Inequalities and Effect of Non-Biological Factors on Perinatal Mortality in Uttar Pradesh.

Approximately 6 million neonatal deaths occur globally, with approximately 99 percent of them occurring in developing countries. This study is an attempt to examine the prevalence and influence of non-biological factors on perinatal mortality in India. National Family Health Survey (2015-2016) data and bivariate and multivariate techniques have been used to fulfill the aforesaid objectives. Findings suggest that approximately 47 perinatal deaths occurred per 1,000 pregnancies lasting seven or more months during the last five years preceding the survey in Uttar Pradesh. Parental education, wealth status, variables related to pregnancy and delivery, mother's demographic factors, mother's height, and child characteristics have shown significant impact on perinatal mortality. For a policy point of view, more emphasis is needed on quality of care of National Health Mission (NHM) strategy at times of greater risk-that is, birth and the first few days of life-which could be the way forward for reducing high perinatal deaths.

Burden of Anaemia, Hypertension and Diabetes among pregnant women in India.

Non-communicable Diseases such as anaemia, hypertension and diabetes and their treatment may upsurge the risk of childbirth-related complications for both women and their babies. The present study is an attempt to assess the level and determinants of Anaemia, Hypertension and Diabetes among pregnant women using the fourth round of National Family Health Survey-4 (2015-16) data. Bivariate and logistic regression techniques have been used for data analysis. Study findings suggest that the prevalence of anaemia among pregnant women was found to be 25.9%, whereas the corresponding figure for hypertension and diabetes were 4.4% and 2.4%, respectively. Further, substantial socio-economic differentials have been observed in the prevalence of Anaemia, Hypertension and Diabetes among pregnant women. Results of regression analysis suggest that anaemia and hypertension were significantly higher among women in their third trimester [(OR = 2.10; p < 0.001) and (OR = 1.63; p < 0.001)], respectively, compared to women in the first trimester. Similarly, pregnant women in the age group 35-49 were at an elevated risk of hypertension (OR = 2.78; p < 0.001)) and diabetes (OR = 2.50; p < 0.001)) compared to women aged 15-24. Further, the risk of anaemia was found to be significantly lower among pregnant women from the richest quintile (OR = 0.71; p < 0.001) and women with higher educational level (OR = 0.72; p < 0.001) when compared to women from the poorest wealth quintile and women with no formal education respectively. Similarly, pregnant women from the richest quintile (OR = 1.68; p < 0.001) and women from other religion (OR = 1.75; p < 0.001) are significantly more likely to develop diabetes compared to women from the poorest quintile and women from the Hindu religion, respectively. In conclusion, early screening for predicting the risk of gestational anaemia, gestational diabetes, and gestational hypertension is critical in minimizing maternal and reproductive outcomes. The existing guidelines for Screening and Management of Gestational Diabetes, Gestational Hypertension need to be contextualized and modified according to a local need for effective treatment.

Trend and Determinants of Fertility in a Declining Fertility Regime: A Study of Rural Uttar Pradesh.

This study is an attempt to examine the socio-economic and demographic differentials in children ever born and desire for additional child in rural Uttar Pradesh using the empirical data set. Two stage stratified random sampling procedure was applied to select the respondents from ten villages of rural Raebareli district. Total 460 women having with at least one child below ten years of age were interviewed during September 2016 to February 2017. Children ever born (CEB) and desire for another child were the main outcome variables of the study. One-way ANOVA and chi-square test were used in the bi-variate analysis. Poisson regression and logistic regression were used in multivariate analysis. The mean children ever born in the study area was 2.7 children per women and 64.7 per cent of fecund women who had two children and not currently pregnant had no desire for another child. Women's education, economic status of the household, autonomy index and higher caste group were significantly negatively associated with the children ever born in the study area. The desire for another child was significantly higher among those who had only daughters (OR = 1.99; p < 0.01). In conclusion, more emphasis needs to be placed on messages conveyed through the mass media, addressing the benefits of small family size and family planning, and programs that focus on reduction in newborn mortality could also be considered, which would also help to reduce fertility.

Health insurance support on maternal health care: evidence from survey data in India.

