Current status of fertility control methods in India

Approximately 48.2% of couples of 15 to 49 years of age practice family planning methods in India. Female sterilization accounts for 34.2%, with male sterilization declining from 3·4% in 1992–93 to 1·9% in 1998–99. Use of the condom increased to 3·1% from 2·4%. There is an urgent need for research to develop new contraceptive modalities especially for men and also for women and to make existing methods more safe, affordable and acceptable. Current efforts in India to develop a male contraceptive are mainly directed towards (i) development of antispermatogenic agents to suppress sperm production, (ii) prevention of sperm maturation, (iii) prevention of sperm transport through vas deferens or rendering these sperm infertile and (iv) prevention of sperm deposition. Research work in the field of prevention of sperm transport through vas deferens has made significant advances. Styrene maleic anhydride (SMA) disturbed the electrical charge of spermatozoa leading to acrosome rupture and consequent loss in fertilizing ability of sperm. A multicentre phase-III clinical trial using SMA is continuing and it is hoped that the SMA approach would be available in the near future as an indigenously developed injectable intra-vasal male contraceptive. The safety and efficacy of available oral contraceptives were evaluated. An indigenously developed oral contraceptive ‘Centchorman’, which is a nonsteroidal, weakly estrogenic but potently antiestrogenic, was found to be safe and effective and is now being marketed in India since 1991 as a ‘once a week’ pill. Cyclofem and Mesigyna have been recommended as injectable contraceptives with proper counselling and service delivery by Indian studies. It has been recommended that these injectable contraceptives be added to the existing range of contraceptive methods available in the National Family Planning Programme. Based on the Indian studies CuT 200 was also recommended. Studies have indicated the advantage of intrauterine devices (IUD); they are long acting, relatively easily removed and fertility returns rapidly after their removal. Recent studies have recommended CuT 200 for use up to 5 years. The combination of some plant products i.e.Embelia ribes, Borax andPiper longum has been found to be safe and effective as a female contraceptive and the results of phase-I clinical trials are encouraging. Research work is going on in the country in various areas with special reference to hormonal contraceptive — a three monthly injectable contraceptive, immuno-contraceptives, antiprogestins, etc.     

Child mortality, social status, and fertility in India

The incidence of child mortality in relation to the social status and fertility of Indian women was investigated on the assumptions that: 1) the higher the social status, the lower the child mortality rate; and 2) the lower the child mortality rate, the lower the family size. 311 married women in Chandigarh were grouped into 4 status categories: (1) higher educated working women (95); (2) higher educated nonworking women (75); (3) less educated nonworking women (75); and (4) less educated working women (66). The 311 women gave birth to a total of 1075 children (960 living and 115 who had died, mostly between the ages 0-5 years). Percentage of children living (89%) was different for each status category: 93% for category 1; 92% for category 2; 91% for category 3; and 81% for category 4. When analyzed by proportion of women who had lost children in each status category, the relationship between child mortality and social status confirmed the assumption that the higher the social status, the lower the mortality. In category 1, 87% had not experienced any child mortality in their family; in category 2, the figure was 77%; category 3, 72%; and category 4, 48%. The findings also confirmed the other assumption that the lower the mortality rate, the lower the fertility (Table 2).     

The effect of women's status and community on the gender differential in children's nutrition in India

This study uses the third National Family Health Survey (2005-06) in India to investigate whether differences in women's status, both at the individual and community levels, can explain the persistent gender differential in nutritional allocation among children. The results show that girls are less likely than boys to receive supplemental food and more likely to be malnourished. In general it appears that higher women's status within a community, as well as higher maternal status, have beneficial effects on a daughter's nutritional status. Further, the moderating effects of community appear to be more consistent and stronger than the individual-level characteristics. A positive relationship between the percentage of literate women in a community and the gender differential in malnutrition appears to be an exception to the general findings regarding the beneficial nature of women's status on a daughter's well-being, showing the need for more than just basic adult literacy drives in communities to overcome the problem of daughter neglect.     

