The Social Science Spectrum is a peer-reviewed journal published by the Society for Scientific Aptitude, dedicated to promoting scientific aptitude and liberal education in society. The journal welcomes original contributions from scholars and researchers across the broad spectrum of social sciences, including economics, demography, gender studies, anthropology, political science, sociology, history, and related interdisciplinary fields. socialsciencespectrum@gmail.com
Geographic Disparities in ICDS Implementation and Child Malnutrition in India
This study investigates the socioeconomic, demographic and geospatial factors influencing the utilisation of Integrated Child Development Services (ICDS) and the prevalence of malnutrition among children under five in India. Using data from the National Family Health Survey (3 & 4), which includes a nationally representative sample of 238,945 children aged 0–59 months from 601,509 households, the findings highlight a slow decline in malnutrition rates, with stunting and underweight prevalence reducing by 9 per cent and 7 per cent respectively since NFHS-3 was conducted a decade ago. Analysis of spatial variation reveals significant clustering in ICDS utilisation and malnutrition, strongly associated with maternal education levels, higher proportions of scheduled castes and scheduled tribes and children of higher birth orders (three or more). Regression models incorporating spatial weights significantly improved predictive accuracy, underscoring the role of geospatial determinants in shaping health outcomes. Key factors negatively impacting children’s nutritional status included maternal low body mass index, low birth weight, higher birth order and caesarean deliveries, all exhibiting notable spatial dependence with stunting and underweight. These findings underscore the need for geographically targeted, equity-focused interventions to enhance ICDS utilisation and address persistent disparities in child nutrition outcomes across India.
Contraceptive Morbidity among Current Users of Modern Temporary Methods in India
The past decade has seen an increasing concern on modern contraception methods for preventing unwanted pregnancy and to attain the desirable number of children. While, the use of contraception has certainly helped to achieve the desired family and many others, it has also increased the possibility of contraceptive morbidities. The District Level Household and Facility Survey, 2007-08 data have been utilized for this study. The study finding shows, women’s health problems such as weakness/inability to work, body ache/backache, abdominal pain, excessive bleeding, and irregular periods are significantly higher in the rural areas compared to their counterpart in urban areas. Furthermore, the result depicts that, while the use of temporary modern contraception methods is higher in an urban setting, the contraceptive morbidity is found to be higher in the rural setting. Use of temporary modern contraception methods is found to be highly associated with contraceptive morbidities. The results show that the educational level of women, their economic status and place of residence are statistically associated with contraceptive morbidity in India.
Religion and social transformation: Christianity in Jyotirao Phule’s life and work
Jyotirao Phule was a social reformer of Maharashtra in the nineteenth century. He sought to improve the condition betterment of the scheduled castes and tribes. He noted that they were victims of Brahmin domination. He was convinced that lack of education kept them in their deplorable condition. Hence, he worked for upliftment through education. He was associated with Christian missionaries and institutions. Therefore, Christianity played an important role in his life and work. Brahmins alleged that he had become a Christian because he was critical of them, undermining their dominance. But such allegations were false. He was a Hindu with sympathies for Christianity and Christian missionaries as he saw much good in them.
Prevalence of chronic diseases among older adults in EAG and non-EAG states of India and its contextual determinants
Population aging is an emerging worldwide phenomenon. As a result of demographic and epidemiology transitions, life expectancy has increased across the globe. With the reflection of aging and increasing global population, chronic (non-communicable) diseases have become a global health challenge. Their burden becoming major public health challenges is more pronounced in low-performing states or developed states in India. Therefore, the present study assesses the prevalence of chronic diseases among older adults in Empowered Action Group (EAG) and non-EAG states, and their contextual factors. The study uses the Longitudinal Ageing Study in India (LASI), Wave-1 data, the survey was conducted during 2017-18. Bi-variate, spatial analyses, and logistic regression models have been carried out to assess the prevalence of chronic diseases among older adults. The prevalence of at least one chronic disease among older adults in India was about 55 per cent and it was about 50 per cent and 59 per cent in EAG and non-EAG states respectively. The prevalence of hypertension (26%) was the leading chronic disease among older adults, followed by gastrointestinal problems (18%), arthritis (16%), diabetes (12%) and chronic lung diseases (6%). The odds of chronic diseases among urban older adults were 39 per cent (Odds Ratio [OR]=1.39; 95% CI:1.29-1.50) and 30% (OR=1.30; 95% CI:1.24-1.35) higher than their rural counterparts in both EAG and non-EAG states respectively. The study concludes that major contextual factors of chronic diseases were higher age, smoking and using smokeless tobacco, physical inactivity, never working, lack of education, Muslim religion, poor economic status and residing in urban areas in both EAG and non-EAG states.
