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Background: Anemia in pregnancy is a pervasive health issue, particularly in developing countries. Aims and Objectives: This study aims to assess various socio-demographic factors, nutritional intake, and other risk factors contributing to anemia among pregnant women attending a tertiary care hospital in Prakasam District, Andhra Pradesh, India. Materials and Methods: A crosssectional study was conducted involving 160 pregnant women. Data were collected on sociodemographic factors (family type, religion, caste, residence, education, socio-economic status, age, occupation), anemia prevalence, antenatal care, birth spacing, nutritional intake (caloric, protein, and iron), and gravida status. Chi-square tests were used for statistical analysis to determine associations between anemia and various risk factors. Results: The study revealed a high prevalence of moderate anemia (74.4%) among the participants. Most women were from nuclear families (75%), lived in rural areas (89.4%), and were predominantly homemakers (83.1%) in the age group of 21–30 years. Nutritional analysis showed 74.6% of women had a calorie intake below 2000 K. Cal/day, 64.7% had a protein intake below 50 g/day, and 87.5% had an iron intake below 20 mg/day. A significant association was found between anemia and factors such as caloric intake (χ²=10.6654, P=0.001092), gravidity (χ²=7.0278, P=0.008025), and iron intake (χ²=27.277, P<0.00001), but not with protein intake (χ²=3.7547, P=0.052658). Conclusion: The study highlights a high prevalence of anemia among pregnant women in the Prakasam District, primarily associated with inadequate caloric and iron intake and increased gravidity. These findings emphasize the need for enhanced nutritional counseling and healthcare interventions focusing on diet and family planning for pregnant women in this region. [ABSTRACT FROM AUTHOR]

Anemia is more prevalent in low- and middle-income countries including India. Anemia in pregnancy is associated with increased risk of maternal health problems and adverse birth outcomes. This study estimates the prevalence and associated risk factors of anemia among pregnant women in India. This cross-sectional study is based on secondary data from the India National Family Health Survey-V (NFHS-5) conducted during 2019–2021. We extracted data of 27,317 currently pregnant women to estimate the prevalence and contributory factors associated with anemia using descriptive statistics and logistic regression analysis. The prevalence of anemia among pregnant women in India was 52.2%. Anemia was higher among adolescent women (61.5%), those with no education (59.2%), those belonging to poorest wealth index (61.9%), scheduled tribes (59.3%), and those from the eastern region of India (62.1%). Further, it was more prevalent among women with a habit of smoking, tobacco, or alcohol (63.0%), and women with shorter birth intervals (59.7%). Among Indian states, anemia prevalence was higher in the state of Bihar (63.1%) and the union territory of Ladakh (71.4%). Logistic regression models show that women with no education (aOR = 1.41, 95% CI = 1.27–1.57), belonging to a poorest wealth quintile (aOR = 1.69, 95% CI = 1.51–1.90), and those with a habit of smoking, tobacco, or alcohol (aOR = 1.39, 95% CI = 1.18–1.63) were more anemic than their counterparts. Additionally, women with no education showed a four-times higher risk of severe anemia (aOR = 4.79, 95% CI = 2.75–8.36) than their highly educated counterparts. Anemia affects half of all pregnant women in India. Anemia prevalence is higher among adolescents, illiterate, poor, and tribal communities. Social norm-based interventions and strengthening the community health facilitators should be implemented to reduce the high burden of anemia in India. Anemia in pregnancy increases the risk of maternal and new-born health problems that lead to unfavorable pregnancy outcomes. This study aimed to find the current proportion and factors influencing anemia among currently pregnant Indian women. This study analyzed the data of 27,317 currently pregnant women reported with hemoglobin levels to find the prevalence and contributing factors of anemia. The study revealed that about 52.2% of pregnant women suffer from anemia inclusive of 1.4% with severe anemia. The anemia proportion was higher in women living in the eastern region of India, the poorest households, teenage pregnant women, and women with no formal education. Severity was higher in women belonging to the poorest households, tribal groups, and those with a habit of smoking, tobacco, or alcohol. Further, women with no formal education were four-times more likely to have a risk of severe anemia during their pregnancy. Maternal anemia hampers the growth and development of the newborns. Thereby, anemia adds a huge burden to the nation's economy and health system. High rates of anemia among pregnant women could be a probable factor linked to the higher rate of maternal and child health illness and death in the eastern region, poorest strata, and other vulnerable populations in India. Special attention needs to be focused to ensure that these populations have easy access to healthy nutrition and the best public health systems. [ABSTRACT FROM AUTHOR]