Socioeconomic status and fertility in rural Bangladesh

Using a unique set of birth registration data from the Demographic Surveillance System of the International Center for Diarrheal Disease Research, Bangladesh, for the period 1974-77, and socioeconomic information collected in the 1974 census, fertility was studied in relation to occupation, size of dwelling, number of cows and number of boats owned. The total fertility rate was found to vary between 6 and 6.5 except in the famine year of 1975. There was no consistent relationship between fertility and education of women. The age-specific fertility rates by religion show that Muslims had higher fertility at all ages in 1974 and 1977 and at older ages in 1975 and 1976. Overall, however, fertility of Hindus is consistently lower than that of Muslims, but the relative differences are under 10%. Fertility differentials by occupation showed that the household heads who were farm laborers had relatively lower fertility compared to other occupational groups, except for the year 1977 where the families of service holders were found to have relatively lower fertility. Women in households whose heads were businessmen or farmers (owning their land) had above average fertility. In 1974, households in the business occupational groups had, on average, 1 birth more than other households. Women in households with fishermen as heads had below average fertility in 1974 and 1975, but very high fertility in 1976 and 1977. Fertility levels differed according to the type of household in which the family resided. Nuclear families had below average fertility up to the age of 35 and above average fertility at the end of the reproductive age. In the 15-19 age group, augmented families had higher fertility each year examined. The association between dwelling place and fertility is positive each year, the relative differences in fertility between the groups being largest in 1974. Positive relations were found between economic status and fertility.     

Educational status,coronary heart disease,and coronary risk factor prevalence in a rural population of India.

OBJECTIVE--To define the association between educational level and prevalence of coronary heart disease and coronary risk factors in India. DESIGN--Total community cross sectional survey with a doctor administered questionnaire, physical examination, and electrocardiography. SETTING--A cluster of three villages in rural Rajasthan, western India. SUBJECTS--3148 residents aged over 20 (1982 men, 1166 women) divided into various groups according to years of formal schooling. RESULTS--Illiteracy and low educational levels were associated with less prestigious occupations (agricultural and farm labouring) and inferior housing. There was an inverse correlation of educational level with age (rank correlation: mean -0.45, women -0.49). The prevalence of coronary heart disease (diagnosed by electrocardiography) was significantly higher among uneducated and less educated people and showed an inverse relation with education in both sexes. Among uneducated and less educated people there was a higher prevalence of the coronary risk factors smoking and hypertension. Educational level showed a significant inverse correlation with systolic and diastolic blood pressure. Logistic regression analysis with adjustment for age showed that educational level had an inverse relation with prevalence of electrocardiographically diagnosed coronary heart disease (odds ratio: men 0.82, women 0.53), hypertension (men 0.88, women 0.56), and smoking (men 0.73, women 0.65) but not with hypercholesterolaemia and obesity. The inverse relation of coronary heart disease with educational level abated after adjustment for smoking, physical activity, body mass index, and blood pressure (odds ratio: men 0.98, women 0.78). CONCLUSION--Uneducated and less educated people in rural India have a higher prevalence of coronary heart disease and of the coronary risk factors smoking and hypertension.     

Mortality burden and socioeconomic status in India

Background

The dimensions along which mortality is patterned in India remains unclear. We examined the specific contribution of social castes, household income, assets, and monthly per capita consumption to mortality differentials in India.

Methods and Findings

Cross-sectional data on 217 363 individuals from 41 554 households from the 2004–2005 India Human Development Survey was analyzed using multiple logistic regressions. Mortality differentials across social castes were attenuated after adjusting for household economic factors such as income and assets. Individuals living in the lowest income and assets quintiles had an increased risk of mortality with odds ratio (OR) of 1.66 (95% CI  = 1.23–2.24) in the bottom income quintile and OR of 2.94 (95% CI  = 1.66–5.22) in the bottom asset quintile. Counter-intuitively, individuals living in households with lowest monthly consumption per capita had significantly lower probability of death (OR  = 0.27, 95% CI  = 0.20–0.38).

Conclusions

Mortality burden in India is largely patterned on economic dimensions as opposed to caste dimensions, though caste may play an important role in predicting economic opportunities.     

Teenage fertility, socioeconomic status and infant mortality

This paper examines the relationship between infant mortality and a complex measure of socioeconomic status for evidence of diminution. In data on counties in the US with a minimum of 20 infant deaths over the 5-year period 1971-75, no evidence of a declining relationship between socioeconomic status and infant mortality was found. Both level of community affluence and racial composition of the population exerted direct effects on levels of infant deaths. In addition, both socioeconomic status and racial composition exhibited indirect effects which operated through teenage childbearing. When total infant mortality was subdivided, teenage fertility serves as a mediating variable in the link between socioeconomic status and neonatal mortality, but not for the postneonatal components. Given the nearly equivalent total effect of socioeconomic status on infant mortality, it is concluded that the classic division into neonatal (supposedly a function of biological and genetic agents) and postneonatal (traditionally attributed to social and environmental agents), may be too crude to allow the contemporary effects of the socioenvironmental milieu to be evaluated effectively.     

