Restrictive social norms and strategic constraints imposed by family members can limit women's access to and benefits from social networks, especially in patrilocal societies. We characterize young ...married women's social networks in rural India and analyze how inter‐generational power dynamics within the household affect their network formation. Using primary data from Uttar Pradesh, we show that co‐residence with the mother‐in‐law is negatively correlated with her daughter‐in‐law's mobility and ability to form social connections outside the household, especially those related to health, fertility, and family planning. Our findings suggest that the mother‐in‐law's restrictive behavior is potentially driven by the misalignment of fertility preferences between the mother‐in‐law and the daughter‐in‐law. The lack of peers outside the household lowers the daughter‐in‐law's likelihood of visiting a family planning clinic and of using modern contraception. We find suggestive evidence that this is because outside peers (a) positively influence daughter‐in‐law's beliefs about the social acceptability of family planning and (b) enable the daughter‐in‐law to overcome mobility constraints by accompanying her to health clinics.
The use of maternal health care is limited in India despite several programmatic efforts for its improvement since the late 1980's. The use of maternal health care is typically patterned on ...socioeconomic and cultural contours. However, there is no clear perspective about how socioeconomic differences over time have contributed towards the use of maternal health care in India.
Using data from three rounds of National Family Health Survey (NFHS) conducted during 1992-2006, we analyse the trends and patterns in utilization of prenatal care (PNC) in first trimester with four or more antenatal care visits and skilled birth attendance (SBA) among poor and nonpoor mothers, disaggregated by area of residence in India and three contrasting provinces, namely, Uttar Pradesh, Maharashtra and Tamil Nadu. In addition, we investigate the relative contribution of public and private health facilities in meeting the demand for SBA, especially among poor mothers. We also examine the role of salient socioeconomic, demographic and cultural factors in influencing aforementioned outcomes. Bivariate analyses, concentration curve and concentration index, logistic regression and multinomial logistic regression models are used to understand the trends, patterns and predictors of the two outcome variables. Results indicate sluggish progress in utilization of PNC and SBA in India and selected provinces during 1992-2006. Enormous inequalities in utilization of PNC and SBA were observed largely to the disadvantage of the poor. Multivariate analysis suggests growing inequalities in utilization of the two outcomes across different economic groups.
The use of PNC and SBA remains disproportionately lower among poor mothers in India irrespective of area of residence and province. Despite several governmental efforts to increase access and coverage of delivery services to poor, it is clear that the poor (a) do not use SBA and (b) even if they had SBA, they were more likely to use the private providers.
Recent evidence suggests nonconstant nature of dispersion in adult women's body mass index (BMI) across sociodemographic groups. The overall variances in BMI and height are also shown to have ...substantially changed over time. We modeled complex variation in adults' anthropometry-BMI and height-by wealth and education, and assessed their differences over time in India.
Data from a total of 768,130 women and 180,691 men from the Indian National Family Health Survey (NFHS) 2006 and 2016 were used for the analysis. The average association between wealth and education with anthropometry was assessed from linear regression models assuming constant variance. Individual heterogeneity was modeled to obtain separate variances in anthropometry for each wealth quintile and education level. All analyses were stratified by survey year and sex.
On average, the positive socioeconomic gradient in adult's BMI and height persisted over time with slight attenuation. The residual variance in BMI ranged from 10.1 to 14.9 (7.2-11.3) by education level and 6.1 to 17.4 (5.0-13.0) by household wealth for women (men) in 2006, and they increased over time for the lower socioeconomic groups but remained the same or decreased for the higher socioeconomic groups. No significant pattern was observed for variation in height for both genders.
We found potential reversal in the socioeconomic patterning in BMI variability in India as suggested by the increasing dispersion among the least educated and poorest populations. For a comprehensive understanding of nutrition transition in developing countries, it is necessary to assess the changes in means and variances of anthropometry in tandem.
Evidence from a number of countries in Europe and North America point towards the secular declining trend in menarcheal age with considerable spatial variations over the past two centuries. Similar ...trends were reported in several developing countries from Asia, Africa and Latin America. However, data corroborating any secular trend in the menarcheal age of the Indian population remained sparse and inadequately verified.
We examined secular trends, regional heterogeneity and association of socioeconomic, anthropometric and contextual factors with menarcheal age among ever-married women (15-49 years) in India. Using the pseudo cohort data approach, we fit multiple linear regression models to estimate secular trends in menarcheal age of 91394 ever-married women using the Indian Human Development Survey.
The mean age at menarche among Indian women was 13.76 years (95 % CI: 13.75, 13.77) in 2005. It declined by three months from 13.83 years (95% CI: 13.81, 13.85) among women born prior to 1955-1964, to nearly 13.62 years (95% CI: 13.58, 13.67) among women born during late 1985-1989. However, these aggregate national figures mask extensive spatial heterogeneity as mean age at menarche varied from 15.0 years in Himachal Pradesh during 1955-1964 (95% CI: 14.89-15.11) to about 12.1 years in Assam (95% CI: 11.63-12.56) during 1985-1989.
The regression analysis established a reduction of nearly one month per decade, suggesting a secular decline in age at menarche among Indian women. Notably, the menarcheal age was significantly associated with the area of residence, geographic region, linguistic groups, educational attainment, wealth status, caste and religious affiliations among Indian women.
