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The paper aims to analyze the coverage of health insurance and its correlates in the north-eastern region of India.

The study accessed the raw data of the National Family Health Survey (NFHS-4) (2015–16), which was an extensive, multiround survey conducted in a representative sample of households throughout India, which included socioeconomic, demographic and information on coverage of health insurance of any member of the household. The multivariate analysis of logistic regression was adopted to find the correlates of health insurance for all the eight (8) north-eastern states of India.

The results observed that among the north-eastern states, the coverage of health insurance was highest in Arunachal Pradesh (59%) followed by Tripura (58%), Mizoram (47%) surpassing the all India level of 27%, whereas the lowest was in Manipur (4%) followed by Nagaland (6%) and Assam (10%). The multivariate analysis of logistic regression found that the socioeconomic and demographic factors, households with a bank account and below poverty line (BPL) cardholders played a significant role in the coverage of health insurance in the north-eastern states of India.

The study focuses only on the coverage and correlates of health insurance. Further evaluation studies on each scheme of the social health insurance are needed for proper assessment of the health insurance schemes in the region.

There has been evidence around the world (South Korea, Taiwan and Thailand) that health insurance could be a protective shield from the entrapment into poverty due to high health expenditure. The NFHS-4 put up the finding that in the north-eastern part of India, the coverage of health insurance had been low. This implied that the region could fall into poverty due to high medical expenses on health. Taking account of multiple health insurance providers, risk pooling and consolidation of health insurance providers have become the need of the hour.

The study is different from other studies of health insurance since it covered all the eight (8) north-eastern states of India, which are ethnically, culturally and historically distinct from the rest of India in general and within the region and states in particular and examines the impact of each of the independent variables with the dependent variables. The study has shown that the variation in health insurance coverage associated with socioeconomic and other household-level demographic attributes (although not very strong).

Indonesia subscribes to rights-based principles of family planning. However, a chasm between principles and practice has long been noted on a global basis, and progress has not been well-documented. This paper aims to assess the extent to which the Indonesian national family planning program has evolved in a manner that is consistent with rights-based principles.

The primary source of data was five Indonesian Demographic Health Surveys undertaken from 1997 to 2017. The analyses were organized around three major categories of family planning-related human rights. Trend analysis and logistic regression were used in analyzing the data.

Indonesian women have considerable autonomy in family planning decision, reporting that family planning decisions were mainly made by themselves or jointly with their spouse. Although contraceptive method awareness and demand for family planning are high, Indonesia fares poorly with regard to informed choice in contraceptive method selection. Access to family planning services is comparatively high as judged by contraceptive prevalence, family planning demand satisfaction and unmet need for family planning. However, significant geographic and socioeconomic inequity were observed on many indicators, with eastern Indonesian provinces consistently lagging behind.

This paper focuses on married couple, as Indonesia has a restrictive policy to limiting access and information of family planning for other groups, unmarried youth in particular.

This paper makes an important contribution to document how effectively the prohuman rights policy orientation toward family planning has been translated into services.

The purpose of this paper is to explore an association between women experience lifetime intimate partner violence (IPV) and women decision making with utilization of reproductive and maternal health services in Cambodia.

An analysis of secondary data of Cambodia Demographic and Health Survey (CDHS) 2014. The total number of sample size was 1,539 married women who had birth in the last five years prior to the time of interview and completed the domestic violence module in the CDHS 2014 questionnaire. χ² test and binary logistic regression were performed in this study.

Results give an evidence that emotional violence had significant impact on receiving sufficient antenatal care (ANC) (OR: 0.7, 95%CI: 0.43–0.86) while physical violence had significant association with deliver with skilled birth attendance (SBA) (OR: 0.5, 95%CI: 0.27–0.79). Further, women’s participation in household decision making played as important factor in enabling women revive sufficient ANC (OR: 1.7, 95%CI: 1.19–2.29), and utilization of modern contraceptive method (OR: 1.5, 95%CI: 1.09–1.97).

This study provides significant finding on the impact of IPV and women’s decision making on reproductive and maternal health in Cambodia. Result has drawn an attention to policy makers, related ministries and stakeholder to promulgate and effectiveness of policies and program implementation within the country.

This study examined the risk factors associated with hypertension in Bhutan.

The cross-sectional data of 30,889 adults from the National Health Survey of Bhutan was used in this study. Multivariable regression accounting for the complex survey design was performed to identify the risk factors. The backward elimination approach was applied in the multivariable analysis.

The prevalence of hypertension was 17%. Increasing age, being female, being previously married, higher wealth status, past alcohol use, having diabetes, loneliness, health service use and low vegetable intake was associated with increased hypertension risk, whereas, higher education level, being employed and residing in the eastern region was associated with reduced risk. Age, gender, education, wealth status, diabetes status, loneliness and health service use were common factors in all the regions. Marital status and vegetable intake were associated with hypertension in the western and central regions, and alcohol use in the eastern and central regions.

Affecting around one-sixth of the population, hypertension is a significant public health problem in Bhutan. Interventions to improve health education and access, motivate healthy lifestyles, and reduce harmful alcohol use, and strategies to create health-promoting social and built environments are needed to curb the hypertension epidemic and its consequences.

The differences in the distribution of factors associated with under-five mortality (UFM) can help explain the rural-urban inequities in UFM. The determinants contributing to UFM in rural and urban areas have not been previously explored in Bhutan. This study examined the factors associated with UFM in rural and urban Bhutan and the role of the factors in explaining UFM disparity.

The dataset of 6,398 single births (4,999 in rural and 1,399 in urban areas) from the 2012 Bhutan National Health Survey was analyzed. Logistic regression analysis accounting for the complex survey design was performed to investigate the determinants.

