Rural women's
health is an infinitely broad topic. Many Indian women have come from
circumstances in which women have limited access to healthcare.
Traditionally, there has been discrimination towards women in
decision-making; access to resources such as food, education and health
care; job opportunities; and in child-rearing and parenting. However,
women's health in rural areas affects everything in their environment
from their families to their economies and vice versa. A woman's health,
especially among the poor and illiterate, is often neglected not just
by her family but by the woman herself. She is taught not to complain
and if she does then she is directed either to use condiments in the
kitchen or try faith healing.
Man is unique in that he has a distinct cultural environment
of his own. This includes all the conditions in which men are born,
brought up, live, work, procreate and perish. Culture as an environment
is deeply related to the health of humans. It includes patterns of
social organizations designed to regulate a particular society; one can
understand the behaviour of people belonging to various sections and
predict how an individual of a particular section will react in a given
situation. With our knowledge of health, the treatment of diseases among
ignorant peoples appears to be strange since they frequently follow
practices of praying, wearing of amulets or consulting an exorcist who
recites certain verbal formula. Hence, we can say that beliefs and
cultural practices are predominately playing significant roles in the
human health more peculiarly in the health of women.
Many
rural people did not know about the services set up for them at
sub-centres and PHC by the government because they did not see any
evidence of these services being provided for them. As a part of the
awareness programmes, the health workers (ANM) have been organizing to
several exposure trips at the villages. It was there that the women were
informed about the specifics of various services supposed to be made
available to them. This encouraged some of them to ask questions and
report on the situation in their PHC. They explained that though a nurse
did visit their village it was not a daily visit, nor did she go beyond
a certain point in the village, and certainly did not take a round of
the village. They made a show of doing their duty by providing nominal
services.
A variety of factors, including an older population,
a limited supply of health care providers, and further distances from
health care resources may contribute to special health concerns for
people in non-metropolitan areas. Access to health care and social
services are critical issues for rural women.
Belief is the
psychological state in which an individual is convinced of the truth of a
proposition. Like the related concepts truth, knowledge, and wisdom,
there is no precise definition of belief on which scholars agree, but
rather numerous theories and continued debate about the nature of belief
1.
The cultural phenomenon of social organization, according
to Giger and Davidhizar (2004), includes groups in the social
environment that influence cultural development and identification. The
family, an important aspect of the social organization phenomenon,
strongly influences cultural behavior through a process of socialization
or enculturation of children and group members (Giger & Davidhizar;
Niska, 1999). These learned cultural behaviors guide individuals
through life situations, events and health practices. Understanding
family from a cultural perspective is a significant element in providing
nursing care to Mexican-Americans since Giger and Davidhizar identify
the family as being most values in this culture.
Environmental
control is defined by Giger and Davidhizar (2004) as the ability of
persons within a particular cultural heritage to plan activities that
control their environment as well as their perception of one’s ability
to direct factors in the environment. Kuipers’ (1999) discussion of this
model, in relation to Mexican-American culture, emphasized the
construct of environmental control with a focus on locus-of-control,
health beliefs, and folk medicine. Locus-of-control explains the way in
which individuals, within their cultural environment, perceive their
ability to control what happens to them and to their health. Health may
be viewed as being dependent on outside forces or their own actions
(Bundek et al., 1993). Beliefs about health and illness, which are
components of environmental control, affect health practices, use of
health resources, and a person’s response to experiences of both health
and illness (Giger & Davidhizer, 2004; Northam, 1996). A third
component of environmental control, folk medicine, includes alternative
therapies such as using herbs and teas or visiting a cultural folk
healer.
Objectives:
1. Exploration of women beliefs on health, risk and their relationship to lifestyles;
2. Elicitation of their views across a range of health-related
behaviours and practices, especially puberty, menstruation, pregnancy
and child rearing, and assessment of the potential for the positive
promotion of women health in these and other areas of her sexual health.
3. Identification of the sources of information and influences on the
development of health beliefs amongst women, particularly with respect
to common elements in attitudes to risk-taking across a number of health
beliefs and practices.
4. To focus on what women themselves
know and want to know, including the salience of health, and the
relevance of health-related knowledge in their lives
Hypothesis:
1. There is a positive relationship between social beliefs and cultural practices of a given society
2. Positive relationship may be observed among the social beliefs and
cultural practices and various other factors such as caste, religion,
social and traditional customs in society
3. The explanation
for the persistence of belief systems is that people remain committed to
them, but for this commitment to last long, the belief system must be
validated
Research Design:
A quantitative and
qualitative study, building on our previous work in this area,
concerning the knowledge, attitudes, beliefs and practices of female
children and young women to health, risk and lifestyles. A guiding
methodological principle underpinning the study was the development of a
sensitive research design for rather than on women: a study grounded
not simply in what women know or need to know, but also in what they
want to know and feel to be important in the context of their everyday
lives. The methods enabling these principles to be taken forward are
described below.
a) Area of the Study:
The Telangana
region of Andhra Pradesh consists of ten districts namely Hyderabad,
Ranagareddy, Mahabubnagar, Medak, Adilabad, Nizamabad, Karimnagar,
Warangal, Nalgonda, and Khammam. From this region, the village
Ramchandrapur in Koheda Mandal of Karimnagar district has been randomly
selected as an area of the study.
b) Universe & Sampling:
According to 2001 census, the village Ramchandrapur has an approximate
population of 1840 who from nearly 550 families. This village has a
primary health centre (PHC), but lacks a major hospital within a range
of 35 kms. And this village has been selected as universe for this
study.
