Does mothers’ pregnancy intention affect their children’s preventive and curative care in India? Evidence from a longitudinal survey

ObjectiveTo assess the effect of unintended births on preventive and curative care of children and their nutritional status.DesignThe study uses a cross-sectional prospective design.SettingIndian Human Development Survey (IHDS) data of two rounds were used in this study. Women data file was used to draw a representative sample of 3905 children who belong to under 5 years of age group.Statistical analysesWe categorised birth as an unintended birth if the mother did not want to have an additional child at IHDS-I but gave birth during the intersurvey. Furthermore, all births exceeding to the desired number of children reported by mothers in the IHDS-II were also included in unintended births. Multivariate logistic regression models were applied to analyse the effect of unintended births on child immunisation and exclusive breast feeding, while multivariate linear regression models were used to assess the effect of childbearing intention on child nutritional status.ResultsThe study shows that by controlling other factors, children from unintended births were less likely to be exclusively breast fed (OR 0.885, 95% CI 0.792 to 0.990, p<0.05) and receive full immunisation (OR 0.830, 95% CI 0.739 to 0.931, p<0.001). Moreover, poor nutrition was more prevalent among children from unintended births as they were more likely to be stunted and underweight.ConclusionsThe study confirmed the adverse effects of unintended pregnancy on children’s preventive and curative care. The findings of the study underscore the importance of formulating policies on more affordable, accessible and available means of family planning to reduce the unintended births.

The role of contraception in preventing HIV-positive births: global estimates and projections

Background Meeting the contraceptive needs of women living with HIV (WLHIV) has primary health benefits for women, in addition to being a key element to prevent mother-to-child HIV transmission. This analysis will estimate the current number of infant HIV infections prevented by contraception in the era of increased HIV treatment coverage and; 2) model the additional HIV benefits of preventing unintended births to WLHIV. Methods Secondary data analysis was conducted using publicly available data from the United Nations Programme on HIV/AIDS (UNAIDS) and Population Division, Demographic Health Surveys, and peer-review literature. National data from 70 countries, that had a UNAIDS estimate for the number of WLHIV nationally, were combined into country-level models. Models estimated the current number of infant HIV infections averted by contraception annually and potentially averted if unintended births to WLHIV were prevented. Estimates take into account pregnancy and live birth rates, contraceptive coverage, contraceptive method mix and failure rates, and HIV treatment coverage during pregnancy to prevent mother to child transmission. Results Contraception use among WLHIV prevents an estimated 43,559 new infant HIV infections annually across 70 countries. Countries with the largest number of infant infections averted by contraception included South Africa (9441), Nigeria (4195), Kenya (3508), Zimbabwe (2586), and India (2145). Preventing unintended births to WLHIV could avert an additional 43,768 new infant infections per year, with the greatest potential gains to be made in South Africa (12,036), Nigeria (2770), Uganda (2552), and the Democratic Republic of the Congo (2324). Conclusions Contraception continues to play an integral role in global HIV prevention efforts in the era of increasing HIV treatment coverage, especially in sub-Saharan Africa. Broad contraceptive availability, increased contraceptive voluntarism and method mix are key components to preventing unintended births and ending new infant HIV infections worldwide.

Unintended Births: Variation Across Social and Demographic Characteristics

Disparities in unintended childbearing remain a public health concern (Healthy People 2030). Using the 2015-19 cycle of the National Survey of Family Growth, we examine sociodemographic variation in birth intendedness, looking at births occurring between 2014-2018 to women aged 15-49. Birth intendedness is based on a series of questions in which women are asked to characterize each birth as on time, mistimed (wanted but occurring earlier than desired), or unwanted (the respondent did not want any births at all, or any additional births). When births are reported as too early, women were then asked how much earlier than desired the birth occurred. We categorize mistimed births into two groups: slightly mistimed (less than two years earlier than desired) or seriously mistimed (two or more years too early). This profile is an update of FP-17-09(1) and the second in a series on unintended childbearing in the U.S.

The Role of Contraception in Preventing HIV-Positive Births: Global Estimates and Projections

Background: Meeting the contraceptive needs of women living with HIV (WLHIV) has primary health benefits for women, in addition to being a key element to prevent mother-to-child HIV transmission. This analysis will estimate the current number of infant HIV infections prevented by contraception in the era of increased HIV treatment coverage and; 2) model the additional HIV benefits of preventing unintended births to WLHIV. Methods: Secondary data analysis was conducted using publicly available data from the United Nations Programme on HIV/AIDS (UNAIDS) and Population Division, Demographic Health Surveys, and peer-review literature. National data from 70 countries, that had a UNAIDS estimate for the number of WLHIV nationally, were combined into country-level models. Models estimated the current number of infant HIV infections averted by contraception annually and potentially averted if unintended births to WLHIV were prevented. Estimates take into account pregnancy and live birth rates, contraceptive coverage, contraceptive method mix and failure rates, and HIV treatment coverage during pregnancy to prevent mother to child transmission. Results: Contraception use among WLHIV prevents an estimated 43,559 new infant HIV infections annually across 70 countries. Countries with the largest number of infant infections averted by contraception included South Africa (9,441), Nigeria (4,195), Kenya (3,508), Zimbabwe (2,586), and India (2,145). Preventing unintended births to WLHIV could avert an additional 43,768 new infant infections per year, with the greatest potential gains to be made in South Africa (12,036), Nigeria (2,770), Uganda (2,552), and the Democratic Republic of the Congo (2,324). Conclusions: Contraception continues to play an integral role in global HIV prevention efforts in the era of increasing HIV treatment coverage, especially in sub-Saharan Africa. Broad contraceptive availability, increased contraceptive voluntarism and method mix are key components to preventing unintended births and ending new infant HIV infections worldwide.

Does pregnancy intention of mother affect child healthcare and growth in India? Evidence from a longitudinal survey

Objective To assess the effect of unintended births on children health care and nutritional status. Design The study uses cross-sectional prospective design. Setting The nationally representative Indian Human Development Survey (IHDS) data of two rounds (i.e. 2004-5, 2011-12) was used in this study. The women data was used to draw representative sample of 7,166, and out of them 3,905 belong to under 5 years of age group. Statistical Analyses Secondary analysis, using bivariate and multivariate linear and logistic models was conducted using both rounds of IHDS data. We categorized birth as an unintended birth if mother did not want to have addition child at IHDS-I but gave birth during inter-survey. Furthermore, all births exceeding to the desired number of children reported by mothers in the IHDS-II were also included in unintended births and all other births were considered as intended births. Multivariate logistic regression models were applied to analyse the effect of unintended and intended births on child-immunization and exclusive breastfeeding. While multivariate linear regression models were used to assess the effect of childbearing intention on child nutritional status. Results The study shows that by controlling other factors, unintended births were less likely to be exclusively breastfed (OR 0.885, p<0.05) and receive full immunization (OR 0.830, p<0.001). Moreover, children poor nutrition was more prevalent among unintended births as they were more likely to be stunting and underweight. Conclusion The findings of the study underscore the importance of investments in family planning to reduce the unintended births to improve children health and growth.