ISSN (Print) - 0012-9976 | ISSN (Online) - 2349-8846

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Is Contraceptive Prevalence Declining in India?

This study investigates the quality of the National Family Health Survey-4 data on contraceptive use by estimating investigator-induced bias. An outlier-bound approach was used to detect investigator bias, and contraceptive use was re-estimated adjusting for the bias in six study states. The findings suggest investigator bias at two levels: over-reporting of women as “never users” of contraception and a tendency to report sterilised women as current non-users and as cases of hysterectomy. Re-estimation of contraceptive use confirmed a declining trend in contraceptive prevalence in four study states. While the effect of the bias was moderate at the state level, it can potentially distort district-level estimates to a great extent.

Status of Women’s Reproductive Health in Bihar

Based on the National Family Health Survey data for 2015–16 and 2019–20, the article shows the precarious sexual and reproductive health of women in Bihar. While there are some improvements in this period, multiple indicators emerging from social and institutional determinants continue to show poor SRH of women in the state.

Dangerous Cooking Using Unsafe Fuels

Despite the efforts of the Indian government to make available and promote clean fuels, the use of cow dung cakes and other traditional fuels continues unabated. A survey conducted in two districts of Punjab reveals that both poor and well-off sections of society use solid biomass for various reasons, and women suffer from various health problems due to the inhalation of smoke released from the burning of these fuels. Policies need to be put in place to ensure the affordability of clean fuels, and people should be made aware of the adverse effects of this practice on health and the environment.

Multiple Vulnerabilities in Utilising Maternal and Child Health Services in Uttar Pradesh, India

Although there are multiple vulnerabilities that may prevent access to maternal and child health services in India, the literature has so far focused on unidimensional vulnerabilities—typically, economic or social vulnerabilities. The linkages between multiple vulnerabilities and the utilisation of MCH services are investigated using data from National Family Health Survey-4 (2015–16) for Uttar Pradesh to analyse whether women received full antenatal care, institutional delivery care, postnatal care, and full immunisation for their children. Bivariate analysis and binomial logistic regression analysis are employed to examine the multiple vulnerabilities that service utilisation across three dimensions—education, wealth, and caste. Women with multiple vulnerabilities are less likely to utilise essential MCH services.

Too Much Care

In the context of India where public expenditure on healthcare is low, the private sector plays an important role in delivering healthcare during childbirth. An analysis of the latest round of National Family Health Survey data to estimate the differential probability of caesarean sections in private medical facilities relative to government facilities, and focusing on unplanned C-sections, reveals that the probability of an unplanned C-section is 13.5–14 percentage points higher in the private sector. These results call for a critical assessment of the role of private sector in healthcare in the context of inadequate public provision, expanding private provision and weak governance structures.

Deepening Divides

Changes in the incidence of vegetarianism across time are sought to be analysed by identifying the specific trends at the level of region,caste and class. Divergence in the attitude towards vegetarianism across these axes points towards deepening divides linked to socioeconomic status and cultural-political power inequalities.

Women’s Education and Fertility in the Hindi Heartland

Using evidences from the Sample Registration System and the third and fourth rounds of the National Family Health Survey, this article shows that the fertility rate continues to be high in the Hindi heartland of the country, and that too among educated women. It also proposes some plausible hypotheses in this regard, which would require validation through further research.

Frequently Asked Questions on Child Anthropometric Failures in India

The National Family Health Survey is analysed to develop critical insights on child anthropometric failure in India. The analysis finds non-response of economic growth on nutritional well-being and greater burden among the poor as two fundamental concerns. This calls for strengthening developmental finance for socio-economic upliftment as well as enhanced programmatic support for nutritional interventions. The gaps in analytical inputs for programmatic purposes also deserves attention to unravel intricacies that otherwise remain obscured through customary enquiries. On the one hand, this may serve well to improve policy targeting, and on the other, this can help comprehend the nature and reasons of heterogeneities and inequities in nutritional outcomes across subgroups. Strengthening the analytical capacities of programme managers and health functionaries is recommended.

Trends, Differentials and Determinants of Child Marriage in India

Despite the law to prevent child marriage, the practice remains unabated in the country due to deep-rooted social and cultural norms. The cohort analysis of data from the National Family Health Surveys suggests that the prevalence of child marriage was around 58% during the decades of 1970s and 1980s, and it started declining, albeit at a slower pace, reached to 46% by 2000. The first decade of the 21st century witnessed faster decline with 21% of the girls aged 18–23 years marrying below 18 years of age, as per the estimates for the most recent reference period. The assessments of the government’s conditional cash transfer scheme to enhance value of the girl child seem to have influenced the attitudes of the parents, rather eliminating child marriage. The government’s cash transfer schemes needs revamping and is recommended to be routed through the educational system in the form of fellowships for higher studies and, in particular, vocational studies of the girls, rather than disbursing cash incentives to the family of the beneficiary girl.

Quality of Data in NFHS-4 Compared to Earlier Rounds

As the quality of data from the fourth round of the National Family Health Survey is likely to be affected both by the overstretching of the number of questions administered as well as the increased involvement of commercial agencies for data collection, rethinking both these aspects of survey management is the need of the hour.

Interpretations and Implications of Increasing Obesity in India

The National Family Health Survey-3 and 4 data show that in the past 10 years, overweight/obesity among women in terms of Body Mass Index has increased quite sharply. In the Indian context, undernutrition and obesity are not separate problems. A large proportion of overweight/obese women are undernourished, with small stature, food transition towards more fats and increasingly sedentary lifestyles making them vulnerable towards being overweight/obese. More diversified diet reduces the risk of overweight/obesity. It is suggested that adequate and good quality diversified diets need to be ensured for comprehensive energy and nutrient adequacy. This requires an overhaul of India’s food programmes.

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