Economic burden of diabetes patients in Latur, India: A Cross Sectional Study
Diabetes mellitus is a modern-day epidemic, silently negative affecting the household economy. The epidemical diabetic burden has increased with the economic burden worldwide. The present study tries to estimate the direct and indirect economic burden of diabetes among diabetes patients. It utilises the empirical data collected from 505 self-reported diabetic patients during May to November 2017. Bivariate and Multivariate techniques were used for data analysis. The results show that more than one fourth of the household monthly income is incurred on direct health expenditure on diabetics. The study reveals that there is a disproportionate economic burden of diabetes among people belonging to rural areas from poor households, illiterate, currently not working patients and patients belonging to social groups including SCs/STs. From a policy point of view there is an urgent need to strengthen public health infrastructure at various community levels (viz. sub-centres, PHCs, and CHCs) with the facility of blood sugar tests and accessibility of medication by subsidized rate to the diabetic person. There is a need for awareness and coverage of community health insurance schemes.
Pattern and Determinants of Maternal Health Care Utilization among Muslim and Non-Muslim mothers in India
Despite progress in many fields, India is lagging behind to achieve Sustainable Development Goals by fulfilling maternal health and improvement in Maternal Mortality Rates, especially sections of the society which often facing social exclusion to access healthcare services. Muslim women suffer from patriarchy, stigma and low utilization of maternal and child health services. Keeping this in mind, our study explores the maternal healthcare services utilization in terms of ante natal care visits, place of delivery and professional assistance at the time of home birth. It also trying to understand the socio-economic determinants that restrict them to use the services compared with the mothers belonging to other religions. The data from the fourth round of National Family Health Survey has been studied. Bivariate technique, logistic regression and Oaxaca decomposition methods have been used. Muslim mothers are lower in terms of receiving ante natal care compared with the women belonging to other religion. But in terms of institutional births and availing professional assistance at the time of home birth, they lie slightly in a better position. A significant rural-urban difference has been observed in the case of institutional births. Maternal and child health services utilization steadily increased with education, employment, mass media exposure, partner’s occupation and educational level. Redefined policy measures on maternal health would be a key step towards improving utilization of MCH services.
Effect of Multiple Health Risk Factors on Non-Communicable Diseases among Older Adults: Insights from the SAGE Wave-1
The rise in health risk factors is a serious concern, adding to the worldwide burden of chronic diseases and affecting public health, particularly among older people. This explores the multidimensional nature of multiple health risk parameters and their relationship with non-communicable diseases (NCDs) in older adults in SAGE nations. We used data from the WHO’s study of Global Ageing and Adult Health (SAGE) Survey Wave-1 (2007-2010), and analysed the information of 33,922 (15,594 males and 18,328 females) people aged 50 years or above in six SAGE countries. We created a composite score of multiple health risk factors and NCDs by socioeconomic characteristics using bivariate and multivariate statistics models. The study finds that 5 per cent have no health risk factors and about 70 per cent are living with 2-5 health risk factors in all SAGE countries. The older adults living with six or more health risk factors were found to be the highest in South Africa (26%) followed by India (22%). The findings also highlight the relatively low burden of health risk factors among Chinese older adults. The increase in a number of health risk factors increases the NCDs. Prioritizing health education and socioeconomic upliftment can lower the health risk factors and enhance health outcomes for older persons.