Background: Spacing of birth is an important parameter affecting maternal and foetal health. Optimal birth spacing provides multiple benefits for both mother and her child. Both short and long inter-delivery interval (IDI) is associated with multiple adverse perinatal outcomes. Therefore, inter-delivery interval is viewed as a potential modifiable risk factor for adverse foetal-maternal outcome. The objective of the study was to study the association of inter-delivery interval and pregnancy outcome in a tertiary care hospital, West Bengal, India. Methods: This Prospective hospital based study was done in Dept of Gynae and Obstetrics, Burdwan Medical College and Hospital, West Bengal, India for a period of 18 months from February 2021 to July 2022. All multigravida women with atleast three antenatal check-ups were included in the study. The data were statistically analysed using Microsoft Excel and SPSS software. Results: Most common age group of the mother was found 20-25 years 64 (64%), followed by 26-30 years 24 (24%). Maximum mothers were parity 3 i.e. 48 (48%), followed by parity 2, 40 (40%). Ectopic was present in 12 (12%) of mothers. Preterm <32 weeks was present in 12 (12%), preterm <36 weeks was present in 20 (20%), induction of labour (IOL) was present in 16 (16%) and cesarean delivery (CS) was observed in 24 (24%) of mothers. Normal birth weight babies delivered were 76 (76%%) and low birth babies delivered were 24 (24%). Maximum interval from last miscarriage was 6-12 months i.e. 32 (320%), followed by 19-24months 24 (24%) and 13-18 months 20 (20%). Miscarriage was observed in 20 (20%) mothers and still birth was 4 (4%). Anaemia was present in 34 (34%) mothers. Conclusions: Lack of contraceptive use significantly increases the risk of short IDI which increases the risk of preterm delivery, maternal anaemia PPH and scar rupture in post-CS pregnancy. [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]

Anthropometric markers are the most important aspect of a child's health assessment. Using large-scale nationally representative data from the National Family Health Survey (NFHS-4), 2015–2016, this study aimed to investigate the relationship between children born to women with high-risk fertility behaviours and children's health outcomes. The sample consisted of 2,55,726 children of currently married women aged 15–49 years in India. The key explanatory variable, high-risk fertility behaviour was defined by women's age at birth (below 18 or above 34 years), birth interval (less than 24 months), and higher birth orders (four and above). The key outcome variables for assessing child health outcomes were stunting, wasting, and underweight in children aged 0–59 months. We used descriptive statistics, Pearson's chi-square test and logistic regression models to analyse the objectives. Approximately 33% of children were born with any single high-risk condition in the last 5 years in India. The bivariate analysis showed that all three components of child health, stunting, wasting, and underweight, were higher among children born to women with high-risk fertility behaviour. The findings from the multivariable analysis suggest that children born with a high risk fertility behaviour were suffering from stunting (AOR = 1.30; 95% CI 1.27–1.33) and underweight (AOR = 1.23; 95% CI 1.20–1.27). In addition, children born to women of multiple high-risk categories had higher odds of stunting (AOR = 1.53; 95% CI 1.46–1.59) and underweight (AOR = 1.38; 95% CI 1.32–1.44) as compared to children born to women with no risk. Our findings highlight an urgent need for effective legislation to prevent child marriage that would be helpful in increasing the maternal age at birth. The government should also focus on the interventions in health education and improvement of reproductive healthcare to promote optimal birth spacing. [ABSTRACT FROM AUTHOR]

