Association Between Intimate Partner Violence and Contraceptive Use in India: Exploring the Moderating Role of Husband's Controlling Behaviors.

Existing studies show a mixed relationship between intimate partner violence (IPV) and contraceptive use. This study assesses the association between women's exposure to IPV and contraceptive use in India. Furthermore, we aim to determine whether husband's controlling behaviors play a moderating role in the IPV-contraception link. We used nationally representative data from the recent round of the National Family Health Survey (NFHS-4), conducted in 2015-2016. In this study, the use of contraceptives is the outcome variable, categorized into three groups: no/traditional methods, modern methods, and female sterilization. Women's exposure to IPV in the past year is the key exposure of interest. Socio-economic and demographic variables were used as covariates. Multinomial logistic regression models were performed to examine the association between women's exposure to IPV and contraceptive use. Of the total participants (N = 58,891), approximately one in every four women (24.1%) experienced any form of IPV in the past year. Slightly over half (50.8%) reported using either traditional methods of contraception or no contraceptive at all. About 14% of the respondents were using modern methods of contraception and 34.9% had undergone sterilization. After controlling for confounding factors, women who experienced IPV were 8% (95% CI [.87, .99]) less likely to report using modern contraceptives than those who did not face any IPV. Conversely, women who faced IPV were 14% (95% CI [1.09, 1.20]) more likely to undergo sterilization. Furthermore, women who experienced any form of IPV and whose husbands endorse controlling attitudes were 12% (95% CI [.81, .95]) less likely to report using modern contraceptives and 11% (95% CI [1.04, 1.17]) more likely to undergo sterilization. Interventions should be made to prevent violence against women that would increase their ability to choose appropriate contraception methods to avoid unintended pregnancies.

Investigating the relationship between women's experience of intimate partner violence and utilization of maternal healthcare services in India.

The utilization of maternal healthcare services is a key measure to reduce the incidence of maternal mortality. This study aims to examine the relationship between women's exposure to intimate partner violence (IPV) and the utilization of maternal healthcare services, using a large-scale nationally representative data among Indian women. Data for this study were drawn from the fourth round of the National Family Health Survey (NFHS-4), which is collected during 2015-2016. In order to analyze, we utilized 24,882 currently married women aged 15-49 years who had at least one living child in the past five years preceding the survey. Women's experience of IPV, which is manifested in various forms of physical, emotional, and/or sexual violence perpetrated by the partner, was considered as the key explanatory variable. Adequate antenatal care (ANC) [four or more ANC visits], delivery assistance by the skilled health provider, and postnatal care (PNC) within two days of delivery were used as outcome variables for assessing the utilization of maternal healthcare services. Descriptive statistics, cross-tabulation, Pearson's chi-square test, and bivariate and multivariate logistic regression models were used in this study. Approximately 26% of the sample women (currently married) experienced any form of IPV in the past year. Bivariate analyses show that the utilization of all three components of maternal healthcare services was lower among women who experienced physical, sexual, or emotional violence, as compared to those who did not face any violence perpetrated by the partner. Multivariate analysis indicates that women's exposure to IPV was significantly associated with a lower likelihood of adequate ANC utilization (Adjusted Odds Ratio [OR]: 0.90, 95% CI 0.84-0.97), even after controlling for socio-demographic characteristics. However, IPV had no significant relationship with skilled delivery assistance and unexpectedly a positive association with PNC usage (Adjusted OR: 1.09, 95% CI 1.02-1.16) in the adjusted analysis. Our study suggests formulating strategies toward the prevention of husband-perpetrated violence against women and targeting women who experienced spousal violence to improve their utilization of maternal healthcare services.

Associations of Power Relations, Wife-Beating Attitudes, and Controlling Behavior of Husband With Domestic Violence Against Women in India: Insights From the National Family Health Survey-4.

This study assesses the relationship of power relations, attitudes toward wife-beating, and controlling behavior of husband with violence against women in India using the recent National Family Health Survey (NFHS-4). In India, about 31% of ever-married women experienced domestic violence committed by their partner during 2015-16. Women's decision-making power was associated with a decreased likelihood of spousal violence. However, the justification of wife-beating and controlling behavior of husband increased the risk of intimate partner violence. This study emphasizes the need for prioritizing girls' education, enhancing women's autonomy, prevention of child marriage, and promoting gender equality in society to address the problem of spousal violence.

Women's autonomy and utilization of maternal healthcare in India: Evidence from a recent national survey.