Association of Consanguineous Marriage with Domestic Violence among Women in India: Evidence from the National Family Health Survey 2015-16
This study investigates the correlation between domestic violence and marriage types in India using data from the fourth round of the National Family Health Survey (NFHS-4). It reveals that the prevalence of any domestic violence is notably higher among women who had consanguineous marriage compared with those in non-consanguineous union. This pattern persists across various forms of violence. Physical violence emerges as the most prevalent, overshadowing emotional and sexual violence. The findings underscore that marrying one's cousin does not offer protection against abuse for married women, highlighting a concerning aspect often obscured by the perception of familial ties. This heightened risk of domestic violence requires targeted interventions that emphasises cultural sensitivity and the promotion of women's safety.
Rural Medical Practitioners: Who are They? What Do They Do? Should They Be Trained for Improvement? Evidence from Rural West Bengal
Private healthcare sector in rural India is often dominated by unqualified rural medical practitioners (RMPs). However, there is limited systematic evidence with regard to RMPs and their potential for an intervention to reduce their harmful practices and improve quality. This paper presents their brief profile. It critically examines their role and explore the need for an intervention for harm reduction and quality improvement. The sample included 104 RMPs, 765 household respondents, 188 Panchayat members and 48 ANMs. They are examined in terms of their knowledge, attitude and practice parameters. Results are analysed in the light of evidence from previous studies. Their knowledge varies by disease but for more than half of the difficult cases they seem to suggest right medicines. Users are generally satisfied with them with regard to effectiveness of treatment and price. Panchayat members and ANMs have mixed opinions but are in favour of a training programme to improve their work. They too feel the need for training but their expectations vary along with willingness to pay for it. RMPs are an essential and unavoidable component of rural health care in India, but their role should not be overemphasized. As a transitional arrangement, the initiative of training them must be explored but not tuned to institutionalise them so as to attract more people to join the RMP force.
My Body, Your Choice: Partner’s Age and Education as Determinants of Contraceptive Use in India
Many couples in low and middle-income countries would like to limit or delay their pregnancy but they do not have sufficient access to modern contraceptive methods. Although women mostly pay for unmet needs for family planning, they are often not considered as fertility decision makers by their partners. This paper aims to explore the role played by a partner’s age and education differences in explaining contraceptive use and unmet need among married couples in India. Data were drawn from the National Family Health Survey-4 survey and a stratified two-stage sample design was adopted to reach out to the surveyed households. A total of 63,696 couples aged 15-49 years of women and men aged 15-54 years were included in the analysis. Among the married couples included in the study, husbands were older and more educated than the wives. Mean and the standard deviation of the age of married couples was 4.84±3.87 &1.44±4.25 years. Woman with more education (OR=1.31) were more likely to use contraception methods than those who had no schooling. Unmet need for family planning was lesser among the couples where the husband was older (OR=0.89) compared with the couples where both were of the same age or wife was older. With the increasing wealth quantile, the use of contraceptive methods was growing from the poorest to the richest group (OR=2.0). According to our findings, not just individuals’ but couples’ characteristics matter in determining unmet needs for family planning and use of contraception.
Living Arrangements and Chronic Morbidity Among Older Adults in India: Evidence from a Large-scale Survey
This study examines the association between living arrangements and the prevalence of chronic morbidity (having ≥2 chronic conditions) among older adults in India. It has used the data of 9,852 persons aged 60 years and above from the survey of Building Knowledge Base on Population Aging in India (BKPAI) conducted in 2011. Bivariate and binary logistic regression analyses were employed to investigate the influence of confounding factors on morbidity. Regression models demonstrated that older adults living with children/others are more likely to suffer from chronic morbidity than those who are living alone. Chronic morbidity was the highest among 80 years and above age group (77.9%) than the other two age groups of 60-69 (57.6%) and 70-79 (66.3%) years. There is a strong association between increased morbidity and living arrangements of older adults. The high prevalence of morbidity observed among older adults living with children/others suggests that programmes and policies should also be oriented towards the living arrangements of older adults while framing the public health support system in India.