Childhood stunting remains a public health concern in India. In Karnataka, the districts vary substantially in stunting prevalence. Using the NFHS-4 and AidData GEO datasets, we tested the hypothesis that 'wet' and 'dry' districts in Karnataka show different contributions to stunting. We found that for 30 environmental and health factors, Bengaluru appears to be distinct from the other districts. Using a mixed linear model approach, we found that for the entire state, and in both wet and dry districts, preceding birth interval, altitude-adjusted haemoglobin level and child age showed significant correlations with height for age (HFA). The wet districts showed an additional association between maternal age and child HFA. However, interaction effects also differed among the three conditions. Our results suggest that subtle variations should not be ignored when considering factors impacting child health outcomes. [ABSTRACT FROM AUTHOR]

A majority of the existing narratives on studying civil society in India are flooded with empirical findings, without much emphasis on theoretical understanding of the subject. Thus, the article tries to provide a historical overview of the development of notion of civil society and its research in "uncivil" Indian tradition from different dominant theoretical angles in the field. After finding their limitations, the study attempts to provide an alternative understanding of emergence of civil society in colonial India. It also aims to explore, how the lineage of traditional inform civic assocciationalism combined with modern institutionalized associational space gave birth to liberal-minded individuals and the conscious public in colonial India. Moreover, the present research further reveals that how civic awareness inculcated among the marginal's along with the educated Indian middle class and how interactions between the state, society, and religion helped in development of spirit of civility among individuals, awareness among the public and voice of protest among community in "uncivil" colonial India which was unique from its western counterpart both in the process of formation and the forms of manifestations. [ABSTRACT FROM AUTHOR]

Covid-19 disease caused by SARS-COV-2 has been a pandemic throughout the world including India. It affects all age groups including children. The disease is much milder among children compared to adults. In neonates, the disease is often mild and has good prognosis. It is still doubtful whether there is vertical transmission to the neonates from infected mothers. Also, it is not proved whether the disease can be transmitted through breast milk. Here we present case reports of three neonates, two of which were born to COVID-19 positive mothers. Rest one got infected at 25days of life. None of the two infants born to COVID-19 positive were positive at the time of birth. Our observation is similar to the previous studies that COVID-19 has not yet been proved to transmit vertically. One of them contracted the disease on day 7 of life from the mother in spite of strict precautions. It could not be proved whether it was transmitted from breast milk or faulty practice. One of the infants presented with late onset sepsis. All of the infants recovered well and was thriving well on follow up. [ABSTRACT FROM AUTHOR]

We analysed population data from the 2015–16 National Family Health Survey to disentangle the intricate underlying effects of reproductive behaviours and fertility preferences on child growth. We expected birth interval length to be more strongly associated with stunting than sibsize and these effects to be moderated by whether the child was wanted or unintended (mistimed/unwanted). Regression analyses showed strong and equal effects of short birth interval and sibsize on stunting, when adjusted for potential confounders and unobserved between-mother heterogeneity. There were no statistical associations between stunting and mistiming/unwantedness of index children, suggesting the absence of discrimination against such children. We conclude that while fertility preferences have no effect, reproductive behaviours exert significant influence on child growth. Sibsize has been falling for many years in India but birth interval lengths have remained largely unchanged. The results underscore the need for strengthening uptake of reversible contraceptives to enable longer birth intervals. [ABSTRACT FROM AUTHOR]

Do firstborn children have a height advantage? Empirical findings have found mostly that, yes, second or higher-order children often lag behind firstborns in height outcomes, especially in developing countries. However, empirical investigations of birth-order effects on child height overlook the potential impact that birth spacing can have. We provide an explanation for the negative birth-order effect on stunting outcomes for young Indian children and show it is driven by short preceding-birth spacing. We find that firstborn children are taller than children of higher birth order: The height-for-age gap for third (or higher)-order children is twice the gap for children second in birth order. However, this pattern is observed when spacing between later-born children and their immediate elder siblings is fewer than 3 y. Interestingly, the firstborn height advantage disappears when later-born children are born at least 3 y after their elder siblings. Thus, our findings indicate that spacing length between children explains differences in height, over birth order. Although India's family planning policy has resulted in a substantial reduction in total fertility, its achievement in spacing subsequent births has been less impressive. In showing that spacing can alleviate or aggravate birth-order effects on attained height, our study fills an evidence gap: Reducing fertility alone may not be sufficient in overcoming negative birth-order effects. To reduce the detrimental effects of birth order on child stunting, policy responses--and therefore research priorities--require a stronger focus on increasing the time period between births. [ABSTRACT FROM AUTHOR]

