Sexual and reproductive health of Indian women, intimate partner violence and COVID-19 pandemic: an analysis using NFHS-IV and NFHS-V data sets

We focus on the structural interrelationship between intimate partner violence (IPV), women empowerment and sexual and reproductive health (SRH) of Indian women and how COVID-19 pandemic influenced SRH issues such as experience of sexually transmitted disease (STI), suffering genital sore and experience of terminated pregnancy in last 12 months. We use National Family Health Survey (NFHS) data sets: NFHS-IV (2015-16) and NFHS-V(2019-21). NFHS-V survey collected data in two phases: a group of states (Phase-I) were surveyed before the outbreak of pandemic whereas for the rest of the states (Phase-II) data collection coincided with the period of pandemic. This feature enables us to investigate the effect of COVID-19 pandemic on SRH of Indian women. First, a structural equation model is applied, which revealed that IPV (physical as well as sexual) is a risk factor of experiencing any genital sore/ulcer, terminated pregnancy and STI in last one year. Women empowerment is a protective factor to experience incidence of genital sore/ulcer. Next, results of multi-level logistic regression model clearly show that probabilities of incidence of STI and genital sore recorded a significant increase in NFHS-V round for all states irrespective of whether surveyed prior to pandemic or after outbreak of pandemic compared to NFHS-IV level. This decline in SRH of Indian women is a matter of serious concern. Secondly, we observe that probability of incidence of terminated pregnancy significantly declined during the pandemic phase of survey indicating towards disruption of abortion related health care facilities during pandemic period.