Regional Variations in Child Malnutrition in Uttar Pradesh
Malnutrition is a major health concern in most developing countries in children aged less than 5 years. Child malnutrition is generally considered as a condition of child being undernourished or underweight or overweight. As Uttar Pradesh (UP) has the largest proportion of the country’s malnourished children, the study of child nutrition is relevant. Very few studies have been done to look into the spatial pattern of child malnutrition in India and none has been done in UP. In this study, we analyse the regional variation in Uttar Pradesh with respect to child malnutrition and examine the determinants of child malnutrition. Economic inequality (wealth index, place of residence and maternal education), social structure of the society (social groups, religion and sex of child), source of drinking water and toilet facility are directly connected with the health of children. Using Multivariate Logistic Regression analysis on the data of NFHS-4, this paper examines the regional variation of child malnutrition in Uttar Pradesh. The overall picture is that the intra-state regional variation of child malnutrition is present in Uttar Pradesh. The problem of wasting and being underweight is very high in the southern region. The eastern region is the second most concerned area for child health. Maternal education has been found to be negatively associated with child malnutrition. Thus, there is a need to implement health programmes region-wise to eliminate malnutrition. Also, there is a need to put a greater focus on female literacy which is low in Uttar Pradesh.
Influence of Childcare Practices on Nutritional Status of Children in India: An Analysis of National Family Health Survey-4
Appropriate childcare practices (CCPs) play a crucial role in achieving optimal health outcomes in early childhood as well as in later life. However, poor childcare practices can lead to stunted growth, immune dysfunction, delayed mental development and significantly increased risk of infectious diseases. In countries like India, the problems of undernutrition are always considered in terms of household food security without recognizing the importance of CCPs, which play a vital role in influencing the nutritional status of children. Therefore, using data from the National Family Health Survey (NFHS-4), this study assesses the effect of CCP on the nutritional status of children aged 6-36 months in India. The principal component analysis was used to create CCP index and generalized linear model was used to assess the association of nutritional indices with CCPs. The results showed a positive association between CCPs and child nutritional indices such as height-for-age Z-scores (HAZ), weight-for-height Z-score (WHZ) and weight-for-age Z-score (WAZ), after controlling for potential confounding factors. Therefore, promoting CCPs that not only include feeding practices but also health services like immunization could improve child health and nutrition in India.
Do Acute Health Care Needs of the Poor Crowd Out Their Chronic Care Utilization? Evidence from Rural India
In rural India, much of the public health facilities are better equipped to provide treatment for either acute ailments or reproductive and child health needs. Chronic diseases are treated mainly in secondary or tertiary hospitals located in sub-division or district headquarters or in the big cities, which makes their treatment more expensive. This paper uses demographic and health surveillance data from Birbhum to test whether there is a crowd-out effect on treatment of chronic diseases in the event of acute ailments in the household. We also test whether households ration the amount they spend on care for chronic ailments based on age and gender. With limited financial means, households prioritize treatment of acute conditions, reduce resources and efforts to treat chronic health care needs and these trade-offs are particularly strong in poorest households, and most disadvantageous to the elderly members within the households.
Eye Injuries among the Tannery Workers of Kanpur City, India
Occupational health hazards among the workers in the tannery industries are well known. However, a study on eye problems/injury among tannery workers is scanty. They are exposed to hazardous chemicals which is directly associated with their health. This study examined the prevalence of eye problems/injuries and their determinants among them. A total of 284 tannery and 289 non-tannery workers were interviewed during January-June 2015 from Kanpur using a three-stage sampling design. Bivariate and logistic regression analysis have been applied for data analysis. Results show that the prevalence of eye problems was higher among tannery workers than non-tannery workers. More than one-fifth (22.5%) of the tannery workers suffered from cloudy and blurry vision. The risk to them was significantly higher among those with eleven or more years of work experience (OR=3.32; p<0.05). They had exposure to dry finishing work (OR=2.65; p<0.1). Tannery workers' exposure to a moderate or high level of chemicals in the air (OR=2.08; p<0.1) resulting in eye injuries is higher than their counterparts elsewhere. In conclusion, they should be trained and self-motivated to use preventive measures to reduce chemical and dust exposure such as wearing protective glasses. Their ocular health must be monitored periodically for adequate and timely treatment. In this regard, health education and safety training are essential to prevent eye injuries.
