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As the cover suggests the redacted report covers postpartum period health of North Indian region. Special Thanks – Dr. Alok Kumar Cover – Jyoti Singh
Authors - Shanu Sharma, Mohit Sharma (Trendster)
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CHAPTER -1 INTRODUCTION
1.1 Rationale of the Problem Medical Sociology is concerned with the social and consequences of health and illness (Cockerham, 2011:1). “Medical sociology as the study of health care as it is institutionalized in society, and of health, or illness and it’s relationship to social factors” (Weiss, 2000 :1). Medical Sociology is sociological Analysis of medical organizations and Institutions the production of knowledge and section of methods-professionals and the social or cultural (rather then
clinical
or
bodily)
effect
of
medical
practice.
(en.wikipeida.org/wiki/medical.sociology). Medical Sociology is the subfield which applies the perspective, conceptualization, theories and methodologies of sociology to phenomena having to do with human health and disease. As a specialization, medical sociology encompasses a body of knowledge which places health and disease in social, cultural, and behavioral context (weiss,2000:1-2). Health is considered as a fundamental human right word wide social goal. It is essential to the satisfaction of basic human needs and improves the quality of life (Mathu, 2008: 332). 3
Health is individuals capacity to perform roles and tasks in everyday living and acknowledges that there are social differences in defining health (Weiss, 2000:107). Health is a state of complete physical, mental and social well being, and not merely the absence of disease or infirmity (W.H.O. 1995). Health is a resource for everyday life, not the objective of living; It is a possible concept, emphasizing social and personal resources as well physical capabilities; (Sundar, 2007 : 97). Women’s health involves women’s emotional, social cultural, spiritual and physical well being, and is determined by the social, political, cultural and economic context of women’s lives, as well as by Biology (www.med women’shealth.html). Women’s health refer to health status of women and the dispararities in health between the sexes are often critical indicators of equality in a society (W.H.O, : 1986). Women’s health is the effect of gender on disease and health the encompasses a broad range of biological and psychosocial issues (http://medical-dectionary thefreedictionay.com) Reproductive health means a satisfying, safe sex life, free from the fear of disease and free from coercion and violence (Mathu, 2008 : 332). Reproductive health is a state which people have the ability to reproduce and regulate their fertility (Sinha, 2007 : 329). Reproductive health a state of complete physical, mental and social well being and not merely the absence of disease or infirmity, in all matters related to reproductive system, it function and process (Sakhuja, 2008 : 102). The 4
reproductive health of women is the backbone of every family, society and nation. Although reproductive health is the integral part of women’s general health, despite the fact, it needs extra care and precaution during specific time and situation (Sakhuja, 2008: 101). Postnatal means reproductive health status of a women after child birth or delivery. Post natal period refers to the period after giving birth. During this period, a new mother must be assessed for any tears and required treatment must be embarked on. Natural, social, medical activities and events occurring after birth. A suitable subdivision is: early postnatal within 48 hours of birth; delayed postnatal- 2 to 7 days; late postnatal-1 to 4 weeks. The postnatal period is associated with physiological psychological and social changes, which can influences sexual and reproductive health (Medical-dictionary/postnatal). The sociologists Like Alok Ranjan Chauaria, 2004; M.N. Sivakumar, 1999; Adrienne M. Lucas, 2013; study the impact of fertility on the women’s health. Pawan Kumar Sharma and Komila Parthi, 2004; Abishek Singh, Faujdar Ram, Rajiv Ranjan, 2006; Anoshua Chaudhury, 2008; study the reproductive health services and program in India. A.S. Dey and A. Shrivastava, 2011; A. Sudarshan Reddy and A. Neelima, 2009; Narendra Singh & Binod C. Agarwal, 2009; study the impact of Health Communication, Health care, and Health modernity on people’s. Nandini Bhattachary and Subha Ray, 2009; study the practice of Induced Abortion seekers of Kolkata, Arvinda Meera & Guntupalli and Parveen Nagia, 2008; Study the women’s autonomy, Contraceptive use and 5
fertility. K.V. Narayana, 2003; study the role of medical care. Santosh Jatrana, 2007; study the importance of child care arrangement of working mothers. Pragya Sharma, 2009; study the health behaviour of Raikas. H.C. Srivastava, 2011; study the male involvement as supportive partners in women’s reproductive health. Thus, there are large number of studies on various dimensions of health, but despite all there are few studies on reproductive health, there is no study which focuses on postnatal reproductive health care which focuses on postnatal reproductive health care. There is the need to conduct such type of study which explore the various aspect of postnatal reproductive health illness and care.
1.2 Statement of the Problem In the light of the above mentioned framework following objectives will be undertaken. 1. To assess the socio-economic profile the women. 2. To identify the attitude towards the age of Marriage pregnancy/delivery and children. 3. To know the attitude of women and their family members after child birth. 4. To examine the prevalence of post-delivery/treatment for post delivery complications. 5. To indentify the source of consultation/treatment for post delivery complications. 6
The first objective takes note of the socio-economic profile of the women in terms of age, religion, caste, education, occupation, income, pattern of family, type of house etc. The second objectives take note of age of marriage, age of first pregnancy, age of first delivery and no. of children. The third objective takes note of the place of delivery, who perform delivery, precautions taken after delivery, time taken to resume work after delivery and pattern of care of new born children. The fourth objective takes note of the post-delivery complications likehigh fever, lower abdominal pain, excessive bleeding, severe headache etc. The fifth objective takes note of the source of consultation/treatment for post-delivery complications and source of consultation/treatment by persons providers for post-delivery complication in a town.
1.3 Area of Study Deoband town has been selected for the purpose of the study. Deoband is situated in the North from Meerut, the distance of Deoband from Meerut is 83Km. and 161Km. from Delhi. The total population of Deoband is 274307 (according to 2011 census). In total population Muslims is 138523, 50.5% and Hindus is 133402, 48.5% Deoband is surrounded by the famous cities like Saharanpur, Muzaffarnagar, Roorkee and Haridwar. There lives many caste in 7
this town. I have selected 100 respondents (50 Hindu and 50 Muslim) Women of two communities for interview guide/scheduled.
1.4 Methodology The data for the present study have been collected from 100 respondents for the require fulfillment of the information. The data have been collected through interview guide/schedule and observation method. Data have been selected by using the purposive sampling. I have been collected the information from two communities women Hindu-Muslim belong to the age group of 21-45 ,in this way I have been collected information from 100 household (50 Hindu and 50 Muslim), purposive sample representing the participants of different categories of age, religion, caste, education, occupation, income, conditions of residence, number of rooms, light and ventilation and separate kitchen have been selected. Data have been collected with help of some specific research techniques like-observation, interview guide/schedule. At first stage observation technique has been used to collect the information, interview guide/schedule have been used at the second phase of data collection initially some case studies have undertaken to understand the maximum possible aspects. The data have been classified by simple statistical techniques, by using the simple classification and tabulation to arrive at the findings 8
CHAPTER -2 AN OVERVIEW OF SELECT LITERATURE
2.1 Medical Sociology Medical Sociology is concerned with the social and consequences of health and Illness (Cockerham, 2001:1). Medical Sociology is sociological Analysis of medical organizations and Institution the production of knowledge and section of methods professionals and the social or cultural (rather then clinical or bodily) effects of medical-practice. Medical sociologist are also interested in the quantities experiences of patient, often working the boundaries of public health, social work, demography generality to explore phenomena at intersection of the social and clinical science (en.wikipdia.org/wiki/medical.sociology).
2.1.1 Meaning and Definition of Medical Sociology Medical Sociology is the subfield which applies the perspective, conceptualization, theories and methodologies of Sociology to phenomena having to do with human health and disease. As a specialization, medical sociology encompasses a body of knowledge which places health and disease in social, cultural, and behavioral context (Weiss, 200:1-2).
9
As an academic discipline, sociology concerned with the social causes and consequences of human behaviour; thus, it follows that medical sociology is concerned with the social causes and consequences of health and illness. Medical sociology brings sociological brings sociological perspectives theories and methods of the study of health and medical practices. Major areas of investigation include the social facts of health and illness, the social behaviour of health care personnel and people who utilize health care, the social function of health organizations and institutions, the sociology patterns of health services, and the relationship of health care delivery systems to other systems (Cockerham, 2001 : 01).
Definition Definitions of the field of medical sociology typically take one of two approaches some utilize a broad perspective and attempt to identify major categories of inquiry with in the field. Florence Ruderman (1981 : 927) defines medical sociology as a “The study of health care as it is institutionalialionalized in a society and of health or illness and its relationship to social factors� (Cockerham, 1998 :98). Other definition simply attempts to delineate essential topics. An example is following definition created by committee on certification in medical sociology (1986) of American sociological Association (ASA).
10
“Medical Sociology is the sub field which applies the perspective, conceptualizations, theories and methodologies of sociology to phenomena having to do human health and disease.� As a specialization and disease in a social, cultural and behavioural context (Cockerham, 1978 : 200) . By these definitions, we may conclude that medical sociology is subfield and it includes the health, healing and Illness and it direct relate to society and health care of society.
2.1.2 Development of Medical Sociology Medical Sociology was established as a specialized field initially in the United States during the 1940s. The first use of the term medical sociology has appeared as early as 1984 1894 in an article by Charles Mcihtire on the importance of Social factors of health (Cockerham, 2001 : 10).
2.1.3 Historical Development of Medical Sociology The “starting point of the field of medical sociology may physicians in ancient times perceived an essential inter relationship among social and economic conditions, Life Style and health and illness. This understanding has been an integral part of medical thinking in some civilizations since than. Often cited as a key historical figure who paved the way for medical sociology is Rudoif Virchow, the great mid nineteenth century physician Virchow identified social and economic conditions as being primary causes on an epidemic of types
11
fever in 1847 and lobbied for improved living conditions for the poor as a primary preventive (Weiss, 2000 : 2).
The 20th Century The last decades of the nineteenth century and the first decades of the twentieth-century were a time of heightened awareness in both the United State and Europe of the need for social programs to respond to health crises. In 1915, Alfred Grotjahn Published a classic work, social pathologies, documenting the role of social factors in disease and illness and urging the role of social factors in disease and illness and urging the development of a social science framework for working with communities and provides in reducing health problem. The term social medicine was coined to refer to efforts to improve public health (Ibid:2).
2.1.4 Institutionalization of Medical Sociology In 1959 medical sociology was accepted as a formal section of the American-Sociological Association-an important step in bringing recognition to a field and en ambling recruitment of new members, second, in 1965, the ASA assumed control of an existing Journal in Medical Sociology and renamed it the journal of health and social behavior. Medical Sociologists published in a wide variety of journals in sociology, public health, and medicine and are increasing employed in health planning, community health education, education of health professionals, and health care administration in addition to colleges and universities (Weiss, 2000: 4). 12
2.2 Health Health is considered as a fundamental human right world wide social goal. It is essential to the satisfaction of basic human needs and improves the quality of life (Mathu, 2008: 332).
