Married Women Of Childbearing Age Research Articles

Evaluation of Renin Level and Some Hormones in Patients with Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS) is one of the most frequent gynecological endocrinopathy that occurs in premenopausal females. This study aimed to investigate the relationship between PCOS and Renin Angiotensin Aldosteron system, by measuring the levels of renin, ACE, Kallikren5, FSH and LH in follicular and luteal phase, in addition to evaluating the level of kallikrein 5, which belongs to the kallikrein-kinin system associated with the renin system. The renin-angiotensin system (RAS) is well known as regulator of electrolytes and blood pressure. Renin is previously considered a major enzyme in this system. The study included 90 blood samples for married women of childbearing age between (18-45) years. These samples included 70 samples for women with polycystic ovary syndrome, which were divided into two groups (35 samples in each one), the first was withdrawn in the follicular phase, named PA, and the second in the luteal phase of the menstrual cycle named PB. As for the remaining 20 samples, they represented the control group of healthy women, which were also divided into two groups (CA and CB) as happened with the patient group. In this study, the levels of serum Renin, ACE, LH, FSH and Kallikren5 were evaluated in PCOS patients and compared with the control group in both phases. The results were analyzed by T-Test and ROC. There were no significant differences between patients and the control group in terms of ACE activity or FSH (P>0.05). The results demonstrated that LH, Renin, and Kallikren5 were higher in patient group in both phases (P<0.05). Renin Angiotensin system was affected by PCOS.

Predictors of fertility awareness among selected married women of childbearing age in Nigeria: a cross-sectional survey.

Increased fertility awareness can help infertile couples to achieve pregnancy. This study aimed to determine both the predictors and levels of fertility awareness among married Nigerian women of childbearing age. A nationwide cross-sectional survey. Data were collected via online and face to face questionnaires. Descriptive and inferential analysis were done with SPSS 25. Most respondents married between ages 24-29 years old (40%) and just over half had good fertility awareness (53%). The associated factors were age at menarche (X2 = 9.962, p = 0.007), geopolitical zone of residence (X2 = 17.301, p = 0.008), level of education (X2 = 64.843, p < 0.001), employment status (X2 = 9.319 p = 0.025) menstrual cycle charting (X2 = 66.392, p < 0.001), use of internet to increase awareness (X2 = 39.849, p < 0.001) and books (X2 = 58.855, p < 0.001). Fertility awareness was lower for those with secondary education than postgraduates (AOR=0.213, 95% CI 0.116-0.390, p < 0.001). Moreover, the odds of having good fertility awareness were less in those who did not chart their menstrual cycle (AOR=0.363, 95% CI 0.245-0.538, p < 0.001). Menstrual cycle charting and level of education were predictors of fertility awareness.

Faktor – Faktor yang Berhubungan dengan Kejadian Unmet Need KB pada Pasangan Usia Subur di Kelurahan Sulanjana Jambi

Unmet need for family planning is a couple of childbearing age who do not want children, want children with a distance of 2 but do not use contraception. The Sulanjana Village has the highest unmet need for KB rating in East Jambi at 38.40%. The study aims to determine the relationship between age, education, employment status, income, and attitudes towards family planning, with the incidence of unmet need for family planning in couples of childbearing age in Sulanjana Village, East Jambi District, Jambi City in 2023This study used a cross-sectional design with a sample of 78 respondents taken using accidental sampling technique. The sample is married women of childbearing age aged 19-49 years. data collection was carried out February-March 2023 by interviewing using a questionnaire. Data processing was performed univariately and bivariately using the SPSS chi-square test. the results of the analysis show a relationship between income (P-value=0.024), and attitude (P-value=0.010), while the variables are age (P-value=0.820), education (P-value=1.000), occupation (P-value= 634) there is no relationship with the incidence of unmet need for family planning in couples of childbearing age in the Sulanjana Village, DistrictEast Jambi Jambi City.to increase knowledge, attitudes in socializing and educating the community regarding the importance of participating in family planning programs and using contraceptives, not only wives but husbands also participate.

