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Item A success story of reduction in childhood stunting and underweight in India: analysis of pooled data from three rounds of Indian Demographic and Health Surveys (1998-2016)(J. Biosoc. Sci., 2022) Swati Srivastava; Ashish Kumar UpadhyayThis study used a series of individual-level datasets from National Family Health Surveys conducted in 1998-99, 2005-06 and 2015-16 to assess the factors behind the reduction in childhood stunting and underweight in India between the years 1998-99 and 2015-16. A multivariable decomposition regression analysis was performed. Results showed that the prevalence of childhood stunting declined from 49.4% in 1998-99 to 34.9% in 2015-16. Over the same period, the prevalence of childhood underweight declined from 41.9% in 1998-99 to 33.1% in 2015-16. The reduction in the prevalence of stunting was found to be contributed largely by a reduction in the combined prevalence of stunting and underweight (60%), followed by stunted only (21%) and the combined prevalence of stunting, underweight and wasting (19%). Likewise, the reduction in the prevalence of underweight was contributed by a reduction in the combined prevalence of stunting and underweight and the combined prevalence of stunting, underweight and wasting. Results of the decomposition analysis showed that over the period 1998-99 to 2015-16, improvement in wealth status and maternal education led to 13% and 12% declines, respectively, in childhood stunting and to 31% and 19% declines, respectively, in childhood underweight. Furthermore, reductions in childhood stunting and underweight were due to an increased average number of antenatal care visits, lower average birth order, decreased share of children with below-average birth size, increased use of clean fuel for cooking and a reduction in the practice of open defecation. These findings suggest that further reduction in the prevalence of childhood stunting and underweight could be attained through more equitable household economic growth, investment in girl's education, greater access to improved toilet facilities, more widespread use of clean fuel for cooking, reduction in average birth order, increased antenatal care visits and greater consumption of IFA tablets by pregnant women. Policymakers need to prioritize these measures to further reduce malnutrition among Indian children.Item Abortion among married young women: findings from a community-based study in Rajasthan and Uttar Pradesh, India(J. Biosoc. Sci., 2020) A. J. Francis Zavier; K. G. Santhya; Shireen J. JejeebhoyAbortion service provision has changed noticeably in the recent past and medication abortion currently accounts for four-fifths of all induced abortions taking place in India. How these changes have modified abortion experiences among young women - a group known to be more disadvantaged than adult women - remains unanswered. This paper fills this gap and examines the experiences of married young abortion seekers, including pre-abortion decision-making, abortion seeking and experiences of the procedure, and post-abortion complications. Data were drawn from a community-based survey of 4952 married young women aged 15-24 years conducted in Uttar Pradesh and Rajasthan in 2015. The study focused on 166 young women who had an induced abortion in the two years before the survey, and used descriptive statistics to describe their abortion experiences. Seventy-four per cent of abortion seekers had relied on medication abortion and 47% had obtained it over the counter without a physician's prescription. Moreover, 90% accessed abortion services from private facilities, including drug sellers. A small proportion (4%) had undergone abortion in the second trimester of pregnancy. At the same time, 13% reported multiple abortion attempts; 17% underwent dilation and curettage; and 52% experienced self-reported complications, including 5% who experienced moderate to severe complications. The findings call for greater attention to providing contraceptive counselling and services to married young women, ensuring abortion services in public health facilities and exploring mechanisms to improve drug sellers' knowledge and practices in providing medication abortion.Item Abortion care seeking in India: patterns and predictors(J. Biosoc. Sci., 2020) Palak Sharma; Manas Ranjan PradhanUnsafe abortions remain a considerable public health problem and continue to be a leading cause of maternal morbidity and mortality throughout the world. This study assessed whether women's choice of type of health care facility for abortion in India varied by their socio-demographic and economic characteristics, and aimed to determine the significant predictors of choice of health care facility. Data were taken from the 2015-16 Indian National Family and Health Survey (NFHS-4). The study sample included women aged 15-49 years, irrespective of their marital status, who had terminated their last pregnancy by induced abortion in the five years before the survey (N= 6876). A bivariate analysis was carried out to assess the pattern in the choice of health care facility type for an abortion, and a multinomial logistic regression model was fitted to assess the predictors affecting the choice of health care facility type for an abortion. The results showed that, at the time of the 2015-16 survey, women in India went to private facilities more than public facilities for abortion care, irrespective of their age, distance to facility and financial constraints. The probability of visiting a private facility increased with women's age, gestational age and the wealth quintile. A wide variation in choice of health facility for abortion care by socioeconomic characteristics was observed.Item Addressing reproductive health knowledge, infertility and coping strategies among rural women in India(J. Biosoc. Sci., 2021) Shraboni Patra; Sayeed UnisaAn awareness of fertility and the factors affecting it is crucial to dealing with infertility, though little research has been conducted in the context of rural India. This study assessed Indian women's perceived causes of, and strategies for coping with, infertility and the associations with levels of reproductive health knowledge in rural areas. Primary data were collected through mapping and listing in high infertility prevalence districts of West Bengal in 2014-15. A total of 159 women aged 20-49 years who had ever experienced infertility were interviewed. A Reproductive Health Knowledge Index (RHKI) was computed to indicate respondent's level of reproductive health knowledge, and to show its association with perceived causes of infertility and coping with infertility. The highest mean RHKI score was observed among women in the lowest age group (RHKI=5.75, p<0.001), those with a higher level of education (RHKI=9.39, p<0.001) and those who had exposure to any media (RHK1=5.88, p<0.001). Women with a poor wealth index (RHKI=2.11, p<0.01) and those from Scheduled Caste, Scheduled Tribe and Other Backward Class communities (RHKI=4.20, p<0.05) had lower RHKI scores than richer women and those from General Caste communities. Women with a higher RHKI score were more likely to give biology (98.0%, p<0.001), old age (94.1%, p<0.01) and repeated abortions/accident/injury (92.2%,p<0.001) as reasons for infertility, whereas women with a low RHKI were more likely to give religious (73.2%, p<0.001) and old-age-related causes (75.0%, p<0.01) of infertility. Women with a high RHKI score were more likely to opt for modern allopathic treatments (RHKI=7.04, p<0.001), whereas those with a low RHKI score were more likely to seek treatment from religious and superstitious practitioners, use home remedies or receive no treatment at all (RHKI=1.66, p<0.001). Appropriate reproductive health knowledge is crucial if rural Indian women are to correctly assess their infertility problems and choose effective coping strategies.