Spatial inequalities in skilled birth attendance in India: a spatial-regional model approach

Background Despite a significant increase in the skilled birth assisted (SBA) deliveries in India, there are huge gaps in availing maternity care services across social gradients - particularly across states and regions. Therefore, this study applies the spatial-regression model to examine the spatial distribution of SBA across districts of India. Furthermore, the study tries to understand the spatially associated population characteristics that influence the low coverage of SBA across districts of India and its regions. Methods The study used national representative cross-sectional survey data obtained from the fourth round of National Family Health Survey, conducted in 2015-16. The effective sample size was 259,469 for the analysis. Moran’s I statistics and bivariate Local Indicator for Spatial Association maps were used to understand spatial dependence and clustering of deliveries conducted by SBA coverage in districts of India. Ordinary least square, spatial lag and spatial error models were used to examine the correlates of deliveries conducted by SBA. Results Moran’s I value for SBA among women was 0.54, which represents a high spatial auto-correlation of deliveries conducted by SBA over 640 districts of India. There were 145 hotspots for deliveries conducted by SBA among women in India, which includes almost the entire southern part of India. The spatial error model revealed that with a 10% increase in exposure to mass media in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Interestingly, also with the 10% increase in the four or more antenatal care (ANC) in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Again, if there was a 10% increase of women with first birth order in a particular district, then the deliveries conducted by SBA significantly increased by 6.1%. If the district experienced an increase of 10% household as female-headed, then the deliveries conducted by SBA significantly increased by 1.4%. Conclusion The present study highlights the important role of ANC visits, mass media exposure, education, female household headship that augment the use of an SBA for delivery. Attention should be given in promoting regular ANC visits and strengthening women’s education.

Association of family structure with gain and loss of household headship among older adults in India: Analysis of panel data

Background Despite huge changes in demographic behaviors, the family continues to be the major source of psychosocial support for older adults in India. The loss of household headship can be a cause of disregard for the aged and is associated in a very fundamental way with other status losses. Our study used the two rounds of the India Human Development Survey to understand the association of family structure on the gain or loss status of household headship among 10,527 older adults. Method Bivariate analysis was done using the chi-square test for association. Equivalently, the multivariate analysis involved estimating multivariable logistic regression models. Multicollinearity did not affect the estimates from the regression models. For examining headship transition, we performed two complete sets of analysis, by taking gain in headship and loss in headship as the outcome variable respectively. Results Across two rounds, a major shift in family structure was noticed as 6.8% of households moved from extended to a single generation. Results indicate that family structure was significantly associated with gaining and losing headship among older adults. Headship loss was more common among nuclear [OR: 2.16; CI: 1.28, 3.65] and extended [OR: 2.76; CI: 1.64, 4.66] family structures. Moreover, gaining headship was found to be significantly associated with married, educated, and working older adults. Conclusion Since living in single generation household may preferably be encouraged among older adults than their living in a complex household without headship and value they deserve, the public intervention may support the independent living within the older population through housing policies that create additional choices presented to older adults making residential decisions.

Distinguishing between household headship with and without power and its association with subjective well-being among older adults: an analytical cross-sectional study in India

Background The status of household headship accorded to the older members of the family is often symbolic and seldom vested with some control over resources. The increased dependency and diminished ability to contribute to household economy are major factors that lead to a decline in the respect accorded to older people and their status in the family. The present study aimed to understand the distinction between the functional and nominal household headship status of older adults based on their decision-making power and examine how it is associated with their subjective well-being. Method The present research used data from the 'Building a Knowledge Base on Population Aging in India' (BKPAI) which is nationally representative. The survey was conducted in 2011, across seven states of India. Descriptive statistics along with percentage distribution were calculated for subjective well-being over explanatory variables. For finding the association between subjective well-being over explanatory variables, binary logistic regression model was used. Results The mean age of the study population was 68 years [CI: 67.8–68.2]. About 5 % of older adults had nominal while 95% had functional headship status. The prevalence of low subjective well-being (LSWB) was significantly higher among older adults with nominal headship status (58%) than functional headship status (23%). After controlling for several other variables, older adults with nominal headship status were 59% significantly more likely to have low subjective well-being than individuals with functional headship status (OR = 1.59; 95% CI: 1.10, 2.31). Further, older adults with psychological distress, chronic morbidity, poor self-reported health, no community involvement and no one to trust on were at higher risk of LSWB than their counterparts. Conclusions Findings suggest that older adults who do not have a household headship with power with active participation in household decision-making as well as those who have no involvement in social activities or have poor health conditions need to be given more attention. Thus, to keep a large proportion of older population gainfully engaged, their care and support should be ensured via providing appropriate services that would enhance their roles and responsibilities and overall wellbeing.