Observation of the Curative Effect of Recombinant Human Interferon α2b Gel Combined with LEEP Knife in Cervicitis Caused by IUD and The Effect of Copper/Low-Density Polyethylene Nanocomposite IUD

In this study, we explored the curative effect of recombinant human interferon α2b gel combined with a loop electrosurgical excision procedure (LEEP) knife to treat cervicitis. We also analyzed the clinical applications of a copper/low-density polyethylene nanocomposite intrauterine device (IUD). We selected 62 patients with IUD-induced cervicitis admitted to our hospital from March 2020 to December 2022 and divided them into experimental and control groups according to the random number table method (n = 31/group). The control group was treated with recombinant human interferon α2b gel only, while the experimental group was treated using a combination of the gel and LEEP knife. We compared the total efficacy rate of both treatments by recording the serum inflammatory cytokines levels, hospitalization, and vaginal drainage times before and after three months of treatment. We selected 50 married women of childbearing age who came to our hospital voluntarily to receive IUDs during the same period and randomly divided them into two groups (n = 25/group). Each group was administered either a copper/low-density polyethylene (Cu/LDPE) nanocomposite intrauterine device (IUD) or a TCu220C IUD. We conducted follow-ups at three, six, and 12 months after the implantation and analyzed the clinical and side effects. We observed that the total efficacy rate of the cervicitis treatment in the experimental group was 93%, 72% higher than in the control group. After six months of treatment, the tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), and interleukin-6 (IL-6) levels, and the leukocyte counts of both groups were lower than that before treatment, with the test group showing lower values than the control group. Simultaneously, the hospitalization and vaginal discharge times of the experimental group were lower than those of the control group. We also followed up on the two different IUD groups after three, six, and 12 months. Compared with TCu220C IUD, the Cu/LDPE nanocomposite IUD group showed lesser side effects, such as uterine bleeding and abdominal pain. There was no significant difference between the hemoglobin levels of both groups before and after IUD insertion. In conclusion, recombinant human interferon α2b gel combined with a LEEP knife is effective in treating cervicitis patients and can control the levels of inflammatory factors in the body. This treatment was safer and quicker and shortened the vaginal discharge time. Additionally, the clinical acceptance of Cu/LDPE nanocomposite IUD for human intrauterine contraception is good due to the low occurrence of adverse reactions, such as uterine bleeding and pain. Therefore, it should be promoted in clinical gynecological practice.

Education for Married Women of Childbearing Age About Cervical Cancer through IVA Testing Behavior in the Gondrong Health Center Work Area

This research aims to teach Women Of Fertilizer Age about Cervical Cancer, to find out the behavior of Women Of Fertilizer Age who carry out IVA tests and to find out the relationship between the knowledge of Women Of Fertilizer Age and the behavior of IVA tests in the Gondrong Community Health Center Work Area in 2021. The research design used is a quantitative design. This research method uses correlation analysis, namely research that aims to find out whether there is a relationship and how close the relationship is and whether the relationship is meaningful or not. This research was conducted with a survey, using cross sectional research, namely research carrying out measurements or observations on several populations at the same time. The population in this study were married women of childbearing age in the Gondrong Community Health Center working area. With a total of 3990 people and the sample numbered 98. Knowledge of Women of Childbearing Age about Cervical Cancer in the Gondrong Community Health Center Work Area in 2021 was found from 98 respondents, more of whom were found to have less knowledge, namely 46 people (46.9%). The behavior of women of childbearing age who underwent an IVA test in the Gondrong Health Center Work Area in 2021 was found to be more likely than 98 respondents to have the behavior of not carrying out an IVA test, namely 68 people (69.9%). It is known that there is a relationship between knowledge of women of childbearing age and behavior of IVA tests in the Gondrong Health Center work area in 2021.

Prevalence and factors associated with the utilisation of modern contraceptive methods among married women of childbearing age in Yemen: a secondary analysis of national survey data

ObjectiveImproving reproductive health requires access to effective contraception and reducing the unmet need for family planning in high-fertility countries, such as Yemen. This study investigated the utilisation of modern contraception...

The Effect of Child Preschool Education on Labor Force Participation of Married Women of Childbearing Age

In the context of the decline in working-age population and exhaustion of demographic dividend in China, how to increase the supply of labor has become an issue critical to economic development. Optimizing preschool education system and enhancing the accessibility of high-quality and low-cost pre-primary schooling help free married women from childcare, boost their labor force participation, and thus, augment the supply of labor. This study discovers that the labor force participation rate of women who enroll all their preschool-age children in kindergartens is 1.32 times that of those who do not do so; and that for working women, preschool attendance of all their kids can increase their working time by four hours per week. After classifying the sample according to the level of household income and type of Hukou (registered permanent residence), it finds that child preschool attendance can more significantly raise the employment probability of women from high-income families and more prominently increase working hours of those with rural Hukou.

Faktor-Faktor Yang berhubungan Dengan Kejadian Unmet Need Pada Wus Di Desa Blang Keutumba Kecamatan Juli Kabupaten Bireuen Tahun 2022

The data obtained at Blang Keutumba still have problems with unmet need in using contraception caused by a lack of knowledge, a lack of awareness of mothers in the data on women of childbearing age in Blang Keutumba Village. The aim of this study was to determine the factors related to the occurrence of unmet need. In Wus in Blang Keutumba Village, Juli District, Bireuen Regency in 2022. This research was conducted using a descriptive analytic method with a Cross Sectional design. The population in this study were all married women of childbearing age aged 20-40 years, namely 418 WUS. Sampling in this study used the Slovin formula, a sample of 81 respondents. Data collection was carried out for 1 week from 9-15 June 2022 by distributing questionnaires. Data analysis used the chi-square statistical test with the STATA program version 14.0. The results showed that there was a relationship between mother's knowledge with unmet need (p-value = 0.038), there is no relationship between husband's work and unmet need (p-value = 0.466), there is a relationship between husband's support and unmet need (p-value = 0.020), there is no relationship the role of health workers with the incidence of unmet need (p-value = 1,000).

Unmet need for family planning and related difficulties among married women of childbearing age in Bandung Slum, Indonesia.

This study was conducted to assess what factors cause women of childbearing age (15-49 years) who live in slums in Bandung City, Indonesia to experience unmet need for family planning. Unmet need for family planning is a phenomenon in the population sector that requires serious and immediate treatment because it can inhibit the increase in Contraceptive Prevalence Rate (CPR) and decrease in Total Fertility Rate (TFR). A cross-sectional survey was conducted from February to July 2021. 304 women were selected as respondents using a purposive sampling technique. Univariate and multivariate regression analysis was performed using STATA 16. The result is 29.3% of women have unmet need for family planning, while the factors that influence the occurrence of unmet need for family planning include marital age, family income, experienced a child's death, number of children living, women's decision-making power, and media exposure. Increasing access to information and free family planning services for married couples is important, especially for low-income families with many children.

Long-acting reversible contraceptives utilization and its determinants among married Yemeni women of childbearing age who no longer want children.

