Scholarly Publications
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This community showcases the academic contributions of faculty and researchers at Banaras Hindu University (BHU) and provides a year-wise compilation of publications across disciplines. Institutional Repository BHU
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PublicationArticle Economic Inequality in Intimate Partner Violence among Forward and Backward Class Women in India: A Decomposition Analysis(Routledge, 2024) Sourav Chowdhury; Aditya Singh; Nuruzzaman Kasemi; Mahashweta ChakrabartyIntimate partner violence (IPV) is a highly sensitive issue in India, where society is patriarchal and primarily segmented into castes/tribes. This study aims to measure and explain the economic inequality in IPV against women in two social groups: backward classes (Scheduled Castes, Scheduled Tribes, and Others Backward Classes) and forward classes (Others), using cross-sectional data from the National Family Health Survey-4 conducted in 2015–16. Economic inequality has been measured using the rate ratio, the concentration index (CI), and the concentration curve. In addition, concentration index has been decomposed to explain the economic inequality in IPV. Economic inequality was relatively higher among the women from the forward classes (CI: −0.30) than those from the backward classes (CI: −0.20). Woman’s education (25%), alcohol consumption by husbands (19.6%), and region of residence (18.7%) were the major contributors to economic inequality in IPV among backward class women. However, for forward class women, woman’s education (23.2%), region of residence (15.6%), parental IPV (14.6%), husband’s education (9.7%), and exposure to mass media were significant contributors to economic inequality in IPV (7%). In conclusion, there is a need for appropriate interventions and programs focused on reducing economic inequality in IPV against women from both backward and forward classes. © 2022 Taylor & Francis Group, LLC.PublicationArticle Intimate Partner Violence among Scheduled Caste Women in India: A Cross-sectional Study(Routledge, 2024) Sourav Chowdhury; Aditya Singh; Nuruzzaman Kasemi; Mahashweta Chakrabarty; Tribarna Roy PakhadharaScheduled Caste (SC) women, one of the most oppressed and neglected groups in India, have the highest prevalence of intimate partner violence (IPV), yet no study has analyzed correlates of IPV within this group, or analyzed them using nationally representative data. This study is an attempt to fill this gap. Information on 11,076 married SC women from the National Family Health Survey-4 was analyzed. Cross-sectional study design was followed. Binary logistic regression was applied to examine the factors associated with IPV. About 40% of married SC women in India suffered physical, mental, or sexual violence from their husbands. Alcohol consumption by husband (OR = 2.99, 95% CI = 2.62–3.41), employment status (OR = 1.26, 95% CI = 1.07–1.48), parity especially having 4 or more children (OR = 2.36, 95% CI = 1.82–3.06; OR = 2.10, 95% CI = 1.61–2.73) were associated with higher odds of IPV. Women from southern, eastern, and central regions of India were more likely to experience IPV. We conclude that there is a need to recognize the diverse experiences of vulnerable subgroups within SC women and undertake suitably designed targeted interventions to lower the high levels of IPV prevalent among these women. © 2022 Taylor & Francis Group, LLC.PublicationArticle Wealth-based disparities in the prevalence of short birth interval in India: insights from NFHS-5(BioMed Central Ltd, 2024) Aditya Singh; Anshika Singh; Mahashweta Chakrabarty; Shivani Singh; Pooja TripathiBackground: Short birth interval (SBI) has profound implications for the health of both mothers and children, yet there remains a notable dearth of studies addressing wealth-based inequality in SBI and its associated factors in India. This study aims to address this gap by investigating wealth-based disparities in SBI and identifying the underlying factors associated with SBI in India. Methods: We used information on 109,439 women of reproductive age (15–49 years) from the fifth round of the National Family Health Survey (2019-21). We assessed wealth-based inequality in SBI for India and its states using the Erreygers Normalised Concentration Index (ECI). Additionally, we used a multilevel binary logistic regression to assess the factors associated with SBI in India. Results: In India, the prevalence of SBI was 47.8% [95% CI: 47.4, 48.3] during 2019-21, with significant variation across states. Bihar reported the highest prevalence