understood ways with traditional medical rituals that precede biomedicine. People often experience biomedical practices and treatments as rituals because they are very similar from an experiential perspective.1 Yet the global public health community often views ritual practices of communities as obstacles to adopting new health-promoting behaviors. The lack of engagement with the biomedical and traditional medical rituals of local populations has obscured understanding the critical functions of these behaviors, limited the potential to leverage ritualization to increase behavioral uptake, and stymied social and behavioral change efforts. Our large-scale, mixed methods research with Community Health Workers (CHW) in Bihar, India, has shown that understanding the rituals of a community provides critical insight into their identities, norms, values, and goals. We propose that health interventions should be informed by, and build upon, knowledge of health rituals. A deep understanding of existing beliefs and behaviors will allow local health "influencers" such as CHW to encourage new and modified rituals that integrate the best of biomedical and traditional health practices in ways that preserve their meaning and shared purpose. Funding: Grants INV-008582 and INV-016014 to C.L. from The Bill & Melinda Gates Foundation funded this manuscript.

Facilitating behavioral change: A comparative assessment of ASHA efficacy in rural Bihar.

Community health worker (CHW) programs are essential for expanding health services to many areas of the world and improving uptake of recommended behaviors. One of these programs, called Accredited Social Health Activists (ASHA), was initiated by the government of India in 2005 and now has a workforce of about 1 million. ASHAs primarily focus on improving maternal and child health but also support other health initiatives. Evaluations of ASHA efficacy have found a range of results, from negative, to mixed, to positive. Clarity in forming a general impression of ASHA efficacy is hindered by the use of a wide range of evaluation criteria across studies, a lack of comparison to other sources of behavioral influence, and a focus on a small number of behaviors per study. We analyze survey data for 1,166 mothers from Bihar, India, to assess the influence of ASHAs and eight other health influencers on the uptake of 12 perinatal health behaviors. We find that ASHAs are highly effective at increasing the probability that women self-report having practiced biomedically-recommended behaviors. The ASHA's overall positive effect is larger than any of the nine health influencer categories in our study (covering public, private, and community sources), but their reach needs to be more widely extended to mothers who lack sufficient contact with ASHAs. We conclude that interactions between ASHAs and mothers positively impact the uptake of recommended perinatal health behaviors. ASHA training and program evaluation need to distinguish between individual-level and program-level factors in seeking ways to remove barriers that affect the reach of ASHA services.

Tradition, taste and taboo: the gastroecology of maternal perinatal diet.

BACKGROUND: Maternal malnutrition is a major source of regional health inequity and contributes to maternal and infant morbidity and mortality. Bihar, a state in eastern India adjacent to Jharkhand and West Bengal, has relatively high neonatal mortality rates because a large portion of infants are born to young mothers. Bihar has the second-highest proportion of underweight children under 3 in India, with infant mortality rates of 48 per 1000 live births. Maternal malnutrition remains a major threat to perinatal health in Bihar, where 58.3% of pregnant women are anaemic. METHODS: We examined dietary beliefs and practices among mothers, mothers-in-law and community members, including Accredited Social Health Activists (ASHAs), using focus group discussions (n=40 groups, 213 participants), key informant interviews (n=50 participants) and quantitative surveys (n=1200 recent mothers and 400 community health workers). We report foods that are added/avoided during the perinatal period, along with stated reasons underlying food choice. We summarise the content of the diet based on responses to the quantitative survey and identify influencers of food choice and stated explanations for adding and avoiding foods. KEY FINDINGS: Analyses for all methodologies included gathering frequency counts and running descriptive statistics by food item, recommendation to eat or avoid, pregnancy or post partum, food group and health promoting or risk avoiding. During pregnancy, commonly added foods were generally nutritious (milk, pulses) with explanations for consuming these foods related to promoting health. Commonly avoided foods during pregnancy were also nutritious (wood apples, eggplant) with explanations for avoiding these foods related to miscarriage, newborn appearance and issues with digestion. Post partum, commonly added foods included sweets because they ease digestion whereas commonly avoided foods included eggplants and oily or spicy foods. Family, friends, relatives or neighbours influenced food choice for both mothers and ASHAs more than ASHAs and other health workers.Perinatal dietary beliefs and behaviours are shaped by local gastroecologies or systems of knowledge and practice that surround and inform dietary choices, as well as how those choices are explained and influenced. Our data provide novel insight into how health influencers operating within traditional and biomedical health systems shape the perinatal dietary beliefs of both mothers and community health workers.

Perinatal risk and the cultural ecology of health in Bihar, India.

