Assessing Socio-Demographic Factors of Cesarean Delivery in India: Insights From National Family Health Survey-4

2020 ◽  
Author(s):  
Avijit Roy ◽  
Pintu Paul ◽  
Jay Saha ◽  
Margubur Rahaman ◽  
Nanigopal Kapasia ◽  
...  

Abstract Background: The rate of cesarean delivery has considerably increased in the world during the last few decades. This paper aims to investigate the prevalence and socio-demographic correlates of cesarean delivery in India with a focus on Bihar and Tamil Nadu, accounting for the lower and higher proportion of cesarean birth.Methods: The study is based on secondary data, collected from the latest National Family Health Survey in 2015-16 (NFHS-4). The present study is based on 190,898 most recent births during the five years preceding the survey. Bivariate and multivariate analyses were carried out to identify the factors associated with cesarean delivery.Results: The highest rate of cesarean delivery was observed in Telengana (60%) and followed by Andhra Pradesh (42%), Tamil Nadu (36%). C-section found to be negligible in low-income states, namely Bihar (7%), Madhya Pradesh (10%) and Jharkhand (11%). Multivariate analysis revealed that the prevalence of cesarean delivery was substantially higher among women who married at higher age, with first birth-order, women in the ‘obese’ category with higher education, those from upper quintile of household wealth. Similarly the incidence of cesarean birth was remarkably higher in private hospitals both in the Indian sample (OR 3.9, 95% CI: 3.77-4.03) and in the selected states, Bihar (12.86, 95% CI: 10.92-15.15) and Tamil Nadu (OR 2.74, 95% CI: 2.40-3.13), compared to the public hospitals. Conclusion: Our study revealed that there are a high proportion of women delivering babies through cesarean section in South India. Thus, medical justifications need to be taken to deal with this concern. On the other hand, Women should also be driven towards regular ANC check-ups for the well-being of maternal and newborn health that can also help to increase the cesarean delivery for women who need C-section delivery especially in low-income states.

Author(s):  
Dr.V.Pugazhenthi

National Family Health Survey-5 (NFHS-5) fieldwork for India was conducted in two phases, during the years between 2019 and 2021 by 17 Field Agencies and gathered information from 636,699 households, 724,115 women, and 101,839 men. Information was gathered from 27,929 households, 25,650 women, and 3,372 men from Tamil Nadu and in Thanjavur from 826 households, 687 women, and 83 men. This research paper points out the health indicators in which Thanjavur District improved over the earlier NFHS and over the State as well as Country level averages in the NFHS-5. As per The NFHS -4 the sex ratio has raised marginally to 1053 and in the NFHS-5, sharply raised to 1112. The sex ratio of the country is also remarkably high crossing 1000 mark, first time in the Indian statistical history in the NFHS-5. NFHS-5 reveals positive note that the child sex ratio restoration back to 934. It reflects the changing mindset proliferating in the district towards the female. Amidst the negative mindset towards upbringing girl children in the state of Tamil Nadu, revealed by the reduced child sex ratio of 878 in NFHS -5 from 954 in NFHS-4 in Tamil Nadu a sharp positive increase in the child sex ratio in Thanjavur is fair enough to the fair sex. On the other hand, the reason for the reduction in the child sex ratio in the rest of the state of Tamil Nadu needs an immediate attention comparing the previous NFHS. It is also to be noted here that even the country level child sex ratio also is in increasing trend as per the present NFHS comparing its earlier survey. KEYWORDS: National Family Health survey, Government sponsored health insurance schemes, health insurance, Sex ratio, child sex ratio, AB-PMJAY.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shobhit Srivastava ◽  
Shubhranshu Kumar Upadhyay ◽  
Shekhar Chauhan ◽  
Manoj Alagarajan

Abstract Background India has achieved impressive gains in child survival over the last two decades; however, it was not successful in attaining MDG 2015 goals. The study’s objective is to inquire how the survival status of the preceding child affects the survival of the next born child. Methods This is a retrospective analysis of data from the National Family Health Survey, 2015–16. Analysis was restricted to women with second or higher-order births because women with first-order births do not have a preceding child. Proportional hazards regression, also called the Cox regression model, has been used to carry out the analysis. Kaplan–Meier (K–M) survival curves were also generated, with a focus on preceding birth intervals. Results Results found that female children were more likely to experience infant mortality than their male counterparts. Children born after birth intervals of 36+ months were least likely to experience infant mortality. Mother’s education and household wealth are two strong predictors of child survival, while the place of residence and caste did not show any effect in the Cox proportional model. Infant and child deaths are highly clustered among those mothers whose earlier child is dead. Conclusion Maternal childbearing age is still low in India, and it poses a high risk of infant and child death. Education is a way out, and there is a need to focus on girl’s education. The government shall also focus on raising awareness of the importance of spacing between two successive births. There is also a need to create a better health infrastructure catering to the needs of rich and poor people alike.