This paper examines recent changes in the life trajectories of Indian women. We use data from four major national population surveys that span the years 1998–2016. We look at several cohorts of women across the states and regions. We compare decisions related to education, marriage, childbearing and participation in the labor force. Though there is considerable diversity across states and regions, as well as religious groups, we find some consistent patterns that emerge everywhere. First, educational attainment and the age at marriage have been steadily increasing. Women who do not complete secondary school are more likely to marry early. Second, caste and religion (rather than education) play a significant role in decisions after marriage, such as the timing of births, the use of contraception and labor force participation. Third, women from disadvantaged communities continue to have very different life trajectories than other social groups. They are more likely to use contraception and participate in the labor force. Lower levels of schooling also appear to exacerbate the disadvantages of social identity. The pace of these changes varies sharply across states as well as regions of the country. [ABSTRACT FROM AUTHOR]

The positive effect of women's empowerment on the use of contraceptives is well established. However, the reverse effect, i.e. the potential effect of use of contraceptives on women's empowerment, is relatively unexplored. This study examined the direct impact of contraceptive use on women's empowerment in currently married women aged 15-49 years in India using data from the National Family Health Survey-4 conducted in 2015-16. A two-stage least squares (2SLS) regression model was used to account for the issue of endogeneity that appears in a general logit model. The use of contraceptives by the sample women was found to be associated with greater women's empowerment in terms of both their mobility and decision-making power. The pathways to greater women's empowerment are often presumed to be factors such as changing perception of their domestic role and sense of control over their own body. While these are integral, this paper highlights how the possible control over family size and birth interval through use of contraception may also be critical pathways to increasing women's empowerment. [ABSTRACT FROM AUTHOR]

Introduction: Indian subcontinent carries 17 % of world's population, being the second largest populated country. The maternal mortality rate of the country is still high. The study was aimed to study factors leading to pregnancy in women with previous two living children and their knowledge about limiting family and their practice for use of contraceptives. Methods: Questionnaire-based study was conducted in the Department of Obstetrics and Gynaecology. Results: 961 pregnant women attending antenatal outpatient department were interrogated and amongst them 167 (17.3 %) multigravida with previous two healthy children were enrolled in study and were asked to document in Questionnaire. Reasons for current pregnancy were gender bias, no desire to limit family, incorrect contraceptive use, contraceptive failure, doctor's mistake and religious belief. Desire for male child emerged as most common reason (37%) followed by improper or no use of contraception. Most significant associated factor was poor education of female partner (p = 0.010). Conclusion: This cross-sectional study evaluated the possible reasons of multiparity. We conclude that preference for male gender child is still very much prevalent in India, along with unmet need of family planning. Improving education of women might help to change attitude towards birth spacing and family size. [ABSTRACT FROM AUTHOR]

Reliance on traditional methods of birth control causes psychological tension in couples because the fear of unwanted pregnancy bars them from experiencing a healthy sexual life. However, in Assam, half of all contraceptive users depend on traditional methods of birth control. The current study used National Family Health Survey 2005–2006 data. Out of 3840 sample women in the age group 15–49 years, 1286 women are filtered for the present study. Most of the demographic and socioeconomic characteristics of traditional method users fall between those of modern spacing method users and terminal method users. Thus, the burden of unwanted fertility is highest among the traditional method users. [ABSTRACT FROM AUTHOR]

