Browsing by Author "Kaushalendra K. Singh"

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Changes in abortion service provision in Bihar and Jharkhand states, India between 2004 and 2013
(Public Library of Science, 2018) Andreea A. Creanga; Kaushalendra K. Singh; Qingfeng Li; Timothee Fruhauf; Amy O. Tsui
Background The Medical Termination of Pregnancy (MTP) Act of 1971 liberalized abortion laws in India. This study examines changes in abortion service provision and characteristics of abortion providers in Bihar and Jharkhand states, India between 2004 and 2013. Methods We used state-representative data from cross-sectional surveys of reproductive health service providers we conducted in 2004 (N = 1,323) and 2012/2013 (N = 1,020). We employed chi-squared tests to examine and compare abortion providers’ characteristics, and fitted separate multivariate logistic regression models for provision of surgical, medical, and any abortion services, respectively, adjusting for potential confounders to identify factors associated with abortion service provision at the two survey time points. Results Of providers interviewed in 2004 and 2012/2013, 63.7% and 84.5%, respectively, offered abortion services. Among abortion providers, 21.1% offered surgical and 10.7% offered medical abortions in 2004; 15.8% and 94.1% did so, respectively, in 2012/2013. Private providers were more likely than public providers to offer abortion services at both time points. Compared to female providers, male providers were significantly less likely to provide both surgical and medical abortions in 2004, and significantly less likely to provide surgical abortions in 2012/2013. Pharmacists and community health workers played increasingly important roles in abortion service provision, especially medical abortion, during the period. © 2018 Creanga et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Couple interaction and predicting vulnerability to domestic violence in Uttar Pradesh, India
(SAGE Publications Inc., 2014) Brijesh P. Singh; Kaushalendra K. Singh; Neha Singh
Domestic violence, when conducted against women, is a type of gender-based violence that negatively impacts a woman's physical and psychological health, causing insecurity, lack of safety, and loss of health and self-worth. Domestic violence is an important consideration for sexual, reproductive, and child health, as it can affect contraceptive behaviors of couples as well as levels of infant mortality. In the present analysis, an attempt has been made to study the relationship between women's experience of domestic violence and couple interaction after controlling for certain socioeconomic and demographic variables using logistic regression. This study looks at data from the National Family Health Survey-III conducted from 2005 to 2006 in Uttar Pradesh, the most populous state of India. Findings reveal that 43% of women suffer from domestic violence in the society as a whole; however, if a couple makes joint decisions in household matters, the prevalence of domestic violence is observed to be 24% less. Education and occupation of women, standard of living, media exposure, and partner's alcoholic behaviors are also found to be possible predictors of domestic violence. © The Author(s) 2014.
Factors associated with unintended pregnancies in India among married women over the past one and half decade (2005–2021): a multivariable decomposition analysis
(BioMed Central Ltd, 2025) Sanjiv Singh; Kaushalendra K. Singh
Background: Along with other low- and middle-income countries unintended pregnancies are a matter of grave concern for India as well as world. Preventing unintended pregnancy can significantly reduce fertility as well as population health. Methods: Our study used data from three recent rounds of national family health survey (NFHS) which were conducted in 2005-06 (NFHS-3), 2015-16 (NFHS-4) and 2019-21 (NFHS-5). In union, currently married and pregnant women who have given birth to at least one child in last five years were taken into consideration for study. Dependent variable was unintended pregnancy (current pregnancy) which included mistimed as well as unwanted pregnancy. Univariate, bivariate analysis with point-to-point change was done to know aboutdependent variable. To know about important covariate of change in unintended pregnancy logistic regression has been used followed by multivariable decomposition analysis. Results: Over all three - survey rounds considered in our study; prevalence of unintended pregnancy declined from 31.76% (NFHS-3) to 15.87% (NFHS-5). Highest percentage decline of 23.02% from NFHS-3 (39.01%) to NFHS-5 (15.99%) in unintended pregnancy was in the women of Muslim religion. Women of rural area have 19% lower chance of unintended pregnancy with adjusted odds ratio 0.81. Odds of having current unintended pregnancy were about 8 times in women whose last birth was unwanted. Women with incorrect knowledge of ovulatory cycle have 20% higher chance of having unintended pregnancy. After analysis it was found that out of total change in unintended pregnancies was proximately 23% due to compositional change and about 77% change was due to behavioural change. Conclusions: Over the time prevalence of unintended pregnancies declining which can be helpful for better health to both child and women. Important factors leading to a decline in unintended pregnancy were young age groups, high education level, unwanted last birth, no and negative fertility gap, no intention to contraceptive use and incorrect knowledge of the ovulatory cycle. Most of decline in unintended pregnancies was due to behavioural change of women considered in our study. © The Author(s) 2025.
