AbstractIn many cultural settings worldwide, within families, men tend to be responsible for important choices relating to the allocation of household resources and care-seeking behaviour that directly impact on the health of women and newborns. This study examines the extent of male participation in antenatal care (ANC), delivery, postnatal care (PNC), household chores and providing food to wives among tribal communities in India. In addition, health care providers' views on male participation in maternal health were examined. Primary data were collected from 385 men aged 15–49 from rural Gadchiroli District in Maharashtra, India. Interviews of 385 men whose wives had delivered a child within the previous 2 years were conducted between November 2014 and March 2015. Bivariate and multivariate analyses were done. The results showed that the tribal men's participation in maternal health care was minimal. Around 22% of the men reported accompanying their wives to ANC, 25% were present at the time of delivery of their children and 25% accompanied their wives to PNC. Participation in household work, and support for wives in other ways, were slightly better. The main reason given by men for not participating in maternal health care was that they didn't think it was necessary, believing that all maternal health issues were women's concern. Health care providers among these tribal communities in India should encourage men to participate in issues related to maternal health care.
AbstractSpousal violence against women is a serious public health problem that is prevalent in all societies, with one in three women around the world experiencing violence in their lifetime. This study examined the prevalence of spousal violence, and its determinants, in Afghanistan using data from the 2015 Afghanistan Demographic and Health Survey. Univariate, bivariate and logistic regression statistical techniques were used to assess the association of socioeconomic variables with spousal violence. The study sample comprised 20,827 currently married women aged 15–49. Fifty-two per cent of women reported experiencing some form of violence by their husband. A significant association was found between women's justification of violence, women's participation in decision-making in their household (COR=0.476; CI=0.446–0.509) and lower risk of experiencing spousal violence. After adjustment for demographic and socioeconomic factors, women's participation in all of four household decisions, either alone or jointly, was found to be associated with a lower risk of experiencing spousal violence (AOR=0.472; CI=0.431–0.516). In both the crude and adjusted models, the risk of experiencing spousal violence was high if the husband's desire for children was different from that of his wife. In the case of inequality in property ownership, the risk of spousal violence was significantly higher (COR=1.263; CI=1.178–1.353; AOR=1.159; CI=1.051–1.278) when women were joint owners of property compared with when they did not own any property. The findings point to an immediate need for legal and social interventions to prevent spousal violence against women, or at least reduce its prevalence, in Afghanistan.
Since time unmemorable, the caste system has been prevalent in Indian society. It has deeply developed roots in human minds, which leads to income inequality in the country. In the era of globalization and privatization, inequalities have extended to a large extent, which in turn has serious consequences for women and children's health. In this article, an attempt has been made to understand the Caste, Income and Regional inequalities as determinants of health of women and children. For this study, the data are derived from the National Family Health Survey III conducted during 2005–2006. Bivariate and regression analysis has been done to understand the likelihood of health status of women and child in different categories. The results show that the scheduled tribes and schedule castes having poor wealth quintile and northern Indian women and children are at a greater disadvantage in all indicators of women and child health as compared to other groups.
Development cannot be achieved without the participation of people from all segments of society. It is a process that requires collective action for social transformation or social change in the socio-economic and political lives of the people. The Total Sanitation Campaign (TSC) is one of the major programmes in India to promote sanitation and hygiene. The article is an attempt made to understanding the Dalit population's participation in the total sanitation programme. The field visits in six villages reveal that illiterate 20 per cent respondents did not participate in the decision-making process. Gram panchayat has not given equal opportunity for participation to Dalit women in the planning process of the campaign activities. Educated people are more likely to get the opportunity for participation in planning and implementation of the scheme. Villages, even gram panchayats, have not conducted any awareness campaign to disseminate the information of the Campaign among Dalit and rural masses.
Background India has progressed in reducing maternal mortality in the last decade, indicating the impact of several health programs launched by the government. However, recent evidence indicates that the quality of care and healthcare providers' behavior during delivery in health facilities is suboptimal in government health facilities. The current study aims to examine the prevalence of various mistreatment and disrespect practices during childbirth in health facilities, and further study explores the women's experiences with a qualitative approach. Methods The study used a community-based cross-sectional design with a mixed-method approach. Both quantitative and qualitative data have been collected from the recently delivered mothers. Using a simple random sampling method recruited 260 recently delivered women from low-income communities in Pune city India. The qualitative data from 15 in-depth interviews were conducted with women who reported experiences of disrespect and mistreatment during childbirth. Results The quantitative result shows that 16.5% of respondents reported physical abuse, 11.9%. Abandonment of care, 35.9% non-consented care, more than half 67% reported condemned care, and 69% reported non-dignified care. Qualitative results also confirm the inhumane practices of healthcare providers during childbirth. Conclusions The study reveals that the non-dignified and disrespectful behaviour with physical abuse by the healthcare workers contributes to women's higher mental and emotional instability, affecting the mother and child's health.
AbstractAs the proportion of women being victims of spousal violence in India is higher than men, laws are usually framed to safeguard women. However, men who have experienced physical spousal violence are not unheard of. The study aims to provide the nationwide prevalence of physical violence against husbands and the risk factors for such violence, using large-scale nationally representative 'National Family Health Survey' (NFHS 4) data. The study used descriptive, bivariate, logistic, and multilevel regression models with a random intercept clustering within states and households to explain the physical violence against husband. Sample size for the analysis was 62,716 currently married women aged 15–49 years. Findings revealed that in most of the states of India, physical spousal violence has increased over time. Behavioural characteristics like marital control, alcoholism, and childhood experience of parental violence have a consistent and strong role in explaining the experience of physical violence across states. With age, experience of violence against husbands increases. Differences in socio-economic characteristics do not have unidirectional effect on violence experienced by husbands across regions of India. Working women who are earning cash and having access to mobile phones perpetrate more physical violence in selected regions. Education shows a gradient on such violence perpetration, indicating that only after achieving a certain level of education, chances of violence reduce. Regionally contrasting social and economic risk factors in explaining violence strengthen the argument that violence is space and culture-specific, and development alone may not resolve violence unless the system is addressing the behavioural aspects. There is a need for supporting men experiencing domestic violence within the existing system facilities. Revisiting the present domestic violence laws and programmes for inclusivity is the need of the hour.
Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572000 deaths and 15.2 million DALYs), and stomach cancer (542000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601000 deaths and 17.4 million DALYs), TBL cancer (596000 deaths and 12.6 million DALYs), and colorectal cancer (414000 deaths and 8.3 million DALYs). Conclusions and Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.
Importance Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data. Objective To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning. Evidence Review We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence. Findings In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs). Conclusions and Relevance The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer