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Background: Short birth interval (SBI) has profound implications for the health of both mothers and children, yet there remains a notable dearth of studies addressing wealth-based inequality in SBI and its associated factors in India. This study aims to address this gap by investigating wealth-based disparities in SBI and identifying the underlying factors associated with SBI in India. Methods: We used information on 109,439 women of reproductive age (15–49 years) from the fifth round of the National Family Health Survey (2019-21). We assessed wealth-based inequality in SBI for India and its states using the Erreygers Normalised Concentration Index (ECI). Additionally, we used a multilevel binary logistic regression to assess the factors associated with SBI in India. Results: In India, the prevalence of SBI was 47.8% [95% CI: 47.4, 48.3] during 2019-21, with significant variation across states. Bihar reported the highest prevalence of SBI at 61.2%, while Sikkim the lowest at 18.1%. SBI prevalence was higher among poorer mothers compared to richer ones (Richest: 33.8% vs. Poorest: 52.9%). This wealth-based inequality was visible in the ECI as well (ECI= -0.13, p < 0.001). However, ECI varied considerably across the states. Gujarat, Punjab, and Manipur exhibited the highest levels of wealth-based inequality (ECI= -0.28, p < 0.001), whereas Kerala showed minimal wealth-based inequality (ECI= -0.01, p = 0.643). Multilevel logistic regression analysis identified several factors associated with SBI. Mothers aged 15–24 (OR: 12.01, p < 0.001) and 25–34 (2.92, < 0.001) were more likely to experience SBI. Women who married after age 25 (3.17, < 0.001) and those belonging to Scheduled Caste (1.18, < 0.001), Scheduled Tribes (1.14, < 0.001), and Other Backward Classes (1.12, < 0.001) also had higher odds of SBI. Additionally, the odds of SBI were higher among mothers in the poorest (1.97, < 0.001), poorer (1.73, < 0.001), middle (1.62, < 0.001), and richer (1.39, < 0.001) quintiles compared to the richest quintile. Women whose last child had passed away were also significantly more likely to have SBI (2.35, < 0.001). Furthermore, mothers from communities with lower average schooling levels (1.18, < 0.001) were more likely to have SBI. Geographically, mothers from eastern (0.67, < 0.001) and northeastern (0.44, < 0.001) regions of India were less likely to have SBI. Conclusion: The significant wealth-based inequality in SBI in India highlights the need for targeted interventions focusing on economically disadvantaged women, particularly in states with high SBI prevalence. Special attention should be given to younger mothers and those from socially disadvantaged groups to enhance maternal and child health outcomes across the country. [ABSTRACT FROM AUTHOR]

Introduction: Short interpregnancy interval (IPI) is a well-known risk factor for preterm births and low birth weights. However, research on the association between interpregnancy interval (IPI) and health outcomes in children under age 5 is limited in India. We examined the associations between IPI and five child health outcomes in India. Methods: We used nationally representative cross-sectional data from three rounds of National Family Health Survey (NFHS) conducted in India during 2005-06, 2015-16 and 2019-21 to examine the associations between IPI [categorized as < 12 months, 12–17 months, 18–23 months (ref), 24–35 months, and 36–59 months] and five child health outcomes – neonatal mortality, postneonatal mortality, diarrhea and/or acute respiratory infections (ARI), stunting, and underweight, for the total sample and, secondarily, using sex-stratified analyses. We used multivariable and mother fixed-effects binary logistic regressions to examine the associations. Results: 3% and 2% of infants died during the neonatal and postneonatal period, respectively. Thirteen, 40, and 37% of children had diarrhea and/or ARI, were stunted, and were underweight, respectively. IPI < 12 months was associated with higher odds of diarrhea and/or ARI (OR: 1.11; 95% CI: 1.05–1.18), stunting (OR: 1.13; 95% CI: 1.08–1.18) and underweight (OR: 1.06; 95% CI: 1.01–1.11). Mother fixed-effects adjustments confirmed these associations and also found that births with IPI of 12–17 months and 36–59 months had higher odds of stunting, and IPI of 12–17 months was also associated with higher odds of underweight. Discussion: Our findings indicate that IPIs shorter than 12 months are a risk factor for diarrhea and/or ARI, and IPIs shorter than 12 months and 12–17 months are risk factors for stunting and underweight among children under 5 in India. Mother fixed-effects models allowed us to adjust our estimates for unobserved heterogeneity; this has rarely been done before. Increases in birth spacing may improve child health outcomes in India. [ABSTRACT FROM AUTHOR]

Infant mortality rate (IMR) is one of the most important development indicators. In India, there is a severe interstate disparity regarding IMR. Kerala registers a very low IMR; whereas in Odisha it is pretty high. It is somewhat paradoxical as Odisha fares substantially better than many other states with lower IMR regarding total fertility rate, antenatal care and in many other aspects. The present article attempts to investigate the applicability of usually perceived major determinants of IMR as evidenced in the existing literature for Odisha. The panel data multiple regression carried out with data of 30 districts of Odisha over three years indicates that physiological and behavioural factors together with maternal and demographic factors are perhaps more important than the health programmes for reduction of IMR in Odisha. Moreover, many of the usually perceived major determinants of IMR including economic betterment are statistically insignificant for Odisha. The policymakers should take into account these facts and instead of a series of health programmes, they might resort to awareness building regarding breastfeeding and birth spacing. Mother’s nutritional status should also be strengthened so that they can sustain exhaustive breastfeeding for first six months after the birth of the child. [ABSTRACT FROM AUTHOR]

The World Health Organisation has called for global action to reduce child stunting by 40% by 2025. One third of the world's stunted children live in India, and children belonging to rural indigenous communities are the worst affected. We sought to identify the strongest determinants of stunting among indigenous children in rural Jharkhand and Odisha, India, to highlight key areas for intervention. We analysed data from 1227 children aged 6–23.99 months and their mothers, collected in 2010 from 18 clusters of villages with a high proportion of people from indigenous groups in three districts. We measured height and weight of mothers and children, and captured data on various basic, underlying and immediate determinants of undernutrition. We used Generalised Estimating Equations to identify individual determinants associated with children's height‐for‐age z‐score (HAZ; p < 0.10); we included these in a multivariable model to identify the strongest HAZ determinants using backwards stepwise methods. In the adjusted model, the strongest protective factors for linear growth included cooking outdoors rather than indoors (HAZ +0.66), birth spacing ≥24 months (HAZ +0.40), and handwashing with a cleansing agent (HAZ +0.32). The strongest risk factors were later birth order (HAZ −0.38) and repeated diarrhoeal infection (HAZ −0.23). Our results suggest multiple risk factors for linear growth faltering in indigenous communities in Jharkhand and Odisha. Interventions that could improve children's growth include reducing exposure to indoor air pollution, increasing access to family planning, reducing diarrhoeal infections, improving handwashing practices, increasing access to income and strengthening health and sanitation infrastructure. [ABSTRACT FROM AUTHOR]

Background: Despite great progress in the last decades, more than 120 million women worldwide want to prevent pregnancy but are not using contraceptives. Objective: To assess the prevalence of contraceptive use among the study group. To calculate the current unmet need of family planning Material& Methods: Community based, Cross-sectional study was done among 280 married women of reproductive age group residing in Agra City, using a standardized questionnaire to assess their fertility preferences & practices. Results: The Contraceptive Prevalence Rate is calculated as 45.4%. The unmet need of spacing is 21.0% and unmet need of limiting is 22.2%. Thus unmet need of family planning is 43.2% [ABSTRACT FROM AUTHOR]

Background: weight of the baby at birth is considered to be a major determinant of future health and survival of the child. It is one of the important factors which determine the readiness with which the newborn baby adjusts to its surrounding. Many maternal socio-biological factors influence birth weight. Objective: To determine maternal socio-biological factors influencing birth weight of newborn. Methodology: Hospital based cross- sectional study undertaken in Obstetrics and Gynaecology ward of Nehru hospital, Gorakhpur. The study period extended from July 2011 to August 2012. The study subject included recently delivered mothers and data was collected on semi-structured interview schedule to know various socio-biological variables such as mother's age, parity, inter-pregnancy interval etc, influencing the low birth weight of newborn. Chi-Square test was applied to observe the significance of association. Results: The overall proportion of low birth weight baby came out to be 32.06%. Out of various socio-biological factors taken the factors which came out to be statistically significant were age of mother, parity, inter-pregnancy interval, SLI, education. The factors which were not statistically significant were father's education, religion. Conclusions: It was concluded that teenage pregnancy, non-utilization of antenatal care practices, anaemia, illiteracy are unfavorable predictors of birth weight of newborn babies. [ABSTRACT FROM AUTHOR]

Breastfeeding is an essential key factor for reducing child mortality and the risk of disease. Therefore, to ensure health and wellbeing for all (Sustainable Development Goal 03), and to reduce inequalities in child health status (SDG 10), understanding the determinants of breastfeeding is essential. Our research aims to investigate determinants of different breastfeeding practices from 2005–06 (NFHS-3) to 2015–16 (NFHS-4), and changes in different breastfeeding practices among various demographic, social, religious, and economic groups during this decade. We have used a multivariate binary logistic regression model to estimate significant determinants of different breastfeeding practices. The results show an 8.4% hike in Exclusive Breastfeeding (EBF), along with a 3.3% and 1% drop in the Continuation of Breastfeeding (CBF) up to one and two years respectively during this decade in India. Significant variation has been found in EBF, CBF1 and CBF2 among various categories of child's birth interval, place of residence, social groups, economic communities, and geographic regions. Maternal nutritional status and anemia levels had significant influence on CBF1 and CBF2, and gender of the children on EBF and CBF2 from 2005–06 to 2015–16. There was no significant variation in CBF1 and CBF2 among children born in different birth orders, whereas EBF was significantly less among higher birth orders children. A dramatic improvement in EBF was found among first birth ordered children, teenage and/or highly educated mother, rich families, and in north India, and CBF2 was significantly raised only among higher educated mothers. The estimation of determinants throughout the decade is essential for improving government policies related to supporting and encouraging breastfeeding. The study suggests more initiatives and investment for the promotion, support and improvement of CBF for one and two years, and reduction of inequality among various demographic and socio-economic groups and geographic regions. • From 2005–06 to 2015–2016 India exhibited an 8.4% increase in exclusive breastfeeding. • Continued breastfeeding up to one and two years declined 2.9% and 1% respectively. • Different types of breastfeeding practices vary significantly by geographic regions, social, economic groups in India. • Maternal physical health (BMI, Anemia level) influences continuation of breastfeeding. • Boys are more privileged in exclusive and continuation of breastfeeding up to two years than girls in India. [ABSTRACT FROM AUTHOR]

