Singh Kk

Husbands reproductive health knowledge attitudes and behavior in Uttar Pradesh India.

To enhance the reproductive health status of couples in developing countries, the knowledge, attitudes, and behavior of both women and men must be investigated, especially where women depend on men for the decision to seek care. This study analyzes data from a survey of 6,727 husbands from five districts in the northern state of Uttar Pradesh, India. Data are presented on mens knowledge of womens health and on their own sexual behavior outside the context of marriage, on their perceptions of sexual morbidity and their attempts at treatment for specific conditions, and on their opinions concerning the social role of wives. Findings indicate that men know little about maternal morbidity or sexual morbidity conditions. Few husbands reported that they had had sexual experience outside of marriage and the majority of these few said they had had such a relationship with more than one partner. Of men who said they had had reproductive morbidity symptoms, many said they had not sought treatment. Mens views concerning the role of wives indicate a low level of womens autonomy in this region of India. Results indicate a pressing need for reproductive health education that targets both women and men in Uttar Pradesh.

Birth spacing, breastfeeding, and early child mortality in a traditional Indian society: A hazards model analysis

There are few studies of the interrelationships among breastfeeding, child spacing, and child mortality in traditional societies that incorporate extensive controls for social and demographic characteristics of the mother and child. In this paper, we investigate the impact of breastfeeding and the length of the preceding birth interval on early child mortality (defined as a death in the first two years of life) using data from a traditional society of India. Multivariate hazards models are used to analyze the data. Most prior analyses related the impact of breastfeeding duration to the duration of child survivability by taking breastfeeding as a fixed covariate. The present study has a methodological focus in the sense that breastfeeding information from retrospective survey data is treated as a time-dependent covariate both as a status variate as well as a duration--with empirical findings compared across the two specifications. The effects of postpartum amenorrhoea and various other demographic and socioeconomic characteristics of mother and child are also studied. The results suggest that breastfeeding duration has a strong impact in reducing the relative risk of early child mortality; but it does not explain the effect of the length of the preceding birth interval on early child mortality.

Smoothed breastfeeding durations and waiting time to conception

Breastfeeding beyond the resumption of mothers menstruation plays a significant role in the proximate determinants of fertility. Breastfeeding and postpartum amenorrhoea data collected from retrospective surveys usually exhibit digit preferences. Here, these heaping errors were smoothed by B-spline and used in multivariate models of risk of conception to investigate the contraceptive effect of breastfeeding. The data used come from a 1987 Indian survey. Results show that lactation, after mothers menses resume, reduces the risk of conception. Heaping in breastfeeding data attenuates this relationship. When adjustment is made, breastfeeding reduced the rate of conception by 47 per cent; the reduction, with adjusted data, was 63 per cent.

The role of breast-feeding beyond postpartum amenorrhoea on the return of fertility in India: a life table and hazards model analysis.

This paper investigates the effects of continued breast-feeding after resumption of menses on fertility, using data from two retrospective surveys in India and single decrement life table and multivariate time-dependent hazards analyses. Breast-feeding even after the return of menses is found to be associated with longer birth intervals. The interaction of breast-feeding duration after resumption of menses and postpartum amenorrhoea has a significant effect on the risk of conception after return of menses.

Analysis of birth intervals in India's Uttar Pradesh and Kerala states

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.

PREVALENCE OF SELF-REPORTED SYMPTOMS OF REPRODUCTIVE TRACT INFECTIONS AMONG RECENTLY PREGNANT WOMEN IN UTTAR PRADESH, INDIA

This study examines the prevalence of self-reported reproductive tract infections (RTIs) and treatment seeking among married, recently pregnant women in Uttar Pradesh state, India. Associations between RTI symptom reporting and background characteristics are examined in a population-based sample of 18,506 married women with a pregnancy in the 3 years prior to a 1995 statewide survey. Logistic regression analyses are used to assess the effects of sociodemographic covariates on the probability of reporting an RTI symptom. Nearly one out of four women reports experiencing at least one RTI symptom, with the most common symptoms being abnormal vaginal discharge and pain during urination. Reporting of RTI symptoms significantly increases if the womans last pregnancy did not end in a live birth or if she has low economic status. Symptom reports also increase with age and decrease with parity. Only one-third of women reporting an RTI symptom sought treatment. The results indicate that survey interviews can be a cost-effective option for measuring the magnitude of RTI symptoms experienced and identifying sociodemographic influences. The findings suggest the need for improved RTI screening procedures and treatment at health facilities in this populous state of northern India.

