ABSTRACT
Background In India, there has been a steady increase in the rate of caesarean section (C-section) deliveries over the past decade, rising from 17% during National Family Health Survey-4 (NFHS-4 (2015-16)) to as high as 21.5% during NFHS-5 (2019-21). Andhra Pradesh, India, is experiencing a particularly high rate of 42.4% as per NFHS-5, which is the highest among the states in the country. This study aims to investigate the prevalence of C-section deliveries across the districts of Andhra Pradesh and to identify the disparities in elective and emergency C-section rates among public and private hospitals in districts of Andhra Pradesh, India. Methods The study utilized secondary data from the NFHS-5 conducted by the International Institute for Population Sciences, Mumbai. A statistical software package was used to perform the analysis, while a quantum geographic information systemâââââââ (QGIS) was used to prepare a map. Descriptive statistics, bivariate analysis, and multivariate binary regression were used for statistical analysis. Results Significant variations in the prevalence of C-section deliveries were found across the districts in Andhra Pradesh. The prevalence ranged from 22.2% in Anantapur to 66% in Krishna. It was also found that private hospitals were the primary drivers of the high prevalence of C-section deliveries. Approximately 31.51% of women underwent C-sections in public institutions, whereas it was 68.49% in private institutions. The overall occurrence of C-section deliveries in Andhra Pradesh was 65% for elective cases and 35% for emergency cases, indicating a relatively higher prevalence for elective procedures. Conclusion The choice of the medical institution, whether private or public, is the most significant factor influencing the high prevalence of C-section deliveries. Additionally, C-section deliveries were found with higher complication rates than normal deliveries. Elective C-sections are more prevalent in the state, and factors such as wealth quintile and birth order are impacting the likelihood of elective versus emergency C-section deliveries. The study suggests that the government should provide awareness and regulations to promote vaginal deliveries and prevent unnecessary C-sections in hospitals.
ABSTRACT
Postpartum depression (PPD) is a psychological illness that affects women following delivery. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), PPD is a serious form of depression that begins four weeks following birth and continues for one year. Pregnancy and the period after delivery can be hazardous for women. Mothers undergo significant biological, emotional, financial, and societal changes during this time. Some women are predisposed to mental health disorders such as melancholy and worry. Many postpartum women do not acknowledge the seriousness of their condition, and many depressed mothers go untreated. Untreated PPD is harmful to both the mother and the newborn. The exact cause of PPD is unclear; however, hormonal fluctuations during pregnancy and childbirth, genetic susceptibility, birth trauma as well as psychosocial and demographic factors may serve as potential risk factors. The objective of this study is to determine the prevalence and risk factors of PPD in India. The review evaluates English language literature on PPD using Scopus, PubMed, and Google Scholar databases searched electronically between 2000 and 2022. The keywords "postpartum depression," or "postnatal depression," and "prevalence," and "causes," and "risk factors," or "predisposing factors," or "predictive factors" were used to search the database. The prevalence of PPD varies in different geographical regions and study settings. In India, the overall prevalence of PPD is 22%. However, the greatest prevalence was in the southern regions (26%; 95% confidence interval [CI]: 19-32) and the lowest in the northern regions (15%; 95% CI: 10-21). This study outlines the burden of PPD in India. Comprehensive intervention programs should be implemented to address the disease at a national level. The national authorities should incorporate PPD screening in the National Mental Health Program and emphasize health promotion activities.
ABSTRACT
Background: Accidents and injuries constitute a sizable share of mortality and morbidity in low- and middle-income countries. This affects the most productive age group and increases disability-adjusted life years (DALYs). It results in a substantial financial burden on the households. To explore the economic burden of accidents and Injuries on Indian households and to find how the catastrophic health expenditure (CHE) from accidents and injuries affects the population. Another objective is to explore Catastrophic out-of-pocket expenditures (OOPE) patterns and distressed financing of households in India. Materials and Methods: The study used data from the 75th round of nationally representative surveys, that is, the National Sample Survey (NSS). Authors have analyzed the data using descriptive binary logistic regression analysis to estimate the rate and average days of hospitalization, average OOPE, and share of the population experiencing the catastrophic impact from the health expenditure separately from the public and private healthcare institutions. Results: The study observed that hospitalization in the private sector imposes 72% of households incur CHE at more than 10% cut-off and 41% at more than 25% cut-off. In comparison, it is less in the public sector, with 22% of households incurring CHE at more than 10% of annual per capita household income and 9% at more than 25%. Conclusion: The increasing incidence of road traffic accidents (RTA) is a concern for the overstretched health system. The government should provide better healthcare facilities and universal health insurance coverage to ensure patients' speedy recovery and financial security.
