Background: Tuberculosis, as a communicable disease, is an ongoing global epidemic that accounts for high burden of global mortality and morbidity. Globally, with an estimated 10 million new cases and around 1.4 million deaths, TB has emerged as one of the top 10 causes of morbidity and mortality in 2019. Worst hit 8 countries account for two thirds of the new TB cases in 2019, with India leading the count. Despite India's engagement in various TB control activities since its first recognition through the resolution passed in the All-India Sanitary Conference in 1912 and launch of first National Tuberculosis Control Programme in 1962, it has remained a major public health challenge to overcome. To accelerate progress towards the goal of ending TB by 2025, 5 years ahead of the global SDG target, it is imperative to outline the incidence and mortality trends of tuberculosis in India. This study aims to provide deep insights into the recent trends of TB incidence and mortality in India from 1990 to 2019. Methods: This is an observational study based on the most recent data from the Global Burden of Disease (GBD) Study 2019. We extracted numbers, age-specific and age-standardized incidence and mortality rates of Tuberculosis for the period 1990–2019 from the Global Health Data Exchange. The average annual percent change (AAPC) along with 95% Confidence Interval (CI) in incidence and mortality were derived by joinpoint regression analysis; the net age, period, and cohort effects on the incidence and mortality rates were estimated by using Age–Period–Cohort model. Results: During the study period, age-standardized incidence and mortality rates of TB in India declines from 390.22 to 223.01 and from 121.72 to 36.11 per 100,000 population respectively. The Joinpoint regression analysis showed a significant decreasing pattern in incidence rates in India between 1990 and 2019 for both male and female; but larger decline was observed in case of females (AAPC: − 2.21; 95% CI: − 2.29 to − 2.12; p < 0.001) as compared to males (AAPC: − 1.63; 95% CI: − 1.71 to − 1.54; p < 0.001). Similar pattern was observed for mortality where the declining trend was sharper for females (AAPC: − 4.35; 95% CI: − 5.12 to − 3.57; p < 0.001) as compared to males (AAPC: − 3.88; 95% CI: − 4.63 to − 3.11; p < 0.001). For age-specific rates, incidence and mortality rates of TB decreased for both male and female across all ages during this period. The age effect showed that both incidence and mortality significantly increased with advancing age; period effect showed that both incidence and mortality decreased with advancing time period; cohort effect on TB incidence and mortality also decreased from earlier birth cohorts to more recent birth cohorts. Conclusion: Mortality and Incidence of TB decreased across all age groups for both male and female over the period 1990–2019. The incidence as well as mortality was higher among males as compared to females. The net age effect showed an unfavourable trend while the net period effect and cohort effect presented a favourable trend. Aging was likely to drive a continued increase in the mortality of TB. Though the incidence and mortality of tuberculosis significantly decreased from 1990 to 2019, the annual rate of reduction is not sufficient enough to achieve the aim of India’s National Strategic plan 2017–2025. Approximately six decades since the launch of the National Tuberculosis Control Programme, TB still remains a major public health problem in India. Government needs to strengthen four strategic pillars “Detect–Treat–Prevent–Build” (DTPB) in order to achieve TB free India as envisaged in the National Tuberculosis Elimination Programme (2020).

Background: Cervical cancer is the fourth most common cancer that occurs to women worldwide. This study aims to assess trends in incidence and mortality of cervical cancer in India and its states over past three decades for tracking the progress of strategies for the prevention and control of cervical cancer. Methods: Data on cervical cancer incidence and mortality from 1990 to 2019 for India and its states were extracted from Global Burden of Disease study and were utilized for the analysis. Spatial and rank map has been used to see the changes in incidence and mortality of cervical cancer in different Indian states. Further, joinpoint regression analysis is applied to determine the magnitude of the time trends in the age standardized incidence and mortality rates of cervical cancer. We obtained the average annual percent change (AAPC) and corresponding 95% confidence intervals (CI) for each state. Results: Overall, from 1990 to 2019 Jharkhand (Incidence: -50.22%; Mortality: -56.16%) recorded the highest percentage decrement in cervical cancer incidence and mortality followed by the Himachal Pradesh (Incidence: -48.34%; Mortality: -53.37%). Tamilnadu (1^st rank), Jammu & Kashmir and Ladakh (32^nd rank) maintained the same rank over the period of three decade for age standardized cervical cancer incidence and mortality. The regression model showed a significant declining trend in India between 1990 and 2019 for age standardized incidence rate (AAPC: −0.82; 95%CI: −1.39 to −0.25; p < 0.05) with highest decline in the period 1998-2005 (AAPC: −3.22; 95%CI: −3.83 to −2.59; p < 0.05). Similarly, a significant declining trend was observed in the age standardized mortality rate of India between 1990 and 2019(AAPC: −1.35; 95%CI: −1.96 to −0.75; p < 0.05) with highest decline in the period 1998-2005 (AAPC: −3.52; 95%CI: −4.17 to −2.86; p < 0.05). Conclusion: Though the incidence and mortality of cervical cancer declined over past three decades but it is still a major public health problem in India. Information, education and communication activities for girls, boys, parents and community for the prevention and control of cervical cancer should be provided throughout the country.

