Time use patterns and household adversities: A lens to understand the construction of gender privilege among children and adolescents in India.

We investigate gender differences in time-use patterns in 1891 children and assess how time is reallocated in response to challenges faced by households in India. We use adaptations made within a household during adversities to understand how gender inequality in time use is produced and reinforced. Using three waves of the Young Lives Panel Survey (2009, 2013, and 2016), we find that boys spend significantly more time on school and leisure than girls. Girls spend more time on household chores, care work, and studying at home than boys while spending fewer hours on school and leisure. Girls perform paid work during household adversities besides carrying out additional care work and household chores. Boys are more likely to engage in unpaid work than girls but are similarly affected in other domains. However, their time for education and leisure is often protected. Thus, girls labor more than boys daily and respond in equal measure during adversities, demonstrating that gender inequality in time use emerges at an early age.

Child marriage as a risk factor for non-communicable diseases among women in India.

BACKGROUND: Child marriage, defined as marriage under the age of 18 years, remains pervasive in India. Global evidence documents a negative association between child marriage and women's reproductive and sexual health outcomes; however, its relationship with non-communicable diseases (NCDs) remains underexplored. METHODS: We utilize biomarkers and self-reported data from the nationally representative National Family and Health Survey 4 (2015-2016) to examine the associations between child marriage and hypertension, diabetes, heart disease, asthma and thyroid disorder among currently married women (N = 421 107). We use regression models adjusted for a range of demographic and socio-economic controls to assess the association between child marriage and NCDs among women in India. We further assess whether and to what extent these relationships are mediated by early motherhood using the Karlson, Holm and Breen method of decomposition. RESULTS: Child marriage was associated with hypertension [adjusted odds ratio 1.20 (95% CI: 1.17-1.24)], diabetes [1.29 (1.22-1.37)], heart disease [1.27 (1.18-1.36)], asthma [1.19 (1.11-1.28)] and thyroid disorder [1.10 (1.02-1.18)]. Early motherhood also increased the risk of NCDs among women. Furthermore, it emerged as a pathway linking child marriage with hypertension, diabetes and heart disease; however, it provided a partial explanation for the disadvantage associated with child marriages. CONCLUSIONS: Child marriage emerges as a risk factor for NCDs among women in India. Health systems need to recognize the enduring influence of child marriages on women's health and ensure early detection and effective treatment of NCDs for this vulnerable group.

Is unintended birth associated with physical intimate partner violence? Evidence from India.

A growing number of studies have tested the association between intimate partner violence (IPV) and the unintendedness of pregnancy or birth, and most have suggested that unintendedness of pregnancy is a cause of IPV. However, about nine in every ten women face violence after delivering their first baby. This study examined the effects of the intendedness of births on physical IPV using data from the National Family Health Survey (2015-16). The multivariate logistic regression model analysis found that, compared with women with no unwanted births (2.9%), physical IPV was higher among those women who had unwanted births (6.9%, p<0.001), followed by those who had mistimed births (4.4 %, p<0.001), even after adjusting for several women's individual and socioeconomic characteristics. Thus, the reduction of women with mistimed and unwanted births could reduce physical IPV in India. The study highlights the unfinished agenda of family planning in the country and argues for the need to integrate family planning and Reproductive, Maternal and Child Health Care (RMNCH) services to yield multi-sectoral outcomes, including the elimination of IPV.

Labour room violence in Uttar Pradesh, India: evidence from longitudinal study of pregnancy and childbirth.

OBJECTIVES: The major objective of this study was to investigate the prevalence of labour room violence (LRV) (one of the forms of obstetric violence) faced by the women during the time of delivery in Uttar Pradesh (UP) (the largest populous state of India which is also considered to be a microcosm of India). Furthermore, this study also analyses the association between prevalence of obstetric violence and socioeconomic characteristics of the respondents. DESIGN: The study was longitudinal in design with the first visit to women made at the time of first trimester. The second visit was made at the time of second trimester and the last visit was made after the delivery. However, we have continuously tracked women over phone to keep record of developments and adverse consequences. SETTINGS: Urban and rural areas of UP, India. PARTICIPANTS: Sample of 504 pregnant women was systematically selected from the Integrated Child Development Scheme Register of pregnant women. OUTCOME: We aimed to assess the levels and determinants of LRV using data collected from 504 pregnant women in a longitudinal survey conducted in UP, India. The dataset comprised three waves of survey from the inception of pregnancy to childbirth and postnatal care. Logistic regression model has been used to assess the association between prevalence of LRV faced by the women at the time of delivery and their background characteristics. RESULT: About 15.12% of women are facing LRV in UP, India. Results from logistic regression model (OR) show that LRV is higher among Muslim women (OR 1.8, 95% CI 0.7 to 4.3) relative to Hindu women (OR 1). The prevalence of LRV is higher among lower castes relative to general category, and is higher among those women who have no mass media exposure (OR 4.7, 95% CI 1.7 to 12.8) compared with those who have (OR 1). CONCLUSION: In comparison with global evidence, the level of LRV in India is high. Women from socially disadvantaged communities are facing higher LRV than their counterparts.

Maternal dietary diversity and odds of low birth weight: Empirical findings from India.

India has the highest proportion of low birth weight (LBW) babies born in the developing world. Poor maternal nutrition during pregnancy is associated with adverse infant health outcomes. The main objective of this paper was to assess the socioeconomic factors associated with dietary diversity among pregnant women and to investigate the association between maternal dietary diversity and LBW among their babies. The data for these analyses were derived from a survey conducted in November and December, 2014 among 230 women who had newly delivered in hospitals in Uttar Pradesh, the largest Indian state that has the poorest maternal outcomes in the country. The results from multivariate binary logistic regression model indicated that low maternal education and economic status was significantly associated with poor dietary diversity among participants. Also, women with low maternal dietary diversity had a significantly higher proportion of LBW babies compared to those in the medium to high dietary diversity categories. From a policy perspective, these findings suggest that continuous tracking of pregnant women's nutritional needs through existing monitoring systems, e.g., the Nutrition Resource Platform and Health Management Information System, and necessary interventions through Integrated Child Development Services may yield better results, thereby, addressing maternal under-nutrition and LBW.