Beliefs and Practices in Women Health

Beliefs and Practices in Women Health				used menstrual cloth also possesses an evil quality. If
• Ramaiah Bheenaveni *				men see the cloth, dry or otherwise, they could go
Rural women's health is an infinitely broad topic. Many				blind. If a cow were to swallow the cloth she would
Indian women have come from circumstances in				curse the girl with infertility. In villages in A.P., women do
which women have limited access to healthcare.				not throw their menstrual cloth-they either burn it or
Traditionally, there has been discrimination towards				bury it.
women in decision-making; access to resources such				There seem to be some similarities between Hindus
as food, education and health care; job opportunities;				and Muslims regarding the practice of some of these
and in child-rearing and parenting. However, women's				rituals. Among Muslims, the menstruating woman
health in rural areas affects everything in their				should not touch holy books lest they become impure.
environment from their families to their economies and				Converted Christians follow, although to a lesser
vice versa. A woman's health, especially among the				degree, the rituals of their original castes. The taboos
poor and illiterate, is often neglected not just by her				and rituals clearly devalue. Women's reproductive
family but by the woman herself. She is taught not to				powers. The notion of women being polluted and
complain and if she does then she is directed either to				unclean can be ascribed to patriarchal control of
use condiments in the kitchen or try faith healing.				women's reproductive powers. While the woman fulfils
Man is unique in that he has a distinct cultural				a vital social role of giving birth to progeny through her
environment of his own. This includes all the conditions				biological reproductive capacity, she is, at the same
in which men are born, brought up, live, work, procreate				time, isolated during menstruation.
and perish. Culture as an environment is deeply related				Cultural Practices of Puberty
to the health of humans. It includes patterns of social				Most women do not know about the physiology of
organizations designed to regulate a particular society;				menstruation and therefore the first experience of
one can understand the behaviour of people belonging				menstruation is filled with fear, shame and disgust. In
to various sections and predict how an individual of a				some areas such as in rural areas of A.P. the girl is
particular section will react in a given situation. With our				sometimes told to dub three or four dots of menstrual
knowledge of health, the treatment of diseases among				blood or mustard oil on the wall and draw a line
ignorant peoples appears to be strange since they				between the second and third or third and fourth; it is
frequently follow practices of praying, wearing of				believed that she will finish her menstruation within two
amulets or consulting an exorcist who recites certain				and a half or three and a half days in all subsequent
verbal formula. Hence, we can say that beliefs and				periods.
cultural practices are predominately playing significant				Elaborate rituals are performed in south Indian
roles in the human health more peculiarly in the health				states-as well as in many parts of north India-at the
of women.				onset of menstruation. The onset of puberty is
Many rural people did not know about the services set				traditionally viewed in terms of the girl's emergent
up for them at sub-centres and PHC by the				sexuality and prospective motherhood. The pubescent
government because they did not see any evidence				girl is given an elaborate ritual bath, after a massage
of these services being provided for them. As a part				with turmeric and vermillion. The Mudiraj communities in
of the awareness programmes, the health workers				A.P. isolate the pubescent girl for 21 days within the
(ANM) have been organizing to several exposure trips				house, away from the male gaze. The room in which
at the villages. It was there that the women were				she is secluded is separated with an iron rod and a fire
informed about the specifics of various services				is kept constantly burning during this period. Fire signifies
supposed to be made available to them. This				purity and also keeps away daiyyam or witches and
encouraged some of them to ask questions and				evil spirits. The girl is polluted and hence prohibited from
report on the situation in their PHC. They explained that				touching people and other people are not allowed to
though a nurse did visit their village it was not a daily				touch her. In case of default, a bath is essential for
visit, nor did she go beyond a certain point in the village,				ritual purification.