Gender inequality and the risk of HIV among married couples in North India
(Routledge, 2015) Shelah S. Bloom; Alpna Agrawal; Kaushalendra K. Singh; Chirayath M. Suchindran
This study investigated the distribution and determinants of HIV risks among married couples in North India. Gender inequality emerged as a potential driver of HIV risks in this region. Data collection took place in 2003 in a probability survey of 3385 couples living in India's most populous state - Uttar Pradesh - and Uttaranchal. Couples' analyses utilizing generalized estimating equations showed that compared with husbands, wives were less knowledgeable about HIV (OR = 0.31, 95% CI = 0.27-0.36), more likely to consider themselves at risk for infection (OR = 6.86, 95% CI = 4.65-10.13), and less likely to feel that a wife had the right to refuse sex with her husband (OR = 0.50, 95% CI = 0.44-0.58). The proportion of husbands reporting non-marital sex in the past year was 7.1% and transactional sex in the past year, 2.2%. Among their wives, 73.4% were unaware of their husbands' non-marital sexual behaviors and only 28.9% of husbands reported condom use during their last non-marital sexual encounter. Logistic regression analyses showed that husbands' alcohol use, husbands' mobility, and urban residence were positively associated with husbands' non-marital sexual behaviors adjusting for other covariates. The data demonstrate that HIV prevention programs among couples in North India should consider both sexual risks and gender inequalities which potentially fuel HIV spread in this region. © 2014 Taylor & Francis.
Husbands' reproductive health knowledge, attitudes, and behavior in Uttar Pradesh, India
(Blackwell Publishing Inc., 1998) Kaushalendra K. Singh; Shelah S. Bloom; Amy Ong Tsui
To enhance the reproductive health status of couples in developing countries, the knowledge, attitudes, and behavior of both women and men must be investigated, especially where women depend on men for the decision to seek care. This study analyzes data from a survey of 6,727 husbands from five districts in the northern state of Uttar Pradesh, India, Data are presented on men's knowledge of women's health and on their own sexual behavior outside the context of marriage, on their perceptions of sexual morbidity and their attempts at treatment for specific conditions, and on their opinions concerning the social role of wives, findings indicate that men know little about maternal morbidity or sexual morbidity conditions. Few husbands reported that they had had sexual experience outside of marriage and the majority of these few said they had had such a relationship with more than one partner. Of men who said they had had reproductive morbidity symptoms, many said they had not sought treatment. Men's views concerning the role of wives indicate a low level of women's autonomy in this region of India. Results indicate a pressing need for reproductive health education that targets both women and men in Uttar Pradesh.
Linking mother’s demographic disadvantages with children’s demographic outcomes in India: a pseudo cohort study
(BioMed Central Ltd, 2025) Anjali Singh; Dil Bahadur Rahut; Kaushalendra K. Singh
Many studies have recognized that a woman’s reproductive history influences the survival status of her fetus and the newborn. In the esteemed literature of demography, abundant evidence acknowledges the linkage between maternal exposure to offspring and their associated adult outcomes and the other way around. This study examines the link between maternal risk factors at birth and long-term outcomes for daughters in India. Using national health survey data, it focuses on three maternal risks: young age, high parity, and short birth intervals. Applying regression analysis to cohort data, the study finds these early-life disadvantages are associated with daughters experiencing stunted growth, undernutrition, child mortality, and low birth weight, as well as limited education and employment. Conversely, daughters of educated mothers have better outcomes, highlighting the importance of maternal education. The pseudo-cohort approach provides valuable longitudinal insights from cross-sectional surveys. The study underscores the need for policies promoting healthy reproductive practices and education access to improve long-term outcomes for women in India. © The Author(s) 2025.