2.2.1 Meaning and Definition of Health Health is individual’s capacity to perform roles and tasks in everyday living and acknowledges that there are social differences in defining health (Weiss, 2000: 107). A human condition measured by four components: Physical, Mental, Social and Spiritual (Henslin, James M, 1997 : 522). Talcott Parson suggested that health be viewed as the ability to comply with social norms. Health is a resource for everyday life, not the objective of living; It is a positive concept, emphasizing social and personal resources as well as physical capabilities (Sundar, 2007 : 97). Health is clearly a complex, multi dimensional concept personal or individual health is largely subjective. It is possible to be physically robust, to be “The picture of good health�, and yet have serious mental or emotional impairment. Conversely, an individual can be profoundly disabled physically yet have an intact mind and be emotionally well adjusted. Health is, ultimately, poorly
13
defined and difficult to measure despite impressive efforts by epidemiologists, vital statisticians, social scientists, and political economists (Ibid, 108). The constitution of the World Health Organization (WHO) affirms. “Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity”. In Oxford dictionary health means – “The state of being free from sickness, injury or disease, bodily conditions; sometimes indicating good bodily conditions”. “The sate of optimum capacity of an individual for the effective performance of the roles and tasks for which has been socialized” (Parsons, 1972: 123). In the above definition parson’s defines health as capacity of an individual for effective performance the role and tasks for which has been socialized.
According to Renu Dubos (1988) “Health can be defined as the ability to function this does not mean that healthy people are free from all health problems; It means that they can function to the point they can do what they want to do” (Cocerham, 1998:2) On the basis of above definition Dubos defines health is as the ability to function, people who are healthy free from all health difficulties. On the basis of all above definitions it may conclude that health is achieve through a combination of physical, mental and social well being, which together
14
is commonly referred to as the health triangle. Health clearly a complex, multi dimensional concept, personal or individual health is largely subjective. The assessment and measurement of individual health must take then all into account.
2.2.2 Measurement of Health John Ware (1986) reviewed the literature of studies on health and identified six primary orientations or dimensions used by researchers. The orientations are given below(i) Physical Functioning– Focuses on physical limitations regarding ability to take care of self, being mobile, and participating in physical activities; ability to perform everyday activities; and number of days confined to bed. (ii) Mental Health- Focuses on feelings of anxiety and depression; psychological wellbeing; and control of emotion and behaviors. (iii) Social Well-being- Focuses on visiting with or speaking on the telephone with friends and family and on number of close friends and acquaintances. (iv) Role Functioning- Focuses on Freedom of limitations in discharging usual role activities such as work or school. (v) General Health Perceptions- Focuses on self-assessment or current health status and on amount of pain being experienced.
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(vi) Symptoms- Focuses on reports of physical and psycho-physiologic symptoms (Weiss, 2000: 108).
2.2.3 Determinants of Health Both individual and population health are determined by physical, biological, behavioural, social and cultural factors the determinates of health are as below-
1. Biological Determinates Biological determinants of health are inherent or acquired. Genetic heritage is a contributing factor to longevity, and to susceptibility or resistance to a wide range of disease that include the pathogenic microorganisms responsible for some of the great plagues that have affected humans for millennia.
2. Behavioural Determinants Behavioural determinants have been much studied. An association of certain diseases with particular personality types has been observed empirically for centuries. An irascible temperament, for example, has been linked to occurrence of strokes, and an association has been demonstrated between high risk of coronary heart disease and a type a personality, marked by forceful and aggressive behaviour (Sundar, 2007 : 101).
(A) Social Factor Social factors influence or determine health are also complex. There is epidemiologic evidence that good health is determined at least in part by social 16
connectedness person who have many and frequent interactions with other family members and with a network of friends have a more favourable health experience in many ways than those who are socially isolated, live alone, are estranged from their family, and have little or no family and social support system (Sundar, 207: 102).
(B) Cultural Factors Cultural is defined as the set of customs, traditions, Values, intellectual, and artistic qualities, and religious beliefs that distinguish one social group or nation from another. Culture influences behaviour through customs such as use of or obstention from meat, alcohol, and tobacco; the practice of rituals such as circumcision; marital customs such as the prevailing age at which women marry; attitudes toward f amily size, child bearing, and child rearing; personal hygiene; disposal of the dead; and much else (Ibid : 102-103).
2.3 Health Behaviour 2.3.1 Meaning and Definition of Health Behaviour Health Behaviour is the undertaken by a person who believes himself or herself to be healthy for the purpose of preventing health problems (Kasl & Cobb 1966). Health life styles, in turn, are ways of living that promote good health and longer life expectancy. Health lifestyles include contact with physicians and other health personnel, but the majority of activities include a proper diet, weight 17
control, exercise, rest and relaxation, and the avoidance of stress and alcohol and drug abuse (Cockerham, 1988 : 111). The activity undertaken by individuals for the purpose of maintaining or enhancing their positive body image (Cockerham, 2000: 90). On the basis of Cockerham’s definition health behaviour is as activity undertaken by individuals for maintaining their body image. An individual believing he or herself to be healthy for the purpose of preventing health problems.
2.3.2 Dimensions of Health Behaviour Alonzo (1993) has identified four separate dimensions of health behaviour. The dimensions of health behaviour is given below1. Prevention- The goal of prevention, or preventive health behaviour is to minimize the risk of disease, injury, and disability 2. Detection- Detection involves activities to detect disease, injury, or disability before symptoms appear and includes medical examinations or screenings for specific disease. 3. Promotion- Health promotion activities consist of efforts to encourage and persuade individuals to engage in health promoting behaviours and to avoid or disengage health harming behaviours.
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4. Protection- Health protection activities occur at the societal rather than the individual level and include efforts to make the environment in which people live as healthy as possible (Weiss 2000 : 108).
2.4 Disease 2.4.1 Meaning and Definition of Disease A disease is an abnormal condition that affects the body of an organism. It is often construed as a medical condition associated with specific symptoms and sign. It may be caused by factors originally from an external source such internal dysfunctions, such as infections disease, or it may be caused by internal dysfunctions, “disease” such as autoimmune disease in humans is often caused more broadly to refers to any condition that caused pain, dysfunction, distress, social problem, or death to the person affected or similar problem for those in contact with the person (em.m. wkipedia.org/wiki/disease). “A condition of the body or some part or organ of the body in which its functions are disrupted or deranged” (Oxford Dictionary). Turner notes that disease can be contained through social hygiene and education in appropriate life-styles. Yet people can also knowingly Jeipardize their health through habits like drug addiction, overrating, smoking, lack of exercise, and alcoholism. These behaviours, he continues, are either already regarded as socially deviant or are well on the way to becoming regarded as such. When certain 19
behaviours threaten the health of people and well being of society (Cockerham, 1998 : 145-155).
2.4.2 Determinates of Disease There are six possible determinates of disease are given below1. Reverse Causality- In this pathway, one’s health status influences position in the social structure rather than the commonly assumed other way around. 2. Differential Susceptibility- The opportunities that individual have for occupational success and/or upward social mobility are influenced by physical traits. 3. Individual Life Style- In this pathway describes differences in health habits and behaviours. But something more than completely unconstrained free choice is at work here because that does not explain differences in average life style patterns between large groups. 4. Physical Environment- Some persons are more likely than others to be exposed to the potentially harmful effects of physical, chemical and biological agents. The presence of harmful substances in the workplace, or in the home or in the neighborhood serve as a pathway to ill health. 5. Social Environment (And Psychological Response)- Included in this pathway are the effects of living a stressful versus less stressful life style and the influence of having or not having significant social support.
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6. Differential access to/response to health care services- Differences in health status may result from systematic differences in access to health care services, in differential propensity to use services, and in differential benefit of services, received (Weiss, 2000 : 59).
2.5 Illness and Illness Behavior 2.5.1 Meaning and Definition of Illness The state of feeling physically or emotionally unwell or sick, and as such different from having or suffering from a disease. Illness refers to the subjective experience of sickness, disease or bad health, and to socially and culturally generated and expressed concepts of physical social and psychological abnormality (Web.linked dictionary-sociology, 1991:291). Today “Illness” is defined as a state/condition of suffering as the result of a disease/sickness” based upon the modern scientific views that an Illness is an abnormal biological views that an Illness is an abnormal biological afflictions or mental disorder with a cause, a characteristic train of symptoms, and a method of treatment. The medical view of illness is that of deviance from a biological norm within a given social system. “The routine nature of illness and its occurrence in primary groups constellations tends to draw illness in to the area of expectable. Non-deviant behavior” (Cockerham, 1978 : 88-89). “Illness is a disvalued process that impairs the functioning or appearance of a human person and may ultimately lead to health” (Cockerham, 1997: 113). 21
In above definition Illness is a disvalued process which impairs functioning of an human being and lead to health. According to Functionalist Theory, “Illness is, dysfunctional because it threatens to interfere with the stability of social system” (Cockerham, 1997:113). On the basis of above discussion we can say that Illness is a disvalued process, a deviant social behavior through disease and dysfunctional because it threatens to interfere with the stability of social system. Illness availability of treatment resources physical proximity, psychological and monetary costs of taking actions.
2.5.2 Meaning and Definition of Illness Behavior Illness behavior refers to activity undertaken by a person who feels ill in order to define the illness and seek relief from it. As outlined by Edward Suchman, the Illness experience consists of five stages: (1) Symptom experience; (2) Assumption of the sick role: (3) Medical Care contact; (4) Dependent patient role; and (5) Recovery and rehabilitation. Decisions that are made during these five stages and the behaviors exhibited are culturally and socially determined. Illness behavior refers to “the way in which symptoms are perceived, evaluated, and acted upon by a person who recognizes some pain, discomfort or other sign of Organic malfunction” (Mechanic and Volkart, 1961:52).
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On the basis of above discussion Illness behavior is a way which refers to evaluated and undertaken by a person who feels ill, recognizes some pain, discomfit and seek relief from it. “Illness behavior refers to the ways individuals respondent to bodily indications, how they monitor internal states, define and interpret symptoms, make attributions take remedial actions and utilize various sources of informal and formal care� (Mechanic, 1995 a : 1205). On the basis of above definition Illness behavior is the way which responded individuals bodily indications, and make attributions take remedical action and utilize various sources of formal or informal care. Some people recognize particular physical symptoms such as pain, a high fever, or nausea and seek out a physician for treatment; other with similar symptoms may attempt self medication or dismiss the symptoms as not needing attention (Cockerham, 2001 : 102). On the basis of above discussion and definition Illness behavior we mean the way in which symptoms are perceived, evaluated and acted upon by a person who recognises some pain discomfort or other sighs or organic malfunction.
2.5.3 Symptoms of Illness Behavior David Mechanic (1978:268-269) identifies 10 factors that determine how individual respond to symptoms of Illness behavior : 1. The visibility, recognizability or perceptual salience of symptoms.