Exposure to Mass Media and Awareness and Correct Knowledge on Mode of Transmission of Tuberculosis in India
WHO estimated that 10 million people fell sick with Tuberculosis (TB) globally in the year 2019 and most of them live in Asia, and India accounts for one-fourth of the TB deaths globally. This study uses data of 6,99,686 women aged 15-49 years and 1,12,122 men aged 15-54 years from the National Family Health Survey-4, (NFHS-4) 2015-16. Eighty per cent of respondents, irrespective of gender, had reported that they ever heard of tuberculosis. Seventeen per cent of women as well as men did not report the correct mode of transmission of TB. Women and men both show almost the same pattern of exposure to mass media and it has significant effect on TB awareness, knowledge and misconception on TB. Likelihood on awareness of TB and perception of TB cure is low among radio listeners. It is clear that audio visual media has more impact on awareness generation and reduces the misconception on TB transmission. Using of 360-degree approach with social behavioural change at the community may help to promote desired behaviour. Government needs to accelerate the TB programme from clinical approach to human centric behavioural approach to provide discrimination free environment to the TB survivors.
‘Other-Gender’ in India: An Analysis of 2011 Census Data
In spite of human rights protection given to the “other-gender” population (transgender) worldwide, they still constitute a deserted community which faces a significant occupational challenges around the world. In India, the other-gender community encompasses individuals with a variety of gender identities forming a culturally unique gender group. Although they have always remained an integral part of the society from the very ancient time, unfortunately their existence is grappling with abject poverty, illiteracy, hatred and mockery. Such stigmatisation and segregation from society have left them to compromise with the employment opportunities available. This paper used the data on ‘other-gender’ released by Census of India for the first time. The 2011 Indian Census reported approximately 4,87,803 individuals belonging to the other-gender category in the country. This data demonstrate that the other-gender community exhibits lower level of literacy and labour force participation when compared with the general population. In this paper, we endeavour to conceptualize these findings and engage in a discussion of the inherent limitations of the data.
Is Financial Inclusion of Education Providers Cognizant: A study based on University employees
Financial inclusion is recognized as one of the major goals of development and its importance is increasingly felt in the current scenario. The government efforts are largely directed towards increasing the banked population; thereby ignoring a considerable section of population and narrowing the concept of financial inclusion. Hence, the present study extends the existing studies to education providers, i.e., university employees working in close proximity to financial services and potential labor force. The study based on a primary survey of 150 employees of University of Rajasthan reveals that modern means of banking do not enjoy universal acceptance. Saving and investment behavior of employees is governed by precautionary motive and non-financial assets. A financial inclusion index constructed using PCA reveals that employees aged 41 years and above, less educated and earning up to 50000 per month depicted low financial inclusion. Informal sources particularly media emerged as the major source of information resulting into less informed financial decision-making. Thus, the study highlights limited role of education for high level of financial inclusion and cautions against preconceived notion of considering a specific sub-group as the need of interventionsFinancial inclusion is recognized as one of the major goals of development and its importance is increasingly felt in the current scenario. The government efforts are largely directed towards increasing the banked population; thereby ignoring a considerable section of population and narrowing the concept of financial inclusion. Hence, the present study extends the existing studies to education providers, i.e., university employees working in close proximity to financial services and potential labor force. The study based on a primary survey of 150 employees of University of Rajasthan reveals that modern means of banking do not enjoy universal acceptance. Saving and investment behavior of employees is governed by precautionary motive and non-financial assets. A financial inclusion index constructed using PCA reveals that employees aged 41 years and above, less educated and earning up to 50000 per month depicted low financial inclusion. Informal sources particularly media emerged as the major source of information resulting into less informed financial decision-making. Thus, the study highlights limited role of education for high level of financial inclusion and cautions against preconceived notion of considering a specific sub-group as the need of interventions
Role and Barriers of Integrated Child Development Service in Bihar, India
Children face a lousy situation due to lack of food and nutrition in the early age of life, the most crucial period when social, emotional, language, cognitive, physical/motor development and life-long learning are laid. The results by analysing NFHS data portrayed that only nine per cent of children aged 0-71 months had availed any services from AWCs, whereas the health check-ups (0.7%) and measurement of weight at AWC (0.5%) services were least likely to be accessed in Bihar (2005-06), while it improved significantly in the latest round of the survey. Poor sections of the society have a better access to the services provided by AWCs. Atmosphere of the AWCs is not up to the mark and requires quality improvement. Poor registration in them is not only due to lack of infrastructure but also to cultural and ecological factors. Children are without basic amenities, poor lighting, and hot humid conditions. If the AWCs get basic amenities, children would be more attracted to join them. With the provision of electricity, workers would be able to take audio and video classes under pre-schooling. Intervention for nutrition also requires multi-sectoral attention.
