BackgroundIn India, while the total fertility rate has been declined from 3.39 in 1992–93 to 2.68 in 2005–06, the prevalence of unintended pregnancy is still stagnant over the same period. A review of existing literature shows that within the country, there are variations in fertility preferences between different regions. Also there is a strong argument that the availability of a health facility at the village level plays an important role in reshaping the fertility behavior of women. Keeping in mind the fact that there is no information at the village level (which is the lowest geographical boundary) in the recent round of National Family Health Survey (NFHS-3), the specific objective of this study is to examine the impact of individual and household level variables on unwanted pregnancies without controlling the village level variation. Further, once the village level variation (i.e. unobserved variation) has been controlled, it is necessary to study whether there has been any alteration in the contribution of factors from earlier results of without adjusting the village level variation.MethodsThis paper attempts to examine the associated factors of unwanted pregnancies, without matching the village and after matching the village, by using the matched case–control design. Nationwide data from India’s latest NFHS-3 conducted during 2005–06 was used for the present study. Frequency and pair wise matching has been applied in the present paper and conditional logistic regression analysis was used to work out the models and to find out the factors associated with unwanted pregnancies.ResultsA major finding of this study was that 1:3 case–control study (without matching the village) shows that women belonging to non Hindu/Muslim religion, Scheduled Tribe, women who have experienced child loss and if the previous birth interval is 24 through 36 months were significant predictors of unwanted pregnancy. However, this relationship did not hold significant after village wise matching. Other factors such as Muslim religion, women and their partners with high school education and above, women belonging to the richest wealth index and if the sex of the last child was female, emerge as significant predictors of unwanted pregnancies.ConclusionsThis study clearly underscores the importance of adjusting the village (PSU) level variation in explaining unwanted pregnancies.

Numerous studies have examined the empirical evidence concerning the influence of demographic and socio-economic factors influencing child immunization, but no documentation is available which shows the actual impact of antenatal care (ANC) visits on subsequent child immunization. Therefore, this paper aims to examine the net impact of ANC visits on subsequent utilization of child immunization after removing the presence of selection bias. Nationwide data from India’s latest National Family Health Survey conducted during 2005–06 is used for the present study. The analysis has been carried out in the two separate models, in the first model 1–2 ANC visit and in the second model three or more ANC visits has been compared with no visit. We have used propensity score matching method with a counterfactual model that assesses the actual ANC visits effect on treated (ANC visits) and untreated groups (no ANC visit), and have employed Mantel-Haenszel bounds to examine whether result would be free from hidden bias or not. Using matched sample analysis result shows that child immunization among the groups of women who have completed 1–2 ANC visits and those who had more than two visits was about 13 percent and 19 percent respectively, higher than the group of women who have not made any ANC visit. Findings of nearest neighbor matching with replacement method, which completely eliminated the bias, indicate that selection bias present in data set leads to overestimates the positive effects of ANC visits on child immunization. Result based on Mantel-Haenszel bounds method suggest that if around 19 percent bias would be involved in the result then also we could observe the true positive effect of 1–2 ANC visits on child immunization. This also indicates that antenatal clinics are the conventional platforms for educating pregnant women on the benefits of child immunization.

The objective of this study is to estimate the impact of Integrated Child Development Services (ICDS) on the institutional delivery and on the nutritional status of children in rural India. Propensity score matching is used to remove selection bias, and then compare the outcome of those who received the ICDS services with those who did not receive. A representative sample of 32,072 women age 15 to 49 years was obtained from the National Family Health Survey-3 (2005Survey-3 ( -2006. The units of analysis were women who had at least one birth during the 5 years period preceding the survey and the children who were born during this period. In this study, the treatment variable was taken as "during pregnancy, received any nutrition and health education from the ICDS." The main outcome measures were institutional delivery and the prevalence of undernutrition. After matching, it was found that the among the rural women who received nutrition and health education specifically from the ICDS had 12.3% higher institutional delivery as compared with those who did not receive. However, no positive impact was observed on children's nutritional status. Thus, for improving the scenario of child nutrition, it is suggested that emphasis be shifted from supplementary feeding to improving environmental hygiene and child feeding practices.