Some contraceptive methods, such as long-acting and permanent methods, are more effective than others in preventing conception and are key predictors of fertility in a community. This study aimed to determine which factors were linked to married women of childbearing age who no longer desired children using long-acting reversible contraceptives (LARCs) in Yemen. We used a population-based secondary dataset from Yemen’s National Health and Demographic Survey (YNHDS), conducted in 2013. The study analyzed a weighted sample of 5149 currently married women aged 15 to 49 years who had no plans to have children. Logistic regression analyses were used to investigate the parameters linked to the present use of LARCs. The final model’s specifications were evaluated using a goodness-of-fit test. An alpha threshold of 5% was used to determine statistical significance. Of the total sample, 45.3% (95% CI: 43.3–47.4) were using contraception. LARCs were used by 21.8% (95% CI: 19.6–24.1) of current contraceptive users, with the majority (63.8%) opting for short-acting reversible contraceptives (SARCs). In the adjusted analysis, maternal education, husbands’ fertility intention, place of residence, governorate, and wealth groups were all linked to the usage of LARCs. According to the findings, women whose spouses sought more children, for example, were more likely to use LARCs than those who shared their partners’ fertility intentions (AOR = 1.44; 95% CI: 1.07–1.94; P = .015). In this study, married women of reproductive age who had no intention of having children infrequently used contraception and long-acting methods. Improving women’s education and socioeconomic status could contribute to increasing their use of LARCs.

Assessing the Use of Contraceptive Methods for Family Planning among Married Women of Rawalpindi [urban

Qualitative data from a survey of married women living in urban areas of Rawalpindi are presented here in an effort to better understand their views on contraceptive techniques and the factors that impact their use. A purposeful selection strategy was used to choose participants, and only married women of childbearing age were eligible to participate. In total, 12 focus groups were held in the urban region of Rawalpindi. Some modern contraceptive methods were known to the majority, but overall use was extremely low. The prevalence of any form of contraception, including IUDs, was especially low. Modern contraception is not widely used because of concerns about side effects, religious apprehensions about harming the unborn child, a lack of information, or a lack of access to high-quality treatment according to the findings. The number of young women in the Pakistan who utilize contraception is influenced by social, demographic, and economic factors. Young women’s access to contraception may be restricted unless these findings are included into public health programs. Access to family planning information and services for young women is highly recommended. Key words: Contraceptive Methods, Family planning, Urban areas, Rawalpindi

CORRELATION OF THE USE OF CONTRACEPTIVE PILL COMBINATION TO RISK OF LEIOMYOMA EVENTS IN RSPAL SURABAYA

The use of contraception is important to control population growth, regulate the interval between pregnancies, avoid unwanted births, control the time of birth in a husband and wife relationship and determine the number of children in the family. According to the Central Statistics Agency (BPS) of East Java Province in 2018, the number of active Family Planning (KB) participants of married women of childbearing age who use hormonal contraception in the form of pills was 19.26%, injections were 50.44%, and implants is 11. 45%. Uterine fibroids occur in 20%-25% of women of reproductive age. The prevalence of leiomyoma may increase with hormonal contraceptives containing the hormone estrogen, either pure or combined. Uterine fibroids can affect the quality of life of the sufferer. Purpose: To analyze the relationship between the use of combined pill contraceptives and those who do not use the combined pill contraception in women with the incidence of leiomyoma. Method: This research is an observational analytic carried out retrospectively with a case-control approach. The sampling technique in this study was non-probability sampling, namely purposive sampling. This study uses secondary data, namely medical records of gynecological patients at the RSPAL Dr. Ramelan Surabaya by meeting the inclusion criteria and exclusion criteria. The data collected will be analyzed by looking at whether leiomyoma patients use combined pill contraception. Result: Patients diagnosed with leiomyoma who used the combined pill contraceptive were 48 (63%), while those who did not use the combined pill were 28 (37%). This study's results indicate a significant relationship between the use of combined pill contraceptives and the incidence of leiomyoma (p=0.001). Conclusion: There is a relationship between the use of combined pill contraceptives with the incidence of leiomyoma.