of SBI at 61.2%, while Sikkim the lowest at 18.1%. SBI prevalence was higher among poorer mothers compared to richer ones (Richest: 33.8% vs. Poorest: 52.9%). This wealth-based inequality was visible in the ECI as well (ECI= -0.13, p < 0.001). However, ECI varied considerably across the states. Gujarat, Punjab, and Manipur exhibited the highest levels of wealth-based inequality (ECI= -0.28, p < 0.001), whereas Kerala showed minimal wealth-based inequality (ECI= -0.01, p = 0.643). Multilevel logistic regression analysis identified several factors associated with SBI. Mothers aged 15–24 (OR: 12.01, p < 0.001) and 25–34 (2.92, < 0.001) were more likely to experience SBI. Women who married after age 25 (3.17, < 0.001) and those belonging to Scheduled Caste (1.18, < 0.001), Scheduled Tribes (1.14, < 0.001), and Other Backward Classes (1.12, < 0.001) also had higher odds of SBI. Additionally, the odds of SBI were higher among mothers in the poorest (1.97, < 0.001), poorer (1.73, < 0.001), middle (1.62, < 0.001), and richer (1.39, < 0.001) quintiles compared to the richest quintile. Women whose last child had passed away were also significantly more likely to have SBI (2.35, < 0.001). Furthermore, mothers from communities with lower average schooling levels (1.18, < 0.001) were more likely to have SBI. Geographically, mothers from eastern (0.67, < 0.001) and northeastern (0.44, < 0.001) regions of India were less likely to have SBI. Conclusion: The significant wealth-based inequality in SBI in India highlights the need for targeted interventions focusing on economically disadvantaged women, particularly in states with high SBI prevalence. Special attention should be given to younger mothers and those from socially disadvantaged groups to enhance maternal and child health outcomes across the country. © The Author(s) 2024.PublicationArticle Prevalence and determinants of anaemia among women of reproductive age in Aspirational Districts of India: an analysis of NFHS 4 and NFHS 5 data(BioMed Central Ltd, 2024) Subhojit Let; Seema Tiwari; Aditya Singh; Mahashweta ChakrabartyBackground: Over one-third of women worldwide suffer from anaemia. The prevalence of anaemia is particularly pronounced among women of reproductive age (WRA) in developing countries, such as India. No prior study has ever exclusively studied the prevalence of anaemia across the Aspirational Districts of India. Therefore, the purpose of this study was to examine the prevalence of anaemia across Aspirational Districts of India and to identify the determinants of anaemia among WRA in these districts. Methods: From the National Family Health Survey (NFHS)-4 (2015-16) and NFHS-5 (2019-21), data on 114,444 and 108,782 women aged 15–49 from Aspirational Districts were analyzed in our study, respectively. Bivariate statistics and multivariable binary logistic regression were used to identify the determinants of anaemia. Results: The national prevalence of anaemia among WRA has increased from 53% in NFHS-4 to 57% in NFHS-5 whereas anaemia among WRA in Aspirational Districts has increased from 58.7% in NFHS-4 to 61.1% in NFHS-5. Between 2015 and 2021, over 60% of Aspirational Districts experienced an increase in the prevalence of anaemia and one-fourth, specifically 29 out of 112, observed a rise by at least 10 percentage points (pp). Notably, there are significant variations in anaemia prevalence among districts, with Simdega and Udalgiri having the highest anaemia prevalence in NFHS-4 and NFHS-5 at 78.2% and 81.5%, respectively. During this period, Barpeta followed by Udalgiri of Assam have witnessed the maximum increase with 29.4% and 26.7% respectively. Moreover, pooled regression results show women with three to four children [AOR: 1.13, 95% CI: 1.08–1.17], women who breastfeed [AOR: 1.17, 95% CI: 1.13–1.20], Scheduled Tribe women [AOR: 1.39, 95% CI: 1.35–1.44], poorest women [AOR: 1.27, 95% CI: 1.22–1.33] and women those who consume fish occasionally [AOR: 1.14, 95% CI: 1.12–1.17] were more likely to be anaemic. Conclusion: The significant increase in anaemia among WRA in Aspirational Districts of India is a matter of concern. Given the rise in anaemia among WRA, determinants-based and district-specific measures must be designed and implemented to reduce the prevalence of anaemia among Aspirational Districts of India. © The Author(s) 2024.PublicationArticle A district-level geospatial analysis of anaemia prevalence among rural men in India, 2019-21(BioMed Central Ltd, 2024) Aditya Singh; Sumit Ram; Rakesh Chandra; Arabindo Tanti; Shivani Singh; Ananya KunduBackground: Despite its considerable impact on health and