Child undernutrition remains a major child health and developmental issue in low- and middle-income countries. The concentration (clustering) of underweight children among siblings at the family level is known to exist in India. This study examined the extent and covariates of clustering of underweight children at the sibling and family level in Uttar Pradesh, the largest state of northern India. Clustering of underweight (low weight-for-age) children was assessed using data on 7533 under-five children from the National Family Health Survey (NFHS) conducted in 2005–06, analysed using binary logistic and binomial regression models. Related bio-demographic, socioeconomic and health care variables were used as covariates in the models. The odds of being underweight for the index child were about two times higher (OR=2.34, p<0.001) if any of the siblings within the household was malnourished or underweight. A longer birth interval increased the odds of a child being underweight. The odds of underweight were significantly lower (OR=0.69, p<0.001) for children born to normal-weight mothers compared with those born to underweight mothers. Similarly, the odds of underweight were significantly lower (OR=0.49, p=0.01) for children born to educated mothers (high school and above) compared with those born to illiterate mothers. The results of the binomial regression model suggested that the deviations between observed and expected number of children were positive (3.09, 3.78 and 2.71) for 1, 2 and 2+ underweight children within the households of underweight women, indicating the concentration of underweight children among underweight/malnourished mothers. Underweight children were found to be clustered among underweight mothers with multiple underweight siblings. The findings suggest that policy interventions need to focus on underweight mothers with multiple underweight children. [ABSTRACT FROM PUBLISHER]

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]

In life history theory, early life adversity is associated with an accelerated reproductive tempo. In harsh and unpredictable conditions in developing societies fertility is generally higher and the reproductive tempo faster than in more secure environments. This paper examines whether differences in female anthropometry, particularly adult height, are associated with fertility intentions of women in urban environments in India. The study population consists of women aged 15-29 (N=4485) in slums and non-slums of eight Indian cities in the National Family Health Survey (NFHS) of 2005-2006. Adult height is taken as a proxy for early childhood health and nutritional condition. Fertility intentions are examined by using two variables: the desire to have a child or another child, and to have it relatively soon, as indicative of accelerated reproductive scheduling. Evidence supporting the acceleration hypothesis is found in two urban frames out of 26 examined in a two-staged multinomial logistic model. In three cases, the relationship between fertility intentions and height is the opposite than expected by the acceleration hypothesis: taller women have a higher predictive probability of desiring a(nother) child and/or narrower birth spacing. Potential explanations for the partly contradictory relationship between the childhood health indicator and fertility intentions are discussed. [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]

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]

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]

While making an attempt to estimate parity progression ratio (PPR) values utilizing procedure of Yadava et al. (1992) for various states of India using National Family Health Survey (NFHS) data of different rounds, it was found that for some southern states the estimates of PPR were unreasonable and sometimes negative also. The procedure is based on an implicit assumption that ith order births are uniformly distributed over time which may be not suited for these southern states since these states have shown steep decline in fertility in recent years. The objective of the paper is to develop modified methodology for estimating PPR under more realistic assumptions suited for the situation. The proposed methodology gives improved estimates of PPR. [ABSTRACT FROM AUTHOR]

India is the second most populous country in the world, with half of its citizens being of reproductive age. Despite the availability of a long-standing national family planning program, India maintains an unmet contraceptive need and high rate of maternal morbidity and mortality. In order to develop strategies to improve the utilization of birth-spacing contraceptive methods, we conducted a qualitative study with providers of family planning services in Karnataka, India. We elicited facilitators and barriers associated with peripartum contraceptive counseling and provision and identified an important opportunity to increase the use of postpartum contraception and improve birth spacing. [ABSTRACT FROM AUTHOR]

Examining waiting time to birth among newlywed couples is likely to provide insights into the desire for spacing births among newlywed husbands and wives. Data from the Indian National Family Health Survey of 2005–06 are used to examine the desired waiting time (DWT) to birth among newlywed couples. The dependent variable is spousal concordance on desired waiting times. Overall 65% of couples have concordant desired waiting times. Among discordant couples, wives were more likely to want to wait longer than their husbands. Couples from richer wealth quintiles were more likely than couples from the poorest quintile to have concordant desired waiting times. Muslims were less likely than Hindus to have concordant desires. There is a need for spacing contraceptive methods among newlyweds in India. This may have implications for the Indian Family Planning Programme, which to date has largely focused on sterilization. Programmes need to include newlywed husbands to promote use of spacing methods. [ABSTRACT FROM AUTHOR]