Delivery Services Utilization Based on Urban Rural Status in Indonesia

INTRODUCTION: Maternal mortality has been listed in the Sustainable Development Goals’ priority. Hence, use of delivery services from health facilities is essential to improve maternal and child health.&#x0D; AIM: This study aimed to analyze the trends and determinants of delivery service utilization between urban and rural areas in Indonesia.&#x0D; METHODS: This quantitative study uses a cross-sectional design. The secondary data source came from the Indonesian Health Demographic Survey (IDHS) in 2007-2017. As many as 29,985 married women of childbearing age (15-49 years old) were selected as samples. The data analysis was done using the chi-square test then binary logistic regression test.&#x0D; RESULTS: Trends in the utilization of health facility delivery services increased in Indonesia. Age, residential area, education level, occupational status, antenatal visits and knowledge of danger signs during pregnancy, and economic status were associated with the utilization of health facility delivery services both in the rural and urban areas. Women who finished college had 4.55 times chances of using health facility delivery services &#x0D; CONCLUSION: Demographic characteristics, antenatal visits, and knowledge of danger signs during pregnancy are associated with use of health facility delivery service sin rural and urban areas. The government needs to consider these factors in reducing inequal use of health facility delivery services between urban and rural areas.

The relationship between cognitive schemas activated in sexual context and early maladaptive schemas among married women of childbearing age

BackgroundHealthy sex can be affected by cognitive schemas activated in the sexual context (CSASCs) and early maladaptive schemas (EMSs). Cognitive schemas are the nuclear structure of the cognitive system which facilitate the interaction between individuals and their environments. CSASCs are emotional and behavioral responses in the sexual context. EMSs are extremely stable, enduring and are developed throughout the life of the individual, beginning in childhood. The present study investigated the relationship between CSASCs and EMSs among married women of childbearing age.MethodsIn a cross-sectional study, 260 married women of childbearing age participated. Using two-stage sampling, ten comprehensive urban health centers were first randomly selected and then 26 individuals from each center were invited to participate. Data collection included demographic variables, the Young Schema Questionnaire-Short Form (YSQ-SF) with 15 EMSs (emotional deprivation, abandonment, mistrust/abuse, social alienation, defectiveness, incompetence, dependency, vulnerability to harm, enmeshment, subjugation of needs, self-sacrifice, emotional inhibition, unrelenting standards, entitlement, and insufficient self-control), and the Cognitive Schema Activation in Sexual Context Questionnaires (CSASCQ) with five subscales (undesirability/rejection, incompetence, self-depreciation, difference/loneliness, and helplessness). Data analysis was performed using a uni-variable and multi-variable linear regression model with a stepwise method at a significance level of 0.05.ResultsThe mean age of the participants was 32.48 years and the average duration of their marriage was 10.34 years. The average score of early maladaptive schemas on the YSQ-SF was 151.5 (out of 450). Higher scores indicate more severe maladaptive schemas, although the total score has no defined cutoff point. Scores greater than 15 on each subscale constitute the internalization of that particular maladaptive schema. The highest average subscale scores were the schemas of self-sacrifice and unrelenting standards (M = 16.12, 15.90, respectively), indicating that these two schemas play important roles in the cognition of the participants. The mean score on the CSASCQ was 34.60 (SD ± 12.59; range: 25–125), with the highest mean reported on the loneliness subscale. Hypoactive sexual desire was the most common unpleasant sexual problem (6.9%) and disillusion was the most dominant feeling experienced by participants (33.3%). The results of the multivariable model showed that the following were significant predictors of the CSASC: three subscales of EMS (emotional deprivation [β = 0.28], social isolation [β = 0.31], and emotional inhibition [β = 0.14]) and two demographic variables (job [β = 0.11] and consanguineous marriage [β = 0.20]). In total, the multi-variable model explained 92% of variance of CSASCs.ConclusionsThe present study found a significant and meaningful association between EMSs and CSASCs adjusting for the effect of socio-demographic characteristics. The findings indicate that the study of schemas and schema therapy should be considered in both premarital and marital counseling.

