Objective: To estimate the prevalence and the socioeconomic and demographic correlates of tobacco consumption in India. Design: Cross sectional, nationally representative population based household survey. Subjects: 315 598 individuals 15 years or older from 91 196 households were sampled in National Family Health Survey-2 (1998-99). Data on tobacco consumption were elicited from household informants. Measures and methods: Prevalence of current smoking and current chewing of tobacco were used as outcome measures. Simple and two way cross tabulations and multivariate logistic regression analysis were the main analytical methods. Results: Thirty per cent of the population 15 years or older-47% men and 14% of women-either smoked or chewed tobacco, which translates to almost 195 million people-154 million men and 41million women in India. However, the prevalence may be underestimated by almost 11% and 1.5% for chewing tobacco among men and women, respectively, and by 5% and 0.5% for smoking among men and women, respectively, because of use of household informants. Tobacco consumption was significantly higher in poor, less educated, scheduled castes and scheduled tribe populations. The prevalence of tobacco consumption increased up to the age of 50 years and then levelled or declined. The prevalence of smoking and chewing also varied widely between different states and had a strong association with individual's sociocultural characteristics. Conclusion: The findings of the study highlight that an agenda to improve health outcomes among the poor in India must include effective interventions to control tobacco use. Failure to do so would most likely result in doubling the burden of diseases-both communicable and non-communicable-among India's teeming poor. There is a need for periodical surveys using more consistent definitions of tobacco use and eliciting information on different types of tobacco consumed. The study also suggests a need to adjust the prevalence estimates based on household informants

RÉSUMÉEtude empirique des attitudes envers la violence faite à la femme chez les hommes et les femmes dans sept pays africains subsahariens.This study used data from the demographic and health surveys (DHS) conducted between 1999 and 2001 in Benin, Ethiopia, Malawi, Mali, Rwanda, Uganda and Zimbabwe, to examine the magnitude and correlates of conditional acceptance of wife-beating among both men and women. Multivariate logistic regression models were fitted to investigate the independent association between different socio-demographic characteristics and acceptance of wife-beating. The acceptance of wife-beating for transgressing certain gender roles was widespread in all the countries. Men were consistently less likely to justify wife-beating than women. Household wealth and education emerged as strongest and most consistent negative predictors of acceptance of wife-beating among both men and women. Older men and women were less likely to justify wife-beating. Men and women in the polygamous union were more likely to accept wife-beating, though the association was not always significant. With the exception of Uganda, women working for pay were more likely to justify wife-beating than non-working women were. The results indicate that dominant social and cultural norms create images of "ideal" women among both men and women that include definition and widespread acceptance of gender roles as well as sanction use of force to enforce these gender roles. The State and its different institutions may fail to mitigate wife-beating, as sensitivity to objectively address wife-beating may be tellingly lacking. Though education, economic growth, etc, can reduce acceptance of wife-beating, the process may be too slow and too late to make a substantial difference in the near future. Proactive measures may be required to change attitudes towards wife-beating among both men and women. Cette étude se sert des données tirées des enquêtes démographique et de santé (EDS) menées entre 1999 et 2001 à Benin City, en Ethiopie, au Malawi, au Rwanda, en Ouganda et au Zimbabwe afin d'examiner l'ampleur et les corrélats de l'acceptation de violence contre la femme aussi bien parmi les hommes que parmi les femmes. Des modèles de la régression logistique multifactoriels ont été établis pour vérifier l'association indépendante entre les caractéristiques démographiques différentes et l'acceptation de la violence contre la femme. L'acceptation de la violence contre la femme pour avoir transgressé certains rôles basés sur les rôles de genre était bien répandue dans les pays. Les hommes avaient régulièrement moins la possibilité de justifier l'agression contre la femme que les femmes. La richesse domestique et l'éducation comptaient parmi les indices négatifs les plus réguliers de l'acceptation de la violence chez les hommes et les femmes. Les hommes et les femmes plus âgés ont plus la possibilité de justifier la violence contre la femme. Les hommes et les femmes dans l'union polygame avaient plus la possibilité d'accepter la violence d...

Using data from the 60(th) round of the National Sample Survey of India (2004), the study investigates the incidence and correlates of 'catastrophic' maternal expenditure (ME) in India. Data on ME come from 6879 births that took place during 365 days prior to the survey. The study adapts earlier definitions and methods for catastrophic total health care expenditure to measure 'catastrophic' ME as: (i) maternal health care expenditure more than 10% of the annual normative household consumption expenditure (ME-1), and (ii) maternal health care expenditure more than 40% of the annual 'capacity to pay' (ME-2). The 'capacity to pay' was derived by subtracting state-wise poverty-line household expenditure from household consumption expenditure. The average maternal expenditure varied by place of delivery: US dollar 9.5, US dollar 24.7 and US dollar 104.3 for birth at home, in a public facility and in a private facility, respectively. Sixteen per cent of households incurred ME of more than 10% of total household consumption expenditure (ME-1), while 51% households incurred ME of more than 40% of household 'capacity to pay' (ME-2). While incidence of ME-1 increased with income decile, the reverse was observed for ME-2, reflecting higher non-utilization of institutional maternal care and its non-affordability among poorer households. All the households from the poorest decile and 99% from the second poorest decile paid more than 40% of their capacity to pay. Multivariate regression results indicate that antenatal care and delivery care in private facilities increased the chances of ME-1 and ME-2 (P < 0.001). Measuring maternal expenditure against 'capacity to pay' (ME-2) may be better than measuring it as a proportion of overall household expenditure when assessing financial constraints in the use of maternal services. Improving the performance of the public sector, appropriate regulation of and partnership with the private sector, and effective direct cash transfers to pregnant women in the poorest households may increase utilization of maternal services and reduce the financial distress associated with ME.

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Poor quality of antenatal care is likely to reduce its utilization. Policy and program interventions to improve the quality of care of antenatal care, especially for the poor and other disadvantaged population groups, more so in north India, are essential to improve maternal health outcomes. The India's National Rural Health Mission (NRHM), launched in 2005, should lay greater emphasis on improving the quality of antenatal care, among other things, to increase utilization of antenatal care and achieve better maternal health outcomes.