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

近几十年来，许多国家的儿童福祉得到了显著改善，例如，全球儿童死亡率在过去20年中下降了近50%。然而，持续和严重的国际不平等仍然存在，生活在撒哈拉以南非洲农村环境中的儿童特别容易健康不良和受教育程度低。拟议的研究旨在提高我们目前的家庭结构的作用，在这种情况下，儿童福祉的决定因素的理解。人口健康科学家普遍认为，“传统的”非洲家庭结构（特别是高生育率、生育年龄过早和一夫多妻制婚姻比例高）导致儿童福利不佳，因为它们导致父母对人力资本的投资明显减少。然而，理解家庭结构作为儿童福祉决定因素的作用的框架，特别是在发展中国家的背景下，也因其相对理论和方法简单而受到批评。拟议的研究金将解决这些不足之处。这将通过在进化人类学的新理论视角接地研究来实现;一个值得注意的框架强调：i）背景因素在确定家庭结构和儿童福祉之间的关系中的作用;以及ii）这种关系中的背景变化反馈到决定家庭形成的文化规范中的潜力。此外，该项目将利用创新的“多层次”统计方法来考虑家庭结构在更广泛的个人、家庭和社区层面的福祉决定因素中的作用。拟议的研究将使用来自一项新研究合作的数据。与“整村项目”合作期间发起，这是一个由非政府组织“永远的坦桑尼亚大草原”运营的监测和评估发展项目，它收集了该国北部56个村庄的纵向人口、经济和发展指标数据。这一重要的数据来源提供了关于住户和家庭结构、社会经济概况、生计生产力和损失（通过农业、畜牧业或雇佣劳动）沿着粮食不安全和营养水平的详细信息。儿童福祉的评估依据是：一）儿童健康，通过对5岁以下儿童身高和体重的身体评估来衡量;二）儿童教育，通过对所有15岁以下儿童的出勤率和入学水平来衡量。此外，由于数据收集的性质，可以根据社区服务的提供情况，例如是否靠近诊所、学校和安全水源，对村庄进行对比。考虑到研究人群的普遍性，坦桑尼亚2010年人口和健康调查也将被用作比较数据的来源。为了实现研究金的目标，计划的分析将考虑（i）家庭规模，（ii）生育年龄和（iii）一夫多妻制与一夫一妻制婚姻的变化如何预测儿童健康和教育方面观察到的不平等，以及这些关系如何与其他已确定的家庭和社区一级的福祉决定因素相互作用。因此，该项目将产生新的与政策有关的知识，具体说明特定的家庭结构模式何时何地使儿童处于危险之中。它还将提供新的数据，以考虑农村生计和社区一级服务提供的变化如何通过改变对儿童福祉的影响，改变对特定家庭组建行为的激励。研究结果将在人口健康和人类学杂志上发表的文章中讨论。还将在开放获取的“简要报告”中对这些报告进行总结，并明确考虑其与发展中国家公共政策和发展举措设计的相关性。

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.