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2. The perceived seriousness of symptoms. 3. The extent to which symptoms disrupt family, work and other social activities. 4. The frequency of appearance of symptoms, their persistence, or frequency of recurrence. 5. The tolerance threshold of there who are exposed to and evaluate the deviant sings and symptoms. 6. Available information, knowledge and culture assumptions and under sending of the evaluator. 7. Perceptual needs which lead to autistic psychological processes. 8. Needs competing with illness response. 9. Competing possible interpretations that can be assigned to the symptoms once they are reorganize. 10. Availability of treatment resources, physical proximity, psychological and monetary costs of taking actions. Person can assist in self maintenance and in system maintenance (Cockerham, 2001 : 132).
2.6 Sick Role 2.6.1 Meaning and Definition of Sick Role Sick Role a concept popularized by Talcott Parsons. According to the parsons the sick role is the whilst disease involves bodily dysfunctions, being 24
sick that is being identified and accepted as ill – is a role governed by social expectations, of which he listed four first, exemption form normal social role – responsibilities. This exemption must be legitimated by some authority, often a medical practitioner second examption form responsibility for being ill, which means that the sick must be looked after. Third, since sickness is deemed undesirable, the sick are obliged to want to get better; and also, fourthly, to seek technically
competent
help
and
co-operate
in
trying
to
get
better
(www.medicalsociologyonline.org). A major expectation concerning the sick is that they are unable to take care of themselves. It thus becomes necessary for the sick to seek medical advice and co-operate with medical experts. This behaviour is predicated upon the assumption made by parsons that being sick is an undesirable state and the sick person wants to get well (Cockerham, 2001 : 160). Parson’s concept of sick role is a useful sociological approach to illness because its views the patient physician relationship with a frame work of social role, attitudes and activities that both parties brings to the situation. On the basis of above discussion we can say the sick role is a behavioral variation, a type of illness, a sat of patterned expectation that define that norms and values appropriate to being sick, both for the individual and for others who in treat with the person and the explanation of the behaviour characteristics of sick person. role of the physician in a complementary but asymmetrical role relationship (Cockerham, 2001 : 149-150). 25
2.6.2 Types/Basis elements of Sick Role The specific aspects of parson’s concept of the sick role can be described in four basis categories : 1.
The Sick person is exempt from “normal” social roles : An individual’s illness is grounds for his or her exemption from role performance and social responsibilities. this exemption, however, is relative to the nature and severity of the illness. The more severe the illness, the greater he exemption. Exemption requires legitimation by the physician as the authority on what constitutes sickness.
2.
The sick persons is not responsible for his or her condition : An individuals illness is usually thought to be beyond his or her own control. A morbid condition of the body needs to be changed curative process a part from personal will power or motivation is needed to get well.
3.
The sick person should try to get well : The first two aspects of the sick role are conditional on the third aspect, which is recognition by the sick person that being sick is undesirable. Exemption form normal responsibilities is temporary and conditional upon the desire to region normal health. Thus the sick person has an obligation to get well.
4.
The sick person should seek technically competent help and cooperate with the physician : The obligation to get well involves a
26
further obligation on the part of the sick person to sick technically competent help, usually from a physician. The sick person is also expected to cooperate with the physician in the process of trying to get well. Parson’s concept of sick role is useful sociological approach to illness because its views the patient physician relationship within a frame work of social role, attitudes and activities that both parties brings to the situation (Cockerham, 2001 : 160-161).
2.6.3 Criticisms of the sick role The four main criticisms of the concept are briefly described here : 1.
The sick role does not account for the considerable variability in behaviour among sick persons.
2.
The sick role is applicable in describing patient experience with about illnesses only and is less appropriate in describing persons with charonic illness.
3.
The sick role does not adequately account for the variety of setting in which physicians and patients interact; It is most applicable to a physician patient relationship that occurs in the physician’s office.
4.
The sick role is more applicable to middle class patients and middle class values than it is for persons in lower socioeconomic groups. Not everyone can follow this pathway; for example, lower income persons
27
have less freedom to curtail their normal responsibilities, especially their jobs, and thus have a more difficult time complying with the model (Weiss 2000 : 130)
Parson’s sick role theory cab be criticized because of 1. Behavioural Variation 2. Types of diseases 3. The patient physician relationship 4. The sick role’s middle class orientation (Cockerham, 2001 : 166).
2.7 Folk Healers and Faith Healers 2.7.1 Meaning and Definition of Faith Healers The terms folk healing refers to healing practices and ideas of body physiology and health preservation known to a limited segment of the population in culture, transmitted informally as generally as general knowledge, and practiced or applied by any one in the culture having prior experience (Cockerham, 2001 : 146). The folk healers practiced holistic medicine they treated the whole person rather than just the particular melody and where more concerned about the cause of illness rather than its symptoms. (Weiss, 2000:237)
Folk Healing Medical practice is not the means of livelihood for folk practitioners, they are either formers or work in the generation. such knowledge allows them to 28
distinguish between curable and in curable disease. It enables them to identify a disease from the disorders that may accompany it (Sujatha, 2007 : 186).
2.7.2 Meaning of Faith Healer Faith Healing relief or cure of bodily ills through some religious attitude on the part of the sufferer. Faith healing is of interest in the field of psychosomatic medicine, and psychotherapy (Cockerham, 2001 : 140). Faith healers are people who use the power of suggestion, prayer, and faith in God to promote healing (Cockerham, 2001: 142)
Acc. to John Denton (1978) To basis beliefs are prevalent in religious healing. 1.
One from to belief supports the idea that healing occurs primarily through
psychological
processes
and
is
effective
only
with
psychophysiological. 2.
The other belief is that healing is accomplished through the intervention of god and constitute a present day miracle (Ibid : 142).
2.8 Medicine 2.8.1 Meaning of Medicine One of the major social institutions that sociologist study; a society’s organized ways of dealing with sickness and injury (Henslin, 1997 : 520). The science or practice of the diagnosis treatment, and prevention of disease (in technical use often taken to exclude surgery) a compound or 29
preparation of disease, especially a drug or drugs taken by mouth. Medicine is applied science or practice of the diagnosis, treatment or prevention of disease. It encompasses a variety of health care practice evolved to maintain and restore health by the prevention and treatment of illness in human being (emm.wikipedia,org/wiki/medicine).
2.8.2 A Brief History of Medicine The crucial event in the development of scientific medicine “that all disease is materially generated by specific etiological agents such as bacteria, viruses, parasites genetic malformations, and internal chemical imbalances” (Barliner, 1989 : 30). How did early humans interpret these medical calamities? Primitive man, noting the rising and setting of the sun and moon, the progress of the seasons, the birth, growth, and inevitable death of plants, animals and humans, did not take long to arrive at the supposition that these phenomena did not occur by chance.... it seemed logical to suppose that they were ordered by some all powerful god, or gods, and equally logical was the belief that fortune and misfortune were signs of the god’s pleasure or displeasure (Camp, 1977 : 11). Hippocrates, the “Father of medicine,” encouraged careful observation of Sickness in patients and a close relationship between physician and patient (Weiss 2001 : 16).
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2.8.3 Medicine from 1600 to 1900 The scientific revolution replaced previous concepts with new ideas of matter and its properties, new applications of mathematics to physics and new methods of experimentation. By 1700, a “new word” view had taken from, modern science rested on inter change and mutual verification f scientific ideas and information by investigators in many countries and these needs were satisfied by the development of scientific societies and publications (Green, 1968 : 83). The centrality of religion’s role in medicine reemerged during the Medieval Era. Then, in the second half of the medieval Era, medicine shifted back of the private sector, and, for the first time, became established in universities (Weiss, 2001 : 32).
2.8.4 Modern Medicine and alternative Medicine Modern Medicine may will be defined as “the experimental study of what happens when poisonous chemicals are placed into malnourished human body (http://www.orthomed.org). Alternative medicine is any practice that is put forward as having the healing effects of medicine but is not based on evidence gathered using the scientific method. It consists of a wide range of health care practices, products and therapies using alternative medical diagnoses and treatments which typically have not been 31
include in the degree course of established medical schools or used in conventional medicine. Examples of alternative medicine include homeopathy, naturopathy, chiropractic and acupuncture. Complementary medicine is alternative medicine used together with conventional medical treatment in a brief not proven by using scientific
methods,
that
is
“Complements”
the
treatment
(en.wikipedia.org/wiki/alternativemedicine).
2.9 Social Epidemiology 2.9.1 Meaning and Definition of Social Epidemiology Social epidemiology is the known as social determinates of health. Social epidemiology is the study of the distribution of disease, impairment and general health status across a population. Epidemiology initially concentrated on the scientific study of epidemics, focusing on now they started and spread. Contemporary social epidemiology is much broader in scope, concerned in scope, concerned not only with non epidemic disease, injuries drug addiction and alcoholism, suicide and mental illness (Schaefer, 2005 : 443-444). Social epidemiology is defined as “The branch of epidemiology that studies the social distribution and social determinates of health” that both specific features of and pathway by which societal conditions affect health” (en.wikipedia.org/wiki/social_epidemology).
32
Social epidemiological analyses of health consequences of discrimination require conceptualizing and operationalsing diverse expressions of exposure, susceptibility, and resistance to discrimination (Sundar, 2007 : 48).
2.9.2 The Development of Social Epidemiology The field of social epidemiology focuses on understanding the causes and distribution of diseases and impairments with in a population. Early in the history of
the
field,
epidemiologists
concentrated
primarily
on
identifying
microorganisms responsible for epidemics of actual, infectious diseases (Weiss, 2000 : 35). As s method of measuring diseases in human aggregates, epidemiology has been a relatively recent development. As long as human beings lived as nomads or in widely scattered was relatively slight. The term social environment in epidemiological research refers to actual living conditions, such as poverty or crowding, and also the norms, values, and attitudes that reflect a particular social and cultural context. Societies have socially prescribed patterns of behaviour and living arrangements, as well as standards pertaining to the use of water, food and food handing, and household and personal hygiene. For example the plague epidemic in Surat, India, in the mid-1990s had its origin in unhealthy behariour and living standards since its inception in the 1850s, epidemiology has passed through three eras and is now entering a fourth.
33
First was the sanitary era of the nineteenth century, during which the focus of epidemiological work was largely on sewage and drainage systems and the major preventive measure was the Introduction of sanitation programs. Second was the infectious disease era that occurred between the late nineteenth and mid-twentieth centuries. The principal preventive approach was to break the chain of transmission between the agent and host. Third is the chronic disease era taking place in the second half of the twentieth century? Here the focus is on controlling risk factors by modifying lifestyles (i.e., diet, exercise), agents (i.e. guns, food), or the environment (i.e. pollution, passive smoking) (Cockerham, 2001 : 23-24).
2.10 Women’s Health 2.10.1 Women A women is a female human. The term women is usually reserved for an adult, with the term girl being the usual term for a female child or adolescent. However, the term women is also sometimes used to identify a female human, regardless of age. Female is the gender that can bear offspring or produce eggs, distinguished biologically by the production of gametes (ova) which can be fertilized by male gamete (en.wikipedia.org/wiki/women).
