ABSTRACT
BACKGROUND: Low birth weight (LBW) predisposes physical and mental growth failure and premature death among infants. Studies report that LBW predominately explains infant mortality. However, existing studies rarely demonstrate the phenomenon of both observed and unobserved factors, which may influence the likelihood of birth and mortality outcomes simultaneously. In this study, we identified the spatial clustering of the prevalence of LBW along with its determinants. Further, the relationship between of LBW and infant mortality, considering the unobserved factors, has been explored in the study. METHODS: Data for this study have been extracted from the National Family Health Survey (NFHS) round 5, 2019-21. We used the directed acyclic graph model to identify the potential predictors of LBW and infant mortality. Moran's I statistics have been used to identify the high-risk areas of LBW. We applied conditional mixed process modelling in Stata software to account for the simultaneous nature of occurrences of the outcomes. The final model has been performed after imputing the missing data of LBW. RESULTS: Overall, in India, 53% of the mothers reported their babies' birth weight by seeing health card, 36% reported by recall, and about 10% of the LBW information was observed as missing. The state/union territory of Punjab and Delhi were observed to have the highest levels of LBW (about 22%) which is much higher than the national level (18%). The effect of LBW was more than four times larger compared to the effect in the analysis which does not account for the simultaneous occurrence of LBW and infant mortality (marginal effect; from 12 to 53%). Also, in a separate analysis, the imputation technique has been used to address the missing data. Covariates' effects showed that female children, higher order births, births that occur in Muslim and non-poor families and literate mothers were negatively associated with infant mortality. However, a significant difference was observed in the impact of LBW before and after imputing the missing values. CONCLUSIONS: The current findings showed the significant association of LBW with infant deaths, highlighting the importance of prioritising policies that help improve the birth weight of new-born children that may significantly reduce the infant mortality in India.
ABSTRACT
BACKGROUND: Globally, one in three women experienced domestic violence. Alike the scenario observed in India, and a very few studies talk about violence and its consequences on women's health. Hence, the purpose of this study is to access the level of various types of spousal violence in India and to understand the association between physical, sexual and emotional violence against ever-married women by their husbands. The study further examines the consequences of spousal violence on women's health in terms of adverse pregnancy outcomes and reproductive health in India. METHODS: The study uses secondary data from National Family Health Survey-4 (NFHS-4, 2015-16). The analysis was based on a sample of ever-married women aged 15-49 years. Bivariate descriptive analysis and multiple regression analyses have been carried out to understand the association between spousal violence and its consequences on women's health. RESULTS: The study finds that the physical, sexual and emotional violence experienced by ever-married women in India are 29.8%, 13.8% and 7.0%, respectively. Further, the physical and sexual violence experienced by women have a significant association with an unwanted pregnancy, abortion, miscarriages and ever had termination of pregnancies. The regression analysis shows that violence by sexual partners among battered women increased the likelihood of unwanted pregnancy. Similarly, abortion and ever had a termination of pregnancies are also adversely affected by partner violence. Further, the risk of sexually transmitted infection increases 77% by sexual violence and 44% by emotional violence among battered women. Also, Sexual violence substantially increases the risk of prolonged labour during pregnancy. CONCLUSION: This study revealed that one in three women experiencing violence by their husband and also it is evident that various forms of spousal violence adversely affect pregnancies outcomes and reproductive health among battered women compared to not battered.