The Transcending Age: A Study of Psycho-social Wellbeing of Elderly Women in India

India is witnessing rapid growth of elderly population. The population aged 60 years or older is projected to climb from 9% in 2015 to 19% in 2050 and to 32% in 2100 (UN, 2017). Aging population requires attention on their physical, social and emotional well-being. Wellbeing encompasses multiple interactive components which are beyond the conventional issues of health and diseases. There is multitude of social relationships and dynamics of social roles that women in this age negotiate in their lives. Family dynamics, compatibility with partner, household headship, decision making and level of autonomy, incidences of domestic violence, security concerns, care-giving, perceptions of self, societal status do influence quality of life and wellbeing. Using primary survey data of 165 women aged 60 to 65 years residing in urban areas in Delhi-National Capital Region (NCR) interviewed during first quarter of 2018, the paper attempts to understand what does well-being mean to them, how do they ensure it, what are the psycho-social barriers and how do they overcome them. Purposive sampling and snowballing techniques has been employed to identify these women. Increase in health related problems especially mobility issues, lifestyle diseases along with depression were predominant in this age. For women in post 60 years of age, respect and appreciation from family and society is vital to ensure their happiness, while family bonding and overall contentment stands out for ensuring wellbeing. Religious pursuits and social interaction are the fundamental coping mechanisms from stress. Inadequate and incomplete education and early marriage rooted in patriarchy and financial dependence are the principal sources of regret in lives of these women. Widowed women were identified as the most vulnerable. Women in the lowest income group and literacy level were further marginalized and needed help from state. Evident gaps were reported in the existing welfare government schemes for this age.

Examining the willingness to produce organic vegetables in the Bono and Ahafo regions of Ghana

PurposeThe purpose of this paper was to analyse the demographic, crop choice, institutional and environmental factors that will influence the vegetable growers in Bono and Ahafo regions of Ghana to produce organic vegetables. The study also assessed the knowledge level of vegetable growers on organic certification processes.Design/methodology/approachPrimary data were collected with the help of a structured questionnaire from 120 vegetable growers via a multistage sampling technique. The Heckman selection model was used to analyse the factors that influence farmers' willingness to adopt organic production as well as the intensity of adoption.FindingsIn this study, pepper (Capsicum spp) production, residential status, knowledge of organic certification processes, perceived negative environmental effect of conventional farming on the soil, and climate change positively influenced willingness to produce organic vegetables. Likewise, pepper production perceived negative environmental effect of conventional farming on the soil positively influenced the intensity of adoption. Household headship status, garden egg (Solanum integrifolium) production, perceived knowledge on grading and standards of vegetables, as well as the perception that only pesticides can be used to control vegetable pests negatively influenced the willingness to produce organic vegetables however perceived expertise of the farmer on grades and standards influenced intensity of adoption negatively.Originality/valueIn Ghana, even though most vegetable farmers do not have the requisite knowledge in the safe handling of pesticides, usage is widespread. Subsequent to this, is a health risk to farmers, consumers and the environment. As a result, there is a growing awareness that organic agriculture has a role to play in addressing problems associated with agrochemical use and over usage. However, most studies are consumer oriented with limited empirical research on the willingness to produce organics by farmers.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/IJSE-12-2019-0723

Farmers’ Exposure to Climate Hazards and Reforestation in Selected African Villages: An Endogenous-Switching Regression Model

Background: Deforestation remains a serious concern for Africa’s economic development and global climatic stability. Emphases are now placed on promoting some essential adaptive and mitigation strategies among smallholder farmers. This paper analyzed the effect of exposure to climate-related hazards on tree planting among smallholder farmers in nine selected African countries. The data were from baseline surveys which were conducted by the CGIAR’s research programme on Climate Change, Agriculture and Food Security (CCAFS). The included countries were Burkina Faso, Ethiopia, Ghana, Kenya, Mali, Niger, Senegal, Tanzania and Uganda. Data were analyzed with Endogenous Switching regression considering the endogeneity potentials of climate-hazard exposure. Results: The results showed that Uganda and Ethiopia had the highest average numbers of tree planting with 1.082 and 1.000 respectively, while Senegal (89.86%), Kenya (87.77%), Burkina Faso (82.86%) and Ethiopia (82.86%) had the highest exposure to climate-related hazards. Endogenous Switching regression results showed that climate hazard exposure was truly endogenous going by statistical significance of the Wald Chi Square test (p<0.05) and it was significantly influenced by female household headship, perception of more droughts, floods and low ground water. The number of tree that were planted increased significantly (p<0.05) with climate hazard exposure, degraded land areas, asset indices and residence in East Africa, while it reduced with female household headship. In addition, Average Treatment Effect (ATE) result indicated that an average household will plant 0.745 trees more when it had been previously exposed to climate shocks while Average Treatment Effect on the Treated (ATET) revealed that an average household that was exposed to climate hazards would plant 0.54 more trees than it would if it had not been exposed to hazards. Conclusion: The major implication of the findings is that without having previously experienced some climatic adversities, farmers may not see the need to engage in tree planting as a mitigating strategy. It was concluded that many farmers had been affected by climate-related shocks and efforts to safeguard future climate through tree planting should be gender sensitive and concentrated among previously affected farmers.