• The study found that 57.5% children were anaemic. • Children with stunting, wasting and underweight were significantly more anaemic as compared to their counterparts. • Children below two years of age were significantly more anaemic as compared to those children aged two years and above. • There was no gender difference observed in the burden of anaemia among male and female children. • The study may be useful for developing strategies to reduce the severity of anaemia focusing on factors such as women education, birth interval, nutritional status of mother and child, and wealth status of the family. Anaemia, an indicator of poor nutrition and health, is a major public health problem in India. The causes of anaemia are multifactorial, which includes iron deficiency, nutritional deficiencies, chronic infections, inherited blood disorders, obesity and non-communicable diseases. Anaemia has been implicated with growth retardation, impaired motor and cognitive development, and childhood morbidity and mortality. Anaemia among children is a public health problem globally. An estimated 273.2 million children aged 6–59 months suffer from anaemia globally. The aim of the study is to determine the prevalence of anaemia and its determinants among children aged 6–59 months in India. Data has been taken from the latest fourth round of National Family Health survey (2015–16). A total of 2,09,495 children aged 6 to 59 months were included in the study for their analysis. Anaemia was present in 1,20,507 pre-schoolers. Chi-square test and binary logistic regression have been used to determine the association between anaemia and its associated covariates. A p -value less than 0.05 was considered as statistically significant. Overall, the prevalence of anaemia was found to be 58 percent. Childhood anaemia was significantly associated with the mother's education, body mass index, place of delivery, maternal anaemia, access to antenatal care, child's age, birth weight, birth interval, stunting, wasting, underweight and wealth status of the household. In both male and female children, the risk of anaemia was almost similar and significantly higher in undernourished children as compared to their counterparts. Anaemia remains a serious public health concern in most states of India. Gender does not play any role as a risk factor for the great burden of anaemia. Strategies for reducing the severity of anaemia should target women education, birth interval, nutritional status of mother and child, and wealth status of the family. [ABSTRACT FROM AUTHOR]

Background: Due to high fertility rates in some low and lower-middle income countries, the interval between pregnancies can be short, which may lead to adverse maternal and neonatal outcomes. Methods: We analyzed data from women enrolled in the NICHD Global Network Maternal Newborn Health Registry (MNHR) from 2013 through 2018. We report maternal characteristics and outcomes in relationship to the inter-delivery interval (IDI, time from previous delivery [live or stillborn] to the delivery of the index birth), by category of 6–17 months (short), 18–36 months (reference), 37–60 months, and 61–180 months (long). We used non-parametric tests for maternal characteristics, and multivariable logistic regression models for outcomes, controlling for differences in baseline characteristics. Results: We evaluated 181,782 women from sites in the Democratic Republic of Congo, Zambia, Kenya, Guatemala, India, and Pakistan. Women with short IDI varied by site, from 3% in the Zambia site to 20% in the Pakistan site. Relative to a 18–36 month IDI, women with short IDI had increased risk of neonatal death (RR = 1.89 [1.74, 2.05]), stillbirth (RR = 1.70 [1.56, 1.86]), low birth weight (RR = 1.38 [1.32, 1.44]), and very low birth weight (RR = 2.35 [2.10, 2.62]). Relative to a 18–36 month IDI, women with IDI of 37–60 months had an increased risk of maternal death (RR 1.40 [1.05, 1.88]), stillbirth (RR 1.14 [1.08, 1.22]), and very low birth weight (RR 1.10 [1.01, 1.21]). Relative to a 18–36 month IDI, women with long IDI had increased risk of maternal death (RR 1.54 [1.10, 2.16]), neonatal death (RR = 1.25 [1.14, 1.38]), stillbirth (RR = 1.50 [1.38, 1.62]), low birth weight (RR = 1.22 [1.17, 1.27]), and very low birth weight (RR = 1.47 [1.32,1.64]). Short and long IDIs were also associated with increased risk of obstructed labor, hemorrhage, hypertensive disorders, fetal malposition, infection, hospitalization, preterm delivery, and neonatal hospitalization. Conclusions: IDI varies by site. When compared to 18–36 month IDI, women with both short IDI and long IDI had increased risk of adverse maternal and neonatal outcomes. Trial registration: The MNHR is registered at NCT01073475. [ABSTRACT FROM AUTHOR]