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Coresidence with mother-in-law and maternal anemia in rural India
Authors: Varghese R, and Roy M
Source: Social Science and Medicine, 226: 37-46; DOI: 10.1016/j.socscimed.2019.02.027
Topic(s): Anemia
Iron supplements
Maternal health
Country: Asia
Published: APR 2019
Abstract: In a highly patriarchal society such as India, and many Middle Eastern, African, and East Asian countries, coresidence with the mother-in-law is ubiquitous during the early years of marriage. During the period when women have to make crucial fertility decisions, they are under the supervision of the mother-in-law. Using the National Family Health Survey 2005-2006, and estimation strategies such as propensity score (PS) weighted regressions and a difference-in-differences type approach with PS matching, we estimate the causal effect of coresidence during pregnancy on maternal anemia among rural women in India. Here, coresidence and non-coresidence during pregnancy define our treatment and control, respectively. Women coresiding with both in-laws had fewer children, were younger, more educated, wealthier, and less likely to be Muslim and from scheduled castes and tribes compared to non-coresident women. Results indicate that the mother-in-law is a potentially valuable resource during pregnancy. For example, living with the mother-in-law reduced the likelihood of moderate to severe anemia by 13.2 percentage points compared to no coresidence. Under joint coresidence with both in-laws, the effect dropped to 8.5 percentage points. Moreover, women living with the mother in-law were 16.8 percentage points more likely to receive any iron supplementation. From a public health perspective and for policy making, the results indicate that safe motherhood programs should be augmented with awareness generation components which target the mother-in-law. Furthermore, pregnant women in nuclear families need particular attention. KEYWORDS: Coresidence; Difference-in-differences; India; Iron supplementation; Joint-family; Maternal anemia; Propensity score