National Family Health Survey

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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.

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.

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.

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.