scholarly journals Intersectional social-economic inequalities in breast cancer screening in India: analysis of the National Family Health Survey

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jyotsna Negi ◽  
Devaki Nambiar
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Marital Status ◽  
Economic Status ◽  
Family Health ◽  
National Family Health Survey ◽  
Place Of Residence ◽  
Breast Examination ◽  
National Family ◽  
Summary Measures

Abstract Background Breast cancer incidence rates are increasing in developing countries including India. With 1.3 million new cases of cancer been diagnosed annually, breast cancer is the most common women’s cancer in India. India’s National Family Health Survey (NFHS-4) data 2015–2016 shows that only 9.8% of women between the ages of 15 and 49 had ever undergone breast examination (BE). Further, access to screening and treatment is unequally distributed, with inequalities by socio-economic status. It is unclear, however, if socio-economic inequalities in breast examination are similar across population subgroups. Methods We compared BE coverage in population sub-groups categorised by place of residence, religion, caste/tribal groups, education levels, age, marital status, and employment status in their intersection with economic status in India. We analysed data for 699,686 women aged 15–49 using the NFHS-4 data set conducted during 2015–2016. Descriptive (mean, standard errors, and confidence intervals) of women undergoing BE disaggregated by dimensions of inequality (education, caste/tribal groups, religion, place of residence) and their intersections with wealth were computed with national weights using STATA 12. Chi-square tests were performed to assess the association between socio-demographic factors and breast screening. Additionally, the World Health Organisation’s Health Equity Assessment Toolkit Plus was used to compute summary measures of inequality: Slope index for inequality (SII) and Relative Concentration Indices (RCI) for each intersecting dimension. Results BE coverage was concentrated among wealthier groups regardless of other intersecting population subgroups. Wealth-related inequalities in BE coverage were most pronounced among Christians (SII; 20.6, 95% CI: 18.5–22.7), married (SII; 14.1, 95% CI: 13.8–14.4), employed (SII: 14.6, 95%CI: 13.9, 15.3), and rural women (SII; 10.8, 95% CI: 10.5–11.1). Overall, relative summary measures (RCI) were consistent with our absolute summary measures (SII). Conclusions Breast examination coverage in India is concentrated among wealthier populations across population groups defined by place of residence, religion, age, employment, and marital status. Apart from this national analysis, subnational analyses may also help identify strategies for programme rollout and ensure equity in women’s cancer screening.

Dietary Adequacy Among Young Children in India: Improvement or Stagnation? An Investigation From the National Family Health Survey

2019 ◽  
Vol 40 (4) ◽  
pp. 471-487
Author(s):  
Nizamuddin Khan ◽  
Arupendra Mozumdar ◽  
Supreet Kaur
Keyword(s):  
Dietary Intake ◽  
Health Survey ◽  
Rural Areas ◽  
Economic Status ◽  
Family Health ◽  
Northern Region ◽  
Eastern Region ◽  
National Family Health Survey ◽  
The Past ◽  
National Family

Background: This study assessed the trend of minimum acceptable dietary practices among children aged 6 to 23 months in India in the past decade. Methods: Data collected in the National Family Health Survey during 2005 to 2006 (NFHS-3) and 2015 to 2016 (NFHS-4) were used. The sample size for this study was 11 727 children for NFHS-3 and 61 158 children for NFHS-4. Bivariate and multivariate analyses were done to identify the predictors of feeding practices. We analyzed data of last-born singleton children aged 6 to 23 months who were living with their mother (ever-married women aged 15-49 years). Results: In India, a low proportion (10%) of children aged 6 to 23 months received a minimum acceptable diet, and its estimate remained the same in the past 10 years. Older mothers, educated mothers, antenatal care, high economic status, and place of residence were the most consistent predictors of minimum acceptable dietary intake. Over the past decade, however, the minimum acceptable dietary intake has declined among older children (odds ratio [OR] = 0.57, 95% confidence interval [CI], 0.47-0.70; P < .001), children with overweight mothers (OR = 0.40, 95% CI, 0.31-0·50; P <.001), and children of well-off families (OR = 0.29, 95% CI, 0.23-0.37; P < .001). The odds for minimum acceptable dietary intake were significantly higher among children of high (4+) birth order (OR = 1.74, 95% CI, 1.41-2.15; P < .001), rural areas, and children living in the central, eastern, and north-eastern region. Conclusion: Results indicate the need for further investigations of poor dietary intake among children living in well-off families and in the northern region. This study suggests policymakers and program managers to address contextual barriers against minimum acceptable dietary intake among children and to reconsider existing strategies in India.