The UFM rate was 2.75 times higher in rural than in urban Bhutan. In rural communities, children of younger mothers, born in households without safe sanitation and electricity, and central and eastern regions had increased UFM odds. Whereas, children born to working mothers and educated fathers, and born in households with non-working household heads had lower UFM odds in urban areas. A higher number of births and smaller household size was associated with an increased UFM odds irrespective of rural-urban residence. Environmental factors were attributable for the largest portion of rural UFM disadvantage.

This study helps to understand the rural-urban differences in the factors influencing UFM in Bhutan. The findings suggest that policies aimed to improve environmental and socioeconomic conditions, women empowerment, and those aimed to enhance health utilization can help reduce the rural-urban child survival disparity and accelerate the achievement of the Sustainable Development Goal target.

This study aims to empirically examine how the Khmer Rouge regime (1975–1979) in Cambodia continues to affect the health of the second generation.

The 2000 and 2005 Cambodia Demographic and Health Surveys were used in the analysis. The study sample were women with a child/children in 2000/2005. The sample population was identified according to whether the person was in utero “91 months or earlier before the Khmer Rouge regime,” “46–90 months before the Khmer Rouge regime” and “1–45 months before the Khmer Rouge regime” and during the Khmer Rouge regime. The authors then regressed the size of babies of the targeted population on the timing of the mothers being in utero.

Mothers who were in utero during the regime had a higher likelihood of giving birth to smaller-than-average babies. Additionally, mothers born in the areas that had a higher probability of death of children aged five or under during the regime were at risk of giving birth to smaller-than-average babies if they were in utero during that time.

This is the first paper to assess the impact of the Khmer Rouge regime on the health of the second generation.

Sixteen million adolescents give birth each year, constituting 11% of all births worldwide. Adverse adolescent pregnancy outcomes are well-documented. Available data on adolescent pregnancies have mainly relied on self-reported age and retrospective survey data, which might not capture adolescent births accurately. This paper reports on trends in adolescent pregnancy and associated adverse birth outcomes in Matlab, Bangladesh, using data from the Matlab Heath and Demographic System (HDSS) which precisely documents maternal age.

The study was conducted in the rural subdistrict of Matlab in Bangladesh. HDSS data were used to examine trends in adolescent motherhood (10–19 years) in the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b) service areas (ISA) and government service areas (GSA) between 2007 and 2015. A total of 4,996 adolescent mothers were included in the analysis. Chi-square testing and binary logistic regression were used to document adolescent pregnancy trends and the differences in and causes of perinatal death.

The fertility rate was 27 per 1000 adolescent mothers in ISA and 20 per 1000 adolescent mothers in GSA, during the 9 years of the study period. The adjusted odd of an adolescent mother having a perinatal death in ISA, relative to GSA was 0.69. Significant determinants of perinatal death among adolescent mothers included maternal education, paternal education, mother’s age at first birth, asset score and distance from the nearest health facility.

This paper documents the real trend of adolescent pregnancy by capturing the accurate age at pregnancy for the first time in Bangladesh.

This study aims to explore whether there is an association between women's empowerment and the utilization of maternal healthcare facilities.

This study considered four indices for measuring women's empowerment – labor force participation index (LFPI), decision-making power index (DMPI), attitude toward partner’s violence index (ATPVI) and knowledge level index (KLI) – and three healthcare facilities – number of antenatal visits, delivery with healthcare facilities and postnatal checkup after delivery. Data extracted for this study were from the Bangladesh Demographic and Health Survey 2011 and 2014. A chi-square test was used for bivariate analysis, and a three-level logistic regression model was applied for multivariate analysis.

An increment was observed in the practice of all considered healthcare facilities, and the percentage of highly empowered women in DMPI decreased from 2011 to 2014. This study found that higher empowerment of women in DMPI, KLI and ATPVI significantly (p-value < 0.05) increases the utilization of healthcare facilities. High empowerment of mothers in LFPI was found negatively associated with facility delivery and positively associated with the postnatal checkup.

Women's empowerment was found significantly associated with the utilization of maternal healthcare facilities. This study is seeking the attention of corresponding authority to come up with a more effective intervention program to empower women to utilize maternal healthcare facilities.

In Kenya, gaps exist in health service provision to slum residents, especially service availability and access to quality care. There is also little information on the health status of people living in slums other than in Nairobi. The purpose of this paper is to generate evidence for use in designing interventions to improve health services in four mid-sized slums in Embu, Nyeri and Thika, Kenya.

A cross-sectional survey of clients receiving services in health facilities was conducted in the targeted slums. Data were collected through face-to-face interviews. Factor scores were generated using the Rasch model; simple and multivariate logistic regression analyses were done using the R statistical software.

Overall, 81 per cent of the 203 participants reported being satisfied with health services. Most clients (89 per cent) reported that health facility staff greeted them warmly; 82 per cent said their consultation was private. The facility type, waiting time and client experience with service providers determined their satisfaction (p < 0.05).

Healthcare managers can improve client satisfaction levels by understanding the client flow in their facilities and addressing causes of client dissatisfaction, such as long waiting times, while at the same time promoting facilitating factors.

The authors use latent variable modelling to compute client satisfaction scores, which were dichotomised into two categories and fitted into a logistic regression model to identify factors that influence client satisfaction. Health facility clients in the four slums are satisfied with services and have confidence the providers will serve them in a friendly and professional manner that promotes respect and quality care. The paper recommend healthcare managers in similar settings carry out client flow analysis and institute remedial measures to address long waiting times. Qualitative studies are recommended to determine the reasons behind the high satisfaction levels reported in this study.