Objective Birth spacing intervals are relatively short in India. Healthy spacing of 3–5 years between births is an effective way to prevent maternal and child mortality and morbidities. Socio-cultural and structural barriers, including limited awareness, socio-cultural norms, and misconceptions need to be addressed for behavior change. Hence the objective was to understand these barriers and accordingly develop separate messages for young women, her husband and her mother-in-law. Methods Data were collected from young women, husbands and mothers-in-law using qualitative methods. Altogether 16 Focus Group Discussions and 30 in-depth interviews were conducted. Beliefs related to need of spacing, disadvantages of closely spaced pregnancies and messages considered suitable for different stakeholders were investigated. Messages were identified for women, husband and mother-in-law; communication aids prepared and community workers trained to appropriately communicate the messages to stakeholders. Quantitative data were collected to measure the effect of the intervention. Results Educational campaign resulted in higher use of contraceptives for spacing among registered pregnant women from experimental area compared to control area. Conclusion Differential audience specific educational campaign is feasible and effective. Practice implications For an effective communication in the community, workers should know how exactly to convey the different health messages to different target population. [Copyright &y& Elsevier]

This short paper offers an original look at the fertility transition in India through the lens of the period parity progression ratios (PPPRs). Taking advantage of nearly 300,000 birth history data collected in three nationally representative surveys (National Family Health Survey, NFHS) conducted in 1992-1993, 1998-1999 and 2005-2006, fertility changes by parity are described from 1977 to 2004. The data indicate that the decline of fertility in India over the last 25 years has been primarily caused by a reduction of third and higher-order births and that a two-child family model is therefore emerging in the country. To assess the parity-based analysis, lifetime average parities are computed and compared to independently derived total fertility estimates from the Sample Registration System (SRS). The results show that the use of the parity progression ratios in the analysis of Indian survey data yields fairly consistent fertility levels and trends in comparison with traditional total fertility estimates obtained from the SRS and that the PPPRs present thus an alternative tool to estimate the consistency and quality of total fertility estimates derived from other data sources. [ABSTRACT FROM AUTHOR]

This short paper offers an original look at the fertility transition in India through the lens of the period parity progression ratios (PPPRs). Taking advantage of nearly 300,000 birth history data collected in three nationally representative surveys (National Family Health Survey, NFHS) conducted in 1992-1993, 1998-1999 and 2005-2006, fertility changes by parity are described from 1977 to 2004. The data indicate that the decline of fertility in India over the last 25 years has been primarily caused by a reduction of third and higher-order births and that a two-child family model is therefore emerging in the country. To assess the parity-based analysis, lifetime average parities are computed and compared to independently derived total fertility estimates from the Sample Registration System (SRS). The results show that the use of the parity progression ratios in the analysis of Indian survey data yields fairly consistent fertility levels and trends in comparison with traditional total fertility estimates obtained from the SRS and that the PPPRs present thus an alternative tool to estimate the consistency and quality of total fertility estimates derived from other data sources. [ABSTRACT FROM AUTHOR]

