Priyanka Kumari

Globally, around 85 million women experience an unintended pregnancy each year, and India accounts for nearly one in every seven of these cases, making it a significant contributor to the global bu...

Intimate partner violence (IPV) can negatively impact the use of child health services, in addition to causing direct harm and even death to women. IPV is defined as physical, sexual, or emotional abuse and controlling behaviors by a current or former partner or spouse. Evidence points to a connection between the children of violent intimate partners and the children’s vaccination status. This study aims to investigate the relationship between women’s exposure to intimate partner violence (IPV) and childhood immunization in India. The National Family Health Survey (NFHS-5) 2019–21 is used, and information from 5106 mothers of children selected from the violence module is utilized in this study. Bivariate and multivariate multilevel logistic regression models were used to examine the associations between women’s exposure to IPV and the full immunization of children. To assess any moderating effect of the education of the woman, the sex of the child, and the birth order on the association between exposure to spousal IPV and full immunization, interactions were checked. The crude analysis revealed that children of mothers who experienced sexual violence (COR: 0.75; 95% CI 0.61–0.83), emotional violence (COR: 0.91, 95% CI 0.81–0.99) and any forms of violence (COR: 0.83, 95% CI 0.70–0.95) were less likely to be fully immunized than no abused women were. Moderation analysis revealed that sexual, emotional, and any form of IPV are also moderated by a secondary level of education. A significant association between any form of IPV and full immunization was found for children in second or third birth order (AOR = 0.66, 95% CI 0.52–0.84; p = 0.001). Intimate partner violence (IPV) severely impacts maternal and child health, influencing decision-making and access to healthcare services. This leads to poorer health outcomes, including lower immunization rates for children. Addressing IPV through targeted interventions is crucial for improving maternal and child well-being. Increased efforts are needed to reduce IPV prevalence and raise awareness about the importance of reproductive and child health initiatives.

Background: There is limited evidence of hysterectomy in India because of a lack of data in large-scale, nationally representative health surveys. In 2015–16, the fourth National Family Health Survey (NFHS-4)—a cross-sectional survey—collected for the first-time direct information on hysterectomy and self-reported reasons for undergoing the procedure among women in the reproductive age group. The current study evaluates the prevalence, determinants, and choice of hospitalization (Public vs. Private) for conducting hysterectomy in India among women aged 15–49 years in 29 states and seven union territories (UTs) based on the new large-scale population-based nationally representative dataset (NFHS 5).Methods: Cross-tabulations and percentage distributions were utilized to analyse the prevalence of hysterectomy and the choice of hospitalization (public vs. private) across different socioeconomic backgrounds and reasons for undergoing hysterectomy. A multivariate binary logistic regression model was also used to find statistically significant determinants of hysterectomy.Results: In India as a whole, 3.3% of women aged 15–49 years had undergone a hysterectomy. The percentage of women who had undergone the procedure was found to vary considerably across the states and the UTs. The southern region stands out for the considerably higher prevalence of hysterectomy; particularly in the states of Andhra Pradesh (8.7%) and Telangana (8.2%), the prevalence was very high followed by Bihar (6%) and Gujrat (4%). On the other hand, the North-eastern region had the lowest prevalence of hysterectomy (1.2%). A noticeable fact that emerged was that the majority of the hysterectomies were performed in the private sector (69.6%) in India. But the scenario was quite different in north-eastern region as in this region more hysterectomies were performed in public health facilities (73%) rather than private health facilities (26.7%). Age, place of residence, religion, caste, level of education, geographic region, wealth quintiles, parity, age at first cohabitation of women were found to be the socio-demographic determinants statistically associated with hysterectomy in India. The likelihood of hysterectomy was higher among women living in rural areas (AOR: 1.3, CI: 1.23–1.35), in the richest wealth quintile (AOR 2.6; CI 2.37–2.76) and in the southern region (AOR 1.6; CI 1.47–1.66). The reasons frequently reported for hysterectomy were excessive menstrual bleeding/pain, followed by fibroids/cysts.Conclusion: This study has attempted to analyse hysterectomy prevalence and its socio-economic determinants using the latest fifth round of NFHS data of all the states and covering 21 states and union territories of India, which gives wider coverage of hysterectomy and more recent with accurate data. More research is needed therefore to unravel the complex dynamics of hysterectomy in India (and elsewhere) which could be used to help women make more informed choices and in turn advance their reproductive health and rights.