Intimate Partner Violence-Driven Fatal Injuries among Women in India: Empirical Evidence from National Family Health Survey 2015-2016
Increasing evidence of violence against women in India is reported in recent studies. However, there is lack of evidence on violence-driven injuries among women in India. The current study examines the prevalence and risk factors of violence against women and violence-driven injuries in India using the fourth round of National Family Health Survey (NFHS-4) data, conducted during 2015-16. Descriptive statistics, bivariate and multivariate analysis were carried out to see the associations of injuries and sociodemographic factors. The prevalence of lifetime experience of violence-driven injuries are: cuts or bruises were the most common injuries (21.4%) of IPV, followed by severe burn (7.8 %), eye injuries/sprains/dislocations/burns (5.4%), and deep wounds/broken bones/broken teeth/any other serious injuries (3.4%). Overall, 24.6 per cent of the of IPV victims have experienced some kind an injury in lifetime. Older women aged 35-49 years (OR = 1.247; CI=1.096-1.419), having 5 or more children (OR=1.244; CI=1.010-1.532), belonging to scheduled castes (OR=1.363; CI= 1.212-1.533) and belonging to Muslim society (OR=1.229; CI=1.075-1.405) were significantly more likely to have violencerelated injuries than their counterparts. The study demonstrated that considerable proportion of women experienced violence and violence-related injuries. Risk factors identified were women’s lack of education, alcoholism, having more than one child and poor socio-economic household status. Violence-driven injuries are among the most prominent public health problems which need urgent attention and strategic interventions to prevent them.
Malnutrition and its Associated Factors among Slum Living Adolescents in Uttar Pradesh, India
Malnutrition is one of the major public health problems worldwide. Adolescence is known to be a second opportunity for growth as it facilitates catch-up growth for children experiencing nutritional deficits in their early life. The present paper examines the prevalence and risk factors of nutritional status among adolescents (12-19) living in the slums of Lucknow, Uttar Pradesh, using a cross-sectional study of 590 sample households in 2015. As a part of this investigation, adolescents’ underweight and stunting status were examined to determine nutritional status using the WHO growth reference. This study performed bivariate analyses to elucidate differentials in nutritional status and fitted logistic regression models to examine the effect of different socio-economic factors on the likelihood of an adolescent’s malnutrition status. About 46 per cent of the adolescents exhibited stunted growth and 10 per cent were severely stunted. About one-fourth of the respondents were underweight and 7 per cent were severely underweight. Reinforcing the existing public health programmes is critical for enhancing the nutritional level among adolescents. Further, school, community and media-based programmes need to become effective platforms to reach adolescents at a stage in their lives when lifelong nutrition patterns are formed.
