1,721,135 research outputs found
Miscarriage in India: a population-based study
No full textThis study estimated birth order-specific miscarriage rates and characterized the influence of maternal age using the complete birth history of 90,303 ever-married women from the 1998–2000 Indian National Family Health Survey. Rates of miscarriage in India were low in association with early childbearing, whereas birth order as well as age substantially influenced miscarriage risk
Disseminating knowledge about AIDS through the Indian family planning program: prospects and limitations. [Correspondence]
No full textThere is growing concern that HIV is spreading to low-risk population groups and to women in India. Data from sentinel surveillance of women attending antenatal clinics in 2001 showed a prevalence of up to 1.75% [1]. There is also evidence of spread to rural areas: among a 1998 sample of 1251 women in a rural area accessible to the large city of Pune, Maharashtra, the prevalence was 1.2% [2]. Although generalization to the national level from regional data is not appropriate, and limited information is available about the actual prevalence of HIV in the rural areas of the different states, the large absolute numbers potentially at risk indicate a major challenge to India's health security.A fundamental condition for protection of the population from HIV infection is the level of knowledge about the disease, which varies considerably between different states in India, between urban and rural areas and between men and women. Overall, 70% of urban and 30% of rural women had heard of AIDS in 1998-1999 [3]. A 2001 survey provided evidence that the urban-rural disparity persists, although overall levels of knowledge had improved [4]. Mass media-based efforts to increase knowledge for health protection are under way. We have attempted to quantify the prospects of using Indian family planning services to deliver information about HIV, by undertaking an analysis of the current status of AIDS knowledge in relation to current or intended use of family planning methods.The 1998-1999 National Family Health Survey (NFHS-2) was utilized in the present study [3]. The survey (n = 90 303) included questions on AIDS knowledge, fertility and family planning use and intentions. The three aspects of AIDS knowledge to which yes/no responses were sought in the survey were awareness of AIDS, knowledge of whether AIDS can be avoided, and knowledge of whether the condom provides protection from AIDS.Table 1 shows that, as a result of previous sterilization or subfertility, the national family planning programme would not have the capacity to address many women currently lacking knowledge of AIDS in rural India. Some 38% of the rural sample both lacked any knowledge of AIDS and did not require family planning services; 52% were both unaware that condom use can prevent infection and did not require family planning services. In absolute numbers, based on the estimate of 177 million eligible women in the reproductive age group for 2001 provided by the Government of India Department of Family Welfare [5] of whom we estimate 131 million reside in rural areas, these percentages would translate to 49 and 68 million women, respectively. Those who have been sterilized or experienced subfertility may be at greater risk of HIV infection through unprotected sex both within and outside marriage. The age at sterilization is currently declining, with a median of 25.7 years in the present survey, potentially increasing women's exposure to unprotected sex
Antenatal care: provision and inequality in rural north India
No full textThe objectives of this paper are to examine factors associated with use of antenatal care in rural areas of north India, to investigate access to specific critical components of care and to study differences in the pattern of services received via health facilities versus home visits. We used the 1998–1999 Indian National Family Health Survey of ever-married women in the reproductive age group and analysed data from the states of Bihar, Madhya Pradesh, Rajasthan, and Uttar Pradesh (n=11,369). Overall, about three-fifths of rural women did not receive any antenatal check-up during their last pregnancy. Services actually received were predominantly provision of tetanus toxoid vaccination and supply of iron and folic acid tablets. Only about 13% of pregnant women had their blood pressure checked and a blood test done at least once. Women visited by health workers received fewer services compared to women who visited a health facility. Home visits were biased towards households with a better standard of living. There was significant under-utilisation of nurse/midwives in the provision of antenatal services and doctors were often the lead providers. The average number of antenatal visits reported in this study was 2.4 and most visits were in the second trimester. Higher social and economic status was associated with increased chances of receiving an antenatal check-up, and of receiving specific components including blood pressure measurement, a blood test and urine testing but not the obstetric physical examination, which was however linked to ever-use of family planning and the education of women and their husbands. Thus, pregnant women from poor and uneducated backgrounds with at least one child were the least likely to receive antenatal check-ups and services in the four large north Indian states. Basic antenatal care components are effective means to prevent a range of pregnancy complications and reduce maternal mortality. The findings indicate substantial limitations of the health services in overcoming socio-economic and cultural barriers to access
Induced abortion in India
No full textComplete birth histories of 90,303 women between 15-49 from the 1998-1999 Indian NFHS were used in the paper. The overall induced abortion ratio was 17.04 per 1,000 pregnancies. The lowest induced abortion ratio was 5.27 per 1,000 pregnancies for first birth order, increased to 25.81 for third birth order and then declined marginally and non-linearly. Education of women was the most important factor that was associated with induced abortion. Having the first and second child late is related to previous induced abortion. Living in rural areas substantially reduced the odds of induced abortion. Nationally, sex of the previous child was not significantly associated with induced abortion. Ratios of induced abortion in India are low in association with a pattern of maternal advantage. Increasing women’s education would have profound implications to induced abortions in India. Timing of intention to conceive rather than sex of the previous child appears to be an important predictor of induced abortion nationally
Simulators for intimate examination training in the developing world
No full textContext: Family planning clinic in urban India.Objective: To assess the usefulness of a pelvic simulator for intimate examination and intrauterine device insertion training, and for enhancing reproductive education for women.Design: Observational study using evaluation forms completed by staff, and focus group interviews with women and girls participating in sexual health education. Content analysis of interview material.Results: Staff being trained in intimate examination found the simulator to be useful in increasing their level of skill. Participants in sexual health education reported an improved range and depth of knowledge following demonstrations with the simulator.Conclusion: Where working and training conditions are crowded and lacking in privacy, inappropriate examination practices are likely to be propagated. Training for intimate examinations can be enhanced by the use of pelvic simulators
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