Paste Table1 here.
Table 1 represents the result of the bivariate analysis and chi-square test of infertile women. Among 40,401 currently married 20-35 year age-group women, 3,782 (i.e. 9.4%) women are infertile. Infertile women are further classified according to their place of residence. Among 40,401 currently married 20-35 year age-group women, 11,657 (28.85%) women residing in urban area, in which 1,242 (10.7%) women are infertile and 28,744 (71.15%) women residing in rural area, in which 2,540 (8.8%) women are infertile. In India, among 29.1%, 37.5% and 33.4% currently married women of age-group 20-25, 25-30 and 30-35, 2.9%, 8.4% and 16.0% women are infertile respectively. In urban area, among 24.4%, 38.2% and 37.4% currently married women of age-group 20-25, 25-30 and 30-35, 2.9%, 9.3% and 17.2% women are infertile respectively. In rural area, among 30.9%, 37.3% and 31.8% currently married women of age-group 20-25, 25-30 and 30-35, 2.9%, 8.1% and 15.5% women are infertile respectively. The results of the chi-square test suggest that age is a significant variable in total, rural and urban areas for further study of infertility. Among the total of 40,401 sampled currently married women of higher fertility age 22.1%, 13.4%, 51.6%, and 13.0% women have no education, primary, secondary and higher education respectively, and among each of these educated groups 7.8%, 9.3%, 9.6% and 10.3% women are infertile respectively. In the urban areas, among 11.8% of illetrate women, 6.7% were infertile, 10.3% of primary educated women 8.6% were infertile, 55.0% of secondary educated women 9.3% infertile, and 22.9% highly educated women 9.8% infertile. In the rural areas, among 26.2% no educated women 8.8% infertile, 14.7% primary educated women 10.5% infertile, 50.2% secondary educated women 11.0% infertile, and 8.9% highly educated women 12.7% infertile. Whole India is divided into many religions but here for simplicity, the religion is classified into three major categories (i.e. Hindu, Muslim, and Others). Among the total sample of 40,401 women 77.5%, 11.6%, and 10.9% women belong to Hindu, Muslim, and Other religions respectively. In each of these religious groups 9.3%, 8.8%, and 10.6% of women are infertile. When infertile women are classified according to religion, then according to the classification we can say that the effect of religion on infertility in urban areas is less compared to rural areas. In urban areas, the effect of religion on infertility is insignificant but in rural areas, the effect of religion on infertility is significant. However, when infertile women are classified according to caste, their effect on infertility is significant in the urban area while insignificant in the rural area. As per Census 2011 report, 68.84% of the people in India are living in rural areas and only 31.16% are living in urban areas. Because the majority of India’s population lives in rural areas, the overall effect of caste on infertility is insignificant. Since the wealth status of respondents, much effects on infertility and is found to be significant in both types of places of residence (i.e. rural as well as urban), so the overall effect of wealth status is also significant. BMI (Body Mass Index) is a pertinent indicator of infertility. If women are over weighted then occurs some issue to conceive in comparison to underweight and normal weight. The result of the chi-square test suggests that BMI is also an important differential variable and that its effect on infertility exists in both types of residences. Exposure to mass media is also found to be a significant variable in infertility. Among the total sample of 40,401 currently married women aged 20-35, 19.2% have no mass media exposure and 80.8% have any type of mass media exposure. Among those not exposed to mass media, 8.6% of women experience infertility, while among mass media-exposed women, 9.5% experience infertility. If the exposure to mass media is classified according to a place of residence then the variable is found to be significant in urban areas while it is found to be insignificant in rural areas. Since the percentage of working women in India is not that high but as the education of women is increasing, the percentage of working women is also increasing. Generally, it has been seen that highly educated women are going to get a job. Among the total sample of 40,401 currently married women, 80.4% are not working of which 8.9% of women are infertile and only 19.6% of women are currently working of which 11.4% women are infertile. The result of the chi-square test shows that the current working status of women is found to be significant for determining the infertility condition in urban as well as rural areas.
Paste Table 2 here.
