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Continuum of care throughout pregnancy, delivery and post-delivery has proved to be a critical health intervention for improving the health of mothers and their newborn children. Using data from the fourth wave of the National Family Health Survey (NFHS-4) conducted in 2015–16, this study examined the correlates of utilization of maternal health care services and child immunization following the continuum of care approach in India. The study also assessed whether the continuity in utilizing maternal health care services affects the immunization of children. A total of 33,422 survey women aged 15–49 were included in the analysis of maternal health care indicators, and 8246 children aged 12–23 months for the analysis of child immunization. The results indicated that about 19% of the women had completed the maternal health continuum, i.e. received full antenatal care, had an institutional delivery and received postnatal care. Women with a higher level of education and of higher economic status were more likely to have complete continuum of care. Continuity of maternal health care was found to be associated with an increase in the immunization level of children. It was observed that 76% of the children whose mothers had complete continuum of care were fully immunized. Furthermore, the results from propensity score matching revealed that if mothers received continuum of care, the chance of their child being fully immunized increased by 17 percentage points. The results suggest that promotion of the continuum of maternal health care approach could help reduce not only the burden of maternal deaths in India, but also that of child deaths by increasing the immunization level of children.

PurposeAlcohol and tobacco consumption are significant public health concerns and considered some of the riskiest behaviors among students. Despite strong indications of heavy consumption of these substances, certain sections of the student population remain unexplored regarding their consumption patterns and associated factors, including research scholars pursuing Doctor of Philosophy degrees. This study aims to explore the patterns and correlations of consumption of alcohol and tobacco among doctoral students in three Indian universities.Design/methodology/approachA cross-sectional study was conducted on a total of 530 scholars from three central universities, Aligarh Muslim University, Banaras Hindu University and Jawahar Lal Nehru University, and focused on two substances (alcohol and tobacco) frequently used by students in India. Bi-variate analysis and penalized logistic regressions were applied to analyse the prevalence and associated factors of alcohol, smoking and smokeless tobacco among doctoral students.FindingsTobacco consumption was observed to be the dominant form of substance use among doctoral students. Findings revealed that 34% of scholars smoked and 25% consumed smokeless tobacco daily and around 14% consumed alcohol at least once a week. Major significant correlates of substance consumption among scholars were found to be gender, religion, parental mortality, dissatisfaction with academic performance and stress about future career/employment. Significant variation in substance use patterns was observed among universities.Originality/valueThis study provides first-hand evidence on substance use patterns and the correlates among doctoral students in three Indian universities. Findings indicate the implementation of specific intervention programs for mental health and counselling for this section of students to prevent substance use addiction would be beneficial.

We investigated the relationship between child marriage among young women and their level of empowerment with spousal physical violence in two culturally distinct states of India (Bihar and Tamil Nadu) using nationally representative survey data. Empowerment index was calculated taking into account parameters such as mobility, economic independence, and decision-making power of a woman using Principal Component Analysis method. Lower level of women empowerment was significantly associated with physical violence in Tamil Nadu (OR = 2.38, p < 0.01 ) whereas marriage before the age of 15 was associated with physical violence in Bihar (OR = 3.27, p < 0.001 ). The mean age at marriage was low among women who reported physical violence as compared to those who did not report physical violence across Bihar and Tamil Nadu and at all India level. Although the majority of the women in Tamil Nadu justified wife beating and witnessed father beating mother as compared to the women from Bihar, however, they were less likely to report physical violence than women from Bihar. Factors contributing to physical violence are distinct in Bihar and Tamil Nadu. Culture specific intervention may be considered while planning intervention strategies to curb spousal violence against women.

This study examined the relationship between Intimate Partner Violence (IPV) and unintended pregnancy among young women in South Asia using Demographic and Health Survey data from India (2005–2006), Bangladesh (2007) and Nepal (2011). The respondents were adolescent and young adult married women aged 15–24 years who had at least one childbirth in the five years preceding the survey. Bivariate and stepwise multivariate logistic regression analyses were performed to assess the relationship between IPV and unintended pregnancy. Thirty-eight per cent of the respondents in India, 52% in Bangladesh and 28% in Nepal reported having experienced physical or sexual IPV. Those who reported physical or sexual IPV had higher odds of unintended pregnancy (1.36 in India and 1.99 in Bangladesh). The findings indicate that IPV is a risk factor for unintended pregnancy among adolescent and young adult married women. Along with violence prevention programmes, a more responsive and youth-friendly health system needs to be in place to provide health care services to young women in these countries.

The emergence of non-communicable diseases (NCDs) in childhood poses a serious risk to a healthy adult life. The present study aimed to estimate the prevalence of NCDs among children and adolescents in slums and non-slums areas of four metropolitan cities of India, and in rural areas of the respective states The study further, investigated the effect of the place residence as slum vs. non-slum and other risk factors of the NCDs. Nationally representative data from the Comprehensive National Nutrition Survey (CNNS) was used.. Estimates were based on children (5-9 years) and adolescents (10-19 years) for whom biomarkers predicting diabetes, high total cholesterol, high triglycerides and hypertension were determined. Weight, height and age data were used to calculate z -scores of the body mass index. Overweight and obesity was higher in urban areas than in rural areas among children and adolescents. Regional differences in the prevalence of diseases were observed; children in Delhi and Chennai had a higher likelihood of being diabetic while children in Kolkata were at a greater risk of high total cholesterol and high triglycerides. The risk of hypertension was strikingly high among non-slum children in Delhi. Children from slums were at a higher risk of diabetes compared to the children from non-slums, while children and adolecents from non-slums were at a greater risk of high triglycerides and hypertension respectively than their counterparts from slums. Male children and adolecents had a higher risk of diabetes and high cholesterol. Screening of children for early detection of NCDs should be integrated with the already existing child and adolescent development schemes in schools and the community can help in prevention and control of NCDs in childhood.