34
2.10.2 Women’s Health Women’s health refers to health issues specific to human female anatomy. These often related to structures such as female genitalia and breasts or to conditions caused by hormones specific to, or most notable in females. Women’s health issues include menstruation, contraception, maternal health, child birth, Menopause and breast cancer. They can also include medical situations in which women face problems not directly related to their biology, for example gender differentiated access to medical treatment (en.wikipedia.org). “The health status of women and the dispararities in health between the sexes are often critical indicators of equality in a society” (Inter Sectoral Action for Health, WHO, 1986). “Women’s health is the effect of gender on disease and health the encompasses bread range of biological and psychosocial issues” (http://medicaldectionary thefreedication.org.com). “Women’s health involves women’s emotional, social cultural, spiritual and physical well being and is determined by the social, political cultural and economic context of women’s lives, as well as by biology”. This definition recognizes the validity of women’s life experiences, and women’s own beliefs about, and experience of, health. Every women should be provided with the opportunity to achieve sustain and maintain health, as defined
35
by
the
women
herself,
to
her
full
potential
(www.med.uottawa.ca/generequity/eng/what-womenshealth.html).
2.10.3 Reproductive Health Reproductive Health encompasses a range of health concerns as indicated in the consensus definition emerging from the year 1998 International conference of population and development (ICPO) at carrio.
Meaning and Definition of Reproductive health In simple words reproductive health means a satisfying, safe sex life, free from the fear of disease and free from coercion and violence (Mathu, 2008 : 332) Reproductive health, implies the people are able to have a responsible, satisfying and safe sexlife and that they have the capability to reproduce and the freedom to decide if, when and how often to do (www.who.int/topics/reproductivehealth/en). “Reproductive health is a state which people have the ability to reproduce and regulate their fertility” (Sinha, 2007 : 329). On the basis of this definition. It may be conclude that reproductive health as a state in which people have the ability to reproduce their fertility. According to united Nations, 1994 – “Reproductive health a state of complete physical mental and social well being and not merely the absence of disease or infirmity, in all matters related to reproductive system, its function and process” (Sakhuja, 2008 : 102). 36
A reproductive health orientation, drawn from this and other sources, more specifically implies.
A satisfying and save sex life free from the fear of disease and free from coercion and violence.
The ability to go safely though pregnancy and child birth and have the best chance of having a healthy infant, and the right of access to appropriate health care services (Mathu, 2008 : 306). The reproductive health of women is the backbone of every family,
society and nation. although reproductive health is the integral part of women’s general health, despite the fact, it needs extra care and precautions during specific time and situation (Sakhuja, 2008 : 101).
2.10.4 Reproductive Health Behaviour The spectrum of sexual and reproductive health behaviours represents and common category of conceptually related acts for a number of significant reasons. First and foremost, sexual and reproductive health behaviour whether they involve
sexual
function
promotion,
contraceptive
utilization
STD/HIV
prevention, reproductive cancer screening, or sexual adaptations to aging, illness or disability, represent sexualized behavioral events. Each of these sexual and reproductive health behaviour has acquired sexual meaning as a result of social ascription (www.tandfonline.com).
37
2.10.5 Pregnancy Pregnancy is the fertilization and development of one or more offspring, known as an embryo or fetus, in a women’s uterus. It is the common name for gestation in humans. A multiple pregnancy involves more than one embryo or fetus a single pregnancy, such as with twins, child birth usually occurs about 38 weeks after conception; in women who have a menstrual cycle length of four weeks, this is approximately 40 weeks from the start of the lost normal menstrual period. Human pregnancy is the most studies of all mammalian pregnancies. An embryo is the developing offspring during the first 8 weeks following conception,
and
subsequently
the
term
fetus
is
used
until
birth
(en.wikipedia.org/wiki/pregnancy).
2.10.6 Delivery Delivery is the culmination of a pregnancy period with the expulsion of one or more new born infants from a women’s uterus. The process of normal child birth is categorized in three stages of labour the shortening and dilation of the cervix, descent and birth of the infant, and birth of the placenta. Delivery expulsion
of
the
child
and
(en.wikipedia.org/wiki/delivery).
38
fetal
membranes
at
birth.
Types of Delivery Abdominal Delivery – Delivery of an infant through an incision made into the intact uterus through the abdominal wall. Breech Delivery – Delivery in which fetal buttocks present first. Forceps Delivery – Extraction of the child from the maternal passages by application of forceps to the fetal head. Post Mortem Delivery – Delivery of a child after death of the mother. Spontaneous Delivery – Birth of an aid from an attendant (en.wikipedia.org/wiki/delivery).
2.10.7 Postnatal Meaning and Definition of Postnatal Post Natal period refers to the period after giving birth. During this period, a new mother must be assessed for any tears and required treatment must be embarked on. She is also assessed for infection and retention. In simple words, Post Natal Means Reproductive health status of a women after child birth or delivery. Natural, Social, Medical activities and events occurring after birth. A suitable subdivision is early postnatal with in 48 hours of birth; delayed postnatal 2 to 7 days; late postnatal 1 to 4 weeks (Medical. dictionary/postnatal). The postnatal period is associated with physiological, psychological and social changes, which can influences sexual and reproductive health. Although women may wish to delay or avoid further pregnancy, they may not know how to 39
access contraception or which methods are safe to use, particularly if they are breastfeeding. There may also be difficulties with sexual function and relationships during this time, for which individuals may require information and/or support.
2.11 Select Studies, Substantive and Methodological Issues 2.11.1 Select Studies Adrienne M. Lucas (2013) state that the effect of Malaria on fertility, and effect of malaria on subsequent birth spacing inconclusive. The present study selected from Srilanka. Data have been taken from Nationality representative world fertility survey. Author examine and analysis that malaria eradication increased fertility, malaria infections on fecundity is negative increased probability of spontaneous abortions and still births, Reduced coital frequency and decrease in general maternal health, Malaria eradication increased female educational attainment by as much as two years in the most heavily faceted region based on estimates from the same eradication. Amir H. Mehryar et. al (2011) discuss the process of demographic changes and fertility decline in Iran during the second half of the 20th century, and consequences during the first half of the 21st century, review the process of age structural transition that has resulted from these changes in Iran. Census and survey data, scale survey was used in study. Author also tries to find that total population grow very slowly during first half of 21st century, the population of 40
Iran experienced a four fold increase during 2nd half of 20th century. Lowered fertility rate in combination with rise in mortality with result in age structure of the population, population will confront Iran with new problems. A.S. Dey and A. Shrivastava (2011) studied to assess health modernity attitudinal and behavioural scale, different components of health modernity, and also tries to find out relationship between level of health modernization and utilization of health. The study was done in the Sagar district of Madhya Pradesh state interview schedule and pilot survey is attempt in the study, The study suggests that there is a need to educate people to impart scientifically values about different myths, misconceptions, ignorance, etc., which are prevailing in the community, relationship between level of health modernization and utilization of different health services is seen various myths, ignorance and misconceptions prevailing in the community are observed. A. Sudarshan Reddy & A. Neelima (2009) studies the context of growing recognition of health as a vital component of human capital and the need for evolving sustainable health care system (HCS), an epidemiologic study was conducted in an area in rural Andhra Pradesh in 2006. He state that people’s perspectives on health care services in Rural Andhra Pradesh. Reddy said that the respondents perspectives are a mounting dissatisfaction of existing public as well as private services, Need for preventive rather than curative approach including health education and re-look at the grass root level increasingly demanding more
41
by way of quality in public health services and greater regulation to ensure cost saving, a health policy in tune with a holistic approach. Nandini Bhattacharya & Subha Ray (2009) try to understand the profile of the abortion seekers belonging to the lower socio-economic group (slum dwellers), and also represent the incidence of induced abortion. The study has been conducted in some of slums area located municipal word No. 7,8,9 municipal co-operation, West Bengal, Kolkata. The study have been collected by a tested questionnaire/Schedule, qualitative and quantitative data, case study is also used to collect the data. The study also finds out the socio economic condition of the population lives in slums areas, The husband of the abortion seekers also have a significant role in the decision making process and at the time of abortion. The working women have a great tendency to adopt family planning practices, and also in taking any decision in the regard as compared to their non working counterparts. Narendra Singh & Binod C. Agarwal (2009) find out that how to communicate with indigenous immunities about health and meaning of modern health care, communication Techniques can be used to improve the understanding of health issues. The study is Chhattisgarh’s schedule tribes. Ethnographic
holistic
approach
and
Interview/Observation
is
used,
communication skills of the tribal healers are excellent and their trust credibility, accessibility can go a long way in co-opting them as agents of change for health practices. 42
Anousha Chaudhary (2008) examines the long term impact on children’s status of a reproductive health programme in rural Bangladesh, and also examines the effect of public programmes on various household out comes. The author also find out the importance of mother’s education in improving the health of their children. Random sampling and analysis is used in the study. Mothers education in improving the health of their children is well established. H.C. Srivastava (2011) identify the determinates of male involvement as supportive partner, in their wives reproductive health and understand husband’s knowledge perception and behaviour towards reproductive and sexual health of their wives. Study was carried out three villages namely Dabok Vishanpura and Vasnikala in Udipur district Rajasthan qualitative and quantitative techniques and interviews are base of the study, A majority of the husbands openied that it is their prime responsibility to take care of their wives, helped their wives with regard their reproductive health problems during menstruation, child bearing period, antenatal and health care. K.V. Narayana (2003) State that the role of the state in privatization and corporatisation of medical care and assess its impact upon public hospitals in Andhra Pradesh. Fifteen most popular state is the area of study and primary data is used in study. State is encouraging privatization and corporatization of medical care tiredly by offering various incentives and indirectly by neglecting public hospitals.