We use panel data from multiple wards from two hospitals spanning a three-year period to investigate the impact of automation of the core error prevention functions in hospitals on medical error ...rates. Although there are studies based on anecdotal evidence and self-reported data on how automation impacts medical errors, no systematic studies exist that are based on actual error rates from hospitals. Further, there is no systematic evidence on how incremental automation over time and across multiple wards impacts the rate of medical errors. The primary objective of our study is to fill this gap in the literature by empirically examining how the automation of core error prevention functions affects two types of medical errors. We draw on the medical informatics literature and principal-agency theory and use a unique panel data set of actual documented medical errors from two major hospitals to analyze the interplay between automation and medical errors. We hypothesize that the automation of the sensing function (recording and observing agent actions) will have the greatest impact on reducing error rates. We show that there are significant complementarities between quality management training imparted to hospital staff and the automation of control systems in reducing interpretative medical errors. We also offer insights to practitioners and theoreticians alike on how the automation of error prevention functions can be combined with training in quality management to yield better outcomes. Our results suggest an optimal implementation path for the automation of error prevention functions in hospitals.
Men who have Sex with Men being sexual minorities are a vulnerable section of society and are at greater risk of ill-treatment if they are 'out of the closet' regarding their sexuality. Previous ...evidence suggests that they experienced heightened susceptibility to physical and mental illnesses owing to widespread discrimination and victimization across different walks of life, particularly in developing countries. However, there is a paucity of sound data and scientific understanding related to linkages between physical-mental health and awareness about Human Immunodeficiency Virus/Sexually Transmitted Infections among Men who have Sex with Men in the Indian context.
Using a mixed-method approach, the present study examined the association between physical-mental well-being and awareness of comprehensive Human Immunodeficiency Virus/Sexually Transmitted Infections/relevant health behaviours based on primary data collected from 300 respondents from six selected metro cities in India. Descriptive statistics, chi-square test and binary logistic regression model have been used for the quantitative data analyses. In-depth interviews were conducted to contextualize and appreciate the substantive meanings and significance coming out from the quantitative results with the lived experiences of the study respondents.
Finding suggests that one-fourth of the respondents were experiencing long-term illnesses while close to four out of ten respondents experienced short-term illnesses. About one-third of the respondents experienced disordered eating behaviour and mood swings. Close to one-fifth of the respondents reportedly contemplated suicidal thoughts. Awareness related to Sexually Transmitted Infections and preventive measures related to Human Immunodeficiency Virus risk was considerably low among Men who have Sex with Men.
Awareness about sexual and reproductive health issues among Men who have Sex with Men needs to be strengthened to curtail the disproportionate risk and vulnerability of Human Immunodeficiency Virus and Sexually Transmitted Infections. The public healthcare system needs to be sensitized and upgraded to cater user-friendly quality healthcare services, without any discrimination against sexual minorities including Men who have Sex with Men. Furthermore, generating public awareness about gender and sexuality-related matters and reducing stigma and discrimination is critical for achieving the health-related sustainable development goals in India without leaving no one behind.
This paper examines the trends and patterns of economic inequalities with respect to child malnutrition by wealth status of population across major regions and states of India. Data from three rounds ...of National Family and Health Survey (NFHS) conducted during 1992–2006 were analyzed. The proportion of underweight children (measure of both acute and chronic malnutrition) has been used as a dependent variable. The wealth index is used as proxy for economic status of the population, and was estimated through principal component analysis by employing a set of variables representing durable asset ownership, access to utilities and infrastructure, and housing characteristics of respondents for all the three survey rounds. Bivariate analyses, poor-rich ratio and concentration indices were used to understand the trends in economic inequalities with respect to child malnutrition. Pooled logistic regression models were fitted to estimate the adjusted effect of economic status on the likelihood of child malnutrition over time. Results indicate sluggish change coupled with concomitant rise in economic inequalities with respect to child malnutrition in India during 1992–2006. The burden of malnutrition was disproportionately concentrated among poor children. In addition, average decline in malnutrition concealed large economic disparities across space and time.
In this work, we employ density functional theory (DFT) to investigate the edge atomic structures and atomic boundaries in graphitic carbon nitride (g-C3N4) nanoribbons to explore their role on ...structural stability and electronic and photocatalytic properties. Interestingly, the nanoribbon structures with mirror twin boundaries (MTBs) have higher structural stability than the conventional nanoribbon structures due to the C–C bond formations at the MTB region. Irrespective of their edge atomic structure, the curved and corrugated nanoribbons with direct band gap are thermodynamically more stable than the planar nanoribbons with indirect band gap. In addition, the distinct electronic structures of nanoribbons with and without MTB are calculated to understand their influence on the band gap and band edge positions of the nanoribbons. Very importantly, unlike the other nanostructures of g-C3N4, nanoribbons are shown to possess unique electronic structures that facilitate the tunable spatial separation of valence and conduction band states. This enhances the lifetime of excited charge carriers in nanoribbon morphology. To garner deep insights into the photocatalytic properties of the g-C3N4 monolayer and nanoribbons, the Gibbs free energies (ΔG) of hydrogen and oxygen evolution reaction intermediates are studied to identify the active sites. To this end, our DFT studies predict enhanced photocatalytic activity of g-C3N4 nanoribbons over the monolayer while providing new insights into the geometry, electronic structure, and photocatalytic properties of the nanoribbons, guiding the plausible development of g-C3N4 nanoribbons.
PDF
