Testing the regional Convergence Hypothesis for the progress in health status in India during 1980-2015.

The key challenges of global health policy are not limited to improving average health status, with a need for greater focus on reducing regional inequalities in health outcomes. This study aimed to assess health inequalities across the major Indian states used data from the Sample Registration System (SRS, 1981-2015), National Family Health Survey (NFHS, 1992-2015) and other Indian government official statistics. Catching-up plots, absolute and conditional ß-convergence models, sigma (σ) plots and Kernel Density plots were used to test the Convergence Hypothesis, Dispersion Measure of Mortality (DMM) and the Gini index to measure progress in absolute and relative health inequalities across the major Indian states. The findings from the absolute ß-convergence measure showed convergence in life expectancy at birth among the states. The results from the ß- and σ-convergences showed convergence replacing divergence post-2000 for child and maternal mortality indicators. Furthermore, the estimates suggested a continued divergence for child underweight, but slow improvements in child full immunization. The trends in inter-state inequality suggest a decline in absolute inequality, but a significant increase or stationary trend in relative health inequality during 1981-2015. The application of different convergence metrics worked as robustness checks in the assessment of the convergence process in the selected health indicators for India over the study period.

Labour room violence in Uttar Pradesh, India: evidence from longitudinal study of pregnancy and childbirth.

OBJECTIVES: The major objective of this study was to investigate the prevalence of labour room violence (LRV) (one of the forms of obstetric violence) faced by the women during the time of delivery in Uttar Pradesh (UP) (the largest populous state of India which is also considered to be a microcosm of India). Furthermore, this study also analyses the association between prevalence of obstetric violence and socioeconomic characteristics of the respondents. DESIGN: The study was longitudinal in design with the first visit to women made at the time of first trimester. The second visit was made at the time of second trimester and the last visit was made after the delivery. However, we have continuously tracked women over phone to keep record of developments and adverse consequences. SETTINGS: Urban and rural areas of UP, India. PARTICIPANTS: Sample of 504 pregnant women was systematically selected from the Integrated Child Development Scheme Register of pregnant women. OUTCOME: We aimed to assess the levels and determinants of LRV using data collected from 504 pregnant women in a longitudinal survey conducted in UP, India. The dataset comprised three waves of survey from the inception of pregnancy to childbirth and postnatal care. Logistic regression model has been used to assess the association between prevalence of LRV faced by the women at the time of delivery and their background characteristics. RESULT: About 15.12% of women are facing LRV in UP, India. Results from logistic regression model (OR) show that LRV is higher among Muslim women (OR 1.8, 95% CI 0.7 to 4.3) relative to Hindu women (OR 1). The prevalence of LRV is higher among lower castes relative to general category, and is higher among those women who have no mass media exposure (OR 4.7, 95% CI 1.7 to 12.8) compared with those who have (OR 1). CONCLUSION: In comparison with global evidence, the level of LRV in India is high. Women from socially disadvantaged communities are facing higher LRV than their counterparts.