POPULATION HEALTH MEETS EVOLUTIONARY ANTHROPOLOGY: FAMILY STRUCTURE, RURAL LIVELIHOODS AND CHILD HEALTH IN TANZANIA

点击翻译按钮获取中文摘要

Over recent decades, many countries have witnessed substantial improvements in child wellbeing, with for example global child mortality reducing by nearly 50% in the last 20 years. Nevertheless, persistent and dramatic international inequalities remain, with children living in rural settings in Sub-Saharan Africa at particular risk of both ill health and low educational attainment. The proposed research seeks to improve our current understanding of the role of family structure as a determinant of child wellbeing in this context. Population health scientists are in wide agreement that 'traditional' African family structures, (specifically high fertility, early age at reproduction and high levels of polygynous marriage), contribute to poor child wellbeing, because they lead to apparent lower parental investments in human capital. However, frameworks for understanding the role of family structure as a determinant of child wellbeing, particularly in the context of the developing world, have also been criticised for their relative theoretical and methodological simplicity. The proposed fellowship will address these shortcomings. This will be achieved by grounding research in the fresh theoretical perspective of Evolutionary Anthropology; a framework notable for emphasizing: i) the role of contextual factors in determining relationships between family structure and child wellbeing; and ii) the potential for contextual variation in such relationships to feedback into cultural norms determining family formation. Furthermore, the project will utilise innovative 'multilevel' statistical methods to consider the role of family structure amid the broader individual, household and community-level determinants of wellbeing.The proposed research will be use data from a new research collaboration initiated during the fellowship with the 'Whole Village Project', a monitoring and evaluation development project run by the NGO 'Savannas Forever Tanzania', which collects longitudinal demographic, economic and development indicator data from 56 villages in the north of the country. This remarkable source of data provides detailed information on household and family structure, socioeconomic profile, livelihood productivity and losses (through agriculture, pastoralism, or wage-labour), along with levels of food insecurity and nutrition. Child wellbeing is assessed by: i) child health, as measured by physical assessments of heights and weights of children under 5yrs, and ii) child education, as measured by attendance and school level-for-age for all children under 15yrs. Furthermore, the nature of data collection enables villages to be contrasted on the basis of community service provision, such as proximity to health clinics, schools and safe sources of water. To consider the generalisability of the study population, the Tanzanian 2010 Demographic and Health Survey will also be used as a source of comparative data.To meet the fellowship's aims, planned analyses will consider how variation in (i) family size, (ii) age at reproduction and (iii) polygynous vs. monogamous marriage, predict observed inequalities in child health and education, and how these relationships interact with other identified household and community-level determinants of wellbeing. As such the project will generate new policy relevant knowledge about specifically when and where particular patterns of family structure place children at risk. It will also provide new data to consider how variation in rural livelihoods and community-level service provision may create shifting incentives for particular family formation behaviours, by changing their impact on child wellbeing. Research findings will be discussed in articles published in both population health and anthropology journals. They will also be summarized in open-access 'Summary Reports', with explicit consideration of their relevance to the design of public policy and development initiatives in the developing world.