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Internally displaced women are underserved by health schemes and policies, even as they may face greater risk of violence and unplanned pregnancies, among other burdens. There are an estimated 450,000 internally displaced persons in India, but they are not formally recognised as a group. Displacement has been a common feature in India's northeast region. This paper examines reproductive and maternal health (RMH) care-seeking among Bru displaced women in India. The study employed qualitative methodology: four focus group discussions (FGDs) were held with 49 displaced Bru women aged 18–45 between June and July 2018; three follow-up interviews with FGD participants and five in-depth interviews with community health workers (Accredited Social Health Activists – ASHAs) in camps for Bru displaced people in the Indian state of Tripura. All interviewees gave written or verbal informed consent; discussions were conducted in the local dialect, recorded, and transcribed. Data were indexed deductively from a dataset coded using grounded approaches. Most women were unaware of many of the RMH services provided by health facilities; very few accessed such care. ASHAs had helped increase institutional deliveries over the years. Women were aware of temporary contraceptive methods as well as medical abortion, but lacked awareness of the full range of contraceptive options. Challenges in accessing RMH services included distance of facilities from camps, and multiple costs (for transport, medicines, and informal payments to facility staff). The study highlighted a need for comprehensive intervention to improve RMH knowledge, attitudes, and practices among displaced women and to reduce access barriers. [ABSTRACT FROM AUTHOR]

There is limited research in India to understand young people's decision-making processes about intimate relationships before marriage. This paper, adopting a life course perspective, explains relationship choices and diachronic trajectories of relationships from adolescence to young adulthood. Retrospective data were collected from 1240 never married 20–29-year-old men and women living in Pune using a relationships history calendar. All the relationships from 10 years of age onwards were plotted on the calendar, and information on predictor variables was collected through structured questionnaires. Data were analysed using descriptive statistics. Sequence analysis approach was used to identify different typologies. Overall, 76% of the participants reported having at least one relationship. More women compared to men (84% vs 70%) ever had a relationship. The median age of starting the first relationship was 17 years for women and 18 for men. Different relationship types were reported, such as "serious", casual, "friends with benefit", and "exploring". The level of emotional involvement, commitment, and physical intimacy significantly differed in different relationship types with significant gender differences. Four typologies of relationships were observed, labelled as (1) Commitment–No sex (N = 187); (2) Commitment–Sex-Some exploration (N = 189); (3) No commitment–Exploration (N = 281), and (4) No relationship (N = 583). Compared to men, women were more likely to follow the trajectory of "Commitment-No sex" (RR 2.13, CI 1.5–3.03). Family environment was significantly related to young people's relationship choices. The findings strongly suggest the need to adopt a developmental perspective towards intimate relationships to understand and address the vulnerabilities of young people across the life course. [ABSTRACT FROM AUTHOR]

The unmet need for contraception is documented as a significant determinant of unintended pregnancies and high number of induced abortions. The period immediately after an abortion is recognised as a unique opportunity to offer contraceptive services. This paper explores the association between place of abortion and women's post-abortion contraceptive behaviour. The reproductive calendar data from the National Family Health Survey (NFHS-4) (2015–16) was used for this study. Multinomial logistic regression models were used to understand factors associated with post-abortion method choices. Single decrement life-tables were built to examine rates of contraceptive discontinuation and proportional hazard models were employed to examine probability and correlates of method discontinuation. About 20% of women who underwent an abortion adopted a contraceptive method by the end of one month following an abortion. The decision to choose methods like sterilisation or intrauterine contraceptive devices (IUCDs) was associated with the place of abortion, past contraceptive behaviour, number and sex of surviving children at the time of abortion, mass media exposure, and time of the abortion. Compared to women who underwent an abortion at private health facilities, women who sought abortion at public health facilities were more likely to choose permanent methods or IUCDs. Furthermore, women who opted for an IUCD were less likely to discontinue the method compared to those using short-acting modern methods. The lack of post-abortion contraceptive choices for women is evident in the low uptake of post-abortion contraceptives in private facilities and the predominant promotion of permanent methods and IUCDs in public health facilities. [ABSTRACT FROM AUTHOR]