Does engagement with frontline health workers improve maternal and child healthcare utilisation and outcomes in India?

BACKGROUND: Poor Maternal and Child Health (MCH) outcomes pose challenges to India's ability to attain Goal-3 of the Sustainable Development Goals (SDGs). The government of India strengthened the existing network of frontline health workers (FHWs), under its National Rural Health Mission in 2005 and subsequent National Urban Health Mission in 2013 as a strategy to mitigate the shortage of skilled health workers and to provide affordable healthcare services. However, there is a lack of robust national-level empirical analysis on the role of maternal engagement with FHWs in influencing the level of maternal and child health care utilisation and child health outcomes in India. METHODS: Using data from the nationally representative Indian National Family Health Survey (NFHS) 2015-2016, this paper aims to investigate the intensity of engagement of FHWs with married women of child-bearing age (15-49 years), its influence on utilisation of maternal and child healthcare services, and child health outcomes. Our empirical analyses use multivariate regression analyses, focusing on five maternal and child health indicators: antenatal care visits (ANC) (4 or > 4 times), institutional delivery, full-immunisation of children, postnatal care (PNC) (within 2 days of delivery), and child survival. RESULTS: Our analysis finds that maternal engagement with FHWs is statistically significant and a positive predictor of maternal and child health care utilisation, and child survival. Further, the level of engagement with FHWs is particularly important for women from economically poor households. Our robustness checks across sub-samples of women who delivered only in public health institutions and those from rural areas provides an additional confidence in our main results. CONCLUSIONS: From a policy perspective, our findings highlight that strengthening the network of FHWs in the areas where they are in shortage which can help in further improving the utilisation of maternal and child healthcare services, and health outcomes. Also, the role of FHWs in the government health system needs to be enhanced by improving skills, working environment, and greater financial incentives.

COVID-19 vaccine hesitancy among adults in India: A primary study based on health behavior theories and 5C psychological antecedents model.

Despite the significant success of India's COVID-19 vaccination program, a sizeable proportion of the adult population remains unvaccinated or has received a single dose of the vaccine. Despite the recommendations of the Government of India for the two doses of the COVID-19 vaccine and the precautionary booster dose, many people were still hesitant towards the COVID-19 full vaccination. Hence, this study aimed to identify the primary behavioral and psychological factors contributing to vaccine hesitancy. Cross-sectional data was collected via a multi-stage sampling design by using a scheduled sample survey in the Gorakhpur district of Uttar Pradesh, India, between 15 July 2022 to 30 September 2022. This study has utilized three health behavior models-the Health Belief Model (HBM), the Theory of Planned Behavior (TPB), and the 5C Psychological Antecedents of vaccination, and employed bivariate and multivariable binary logistic regression model to assess the level of vaccine hesitancy and predictive health behavior of the respondents. Results indicate that among the constructs of the HBM and 5C Antecedents models, "perceived benefits", "confidence" and "collective responsibility" showed a lesser likelihood of COVID-19 vaccine hesitancy. However, in the TPB model constructs, a 'negative attitude towards the vaccine' showed a four times higher likelihood of COVID-19 vaccine hesitancy. From the future policy perspective, this study suggested that addressing the issue of 'negative attitudes towards the vaccine' and increasing the trust or confidence for the vaccine through increasing awareness about the benefits of the vaccination in India may reduce vaccine hesitancy.

Data on water, sanitation, and hygiene in six select metro cities of India.

The purpose of this data article is to describe the data and provide the methodological notes on the construction of availability, accessibility, and overall Water, Sanitation and Hygiene (WASH) performance index using a set of thirteen indicators for six metro cities in India. It also presents the details on survey design and the nature of data collected on WASH indicators in India Human Development Survey for 2004-05 (IHDS-I) and 2011-12 (IHDS-II). The principal component analysis (PCA) procedure was used in the construction of the WASH indices. The IHDS is the only survey that provides comprehensive data on WASH indicators for six metro cities in India (Delhi, Mumbai, Kolkata, Chennai, Hyderabad, & Bangalore). The IHDS has been jointly conducted by researchers from the National Council of Applied Economic Research (NCAER), New Delhi and the University of Maryland, the United States of America (USA). The database is hosted in the public repository at the Inter-University Consortium for Political and Social Research (ICPSR) and the reference number for IHDS-I and IHDS-II are ICPSR 22626 and ICPSR 36151 respectively. The data are publicly available through ICPSR. Interpretation of the present data can be found in the research article titled "Availability, accessibility, and inequalities of water, sanitation, and hygiene (WASH) services in Indian metro cities" (Saroj et al., 2019) [9].