43
Pragya Sharma (2009) identifies a person who confined to bed because of the lack of normal capacity to work is considered ill. The study selected from Rajasthan and data is collected by observation. Such person stops his daily activities and can’t perform his routine work Raikas believe that person has some disease in body is not in order both physically and mentally. Alok Ranjan Chaurasia (2004) discuss the estimates of fertility and contraceptive prevalence for the development blocks of Madhya Pradesh, poorco-relation between the fertility level and contraceptive use due two reasons. Existing family planning services, specifically target high faced women. Micro level analyeses and reverse survival techniques are used. The estimate of fertility arrived at are related to fertility with in the institution of marriage only. Pawan Kumar Sharma & Komila Parthi (2004) studied the differential between the Non SCs and SCs in accessing the reproductive health services in Punjab and also be made to identify specific parameters on which the two communities differ in terms of utilisation of reproductive health care services. The study have been selected from Patiala and Rupnagar district in Punjab. interviews and Random sample are used in study. Non SCs and SCs were almost the same level; on the count of natal care practices, Non SCs were only marginally ahead, on health care practices, especially in terms of house hold visits by the female multipurpose health workers immediately after delivery. SCs has made them more a ware about their health status as well as conscious of their
44
constitutional right. They are fairly motivated to access the reproductive health services. Abhishek Singh et.al (2006) examine the extent to which couples agree with each other on fertility intentions, sex of the next child and intention to use family planning in future. The role of husband’s in the couple’s reproductive behaviour and intention to use family planning in future, author also find that the husband’s attitude on women’s intention to use family planning in future after controlling, the study taken from demographically backward state of Uttar Pradesh, India, primary sampling and interviews is the base of the method, more husbands than wives desire another child, decline in family sife preference the first step in women male’s reproductive preferences is very important in formulating effective policies and programmes. Ashesh Das Gupta (2003) in his study try to explores the impact of son preference a story cultural value, on the reproductive behavior of married couples belonging to the Hindu, Muslim, and Christian and Sikh religious communities in Patna. The study was conducted in Patna. Data were gathered with the help of an interview schedule. He find out that the son preference value is a potential promoter of higher fertility in all the four religious communities though this value operates differently in different religious communities. Santosh Jatrana (2007) studies the direction and examines the child care arrangements, preferences and decision making process of working mothers of children aged 0-36 months, and suggested that whether the actural child can 45
arrangement actual children arrangement which employed mothers make are based on their preference. The study have been taken from India. Qualitative and Quantitative data take from (HFHS-2) Second National Family and Health Survey : Empirical analyses, informal interviews are taken. Study also finds out the decisions to use a particular type of child care are shaped not only by individual preferences but also by availability convenience and practicality, majority of mothers expressed as strong preference for care by relatives especially for infants and toddlers most of them are making their choices on the basis of practicality, availability or convenience. Availability of good quality Institution aliased care might lead to the mother’s care being replaced by a nonmaternal care. Aravinda Meera, Guntupalli and Parveen Nangia (2008), wants to understand the difference between scheduled tribe or non scheduled tribe women’s economic activities, Education level, knowledge & usages of family planning methods, contraception method, women’s autonomy, and reproductive behaviour study was selected from Baster district in Madhya Pradesh. Random sampling, observation, case study have been done. The author try to find out that more STs women contribute to economic activities than non STs women, lower level of education than others, family planning’s method, contraception knowledge is higher in non ST women’s than STs women. M.N. Sivakumar (1999) finds out whether changes occur in timing of marriage and fertility over the time periods and also finds these changes occur 46
among women in all socio-economic classes over the time period. Data was collected in three district in Kerla state Vi2 Palghat, Erana Kulum and Alleppey. Micro level study and Interviews are the base of study. In this study the author finds that better educated women have lower fertility than the less educated women, age at marriage and the decline in the fertility level over the birth cohorts are found to be statistically significant, Both the Hindu and Christen women have higher age at marriage and lower fertility than the Muslim women. The working women have slightly higher age at marriage and lower fertility than non working women over the birth cohorts.
2.11.2 Substantive Issues On the basis of above studies by dealing with different aspect of health we can depict upon the substantive issues. 1.
Aeshesh Das Gupta (2003) has described son preferences and reproductive behavioral of married couple belonging to the Hindu, Muslim, Christen and Sikh religious Communities in Patna.
2.
Alok Ranjan Chaurasia (2004) state that the estimates of fertility and contraceptive prevalence for the development blocks of Madhya Pradesh.
3.
Narendra Singh and Binod C. Agarwal (2009) studies the Health communication among scheduled tribes of Chhattisgarh.
47
4.
Nandini Bhattacharya and Subha Ray (2009) discusses the incidence of induced abortion among slum dwellers of Kolkata.
5.
M.N. Sivakumar (1999) state that whether changes occur in timing of marriage and fertility over the time periods.
6.
Pawan Kumar Sharma and Kamila Parthi (2004) discusses the differential between the non SCs and SCs in accessing the reproductive health services in Punjab.
7.
Anoshua Chaughary (2008) state the long term impact on children’s health status of a re-productive health programme in rural Bangladesh.
8.
Abhishek Singh et.al. (2008) studied couples reproductive goal’s in India and their policy relevance and extent to which couples agree with each other on fertility intentions.
9.
A.S. Dey and A. Shrivastava (2011) discusses the relationship between level of health modernisation and utilisation of health services in Madhya Pradesh.
10. Arvinda Meera Guntupalli and Parveen Nangia (2008) discusses the difference between STs women and non STs women on the basis of economic activities, educational level, knowledge and usages of family planning methods, contraceptive usages women’s autonomy and reproductive behaviour. 11. Amir H. Mehryar et. al. (2011) state the rapid fertility decline and age structural transition in Iran. 48
12. Adrienne M. Lucas (2013) state that the impact of Malaria eradication on fertility. 13. Santosh Jatrana (2007) discuss the direction and examines the child care arrangements and decision making process of working mothers. 14. A. Neelima and A. Sudarshan Reddy (2009) state that the private sector to ensure cost saving, increasing the access and in overall, a health policy in tune with a holistic approach. 15. Pragya Sharma (2009) said that illness not only upon that person but also upon the members of family and community. 16. K.V. Narayana (2003) highlight the role of the state in the privatization and corporatization of medical care and assess its impact upon public hospitals in Andhra Pradesh. 17. H.C. Srivastava (2011) identify the determinates of male involvement as, supportive partner in their wives reproductive health and understand husband’s knowledge perception and behaviour towards reproductive and sexual health of their wives.
2.11.3 Methodological Issues On the basis of above studies it may be conclude that sociologists used different techniques/method for data collection which followingAshesh Das Gupta (2003) used the Quota sampling Study and data collected through interview scheduled/guide.
49
Alok Ranjan Chaurasia (2004), used Micro Level analyses and reverse survival techniques. Narendra Singh and Binod C. Agarwal (2009), used ethnographic holistic approach and data collected by interviews and observation. Nandini Bhattacharya and Subha Ray (2009), has been used both quantitative and qualitative data collected by case study. M.N. Sivakumar (1999), used Micro Level study and collected the data by interview. Pawan Kumar Sharma and Komila Parthi (2004), used field work and collected data by surveyed. Anoshua Chaughury (2008), used random sampling and surveyed. Abhishek Singh (2006), used analysis (DLHS) and collect data by primary sampling and interview. A.S. Dy and Shrivastava (2011), used in his pilot survey and collected the data by interview schedule. Arvind Meera Guntupalli and Parveen Nangia (2008), used to collect the data by Random sampling, Observation and case study. Amir H. Mehryar (2011), used census survey data and scale survey to collect the data. Adrienne M. Lucas (2013), has been used survey method to collect the data.
50
Santosh Jatraha (2007), used both quantitative and qualitative data Emprical analysis to collect the data by informal interviews. A Neelima and A. Suddarshan Reddy (2009), collected the data through empirical Research Method. Pragya Sharma (2009), has been used the method observation for collectionof data. K.V. Narayana (2003), used primary data for collect the data. H.C. Srivastava (2011), used both quantitative and qualitative and interviews for collect the data.
51
CHAPTER – 3 AREA OF SUTDY
The present study “Postnatal Reproductive Health Care” conducted in a town “Deoband” of district Saharanpur. There are various reasons for choosing Deoband town. First of all it’s my home town and my birth place also so there is no problem to access to make a report with the respondents. Another reason for selecting the place Deoband was that I earlier conducted my field work experiences in my mater degree. My project work is on two communities Hindu and Muslim. There is no problem to conduct a comparative study. So that I felt assured that it would be advantageous to work in the town.
3.1 Location Deoband is situated in north from Meerut in Muzzafarnagar to Saharanpur road. Deoband town at the attitude of 348 meters (1093 feet) from sea level at 29.70 N- 77.680 E, It has an average elevation of 348 meters (1093 feet). The distance of Deoband from Meerut is 83 Km, and 161 Km. from Delhi. Deoband is surrounded by the famous cities like Saharanpur, Muzaffarnagar, Roorkee and Haridwar.
52
3.2 Culture Heritage/History Deoband is an ancient town described in Mahabharta. The actual name of Deoband was Dev Vrind. Pandwas come and stay first in Deoband. An ancient story is also linked with Deoband, Devta’s prisioned by Rakshasa in Deoband. The goddes Maa Bala Sundari killed the Rakshasa and then town is known as Dev Vrind. In U.P. Government’s Gazat, 1868 have been written that Deoband is a Heritage town. Deoband is situated before 153 years. After the defeat of 1857, some prominent Muslim leaders of the freedom movement found it very hard to save India from the cultural onslaught of the British. They planned to established a revolutionary Institution Darul Ullom the most eminent Islamic learning centre thus was established in 21st May, 1866 : by Maulana Muhammad Qasim Nanautavi. The town is also known by this world famous University today.
3.3 Social Structure of the Town The total population of the Deoband is 274307. In this town total population consists of Hindu 133402, Muslims 138523. There are various castes like Brahmin, Baniye, Saini, Chamar, Bhangi, Punjabi, Rajput, Gujjar, Gadariye, Dhawe in Hindus and Pathan, Malik, Siddki, Rehman, Gade, Alwi, Banjare, Ansari, Kuraishi, Muslim Gujjar in Muslims.
53
3.4 Occupational Structure of the Town The town consists of two religious community Hindu and Muslim. Hindu and Muslims both deal with different occupations. Following table comprise of caste wise distribution in the town.
Table- (A) : Occupation of the Hindu Castes S.No. 1.
Hindu Caste
Occupation
Brahmin
Agriculture, Services & Ritual Works
Baniye
Agriculture Service & Business
Rajput
Agriculture, Service & Business
4.
Punjabi
Service, Business
5.
Gujjar
Agriculture & Business
Gadariyea
Agriculture & Service
7.
Saini
Agriculture & Service
8.
Chamar
Government Service, Tradition Labour
Balmiki
Government Service, Tradition Labour
Dawe
Tradition Labour
2. 3.
6.
UPPER CASTE
MIDDLE CASTE
9.
LOWER CAST
10.
54
Table- (B) : Occupation of the Muslim Castes S.No.
1.
Muslim Caste
Occupation
Pathan
Agriculture, Business & Labour
Siddki
Business & Service
3.
Rehman
Service & Business
4.
Kuraishi
Tradition Labour
Ansari
Tradition Weaver, Business & Labour
6.
Muslim Gujjar
Agriculture, Business & Service
7.
Malik
Agriculture, Laboure & Business
Banjare
Tradition Labour & Business
9.
Gade
Agriculture, Business & Service
10.
Alwi (Shah)
Tradition Labour
UPPER 2. CASTE
MIDDLE 5. CASTE
8. LOWER CAST
55
3.5 Medical Facilities of the Town Medical facilities are available also in the town. There is 1 Government Hospital and 6 private Hospitals. 15 Medical Clinic and 1 Government Vetenary Hospital. There are a very large number of doctors. Doctor’s are available for 24 hours in the town.
