International Institute for Population Sciences
Mumbai, India

The International Institute for Population science serves as a regional Institute for Training and Research in Population Studies for the ESCAP region. It was established in Mumbai in July 1956, till July 1970 it was known as the Demographic Training and Research Center and till 1985 it was known as the International Institute for Population Studies . The Institute was re-designated to its present title in 1985 to facilitate the expansion of its academic activities and was declared as a 'Deemed University' on August 19, 1985 under Section 3 of the UGC Act, 1956 by the Ministry of Human Resource Development, Government of India. The recognition has facilitated the award of recognized degrees by the Institute itself and paved the way for further expansion of the Institute as an academic institution.Started in 1956 under the joint sponsorship of Sir Dorabji Tata Trust, the Government of India and the United Nations, it has established itself as the premier Institute for training and research in Population Studies for developing countries in the Asia and Pacific region. IIPS holds a unique position among all the regional centers, in that it was the first such center to be started, and serves a much larger population than that served by any of the other regional centers. The Institute is under the administrative control of the Ministry of Health and Family Welfare, Government of India.Besides teaching and research activities, the Institute also provides consultancy to the Government and Non-Government organizations and other academic institutions. Over the years, the Institute has helped in building a nucleus of professionals in the field of population and health in various countries of the ESCAP region. During the past 53 years, students from 42 different countries of Asia and the Pacific region, Africa and North America have been trained at the Institute. Many, who are trained at the Institute, now occupy key positions in the field of Population and Health in Government of various countries, Universities and Research Institutes as well as in reputed National and International organizations. Wikipedia.

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Arokiasamy P.,International Institute for Population Sciences | Pradhan J.,National Institute of Technology Rourkela
Health Policy and Planning | Year: 2011

The concentration index is the most commonly used measure of socio-economic-related health inequality. However, a critical constraint has been that it is just a measure of inequality. Equity is an important goal of health policy but the average level of health also matters. In this paper, we explore evidence of both these crucial dimensions - equity (inequality) and efficiency (average health) - in child health indicators by adopting the recently developed measure of the extended concentration index on the National Family Health Survey (NFHS-3) data from India. An increasing degree of inequality aversion is used to measure health inequalities as well as achievement in the following child health indicators: under-2 child mortality, full immunization coverage, and prevalence of underweight, wasting and stunting among children. State-wise adjusted under-2 child mortality scores reveal an increasing trend with increasing values of inequality aversion, implying that under-2 child deaths have been significantly concentrated among the poor households. The level of adjusted under-2 child mortality scores increases significantly with the increasing value of aversion even in states advanced in the health transition, such as Kerala and Goa. The higher values of adjusted scores for lower values of aversion for child immunization coverage are evidence that richer households benefited most from the rise in full immunization coverage. However, the lack of radical changes in the adjusted scores for underweight among children with increasing degrees of aversion implies that household economic status was not the only determinant of poor nutritional status in India. © The Author 2010; all rights reserved.

Chattopadhyay A.,International Institute for Population Sciences
Journal of Biosocial Science | Year: 2012

Men's supportive stance is an essential component for making women's world better. There are growing debates among policymakers and researchers on the role of males in maternal health programmes, which is a big challenge in India where society is male driven. This study aims to look into the variations and determinants of maternal health care utilization in India and in three demographically and socioeconomically disparate states, namely Uttar Pradesh, West Bengal and Maharashtra, by husband's knowledge, attitude, behaviour towards maternal health care and gender violence, using data from the National Family Health Survey III 2005-06 (equivalent to the Demographic and Health Survey in India). Women's antenatal care visits, institutional delivery and freedom in health care decisions are looked into, by applying descriptive statistics and multivariate models. Men's knowledge about pregnancy-related care and a positive gender attitude enhances maternal health care utilization and women's decision-making about their health care, while their presence during antenatal care visits markedly increases the chances of women's delivery in institutions. From a policy perspective, proper dissemination of knowledge about maternal health care among husbands and making the husband's presence obligatory during antenatal care visits will help primary health care units secure better male involvement in maternal health care. © 2011 Cambridge University Press.

Pathak P.K.,International Institute for Population Sciences | Singh A.,International Institute for Population Sciences | Subramanian S.V.,Human Development and Health
PLoS ONE | Year: 2010