Table 2 shows the results of unadjusted logistic regression of infertile women in India and by place of residence. Women who are currently aged 25-30 and 30-35 are 3 times and 6 times more likely to experience infertility than women in the 20-25 age group. This covariance has been found to be significant in both rural and urban dwellings. Women who belong to the age group 25-30 and 30-35 are 3 times and approx 7 times more likely to experience infertility in urban, whereas in rural 2 times and 6 times more likely to experience infertility than 20-25 age group women. This result suggests that urban women in the same age group experience more infertility than rural women. The result of unadjusted logistic regression was found to be significant according to education. Women who are primarily educated, secondary educated, and highly educated are 22.3%, 25.6%, and 36.1% more likely to experience infertility than women who have no education. In the urban areas, primary educated women are 29.9%, secondary educated women are 42.1% and highly educated women are a 51.4% higher chance to become infertile than no educated women, whereas, in rural areas, primary educated women are 22.3%, secondary educated women are 29.5% and highly educated women are 51.2% more likely to experience infertility than no educated women. The result of unadjusted logistic regression shows that the effect of religion on infertility as a whole is found to be significant. This covariate is found to be significant in rural areas but not in urban areas. In the rural areas, Muslims are 15% less likely and other religions are 21.6% more likely to experience infertility than Hindus. When caste is considered to be covariant, its effect is found to be opposite to that of religion, meaning that the effect of caste is found to be significant in urban areas, but not in rural areas. Moreover, in the urban areas, other caste women are 20.6% and OBC caste women are 16.2% more likely to experience infertility than SC/ST women.
The results of Table 2 suggest that the wealth status of women is significant in rural as well as urban. With the increase in wealth status of women, the likelihood of experiencing infertility increases. Women who have wealth status poorer, middle, richer, and richest are 13.9%, 19.3%, 34.9%, and 24.3% more likely to experience infertility than the poorest women. Moreover, the effect of an increase in wealth status is greater in urban areas than in rural areas. Women who are underweight are 20% less likely and obese women are 71% more likely to experience infertility compared to normal-weight women. Women who have mass media exposure are 11.5% more likely to experience infertility than women who are not exposed to mass media. According to the result of un-adjusted logistic regression, mass-media exposure was found to be significant only in the urban area, whereas it was insignificant in the rural area. Taking into account the current working status of women, Table 2 shows that women who are currently working are 32.4% more likely to experience infertility than women who are not working, and furthermore, this covariate has been found to be significant in both urban and rural. When we see the interaction effect of higher education and the current working status of women then we found that women who are highly educated as well as currently working are 22.5% more likely to experience infertility than women of other statuses and this interaction effect was found to be significant in both habitat types.
Paste Table 3 here.
Paste Table 4 here.
Table 3 shows the results of adjusted logistic regression of infertile women in India and by place of residence when the current working status of women is not considered in the model while Table 4 shows the result of adjusted logistic regression of infertile women in India and by place of residence when the current working status of women and the interaction effect of highly educated and currently working status of women are considered in the model after controlling for certain socioeconomic and demographic variables of the model I. Considering age, Table 4 shows that women whose current age belongs to the age group 25-30 and 30-35 are 3 times (95% CI 2.582-3.298) and approx 6 times (95% CI 5.115-6.493) more likely to experience infertility than 20-25 age group women. This covariate is found to be significant in both types of regions that are rural as well as urban. In urban, women who belong to the age group 25-30 and 30-35 are 3 times (95% CI 2.636-4.288) and approx 7 times (95% CI 5.168-8.307), whereas in rural approx 3 times (95% CI 2.396-3.183) and 5 times (95% CI 4.765-6.287) more likely to experience infertility than 20-25 age group women. The result of adjusted logistic regression shows that women with primary, secondary, and higher education are 9.7% (95% CI 1.015-1.295), 21.4% (95% CI 1.059-1.343), and 33.2% (95% CI 1.083-1.538) more likely to become infertile as compared to no educated women. So this shows that as education increases, infertility also increases. In the urban area, the effect of education on infertility is more as compared in the rural areas. In the urban area, 12% (95% CI 1.033-1.314), 19.1% (95% CI 1.062-1.473), and 24.1% (95% CI 1.097-1.498) primary, secondary, and highly educated women are more likely to become infertile compared to no educated women whereas, in rural areas, 2% (95% CI 0.812-1.043) which is insignificant, 10.4% (95% CI 1.014-1.243) and 15.2% (95% CI 1.088-1.418) primary, secondary and highly educated women are more likely to become infertile as compared to no educated women.