Contraceptive use among postpartum women in India

Various family planning programmes have recognised the importance of family planning in the first year postpartum. Contraception plays a critical role for women in the postpartum period in preventing unwanted pregnancy and reducing the risk of infant and maternal mortality by lengthening the subsequent birth intervals. In the present study, an attempt has been made to explore the level and patterns of contraceptive use and associated factors affecting the use of contraception during the first 12-month-postpartum period among Indian women. A comparison regarding postpartum contraceptive use between rural and urban women of India clearly shows that rural women are still lagging behind urban women with regard to awareness about postpartum contraceptive use within one year of childbirth. Education as well as economic status, amenorrheic and abstinence status, postpartum duration and media exposure were found to be the important factors affecting postpartum contraceptive use among Indian women.

Breastfeeding and postpartum amenorrhea in a traditional society: a hazards model analysis.

There is considerable variation in the length of the postpartum amenorrhea during which breastfeeding suppresses fertility, both within and between societies. In this paper, we investigate the association between breastfeeding and the resumption of menses and the impact of various biological and social covariates thereon, using data from two retrospective surveys in India. We use both univariate life table and multivariate time-dependent hazards techniques to analyze the data. Most prior investigations related the impact of breastfeeding to postpartum amenorrhea by taking duration of breastfeeding as a fixed covariate. However, breastfeeding beyond the resumption of menstruation cannot affect the duration of menses. Accordingly, the present study has a methodological focus in the sense that breastfeeding is treated as a time-dependent covariate. We found that breastfeeding, age of mother at childs birth, social status, level of income, religion and caste (subcaste), and residential status have significant effects on return of menses in Indian traditional society.

Most Recent Birth Intervals in a Traditional Society: A Life Table and Hazards Regression Analysis

Retrospective data is obtained from the 1988-89 Survey of the Effects of Socioeconomic Factors on Fertility among Scheduled Castes in Rural Karimganj District Assam India (1805 scheduled caste households in selected villages). Multivariate hazard regression models are used to estimate the net effect of explanatory variables on the most recent (closed) birth interval and the interaction of explanatory variables. Rindfuss et al. guidelines and Namboodiri and Suchindran life-table techniques are used in constructing median birth intervals and the proportion not conceiving within 97 months and measuring the tempo and amount of fertility. Birth intervals exclude the postpartum amenorrhea period which has a median of 9-13 months in Assam. Findings show that the median most recent birth (MRB) interval is 2.25 years. The shortest interval is an average of 1.5 years and followed an infant death. MRB interval increases with decreasing age at marriage and increased age parity and spousal age differences. MRB interval increases also with increased income. The Wilcoxon test shows statistically significant differences between groups for the following factors: marriage age maternal age parity spousal age difference survival status of the next-to-the-last birth and family income. Multivariate hazards regression models show that females married at 19 years of age or higher have a greater likelihood of having a long MRB interval. Longer birth intervals are also more likely among the youngest female cohort aged less than 25 years the highest parity of 5 or higher and the lower income households. The youngest birth cohort has a risk of having an MRB over 2 times higher than the oldest birth cohort. The risk is 1.69 times higher for women with a prior childs death than for women without this experience. Maternal age is highly significantly related to parity and education. The length of MRB interval is significantly more likely to increase with increased maternal age of literate mothers with lower parities. A younger age at marriage older cohorts lower parities lower income groups higher age differences between spouses and having a prior surviving child are related to a slower pace at which the last child was born.

Age at return marriage and timing of first birth in India's Uttar Pradesh and Kerala states

The study investigates the relationship between age at marriage and the length of first birth interval in two states of India: Uttar Pradesh and Kerala. Life tables of first-birth intervals and median first-birth intervals are computed for several subgroups of the study population. Multivariate hazards modelling technique is used to study the net effect of age at marriage, controlling for a multiple of socioeconomic factors. The result shows that the average first-birth interval varies by age at marriage and is much longer in Uttar Pradesh than in Kerala.