3.6 Educational Facilities in the Town World Famous “Darul Uloom University” is situated in the town. Important and influential schools of Islamic studies and another Jamia Tibbiya College of Unani Medicine, imparting the qualifications of B.U.M.S and M.D. The educational status of Deoband is very high, There is a Government Degree College providing courses like B.A., B.Com. M.A., M.Com. B.B.A., B.C.A., I.T.I., L.L.B. and 3 Non Government Colleges providing also these courses. There is a Sanskrit Mahavidhyalya which provide Acharya and Shastri Degree to his students, 4 Government Inter Colleges and 3 Non Government Inter Colleges, 4 Higher Secondary Schools and several numbers of Junior High Schools and Public Schools. So there is no problem to get higher education in the town.
56
3.7 Transportation, Communication, Marketing and Other Facilities in the Town Deoband is situated on Muzaffernagar to Saharanpur Road it is well connected by Buses and Trains. Transportation condition is very well in the town Muzaffarnagar Roadways, Saharanpur Roadways and also a Railway Station in the town are well established and other private transport are also available for 24 hours. Communication is also non-bearing in the town. BSNL Telephone exchange and many mobile companies tower like – Idea, Vodaphone, Uninor, Tata Docomo, Airtel etc. are well situated. Transport and communication facilities play an important role in socio-economic life of the people in the town. Market facility is available in the town. There are 3 big markets. Its is known as Main Bazar, Deoband famous for clothes, and general merchants and provisional stores, Book shops, shoe shops, mobile recharge points. 2 nd is Meena Bazaar, Deoband, famous for cosmetics and Ladies garments. 3rd is Sarrafa Bazaar and Sarsata Bazaar, Deoband, famous for Jewelry and Restaurants. There is a Anaaj Mandi and Sabji Mandi also.
57
CHAPTER -4 SOCIO-ECONOMIC PROFILE OF THE WOMEN
The Socio-economic profile of the respondent plays an important role because it effects every aspect of respondents day to day life, The socioeconomic profile of the following variables have been include as age, religion, caste, education, size of family, occupation and income of the respondents. The respondent who belong to different socio-economic profile, the aspect about that are as below-
4.1 Age It is well established fact that the age is an important factor of any person according to their age may have different degree of awareness personality and value. The age distribution of the respondents is given in the following table :
58
Table-1- Age of the Women No. of the Married Women S.No.
Age
Total Hindu
Muslim
1
21-25
08
17
25
2
26-30
18
12
30
3
31-35
13
10
23
4
36-40
07
06
13
5
41-45
04
05
09
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013 )
The above table shows that out of 50, 08 Hindu Women belong to the age group of 21-25, 18 belong to the age group of 26-30, 13 belong to the age group of 31-35 and 07 belong to the age group of 36-40, and rest of the 04 belong to the age group of 41-45. In the next group of 50, 17 Muslim Women belong to the age group of 21-25, 12 belong to the age group of 26-30, 10 belong to the age group of 31-35, 06 belong to the age group of 36-40, 05 belong to the age group of 41-45. Thus the above fact reveals that larger segment of Muslim women belong to the lower age group of 21-25, where as the larger segment in Hindu women belong to the age group of 26-30.
59
Thus, the Muslim Women are more young in the comparison to Hindu Women.
4.2 Religion Religion is an important variable. Religion is a set of belief symbols and practices which is based on the idea of belief in to a socio religious community. Religion play an important role in every bodies day-to-day life and in performing of their religions rituals the religion of the respondents is given in the following table-
Table-2- Religion of the Women S. No.
Religion
No. of Respondents
Total
1
Hindu
50
50
2
Muslim
50
50
Total
100
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that there are 50 Hindu women respondents and 50 Muslim Women respondents.
4.3 Caste Caste is the another important factor of an individual which identifies to status of particular individual in both social and occupational spheres. Caste has been over simplified by those seeking an ideal type of rigid hierarchical social
60
stratification bases on extreme closer criteria. The caste distribution of the respondents is given below-
Table-3- Caste of the Women No. of the Married Women S.No.
Caste
Total Hindu
Muslim
1
Upper
15
15
30
2
Middle
20
15
35
3
Lower
15
20
35
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that out of 50, 15 Hindu Women belong to upper caste, 20 belong to Middle Caste and 15 belong to Lower Caste. And out of 50, 15 Muslim women belong to upper caste, 15 belong to Middle Caste and 20 belong to Lower Caste. Thus above fact reveals that larger segment in Hindu Women belong to Middle caste whereas the large Muslim Women belong to Lower Caste.
4.4 Education Education is the most important factor for any person in the present time which may effect every aspect of the life without education there level of the respondent is given in the following table:
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Table-4- Education of the Women S.No.
Education Level
1
No. of the Married Women
Total
Hindu
Muslim
Illiterate
12
19
31
2
Primary Level (1-5)
04
06
10
3
Secondary Level (6-10)
10
15
25
4
High Secondary Level
07
03
10
08
04
12
09
03
12
50
50
100
(10+2) 5
Graduation Level (10+2+3)
6
Post Graduation Level (10+2+3+2) Total
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that out of 50, 12 Hindu Women are Illiterate, 4 are educated up to primary level, 10 are educated up to secondary level, 07 are educated up to High Secondary Level, 08 are educated up to Graduate Level, and 09 are educated up to Post-graduate level. And out of 50, 19 Muslim Women are Illiterate, 06 are educated up to primary level, 15 are educated up to secondary level, 03 are educated up to secondary level, 04 are educated up to graduate level, 03 are educated upto PostGraduate level.
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Among the illiterate Muslim Women are more in the comparison to Hindu Women where as among the graduate and post graduate Hindu women are more in the comparison to Muslim women. Thus, Hindu women are more educated in the comparison to Muslim women.
4.5 Occupation Occupation is an important factor which effects, every aspect of the life and decides the position of any bodies in their society. The occupation distribution of the respondents is given in the following table :
Table-5- Occupation of the Women S.No.
Occupation
1
No. of the Married Women
Total
Hindu
Muslim
House Wife
35
40
75
2
Service/teaching
13
09
22
3
Business
02
01
03
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that out of 50, 35 Hindu women are house wives, 13 are engage in service/teaching and 2 are in business. And out of 50, 40 Muslim women are house wives, 09 are engage in service/teaching, only 01 is in business.
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Thus, the Hindu women are more in servicer/ teaching profession in the comparison to Muslim Women, whereas among the housewives Muslim women are more in the comparison to Hindu Women.
4.6 Type of Family Type of family is also an important, factor which is family essentially the most important role play in providing support. The type of family of the women given in the following table.
Table-6- Type of Family of the Women S.No.
Type of Family
1 2
No. of the Married Women
Total
Hindu
Muslim
Nuclear
22
29
51
Joint
28
21
49
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that out of 50, 22 Hindu Women belong to Nuclear family, 28 belong to joint family. And out of 50, 29 Muslim women belong to Nuclear family and 21 belong to joint family. Thus the above fact reveals that larger segment of Muslim women lives in Nuclear Families, whereas the larger segment of Hindu Women lives in Joint familis.
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4.7 Size of Family Family is also an important factor because family relation are essentially the most-important source of support. The family size of the respondents is given in the following table-
Table-7- Family Size of the Women S.No.
Family Size
1 2
No. of the Married Women
Total
Hindu
Muslim
Small (1-4 Members)
15
12
27
Middle (5-8 Members)
32
30
62
Large (9 and above-
03
08
11
50
50
100
members) Total
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that out of 50, 15 Hindu Women belong to small size (1-4) members family, 32 belong to middle size (5-8) member family, 03 belong to large family size (9 and above). And out of 50, 12 Muslim belong to small size (1-4) member family, 30 belong to middle size (5-8) members family 08 belong to large family size (9 and above). More Hindu Women live in small families in the comparison to Muslim women whereas more Muslim Women lives in large families in comparison to Hindu women.
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4.8 Income Income is an important variable because it decides every bodies living standard. It decides our social position also in our society. The distribution of income of the respondent is given in the following table-
Table-8- Income of the Women S.No.
Income of the Women
1
No. of the Married Women
Total
Hindu
Muslim
1000-4000
19
26
45
2
4001-8000
16
19
35
3
8001-12000
06
04
10
4
12001-16000
00
00
00
5
16001 and above
09
01
10
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that out of 50, 19 Hindu women belong to 1000 to 4000 income group, 16 belong to 4001-8000 income group, 06 belong to 8001 to 12000 income group, and 09 belong to 16001 and above. And out of 50, 26 Muslim women belong to 1000 to 4000 income group, 19 belong to 4001 to 8000 income group, 04 belong to 8001 to 12000 income group only 01 belong to 16001 and above. Thus, among the poor income 1000-4000 group of Muslim women are in majority in comparison to Hindu woman whereas among the higher income group 16001 and above almost all women are Hindu. 66
4.9.1 Condition of Residence: (A) Type of House To assess the economic status of the respondents one item to-inquire is considered appropriate that is that the condition of residence, which we can know in the following table. The type of the house of the women is given in the following table-
Table-9 - Type of House of the Women No. of the Married Women S.No.
Type of House
Total Hindu
Muslim
1
Kaccha
16
27
43
2
Pukka
34
23
57
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that out of 50, 16 Hindu Women lives Kaccha House and 34 Hindu women lives in Pukka house. And out of 50, 27 Muslim women lives in Kaccha house and 23 Muslim Women lives in Pukka house. Thus the above fact reveals that larger segment of Muslim women lives in Kaccha house, where as larger segment of Hindu women lives in Pukka house.
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4.9.2 (b) No. of Rooms To assess of the economic status of the respondents one item is inquire is considered appropriate and that is no. of rooms which we can know in the following table-
Table-10 Condition of Residence (Size) No. of the Married Women S.No.
No. of Rooms
Total Hindu
Muslim
1
Single Room
01
07
08
2
2-3 Rooms
39
42
81
3
4-5 Rooms
08
01
09
4
6& above Rooms
02
00
02
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that out of 50 only 01 Hindu women have single room, 39 have 2-3 rooms, 08 have 4 or 5 room and 02 have 6 and above room. And out of 50, 07 Muslim women have single room, 42 have 2 or 3 rooms, only 01 have 4 or 5 room and none of have 6 and above room. Thus, more Muslim women live in single room set house in comparison to Hindu Women whereas more Hindu women live in 4-5 room set house in comparison to Muslim women.
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4.9.3 (c) Light and Ventilation To assess the economic status of the respondents one item to inquire is considered appropriate that is light and ventilation in their houses, which we can know in the following table-
Table-11- Light and Ventilation No. of the Married Women S.No.
Light and Ventilation
Total Hindu
Muslim
1
Yes
50
50
100
2
No
00
00
00
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
Thus, the above table shows that almost all Hindu and Muslim women have light and ventilation in their houses.
4.9.4 (d) Separate Kitchen To assess the economic status of the respondents one item to inquire is considered appropriate that is separate kitchen in their house, which we can know in the following table:
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Table-12- Separate Kitchen S.No.
Separate Kitchen
1 2
No. of the Married Women
Total
Hindu
Muslim
Yes
44
22
66
No
06
28
34
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that out of 50, 44 Hindu Women have separate Kitchen in their houses. And out of 50, 22 Muslim Women have separate Kitchen in their houses and 28 don’t have separate kitchen in their house. Thus, more Hindu women have separate kitchen in their houses whereas Muslim women don’t have separate kitchen in their houses.
