Background Exclusive use of hygienic methods (sanitary napkins, locally prepared napkins, tampons, and menstrual cups) to prevent the visibility of bloodstains during menstruation is still considerably low among adolescent women in rural India. However, no prior research has explored the prevalence and determinants of exclusive hygienic methods among rural Indian adolescent women. To address this gap, this study examines the factors affecting adolescent women’s exclusive use of hygienic methods in rural India. Additionally, this study explores state- and district-level geographical disparities in the exclusive use of hygienic methods among adolescent women in rural India. Methods Information on 95,551 adolescent women from rural India from the latest round of National Family Health Survey (NFHS-5) was analyzed. Bivariate statistics and multilevel logistic regression analysis were used to assess the Individual- and community-level factors associated with exclusive use of hygienic methods among adolescent women in rural India. Choropleth maps were used to discern the geographical disparities in the exclusive use of hygienic methods. Results In rural India, only 42% of adolescent women exclusively used hygienic methods, with substantial geographic disparities at the state and district levels. At the state level, the exclusive use of hygienic methods varied from 23% in Uttar Pradesh to 85% in Tamil Nadu. Even greater variation was observed at the district level. There was a clear north-south divide in the exclusive use of hygienic methods among adolescent women in rural India. The results of multilevel logistic regression indicated a considerable amount of variation in the exclusive use of hygienic methods at community level which further reduced when controlled for individual and community-level factors. Rural Indian adolescent women with higher education (AOR:3.20, 95% CI: 2.81–3.64), from general category (AOR: 1.14, 95% CI: 1.07–1.21), with medium mass media exposure (AOR: 1.43, 95% CI: 1.35–1.51), and from richest wealth quintile (AOR: 3.98, 95% CI: 3.69–4.30) were more likely to use hygienic methods exclusively. Conclusion Wide differential across biodemographic and socioeconomic groups, and substantial geographic disparities at state- and district-level in the exclusive use of hygienic methods suggests a need to adopt context-specific interventions for adolescent women in rural India. Distribution of subsidized or free menstrual hygiene methods to disadvantaged adolescent women, and in the low-prevalence districts may increase the level of exclusive use of hygienic methods remarkably.

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Background The exclusive use of hygienic materials during menstruation (sanitary napkins, locally made napkins, tampons, and menstrual cups) among urban women in India has been increasing over time. However, little is known about the wealth-based disparity in the exclusive use of hygienic materials during menstruation among these women. This study, therefore, measures wealth-based inequality in the exclusive use of hygienic materials during menstruation among urban women in India. Furthermore, the measured inequality is decomposed to unravel its contributing factors. Data and methods Using data from the National Family Health Survey-5 (2019–21), we calculated the Erreygers normalized concentration index (CI) for India and each of its states to measure wealth-based inequality in the exclusive use of hygienic materials during menstruation among women in urban India. Further, we decomposed the Erreygers CI to estimate the relative contribution of covariates to wealth-based inequality in the exclusive use of hygienic materials during menstruation. The analysis included 54,561 urban women aged 15–24 from 28 states and eight union territories of India. Results The Erreygers CI value of 0.302 indicated a pro-rich inequality in the exclusive use of hygienic materials among urban women in India. While all the states and UTs showed pro-rich inequality, the CI varied considerably across the country. Among the bigger states, the inequality was highest in Madhya Pradesh (CI: 0.45), Assam (CI: 0.44), Bihar (CI: 0.41), and West Bengal (CI: 0.37) and the lowest in the south Indian states of Tamil Nadu (CI: 0.10), Andhra Pradesh (CI: 0.15), Telangana (CI: 0.15), and Kerala (CI: 0.20). Erreygers decomposition revealed that wealth-based inequality in women’s education and mass media exposure contributed almost 80% of the wealth-based inequality in the exclusive use of hygienic materials during menstruation among urban women in India. Conclusion Substantial pro-rich inequality in the exclusive use of hygienic materials suggests that the policies and program initiatives should prioritize reaching out to poor women to increase the overall rate of exclusive use of hygienic materials during menstruation in urban India.

Short Birth Interval (SBI) is one of the main causes of adverse maternal and child health outcomes. A 33-month birth-to-birth interval between two successive live births should be followed to minimize the risk of adverse maternal and child health. This study aimed to examine the prevalence of SBI and the associated factors in rural India. Information on 98,522 rural mothers from the fourth round of National Family Health Survey data was analyzed. Bivariate statistics, logistic regression, Moran’s I, and Cluster and Outlier Analysis have been used to assess the prevalence and spatial pattern of SBI in rural India. Results revealed that about half of the mothers in rural India had experienced SBI. Rural Indian mothers whose child was not alive (OR = 1.76, 95% CI = 1.63–1.90), were not using any contraceptive methods (OR = 1.42, 95 % CI = 1.37–1.48) and not breastfeeding (OR = 2.73, 95% CI = 2.50–2.97) were more likely to experience SBI. On the other hand, rural mothers from the middle, richer and richest wealth quintiles (OR = 0.91, 95% CI = 0.86–0.97; OR = 0.84, 95% CI = 0.80–0.92; OR = 0.60, 95% CI = 0.55–0.66) and of age over 30 years (OR = 0.38., 95% CI = 0.36–0.39) were less likely to experience SBI. Analysis of spatial patterns revealed clear east-west differences in the prevalence of SBI. There was strong clustering of high values of SBI in most districts across the central, northern, western, and southern regions. The study suggests the need to introduce appropriate interventions and programs focused on reducing the prevalence of SBI in rural India.

Anaemia among men is a significant health issue which has not been given due importance. Only a handful of studies have captured the prevalence of anaemia among men. There is dearth of evidence base on anaemia among men in India. Therefore, this study attempts to fill this research gap by examining the socioeconomic, geographic, health-related, and behavioural differentials of anaemia among rural men in India. We analysed a cross-sectional sample of 61,481 men aged between 15–54 and living in rural areas from the National Family Health Survey (NFHS-5), conducted in 2019–21. Bivariate statistics and multivariable logistic regression were employed to assess the factors associated with anaemia. In rural India, three out of ten men were found to be anaemic. Older men [49–54 years] (Odds Ratio: 1.10, 95% CI, 1.00–1.21), men without a formal education (OR: 1.36, 95% CI, 1.26–1.47), those from Scheduled Tribes (OR: 1.48, 95% CI, 1.39–1.58) and men who belonged to the poorest wealth quintile (OR: 1.24, 95% CI: 1.25–1.35) had a higher risk of anaemia. Men who were underweight were more likely to be anaemic (OR: 1.36, 95% CI: 1.30–1.43). When compared to the central region, men from the eastern (OR: 1.47, 95% CI: 1.39–1.55) parts of India had higher a risk of anaemia. The findings suggest the need to recognise anaemia among men as a public health issue. When developing policy, significant variation in socioeconomic, geographic, health-related, and behavioural factors must be taken into account. Men should also be screened on a regular basis in order to reduce the national burden of anaemia.