scholarly journals Does socio-economic inequality exist in micro-nutrients supplementation among children aged 6–59 months in India? Evidence from National Family Health Survey 2005–06 and 2015–16

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shobhit Srivastava ◽  
Shubham Kumar
Keyword(s):  
Vitamin A ◽  
Iron Supplementation ◽  
Economic Status ◽  
Family Health ◽  
Educational Status ◽  
National Family Health Survey ◽  
Vitamin A Supplementation ◽  
Nutrient Supplementation ◽  
Socio Economic Status ◽  
National Family

Abstract Background Globally, about 25% of children suffer from subclinical vitamin A deficiency (VAD), and approximately 300 million children globally had anemia as per 2011 estimates. Micronutrient deficiencies are generally referred to as “hidden hunger” because these deficiencies developed gradually. The present study determines the socio-economic inequalities in vitamin A supplementation (VAS) and Iron supplementation (IS) among children aged 6–59 months in India and to estimate the change in the percent contribution of different socio-economic correlates for such inequality from 2005 to 06 to 2015–16. Methods Data from National Family Health Survey (NFHS) 2005–06 and 2015–16 was used for the analysis. Bivariate analysis and logistic regression analysis was used to carve out the results. Moreover, Wagstaff decomposition analysis was used to find the factors which contributed to explain socio-economic status-related inequality among children in India. Results It was revealed that the percentage of children who do not receive vitamin A supplementation was reduced from 85.5% to 42.1%, whereas in the case of IS, the percentage reduced from 95.3% to 73.9% from 2005-06 to 2015–16 respectively. The child’s age, mother’s educational status, birth order, breastfeeding status, place of residence and empowered action group (EAG) status of states were the factors that were significantly associated with vitamin A supplementation and iron supplementation among children in India. Moreover, it was found the children who do not receive vitamin A supplementation and iron supplementation got more concentrated among lower socio-economic strata. A major contribution for explaining the gap for socio-economic status (SES) related inequality was explained by mother’s educational status, household wealth status, and empowered action group status of states for both vitamin A supplementation and iron supplementation among children aged 6–59 months in India. Conclusion Schemes like the Integrated Child Development Scheme (ICDS) would play a significant role in reducing the socio-economic status-related gap for micro-nutrient supplementation among children in India. Proper implementation of ICDS will be enough for reducing the gap between rich and poor children regarding micro-nutrient supplementation.

scholarly journals Changing Scenario of Anemia Among Women in India: Understanding the Maternal Health Concern and Its Associated Predictors Through National Family Health Survey

2021 ◽  
Author(s):  
Nivedita Roy ◽  
Vijay Kumar Mishra ◽  
Piyush Kumar Mishra ◽  
Ashish Bandhu ◽  
Rajeev Dhakad
Keyword(s):  
Health Survey ◽  
Economic Status ◽  
Decomposition Analysis ◽  
Family Health ◽  
Health Concern ◽  
National Family Health Survey ◽  
Percentage Contribution ◽  
Poor Households ◽  
National Family ◽  
Prevalence Of Anemia

Abstract Objectives: To study the changes in Anemia among women and to study the association between anemia and socio-demographic and economic predictors, also estimating the percentage contribution of selected predictors to Anemia among women belonging to poor and non-poor households.Methods: The State-wise percentages were taken from the extracted factsheets of National Family Health Survey 2015-2016 and 2019-2020. Absolute and relative percent changes to understand the changes in prevalence have been calculated. Multiple logistic regression was done to understand the associated varying predictors of Anemia among women. Percentage contribution of selected varying predictors through multivariate decomposition analysis have also been estimated. Results: Anemia prevalence was found the highest among the women in Goa and least in Lakshwadeep. The relative change in prevalence of Anemia was highest in Assam and lowest in Lakshwadeep. Socio-economic factors like marriage at a young age, lack of education, exposure to media, malnutrition, and poor economic status contribute significantly to the prevalence of Anemia among women of age 15-49 years.Conclusion: It is seen that the socio-demographic and economic burden on Anemia still continues to be higher than other medical predictors. The focus should be made more on education, malnutrition, and economic status to reduce the prevalence of Anemia.

scholarly journals Uptake and Correlates of Cervical and Breast Cancer Screening Among Women in Jordan: National Results of the 2017-2018 Population and Family Health Survey

