RANJAN KUMAR PRUSTY

Background: In India, community based studies and media reports indicate a surge in the number of young women undergoing hysterectomy in the past few years. This has led to suspicion on the misuse of procedure, and intense debates on its potential ill health-effects on young women. However, there are no population-based studies that provide insights into hysterectomy prevalence and its determinants at the national level. Data and methods: This study used data from India's District Level Household Survey that involved a sample of 3, 16,361 married women in the age group of 15–49 years spread across 21 States and Union Territories of India. Bivariate and multivariate regression analysis was performed to estimate hysterectomy prevalence and identify its predictors. Results: The study estimated hysterectomy prevalence of 17 per 1000 ever married women. The number of women undergoing hysterectomy ranged from 2 to 63/1000 across different states. A little more than one-third of women who had undergone hysterectomy were under the age of 40 years. The proportion of women below 40 years of age who had had hysterectomy was much higher in southern states of Andhra Pradesh (42%) and Telangana (47%). The likelihood of hysterectomy was higher among women belonging to households with health insurance (OR: 1.88, CI: 1. 77–2.00) and women who were sterilized (OR 1.55; CI 1.45–1.67) than uninsured and unsterilized women, and lower among women with education level of matriculation and above (OR 0.47; CI 0.42–0.50) than those with no and/or low education. Conclusions: A sizable proportion of young women undergoing hysterectomy in India may have severe ill-health effects on their physical, reproductive and socio-psycho health. As women with low or no education are also more prone to hysterectomy, providing more information and education to them on the possible after-effects of hysterectomy and alternative options will enable them to make more informed choices.

ABSTRACT: Background Recent evidence indicated that gender disparity in child health is minimal and narrowed over time in India. However, considering the geographical and socio-cultural diversity in India, the gender gap may persist across disaggregated socioeconomic context which may be masked by average level. This study examines the dynamics of gender disparity in childhood immunization across regions, residence, wealth, caste and religion in India during 1992–2006. Method We used multi-waves of the cross-sectional data of National Family Health Survey conducted in India between 1992–93 and 2005–06. Gender disparity ratio was used to measure the gender gap in childhood immunization across the selected socioeconomic characteristics. Multinomial regression analysis was used to examine the gender gap after accounting for other covariates. Result Results indicate that, at aggregate level, gender disparity in full immunization is minimal and has stagnated during the study period. However, gender disparity – disfavouring female children – becomes apparent across the regions, poor households, and religion - particularly among Muslims. Adjusted gender disparity ratio indicates that, full immunization is lower among female than male children of the western region, poor household and among Muslims. Between 1992–93 and 2005–06, the disparity in full immunization had narrowed in the northern region whereas it had, astonishingly, increased in some of the western and southern states of the country. Conclusion Our findings emphasize the need to integrate gender issues in the ongoing immunization programme in India, with particular attention to urban areas, developed states, and to the Muslim community.

"The paper provides a comprehensive picture of knowledge and contraceptive use among Scheduled Tribes of India and selected central hilly states, where tribal population contributes more than 30% of the total population of the country. An attempt is also made to know how far scheduled tribes differ from non-tribes in these states namely Jharkhand, Madhya Pradesh and Chhattisgarh using information collected in the third round of District Level Household Survey (DLHS-RCH III: 2007-08).

Methods: Bivariate analysis is used to understand level knowledge, use and unmet need for contraception among different tribal and non-tribal groups. Binary Logistics regression is used to understand the factors associated with contraception use among tribal women.

Results: Knowledge of temporary contraceptive method is considerably lower among tribal women as compared to their non-tribal counterparts. The result shows that contraceptive use among tribal women is lower than the non-tribal women in these states. The unmet need for family planning among them is quite high especially in the state of Jharkhand. Multivariate analysis substantiates the role of women and husband’s education, age of women and number of boys surviving in use of any modern method of contraception.

Conclusion: Strengthening free supply of modern contraceptives and educating women as well as their husband may solve the problem of high unmet need for family planning among these tribal women."

Using data of the third round of the National Family Health Survey (NFHS) 2005-2006, this study examined
the prevalence of overweight and obesity among women from different economic strata in urban
India. The study used a separate wealth index for urban India constructed using principal components
analysis (PCA). The result shows that prevalence of overweight and obesity is very high in urban areas,
more noticeably among the non-poor households. Furthermore, overweight and obesity increase with
age, education, and parity of women. The results of multinomial logistic regression show that non-poor
women are about 2 and 3 times more at risk of being overweight and obese respectively. Marital status and
media exposure are the other covariates associated positively with overweight and obesity. Thus, the growing
demand which now appears before the Government or urban health planners is to address this rising
urban epidemic with equal importance as given to other issues in the past.

Anemia is a common disorder among women in India mostly during reproductive time period where about 55 percent women aged between 15- 49 having anemia because of low dietary habit and other related causes.  Anemia prevalence is highest among pregnant women due to high iron demands of growth of foetus at the time of pregnancy. The paper tries to examine the causes and consequences of anemia among pregnant women with birth outcomes and complications by using National Family Health Survey-III and multivariate and bivariate analysis were performed. Finding shows that higher risks of poor pregnancy outcome by anaemic women like premature birth, low weight at birth and termination of pregnancy. There is an U-shaped relationship exist between maternal haemoglobin concentration and poor birth outcomes leads to higher risk of deliver premature birth. Study also reveals that prevalence of anemia exists because of poor dietary habit and other lifestyle behaviour.

In this study, we examined the pattern of perceived health status, immobility, and hospitalization among the elderly of India using the 60th round of National Sample Survey data collected during 2004. Bivariate and multivariate analysis is used to understand the differentials and determinants of outcome variable among the elderly of India. Age group, economic dependency, education, sex, and living arrangements play an important role in the health status of the elderly.
The most common diseases the elderly suffer from are eye ailments, cardiovascular diseases, and joint pain as reported. Logistic regression result shows that age, sex, dependency, and living arrangements as the most important factors affecting mobility and hospitalization of elderly. Indian elderly have a poor health status either in terms of self-assessed or mobility or hospitalization. So special attention to the elderly particularly focusing on females, living alone, poor, 70+ age and elderly of northern and eastern regions, is required.