Chander Shekhar

• B.Sc.(Hons.), M.Sc.(Statistics), MPS, PhD
• Professor (Full) at International Institute for Population Sciences

India's National Family Welfare Programme has effectively promoted family planning (FP) and its benefits through various media channels, ensuring straightforward and accessible information dissemination to various societal segments. This study examines the variation in the equity of demand satisfied according to the level of mass media exposure in...

Background Antenatal care (ANC) is an important component in the continuum of care. Providing adequate quality ANC is necessary to prevent maternal and newborn mortality. The coverage of ANC has increased significantly in the last decade in India, but a mere increase in coverage is insufficient if the issue of quality is not simultaneously addresse...

Background Early marriage and motherhood have long been prevalent in India, with 44.5% of women aged 20–24 reporting marriage before 18 in NFHS 3 (2005–2006), dropping to 26.8% in NFHS 4 (2015–2016). Early motherhood has also seen a significant decline, with first births by age 18 decreasing from 34.3% in NFHS I to 8.2% in NFHS V. Despite these imp...

Objectives: To examine the relationship between children’s educational attainment and the risk of food insecurity among older parents and to determine if this relationship varies by the sex and residence of the children. Methods: This study utilized data from the Longitudinal Ageing Survey in India (LASI, 2017-18), comprising 25,914 individuals age...

Putting an end to the silent pandemic of unsafe abortion is a major public health concern globally. Adoption of post-abortion contraception is documented as a significant contributor to reduce the number of unintended pregnancies and number of induced abortions. This study aimed at investigating the post abortion contraceptive behavior of Indian wo...

Life satisfaction is an important component of successful aging and is known to be associated with health, well-being, and longevity. This study examines the association between children’s educational attainment and life satisfaction among older parents in India while also exploring the moderating effect of the children’s and parents’ sex on the ex...

Background Women in their reproductive age have tremendous health implications that affect their health and well-being. Anaemia is an indicator of inadequate dietary intake and poor health. Maternal malnutrition significantly impacts maternal and child health outcomes, increasing the mother's risk of dying during delivery. High-risk fertility behav...

Objective The present study was carried out to describe contraceptive adoption following pregnancy terminations that resulted in outcomes other than live birth. Method Retrospective calendar data on 31486 women who had experienced a pregnancy loss within the last 60 months prior to the survey date were drawn from a nationally representative datase...

Background In South Asia, one in two children under the age of five are stunted or wasted due to malnutrition, which affects one in three children globally. There are close linkages between maternal health care services and child feeding practices that need to be investigated. Materials and Method The present study analyzed two rounds of Demograph...

Vitamin D deficiency is a serious issue in developing nations, including India. This study investigates the determinants of vitamin D deficiency among Indian adolescents and assesses their relative importance using dominance analysis. Data from the Comprehensive National Nutrition Survey (CNNS) conducted between 2016 and 2018 were utilized in this...

Introduction Fertility transition refers to the one-time decline in a country's fertility from an average of above five births per woman to two or below. This major demographic transformation is closely connected with socio-economic, urban, and gender-role transformations and improvements in the health and family planning of a country. Understandin...

Aim Recent National Family Health Survey results portray striking improvements in most population and health indicators, including fertility, family planning, maternal and child health, gender treatment, household environments, and health insurance coverage of the Pradhan Mantri Jan Arogya Yojana (PM-JAY), with all India resonance. However, the pre...

In recent years, developing and developed countries are witnessing delayed childbearing among women contributing to the overall decline in fertility rates. The age at which a woman has her last child impacts maternal and child health, especially in a country with high maternal and perinatal mortality rates. This study aims to investigate the trends...

The disproportionate share of contraceptive use by women makes family planning services women-centric in India. The meagre and declining share of male-based contraceptive use, along with the overwhelming prevalence of female sterilization, has its underpinning in the lack of emphasis on fertility regulation with the use of temporary methods. The re...

Introduction Reproductive health events have changed fertility and family planning needs, depicting the changing life patterns of women and the population to which they belong. Understanding the pattern at which these events occur helps in understanding the fertility pattern, family formation and the idea about health essential needs for women. Thi...

