Manas Ranjan Pradhan

Perceived gender role that shape youth sexual behaviour: Evidence from rural Orissa, India.

The study attempts to understand the association of perceived gender role with youth sexual behavior using qualitative data such as focus group discussions (N=8), in-depth interviews (N=42), and free listing (N=50) of rural married youths from Orissa, India. Data collection was conducted during July 2006-April 2007. Atlas. ti and ANTHROPAC packages have been used for the analysis. Youths in general are expected to adhere to the roles ascribed for them based on their biological construct and any deviation is not warranted for, more so for young women. Moreover, for many young men perceived gender role coupled with poor self risk perception result into unsafe sexual activities, putting them as well as their partners at the risk of STI/HIV and unintended parenthood.

The incidence of abortion and unintended pregnancy in India, 2015

Summary Background Reliable information on the incidence of induced abortion in India is lacking. Official statistics and national surveys provide incomplete coverage. Since the early 2000s, medication abortion has become increasingly available, improving the way women obtain abortions. The aim of this study was to estimate the national incidence of abortion and unintended pregnancy for 2015. Methods National abortion incidence was estimated through three separate components: abortions (medication and surgical) in facilities (including private sector, public sector, and non-governmental organisations [NGOs]); medication abortions outside facilities; and abortions outside of facilities and with methods other than medication abortion. Facility-based abortions were estimated from the 2015 Health Facilities Survey of 4001 public and private health facilities in six Indian states (Assam, Bihar, Gujarat, Madhya Pradesh, Tamil Nadu, and Uttar Pradesh) and from NGO clinic data. National medication abortion drug sales and distribution data were obtained from IMS Health and six principal NGOs (DKT International, Marie Stopes International, Population Services International, World Health Partners, Parivar Seva Santha, and Janani). We estimated the total number of abortions that are not medication abortions and are not obtained in a health facility setting through an indirect technique based on findings from community-based study findings in two states in 2009, with adjustments to account for the rapid increase in use of medication abortion since 2009. The total number of women of reproductive age and livebirth data were obtained from UN population data, and the proportion of births from unplanned pregnancies and data on contraceptive use and need were obtained from the 2015–16 National Family Health Survey-4. Findings We estimate that 15·6 million abortions (14·1 million–17·3 million) occurred in India in 2015. The abortion rate was 47·0 abortions (42·2–52·1) per 1000 women aged 15–49 years. 3·4 million abortions (22%) were obtained in health facilities, 11·5 million (73%) abortions were medication abortions done outside of health facilities, and 0·8 million (5%) abortions were done outside of health facilities using methods other than medication abortion. Overall, 12·7 million (81%) abortions were medication abortions, 2·2 million (14%) abortions were surgical, and 0·8 million (5%) abortions were done through other methods that were probably unsafe. We estimated 48·1 million pregnancies, a rate of 144·7 pregnancies per 1000 women aged 15–49 years, and a rate of 70·1 unintended pregnancies per 1000 women aged 15–49 years. Abortions accounted for one third of all pregnancies, and nearly half of pregnancies were unintended. Interpretation Health facilities can have a greater role in abortion service provision and provide quality care, including post-abortion contraception. Interventions are needed to expand access to abortion services through better equipping existing facilities, ensuring adequate and continuous supplies of medication abortion drugs, and by increasing the number of trained providers. In view of how many women rely on self-administration of medication abortion drugs, interventions are needed to provide women with accurate information on these drugs and follow-up care when needed. Research is needed to test interventions that improve knowledge and practice in providing medication abortion, and the Indian Government at the national and state level needs to prioritise improving policies and practice to increase access to comprehensive abortion care and quality contraceptive services that prevent unintended pregnancy. Funding Government of UK Department for International Development (until 2015), the David and Lucile Packard Foundation, the John D. and Catherine T. MacArthur Foundation, and the Ford Foundation.