BACKGROUND: Maternal health care financing is key to the smooth functioning of health systems in a country. In India, maternal health care still persists as a major public health issue. Adequate health insurance could transform the utilization of maternal health care services. Therefore, we aim to examine the health insurance policies that cover maternal health and their performance in India. METHODS: The unit-level data of social consumption on health by the National Sample Survey Organizations, conducted in India (2017-18), are used. Bivariate analysis, logistic regression and propensity scoring matching are applied. RESULTS: About 14.1% women are covered by health insurance support at the national level. Uninsured women are less likely to receive full antenatal care (ANC) services and institutional delivery. Socio-economic characteristics play a significant role in utilizing maternal health care benefits through health insurance support. CONCLUSIONS: Our study concludes that the health insurance coverage is the most significant contributor to the better utilization of full ANC and institutional delivery at the national level and hindrances in accessing them. There is a need for proactive and inclusive policy development by the Government of India to incentivize public financing through health insurance, which can shrink the challenges of public health burden and reduce the health risk.

Prevalence and predictors of spousal violence against women in Afghanistan: evidence from Demographic and Health Survey data.

Spousal violence against women is a serious public health problem that is prevalent in all societies, with one in three women around the world experiencing violence in their lifetime. This study examined the prevalence of spousal violence, and its determinants, in Afghanistan using data from the 2015 Afghanistan Demographic and Health Survey. Univariate, bivariate and logistic regression statistical techniques were used to assess the association of socioeconomic variables with spousal violence. The study sample comprised 20,827 currently married women aged 15-49. Fifty-two per cent of women reported experiencing some form of violence by their husband. A significant association was found between women's justification of violence, women's participation in decision-making in their household (COR=0.476; CI=0.446-0.509) and lower risk of experiencing spousal violence. After adjustment for demographic and socioeconomic factors, women's participation in all of four household decisions, either alone or jointly, was found to be associated with a lower risk of experiencing spousal violence (AOR=0.472; CI=0.431-0.516). In both the crude and adjusted models, the risk of experiencing spousal violence was high if the husband's desire for children was different from that of his wife. In the case of inequality in property ownership, the risk of spousal violence was significantly higher (COR=1.263; CI=1.178-1.353; AOR=1.159; CI=1.051-1.278) when women were joint owners of property compared with when they did not own any property. The findings point to an immediate need for legal and social interventions to prevent spousal violence against women, or at least reduce its prevalence, in Afghanistan.

Violence against women in urban slums of India: A review of two decades of research.

It is estimated that about one-third of women ever experienced violence in their lifetime. India has experienced steady urban growth accompanying increase of urban populations living in slums. Several studies have reported prevalence of various forms of violence in urban slums. To our knowledge, no systematic review has been conducted exclusively reporting violence against women in India's urban slums. The review aims to synthesise the studies of violence against women conducted in the last two decades (2000-2020). We searched PubMed, Scopus and other relevant search engines to identify articles published between years 2000 and 2020, which focused on Indian women slum dwellers' experiences of violence. We included 14 studies, which satisfied the inclusion criteria in this review. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol was used to assess the studies. The prevalence of any form of violence against women, as reported in the studies, ranged from 15% to 59.3%. The major risk factors identified were husband's alcohol abuse, women justifying the violence inflicted on then, low educational levels of both women and men, dowry issues, age difference between the spouses and termination of a previous pregnancy. It is evident from the review that urban slum women experience persistent violence.

Effect of Maternal Healthcare Utilization on Early Neonatal, Neonatal and Post-Neonatal Mortality in India.

This paper examines the effect of maternal healthcare utilization on early neonatal, neonatal and post-neonatal mortality in India using the recent round of National Family Health Survey (NFHS-4) data. At the national level, for the last live birth of women during the five year preceding the survey, the early neonatal mortality rate was about 16, neonatal mortality rate was 19 and post-neonatal mortality was 7 per thousand live births. Also, only one-fifth of women who had a birth in the past five years received full antenatal care (ANC), 83 percent women received safe delivery and 65 percent women received post-natal care. Findings of the study indicate that full ANC and postnatal care were significantly associated with early neonatal and neonatal mortality. However, no significant association between safe delivery and newborn mortality were found after adjusting the socio-economic and demographic characteristics. Therefore, for a policy point of view, there is a dire need to strengthen supply dependent factors regarding public awareness, accessibility, and affordability of maternal and child healthcare services. It is also necessary to focus on increasing utilization along with continuum of care of maternal and child healthcare services to sustain the reduction in mortality during infancy.