Background: The use of maternal health care is limited in India despite several programmatic efforts for its improvement since the late 1980's. The use of maternal health care is typically patterned on socioeconomic and cultural contours. However, there is no clear perspective about how socioeconomic differences over time have contributed towards the use of maternal health care in India. Methodology/Principal Findings: Using data from three rounds of National Family Health Survey (NFHS) conducted during 1992-2006, we analyse the trends and patterns in utilization of prenatal care (PNC) in first trimester with four or more antenatal care visits and skilled birth attendance (SBA) among poor and nonpoor mothers, disaggregated by area of residence in India and three contrasting provinces, namely, Uttar Pradesh, Maharashtra and Tamil Nadu. In addition, we investigate the relative contribution of public and private health facilities in meeting the demand for SBA, especially among poor mothers. We also examine the role of salient socioeconomic, demographic and cultural factors in influencing aforementioned outcomes. Bivariate analyses, concentration curve and concentration index, logistic regression and multinomial logistic regression models are used to understand the trends, patterns and predictors of the two outcome variables. Results indicate sluggish progress in utilization of PNC and SBA in India and selected provinces during 1992-2006. Enormous inequalities in utilization of PNC and SBA were observed largely to the disadvantage of the poor. Multivariate analysis suggests growing inequalities in utilization of the two outcomes across different economic groups. Conclusions: The use of PNC and SBA remains disproportionately lower among poor mothers in India irrespective of area of residence and province. Despite several governmental efforts to increase access and coverage of delivery services to poor, it is clear that the poor (a) do not use SBA and (b) even if they had SBA, they were more likely to use the private providers. © 2010 Pathak et al.

Tripathi N.,International Institute for Population Sciences | Sekher T.V.,International Institute for Population Sciences
PLoS ONE | Year: 2013

Context:Sex education/family life education (FLE) has been one of the highly controversial issues in Indian society. Due to increasing incidences of HIV/AIDS, RTIs/STIs and teenage pregnancies, there is a rising need to impart sex education. However, introducing sex education at school level always received mixed response from various segments of Indian society.Data and Methods:We attempt to understand the expectations and experiences of youth regarding family life education in India by analysing the data from District Level Household and Facility Survey (DLHS-3: 2007-08) and Youth Study in India (2006-07). We used descriptive methods to analyse the extent of access to FLE and socio demographic patterning among Indian youth.Results and Discussions:We found substantial gap between the proportion of youth who perceived sex education to be important and those who actually received it, revealing considerable unmet need for FLE. Youth who received FLE were relatively more aware about reproductive health issues than their counterparts. Majority among Indian youth, irrespective of their age and sex, favoured introduction of FLE at school level, preferably from standard 8th onwards. The challenge now is to develop a culturally-sensitive FLE curriculum acceptable to all sections of society. © 2013 Tripathi, Sekher.

Singh P.K.,International Institute for Population Sciences
PLoS ONE | Year: 2013

Background:Although child immunization is regarded as a highly cost-effective lifesaver, about fifty percent of the eligible children aged 12-23 months in India are without essential immunization coverage. Despite several programmatic initiatives, urban-rural and gender difference in child immunization pose an intimidating challenge to India's public health agenda. This study assesses the urban-rural and gender difference in child immunization coverage during 1992-2006 across six major geographical regions in India.Data and Methods:Three rounds of the National Family Health Survey (NFHS) conducted during 1992-93, 1998-99 and 2005-06 were analyzed. Bivariate analyses, urban-rural and gender inequality ratios, and the multivariate-pooled logistic regression model were applied to examine the trends and patterns of inequalities over time.Key Findings:The analysis of change over one and half decades (1992-2006) shows considerable variations in child immunization coverage across six geographical regions in India. Despite a decline in urban-rural and gender differences over time, children residing in rural areas and girls remained disadvantaged. Moreover, northeast, west and south regions, which had the lowest gender inequality in 1992 observed an increase in gender difference over time. Similarly, urban-rural inequality increased in the west region during 1992-2006.Conclusion:This study suggests periodic evaluation of the health care system is vital to assess the between and within group difference beyond average improvement. It is essential to integrate strong immunization systems with broad health systems and coordinate with other primary health care delivery programs to augment immunization coverage. © 2013 Prashant Kumar Singh.

Mohanty S.K.,International Institute for Population Sciences
International Perspectives on Sexual and Reproductive Health | Year: 2012

CONTEXT: Research on inequalities in the utilization of maternal health care services is often confined to only the economic domain. Individuals and families living in acute poverty may simultaneously experience multiple dimensions of deprivation, which together may obstruct their access to basic health services. It is important to examine the linkages between multiple deprivations and maternal health care. METHODS: Data from the 2005-2006 Indian National Family Health Survey were used to examine ever-married women's receipt of antenatal care, medical assistance during delivery and postnatal care services across three dimensions of deprivation: education, wealth and health. Bivariate analyses, principal component analyses and binomial logistic regression analyses were conducted. RESULTS: Thirty-two percent of ever-married Indian women reported being deprived in one of the three dimensions, 18% in two and 7% in all three; 43% were deprived in none. Women deprived in all three dimensions were less likely than those not deprived in any to have received antenatal care (predicted probabilities, 0.3 vs. 0.8) or postnatal care (0.2 vs. 0.7); the likelihood that a birth occurred with medical assistance was smaller for women deprived in three dimensions than for those deprived in none (0.2 vs. 0.8). These patterns held true for all of the larger Indian states. Differentials in utilization of maternal care services across deprivation levels were higher in states where service coverage was low and lower in states where service coverage was high. CONCLUSION: More research is needed to understand how multiple deprivations are associated with health inequality across cultures and how to use this knowledge to improve delivery of basic health services.