Inequality in the Utilization of Maternal Healthcare Services in Odisha, India

Odisha, one of the socioeconomically disadvantaged states of India, registers high maternal deaths. The state features wide regional and sociodemographic diversity with the Koraput-Balangir-Kalahandi (KBK) districts, dominated by disadvantaged tribal population. This study aims to assess the level and pattern of maternal healthcare services utilization among different subgroups of women in Odisha with a special focus on the regional, economic, and educational inequality using the latest District Level Household and Facility Survey (DLHS-III, 2007-08). Descriptive statistics and bivariate and multivariate analysis were used to understand the pattern of utilization of maternal healthcare services among women by different background characteristics. Concentration curve and decomposition analysis were used to understand the inequalities in utilization of maternal healthcare services and contribution of different socioeconomic factors. Results reveal wide regional variation in the utilization of maternal healthcare services. The utilization of maternal healthcare services is more concentrated among affluent households. Economic inequality in safe delivery is high. Decomposition analysis shows education as the leading contributor in explaining maternal healthcare services utilization. Enhancing literacy among women and improving of health infrastructure and its quality in rural and disadvantaged regions may be prioritized to improve the maternal health in Odisha.

Female sterilization and ethical issues: The Indian experience:

In view of the prevalent gender norms that rationalize the bargaining power of women, lack of informed choice and high infant as well as child mortality, female sterilization as a family planning measure in India raises questions that need urgent attention in the broader context of individual freedom and human ethics. Data from the District Level Household Survey-Reproductive and Child Health (2002-04) covering a nationally representative sample of 507622 currently married women aged 15-44 years has been used for the present analysis. Bivariate and multivariate analyses have been performed to identify the factors associated with female sterilization acceptance within the broader framework of ethical issues. Although about one-third of Indian women use female sterilization as a method for regulating fertility, analysis reveals that people from different socio-economic, religious and demographic strata do not generally opt for sterilization in equal proportion. Informed choice has found to be very poor among women and so also the quality of available services. The need of the hour is to offer choice and quality services. Besides sensitizing the providers about the importance of ethical issues, government need to think over improving information education and communication, better quality services, and importance on spacing methods.

Self-rated health status and its correlates among the elderly in India

AimPopulation ageing is emerging as a major demographic issue for India with wide socio-economic implications. This study examines the self-rated health status of the elderly and its correlates in India.Subject and methodsData from the ‘Building a Knowledge Base on Population Ageing in India (BKPAI)’ survey conducted in seven Indian states in 2011 was used for analysis (n = 9852). Logistic regression analysis was performed to estimate the effect of covariates on self-rated health.ResultsFifty-five percent of the elderly self-rated their health as poor. Age, education, marital status, religion, occupation, chronic diseases, functional status, and routine medical check-ups were significant correlates of self-rated poor health. The elderly with three or more chronic diseases were four times more likely to rate their health as poor than those without any chronic diseases. Those who faced more difficulties in daily living were more likely to rate their health as poor than those who faced fewer problems. The elderly who went for routine medical check-ups were more likely to assess themselves as having poor health than those who did not.ConclusionThis study found a sizeable number of elderly with self-rated poor health along with extensive disparity by socio-economic and demographic characteristics. Chronic disease, functional limitations and routine medical check-ups were strong predictors of self-rated health. Given the higher proportion of poor self-rated health among the elderly, and the increasing size of the ageing population in India, this study indicates the need to strengthen health care services and social security programs for the elderly.

Is fertility associated with the number of siblings of the couple? Evidence from India

Abstract The influence of family on an individual’s fertility has long been an important topic of interest in fertility research. Although studies conducted mostly in developed countries found a significant bearing of fertility of the parents on the fertility of the children, there is a lack of formal research around this topic in India. The present study analyses the effect of sibling size of husband and wife on the completed family size of women using information of 5506 ever-married women aged 45–49 years incorporated in the India Human Development Survey-II (2011–2012). Inferential statistics, bivariate, Chi-square and Poisson regression were used as the methods of analysis. The unadjusted estimates of Poisson regression reveal sibling size of women (IRR: 1.02; p < 0.001) and husband (IRR: 1.01; p < 0.001) have a positive correlation with the completed family size of women. However, in the adjusted model, the effect of sibling size especially of husband diminishes gradually in the presence of socio-economic covariates of the women.