The objective of the current study is to examine the cultural ecology of health associated with mitigating perinatal risk in Bihar, India. We describe the occurrences, objectives and explanations of health-related beliefs and behaviours during pregnancy and postpartum using focus group discussions with younger and older mothers. First, we document perceived physical and supernatural threats and the constellation of traditional and biomedical practises including taboos, superstitions and rituals used to mitigate them. Second, we describe the extent to which these practises are explained as risk-preventing versus health-promoting behaviour. Third, we discuss the extent to which these practises are consistent, inconsistent or unrelated to biomedical health practises and describe the extent to which traditional and biomedical health practises compete, conflict and coexist. Finally, we conclude with a discussion of the relationships between traditional and biomedical practises in the context of the cultural ecology of health and reflect on how a comprehensive understanding of perinatal health practises can improve the efficacy of health interventions and improve outcomes. This article is part of the theme issue 'Ritual renaissance: new insights into the most human of behaviours'.

Extrinsic Mortality Can Shape Life-History Traits, Including Senescence.

The Williams' hypothesis is one of the most widely known ideas in life history evolution. It states that higher adult mortality should lead to faster and/or earlier senescence. Theoretically derived gradients, however, do not support this prediction. Increased awareness of this fact has caused a crisis of misinformation among theorists and empirical ecologists. We resolve this crisis by outlining key issues in the measurement of fitness, assumptions of density dependence, and their effect on extrinsic mortality. The classic gradients apply only to a narrow range of ecological contexts where density-dependence is either absent or present but with unrealistic stipulations. Re-deriving the classic gradients, using a more appropriate measure of fitness and incorporating density, shows that broad ecological contexts exist where Williams' hypothesis is supported.

Density-dependence interacts with extrinsic mortality in shaping life histories.

The role of extrinsic mortality in shaping life histories is poorly understood. However, substantial evidence suggests that extrinsic mortality interacts with density-dependence in crucial ways. We develop a model combining Evolutionarily Stable Strategies with a projection matrix that allows resource allocation to growth, tissue repairs, and reproduction. Our model examines three cases, with density-dependence acting on: (i) mortality, (ii) fecundity, and (iii) production rate. We demonstrate that density-independent extrinsic mortality influences the rate of aging, age at maturity, growth rate, and adult size provided that density-dependence acts on fertility or juvenile mortality. However, density-independent extrinsic mortality has no effect on these life history traits when density-dependence acts on survival. We show that extrinsic mortality interacts with density-dependence via a compensation mechanism: the higher the extrinsic mortality the lower the strength of density-dependence. However, this compensation fully offsets the effect of extrinsic mortality only if density-dependence acts on survival independently of age. Both the age-pattern and the type of density-dependence are crucial for shaping life history traits.

Evolutionary theory of ageing and the problem of correlated Gompertz parameters.

The Gompertz mortality model is often used to evaluate evolutionary theories of ageing, such as the Medawar-Williams' hypothesis that high extrinsic mortality leads to faster ageing. However, fits of the Gompertz mortality model to data often find the opposite result that mortality is negatively correlated with the rate of ageing. This negative correlation has been independently discovered in several taxa and is known in actuarial studies of ageing as the Strehler-Mildvan correlation. We examine the role of mortality selection in determining late-life variation in susceptibility to death, which has been suggested to be the cause of this negative correlation. We demonstrate that fixed-frailty models that account for heterogeneity in frailty do not remove the correlation and that the correlation is an inherent statistical property of the Gompertz distribution. Linking actuarial and biological rates of ageing will continue to be a pressing challenge, but the Strehler-Mildvan correlation itself should not be used to diagnose any biological, physiological, or evolutionary process. These findings resolve some key tensions between theory and data that affect evolutionary and biological studies of ageing and mortality. Tests of evolutionary theories of ageing should include direct measures of physiological performance or condition.

Postnatal depression and reproductive success in modern, low-fertility contexts.