Menstrual Hygiene Practices among Women Aged 15-24 years in India: Evidence from NFHS-4
The study assesses the prevalence of menstrual hygiene habits and the factors influencing them among Indian women aged 15 to 24 years. It utilises the National Family Health Survey (NFHS-4) data collected from women who have menstruated in the age group of 15-24 years. Bivariate and multivariate analyses were carried out with the selected socioeconomic and demographic factors associated with the use of hygienic methods during menstruation. The analysis shows that 57 per cent women practised hygienic methods in India and more than 60 per cent used cloth during their menstruation to prevent the blood stains from becoming evident. Place of residence, year of schooling, caste/tribe, wealth index, region, marital status, structure of the house and exposure to mass media were statistically significant with the use of hygienic methods. A significant proportion of adolescent females does not practise good menstrual hygiene. It is crucial that young girls are taught the value of keeping their bodies clean throughout their menstrual periods in order to lower their chances of developing reproductive tract infections.
Association of Marital Violence with Contraceptive Use in India
Intimate Partner Violence (IPV) against women is a global issue (a prominent social determinant of health) and a significant public health concern. Ever married women’s ever experience of spousal physical or sexual violence has declined from 37 per cent in NFHS-3 to 29 per cent in NFHS-4. However, there has been almost no change in women’s experience of spousal physical or sexual violence in the 12 months preceding each survey (24% in NFHS-3 and 22% in NFHS-4). The infliction of physical violence has multi-dimensional implications. On the one side, it has a long trail of ill-effects for the victims ranging from physical, reproductive and mental health outcomes and, on the other side, it has far-reaching consequences for family planning in India. The paper throws light on the hidden factors that are obstacles to the use of contraception with any violence by using the data of women’s file from NFHS-4 (2015-16). We used binary logistic regression, multinomial logistic regression and bivariate analysis for all the objectives. The key finding of the paper is that limiting methods are used more than spacing methods by women experiencing physical, sexual or emotional violence. Coordinated efforts can be undertaken to increase awareness about the adverse impact of domestic violence on contraception.
Measuring and Decomposing Inequalities in Mental Disorders among Elderly in Five Low- and Middle-Income Countries: Evidence from WHO-SAGE, Wave 1
The paper aims to quantify the extent of inequalities among the older population in India, China, Ghana, Russia and South Africa. Though studies show prevalence of mental disorder among these countries, little is known about relative contribution of explanatory factors for health-related inequality in mental disorders among elderly. Data from Global Ageing and Adult Health (SAGE), WAVE-1 (2007-10), has been used for analysis. Finding portrays that though inequality prevails more in China, Indian older population suffers more from mental disorders compared with the other selected countries. Further, decomposition analysis reveals that age, urban residence, male sex and education (high school or more) show significantly more importance in order to explain relative contribution in inequality for mental disorders. In contrast, relative contribution of employment is very less. The lower value of unexplained CI shows that selected explanatory factors significantly explain the existing inequalities. In essence, results indicate that inequalities are artefacts of existing inequalities through place of residence, gender, education and economic factors, which need instant attention of policy makers to promote mental well-being through active and healthy ageing.
Importance of Proximity to Outpatient Care Facilities in Rural India
The paper illustrates the additional travel and associated burden while accessing outpatient care services in Rural India. Analysis based on the 75th round of National Sample Survey (2017-18) on ‘Health Care Consumption’, showed that only 54 per cent people in rural India were able to avail outpatient care within their locality in comparison with 94 per cent in urban India. The need to travel outside their rural locality is lowest for those seeking care from private clinic/doctor (62%), followed by those seeking government facilities (56%). The utilization of outpatient services from their localities were more for non-chronic ailments (62%) than for chronic ailments (46%). Those seeking health care outside their locality reported higher out of pocket expenditure and had higher loss in household income due to outpatient treatment. Results indicate the achievement of the long-standing goals set for establishing adequately staffed PHCs and CHCs in rural areas and a provision to provide incentives to set up health facilities in remote rural areas is essential to ensure equitable access to basic health care in here. Since the establishment of specialized care in all the rural areas is financially not viable, the solution suggested here is to compensate the rural population for travel and other related costs.