So for this study, the researcher adopted
stratified-proportionate random method of sampling based on caste
composition of the villagers and selected the respondents from the
families mentioned in the habitation list of Ramchandrapur. This village
population data was collected from Supraja Seva Samithi, a voluntary
organization, which is working in the region for the last 10 years in
the fields of health, education and environmental protection. The list
consists of various caste grouping and from which proportionate
stratified samples were selected. Then a list of about 181 respondents
was prepared for data collection. Therefore, it is obvious that an
attempt has been made to present a general picture of community data and
on the basis of which, views and attitudes of the respondents were
taken into consideration.
C) Tools of Data Collection:
As the research is qualitative and quantitative, non-participant
observation and interview schedule was adopted for the collection of
primary data. The aspects that will cover in the interview schedule were
defined under two parts, one is for socio-economic and cultural status
of respondents such as name, sex, age, social status, education,
religion, income, nature and type of the house, etc. and the other for
socio-cultural beliefs and practice patterns in health and the related
treatment of the villagers.
D) Analysis and interpretation of data:
After arranging the collected data through tabulation and
classification, they were analyzed and interpreted in the socio-cultural
context so as to give a scientific basis to the study. Although
statistical methods like frequencies, percentages, means, standard
deviations, t-test, chi-squire and ANOVA have been used in the study,
they were applied in a relevant way.
Findings:
Socio-Economic Profile:
During the field work, observed that 22 castes were appeared and most
of the respondent belongs to the BC castes like Yadava, Gouda, Munnuru
Kapu, Vishwa Brahmin, Mudiraj and a insignificant number of people
belongs to services caste like Mangali, Chakali, Mera and so on. A
considerable amount of people belongs to SC community i.e. Mala and
Madigas. Only a few respondents belong to ST (Erukala) community. Out of
the 181 respondents, 55 percent are male and 45 percent female,. This
research is carried out with almost all the equal four fold age groups
of respondents. Thus, it is noted that age group is scattered in this
study. More number of respondents i.e. 91% belongs to Hindu religion and
5% are Muslim. Nearly 4% of the respondents belong to Christianity. It
is also proved that common phenomena of religion composition in India.
In this village, a majority of the respondents i.e. 82 (45%) are
illiterates. The next more number of respondents have studied up to
primary and secondary level i.e. 24 (13%). There are 21 (12%) of the
respondents can read and write. A significant number of respondents i.e.
18 (10%) claimed to have studied up to college level while the small
number of people who have studied up to professional level, technical
level and others stands at 7 (4%), 3 (2%) and 2 (1%) respectively. The
findings reveal that more number of the respondents i.e. 55 (30.4%) are
labourers and one-fourths of the respondents i.e. 45 (24.9%) are
engaging in the farming. On the whole 38(21%) are continuing their caste
occupation while 20 (11%) and 17 (9.4%) respondents are doing other
occupation and brought up into the service sector respectively. Only a
few of the respondents i.e. 6 (3.3%) are carrying out business.
It is also noted that a majority of the respondents i.e. 84.21% are
living under the tiled houses and a significant number of the
respondents i.e. 15.79% posses R.C.C houses. A substantial number of the
BC community respondents i.e. 75% owned the tiled house and rest of
them i.e. 14.29% have R.C.C. houses and 8.04% own asbestos roofed
houses. Most of the SC respondents i.e. 91.49% are residing under the
tiled houses while only 8.51% consist R.C.C. houses. Among the ST
respondents, 33.33% have R.C.C., tiled house and thatched house equally.
Regarding the income, less than 24% of the respondents earn Rs. 1501 –
2000 per month. Almost equal number i.e. 22.7 and 21.5 % of the
respondents earn below Rs. 500 and between Rs. 1001 and 1500
respectively. A significant number of respondents i.e. 20 % obtaining
monthly income is in the range of Rs. 501 – 1000 while only 12.7%
claimed their income was over Rs. 2000.
This village consist
very good fertile lands, There is just below half of the respondents
i.e. 84 (46.4%) have not possess any land on their own. There are 35
(19.3%) of the respondents possess land between 1- 2.19 acres. A
significant number of respondents i.e. 28 (15.5%) and 20 (11.04%) are
having land between 2.20 – 4.39 acres and 5 – 9.39 acres respectively. A
considerable number of respondents i.e. 14 (7.7%) are owned land 10 and
above acres.