A Phenomenological Analysis of Rural Women’s Childbirth Preferences

Women’s agency and reproductive control directly bear their current pregnancy and future childbearing experiences. This study deals with knowledge construction in childbirth planning. The study is based on a phenomenological approach relying on in-depth interviews of sixty married women of childbearing age who have recently been through the birthing process. Cultural discourses provide an understanding of socio-familial context reinforcing traditional home birthing. Findings indicate that the desire for natural childbirth experience, apprehensions regarding obstetric interventions by medical doctors, emotional support, comfort and assistance provided by female relatives, traditional birth attendants, and their husbands’ preference add to their decision for home birthing. In addition, another determinant was the role of authoritative knowledge and shared experiences of older women that may deprive many young women of the chance to access maternal care in hospitals. The study suggests that rural women effectively utilize reproductive health care services in Pakistan.

DETERMINANTS OF NEONATAL MORTALITY BASED ON THE 2017 INDONESIAN DEMOGRAPHIC AND HEALTH SURVEY (IDHS)

ABSTRACTInfant mortality is still a major health problem in Indonesia as 63% of deaths occur in the neonatal period. The trend of the neonatal mortality rate in Indonesia has decreased from 15 (2017) to 13 deaths per 1,000 live births (2018), but this does not meet the Sustainable Development Goals (SDGs) target. Evidence-based health interventions are based on determinants that most influences neonatal mortality. The purpose of this study was to determine the most influential determinants of neonatal mortality in Indonesia. This research is an analytic observational study that uses the 2017 Indonesian Demographic and Health Survey (IDHS) data, with a cross-sectional design. This study’s population was the last baby of married women of childbearing age (15-49 years) and was recorded in the 2017 IDHS with a sample of 15,102 babies. The outcome variable in this study was neonatal mortality. The analysis was conducted in stages, namely univariate analysis, bivariate analysis using the chi-square statistical test (X2), and multivariate analysis using logistic regression. The results showed that 85.71% of deaths occurred in the early neonatal period. The most influential determinants of neonatal mortality were male sex (adj OR = 2.91: 95% CI 1.78-4.76), low birth weight (adj OR = 12.08: 95% CI 7.38-18.86) and parity status ≥ 4 (adj OR = 2.11: 95% CI 1.22-3.61). Public health interventions aimed at reducing neonatal mortality should be linked to newborn and maternal characteristics that significantly influence Indonesia's neonatal mortality. Therefore, health services must consider adequate postpartum neonatal care that is fully integrated with medical care. Moreover, further prevention of potential factors that cause low birth weight before conception should be implemented and further control of births would optimize the family planning program. Keywords: gender, low birth weight, parity status, determinant, neonatal mortality, Indonesia

Factors Associated with Attitude towards Wife-Beating among Married Women of the Reproductive Ages in Arba Minch Town, Southern Ethiopia: A Community-Based Cross-Sectional Study.

Evidence from demographic and health surveys in various countries and Ethiopia too showed that more women are generally believed to justify intimate partner violence (IPV) than men do. An attitude that justifies IPV is one of the factors affecting victimization and perpetration from IPV. However, women's justification about the violence and factors affecting the justification are not well documented, particularly by addressing household factors such as household food conditions. Therefore, the present study aims to fill this gap among married women of childbearing age so that evidence can be drawn for holistic interventions. A community-based cross-sectional study was conducted among 696 currently married women of childbearing age (15–49) by using a multistage cluster sampling technique to obtain the women from 11 kebeles (the smallest administrative unit in the government structure of Ethiopia) of Arba Minch town, Southern Ethiopia. Data were collected using a pretested and structured questionnaire. Logistic regression was performed using IBM SPSS version 20. The odds ratio with its 95% confidence interval was used to show the degree of association between the outcome variable and explanatory variables. Nearly two-thirds (59.5%) of the study women justified wife-beating in at least one of the five conditions. A higher odds of justification of wife-beating was observed among women whose marriage was arranged by any other person than the couples themselves, from food-insecure households, with a family size of 5 and above, in the age group of 30–39 years, and whose partner was in the age range of 31–39 years. In contrast, lower odds of justification of wife-beating was observed among women having an age difference of 10 or more years with their partner and those in a household wealth index of middle and higher category. Despite great efforts in realizing gender equality in the country, a higher proportion of women were having the attitude that justifies wife-beating in the five conditions specified to them. Interventions targeting the improvement of women's attitude towards wife-beating should target against the traditional norms of arranged marriage, improve household food conditions, and decrease family size.

