Sikdar Roni, Bansod Dhananjay W
Department of Public Health & Mortality Studies, International Institute for Population Sciences, Mumbai, Maharashtra, India.
PLoS One. 2025 Aug 12;20(8):e0329375. doi: 10.1371/journal.pone.0329375. eCollection 2025.
The global demographic landscape is experiencing a significant transformation of declining fertility rates, which has far-reaching implications for societal development and women's well-being. The study investigates the association between declining fertility rates and women's reproductive health in India, considering socioeconomic and demographic factors as well as regional variations.
The study uses data from the recent National Family Health Survey (NFHS-5) round conducted during 2019-21. A composite index called the Reproductive Health Index (RHI) is constructed by equally weighing indicators such as antenatal care, anemia, and body mass index. To evaluate the robustness of this index, a sensitivity analysis is performed. Descriptive statistics and Poisson regression models are employed to explore the association between fertility and RHI among currently married women.
The findings show substantial differences in RHI scores across socio-economic, demographic groups, and geographical regions. The lowest RHI score of 4.09 is found in the Eastern region, whereas those in the Northern region exhibit the highest score of 4.42. The analysis further indicates a negative relationship between fertility and reproductive health. Women with four or more children exhibit an RHI score of 1.97 compared to 2.98 among those with one child. The Poisson regression analysis indicates that women with at least four children have lower RHI scores, even after adjusting for socio-economic and demographic factors. Women in wealthier quintiles and those with media exposure report significantly higher RHI score compared to those in the poorest wealth quintiles and no media exposure.
In conclusion, this research highlights the critical need for targeted interventions to address regional and socio-economic inequities in healthcare access and reproductive health services. By exploring the intricate relationship between low fertility and reproductive health, this study contributes to the discourse on gender equality, reproductive rights, and sustainable societal development. The findings provide evidence to guide public health policies and programs designed to promote women's reproductive health.
全球人口格局正经历生育率下降这一重大转变，这对社会发展和妇女福祉具有深远影响。该研究考察了印度生育率下降与妇女生殖健康之间的关联，同时考虑了社会经济和人口因素以及地区差异。
该研究使用了2019 - 2021年期间进行的最新一轮全国家庭健康调查（NFHS - 5）的数据。通过对诸如产前护理、贫血和体重指数等指标进行同等加权，构建了一个名为生殖健康指数（RHI）的综合指数。为评估该指数的稳健性，进行了敏感性分析。采用描述性统计和泊松回归模型来探究当前已婚妇女的生育率与生殖健康指数之间的关联。
研究结果显示，不同社会经济、人口群体以及地理区域的生殖健康指数得分存在显著差异。东部地区的生殖健康指数得分最低，为4.09，而北部地区的得分最高，为4.42。分析进一步表明生育率与生殖健康之间存在负相关关系。有四个或更多孩子的妇女的生殖健康指数得分为1.97，而只有一个孩子的妇女的得分则为2.98。泊松回归分析表明，即使在调整了社会经济和人口因素之后，至少有四个孩子的妇女的生殖健康指数得分仍然较低。与最贫困五分位数且无媒体接触的妇女相比，处于较富裕五分位数且有媒体接触的妇女的生殖健康指数得分显著更高。
总之，本研究强调了针对性干预措施的迫切需求，以解决医疗保健获取和生殖健康服务方面的地区及社会经济不平等问题。通过探究低生育率与生殖健康之间的复杂关系，本研究为关于性别平等、生殖权利和可持续社会发展的讨论做出了贡献。研究结果为指导旨在促进妇女生殖健康的公共卫生政策和项目提供了证据。