Social network members play a crucial role in shaping one’s health. Children can be considered the most proximal members of one’s social network; thus, the upward transmission of human capital from children to parents could be expected. Using nationally representative data from the Longitudinal Ageing Study in India (LASI, 2017-2018), this study in...

We document that US IPOs that take place during a world cup in football (soccer), compared to IPOs before or after, exhibit 9% lower underpricing and 6% lower price adjustment. IPOs during world cups receive less attention from foreign investors and exhibit significantly higher long-run returns. Our results are robust to excluding the IPO bubble pe...

Reproductive health and well-being of a woman are associated with factors such as menarche, first marriage, first sex, first birth, and menopause. The beginning of these events also brings about significant changes in women's lives. Despite marrying early being acknowledged as a detrimental and discriminatory socio-cultural global practice, a huge...

Child marriage in India is still a major concern to attain the sustainable development goal. Although child marriage or early marriage is a violation of human rights and has many demographic and health consequences, it remains high in many parts of the country, and the state of Rajasthan, one among them, needs attention. Hence, this study attempted...

Reproductive health events have changed fertility and family planning needs, depicting the changing life patterns of women and the population to which they belong. Understanding the pattern at which these events occur helps in understanding the fertility pattern, family formation and the idea about health essential needs for women. This paper attem...

India has a very high prevalence of female sterilisation compared to other countries in the world, with a prevailing situation of very low level of information about contraceptive options given to women. It is well established in demographic research that, there exists a strong association between knowledge of contraceptive methods and type of cont...

Background Vitamin D deficiency has been found to associated with numerous skeletal and non-skeletal diseases including Diabetes Mellitus. Insulin Resistance (IR) is considered as one of the primary reasons of Type-2 Diabetes Mellitus (T2DM). The association between vitamin D deficiency and IR has been extensively explore in previous studies, but n...

Treatment-seeking behaviour is closely associated with the health status of individuals and countries. About 800 million people have no access to health services in the developing world. Though the situation has been improving, the inequalities across geographical regions, socioeconomic status, and disease types continued to persist. The available...

Maharashtra state report from the 2019-2021 National Family Health Survey (NFHS-5)

Background In a patriarchal society, women often keep their use of contraceptives secret in order to meet their reproductive goals and satisfy their reproductive preferences. Nevertheless, to our knowledge, women’s covert contraceptive use and its association with husband’s gender attitude have not been studied in the Indian settings. The present s...

Objectives The transition to small family size is at an advanced phase in India, with a national TFR of 2.2 in 2015–16. This paper examines the roles of four key determinants of fertility—marriage, contraception, abortion and postpartum infecundability—for India, all 29 states and population subgroups. Methods Data from the most recent available n...

Background Registration of vital events has been low coverage in India since long, especially registration of marriages. Studies and data on marriage registration are very limited in India. Therefore, the present study tried to examine critical determinants of the under-registration of marriage. Methods The present study is cross-sectional and exp...

Background: Maternal dietary diversity during pregnancy is a major determinant of birth weight and birth size of infant. During pregnancy, mother diet is highly dependent on their topographical, cultural, and sociodemographic circumstances. Objective: The objective of the study was to assess the association between the maternal dietary intake with...

Background: Unsafe abortion continues to draw the researcher's attention due to its close association with maternal morbidity and mortality. Empirical evidence on the role of health facilities in providing safe abortion care addressing the reproductive rights of Indian women is limited.Methods: Using data from the 2015 ‘unintended pregnancy and abo...

Background Primary Health Centers (PHCs) are crucial in providing primary and secondary level healthcare services in rural India. Despite immense efforts and huge funding, a very small proportion of deliveries are carried out at PHCs. The present study aims to explore the availability of facilities at PHCs and its association with likelihood of del...

Background Hypertension has been described as an “iceberg disease” as those who suffer are usually unaware and hence usually seek healthcare services at a very late stage. It is estimated that more than two million Indians are suffering from hypertensive heart diseases that contributed to above 0.13 million deaths in 2016. Objectives The present s...

