Does mother’s pregnancy intention affect child healthcare and growth in India? Evidence from a longitudinal survey

ABSTRACT Objective To assess the effect of unintended births on children’s health care and nutritional status. Design The study uses cross-sectional prospective design. Setting The nationally representative Indian Human Development Survey (IHDS) data of two rounds (i.e. 2004-5, 2011-12) was used in this study. The women data was used to draw representative sample of 7,166, and out of them 3,905 belong to under 5 years of age group. Statistical Analyses Secondary analysis, using bivariate and multivariate linear and logistic models was conducted using both rounds of IHDS data. We categorized birth as an unintended birth if mother did not want to have addition child at IHDS-I but gave birth during inter-survey. Furthermore, all births exceeding to the desired number of children reported by mothers in the IHDS-II were also included in unintended births and all other births were considered as intended births. Multivariate logistic regression models were applied to analyse the effect of unintended and intended births on child-immunization and exclusive breastfeeding. While multivariate linear regression models were used to assess the effect of childbearing intention on child nutritional status. Results The study shows that by controlling other factors, unintended births were less likely to be exclusively breastfed (OR 0.885, p<0.05) and receive full immunization (OR 0.830, p<0.001). Moreover, children’s poor nutrition was more prevalent among unintended births as they were more likely to be stunting and underweight. Conclusions The findings of the study underscore the importance of investments in family planning to reduce the unintended births to improve children’s health and growth. Strengths and limitations of the study The findings of this study are from nationally representative sample of 3,905 belong to under 5 years of age group. Other child development indicators namely cognitive skills and academic performance are not included in this study. The seven years of duration between the survey period could have changed women’s childbearing intention.