Post-abortion Complications and Treatment-seeking Behaviour among Women in India
Studies on abortion, post-abortion complications and their treatment seeking behaviour is limited in Indian context mainly because of the stigma and taboos associated with abortion. The present study attempts to find out the place of abortion, post-abortion complication and determinants of treatment-seeking behaviour of post-abortion complications in India. Using the data from NFHS-4 and employing both bi-variate and multivariate analyses, it found that more than half of the abortions happened in private health facilities, one-fifth in public facilities and about one-fourth outside the health facilities. Post-abortion complication is higher in the northern region, followed by the central region. Fifteen per cent of women did not go for treatment for post-abortion complications mainly because they can’t afford the treatment and social stigma. Therefore, these women should have a priority in policy. As there is social stigma attached to abortion in India, its reporting is a matter of concern. To minimize this, awareness about abortion to the people should be created and women educated.
Adult Out-Migration and Multi-Dimensional Well-Being of Elderly Parents ‘Left Behind’: A Cross-Sectional Study of India
Obtaining data from a nationally representative survey of old age population—Building a Knowledge Base on Population Ageing in India (BKPAI) comprising 9852 older adults, the present study empirically evaluates different dimensions of wellbeing among Indian elderly individuals left behind by their adult migrant children. We focus on five different dimensions of well-being among elderly, viz., physical, psychological, subjective, social and housing. Data were analyzed using propensity score matching technique. Findings suggest that the elderly individuals with adult migrant children were more likely to attain better physical and subjective well-being whereas the migration of adult children showed adverse effect on the psychological and social well-being indicators. However, results did not show any statistically significant association between migration and housing wellbeing of left behind elderly. Given the rising proportion of ageing population in India combined with an increasing trend in rural-urban adult migration, our findings suggest that the policy-makers should pay more attention to the migration status of adult children to keep track of the psychological and social welfare among Indian older adults.
A Review on Interventions to Improve the Maternal Care during Pregnancy and Childbirth in Rural India
Most of the maternal deaths occur in developing countries and India contributes to onefifth of this maternal mortality. Many of these deaths are preventable through effective interventions. The present study aims to address the gap in the effect of improved quality of care in pregnancy and childbirth through a review of existing literature. Its focus on displaying the evidence of interventions on care during pregnancy and childbirth in rural India and to compile the existing evidence of the effectiveness of these interventions which may be helpful for policy making. The search strategy was to identify relevant articles in the database like MEDLINE, PubMed, Popline, and Cochrane. A total of 264 abstracts from 2005 to 2018 were identified from the database search. After reviewing the abstracts against inclusion and quality assessment, 16 articles were found suitable for review. The review shows that community-level interventions focusing on women, frontline health workers and family members through knowledge enhancement, use of mobile technology and upgrading health facilities resulted in improvement in the utilization of maternal practices. This review found evidence that community health workers were effective in delivering health promotion or education or preventive intervention for maternal services in rural India.
Going beyond the Numbers: A Narrative Literature Review of Child Sex Ratio in India
Declining child sex ratio (CSR) is an important demographic feature in South Asian countries, particularly in India. In recent decades the situation has become alarming. Literature on changing CSR in India has traversed through various narratives. Straight forward explanations to decline in CSR have been elusive. Diverse disciplines have highlighted different aspects of CSR. For instance, while demographers focus on spatial and temporal aspects, sociologists emphasised women’s status and autonomy, economists underline the economic value of children. This paper examines the narratives from the existing literature to help clarify the issues that shape the changes in CSR. The purpose of this paper is to review and thematise the relevant literature. For this the relevant literature was chronologically arranged to temporally map the scholarship and debates. Apart from underlining the significance of examining the influence of social factors in CSR, the study found that over time, the role of technology and policy surrounding it started occupying more and more space in the landscape. This conceptual clarity and new insights form the scope for the future research and further studies.
Prasad, Anirudh (2016). JP’s Vision of Rural Reconstruction and Entrepreneurship Development. Bihar Vidyapeeth, Patna. 40p. Price not mentioned.
This booklet was brought out to commemorate the 117th birth anniversary of Jayaprakash Narayan, popularly known as ‘JP’. It contains five sections.