Background Maternal and child health services, like antenatal care, skilled birth attendance and postnatal care, are crucial to improve maternal and neonatal health outcomes. Numerous studies have been conducted on the distribution of utilization of maternal and child healthcare (MCH) services in India with respect to socioeconomic and demographic...

Abstract Background Vitamin D is an essential micronutrient for the overall health and well-being of individuals. For strong musculoskeletal and neurological development of human body, vitamin D levels during childhood and adolescence have key importance. This is the first national-level study that analyzes the deficiency and concentration of serum...

There has been a drastic decline in the child sex ratio (number of females per 1000 males between ages 0 and 4) in India and many of its states. This study aimed to examine if prenatal factors, such as change in sex ratio at birth, or postnatal factors, such as change in relative mortality of females and males, contribute to this more by analysing...

Introduction Maternal undernutrition plays a critical role in influencing maternal, and child health outcomes and magnifies the risk of death of the mother at the time of delivery. High-risk fertility behaviour is an obstacle to tackle maternal and child mortality. Objectives The aim of this study is to understand the level of high-risk fertility b...

Early initiation of breastfeeding (EIBF) is considered one of the most cost-effective interventions for infant survival and well-being. This study aimed to examine the variations in, and determinants of, early initiation of breastfeeding among women in high and low neonatal mortality rate (NMR) settings in India using data from the fourth round of...

Introduction Pregnancy loss is a public health issue throughout the world. Miscarriage and induced abortion are the two main dimensions of pregnancy loss. The prevalence of early pregnancy loss due to miscarriage and abortion is mostly unknown due to the lack of early registration of pregnancies in most places, and especially in low- and middle-inc...

Introduction: Pregnancy loss is a public health issue throughout the world. Miscarriage and induced abortion are the two main dimensions of pregnancy loss. The prevalence of early pregnancy loss due to miscarriage and abortion is mostly unknown due to the lack of early registration of pregnancies in most places, and especially in low-and middle-inc...

Objective The present study aims to analyze the association between the availability of facilities at PHCs and their association with healthcare-seeking from PHCs in rural India. Data and methods The data used in the study were extracted from HMIS (Health Management Information System) and NFHS-4. Using ‘HMIS rural health infrastructure data’ we c...

Abortion has been legal under broad criteria in India since 1971. However, access to legal abortion services remains poor. In the past decade, medication abortion (MA) has become widely available in India and use of this method outside of health facilities accounts for over 70% of all abortions. Morbidity from unsafe abortion remains an important h...

The outbreak of novel coronavirus disease of 2019 (COVID-19) has a wider geographical spread than other previous viruses such as Ebola and H1N1.This study aims to provide the estimates of the basic reproduction rate (R 0) and case fatality rate (CFR), which applies to a generalized population. The systematic review helped to retrieve the published...

Objectives The study aims to examine the linkages between occupation and elevated blood pressure among men aged 25–54 years in India.Methods The study is based on the National Family Health Survey India, 2015–16. Age-standardized prevalence rates, χ2 tests and multivariable ordered logistic regression models were used to fulfill the study objective...

In this paper, an attempt has been made to assess the impact of complete lockdown on COVID-19 infection in India. This study obtained COVID-19 data on daily confirmed, recovered, and deaths for 21 days and have implemented the exponential growth model to predict future cases and study the role of lockdown in reducing the number of confirmed COVID 1...

Introduction Infant and child mortality are considered as one of the most important indicators of social and economic development of the nation. This paper intends to shed light on the prevalence of infant and under-five death rates with special reference to differentials in SCs, STs, and non-SCs/STs population in India. In addition, to determine t...

Potential Factors of Transmission and Spread of COVID 19 in Indian States and Districts Sayeed Unisa, Balram Rai, Shreyans Rai, Abhishek Saraswat, Swagata Mondal, Preeti Dhillon, Laxmi Kant Dwivedi, Suryakant Yadav, and Chander Shekhar Background: On 30th January 2020, importation of the first case of novel coronavirus (SARS-CoV-2) popularly know...