4.9.5 (e) Facility of Toilet To assess the economic status of the respondents one item to inquire is considered appropriate that is the facility of toilet in their, house which we can know in the following table:
Table-13- Toilet Facility S.No.
Toilet
1 2
No. of the Married Women
Total
Hindu
Muslim
Yes
50
50
100
No
00
00
00
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
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The above table shows that all most all Hindu and Muslim women have Toilet in their houses.
4.9.6. (f) Facility of Bathroom To assess the economic status of the respondents one item to inquire is considered appropriate that is the facility of Bathroom in their houses, which we can know in the following table:
Table-14- Bathroom Facility No. of the Married Women S.No.
Bathroom
Total Hindu
Muslim
1
Yes
50
44
94
2
No
00
06
06
Total
50
50
100
(Source: Data Collected by the Researcher herself during the month of Oct.-Nov. 2013)
The above table shows that almost all Hindu Women have Bathroom in their house. And out of 50, 44 Muslim women have bathroom in their houses, and only 06 don’t have bathroom in their houses. Thus, All Hindu women have bathroom in their houses whereas very few no. of Muslim women have separate bathroom in their houses.
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CHAPTER -5 ATTITUDE TOWARDS MARRIAGE, PREGNANCY/DELIVERY AND CHILDREN Marriage is considered as an essential social institution to enter in family life and for procreation of new generations: Almost in all societies, traditional or modern. In India unlike some other countries, reproduction and fertility of adolescents, Young and adults occur mainly with the context of marriage-
5.1 Age at Marriage Information on the respondents is given in the following table-
Table-15- Age at Marriage of the Women Age at
No. of the Married Women
S.No.
Total Marriage
Hindu
Muslim
1
15-20
20
31
51
2
21-25
26
18
44
3
26-30
04
01
05
Total
50
50
100
(Source: Data Collected by researcher herself during the month of Oct.-Nov. 2013)
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The above table shows that out of 50, 20 Hindu women belong to the age group of marriage 15-20, 26 belong to the age group of marriage 21-25, 04 belong to the age group of marriage 26-30. And out of 50, 31 Muslim women belong to the age group of marriage 15-20, 18 belong to the age group of marriage 21-25 and 01 belong to the age group of marriage 26-30. Thus the above fact reveals that majority of Muslim women got married at the age of 15-20 and majority of Hindu women got married at the age of 21-25. Thus, Muslim women got married at an early age comparison to Hindu women.
5.2 Age at First Pregnancy Age at first pregnancy of the women respondents is given in the following table-
Table-16- Age at First Pregnancy of the Women S.No.
Age at First
No. of the Married Women
Total
Pregnancy
Hindu
Muslim
1
17-20
10
23
33
2
21-24
24
19
43
3
25-28
14
07
21
4
29-32
02
01
03
Total
50
50
100
(Source: Data Collected by researcher herself during the month Oct.- Nov. 2013)
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The above table shows that out of 50, 10 Hindu women belong age group 17-20 age in their first pregnancy, 24 belong age group 21-24 in their first pregnancy, 14 belong age group at 25-28 in their first pregnancy, 02 belong group 29-32, in their first pregnancy. And out of 50, 23 Muslim women belong age group 17-20 in their first pregnancy, 19 belong age group 21-24 in their first pregnancy, 07 belong age group 25-28 in their first pregnancy and 01 belong age group 29-32 in their first pregnancy. Thus the above fact reveal that large no. of Muslim women got pregnant at the age group 17-20 and large segment of Hindu women got pregnant at the right age group 21-24 comparison to Hindu women. Thus, Muslim women got pregnant at an early age in comparison to Hindu women.
5.3 Age at First Delivery Age at first Delivery of women is given in the following table-
Table-17- Age at First Delivery of women No. of the Married Women
S.No.
Age at First Delivery
Hindu
Muslim
1
18-21
11
24
35
2
22-25
29
19
48
3
26-29
08
06
14
4
30-33
02
01
03
Total
50
50
100
Total
(Source: Data Collected by researcher herself during the month Oct. to No. 2013)
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The above table shows that out of 50, 11 Hindu women belong to 18-21 age group in first delivery, 29 belong 22-25 age group in first delivery, 08 belong 22-25 age group in first delivery, 08 belong 26-29 age group in first delivery and 02 belong 30-33 age at first delivery. Out of 50 Muslim Women 24 belong to 18-21 age group in first delivery, 19 belong 22-25 age group in first delivery, 06 belong 26-29 age group in first delivery and 01 belong to 30-33 age group in first delivery. Thus, large segment of Muslim women performed delivery at the low age 18-21 between and majority of Hindu women performed delivery at right age between 22-25, thus Muslim women performed delivery in early age in comparison Hindu women.
5.4 No. of Children No. of Children of Women is given in the following table-
Table-18- No. of Children of Women S.No.
No. of Children
1
No. of the Married Women
Total
Hindu
Muslim
Single
11
03
14
2
2-3
33
26
59
3
4-5
04
11
15
4
5 and above
02
10
12
Total
50
50
100
(Source: Data Collected by researcher herself during the month Oct. to No. 2013)
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The above table shows that out of 50, 11 Hindu women have single child 33 have 2 or 3 children, 04 have 4-5 children and 02 have 5 and above children. And out of 50, 03 Muslim women have single child, 26 have 2 or 3 children, 11 have 4-5 children and 10 have 5 and above children. Thus the above fact reveals that more Hindu women have 2 or 3 children in the comparison to Muslim women, whereas large segment of Muslim women have more no. of children, 5 and above in comparison to Hindu Women.
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CHAPTER – 6 ATTITUDE OF WOMEN AND THEIR FAMILY MEMBERS AFTER DELIVERY
Pregnancy period and child birth is very important and the matter of anxiety for every married couple. For women, the child birth is the matter of life and death, and at the same time the first experience of motherhood, is a great pride for every woman so the pregnancy and child birth is the most crucial issue of women’s reproductive health, so an extra health care behavior and proper medical treatment are needed for this crucial period. Attitude of women and their family members may be observed on precaution and care taking during pregnancy type of precautions and care taking, place of delivery who perform delivery, precautions taken after delivery problems related to child birth, time taken to resume work after delivery and pattern of care of new born children during the house hold chores and outside work, the facts about all that are as below-
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6.1 Place of Delivery Place of delivery of women respondent is given in the following table :
Table – 19- Information on Place of Delivery of Women S.No.
Place of Delivery
No. of Married Women
Total
1.
Home
05
24
29
2.
Hospital
45
26
71
Total
50
50
100
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that out of 50, 05 Hindu women have told that the delivery had taken place at their home and 45 have told that they went to the hospital or near by nursing home for delivery. And out of 50, 24 Muslim women have told that the delivery had taken place at their home and 26 have told that they went to the hospital or near by nursing home for delivery. Thus, the above fact reveals that the large segment of Muslim women’s deliveries take place at home whereas the large segment of Hindu women’s go to the hospital or nearby nursing home.
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6.2 Type of Delivery Type of delivery of the women is given in the following table :
Table – 20-Information on Type of Delivery of Women S.No.
Type of Delivery
No. of Married Women
Total
1.
Normal
40
43
83
2.
Caesarean
10
07
17
Total
50
50
100
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that out of 50, 40 Hindu women have performed normal deliveries and 10 have performed caesarean deliveries. And out of 50, 43 Muslim women have performed normal deliveries and 07 have performed caesarean deliveries. Thus, the above fact reveals that large majority of the Muslim women performed normal deliveries whereas 1/6 of women performed caesarean deliveries.
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6.3 Pregnancy Wastage Pregnancy Wastage of the women is given the following table :
Table – 21-Pregnancy Wastage of Women S.No.
Pregnancy Wastage
No. of Married Women
Total
1.
Yes
35
45
80
2.
No
15
05
20
Total
50
50
100
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that out of 50, 35 Hindu women have face pregnancy wastage, and 15 don’t have face pregnancy wastage. And out of 50, 45 Muslim women have face pregnancy wastage, and only 05 don’t have face pregnancy wastage. Thus, the above fact revels that pregnancy wastage among Muslim women are in majority in comparison to Hindu women whereas most of the Hindu women never face this situation.
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6.4 Who Perform Delivery Performer of the delivery of women is given in the following table :
Table – 22- Performer of Delivery S.No.
Performer of Delivery
No. of Married Women Hindu
Muslim
Total
1.
Lady Doctor
45
25
70
2.
Midwife (Dai)
04
23
27
3
Other (Elder Sister,
01
02
03
50
50
100
Relative, Gent’s Doctor) Total
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that out of 50, 45 Hindu women deliveries are performed by female doctors, 04 deliveries are performed by mid wives (Dai) and only 01 woman delivery is performed by other. And out of 50, 25 Muslim women deliveries are performed by female doctor 23 deliveries are performed by mid wives (Dai) and only 02 women delivery are performed by other. Thus, the above fact revels that deliveries of almost Hindu women are performed by lady doctors whereas half delivery cases of Muslim women still performed by mid wives (Dai).
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6.5 Precaution Taken After Delivery The following table show the precaution taken after delivery
Table – 23-Precaution Taken After Delivery Precaution Taken
No. of Married Women
S.No.
Total after delivery
Hindu
Muslim
1.
Take complete Rest
40
20
60
2.
Use of Fruit, Milk,
25
10
35
20
15
35
36
20
56
Nothing Particular
28
30
58
Total
149
95
244
Ghee, etc. 3.
Special Care about cleanliness
4.
Use of Tonic & Medicine
5.
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that 40 Hindu women take complete rest after child birth, 25 use Fruit, Milk, Ghee, etc., 20 have reported that they take care about cleanliness, 36 have told if necessary then they take Tonic & Medicine and nutritious diet and 28 have told they take that normal diet and normal care after child birth, they don’t get any special diet or medical care. And 20 Muslim women take complete rest after child birth, 10 use of Fruit, Milk, Ghee, etc, 15 have reported that take care about cleanliness, and 20 82
have told if necessary then they take tonic & medicine and nutritious diet 30 have told that they take normal diet and normal care after child birth and 30 told that they don’t get any special diet to medical care. The above fact revels that more Hindu women take complete rest and use Fruit, Milk, Ghee and they also use tonic & medicine after delivery or child birth in comparison to Muslim women.
6.6 Who Support During Rest Period Support during the rest period of women respondents is given in the following table.
Table – 24-Who Support During the Rest Period of Women Support during Rest
No. of Married Women
S.No.
Total Period
Hindu
Muslim
1.
Mother in Law
20
30
50
2.
Sister in Law
05
03
08
3.
Husband
16
10
26
4.
Mother
04
07
11
5.
Relative
03
03
06
6.
