Asia-Pacific Population Journal - Volume 19, Issue 1, 2004

Early initiation of smoking and drinking are well known to have both immediate and long-term adverse health and social consequences (CDC, 1994; Gruber and others, 1996; WHO, 1997). Premarital sex during adolescence is often unprotected against unwanted pregnancies and sexually transmitted infections, and as a consequence, often results in adverse social, economic, and health consequences (UNICEF, UNAIDS and WHO, 2002; WHO, 2001). For these reasons, substance use and premarital sex during adolescence are regarded as risk-taking behaviour. Limited studies on substance use and premarital sex also indicate that the prevalence of these risk-taking behaviours among adolescents is increasing in Asian countries (Corraro and others, 2000; Tan, 1994; Issarabhakdi, 2000). In order to formulate and implement effective adolescent health policies and programmes it is essential that the prevalence of adolescent risk-taking behaviousr and the factors associated with them are identified.

The first family planning programme in the Islamic Republic of Iran started in 1966 and continued until the 1979 Islamic Revolution. The programme only slightly affected fertility. During the period 1966-1976, the population of the Islamic Republic of Iran experienced a modest fertility decline, but this was restricted to urban areas (Mirzaie, 1998; Aghajanian and Mehryar, 1999). Shortly after the Revolution, the family planning programme was suspended, although the provision of family planning services continued. In addition, the new Government adopted a pronatalist approach encouraging earlier marriage in the society. The eight-year war with Iraq also created a pronatalist atmosphere in the Islamic Republic of Iran. A rationing system was introduced for food and basic necessities, and this was helpful to large families. Two years after the revelation of the high population growth rate by the 1986 Census, the government population policy was reversed and a new antinatalist programme was officially inaugurated in December 1989. The details of this fundamental policy reversal and its success in such a short period of time have been elaborated elsewhere (Aghajanian, 1995; Mehryar and others, 2001; Abbasi-Shavazi, 2000a, 2002a; Abbasi-Shavazi and others, 2002; Kaveh-Firouz, 2002).

Previous studies of migrants’ health-seeking behaviour have demonstrated that migrants under-utilize health services in their new environment owing to problems of access, urban assimilation and the continuation of traditional rural practices (Tam, 1994; Zulkifli and others, 1994; Bender and others, 1993; Davidson, 1983; Uyanga 1983). Migrants, however, have been shown to increase their utilization of services relative to those remaining in rural areas (Tam, 1994). This study examines the maternal health-seeking behaviour of rural-urban migrants in a slum pocket of Mumbai. The objective of this study is to identify and compare the nature, prevalence and typology of maternal and child health service utilization by rural-urban migrant and non-migrant populations in Maharashtra, India. At the same time, the research aims to identify key social, cultural and economic influences on service utilization and suggest possible ways to increase the use of maternal health-care services among recent migrants to Mumbai.

Consistent with the pattern observed in other countries, Nepal’s population is ageing as fertility and mortality levels decline. During the last three decades, the total fertility rate has declined by one third, from around 6 children per woman in the 1970s (United Nations, 2001) to around 4 at the turn of the century (Ministry of Health, 2002). For the corresponding period, the life expectancy at birth has increased by nearly 20 years to reach about 60 years (United Nations, 2001). The decline in fertility and mortality has resulted in an increase, albeit modest, in the share of the population aged 60 years and over from about 6 per cent of the total population in the 1970s (United Nations, 2001) to about 7 per cent in 2001 (2001 Population Census). The older population grew faster (2.73 per cent) than the national population (2.07 per cent) during the last two decades (1981-2001). The share of the older population in the total population is expected to grow even further with the accelerated decline in fertility and mortality occurring in the twenty-first century. The percentage of the overall population aged 60 and over will increase nearly twofold by mid-century with fertility reaching replacement level and life expectancy at birth approaching 75, according to the United Nations medium variant projections (United Nations, 2001).