The Determinant for Choice of Delivery Method in Indonesia 2018

Pregnancy complications become one of the considerations in choosing a delivery method. Choosing the appropriate delivery method will save the mother and baby from mortality threat. This analysis is aimed to know how the relationship between the maternal characteristics with pregnancy complication and the choice of delivery method, such as caesarean section surgery procedure. This study is an advanced analysis of Riskesdas data 2018, using married women of childbearing age between 10 – 54 years old as the population, while the sample is whom they gave birth and became the Riskesdas sample in 2018 as much as 78,736. The chosen variables for this study are the maternal characteristics and the pregnancy complications as the independent variables, and the choice of delivery method as the dependent variable. This study shows that the maternal characteristics such as age, education, occupation and pregnancy complications also the source of labor cost related to the choice of delivery method with p-value 0.00. Mothers who have a pregnancy complication tend to do a caesarean section delivery process 9.4 bigger than who do not have any. Based on the result, it can be concluded that the maternal characteristics such as age, education, occupation, source of labor cost and the pregnancy complication are related to the choice of the delivery method in Indonesia in 2018.

Decision-making autonomy of women and other factors of anemia among married women in Ethiopia: a multilevel analysis of a countrywide survey

BackgroundAnemia is one of the world’s public health problem, especially in developing nations. The majority of women of childbearing age (15–49) are affected by anemia. Women’s role in the decision-making process is significant for their health and related issues such as anemia. So far, there is no evidence of women’s decision-making autonomy on anemia. Consequently, this study aimed to robustly examine both individual- and group-level women’s decision-making autonomy and other determinants of anemia among married women in Ethiopia.MethodsWe examined data from an Ethiopian demographic and health survey conducted in 2016. Our analysis included 9220 married women of childbearing age (15–49 years). For bivariate analysis, we applied the chi-squared (X2) test. The relationship between individual and group-level women’s decision-making autonomy and anemia was assessed using multilevel binary logistic regression models while adjusting other socio-demographic and economic characteristics.ResultsIn this study the magnitude of anemia was 30.5% (95% CI; 29.5–31.4). According to our multilevel analysis, group-level women’s autonomy was found to be negatively related with anemia than individual-level women’s autonomy (AOR = 0.53, 95% CI = 0.41–0.69). In addition, the indicator of women’s wealth index at group level was a protective factor (AOR = 0.68, 95% CI =0.51–0.90) to develop anemia. Among individual-level indicators women’s age (AOR = 0.73, 95% CI = 0.60–0.89), use of contraceptive (AOR = 0.66, 95% CI = 0.55–0.81), BMI (AOR = 0.71, 95% CI = 0.59–0.86) and employment status (AOR = 0.88, 95% CI = 0.79–0.98) were negatively related with anemia. While women who follow Muslim religion (AOR = 1.62, 95% CI = 1.32–1.97,), women who had five and above number of children (AOR = 93, 95% CI = 1.53–2.46), and who were pregnant (AOR = 1.21, 95% CI = 1.04–1.40) were positively associated with anemia.Our final model showed that around 27% of the variability of having anemia was because of group-level differences (ICC = 0.27, P < 0.001). In addition, both individual and group-level factors account for 56.4% of the variance in the in the severity of anemia across communities (PCV = 56.4%).ConclusionsOur study showed that empowering women within households is not only an important mechanism to reduce anemia among married women but also serves as a way to improve the lives of other women within the society.

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

BackgroundPoor 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.MethodsUsing 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.ResultsOur 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.ConclusionsFrom 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.