Objectives Nationally representative evidence on abortion service provision is scarce in South Asia. To inform improvements in service provision, this paper assesses the availability of facility-based postabortion services in Nepal, India (six states), Bangladesh and Pakistan, and legal abortion services in India and Nepal and Bangladesh (where the...

Background: The outbreak of novel coronavirus disease of 2019 (COVID-19) has a wider geographical spread than other previous viruses such as Ebola and H1N1. The onset of disease and its transmission and severity has become a global concern. The policymakers have a serious concern for containing the spread and minimising the risk of death. Aim: Thi...

The case-fatality ratio (CFR) has been increasing rapidly in the most affected countries during the outbreak. On an average it increased from 3.4% (as of 25 February 2020) to 7.0% (as of 21 April 2020) across countries. Italy and Iran showed an early increment in CFR. However, the Iran curve has been flattened by late March 2020, but Italy continue...

Objective The study was explorative in nature, implemented at hospital level to investigate how respectfully women are treated while accessing delivery care in the health facilities. Methods A total of 115 differently-managed i.e. public, private and public-private partnerships (PPP) health facilities in Ganjam and Kandhamal districts of Odisha we...

Objective: Although abortion has been legal in India since 1971, but very little research has been done so far on the issue of the quality of abortion services. To fill this gap, this paper examines whether the quality of abortion services provided in the country is in line with the WHO's recommendations. Study design: We analyse a cross-section...

Marriage squeeze is a demographic phenomenon underlining the asymmetry between the availability of potential brides and grooms in a population. Since mate selection is very specific and bound by religion, caste, and region in India, existing demographic and sociocultural variability reflects even more emphatically on marriage squeeze in these subgr...

Background: Millennium Development Goal 4 (MDGs) mobilised countries to reduce child mortality by two thirds the 1990 rate in 2015. While India did not reach MDG 4, it considerably reduced child mortality in the MDG-era. Efficient and targeted interventions and adequate monitoring are necessary to further progress in improvements to child health....

Malnutrition is a major contributor to disease burden in India. To inform subnational action, we aimed to assess the disease burden due to malnutrition and the trends in its indicators in every state of India in relation to Indian and global nutrition targets.

Background Safe abortion services are essential if women are to fulfill their right to have the number of children they want, when they want them. This paper examines the provision of abortion and menstrual regulation (MR) services in four South Asian countries that have many commonalities in sexual and reproductive outcomes and in barriers to acce...

Background: Malnutrition is a major contributor to disease burden in India. To inform subnational action, we aimed to assess the disease burden due to malnutrition and the trends in its indicators in every state of India in relation to Indian and global nutrition targets. Methods: We analysed the disease burden attributable to child and maternal...

Background: Evidence of hysterectomy in India is limited mainly due to lack of information 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 pr...

Medical methods of abortion, MMA, has been legal in India since 2002. Guidelines stipulate that it should be administered by a provider or acquired via prescription. 1.2 million women having abortions in India use MMA acquired from health facilities [Singh, S., Shekhar, C., Acharya, R., Moore, A. M., Stillman, M., Pradhan, M. R., … Browne, A. (2018...

Marriage is a socially essential and vital event in the life of a person. Though the person itself decides the partner in the developed world; with increasing modernization and urbanization, the pattern of marriage is also changing in developing countries from arranged to self-selection mate. This study examines women's participation in the selecti...

This article attempts to find types of sources and providers, and likelihood of self-reported complication among Indian women. Fifty-three percent of abortions are done at private health facilities. Only one in every 5 women went to public health facilities, and the rest did not go anywhere (27.5%). Doctors are the major abortion service providers...

This study shed light on women's empowerment associated with increased utilization of reproductive and child health services in selected countries of South Asia. The research questions are explored through the use of bivariate and multivariate analyses based on nationally representative data from the Demographic and Health Survey of India, Nepal, a...