The findings of Table 4 suggest that in India, the Muslim religion significantly affects infertility, but other religions do not. In urban areas, it is not found to be significant among Muslims, but in other religions, it is found to be significant at a level of 10% as compared to Hindus. In Rural, religion is found to be significant. Muslims are 15.6% (95% CI 0.721-0.987) less likely to become infertile at a 5% level of significance and other religions are 6.2% (95% CI 1.007-1.312) more likely to become infertile at 10% level of significance as compared to Hindu. Caste is found to be significant overall. Others and OBC caste are 13.2% (95% CI 1.023-1.253) and 10% (95% CI 1.002-1.207) more likely to experience infertility as compared to SC/ST. Caste is considered important in urban areas but not in rural areas which is just opposite to religion. The wealth index is found to be a significant indicator of infertility. Poorer, Middle, Richer and Richest are 18.6% (95% CI 1.050-1.341), 20.4% (95% CI 1.056-1.373), 27.2% (95% CI 1.108-1.461) and 17.8% (95% CI 1.013-1.369) more likely to become infertile than poorest women. Wealth Index is found to be a significant indicator in both rural as well as urban, but the effect of wealth status in urban areas is very high than in rural areas. BMI also plays a significant role in determining infertility. Underweight and overweight women are 12.6% (95% CI 0.793–0.965) less and 46.2% (95% CI 1.344–1.590) more likely to be infertile, respectively, compared to normal-weight women. BMI is found to be a significant indicator in both urban as well as rural areas. In the urban areas, 18.1% (95% CI 0.660-0.923) of underweight women are less likely and 25.8% (95% CI 1.103-1.435) of overweight women are more likely to become infertile while in rural areas, 9.7% (95% CI 0.709-0.982) underweight women are less likely and 60.7% (95% CI 1.442-1.792) overweight women are more likely to become infertile. Mass media exposure is found to be significant at the 10% level of significance overall. Women with mass media exposure are 9.4% (95% CI 1.009–1.131) more likely to experience infertility than women who are not exposed to mass media. In the urban areas, 35.1% (95% CI 1.152–1.841) of currently married women who have mass media exposure are more likely to be infertile than women who are not exposed to mass-media, whereas in rural areas, exposure to mass media on infertility is not found to be significant.
In Model-II, variables for employed women and the interaction of highly educated and employed women have been introduced. All predictors considered in Model-I are still found in the almost similar pattern in Model-II, with additional explanatory variables, employed women and highly educated working women, being positively associated with the likelihood of infertility. This indicates that women who are highly educated as well as employed have a highly significant relationship with infertility status. Women who are working in any field are 11.8% (95% CI 1.029–1.213) more likely to experience infertility than non-working women. The findings advocate that women working in urban areas are more likely to experience infertility. In urban areas, 18.9% (95% CI 1.020–1.386) of women with current working status are more infertile than women who are not currently working. Women working in rural areas are also facing the condition of infertility, but the percentage is less as compared to urban resident women. In rural areas, women with working status are 9.3% (95% CI 1.009-1.206) more infertile than non-working women, while in urban areas the percentage of women experiencing infertility is twice that of rural residing women. Highly educated as well as currently working women are 20.2% (95% CI 1.035–1.538) more likely to be infertile than other women. This interaction effect is more likely to be observed in urban than rural. In urban areas, highly educated working women are 31.8% (95% CI 1.126-1.676) more likely to experience infertility than other women, while only 6.6% (95% CI 1.008-1.536) of highly educated working women in rural areas are more likely to experience infertility than other women. In assessing the strength of the models, the values of -2Log likelihood were determined. This diagnostic tool indicates that Model-II is better than Model-I, and thus Model-II, which comprises variables for working women and highly educated working women, is superior at explaining the incidence of infertility in India and on the basis of the place of residence in it.