Prevalence and Risk Factor of Occupational Skin Complaints among Male Tannery Workers of Kanpur, India.

BACKGROUND: Occupational skin illnesses are the second most common occupational health hazard following musculoskeletal disorders. Tannery workers have frequent and prolonged exposure to skin irritants and allergens and may have a higher risk of developing occupational dermatitis. AIMS AND OBJECTIVES: The aim of this study is to examine the extent of skin problems and their determinants among male tannery workers. MATERIALS AND METHODS: The data for the present research was drawn from a cross-sectional household study of tannery and nontannery workers in the Jajmau area of Kanpur, Uttar Pradesh. A total of 284 tannery and 289 nontannery workers were interviewed using purposive sampling technique. Descriptive statistics and multivariate techniques have been used. RESULTS: Tannery workers experienced itching hands or fingers with fissures (21%), scaling of hands or fingers with fissures (18%), red and swollen hands or fingers (11%), and vesicles on the hands or between the fingers (11%). The workers who had moderate/high dermal exposure to chemicals were 35(P < 0.001), and they were 31 (P < 0.001) times more likely to experience vesicles on scaling hands or fingers with fissures, and itching hands or fingers with fissures. The tannery workers engaged in wet finishing work were significantly 3.9 (P < 0.1) times more likely to experienced scaling on hands or fingers with fissures. CONCLUSION: The study acclaims the mechanization of tannery activities at workplaces, so that risk of skin complaints can be minimized among tannery workers. As the risk of skin complaints is very high with the dermal exposure to chemicals, personal protective equipment must be provided and their use should be included in the curriculum of the ternary workers.

Factors Affecting the Utilization of Maternal and Child Health Care Services in Tribal Dominated Population States of India.

The present study intended to examine that factors affecting the utilization of maternal health services in the Three tribal-dominated states of India namely Madhya Pradesh, Jharkhand and Chhattisgarh. The study used National Family Health Survey (NFHS-4) data. Both bivariate and multivariate techniques have been applied for data analysis. Logistic regression techniques and concentration curve and index have been used . Findings of the study indicate that there were wider socio-economic differential exits in the utilization of MCH services (full ANC, Safe delivery and post-natal care) in all the three states under study. The regression result shows that the tribal population is less likely to utilize maternal and child health care services than other Caste groups. The economic inequality in accessing the all three components of maternal health care utilization was higher in the Jharkhand than Madhya Pradesh and Chhattisgarh. Further, economic inequality was higher in accessing the full ANC than safe delivery and post-natal care across all the states under study. From policy point of view, the government schemes to provide maternal health services to tribal communities should consider the community-level factors affecting maternal health care utilization and should extend its operations in the small villages.

Prevalence and Determinants of Premature Menopause among Indian Women: Issues and Challenges Ahead.

Premature menopause refers to the occurrence of menopause in women less than 40 years of age. This heterogeneous disorder affects 1 percent and 0.1 percent of women less than 40 and 30 years of age, respectively. The study reported in this article attempts to understand the prevalence and determinants of premature menopause among Indian women by studying the effects of various socioeconomic indicators, such as age, education, wealth index, rural-urban settlement, work status, religion, and caste, on women. The study analyzed the National Family Health Survey-3, which is equivalent to the Demographic Health Survey in India. Bivariate and logistic regression analyses were performed to tease out the determinants of premature menopause. Results indicate that the percentage of premature menopause is very high (5.5 percent) among Indian women. Among Indian states, Andhra Pradesh women have the highest percentage of premature menopause (14.6 percent). Smoking and the nutritional status of women are strongly associated with early menopause. Furthermore, women living in rural areas and using tobacco are at a greater risk of premature menopause.