and certainly did not take a round of the village. They				The Impact of the Food Habits on Women Health:
made a show of doing their duty by providing nominal				Although women are more or less marginalized and
services.				neglected in relation to the quality and quantity of food,
A variety of factors, including an older population, a				certain occasions in a woman's life are celebrated with
limited supply of health care providers, and further				the offering of a variety of nutritious foods specially
distances from health care resources may contribute				prepared for her. Almost every community has the
to special health concerns for people in				practice of feeding a girl on her first menstruation with
non-metropolitan areas. Access to health care and				delicious and nutritive foods, with the time of seclusion
social services are critical issues for rural women.				for the period ranging between nine to 21 days. In parts
Belief is the psychological state in which an individual is				of A.P., sweets made of jaggery, groundnuts, sesame,
convinced of the truth of a proposition. Like the related				fenugreek, wheat flour and sorgum are given to the
concepts truth, knowledge, and wisdom, there is no				girl. Menstruation for the first time in the house of one's
precise definition of belief on which scholars agree, but				in-laws is also considered very auspicious in all regions
rather numerous theories and continued debate about				of A.P. and is celebrated with gaiety.. The idea seems
the nature of belief 1.				to be to give the girl 'rich', that is, strength-giving foods
The cultural phenomenon of social organization,				as well as both 'hot' and 'cold' foods.
according to Giger and Davidhizar (2004), includes				Certain 'hot' foods (like jaggery) and 'cold' foods (like
groups in the social environment that influence cultural				tamarind and lemons) are taboo as it is believed that
development and identification. The family, an important				the girl will suffer from menstrual pain. 'Hot' foods may
aspect of the social organization phenomenon, strongly				cause heavy bleeding and 'cold' foods may cause
influences cultural behavior through a process of				severe menstrual pain. Special foods are understood
socialization or enculturation of children and group				to compensate for the loss of blood, regularise the
members (Giger & Davidhizar; Niska, 1999). These				menstrual cycle and flow, strengthen her reproductive
learned cultural behaviors guide individuals through life				organs and generally contribute to her fertility.
situations, events and health practices. Understanding				Work Prohibition of Pregnant Women:
family from a cultural perspective is a significant				It is also observed during the fieldwork that almost all
element in providing nursing care to				the respondents have revealed that prohibition of work
Mexican-Americans since Giger and Davidhizar identify				is compulsory while a women pregnancy but this
the family as being most values in this culture.				notion is varies to one community to another. The
Environmental control is defined by Giger and				higher social status communities are not allowed to
Davidhizar (2004) as the ability of persons within a				perform the works even domestic works also from
particular cultural heritage to plan activities that control				the early months to after late months of maternity.
their environment as well as their perception of				Whereas weaker section women perform the daily
one’s ability to direct factors in the environment.				domestic actives some of them perform field
Kuipers’ (1999) discussion of this model, in				activates but it is only in the early months. They should
relation to Mexican-American culture, emphasized the				also take rest in the late months of pregnancy and
construct of environmental control with a focus on				early months of maternity.
locus-of-control, health beliefs, and folk medicine.				Encourage and Disencourage Food Items During the
Locus-of-control explains the way in which individuals,				Pregnancy of Women:
within their cultural environment, perceive their ability to				During pregnancy and lactation, many traditional
control what happens to them and to their health.				communities across the country restrict a woman's
Health may be viewed as being dependent on outside				food intake. It is believed that if a pregnant woman
forces or their own actions (Bundek et al., 1993). Beliefs				eats too much, the foetus will not have room to move.
