Search

Background: Health is an inseparable part of life and central to all life supporting systems. The reproductive and child health shares a major portion of public health cases that is crucial for socio-economic development. Studies on reproductive and child health have traditionally been focused on demographic aspects using socio-economic parameters. Given the emphasis of Sustainable Development Goal (SDG)-3 on health and well-being, it is imperative to understand the geo-spatial dimension with the visible transition of key health indicators of fertility, maternal and infant/child health in the high burdened districts within these high focus Empowered Action Group (EAG) states of Rajasthan, Madhya Pradesh, Uttar Pradesh and Bihar that make up nearly 40% of India's population with relatively laggard health status. Methodology: This paper aims to understand the status and trend of key reproductive and child health indicators and vital statistics based on the recent representative demographic surveys. We intend to undertake a district level spatio-temporal analysis by developing District Composite Health Profile (DCHP) using Composite Index Method on selected 13 equally weighted key reproductive and child health indicators. The study has been carried out using data from National Family Health Survey-4 (2015–16) and National Family Health Survey-5 (2019–21) survey rounds. We employed geo-spatial techniques i.e. Moran's–I, and univariate LISA to comprehend the geographical clustering of high and low health burden districts and their heterogeneities at the district level. Results/Conclusions: The study highlights emerging inter-districts, and inter-state disparities over survey periods. With consistent improvement in the selected EAG states over time, the overall reproductive and child health status through DCHP along with each indicator was relatively better in the states of Rajasthan and worse in Bihar. Districts along the Terai belt in Uttar Pradesh and Bihar consistently performed sluggish during survey rounds. The geo-spatial clustering follows the political boundary of states, albeit with intra-state variations. Monitoring of key health indicators using composite index method provides a useful leverage for identifying priority districts/regions for universal health access that should also consider geographical space as an important policy dimension. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]