Other (Elder Sister)
02
02
04
Total
50
50
100
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that out of 50, 20 Hindu women are cared by their mother-in-laws during their rest period, 05 are cared by their sister-in-laws, 16 83
are cared by their husbands, 04 are cared by their mothers, 03 are cared by relatives and only 02 are cared by other. And out of 50, 30 Muslim women are cared by their mother-in-laws, 03 are cared by their sister-in-laws, 10 are cared by their husbands, 07 are cared by their mothers, 03 are cared by relatives and only 02 cared by others. Thus, more Hindu women are cared by their husbands in comparison to Muslim women, and Muslim women are more cared by their mother-in-laws during their rest period.
6.7 Time Taken to Resume Work After Delivery Time taken to resume work of women is given in the following table :
Table – 25-Time Taken to Resume Work After Delivery No. of Married Women S.No.
Time taken
Total Hindu
Muslim
1.
After 15 days
12
06
18
2.
After one month
17
33
50
3.
After 45 days
21
11
32
Total
50
50
100
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that out of 50, 12 Hindu women have reported that they had to do household chores & other work also. So they took rest of 15 days after delivery, 17 have told that they resumed work after one month of delivery, 84
21 have told that they were fortunate enough and they took rest 45 days and then they started to work. And out of 50, 06 Muslim women have reported that they had to do household chores & other work also so they took rest 15 days after delivery, 33 have told that they resumed work after one month of delivery, 11 have told that they were fortunate enough and took rest of 45 days. Thus, the majority of Muslim Women to resumed work after one month of delivery in comparison to Hindu women, and largest segment of Hindu women resumed work after 45 days of delivery. Thus Hindu women to take rest more in the comparison Muslim women.
6.8 Pattern Care of New Born Child Pattern care of new born of the women is given in the following table :
Table – 26-Pattern Care of New Born Pattern Care of New
No. of Married Women
S.No.
Total Born
Hindu
Muslim
1.
Care child with themselves
20
24
44
2.
In laws look after baby
23
21
44
3.
Husband take care
07
05
12
Total
50
50
100
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
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The above table shows that out of 50, 20 Hindu women have told that they them selves have to manage house hold work and care of the babies side by side and when they had to go outside for the purpose of any work then they had to take their babies with them, 23 have reported that their in laws take care of new born, while they work in or out of house, 07 have told their husband’s take care of babies while they work. And out of 50, 24 Muslim women have told that they themselves have to manage house hold work and care of the baby side by side and when they had to go out side for the purpose of any work then they had to take their babies with them 21 have reported that their in laws take care of new born, while they work or out side, and 05 have told their husband’s take care of babies while they work. Thus, the above fact reveals that more Muslim women take care of child themselves in the comparison of Hindu women whereas in Hindu women’s Inlaws take care of child in comparison of Muslim women.
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CHAPTER – 7 POST DELIVERY COMPLICATIONS AND SOURCE OF CONSULTATIO/N/TREATMENT
7.1 Post Delivery Complications Related to Mother Post delivery complications related to women is given in the following table :
Table – 27-Post Delivery complications related to mother (Women) No. of Married Women S.No.
Post Delivery Complications
Total Hindu
Muslim
1.
Severe Headache
00
00
00
2.
High Fever
03
01
04
3.
Lower abdominal pain
20
15
35
4.
Back pain
25
15
40
5.
Weakness
30
20
50
6.
Stitches pain or infection
06
05
00
7.
other
00
00
00
8.
No. Disease
15
22
37
Total
99
78
177
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
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The above table shows that only 03 Hindu women have told that they suffer the problem of high fever, 20 have told that they face the problem of lower abdominal pain, 25 have told they suffer from back pain, 30 face the problem of weakness, 06 have told that they suffer from stiches pain or infection and 15 women have told that they feels normal they don’t suffer any problem after delivery or child birth. And only 01, Muslim women have told that she suffer the problem of high fever, 15 have face the problem of lower abdominal pain, 15 have told that they suffer from back pain, 20 have told that they suffer from weakness, 05 have told that they suffer from stiches pain or infection and 22 have reported that they feels normal, they don’t have any problem after delivery or child birth. Thus, the above facts reveals that more Hindu women suffer from the various diseases like back pain, weakness & lower abdominal pain in comparison to Muslim women. Another contrary finding is that Muslim women are in majority who have no disease in comparison to Hindu women.
7.2 Post Delivery Complications Related to Infant Complications related to infant is given in the following table :
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Table – 28-Post Delivery Complications Related to Infant
S.No.
No. of Married Women
Post Delivery Complications
Total
related to infant
Hindu
Muslim
1.
Premature Delivery
02
02
04
2.
Jaundice
04
01
05
3.
Pneumonia
03
02
05
4.
Early infant death
01
-
01
5.
Other (Weak, Lack of water)
02
02
04
6.
No. Disease
38
43
81
Total
50
50
100
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that out of 50, 02 Hindu women have experienced the problem of premature delivery, 04 have told that their new born babies had suffered form Jaundice, 03 have told that their babies had suffered from pneumonia, and only 01 had to suffer the early death of their infant, 02 have told that their babies are weak and they suffer from lack of water, 38 women have told their babies are normal and they don’t have any problem after birth. And out of 50, 02 Muslim women have experienced the problem of premature delivery, only 01 have told that their new born is suffer from Jaundice, 02 have told that their babies had suffer from lack of water, to women have told that their babies are weeks, 43 women told that their babies are normal and they don’t have any problem after birth.
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Thus the fact reveals that Muslim infant are more healthy in comparison to Hindu infant.
7.3 Source of Consultation Consultation/Treatment for women respondent is given in the following table :
Table – 29-Source of Consultation/Treatment No. of Married Women S.No.
Source of consolation/Treatment
Total Hindu
Muslim
1.
Government hospital
11
12
23
2.
Private hospital
29
14
43
3.
Other (relatives, friends)
10
24
34
Total
50
50
100
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that out of 50, 11 Hindu women go to Government hospital for their treatment and consultation, 29 go to private hospital 10 go to their relatives and friends for treatment and consultation. And out of 50, 12 Muslim women go to Government hospital for their treatment and consultation, 14 go to private hospital, 24 go to their relatives and friends for treatment and consultation. Thus, the above fact reveals that majority of Hindu women go to private hospital for their consultation and treatment whereas majority of Muslim women approach to their relatives & friends for their consultation and treatment.
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7.4 Source of Consultation/Treatment by Person Table – 30-Soruce of Consultation/Treatment by Person S.No.
Source of conultation/Treatment
No. of Married Women
Total
by Person
Hindu
Muslim
1.
Consult by Doctor
34
26
60
2.
Consult by Elder people of Family
12
10
22
3.
Relatives
01
03
04
4.
Other (Neighbour, Friends)
03
11
14
Total
50
50
100
(Source : Data collected by the researcher herself during the month of Oct-Nov 2013)
The above table shows that out of 50, 34 Hindu women have told that after delivery they consulted and take treatment by doctor, 12 have told that they consulted and take treatment by elder people of family, only 01 is consulted by relatives and 03 have told that they consulted and are treated by their Neighbour and friends And out of 50, 26 Muslim women have told that after delivery they consulted and take treatment by doctor, 10 have told they consulted and take treatment by elder people of family, 03 have told they consulted by relatives and only 01 have told that she is consulted and treat by her Neighbour and friends. The above fact revels that majority of Hindu women consult doctor for their treatment in comparison to Muslim women whereas more Muslim women consulted with their neighbour and friends for their treatment in comparison to Hindu women.
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Interview Schedule POSTNATAL REPRODUCTIVE HEALTH CARE : A SOCIOLOGICAL STUDY PART-1 A. Socio-economic Profile of the Women 1. Age 2. Religion 3. Caste 4. Education 5. Occupation 6. Type of Family 7. Size of Family (No. of Members) 8. Income 9. Conditions (a) Type of House (i) Kaccha House
(ii) Pakka House
(b) No. of Rooms
92
(c) Light of Ventilation (i) Yes
(ii) No
(d) Separate Kitchen (i) Yes
(ii) No
(e) Bathroom (i) Yes
(ii) No
(f) Toilet (i) Yes
(ii) No
PART-2 (B) Attitude towards marriage, pregnancy /delivery and children1. Age at Marriage 2. Age at First Pregnancy 3. Age a First Delivery 4. No. of Children 5. Other
PART-3 (C) Attitude of Women and their family members after delivery (after child birth)1. Place of Delivery (i) Home
(ii) Hospital
(iii) Other
2. Type of Delivery (i) Normal
(ii) Caesarean
3. Pregnancy Wastage 93
(iii) Other (Instrumental/Assisted)
(i) No
(ii) Yes
4. Who perform delivery (i) Lady Doctor
(ii) AnM
(iv) Elder person of Family
(v) Other
5. Precautions taken after Delivery (i) Take complete rest (ii) Use of Fruits, Milk and Ghee etc. (iii) Use of Tonic and Medicine (iv) Special Care about Cleanliness (v) Nothing Particular (vi) Other 6. Who support during rest period (i) Mother in Law (ii) Sister in Law (iii) Husband (iv) Mother (v) Devarani (vi) Jaithani (vii) Relatives (viii) Neghbours (ix) Other 7. Time taken to resume work after Delivery (i) After 15 days (ii) After one month 94
(iii) Mid Wife or Dai
(iii) After 45 days (iv) More than 45 days 8. Pattern of care of new born children during household chores and out side work. (i) Care child with themselves (ii) In Laws look after baby (iii) Husband take care (iv) House maid take care (v) Neighbour take care (vi) Other
PART-4 D. Past Delivery Complication 1. Post Delivery complications related to mother (i) Severe Headache (ii) Higher Fever (iii) Lower abdominal pain (iv) Back pain (v) Weakness (vi) Swelling (vii) Stichis pain or infection (viii) Smelling/Discharch (ix) Other 2. Post Delivery complications relate to infant (i) Premature Delivery 95
(ii) Under Weight baby (iii) Jaundice (iv) Pneumonia (v) Early Infant Death (vi) Other
PART-5 E. 1. Source of Consultation/Treatment for Post Delivery Complication(i) Government Hospital (ii) Government Dispensary (iii) Private Hospital (iv) Private Clinic (v) NGO/Trust Hospital (vi) Other (Relatives, Friends) (vii) Did not seek any treatment 2. Source
of
Consulation/treatment
Complications(i) Consult by Doctor (ii) Consult by ANM/Nurse (iii) Consult by Maid or Dai (iv) Relatives (v) Other (vi) Did not seek any treatment
96
by
person
for
post
delivery
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OTHER SOURCES o www.google.com o en.wikipedia.org/wiki/medicalsocialogy o em.m.wikipedia.org/wiki/disease o www.medicalsocilogyonline.org o emm.wikipedia.org/wiki/medicine o http://www.orthomed.org o en.wikipedia.org/wiki/alternativemedicine o en.wikipedia.org/wiki/socialepidemology o en.wikipedia.org/wiki/women o en.wikipedia.org o http://mecial-dectionary the free dictionary.com o www.med.women’s health.html o www.tandfonline.com o en.wikipedia.org/wiki/delivery
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