JHUMKI KUNDU - Academia.edu (original) (raw)

Papers by JHUMKI KUNDU

Research Square (Research Square), Jun 3, 2022

Education and non-communicable diseases in India: an exploration of gendered heterogeneous relationships

International health, May 24, 2024

BMC Women's Health, Dec 12, 2022

Background: There is limited evidence of hysterectomy in India because of a lack of data in large... more Background: There is limited evidence of hysterectomy in India because of a lack of data 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 procedure among women in the reproductive age group. The current study evaluates the prevalence, determinants, and choice of hospitalization (Public vs. Private) for conducting hysterectomy in India among women aged 15-49 years in 29 states and seven union territories (UTs) based on the new large-scale population-based nationally representative dataset (NFHS 5). Methods: Cross-tabulations and percentage distributions were utilized to analyse the prevalence of hysterectomy and the choice of hospitalization (public vs. private) across different socioeconomic backgrounds and reasons for undergoing hysterectomy. A multivariate binary logistic regression model was also used to find statistically significant determinants of hysterectomy. Results: In India as a whole, 3.3% of women aged 15-49 years had undergone a hysterectomy. The percentage of women who had undergone the procedure was found to vary considerably across the states and the UTs. The southern region stands out for the considerably higher prevalence of hysterectomy; particularly in the states of Andhra Pradesh (8.7%) and Telangana (8.2%), the prevalence was very high followed by Bihar (6%) and Gujrat (4%). On the other hand, the Northeastern region had the lowest prevalence of hysterectomy (1.2%). A noticeable fact that emerged was that the majority of the hysterectomies were performed in the private sector (69.6%) in India. But the scenario was quite different in northeastern region as in this region more hysterectomies were performed in public health facilities (73%) rather than private health facilities (26.7%). Age, place of residence, religion, caste, level of education, geographic region, wealth quintiles, parity, age at first cohabitation of women were found to be the sociodemographic determinants statistically associated with hysterectomy in India. The likelihood of hysterectomy was higher among women living in rural areas (AOR: 1.3, CI: 1.23-1.35), in the richest wealth quintile (AOR 2.6; CI 2.37-2.76) and in the southern region (AOR 1.6; CI 1.47-1.66). The reasons frequently reported for hysterectomy were excessive menstrual bleeding/pain, followed by fibroids/cysts.

Comprehensive knowledge of HIV and STI and its association with contraceptive use among unmarried adolescents: a two-wave longitudinal study in India

Journal of Public Health

Socio-economic inequalities in burden of communicable and non-communicable diseases among older adults in India: Evidence from Longitudinal Ageing Study in India, 2017–18

PLOS ONE, Mar 30, 2023

Developing countries like India grapple with significant challenges due to the double burden of c... more Developing countries like India grapple with significant challenges due to the double burden of communicable and non-communicable disease in older adults. Examining the distribution of the burden of different communicable and non-communicable diseases among older adults can present proper evidence to policymakers to deal with health inequality. The present study aimed to determine socioeconomic inequality in the burden of communicable and noncommunicable diseases among older adults in India. This study used Longitudinal Ageing study in India (LASI), Wave 1, conducted during 2017-2018. Descriptive statistics along with bivariate analysis was used in the present study to reveal the initial results. Binary logistic regression analysis was used to estimate the association between the outcome variables (communicable and non-communicable disease) and the chosen set of separate explanatory variables. For measurement of socioeconomic inequality, concentration curve and concentration index along with state wise poor-rich ratio was calculated. Additionally, Wagstaff's decomposition of the concentration index approach was used to reveal the contribution of each explanatory variable to the measured health inequality (Communicable and non-communicable disease). The study finds the prevalence of communicable and noncommunicable disease among older adults were 24.9% and 45.5% respectively. The prevalence of communicable disease was concentrated among the poor whereas the prevalence of NCDs was concentrated among the rich older adults, but the degree of inequality is greater in case of NCD. The CI for NCD is 0.094 whereas the CI for communicable disease is-0.043. Economic status, rural residence are common factors contributing inequality in both diseases; whereas BMI and living environment (house type, drinking water source and toilet facilities) have unique contribution in explaining inequality in NCD and communicable diseases respectively. This study significantly contributes in identifying the dichotomous concentration of disease prevalence and contributing socioeconomic factors in the inequalities.