Social Dogmatism on Menstruation
Patriarchal societies have tended to control women by first announcing
menarche (the onset of menstrual cycle in a young girl) to the world in
an apparently celebratory fashion while thereafter attempting to control
the implied fertility and sexual power by monthly rites of pollution,
restriction and isolation of the menstruating woman.
The
various names for menstruation or 'periods' point to its polluting
quality. For instance in Telugu, it is called samurta or peddamanshi
meaning attaining maturity. Menstrual blood is believed to be polluting.
There are varying restrictions put on a girl due to this belief such as
not touching people or hanging washed clothes out to dry; not touching
certain flowering plants lest they die or not fruit; sleeping on a jute
bag or woollen blanket away from others. A woman cannot touch her child
during menstruation. If she has to, the child must first be unclothed
completely or made to wear silken clothes. Visiting or touching images
of gods, temples, religious scriptures is also prohibited. A fear is
inculcated in the adolescent that she will sin if she breaks these
taboos. Restrictions are also placed on diet. These pollution taboos
result in many women getting an enforced rest for at least these three
days of the month since they are barred from carrying out their normal
activities.
Not only is menstrual blood supposed to be dirty,
but evil too. A menstruating girl should not let her shadow fall on a
child with measles lest the child turn blind. The used menstrual cloth
also possesses an evil quality. If men see the cloth, dry or otherwise,
they could go blind. If a cow were to swallow the cloth she would curse
the girl with infertility. In villages in A.P., women do not throw their
menstrual cloth-they either burn it or bury it.
There seem to be some similarities between Hindus and Muslims
regarding the practice of some of these rituals. Among Muslims, the
menstruating woman should not touch holy books lest they become impure.
Converted Christians follow, although to a lesser degree, the rituals of
their original castes. The taboos and rituals clearly devalue. Women's
reproductive powers. The notion of women being polluted and unclean can
be ascribed to patriarchal control of women's reproductive powers. While
the woman fulfils a vital social role of giving birth to progeny
through her biological reproductive capacity, she is, at the same time,
isolated during menstruation.
Cultural Practices of Puberty
Most women do not know about the physiology of menstruation and
therefore the first experience of menstruation is filled with fear,
shame and disgust. In some areas such as in rural areas of A.P. the girl
is sometimes told to dub three or four dots of menstrual blood or
mustard oil on the wall and draw a line between the second and third or
third and fourth; it is believed that she will finish her menstruation
within two and a half or three and a half days in all subsequent
periods.
Elaborate rituals are performed in south Indian
states-as well as in many parts of north India-at the onset of
menstruation. The onset of puberty is traditionally viewed in terms of
the girl's emergent sexuality and prospective motherhood. The pubescent
girl is given an elaborate ritual bath, after a massage with turmeric
and vermillion. The Mudiraj communities in A.P. isolate the pubescent
girl for 21 days within the house, away from the male gaze. The room in
which she is secluded is separated with an iron rod and a fire is kept
constantly burning during this period. Fire signifies purity and also
keeps away daiyyam or witches and evil spirits. The girl is polluted and
hence prohibited from touching people and other people are not allowed
to touch her. In case of default, a bath is essential for ritual
purification.
The Impact of the Food Habits on Women Health:
Although women are more or less marginalized and neglected in relation
to the quality and quantity of food, certain occasions in a woman's life
are celebrated with the offering of a variety of nutritious foods
specially prepared for her. Almost every community has the practice of
feeding a girl on her first menstruation with delicious and nutritive
foods, with the time of seclusion for the period ranging between nine to
21 days. In parts of A.P., sweets made of jaggery, groundnuts, sesame,
fenugreek, wheat flour and sorgum are given to the girl. Menstruation
for the first time in the house of one's in-laws is also considered very
auspicious in all regions of A.P. and is celebrated with gaiety.. The
idea seems to be to give the girl 'rich', that is, strength-giving foods
as well as both 'hot' and 'cold' foods.
Certain 'hot' foods
(like jaggery) and 'cold' foods (like tamarind and lemons) are taboo as
it is believed that the girl will suffer from menstrual pain. 'Hot'
foods may cause heavy bleeding and 'cold' foods may cause severe
menstrual pain. Special foods are understood to compensate for the loss
of blood, regularise the menstrual cycle and flow, strengthen her
reproductive organs and generally contribute to her fertility.
Work Prohibition of Pregnant Women:
It is also observed during the fieldwork that almost all the
respondents have revealed that prohibition of work is compulsory while a
women pregnancy but this notion is varies to one community to another.
The higher social status communities are not allowed to perform the
works even domestic works also from the early months to after late
months of maternity. Whereas weaker section women perform the daily
domestic actives some of them perform field activates but it is only in
the early months. They should also take rest in the late months of
pregnancy and early months of maternity.
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