BackgroundIn addition to the number of antenatal care (ANC) visits, the items of ANC services covered by ANC visits greatly influence the effectiveness of the ANC services. Recently the World Health Organization (WHO) recommended not only to achieve a minimum of eight ANC visits, but also to use a core set of items of ANC services for safe motherhood. This study examined the levels and determinants of frequency and contents of ANC visits in Bangladesh and thus assessed the level of compliance with the WHO recommended number and the content of ANC services during pregnancy in Bangladesh.MethodsThe data for the study come from the 2014 Bangladesh Demographic and Health Survey (BDHS), which covereda nationally representative sample of 17,863 ever-married women aged 15–49 years. Data derived from 4,627 mothers who gave birth in the three years preceding the survey constituted the study subjects. Descriptive, inferential and multivariate statistical techniques were used for data analysis.ResultsOn average, mothers received less than three (2.7 visits) ANC visits and only 6% receive the recommended eight or more ANC visits. About 22% of the mothers received all the prescribed basic items of ANC services. About one-fifth (21%) of the mothers never received ANC visits and thus no items of ANC services. Measurement of blood pressure was the most common item received during ANC visit as reported by 69% mothers. Blood test was the least received item (43%). Significant positive association was found between frequency of ANC visits and receiving the increased number of items of ANC services. High socio-economic status, low parity, living in urban areas and certain administrative regions, planned pregnancies, having media exposure, visiting skilled providers for ANC services and visit to public or NGO health facilities are associated with frequent ANC visits and receiving higher number of items of ANC contents.ConclusionAn unsatisfactory level of coverage of and content of ANC visits have been observed in Bangladesh. Further investigation is needed to identify the causes of under-utilization of ANC services in Bangladesh. A greater understanding of the identified risk factors and incorporating them into short and long term strategies would help improve the coverage and contents and thus quality of ANC services in Bangladesh.

The practice of consanguineous marriage has been the culturally preferred form of marriage in most Arab and the Middle Eastern countries, including Oman, but due to a paucity of population-based data in the past there is a dearth of information about its form and dynamics in Oman. Recent national-level surveys allow this gap to be filled. This paper examines the prevalence, trends and determinants of consanguineous marriages in Oman using data from the 2000 Oman National Health Survey. The results indicate a very high prevalence of consanguineous marriage in Oman, as more than half (52%) of marriages are consanguineous. First cousin unions are the most common type of consanguineous unions, constituting 39% of all marriages and 75% of all consanguineous marriages. The study observed various patterns of consanguinity, some of them common with other Arab nations, and some unique in nature. Women's age at marriage, employment, place of childhood residence and geographical region appear to be significant determinants of consanguineous marriages. Consanguineous marriage shows a strong association with marital stability, early age at marriage and early-age childbearing. There has been no appreciable change in the prevalence of consanguineous unions in Oman over the last four decades despite massive socioeconomic development and modernization. However, recent marriage cohorts show slight declining trends. The results suggest that consanguinity is likely to remain stable in the future or decline at a slow rate. Specific health education and genetic counselling should be followed in line with WHO recommendations to minimize the negative health consequences of consanguinity for child health.

This paper analyses the levels and trends of childhood mortality in urban Bangladesh, and examines whether children's survival chances are poorer among the urban migrants and urban poor. It also examines the determinants of child survival in urban Bangladesh. Data come from the 1999-2000 Bangladesh Demographic and Health Survey. The results indicate that, although the indices of infant and child mortality are consistently better in urban areas, the urban-rural differentials in childhood mortality have diminished in recent years. The study identifies two distinct child morality regimes in urban Bangladesh: one for urban natives and one for rural-urban migrants. Under-five mortality is higher among children born to urban migrants compared with children born to life-long urban natives (102 and 62 per 1000 live births, respectively). The migrant-native mortality differentials more-or-less correspond with the differences in socioeconomic status. Like childhood mortality rates, rural-urban migrants seem to be moderately disadvantaged by economic status compared with their urban native counterparts. Within the urban areas, the child survival status is even worse among the migrant poor than among the average urban poor, especially recent migrants. This poor-non-poor differential in childhood mortality is higher in urban areas than in rural areas. The study findings indicate that rapid growth of the urban population in recent years due to rural-to-urban migration, coupled with higher risk of mortality among migrant's children, may be considered as one of the major explanations for slower decline in under-five mortality in urban Bangladesh, thus diminishing urban-rural differentials in childhood mortality in Bangladesh. The study demonstrates that housing conditions and access to safe drinking water and hygienic toilet facilities are the most critical determinants of child survival in urban areas, even after controlling for migration status. The findings of the study may have important policy implications for urban planning, highlighting the need to target migrant groups and the urban poor within urban areas in the provision of health care services.