BMC Public Health

Background The present study tries to provide a comprehensive estimate of gender differences in t... more Background The present study tries to provide a comprehensive estimate of gender differences in the years of life lost due to CVD across the major states of India during 2017–18. Methods The information on the CVD related data were collected from medical certification of causes of death (MCCD reports, 2018). Apart from this, information from census of India (2001, 2011), SRS (2018) were also used to estimate YLL. To understand the variation in YLL due to CVD at the state level, nine sets of covariates were chosen: share of elderly population, percentage of urban population, literacy rate, health expenditure, social sector expenditure, labour force participation, HDI Score and co-existence of other NCDs such as diabetes, & obesity. The absolute number of YLL and YLL rates were calculated. Further, Pearson’s correlation had been calculated and to understand the effect of explanatory variables on YLL due to CVD, multiple linear regression analysis had been applied. Results Men have a h...

Factors Associated with Food Insecurity among Older Adults in India: Impacts of Functional Impairments and Chronic Diseases

Ageing International

Food security is an important agenda in MDG goals for people of all age groups irrespective of so... more Food security is an important agenda in MDG goals for people of all age groups irrespective of socioeconomic strata in all developing and developed countries. For India, with increasing hunger index, provision of food security among older adults comes out to be a rising concern and matter of discussion under hunger eradication programmes and policies. The study concentrated on prevalence of food insecurity among population aged 60 and above in India and their associated health factors controlling the level of food insecurity. The data used for the research is taken from a nationally representative survey, Longitudinal Ageing Study in India (LASI), Wave I (2019-2020) with a sample of 31,464 people aged 60 and above all over India. The outcome variable of food insecurity is made with composite scores from 5 sets of questions and made a binary variable of whether the respondent is food secure or insecure. Descriptive and bivariate analysis are performed to understand the correlation between the food insecurity and associated explanatory variables, with special focus on various types of functional impairments and chronic diseases. Through binary logistic regression models, the likelihood of food insecurity under different vulnerable conditions are analysed. The result describes 10.6% of older population aged 60 years and above of India experience food insecurity especially in rural areas (12.6%). Older adults living alone, in rural areas, with poor household income, with multimorbidity and functional impairments are more susceptible to be food insecure in India. With increasing number of functional limitations, the likelihood of being food insecure increases around 1.6 times. While presence of multimorbidity increases food insecurity; individual diseases like diabetes and hypertension negatively affects food insecurity among older adults.

Predictors of Healthcare Utilization among Geriatrics in India: Evidence from National Sample Survey Organization, 2017–18

Ageing International, 2022

India has also joined the club of ageing countries in the world with a rapid health transition an... more India has also joined the club of ageing countries in the world with a rapid health transition and experienced demographic ageing. The rapid growth of the older adult population has raised serious concerns about their health and healthcare utilization. However, very limited research has been done on the effects of demographic ageing on health and healthcare utilization. With this perspective, the present study looked at patterns in morbidity prevalence and health-seeking behaviour among older adults in India. The data was used from the National Sample Survey Organization, 75th round (2017–18) government of India. The total sample for the analysis is 1,26,42 older adults aged 60 and above. Univariate, bivariate, and binary logistic regression analysis was employed to understand the effects of socio-demographic conditions on morbidity prevalence among older adults and their healthcare-seeking behaviour. The prevalence of non-communicable diseases were found to be higher (14.4%) than communicable diseases (5.4%), and other morbidities (8.5%) among older adults (≥ 60) in India during 2017–18. The prevalence of communicable (6.3%), non-communicable (21.8%), and Other diseases (11.7%) were higher among the oldest-older adults (80 + years) compared to other groups. The prevalence of the non-communicable disease was considerably higher among male older adults as compared to females. The morbidity pattern of older adults varies remarkably across the states of India. More than half of the older adults (54%) visited private health care facilities for seeking their in-patient care. The utilization of private health facilities was higher among male than female older adults in India. The findings of this study are essential in assisting policymakers and healthcare providers in identifying individuals at risk, and might be incorporated into present initiatives for older people's social, economic, and health security.

Clinical Epidemiology and Global Health, 2022

Background: The elderly population in India is expanding fast, which indicates a growing share of... more Background: The elderly population in India is expanding fast, which indicates a growing share of people with more specialized needs for health and support. One of the prominent issues is the choice of health care services among the elderly, leading to its impact on health expenditure. Under Andersen's Health Behavioral Model, this study attempts to examine the nature of interregional disparity in the choice of health care services, along with investigating the choice-making in hospitalization services between private and public sources among the elderly. Besides, this study also comprises the regional dynamics of geriatric health care utilization. Methods: The current study uses data from the NSS, 75th round. The difference between choice in healthcare utilization and inpatient out-of-pocket (OOP) expenditure showed using the t-test and Z-test. The study also uses binary logistic regression analysis to explore the association of predisposing, enabling, and need factors with health services utilization. Results: The results suggest that the utilization of public facilities for inpatient services was very low, except in eastern and northeastern states. Caste, education, monthly per capita expenditure (MPCE), and need for surgery were the main factors explaining the choice of either public or private facilities. Conclusion: The findings of the study stresses the need to provide suitable health facilities for India's senior population in the hospital, which may help policymakers better understand their health care needs.