BACKGROUND AND OBJECTIVES: Postnatal depression (PND) presents a puzzling phenomenon to evolutionary anthropologists as it is highly prevalent and yet detrimental to child development and maternal health. Adaptive explanations have been proposed, but have not been tested with data that directly link PND to female fertility. METHODOLOGY: A survey was designed to gather complete reproductive histories and retrospective measures of PND to measure the effects of PND on fitness. Respondents were born between 1930 and 1967, with the majority based in the UK during their childrearing years. The hypothesis that PND is detrimental to fitness is assessed using Mann-Whitney U tests on completed fertility. Binary logistic regression modelling is used to test the hypothesis that PND reduces the likelihood of parity progression. RESULTS: Women experiencing PND at their first or second birth have lower completed fertility, with PND at the first birth leading to lowered fertility. Logistic regression analyses show that this is the result of reductions in the likelihood of parity progression to a third birth when PND is experienced at the first birth or when repeat bouts occur. CONCLUSIONS AND IMPLICATIONS: Our results call into question adaptationist arguments, contribute to the growing understanding of the importance of emotional wellbeing to fertility decision making, and given the economic consequences of markedly below replacement fertility, highlight a potential new source of financial incentive to invest in screening and preventative measures to ensure good maternal mental health.

How does variance in fertility change over the demographic transition?

Most work on the human fertility transition has focused on declines in mean fertility. However, understanding changes in the variance of reproductive outcomes can be equally important for evolutionary questions about the heritability of fertility, individual determinants of fertility and changing patterns of reproductive skew. Here, we document how variance in completed fertility among women (45-49 years) differs across 200 surveys in 72 low- to middle-income countries where fertility transitions are currently in progress at various stages. Nearly all (91%) of samples exhibit variance consistent with a Poisson process of fertility, which places systematic, and often severe, theoretical upper bounds on the proportion of variance that can be attributed to individual differences. In contrast to the pattern of total variance, these upper bounds increase from high- to mid-fertility samples, then decline again as samples move from mid to low fertility. Notably, the lowest fertility samples often deviate from a Poisson process. This suggests that as populations move to low fertility their reproduction shifts from a rate-based process to a focus on an ideal number of children. We discuss the implications of these findings for predicting completed fertility from individual-level variables.

What if fertility decline is not permanent? The need for an evolutionarily informed approach to understanding low fertility.

'Demographic transition theory' assumes that fertility decline is irreversible. This commonly held assumption is based on observations of recent and historical reductions in fertility that accompany modernization and declining mortality. The irreversibility assumption, however, is highly suspect from an evolutionary point of view, because demographic traits are at least partially influenced by genetics and are responsive to social and ecological conditions. Nonetheless, an inevitable shift from high mortality and fertility to low mortality and fertility is used as a guiding framework for projecting human population sizes into the future. This paper reviews some theoretical and empirical evidence suggesting that the assumption of irreversibility is ill-founded, at least without considerable development in theory that incorporates evolutionary and ecological processes. We offer general propositions for how fertility could increase in the future, including natural selection on high fertility variants, the difficulty of maintaining universal norms and preferences in a large, diverse and economically differentiated population, and the escalating resource demands of modernization.

Socio-Economic Instability and the Scaling of Energy Use with Population Size.

The size of the human population is relevant to the development of a sustainable world, yet the forces setting growth or declines in the human population are poorly understood. Generally, population growth rates depend on whether new individuals compete for the same energy (leading to Malthusian or density-dependent growth) or help to generate new energy (leading to exponential and super-exponential growth). It has been hypothesized that exponential and super-exponential growth in humans has resulted from carrying capacity, which is in part determined by energy availability, keeping pace with or exceeding the rate of population growth. We evaluated the relationship between energy use and population size for countries with long records of both and the world as a whole to assess whether energy yields are consistent with the idea of an increasing carrying capacity. We find that on average energy use has indeed kept pace with population size over long time periods. We also show, however, that the energy-population scaling exponent plummets during, and its temporal variability increases preceding, periods of social, political, technological, and environmental change. We suggest that efforts to increase the reliability of future energy yields may be essential for stabilizing both population growth and the global socio-economic system.

The human post-fertile lifespan in comparative evolutionary context.

There persist two widely held but mutually inconsistent views on the evolution of post-fertile lifespan of human females. The first, prevalent within anthropology, sees post-fertile lifespan (PFLS) in the light of adaptive processes, focusing on the social and economic habits of humans that selected for a lengthy PFLS. This view rests on the assumption that human PFLS is distinct from that of other species, and focuses on quantifying the selective causes and consequences of that difference. The second view, prevalent within gerontology and comparative biology, emphasizes that PFLS is a phylogenetically widespread trait or that human PFLS is predictable based on life-history allometries. In this view, human PFLS is part of a broad cross-species pattern and its genesis cannot, therefore, rely on human-specific traits. Those who advocate the second view have questioned the "special pleading" for human specific explanations of PFLS, and have argued that human PFLS is quantitatively greater but not qualitatively different than PFLS in many other animals. Papers asking whether human PFLS is explained by the importance of mothers more than grandmothers, whether paternal or maternal grandparents have more of an effect on child survival, or who is providing the excess calories are associated with the first view that assumes the need to explain the existence of human PFLS on the basis of a uniquely human socioecology. Anthropologists largely see human PFLS as derived, while comparative gerontologists point to evidence that it is one instance of a ubiquitous cross-species pattern. The two groups generally occupy non-overlapping research circles, in terms of conferences and journals, and therefore interact little enough to largely avoid the need to reconcile their views, allowing the persistence of misconceptions in each field. Our goal is to identify and address the most important of these misconceptions and thereby make clear that both of these seemingly incongruent views contain valid points. We argue that two distinct but related traits have been lumped together under the same concept of "post-reproductive lifespan," one (post-fertile viability) that is tremendously widespread and another (a post-fertile life stage) that is derived to hominins, and that the differences and connections between these two traits are necessary for understanding human life-history evolution.