OBJECTIVE: The present study aims to examine the association between women's decision-making autonomy and utilization of maternal healthcare services among the currently married women in India. METHODS: A total of 32,698 currently married women aged 15-49 years who had at least one live birth in the past five years preceding the survey and had information regarding autonomy collected by the National Family Health Survey 2015-16 were used for analysis. Bivariate and multivariate logistic regression models were employed for the analyses of this study. RESULTS: Utilization of maternal healthcare services was higher among the women having a high level of decision-making autonomy compared to those who had a low autonomy in the household. The regression results indicate that women's autonomy was significantly associated with increased odds of maternal healthcare services in India. Women with high autonomy had 37% and 33% greater likelihood of receiving ANC (AOR: 1.37, 95% CI: 1.25-1.50) and PNC care (AOR: 1.33, 95% CI: 1.24-1.42) respectively compared to women having low autonomy. However, no significant association was observed between women's autonomy and institutional delivery in the adjusted analysis. CONCLUSION: This study recommends the need for comprehensive strategies involving improvement of women's autonomy along with expansion of education, awareness generation regarding the importance of maternity care, and enhancing public health infrastructure to ensure higher utilization of maternal healthcare services that would eventually reduce maternal mortality.

Effects of indoor pollution on acute respiratory infections among under-five children in India: Evidence from a nationally representative population-based study.

OBJECTIVE: Acute respiratory infections (ARI) are the leading causes of neonatal and child mortality. Despite several national efforts to reduce the incidence of mortality among children, India is one of the largest contributors to under-five mortality in the world. In this study, we examined the effects of indoor pollution on ARI among under-five children in India. METHODS: A cross-sectional study was carried using nationally representative data from the 2015-2016 National Family Health Survey (NFHS-4). This study is based on 247,743 living children under the age of five years. Bivariate and multivariate analyses were performed to assess the impact of indoor air pollution on children's ARI. RESULTS: Almost two-thirds of households (65.2%) used biomass fuels for cooking, 54.9% of households had a separate kitchen, and 47.2% of households had a smoker. About 2.7% of children suffered from ARI in the past two weeks preceding the survey. The use of biomass fuels (OR [odds ratio]: 1.10, 95% CI: 1.01-1.20), households having no separate kitchen (OR: 1.22, 95% CI: 1.14-1.30), and smoking behavior of household members (OR: 1.06, 95% CI: 1.00-1.12) were associated with greater risk of ARI among under-five children even after adjusting for age of child, sex of child, birth order, maternal age, maternal education, caste, religion, wealth quintile, any HH members suffer from tuberculosis (TB), and household crowding. Furthermore, the results revealed that the combined effects of biomass fuels and households without separate kitchen increased the likelihood of children's ARI by 36% (Adjusted OR: 1.35, 95% CI: 1.21-1.51). CONCLUSION: The findings of this study suggest policy interventions to reduce the exposure of indoor air pollution, particularly among the impoverished groups. The government should ensure cleaner fuels for cooking, such as LPG and electricity, to minimize the risk of respiratory diseases among children.

Maternal experience of intimate partner violence and its association with morbidity and mortality of children: Evidence from India.

OBJECTIVE: This study attempts to investigate the association between maternal exposure to intimate partner violence (IPV) and morbidity and mortality of children. STUDY DESIGN: A cross-sectional study was carried out using the most recent nationally representative data of the National Family Health Survey (NFHS-4) in India. RESULTS: The prevalence of morbidity and mortality was higher among the children whose mothers faced physical, emotional, or sexual violence perpetrated by the partner than those who did not encounter any violence. Multivariate analysis revealed that maternal exposure to physical and sexual violence significantly increased the risks of childhood diarrhea and fever; and emotional violence was associated with an increased likelihood of diarrhea, fever, and acute respiratory infection (ARI) in the past 2 weeks among under-five children. Moreover, women's experience of physical and emotional violence were associated with increased odds of infant mortality (<1 year) and under-five mortality (<5 years) in crude analysis. However, these associations were insignificant in the adjusted analysis. Similarly, we did not find any significant association between maternal exposure to IPV and child mortality (1 to < 5 years). CONCLUSION: Maternal experience of domestic violence was associated with an increased risk of childhood morbidity (diarrhea, fever and ARI). However, no significant association was found between violence against women and mortality of children. Prevention of domestic violence may help to reduce childhood illnesses. Additional efforts are needed for maternal and child healthcare programs to improve health status of women and children.