productivity, anemia among men has received limited attention. In a country as diverse as India, characterized by extensive geographic variations, there is a pressing need to investigate the nuanced spatial patterns of anemia prevalence among men. The identification of specific hotspots holds critical implications for policymaking, especially in rural areas, where a substantial portion of India’s population resides. Methods: The study conducted an analysis on a sample of 61,481 rural men from 707 districts of India, utilizing data from the National Family Health Survey-5 (2019-21). Various analytical techniques, including Moran’s I, univariate LISA (Local Indicators of Spatial Association), bivariate LISA, and spatial regression models such as SLM (Spatial Lag Model), and SEM (Spatial Error Model) were employed to examine the geographic patterns and spatial correlates of anaemia prevalence in the study population. Results: In rural India, three out of every ten men were found to be anemic. The univariate Moran’s I value for anaemia was 0.66, indicating a substantial degree of spatial autocorrelation in anaemia prevalence across the districts in India. Cluster and outlier analysis identified five prominent ‘hotspots’ of anaemia prevalence across 97 districts, primarily concentrated in the eastern region (encompassing West Bengal, Jharkhand, and Odisha), the Dandakaranya region, the Madhya Pradesh-Maharashtra border, lower Assam, and select districts in Jammu and Kashmir. The results of SLM revealed significant positive association between anaemia prevalence at the district-level and several key factors including a higher proportion of Scheduled Tribes, men in the 49–54 years age group, men with limited or no formal education, individuals of the Muslim faith, economically disadvantaged men, and those who reported alcohol consumption. Conclusions: Substantial spatial heterogeneity in anaemia prevalence among men in rural India suggests the need for region-specific targeted interventions to reduce the burden of anaemia among men in rural India and enhance the overall health of this population. © 2024, The Author(s).PublicationArticle Anaemia among lactating adolescents (15–19 years) in India: a repeated cross-sectional analysis of the NFHS data (2005–2021)(BioMed Central Ltd, 2024) Ananya Kundu; Aditya Singh; Sumit Ram; Rakesh Chandra; Arabindo Tanti; Shivani SinghBackground: Anaemia continues to be a pressing public health concern in India. Despite the high burden of anaemia among lactating adolescents in the country, research addressing this concern among this population remains scarce. Hence, this study attempted to examine the prevalence and determinants of anaemia among lactating adolescents in India. Methods: We used data from three latest rounds of the National Family Health Survey (NFHS) carried out in 2005-06, 2015-16, and 2019-21 and analysed a pooled sample of 10,689 lactating adolescents aged 15–19 years from these three rounds. Bivariate statistics was used to analyse the prevalence of anaemia according to the background characteristics of lactating adolescents. Further, binary multivariate logistic regression was carried out to examine the factors associated with anaemia in the study population. Results: Three in every five lactating adolescents from the pooled sample were found to have anaemia (66.98% in NFHS-3, 61.08% in NFHS-4 and 66.27% in NFHS-5). Lactating adolescents with a higher education had a 30% lower likelihood [adjusted odds ratio (AOR): 0.70, 95% CI: 0.49–1.01, p = 0.050] of being anaemic compared to those with no education. The likelihood of being anaemic among the poorest quintile was 41% (AOR: 1.41, 1.12-1.77; p = 0.003) higher than those from the richest quintile. Lactating adolescents from the Scheduled Tribe category had higher odds (AOR: 1.29, 95% CI: 1.01–1.46, p = 0.001) of anaemia than those categorised as ‘Others’. Those living in rural areas were 22% more likely to suffer from anaemia (AOR: 1.22, 95% CI: 1.00-1.26, p = 0.050) compared to their urban counterparts. Additionally, underweight lactating adolescents were 15% more likely (AOR: 1.15, 95% CI: 1.05–1.26, p = 0.002) to be anaemic than those with normal BMI. Odds of being anaemic were higher among the ones receiving supplementary nutrition during pregnancy (AOR: 1.18, 95% CI: 1.08–1.29, p < 0.001) in contrast to those not receiving. Conclusion: The consistently high prevalence of anemia among lactating adolescents, especially among those with lower education level, rural residence, underweight status, and belonging to ST category and poorest quintile, underscore the urgent need for