Burden and determinants of multimorbidity among women in reproductive age group: a cross-sectional study based in India

Abstract

Background: India's government is currently running several programs with a sole focus on women's health during their child-bearing years. However, none of these programs incorporate the management of chronic health conditions during the reproductive span. This issue is an emerging public health concern; therefore, the present study aims to identify the patterns and correlates of multimorbidity among women in reproductive age groups in India. Methods: The study utilizes nationally-representative cross-sectional data from the Demographic and Health Survey on 661,811 women in the reproductive age group of 15-49 years. The study uses information on seven chronic morbidities, namely asthma, cancers, heart disease, diabetes, tuberculosis, hypertension, and thyroid disorder. Descriptive, bivariate, and multivariable techniques were utilized to accomplish the study objective. Results: The findings show that 17.4 and 3.5 per 100 women of reproductive age suffered from any one morbidity and multimorbidity, respectively. Hypertension, diabetes, and thyroid disorders were commonly occurring morbidities. The prevalence of having any one morbidity or multimorbidity increased with age. Variables like religion, wealth, parity, menopause, consumption of tobacco and alcohol, body mass index, and type of diet were found to be significantly related to the burden of multimorbidity. The prevalence of multimorbidity was found to be higher for women who belong to the Southern, Eastern, and North-Eastern regions of India. Conclusions: Findings suggest the importance of multimorbidity in the context of women of reproductive age. Inclusion of chronic disease management strategies with maternal and child health services needs to be taken into consideration by the program and policymakers. The annexation of social marketing approaches at the primary level of healthcare would assist policy-makers in educating women about the importance of leading a healthy lifestyle. Practicing dietary diversity can help in maintaining optimal estrogen levels, which would further help in decreasing multimorbidity rates among women in India.

Multimorbidity among midlife women in India: well-being beyond reproductive age

“…This implies that chronic conditions start from an early age and accumulate with ageing. This is consistent with the findings of our previous study among women in the reproductive age group using data from the Demographic and Health Survey, 2015–16, which suggested an increase in multimorbidity from 0.5 per 100 women to 10.3 per 100 women across 15 to 49 years of age [ 21 ]. This manifests a need for early intervention as multimorbidity surfaces around reproductive years and cumulates to reach an alarming height during midlife surprising the individual.…”

“…Present study examined a multidimensional linkage between socio-economic and demographic [ 16 , 17 ], health behaviours [ 18 , 19 ], anthropometric predictors [ 20 , 21 ], and family and reproductive predictors [ 22 – 24 ] with single and multimorbidity [ 25 ]. Socio-economic and demographic context included information on the respondent’s age (in years), residence, religion, social group, level of education, occupation, and wealth.…”

Temporal dynamics, patterns and correlates of single and multimorbidity in India, 1994–2018

“…Hypertension and diabetes were highlighted as frequently occurring chronic conditions in other studies conducted in LMICs. 15 , 27 , 28 Our study findings highlighted that the prevalence of thyroid disorder, cancer, and neurological disorder is also booming over time. This increased disease prevalence could be caused by the cognizance that hypertension, diabetes, cardiovascular disease, and cancer have received amidst the national programme for prevention & control of cancer, diabetes, cardiovascular diseases & stroke (2010).…”

“…NCD management in India is traditionally based on the “single disease model,” which is not optimally oriented for multiple disease management among older adults. 11 , 23 , 27 Multimorbidity demands intricate healthcare needs, which are not adequately understood by a vast majority of physicians. A study in the domain suggests that multiple healthcare specialists’ visits could lead to polypharmacy.…”

Profile of multimorbidity in outpatients attending public healthcare settings

“…Further, some of these child-bearing age group women may become pregnant. [ 29 ] Since mostly pregnant women have been excluded from multimorbidity studies, future research should specifically assess this special group. Moreover, we found a higher percentage of females without education than males (21.40% vs. 15.83%).…”