2021 ◽  
pp. 002190962110120
Author(s):  
Harihar Sahoo ◽  
Paramita Debnath ◽  
Chaitali Mandal ◽  
R. Nagarajan ◽  
Sathiyasusuman Appunni

Consanguineous marriage is still a preferred option in many societies of southern India. Therefore, this study addresses the state and district wise variation in consanguineous marriages and also attempts to find out the underlying factors of this practice in different marriage cohorts of South India. Drawing data from National Family Health Survey-4, the result revealed that there is a reduction in consanguineous marriages from 32.6% who married before 1985 to 23% during 2010–2014. About 13 districts in Tamil Nadu had the highest prevalence of consanguineous marriages, indicating that recent socio-demographic changes such as delays in age at marriages, lesser age gaps between partners, increase in the level of education, etc., did not explicitly affect the consanguineous marriages.


Author(s):  
Mohankumar Raju

Background: The sustainable development goal emphasises on reduction in mothers dying due to pregnancy. Recommended care for the pregnant mothers will help achieve this goal. Tamil Nadu is one of the best performing state in maternal and child health care. Author analysed the full antenatal care coverage of pregnant mothers of the districts of Tamil Nadu by using National Family Health Survey (NFHS)-4 data. Methods: Author did a secondary data analysis of NFHS 4 data for the districts of Tamil Nadu for understanding the MCH coverage. Results: Tamil Nadu showed 45% full AN coverage with 46.3% in urban and 43.8% in rural population, among 32 districts, Krishnagiri (65.5%) is the best performing and Virudhunagar (13.7%) is the poorest performing district of Tamil Nadu. Full AN coverage includes at least 4 AN check-up, vaccination of tetanus toxoid and consumption of 100 IFA tablets in last pregnancy. Tamil Nadu showed 81.1% of at-least 4 AN visit, 71% with vaccination for TT and 64% on consumption of 100 IFA tables. Similar coverage trend among the components of full ANC coverage is seen among all the districts of Tamil Nadu. Conclusion: Focusing on the coverage of IFA tablet consumption and also showing special interest among the rural population will increase the coverage. A detailed assessment for understanding the reasons for poor performance among the districts of Tamil Nadu is needed for better evidence-based practices.


2021 ◽  
Vol 6 (2) ◽  
pp. e003717
Author(s):  
Phuong Hong Nguyen ◽  
Rasmi Avula ◽  
Lan Mai Tran ◽  
Vani Sethi ◽  
Alok Kumar ◽  
...  

ObjectivesExisting health and community nutrition systems have the potential to deliver many nutrition interventions. However, the coverage of nutrition interventions across the delivery platforms of these systems has not been uniform. We (1) examined the opportunity gaps between delivery platforms and corresponding nutrition interventions through the continuum of care in India between 2006 and 2016 and and (2) assessed inequalities in these opportunity gaps.MethodsWe used two rounds of the National Family Health Survey data from 2005 to 2006 and 2015–2016 (n=36 850 and 190 898 mother–child dyads, respectively). We examine the opportunity gaps over time for seven nutrition interventions and their associated delivery platforms at national and state levels. We assessed equality and changes in equality between 2006 and 2016 for opportunity gaps by education, residence, socioeconomic status (SES), public and private platforms.ResultsCoverage of nutrition interventions was consistently lower than the reach of their associated delivery platforms; opportunity gaps ranging from 9 to 32 percentage points (pp) during the pregnancy, 17 pp during delivery and 9–26 pp during childhood in 2006. Between 2006 and 2016, coverage improved for most indicators, but coverage increases for nutrition interventions was lower than for associated delivery platforms. The opportunity gaps were larger among women with higher education (22–57 pp in 2016), higher SES status and living in urban areas (23–57 pp), despite higher coverage of most interventions and the delivery platforms among these groups. Opportunity gaps vary tremendously by state with the highest gaps observed in Tripura, Andaman and Nicobar islands, and Punjab for different indicators.ConclusionsIndia’s progress in coverage of health and nutrition interventions in the last decade is promising, but both opportunity and equality gaps remained. It is critical to close these gaps by addressing policy and programmatic delivery systems bottlenecks to achieve universal coverage for both health and nutrition within the delivery system.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Balhasan Ali ◽  
Shekhar Chauhan

An amendment to this paper has been published and can be accessed via the original article.


2019 ◽  
Vol 15 (4) ◽  
Author(s):  
Tarun Shankar Choudhary ◽  
Akanksha Srivastava ◽  
Ranadip Chowdhury ◽  
Sunita Taneja ◽  
Rajiv Bahl ◽  
...  

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