targeted public health interventions to address and reduce anemia in this population. © The Author(s) 2024.PublicationArticle Spatial heterogeneity in unintended pregnancy and its determinants in India(BioMed Central Ltd, 2024) Anshika Singh; Mahashweta Chakrabarty; Aditya Singh; Shivani Singh; Rakesh Chandra; Pooja TripathiBackground: Understanding the geographic variation of unintended pregnancy is crucial for informing tailored policies and programs to improve maternal and child health outcomes. Although spatial analyses of unintended pregnancy have been conducted in several developing countries, such research is lacking in India. This study addresses this gap by investigating the geographic distribution and determinants of unintended pregnancy in India. Methods: We analysed data from the National Family Health Survey-5 encompassing 232,920 pregnancies occurring between 2014 and 2021 in India. We conducted a spatial analysis to investigate the distribution of unintended pregnancies at both state and district levels using choropleth maps. To assess spatial autocorrelation, Global Moran’s I statistic was employed. Cluster and outlier analysis techniques were then utilized to identify significant clusters of unintended pregnancies across India. Furthermore, we employed Spatial Lag Model (SLM) and Spatial Error Model (SEM) to investigate the factors influencing the occurrence of unintended pregnancies within districts. Results: The national rate of unintended pregnancy in India is approximately 9.1%, but this rate varies significantly between different states and districts of India. The rate exceeded 10% in the states situated in the northern plain such as Haryana, Delhi, Uttar Pradesh, Bihar, and West Bengal, as well as in the Himalayan states of Himachal Pradesh, Uttarakhand, Sikkim, and Arunachal Pradesh. Moreover, within these states, numerous districts reported rates exceeding 15%. The results of Global Moran’s I indicated a statistically significant geographical clustering of unintended pregnancy rates at the district level, with a coefficient of 0.47 (p < 0.01). Cluster and outlier analysis further identified three major high-high clusters, predominantly located in the districts of Arunachal Pradesh, northern West Bengal, Bihar, western Uttar Pradesh, Haryana, Delhi, alongside a few smaller clusters in Odisha, Madhya Pradesh, Uttarakhand, and Himachal Pradesh. This geographic clustering of unintended pregnancy may be attributed to factors such as unmet needs for family planning, preferences for smaller family sizes, or the desire for male children. Results from the SEM underscored that parity and use of modern contraceptive were statistically significant predictors of unintended pregnancy at the district level. Conclusion: Our analysis of comprehensive, nationally representative data from NFHS-5 in India reveals significant geographical disparities in unintended pregnancies, evident at both state and district levels. These findings underscore the critical importance of targeted policy interventions, particularly in geographical hotspots, to effectively reduce unintended pregnancy rates and can contribute significantly to improving reproductive health outcomes across the country. © The Author(s) 2024.PublicationArticle Decomposing the gap in undernutrition among under-five children between EAG and non-EAG states of India(Elsevier Ltd, 2023) Sourav Chowdhury; Nuruzzaman Kasemi; Aditya Singh; Mahashweta Chakrabarty; Shivani SinghIn India, the Empowered Action Group (EAG) states (Bihar, Madhya Pradesh, Rajasthan, Uttar Pradesh, Uttarakhand, Odisha, Jharkhand, and Chhattisgarh, including Assam) have a higher prevalence of undernutrition among children under the age of five (U5) than non-EAG states. However, no research has attempted to explain the difference in U5 child undernutrition between EAG and non-EAG states. To fill this gap, this study used data from the fourth round of the National Family Health Survey (NFHS-4) and applied modified Blinder–Oaxaca decomposition (also known as Fairlie decomposition). This decomposition helps quantify the relative contribution of various factors explaining the gap between EAG and non-EAG states in U5 child undernutrition. In EAG states, nearly four out of ten U5 children suffered from being underweight and stunted, and one out of five suffered from wasting. The prevalence of undernutrition was relatively higher in the EAG states than in the non-EAG states. The decomposition results revealed that almost two-thirds of the gap in U5 undernutrition between EAG and Non-EAG states was explained by the variables used in the analysis. Household