about health and illness, which are components of				The abdomen is supposed to contain both the food
environmental control, affect health practices, use of				and the foetus and the latter's space needs should be
health resources, and a person’s response to				given greater priority. Another reason for controlling a
experiences of both health and illness (Giger &				pregnant woman's food consumption is perhaps that
Davidhizer, 2004; Northam, 1996). A third component of				excess weight would reduce the productivity of her
environmental control, folk medicine, includes alternative				work in the fields and around the house. A widely
therapies such as using herbs and teas or visiting a				prevalent practice all over India is shrimanta. In the
cultural folk healer.				seventh month of pregnancy special rituals are
Objectives:				performed and different types of sweets are
1. Exploration of women beliefs on health, risk and their				prepared and given to the parents-to-be. The purpose
relationship to lifestyles;				is to give moral support and encouragement to the
2. Elicitation of their views across a range of				pregnant woman and celebrate her achievement of
health-related behaviours and practices, especially				having reached near full-term. The sweets are
puberty, menstruation, pregnancy and child rearing, and				generally made of wheat flour, jaggery, ghee,
assessment of the potential for the positive promotion				fenugreek and dry fruits. In the final stages of
of women health in these and other areas of her				pregnancy, the pregnant woman is supposed to cat
sexual health.				these foods custom every day. This is a good custom
3. Identification of the sources of information and				because it provides the calories and protein needed
influences on the development of health beliefs				for the rapidly growing foetus in the last trimester of
amongst women, particularly with respect to common				pregnancy.
elements in attitudes to risk-taking across a number of				Food Items Encourage % Disencourage %
health beliefs and practices.				1.Milk 173 95.5 8 4.4
4. To focus on what women themselves know and				2.Green leafs 148 81.7 33 18.2
want to know, including the salience of health, and the				3.Toddy 80 44.1 101 55.8
relevance of health-related knowledge in their lives				4.Non-Veg 132 72.9 49 27
Hypothesis:				5.Papaya --- --- 181 100
1. There is a positive relationship between social beliefs				6.Potato 49 27 132 72.9
and cultural practices of a given society				7.Brinjal 50 27.6 131 72.3
2. Positive relationship may be observed among the				The above table explains the villager’s
social beliefs and cultural practices and various other				perceptions on encourage and disencourage food
factors such as caste, religion, social and traditional				items during the pregnancy of women. The data
customs in society				shows that there are 173 (95.5%) of the respondents
3. The explanation for the persistence of belief				have stated that they are encouraging milk and its
systems is that people remain committed to them, but				related food items and only insignificant number of
for this commitment to last long, the belief system				respondents i.e.8 (4.4%) are not encouraging the food
must be validated				items of milk. As many as 148 (81.7%) of them
Research Design:				revealed that they are encouraging green leafs and
A quantitative and qualitative study, building on our				rest of the significant number of respondents i.e. 33
previous work in this area, concerning the knowledge,				(18.2%) are not interested to give the green leafs to
attitudes, beliefs and practices of female children and				the pregnants. Interestingly the data depicts that more
young women to health, risk and lifestyles. A guiding				than half of the respondents i.e. 101 (55.8%) have said
methodological principle underpinning the study was the				that they are encouraging toddy and 80 (44.1%) of
development of a sensitive research design for rather				them are not giving taking toddy. A substantial number
than on women: a study grounded not simply in what				of the respondents i.e. 132 (72.9%) have expressed
women know or need to know, but also in what they				that they are encouraging the consummation of
want to know and feel to be important in the context				non-vegetarian foods like mutton, chicken and egg. The
of their everyday lives. The methods enabling these				total number of respondents is practicing the prohibition
principles to be taken forward are described below.a)				of papaya consummation during the pregnancy. All
Area of the Study:				most all equal number of respondents i.e. 49 (27%) and
The Telangana region of Andhra Pradesh consists of				50 (27.6%) have revealed that Potato and Brinjal are
ten districts namely Hyderabad, Ranagareddy,				encouraged food items and as similar 132 (72.9%) and
Mahabubnagar, Medak, Adilabad, Nizamabad,				131 (72.3%) of them are not encouraging the food
Karimnagar, Warangal, Nalgonda, and Khammam.				items of Potato and Brinjal.