Reproductive health and well-being of a woman are associated with factors such as menarche, first marriage, first sex, first birth, and menopause. The beginning of these events also brings about significant changes in women's lives. Despite marrying early being acknowledged as a detrimental and discriminatory socio-cultural global practice, a huge proportion of girls are being married at an early age, often detrimental to maternal and child health. Adding to the current national debate for the revision of the minimum age at marriage for girls from 18 to 21 years it becomes important to understand the past scenario and current situation of age at marriage in India. In this study, first five rounds of the National Family Health Survey (NFHS) have been used as a data source. Cox Proportional Hazard Model, Multiple Classification Analysis (MCA), Kaplan Meier Curve, Life table survival analysis, hierarchical clustered heat map, Multivariate Decomposition Analysis (MDA), and geospatial mapping were used to fulfill the objective of the study. The results showed that almost 65.9% of women got married before reaching the age of 18 years in the year 1992-93 which reduced to 23.2% among women aged 20-24 years in 2019-21. Region, respondent's level of education, caste, religion, wealth, and mass media exposure were significantly associated with the age at first marriage. The hazard of age at marriage declined significantly with higher educational attainment [higher education- AHR:0.37; CI:0.36 to 0.37], improving household wealth [richest wealth- AHR:0.91; CI:0.90 to 0.91], and mass media exposure [AHR:0.96; CI:0.95 to 0.96]. Since, the age at marriage has a substantial impact on fertility pattern and has a strong association with maternal & child health, policies regarding improving the age at marriage and better enforcement of the concerned laws are required to meet the SDG targets.

Pregnancy during adolescence is a major risk factor for adverse pregnancy outcomes. Further, Motherhood during the adolescent period is identified as a major global health burden. Considering the widely known importance of the negative impact of adolescent pregnancy, motherhood at an early age, and adverse pregnancy outcomes, this paper aims to provide insight into correlates of teen pregnancy, adolescent motherhood and adverse pregnancy outcome. This study utilizes the data from UDAYA survey conducted in Uttar Pradesh and Bihar. The eligible sample size for the study was 4897 married adolescent girls between the ages of 15 and 19 years. Bivariate analysis with a chi-square test of association and Multivariable logistic regression analysis was performed to fulfill the aim of the study. Our study shows that a major proportion of married adolescents (61%) got pregnant before the age of 20 years and around 42% of all adolescent married women gave birth to a child before reaching the age of 20 years. Adolescents who married before the age of 18 years were 1.79 times more likely to experience pregnancy (OR: 1.79; CI: 1.39–2.30) and 3.21 times more likely to experience motherhood (OR: 3.21; CI: 2.33–4.43). In the present study, women who experienced physical violence were at higher risk for having an adverse pregnancy outcome (OR: 1.41; CI: 1.08–1.84) than those who did not experience physical violence. To conclude, regional and national level efforts focused on improving early marriage, education and empowering women and girls can be beneficial.

In recent years, developing and developed countries are witnessing delayed childbearing among women contributing to the overall decline in fertility rates. The age at which a woman has her last child impacts maternal and child health, especially in a country with high maternal and perinatal mortality rates. This study aims to investigate the trends of age at the last birth among Indian women and to identify the potential factors contributing towards higher maternal age. The present study uses the data from five consecutive rounds (1992–1993, 1998–1999, 2004–2005, 2015–2016, and 2019–2021) of the National Family Health Survey (NFHS). We have used descriptive statistics, bivariate, Cox proportional hazard regression analysis, multiple classification analysis (MCA), Kaplan–Meier curve, life table survival analysis, hierarchical clustered heat map, multivariate decomposition analysis (MDA) and geospatial mapping to fulfill the objective of the study. Results show that the proportion of women with age at last birth before reaching the age of 30 years was less than half (nearly 35%) during NFHS-I while during NFHS-V proportion becomes more than half and reaches 64.3% among 40–49 years women. Within three decades (1992–2021) there has been a decline of 15.8% in median age at last birth among women aged 40–49 years. Additionally, the highest percentage decline in predicted mean age at last birth was noted among individuals from rural area (10.7%, 3.3 years), Hindu religion (10.8%, 3.3 years), poor wealth quantile (12.5%, 4.0 years) and those with mass media exposure (10.6%, 3.2 years) from NFHS-I (1992–1993) to NFHS-V (2019–2021). Although there exists the need to delay age at first childbirth, the age at last childbirth also plays an important role in women’s and child health status. Hence, it is important to address the healthcare needs of those delaying their childbirth.