Pregnancy to postpartum: Analyzing dropouts and socioeconomic predictors of continuum of maternal healthcare in India
(Elsevier B.V., 2025) Pooja Singh; Sanjiv Singh; Kaushalendra K. Singh
Background: Continuum of care (CoC) emphasizes the importance of establishing connections between maternal healthcare service provided at various stages throughout pregnancy, labour, and the postpartum period. The objective of this study was to investigate the CoC for maternal health, focusing on recent utilization and dropout pattern and to examine the underlying wealth inequality and its association with the dimensions of women's empowerment. Material and methods: For our analysis, we focused on mothers who had given birth within the five years preceding the National family health survey (NFHS)-5 survey. Outcome variable, the CoC for maternal health was assessed at three distinct levels: CoC until 4+ antenatal care (ANC), CoC until skilled birth attendance (SBA), CoC until postnatal care (PNC) or complete CoC. Binary logistic regression, concentration curve and index were utilized to address the objectives of the study. Results: Our study found that 93.8 % of women initiated maternal healthcare with at least one ANC visit, but only 63.1 % completed the recommended 4+ visits. Among them, 94.6 % received SBA, yet only 62 % continued to PNC. A concerning dropout pattern was observed across all states, with even prosperous states like Chandigarh, West Bengal, Goa, Kerala, New Delhi, and Gujarat showing higher dropout rates before PNC than the national average of 38 %. Concentration curves revealed pro-rich inequality in CoC. Women's social independence positively influenced CoC adherence, along with parity, pregnancy intention, wealth index, and region of residence as key determinants. Conclusion: Our findings reveal significant gaps in the continuum of maternal healthcare, including high dropout rates before postnatal care and persistent wealth-based disparities. Addressing these issues requires targeted policies, greater women's empowerment, and equitable healthcare access. Future research should conduct a comprehensive analysis to understand why dropout rates remain high, even in relatively prosperous states, by examining health system inefficiencies, sociocultural barriers, and policy gaps. © 2024
Prevalence of self-reported symptoms of reproductive tract infections among recently pregnant women in Uttar Pradesh, India
(2001) Kuhu Maitra; Joseph Degraft-Johnson; Kaushalendra K. Singh; Amy O. Tsui
This study examines the prevalence of self-reported reproductive tract infections (RTIs) and treatment seeking among married, recently pregnant women in Uttar Pradesh state, India. Associations between RTI symptom reporting and background characteristics are examined in a population-based sample of 18,506 married women with a pregnancy in the 3 years prior to a 1995 statewide survey. Logistic regression analyses are used to assess the effects of sociodemographic covariates on the probability of reporting an RTI symptom. Nearly one out of four women reports experiencing at least one RTI symptom, with the most common symptoms being abnormal vaginal discharge and pain during urination. Reporting of RTI symptoms significantly increases if the woman's last pregnancy did not end in a live birth or if she has low economic status. Symptom reports also increase with age and decrease with parity. Only one-third of women reporting an RTI symptom sought treatment. The results indicate that survey interviews can be a cost-effective option for measuring the magnitude of RTI symptoms experienced and identifying sociodemographic influences. The findings suggest the need for improved RTI screening procedures and treatment at health facilities in this populous state of northern India.
The Role of Breast-Feeding Beyond Postpartum Amenorrhoea on the Return of Fertility in India: A Life Table and Hazards Model Analysis
(1994) Dilip C. Nath; Kenneth C. Land; Kaushalendra K. Singh
[No abstract available]