Correlates of Occurrence of Obstetric Fistula among Women in Selected States of India: An Analysis of DLHS-3 Data.

Obstetric fistula is the most devastating form of maternal morbidity. It is an opening in the wall of vagina connecting to bladder or to rectum due to prolonged obstructed labour without timely medical assistance. A few research studies carried out in India and recently conducted DLHS-3 survey (2007-08) has information on obstetric fistula that gives scope for further research. This paper examines prevalence of obstetric fistula and its correlates using DLHS-3 data for selected states in India. Ever experience of obstetric fistula among women in these states ranges from 0.3 percent to 3.4 percent, being highest in Uttarakhand. Women living in rural areas have higher chance of obstetric fistula. Age and physical maturity is important factor in the occurrence of fistula and it is found that those women who were below 18 years at the time of their first birth have higher risk of fistula in comparison to those who had child at 18 or above years. In addition to this, those having problems at the time of delivery are around two times more likely to have fistula. Auxulary Nurse Midwife can be key players in the early detection and referral of cephalo-pelvic disproportion, malpresentation and prolonged, obstructed labour cases.

Trends of Infertility and Childlessness in India: Findings from NFHS Data.

Etiology of infertility varies from region to region and from one population to another and even from one locality to another within the same population. Childlessness has serious demographic, social and health implications. Hence an attempt has been made to get some approximation about levels and patterns of infertility and childlessness in India by using National Family Health Survey-2 (1998-1999) and National Family Health Survey-3 (2005-2006) data. The study population consists of women aged 20-49 years married for ≥ 5 years. Age of women, age at first marriage, place of residence, standard of living, working status of women, and region are some of the variables related with the rate of infertility and childlessness. Infertility rate is high among women in urban areas. This may be due to lifestyle or a later age at first marriage. Considering religion, Muslims show the lowest infertility rate. Scheduled tribes have high infertility rate. With increasing levels of educational attainment among women, infertility rate increases. This can be related to the fact that with aspirations for attaining higher educational level, marriage is delayed as a result of which in confirmation with aforementioned causation factors (higher age at marriage, urban living style etc.), infertility rate is high among this sub group of population.

South African nurse managers' perceptions regarding cost containment in public hospitals.

The perceptions of nurse managers regarding cost containment issues in selected public hospitals in the Port Elizabeth metropole of the Eastern Cape were investigated. Results indicated that nurse managers required better preparation for their cost control responsibilities. Although the majority of the nurse managers realised that staffing issues affected cost containment efforts, they were reportedly unable to prevent nurses from leaving their points of duty without due authorisation, curb the rate of absenteeism or reduce the number of resignations. Nurse managers suggested that cost containment efforts would benefit from effective security checks to curb losses of stock and equipment, including wheel-chairs, and that more public telephones should be installed in hospitals. Rationalisation of staff and specialised services among the four major hospitals could further enhance cost containment efforts.

Demographic profile of the girl child in India.

PIP: This article presents a statistical profile of the demographic and socioeconomic characteristics of female children in India during 1951-91. The population 0-14 years old increased during 1951-81. In 1991, there were 52-55 million children 0-4 years old. 40% of all women were 0-14 years old, 19% of the total population in 1991. Boys outnumbered girls at all childhood ages. Males gained more in mortality improvements than girls did over time. The decline in the 1991 sex ratio is attributed to female amniocentesis and differences in undercounts. Infant mortality was high and fluctuated prior to 1941. Rates thereafter declined below 200. Infant mortality improved considerably after the 1950s. The 1988 infant mortality rate (IMR) was 95 for males and 93 for females per 1000 live births. A higher female IMR during 1972-87 is attributed to low female status, sex bias in health care, and higher female rates of common childhood diseases. Boys are breast fed longer. Child marriage below the age of 14 years declined over time. In 1981, 93% of girls 0-14 years old were unmarried. The singulate mean age of marriage increased from 15.59 years in 1951 to 18.32 years in 1981. Literacy rates increased for both males and females during 1961-81 and increased rapidly during 1981-91. The gap between male educational levels and female educational levels was narrowing. School attendance was 62.07% among 10-14 year old boys and 37.47% among 10-14 year old girls. Kerala state was the only state where girls have very high attendance rates. School attendance among 10-14 year old children was positively correlated with higher budget allocations and the average cost per student. School attendance was negatively correlated with illiteracy among household members. In rural areas, girl's attendance was related to access to primary school facilities and roads.^ieng