This study shed light on women’s empowerment associated with increased utilization of reproductive and child health services in selected countries of South Asia. The research questions are explored through the use of bivariate and multivariate analyses based on nationally representative data from the Demographic and Health Survey of India, Nepal, a...

Background: Reliable information on the incidence of induced abortion in India is lacking. Official statistics and national surveys provide incomplete coverage. Since the early 2000s, medication abortion has become increasingly available, improving the way women obtain abortions. The aim of this study was to estimate the national incidence of abor...

In India, research prioritization in Maternal, Newborn, and Child Health and Nutrition (MNCHN) themes has traditionally involved only a handful of experts mostly from major cities. The Indian Council of Medical Research (ICMR)-INCLEN collaboration undertook a nationwide exercise engaging faculty from 256 institutions to identify top research priori...

Background: Unsafe induced abortion contributes significantly to maternal morbidity and mortality. Irrespective of availability of contraceptive services women still seek for repeated induced abortion. This study examined the contraceptive behavior of currently married women who had induced abortion.Methods: Third round of District Level Household...

The fourth round of National Family Health Survey (2015-16) is discussed with a brief exposition of the trends in household environment and sanitation, fertility, child health and child mortality, nutrition, health, and status of women between 2005-06 (NFHS-3) and 2015-16 (NFHS-4)

Background: International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of...

Background International studies of the health of Indigenous and tribal peoples provide important public health insights. Reliable data are required for the development of policy and health services. Previous studies document poorer outcomes for Indigenous peoples compared with benchmark populations, but have been restricted in their coverage of co...

A brief exposition of the trends in health, fertility, status of women, nutrition and child mortality between 2005-06 and 2015-16 as have emerged from the National Family Health Survey in 17 states.

Background: Postpartum amenorrhea is considered to be the conception variable and its affect natural fertility by lengthening the inter-live birth interval. In societies where the fertility is not regulated through the use of contraception method there amenorrhea period can exert a dominant fertility inhibiting effect on fertility. In this paper we...

Background: Ageing starts with chronic diseases, which affects quality of life, osteoarthritis of knee (OAK) is one of major disease, affecting significant geriatric population. Females reported significantly more prevalent than males. Diagnosed cases are treated with exercise, physiotherapy and some medication however in extreme cases knee arthrop...

Unintended pregnancy accounts for more than 40% of the total pregnancies worldwide. An Unintended pregnancy can have serious implications on women and their families. With more than one-fourth of the children in India born out of unintended pregnancies such pregnancies are considered to be one of the major public health concerns today. The present...

Historically most populations suffering from obesity resided in high-income, industrialized countries. In recent times, dramatic increases in the prevalence of overweight or obesity are seen in low-income countries. In India more than 30 million of people are either overweight or obese. It is higher among women than men. Considering the increasing...

Historically most populations suffering from obesity resided in high-income, industrialized countries. In recent times, dramatic increases in the prevalence of overweight or obesity are seen in low-income countries. In India more than 30 million of people are either overweight or obese. It is higher among women than men. Considering the increasing...

Women have commonly less power, chance and empowerment to interfere in making decision about RCH matters between men in most parts of South Asia. It is related to her education, ethnicity, deprivation level, urban/rural classification. This study based on this issue that, does level of woman empowerment affect Inter-spousal communication on RCH mat...

A multi-dimensional study of measures provides alternative ways through which women's empowerment can be viewed and understand how each domain contributes to enhance the empowerment of women in the developing countries. In this study, we examined women's empowerment levels using three domains that are directly related to issues regarding the positi...

This article is an effort to analyze the influence of education and occupation as critical determinants of smokeless tobacco use among adult males in India and its selected states. Global Adult Tobacco Survey (GATS) India 2009–10 data are used to analyze the prevalence of smokeless tobacco use among adult males aged 15 years and above (N = 33,767)...

A large body of research has attempted to explore the relationships between women's empowerment and their reproductive health practices in some developing countries. The objective of this study was to investigate whether women's empowerment in Nigeria and Uttar Pradesh (India) is related with women's reproductive health practices. The study used th...