wealth explained about half the difference in stunting and wasting, while religion accounted for a quarter of the difference in underweight and wasting. Maternal education explained a fourth of the difference in stunting between EAG and Non-EAG states. The disparity in undernutrition between EAG and non-EAG states could be reduced by introducing suitable long- and short-term interventions and programs. Increasing access to the public distribution system (PDS), raising awareness among low-income mothers regarding optimal inter-birth intervals, proper health and hygiene, appropriate family planning, and the importance of maternal and child health care services by frontline workers (ASHAs, Anganwadi workers, etc.) could be some of the ways to bridge the gap in undernutrition between EAG and non-EAG states in the near future. © 2022 Elsevier LtdPublicationArticle Spatial heterogeneity in the exclusive use of hygienic materials during menstruation among women in urban India(PeerJ Inc., 2023) Aditya Singh; Mahashweta ChakrabartyBackground. Menstrual hygiene is essential for women to live with dignity. However, a large proportion of Indian women still suffer from unhygienic menstrual practices leading to reproductive tract infections. To understand the socioeconomic and biodemographic determinants of menstrual hygiene practices, various national or local level studies have been conducted in India and around the world, however, no previous study has tried to understand the spatial heterogeneity across Indian districts in the use of hygienic materials among young urban women. Methods. This study used data from 54,561 urban women aged 15–24 from the National Family Health Survey-5. Global Moran’s I was applied to assess the degree of spatial autocorrelation and cluster and outlier analyses to locate hot-spots and clod-spots in the exclusive use of hygienic materials across the districts. Ordinary least square, spatial lag, and error models were used to identify determinants of exclusive use of hygienic materials. Results. Approximately 66.8% of urban women exclusively use of hygienic materials which varied across districts. Global Moran’s I of 0.46 indicated positive spatial autocorrelation in the outcome. Cluster and outlier analysis revealed cold-spots in central Indian districts and hotspots in south Indian districts. Results of spatial error model identified women’s years of schooling, marital status, social group, and household wealth were major determinants of the exclusive use of hygienic materials among urban women across Indian districts. Conclusion. Substantial spatial heterogeneity in the outcome among urban women in India suggests the need to design targeted and context-specific behavioural interventions and programs for women in urban India. Copyright 2023 Singh et al.PublicationArticle Short birth interval and associated factors in rural India: A cross-sectional study(Cambridge University Press, 2023) Sourav Chowdhury; Aditya Singh; Nuruzzaman Kasemi; Mahashweta Chakrabarty; Shivani SinghShort Birth Interval (SBI) is one of the main causes of adverse maternal and child health outcomes. A 33-month birth-to-birth interval between two successive live births should be followed to minimize the risk of adverse maternal and child health. This study aimed to examine the prevalence of SBI and the associated factors in rural India. Information on 98,522 rural mothers from the fourth round of National Family Health Survey data was analyzed. Bivariate statistics, logistic regression, Moran’s I, and Cluster and Outlier Analysis have been used to assess the prevalence and spatial pattern of SBI in rural India. Results revealed that about half of the mothers in rural India had experienced SBI. Rural Indian mothers whose child was not alive (OR = 1.76, 95% CI = 1.63–1.90), were not using any contraceptive methods (OR = 1.42, 95 % CI = 1.37–1.48) and not breastfeeding (OR = 2.73, 95% CI = 2.50–2.97) were more likely to experience SBI. On the other hand, rural mothers from the middle, richer and richest wealth quintiles (OR = 0.91, 95% CI = 0.86–0.97; OR = 0.84, 95% CI = 0.80–0.92; OR = 0.60, 95% CI = 0.55–0.66) and of age over 30 years (OR = 0.38., 95% CI = 0.36–0.39) were less likely to experience SBI. Analysis of spatial patterns revealed clear east-west differences in the prevalence of SBI. There was strong clustering of high values of SBI in most districts across the central, northern, western, and southern regions. The study suggests the need to introduce appropriate interventions and programs focused on reducing the prevalence of SBI in rural India. © The Author(s), 2022.