CONTEXT: Use of modern contraceptive methods has increased fourfold in India since the 1970s, characterized by a predominance of female sterilization. There has been considerable investigation about women's choice of female sterilization, but little from the male perspective. METHODS: Seven focus group discussions were conducted among 58 men currently married to women aged 15-45, followed by a cross-sectional survey among 793 men currently married to same-aged women. Bivariate analysis was used for the survey data, and content analysis was used for the qualitative data. RESULTS: Men's primary source of reproductive health information was mass media, although they expressed interest in getting information through discussion with knowledgeable sources. Men understood family planning and contraception to be two separate issues: Men viewed "family planning" as synonymous with female sterilization, whereas they saw "contraception"as referring to spacing methods, knowledge of which was limited. Thirty-four percent of men reported that their wives had been sterilized; 79% of men who did not rely on any permanent method said they wanted their wives to be sterilized. In focus group discussions, most men reported themselves as their family's sole decision maker about reproductive health; however, only one-third of survey respondents did so. CONCLUSION: Men are interested in acquiring family planning information, but lack knowledge about available information sources, which hampers their ability to make informed family planning choices. Family planning service providers and program planners need to be aware of males' knowledge and perceptions pertaining to family planning, and make appropriate modifications to communication strategies. [ABSTRACT FROM AUTHOR]

Background Birth spacing is an important determinant of the high fertility populations and has a strong bearing on maternal and infant health. The birth interval is composed of three major components namely postpartum amenorrhoea (PPA), waiting time to conception and gestation. To manage the high fertility in India, the present study is aimed to investigate the differential pattern of duration of birth interval components with respect to various socio demographic, child mortality, family planning services etc. Methods The data for this analysis was taken from National Family Health Survey 2015-16 (NFHS-4), provides information on population, health and nutrition for India and each State / Union territory. It gathered information from 601,509 households from overall India. Results Cox' regression explores infant mortality, lactation, use of contraceptive devices, son preference and religion are found significant (P < 0.01) factors on the dynamics of birth interval components After adjustment of the effects of other explanatory variables, duration of breast feeding (P < 0.01), infant mortality (P < 0.01) and family income (P < 0.05) are found to have their significant impacts on the variation of PPA whereas death of previous child in infancy (P < 0.01), sex of previous child (P < 0.05), lactation (P < 0.01), education of mother (P < 0.05), and use of effective contraceptives have are found to be significant factors influencing the duration of waiting time to conception. Conclusions Among the determinants, infant mortality, lactation and religion have significant impacts on both duration variables in the Cox's stepwise regression models. Key messages To control the growth of population, birth spacing must be maintained. [ABSTRACT FROM AUTHOR]

Summary Background Fewer girls than boys are born in India. Various hypotheses have been proposed to explain this low sex ratio. Our aim was to ascertain the contribution of prenatal sex determination and selective abortion as measured by previous birth sex. Methods We analysed data obtained for the Special Fertility and Mortality Survey undertaken in 1998. Ever-married women living in 1·1 million households in 6671 nationally-representative units were asked questions about their fertility history and children born in 1997. Findings For the 133 738 births studied for 1997, the adjusted sex ratio for the second birth when the preceding child was a girl was 759 per 1000 males (99% CI 731-787). The adjusted sex ratio for the third child was 719 (675-762) if the previous two children were girls. By contrast, adjusted sex ratios for second or third births if the previous children were boys were about equal (1102 and 1176, respectively). Mothers with grade 10 or higher education had a significantly lower adjusted sex ratio (683, 610-756) than did illiterate mothers (869, 820-917). Stillbirths and neonatal deaths were more commonly male, and the numbers of stillbirths were fewer than the numbers of missing births, suggesting that female infanticide does not account for the difference. Interpretation Prenatal sex determination followed by selective abortion of female fetuses is the most plausible explanation for the low sex ratio at birth in India. Women most clearly at risk are those who already have one or two female children. Based on conservative assumptions, the practice accounts for about 0·5 million missing female births yearly, translating over the past 2 decades into the abortion of some 10 million female fetuses. India [ABSTRACT FROM AUTHOR]

Analyzes data on married women's use of birth spacing methods in Kerala, India. Prevalence of adoption of sterilization as a method for delaying births; Linking of educational attainment and socio-economic status to increased use of temporary birth control methods.