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Background: Low birth weight (< 2.5 kg) is an important indicator of health and development of infants throughout their life. Aims: This study aimed to determine the prevalence and risk factors for low birth weight in Jordan and its association with under-5 mortality. Methods: In this secondary analysis, data were extracted from the 2012 Jordan Population and Family Health Survey for 9734 live births born in the 5 years preceding the survey and for which birth weight was reported. Data were collected on child and maternal characteristics. Multivariable regression analysis was used to determine the significant risk factors for low birth weight and mortality. Results: Of the 9734 births analysed, 13.8% were low birth weight and 1.3% were very low birth weight. Mother's age (< 30 and ≥ 35 years), education (less than higher education), birth interval (< 24 months and first birth), unplanned pregnancy, household wealth status (poorest and richest), consanguinity, residence (central and south regions of Jordan), female sex, birth order (1 and ≥ 6), twin birth and maternal smoking during pregnancy were significant risk factors for low birth weight. The risk of death under 5 years of age was 4.8 times higher in children with low birth weight than children with normal birth weight. Conclusions: The high rate of low birth weight and its increasing rate in Jordan is a challenge for public health. Preventing low birth weight neonates and increasing their survival need to be prioritized in the national health strategy. Special care needs to be taken for the high-risk groups identified in this study.

Objectives: This study aimed to provide an updated estimate of the prevalence of autism spectrum disorder (ASD) among Omani children. Methods: This retrospective descriptive study was conducted from December 2011 to December 2018. Data were retrieved from the three main autism diagnostic centres in Oman: Sultan Qaboos University Hospital, Royal Hospital and Al-Massarah Hospital. The ASD diagnosis was made by experienced clinicians based on the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The overall population prevalence estimates per 10,000 children aged 0–14 years old in Oman were calculated using the denominator of the mid-period population data. Results: A total of 1,705 ASD cases were identified with the majority of cases being male (78.1%). The overall prevalence rate of ASD was estimated at 20.35 per 10,000 children (95% confidence interval: 19.39–21.32) between 2012–2018. Boys were found to have a 3.4-fold higher prevalence of ASD than girls (31.23/10,000 versus 9.07/10,000). Regionally, the majority of cases were found in the capital, Muscat, where the highest prevalence was 36.51 cases per 10,000 children. Conclusion: The prevalence of ASD among Omani children is 15-fold higher than estimates from 2011. This increase can be attributed to improvements in diagnostic services, increased awareness of ASD, better screening programmes and changes in diagnostic criteria. In addition, this increase in prevalence suggests a need for a registry of developmental disabilities and more extensive diagnostic and rehabilitation services in Oman.Keywords: Autism Spectrum Disorder; Epidemiology; Prevalence; Oman.

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SummaryThis study examined the recent level, trends and determinants of consanguineous marriage in Jordan using time-series data from the Jordan Population and Family Health Surveys (JPFHSs). According to the 2012 JPFHS, 35% of all marriages were consanguineous in Jordan in 2012. There has been a declining trend in consanguinity in the country, with the rate decreasing from a level of 57% in 1990. Most consanguineous marriage in 2012 were first cousin marriages, constituting 23% of all marriages and 66% of all consanguineous marriages. The data show that women with a lower age at marriage, older marriage cohort, larger family size, less than secondary level of education, rural place of residence, no employment, no exposure to mass media, a monogamous marriage, a husband with less than higher level of education and lower economic status, and those from the Badia region, were more likely to have a consanguineous marriage. Increasing age at marriage, level of education, urbanization and knowledge about the health consequences of consanguinity, and the ongoing socioeconomic and demographic transition in the country, will be the driving forces for further decline in consanguinity in Jordan.