Clinical Epidemiology and Global Health, 2021

Background: With the turn of the century, CVDs have become the leading cause of mortality in Indi... more Background: With the turn of the century, CVDs have become the leading cause of mortality in India. Despite the wide heterogeneous prevalence of risk factors across different regions, CVD is the major cause of death in all parts of India. Therefore, the study aimed to investigate the prevalence of CVDs and its associated risk factors among older adults in India. Methods: The current study used data from the LASI, Wave 1, the world's largest and India's first longitudinal aging study. The total sample for the analysis was 65562 (45 and above individuals). The self-reported prevalence of CVDs was calculated by considering any one of the self-reported diagnosed conditions of hypertension, stroke, and chronic heart diseases. Binary Logistic regression was carried out between CVD and its associated risk factors like age, sex, place of residence, physical activity, family history of CVD, Diabetes/blood sugar, high cholesterol. P < 0.05 from two-sided statistical tests was regarded statistically significant. Results: The study indicated that the overall self-reported prevalence of diagnosed CVDs was 29.4% for older adults age 45 and above in India. Age was associated with increased risk of CVD Female older adults were more likely to have CVDs than male.The place of residence also had a stronger association with CVDs.In addition, high cholesterol, diabetes and physical inactivity were key risk factors for CVDs.The study also indicated that Family history was associated with a greater perceived risk for CVDs. The greater prevalence of CVDs risk factors among older adults manifested alarming public health concerns and a future health demand. It creates a threat if health promotion and awareness programs are not well designed.

Reproductive Health, 2019

Background: Evidence of hysterectomy in India is limited mainly due to lack of information in lar... more 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 surveycollected for the first time direct information on hysterectomy and self-reported reasons for undergoing the procedure among women in the reproductive age group. This paper examines the prevalence and determinants of hysterectomy in India among women aged 30-49 years in 29 states and seven union territories (UTs) of India using the NFHS-4 dataset. Methods: Percentage weighted by sampling weights was used for estimating the prevalence of hysterectomy. The paper used crosstabulations and percentage distributions to estimate the prevalence of hysterectomy across different socioeconomic backgrounds and reasons for undergoing hysterectomy respectively. A multivariate binary logistic regression model was also used to find statistically significant determinants of hysterectomy. Results: In India as a whole, 6 % of women aged 30-49 years had undergone a hysterectomy. The percentage of women who had undergone the procedure was found to vary considerably across the states and the UTs (from a minimum of 2% in Lakshadweep to a maximum of 16% in Andhra Pradesh). A noticeable fact that emerged was that the majority of the hysterectomies were performed in the private sector except in the northeast region. Years of schooling, caste, religion, geographic region, place of residence, wealth quintiles, age, parity, age at first cohabitation, marital status, and body mass index of women were found to be the sociodemographic determinants statistically associated with hysterectomy in India. The reasons reported frequently for hysterectomy were excessive menstrual bleeding/pain (56%), followed by fibroids/cysts (20%). The percentage and likelihood of undergoing hysterectomy are relatively high among women from older age groups (45-49), those who reside in rural areas, those without schooling, those who are obese, those having high parity, those with a low age at first marriage, and those who reside in the eastern and southern parts of India. The policy implication of these findings is that the reproductive health program managers should ensure regular screening and timely treatment of the problems resulting in hysterectomy.

Elder Abuse and Its Implications on Health Status of the Elderly in India

International Perspectives on Aging, 2021

The elderly in India face the double burden of ageing since they are old and cannot work; their h... more The elderly in India face the double burden of ageing since they are old and cannot work; their health also deteriorates due to old age. They also experience some kinds of abuse inside and outside the family; it directly affects their health, physically and psychologically. With this background, an effort has been made to explore the extent of abuse in India and its implications for the elderly&#39;s health. This study used data from the ‘Building a Knowledge Base of Population Ageing Survey (BKPAI)’ conducted in 2011 in seven states of India. The survey collected information on various socio-economic characteristics, health status, living arrangements, elder abuse, health and care-seeking behaviour. The preliminary analysis shows that 14% of the elderly experienced one or the other form of abuse. It is higher in rural areas than in urban and slightly higher for women as compared to men. The oldest-old, and widowed are the most sufferers from any form of abuse. It also observed that the elderly who belong to the lowest wealth quintile and currently working face more insult. Verbal abuse is the main form of harassment; about 10% of the elderly face abuse within the family and outside, specifically verbal abuse. The primary abusers are neighbours, followed by son/s daughters-in-law, etc. There is a positive association between abuse and health problems. There is an intense need to prevent elder abuse at all levels so that older persons can live the last phase of their life with peace and dignity.