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

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Intimate Partner Violence

Unless India acts on all important causes, including intimate partner violence, that are hindering improvements in reproductive, maternal, and child health outcomes, the sustainable development goals related to health will remain difficult to achieve. Using the National Family Health Survey 2015–16, it is found that intimate partner violence has adverse impacts on the pregnancy outcomes, maternal and newborns’ health, and related healthcare access.

Stagnancy in the Unmet Need for Family Planning in India

Though addressing the unmet need for contraception was one of the immediate objectives of India’s National Population Policy 2000, the available evidence shows that there has been stagnancy in the level of the unmet need for family planning for quite some time. Data from the fourth round of the National Family Health Survey carried out during 2015–16 show that about 13% of couples of reproductive ages wanted to stop childbearing or delay the next birth but did not get the contraceptive services they desired to have. Trends in the level and nature of the unmet need for contraception, whether for spacing or limiting, are examined here on the basis of the data from the series of NFHS rounds. Further, socio-economic and regional differentials in the unmet need have been assessed. It is seen that while socio-economic differentials in the unmet need exist but are not large, there are notable interstate differences, and some states have a high unmet need. Besides, the unmet need has risen in a few states in the recent years. The paper also provides estimates of implications of the unmet need in terms of unwanted births and fertility.

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.

Demographic and Health Diversity in the Era of SDGs

Despite the progress achieved in demographic and health-related indicators, achieving targets in the Sustainable Development Goals by 2030 remains a demanding task. This study acts as a perfect benchmark for monitoring several demographics and health-related indicators in the era of the SDGs. There is a need to advance the right sources of data and cutting-edge tools for measuring and monitoring progress. The efforts to reduce regional disparities in demographic and health-related indicators are hindered by the lack of adequate funding to the programmes and the absence of reliable micro-level evidence-based policy.

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.

Building Regulations Must Ensure Safety and Public Health For All

The Ministry of Urban Development released the “Model Building Byelaws” in 2016 to maximise public health and safety by regulating construction work and maintenance. However, these laws can have the opposite impact and push low-income residents into further precariousness. This is because multiple barriers prevent low-income people from complying with laws, such as the lack of information about regulation, shortage of formally trained masons, expensive compliant construction material, blanket application of laws and punitive measures.

Sanitation and User Charges in Indian Slums

Despite the efforts of successive governments, sanitation coverage remains low in India. While several studies have explored the impact of user financing on the improvement of sanitation facilities, this article looks at the conditions of housing, infrastructure and the surroundings of slums, under which different sanitation arrangements are made. The sanitation arrangements considered are of various types of ownership and cost-sharing arrangements. The findings provide useful insights that challenge one of the basic motivations for user financing: increased accountability in service delivery.

Cost-effectiveness Threshold and Health Opportunity Cost

With the setting up of the health technology assessment board, evidence from cost-effectiveness analysis will play an important role in decision-making. This raises the fundamental question: How much extra cost per unit of health gained is considered cost-effective? Various approaches for assessing the appropriate cost-effectiveness threshold for India are discussed. A robustly determined opportunity cost of healthcare spending should serve as a proxy for setting up a CET, and it should be used to advocate for greater resources towards achieving universal health coverage.

Where Is All Our Health Data Going?

Multiple initiatives going on in India regarding the collection of digital personal health data are analysed, and the question of how the data is being used is examined. While such data could facilitate healthcare and referral services, a strong and sensitive governance structure is needed to be in place to enable its optimal use and to ensure that the data is not used to further the agendas of surveillance and control.

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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