Current status of Potyvirus in India

Potyvirus particles are flexuous rods of 700–900?nm in length and contain one positive sense single-stranded genomic RNA molecule of approximately 10?kb, which is encapsidated by a single type of coat protein. According to available NCBI database, Potyvirus infection is prominently present in Solanaceae, Leguminosae and Cucurbitaceae families in India. Potyviruses can induce a wide range of different symptoms in infected host plants including mosaic, stripe, mottling, vein clearing, vein banding, ringspots, necrotic or chlorotic lesions, flower breaking, stunting, wilting, and most commonly lead tostunting and yield losses. PCR-based methods for the detection and identification of potyviruses rely on degenerate primers designed for conserved regions. Potyvirus infection requires the interaction of host factors with viral proteins and RNA for its replication and systemic spread, i.e interaction between VPg and eIF4E is required for Potyvirus genome translation. Mutations in host translational initiation factor eIF4E cause the conformational shift in encoded proteins which are unable to bind with viral protein (VPg), resulting in broad-spectrum Potyvirus resistance.     

Micronutrient status and fertilizer use scenario in India

India was dependent on external food supplies in the early 1960s. To meet the growing demand for food, fiber and fuel, high yielding cultivars were introduced. These high yielding crop cultivars were highly responsive to fertilizers. Thus, slowly the soils were exhausted of their nutrients. Application of major nutrients (nitrogen, phosphorus, potassium) became common, therefore the crops started responding to micronutrient fertilizers. Concerted efforts have been made through the All India Coordinated Research Project on Micronutrients to delineate the soils of India regarding the deficiency of micronutrients. At present about 48.1% of Indian soils are deficient in diethylenetriaminepentaacetate (DTPA) extractable zinc, 11.2% in iron, 7% in copper and 5.1% in manganese. Apart from the deficiency of these micronutrients, deficiencies of boron and molybdenum have also been reported in some areas. Areas with multi-micronutrient deficiencies are limited, thus simple fertilizers are sufficient to exploit the potential of crops and cropping systems. Based on the extent of deficiency, cultivated area, and crop removal, the micronutrient fertilizer demand in 2025 is projected using sufficiency and maintenance approaches.     

Micronutrient status and fertilizer use scenario in India

India was dependent on external food supplies in the early 1960s. To meet the growing demand for food, fiber and fuel, high yielding cultivars were introduced. These high yielding crop cultivars were highly responsive to fertilizers. Thus, slowly the soils were exhausted of their nutrients. Application of major nutrients (nitrogen, phosphorus, potassium) became common, therefore the crops started responding to micronutrient fertilizers. Concerted efforts have been made through the All India Coordinated Research Project on Micronutrients to delineate the soils of India regarding the deficiency of micronutrients. At present about 48.1% of Indian soils are deficient in diethylenetriaminepentaacetate (DTPA) extractable zinc, 11.2% in iron, 7% in copper and 5.1% in manganese. Apart from the deficiency of these micronutrients, deficiencies of boron and molybdenum have also been reported in some areas. Areas with multi-micronutrient deficiencies are limited, thus simple fertilizers are sufficient to exploit the potential of crops and cropping systems. Based on the extent of deficiency, cultivated area, and crop removal, the micronutrient fertilizer demand in 2025 is projected using sufficiency and maintenance approaches.     

Population genetics study of the differential fertility in urban populations

In an urban population with widespread birth control practice the distribution of the number of pregnancies, births and abortions was studied in a cohort of women of completed fertility. The mean number of pregnancies per woman was 4.03 +/- 0.08 (sigma = = 2.98); the mean number of births - 1.12 +/- 0.02 (sigma = 0.77). 7.4% of women which had completed their reproductive performance had no pregnancies and 19.5% - no births. The Crow's Index of the Opportunity for Selection and its components connected with differential fertility and differential mortality were estimated. In the population under study two components of selection - selection at the prenatal stages and selection associated with infertility - are shown to be still significant. Such type of selection is exemplified by investigation of couples suffering from repeated spontaneous abortions.     

Fat and fertility: Demographic implications of differential fat storage

Anthropologists interested in human nutrition have become intrigued by the possibility of a link between nutritional status, fat stores, and fertility. Frisch (1978) and Frisch and McArthur (1974) have hypothesized such a link, based on studies of body composition at menarche and menstrual dysfunction in anorectics. This review indicates that both over- and undernutrition may interfere with reproductive function, but probably do so only when extreme. Evidence for fat as a regulator of fecundity is conflicting, and is best documented for age at puberty. Effects of fat on birth interval (a demographically more significant parameter) are confounded by the influence of lactation. A review of hormonal and metabolic patterns in obesity and inanation indicate similarities between these conditions and general or psychological stress. It is suggested that fat is better seen as an indicator of systemic function than as a single independent factor. The adaptive value of fat for human populations may lie in its ability to enhance work performance as much as in its influence on fecundity.