2020 ◽  
Author(s):  
Supa Pengpid ◽  
Karl Peltzer ◽  
Chao Zhang
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Health Survey ◽  
Pap Smear ◽  
Family Health ◽  
Clinical Breast Examination ◽  
The Past ◽  
Breast Examination ◽  
Clinical Breast

The study aimed to estimate the prevalence and associated factors of cervical and breast cancer screening among women in the general population in Jordan. Nationally representative cross-sectional data were analysed from 14,689 women (34 years median age, range 15-49) that took part in the &ldquo;2017-18 Jordan Population and Family Health Survey&rdquo;. Information about cancer screening uptake included Pap smear, clinical breast examination, and mammography. Results indicate that the prevalence of ever Pap smear cancer screening was 15.3%, clinical breast examination in the past 12 months 13.9% and ever mammography 8.7%. In adjusted logistic regression analysis, older age, higher wealth, greater media exposure and tobacco use were positively and being Syrian, and living in the southern region were negatively associated with ever Pap smear, clinical breast examination in the past 12 months, and ever mammography. In addition, high decision-making power was associated with the uptake of Pap smear and higher education was associated with ever mammography. The study showed a low cancer screening uptake, and several factors were identified that can assist in promoting cancer screening in Jordan.

scholarly journals Missed opportunities for delivering nutrition interventions in first 1000 days of life in India: insights from the National Family Health Survey, 2006 and 2016

2021 ◽  
Vol 6 (2) ◽  
pp. e003717
Author(s):  
Phuong Hong Nguyen ◽  
Rasmi Avula ◽  
Lan Mai Tran ◽  
Vani Sethi ◽  
Alok Kumar ◽  
...  
Keyword(s):  
Health Survey ◽  
Urban Areas ◽  
Family Health ◽  
Universal Coverage ◽  
National Family Health Survey ◽  
Nutrition Interventions ◽  
Missed Opportunities ◽  
Health And Nutrition ◽  
National Family ◽  
Opportunity Gaps

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.

scholarly journals Correction to: Inequalities in the utilisation of maternal health Care in Rural India: Evidences from National Family Health Survey III & IV

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Balhasan Ali ◽  
Shekhar Chauhan
Keyword(s):  
Health Care ◽  
Maternal Health ◽  
Health Survey ◽  
Family Health ◽  
Maternal Health Care ◽  
Rural India ◽  
National Family Health Survey ◽  
National Family

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

Financial Anxiety is Associated With Cancer Screening Adherence in Women at High Risk of Breast Cancer

2021 ◽  
Author(s):  
Salene M W Jones ◽  
Tammy A Schuler ◽  
Tasleem J Padamsee ◽  
M Robyn Andersen
Keyword(s):  
Breast Cancer ◽  
Cancer Screening ◽  
High Risk ◽  
Pap Smear ◽  
Clinical Breast Examination ◽  
Lower Odds ◽  
Breast Examination ◽  
Clinical Breast ◽  
Financial Anxiety ◽  
Screening Adherence

Abstract Background Previous studies have examined the impact of material financial hardship on cancer screening but without focusing on the psychological aspects of financial hardship. Purpose This study examined the effects of different types of financial anxiety on adherence to breast cancer screening in women at high risk of breast cancer. Adherence to cervical cancer screening was also examined to determine whether associations between financial anxiety and screening adherence were unique to breast cancer screening or more general. Methods Women (n = 324) aged 30–50 and at high risk for inherited breast cancer completed a survey on general financial anxiety, worry about affording healthcare, financial stigma due to cancer risk, and adherence to cancer screening. Multivariate analyses controlled for poverty, age, and race. Results More financial anxiety was associated with lower odds of mammogram adherence (odds ratio [OR] = 0.97, confidence interval [CI] = 0.94, 0.99), Pap smear adherence (OR = 0.98, CI = 0.96, 0.996), and clinical breast examination adherence (OR = 0.98, CI = 0.96, 0.995). More worry about affording healthcare was associated with lower odds of clinical breast examination adherence (OR = 0.95, CI = 0.91, 0.9992) but not mammogram or Pap smear adherence (p &gt; .05). Financial stigma due to cancer risk was associated with lower odds of Pap smear adherence (OR = 0.87, CI = 0.77, 0.97) but no other cancer screenings (p &gt; .07). Conclusions Financial anxiety may impede cancer screening, even for high-risk women aware of their risk status. Clinical interventions focused on social determinants of health may also need to address financial anxiety for women at high risk of breast cancer.

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