• 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]

• Clustering of neonatal and post-neonatal deaths occurs among the Indian mothers. • Neonatal and post-neonatal death clustering is higher among urban and rural mothers respectively. • Rural children who lost their previous sibling had 2.4 times greater risk of neonatal mortality. • Post-neonatal mortality is 1.6 and 1.4 times higher among rural and urban children who lost their previous sibling. It is universally accepted that the first 365 days after birth is a critical period for child survival. The present study explored the phenomenon of neonatal and post-neonatal mortality clustering among Indian siblings and the existing urban–rural differential in the same using birth history data of National Family Health Survey (NFHS) 2015–16. We estimated random-intercept logit models for 1,296,196 and 1,248,535 children born to 474,786 and 456,662 mothers for analysing neonatal and post-neonatal mortality clustering respectively. The effect of scaring and unobserved heterogeneity among mother along with an urban–rural variation on neonatal and post-neonatal mortality of child was examined. Children, whose previous siblings were dead during their conception, had 2.42 [CI: 2.32–2.52] and 2.36 [CI: 2.16–2.58] times higher risk of neonatal mortality in the rural–urban regions respectively. Further, the risk of post-neonatal mortality was 1.60 [CI: 1.51–1.71] and 1.45 [CI: 1.25–1.67] times higher among rural and urban children respectively who had lost their preceding siblings. Moreover, we found a higher clustering of neonatal deaths among urban mothers compared to their rural counterparts. Comparatively, the clustering of post-neonatal deaths was common among rural mothers of India. Even after controlling for relevant covariates, we find the risk of neonatal and post-neonatal mortality varies greatly with the risk variation being slightly higher among urban mothers. The findings point toward targeting high-risk mothers with crucial programme benefits. Additionally, higher mortality clustering within mothers from urban regions means that region-wise interventions are required to tackle neonatal and post-neonatal mortality existing in urban–rural region separately. [ABSTRACT FROM AUTHOR]

The traditional preference for sons may be the main hindrance to India's current population policy of two children per family. In this study, the effects of various sociodemographic covariates, particularly sex preference, on the length of the third birth interval are examined for the scheduled caste population in Assam, India. Life table and hazards regression techniques are applied to retrospective sample data. The analysis shows that couples having two surviving sons are less likely to have a third child than those without a surviving son and those with only one surviving son. Age at first marriage, length of preceding birth intervals, age of mother, and household income have strong effects on the length of the third birth interval. [ABSTRACT FROM PUBLISHER]

Life tables of birth intervals and median birth intervals in two Indian states, Uttar Pradesh and Kerala, were computed for several subgroups of the study population. Multivariate hazards modelling technique was used to examine the net effect of each of the variables studied. The results show a substantial effect of socioeconomic variables in child-spacing after controlling for the major intermediate variables. [ABSTRACT FROM PUBLISHER]

This paper presents a method of estimating the number of births averted due to induced abortions by utilising the data on prospective birth intervals of the women. Numerical illustrations are given. [ABSTRACT FROM PUBLISHER]

Studies the effects of various sociodemographic covariates on the length of the first birth interval for two states in India. Use of life table and multivariate hazards modeling techniques; Effect of age of marriage, present age of mother, female's occupation, family income and place of residence.

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]

The author reports that a national household survey has determined that women in India who marry before they turn 18 are more likely than women who marry later to have high parity and inadequate birth spacing. The findings demonstrate that the social setting of child marriage results in less control by women of their reproduction as adults. The researchers recommend the implementation of family planning programs for married adolescents and programs to address gender inequality for girls in India.

Short birth intervals have been associated with adverse birth outcomes. This study examines the association between preceding interval and risk of stillbirth or neonatal death in rural north India (n = 80 164). Adjusted odds ratios (OR) and 95% confidence interval (CI) of stillbirth and neonatal mortality were calculated. The odds of stillbirth were significantly greater among birth intervals of 59 months (OR 1.44; CI 1.19–1.73), compared with intervals of 36–59 months. Neonatal death was associated with birth intervals of <18 months (OR 4.12; CI 3.74–4.55) and 18–35 months (OR 1.78; CI 1.63–1.94), compared to births spaced 36–59 months. Previous history of either stillbirth or neonatal death was significantly associated with risk of stillbirth and neonatal death, respectively, as were multiple births. [ABSTRACT FROM AUTHOR]