Human mortality improvement in evolutionary context.

Life expectancy is increasing in most countries and has exceeded 80 in several, as low-mortality nations continue to make progress in averting deaths. The health and economic implications of mortality reduction have been given substantial attention, but the observed malleability of human mortality has not been placed in a broad evolutionary context. We quantify the rate and amount of mortality reduction by comparing a variety of human populations to the evolved human mortality profile, here estimated as the average mortality pattern for ethnographically observed hunter-gatherers. We show that human mortality has decreased so substantially that the difference between hunter-gatherers and today's lowest mortality populations is greater than the difference between hunter-gatherers and wild chimpanzees. The bulk of this mortality reduction has occurred since 1900 and has been experienced by only about 4 of the roughly 8,000 human generations that have ever lived. Moreover, mortality improvement in humans is on par with or greater than the reductions in mortality in other species achieved by laboratory selection experiments and endocrine pathway mutations. This observed plasticity in age-specific risk of death is at odds with conventional theories of aging.

Human macroecology: linking pattern and process in big-picture human ecology.

Humans have a dual nature. We are subject to the same natural laws and forces as other species yet dominate global ecology and exhibit enormous variation in energy use, cultural diversity, and apparent social organization. We suggest scientists tackle these challenges with a macroecological approach-using comparative statistical techniques to identify deep patterns of variation in large datasets and to test for causal mechanisms. We show the power of a metabolic perspective for interpreting these patterns and suggesting possible underlying mechanisms, one that focuses on the exchange of energy and materials within and among human societies and with the biophysical environment. Examples on human foraging ecology, life history, space use, population structure, disease ecology, cultural and linguistic diversity patterns, and industrial and urban systems showcase the power and promise of this approach.

Industrial energy use and the human life history.

The demographic rates of most organisms are supported by the consumption of food energy, which is used to produce new biomass and fuel physiological processes. Unlike other species, modern humans use 'extra-metabolic' energy sources acquired independent of physiology, which also influence demographics. We ask whether the amount of extra-metabolic energy added to the energy budget affects demographic and life history traits in a predictable way. Currently it is not known how human demographics respond to energy use, and we characterize this response using an allometric approach. All of the human life history traits we examine are significant functions of per capita energy use across industrialized populations. We find a continuum of traits from those that respond strongly to the amount of extra-metabolic energy used, to those that respond with shallow slopes. We also show that the differences in plasticity across traits can drive the net reproductive rate to below-replacement levels.

Current demographics suggest future energy supplies will be inadequate to slow human population growth.

Influential demographic projections suggest that the global human population will stabilize at about 9-10 billion people by mid-century. These projections rest on two fundamental assumptions. The first is that the energy needed to fuel development and the associated decline in fertility will keep pace with energy demand far into the future. The second is that the demographic transition is irreversible such that once countries start down the path to lower fertility they cannot reverse to higher fertility. Both of these assumptions are problematic and may have an effect on population projections. Here we examine these assumptions explicitly. Specifically, given the theoretical and empirical relation between energy-use and population growth rates, we ask how the availability of energy is likely to affect population growth through 2050. Using a cross-country data set, we show that human population growth rates are negatively related to per-capita energy consumption, with zero growth occurring at ∼13 kW, suggesting that the global human population will stop growing only if individuals have access to this amount of power. Further, we find that current projected future energy supply rates are far below the supply needed to fuel a global demographic transition to zero growth, suggesting that the predicted leveling-off of the global population by mid-century is unlikely to occur, in the absence of a transition to an alternative energy source. Direct consideration of the energetic constraints underlying the demographic transition results in a qualitatively different population projection than produced when the energetic constraints are ignored. We suggest that energetic constraints be incorporated into future population projections.