From this region, the village Ramchandrapur in Koheda				The data regarding Caring of Pregnant Women
Mandal of Karimnagar district has been randomly				among the Villagers clarifies the pursuance of the
selected as an area of the study.b) Universe &				opinion of several communities respondents such as
Sampling:				Yadava 14 (7.7%), Gouda 3 (1.7%), Munurukapu 11
According to 2001 census, the village Ramchandrapur				(6.1%), Oddera 6 (3.3%), Vishwa Brahmin 5 (2.8%), Mala
has an approximate population of 1840 who from				25 (13.8%), Madiga 21 (11.6%), Padmashali 7 (3.9%),
nearly 550 families. This village has a primary health				each 3 (1.7%) of Mangali, Dudekula and Erukala, Kumari
centre (PHC), but lacks a major hospital within a range				2 (1.1%) and each 1 (0.6%) of Pusala, Mera, Chindi and
of 35 kms. And this village has been selected as				Dakkali have stated that family and their kins are
universe for this study.				taking care of their pregnant women. In this category
So for this study, the researcher adopted				the total numbers of SC and ST communities are
stratified-proportionate random method of sampling				appeared because of less financial status and peer
based on caste composition of the villagers and				group pressure. A majority number of working caste
selected the respondents from the families mentioned				like Yadava, Munnurukapu, Oddera, Padmashali,
in the habitation list of Ramchandrapur. This village				Dudekula and Kummari are appeared. However, these
population data was collected from Supraja Seva				communities’ people are visiting either
Samithi, a voluntary organization, which is working in the				government or private hospital for check up their
region for the last 10 years in the fields of health,				health conditions during early pregnant hood as well as
education and environmental protection. The list				before delivery. One more interesting thing that the
consists of various caste grouping and from which				caste Mangali itself is traditional birth attendant
proportionate stratified samples were selected. Then a				community in this village so we may consider them in
list of about 181 respondents was prepared for data				response to this query that they are taking care about
collection. Therefore, it is obvious that an attempt has				pregnant as a traditional birth attendant and as a
been made to present a general picture of community				family. On the whole 3 (1.7 %) of Yadava, 2 (1.1 %)
data and on the basis of which, views and attitudes of				Gouda, 1 (0.6 %) of Munnurukapu and Kummari, 8 (4.4
the respondents were taken into consideration.				%) of Chakali, 5 (2.7%) of Dudekula and the total
C) Tools of Data Collection:				number of Mudiraj 7 (4%) community respondent have
As the research is qualitative and quantitative,				expressed that traditional birth attendant are taking
non-participant observation and interview schedule				care about pregnant of their communities. It is
was adopted for the collection of primary data. The				important to note that previous these caste people
aspects that will cover in the interview schedule were				took care about pregnant but at presently they are
defined under two parts, one is for socio-economic				seeking the help of traditional birth attendant by reason
and cultural status of respondents such as name, sex,				of saving of time. These kind of villagers always busy
age, social status, education, religion, income, nature and				in their routine work if they involve in the caring
type of the house, etc. and the other for socio-cultural				process they should be lost more time in order to
beliefs and practice patterns in health and the related				money also. The data also describes that all most all
treatment of the villagers.				the respondents of Deshmukh 3 (1.6%), Vysya 4
D) Analysis and interpretation of data:				(2.2%) and Vaisnava 5 (2.7%) communities have
After arranging the collected data through tabulation				revealed that health workers or ANMs are looking
and classification, they were analyzed and interpreted				after the pregnant women. It may due to the higher
in the socio-cultural context so as to give a scientific				awareness regarding health and personal bias or
basis to the study. Although statistical methods like				prejudices of health workers or ANMs who are
frequencies, percentages, means, standard deviations,				interested to associate with the higher social status
t-test, chi-squire and ANOVA have been used in the				communities.