Arokiasamy P.,International Institute for Population Sciences
Primary health care research & development | Year: 2013

In this paper, we assess the degree to which the observed consistency in maternal health-care utilization can be accounted for by social and economic demand determinants at individual and household level on the one hand and community access to health services in terms of health, road and education facilities on the other. Data from the three rounds of national family health survey of India (NFHS-1, -2 and -3) conducted in 1992-93, 1998-99 and 2005-06 are used in this analysis. The results of the analysis are presented in two sections. First, statewise profiles of maternal health-care utilization from NFHS-1, -2 and -3 are presented to compare the trends. Second, the influence of demand and access factors estimated from multi-level logistic regression models are presented for selected states of India. Results reveal that inequalities in maternal health-care utilization by socio-economic status have narrowed because of the impact of complementing factors of greater community access, and social and economical advancement in the south Indian states, where overall maternal health-care coverage is at the top end of the scale. In contrast, in the demographically lagging northern states of India, which are at the bottom end of the health coverage scale, both access and socio-economic demand determinants indicate greater inequalities in maternal health-care utilization. Lack of access to health care, slow progress in socio-economic conditions and cultural constraints are major determinants of poor maternal health-care coverage among Indian states.

Mohanty S.K.,International Institute for Population Sciences
PLoS ONE | Year: 2011

Background: Though the concept of multidimensional poverty has been acknowledged cutting across the disciplines (among economists, public health professionals, development thinkers, social scientists, policy makers and international organizations) and included in the development agenda, its measurement and application are still limited. Objectives and Methodology: Using unit data from the National Family and Health Survey 3, India, this paper measures poverty in multidimensional space and examine the linkages of multidimensional poverty with child survival. The multidimensional poverty is measured in the dimension of knowledge, health and wealth and the child survival is measured with respect to infant mortality and under-five mortality. Descriptive statistics, principal component analyses and the life table methods are used in the analyses. Results: The estimates of multidimensional poverty are robust and the inter-state differentials are large. While infant mortality rate and under-five mortality rate are disproportionately higher among the abject poor compared to the non-poor, there are no significant differences in child survival among educationally, economically and health poor at the national level. State pattern in child survival among the education, economical and health poor are mixed. Conclusion: Use of multidimensional poverty measures help to identify abject poor who are unlikely to come out of poverty trap. The child survival is significantly lower among abject poor compared to moderate poor and non-poor. We urge to popularize the concept of multiple deprivations in research and program so as to reduce poverty and inequality in the population. © 2011 Sanjay K. Mohanty.

Ladusingh L.,International Institute for Population Sciences
European Journal of Health Economics | Year: 2010

Length of stay (LOS) in hospital for inpatient treatment is a measure of crucial recovery time. Using nationwide data on inpatient healthcare in India, a threecomponent finite mixture negative binomial model was found to provide a reasonable fit to the heterogeneous LOS distribution. Associated risk factors for short-stay, mediumstay and long-stay subgroups were identified from the respective negative binomial components. In addition, significant heterogeneities within each group were also found. © Springer-Verlag 2009.

Mohanty S.K.,International Institute for Population Sciences | Srivastava A.,International Institute for Population Sciences
Health Policy and Planning | Year: 2013

Context Though promotion of institutional delivery is used as a strategy to reduce maternal and neonatal mortality, about half of the deliveries in India are conducted at home without any medical care. Among women who deliver at home, one in four cites cost as barrier to facility-based care. The relative share of deliveries in private health centres has increased over time and the associated costs are often catastrophic for poor households. Though research has identified socio-economic, demographic and geographic barriers to the utilization of maternal care, little is known on the cost differentials in delivery care in India.Objective The objective of this paper is to understand the regional pattern and socio-economic differentials in out-of-pocket (OOP) expenditure on institutional delivery by source of provider in India.Methods The study utilizes unit data from the District Level Household and Facility Survey (DLHS-3), conducted in India during 2007-08. Descriptive statistics, principal component analyses and a two-part model are used in the analyses.Findings During 2004-08, the mean OOP expenditure for a delivery in a public health centre in India was US$39 compared with US$139 in a private health centre. The predicted expenditure for a caesarean delivery was six times higher than for a normal delivery. With an increase in the economic status and educational attainment of mothers, the propensity and rate of OOP expenditure increases, linking higher OOP expenditure to quality of care. The OOP expenditure in public health centres, adjusting for inflation, has declined over time, possibly due to increased spending under the National Rural Health Mission. Based on these findings, we recommend that facilities in public health centres of poorly performing states are improved and that public-private partnership models are developed to reduce the economic burden for households of maternal care in India. © 2012 Author all rights reserved.

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