study, they were applied in a relevant way.				On account of preferable birthplace; the responses of
Findings:				majority respondents i.e. 112 (62%) is that birth at the
Socio-Economic Profile:				traditional birth attendant is more preferable. As many
During the field work, observed that 22 castes were				as number of respondent i.e. 36 (20%) have revealed
appeared and most of the respondent belongs to the				that they prepared birthplace is Government Hospitals
BC castes like Yadava, Gouda, Munnuru Kapu, Vishwa				and the reaming respondents i.e. 32 (18%) have
Brahmin, Mudiraj and a insignificant number of people				expressed their perception that Private Hospital are
belongs to services caste like Mangali, Chakali, Mera				preferable to give the birth. The cluster analysis of
and so on. A considerable amount of people belongs				data also provides the social status wise explanation
to SC community i.e. Mala and Madigas. Only a few				that there are 7 (4%) of OC respondents, 19 (10.5%) of
respondents belong to ST (Erukala) community. Out of				BCs and 10 (5.5%) of SCs are interested to go to the
the 181 respondents, 55 percent are male and 45				government hospitals. There are 10 (5.5%) of OCs and
percent female,. This research is carried out with				23 (12.7%) of BCs were interested on Privates
almost all the equal four fold age groups of				hospitals. Among the reaming of categories, the more
respondents. Thus, it is noted that age group is				number of BC respondents i.e. 70 (38.5%), 37 (20.5%)
scattered in this study. More number of respondents i.e.				and the total number of ST community respondents i.e.
91% belongs to Hindu religion and 5% are Muslim.				3 (1.7%) and only few {2(1.1%)} of OC respondent are
Nearly 4% of the respondents belong to Christianity. It				still interested to give birth under the observation or
is also proved that common phenomena of religion				treatment of traditional birth attendant.
composition in India.				Practices after Delivery:
In this village, a majority of the respondents i.e. 82				Women underfed themselves during pregnancy and
(45%) are illiterates. The next more number of				strove for a small baby to ensure easy delivery.
respondents have studied up to primary and				Babies were not to be breast fed on first three days
secondary level i.e. 24 (13%). There are 21 (12%) of the				and baby-clothes were not used till a ceremony
respondents can read and write. A significant number				(purudu/Naming) on 9th day to 21st day. Mothers could
of respondents i.e. 18 (10%) claimed to have studied up				not leave the delivery room till that day. To minimize
to college level while the small number of people who				the toilet needs, they severely restricted their intake of
have studied up to professional level, technical level				fluids and food during first week after delivery. Mothers
and others stands at 7 (4%), 3 (2%) and 2 (1%)				did not wash hands properly; their clothes and linen
respectively. The findings reveal that more number of				were often dirty. Newborn babies, even if sick, were
the respondents i.e. 55 (30.4%) are labourers and				not moved out of home. The usual explanations for
one-fourths of the respondents i.e. 45 (24.9%) are				the sicknesses in neonates were ‘evil
engaging in the farming. On the whole 38(21%) are				eye’, ‘witch craft’, or ill effects of
continuing their caste occupation while 20 (11%) and 17				foods eaten by mother.
(9.4%) respondents are doing other occupation and				The practice of breast-feeding female children for
brought up into the service sector respectively. Only a				shorter periods of time reflects the strong desire for
few of the respondents i.e. 6 (3.3%) are carrying out				sons. If women are particularly anxious to have a male
business.				child, they may deliberately try to become pregnant
It is also noted that a majority of the respondents i.e.				again as soon as possible after a female is born.
84.21% are living under the tiled houses and a				Conversely, women may consciously seek to avoid
significant number of the respondents i.e. 15.79%				another pregnancy after the birth of a male child in
posses R.C.C houses. A substantial number of the BC				order to give maximum attention to the new son
community respondents i.e. 75% owned the tiled house				Summary and Conclusions:
and rest of them i.e. 14.29% have R.C.C. houses and				Due to the orthodoxical and traditional dogma, majority
8.04% own asbestos roofed houses. Most of the SC				numbers of respondent are not possess proper notion
respondents i.e. 91.49% are residing under the tiled				on Women’s health. In addition to supernatural
houses while only 8.51% consist R.C.C. houses. Among				beliefs about what brings on disease, women also
the ST respondents, 33.33% have R.C.C., tiled house				have some beliefs about the non-physical causes of
and thatched house equally. Regarding the income, less				ill-health. The most commonly found syndrome was
than 24% of the respondents earn Rs. 1501 –				'weakness' which consists of fatigue, body ache,
2000 per month. Almost equal number i.e. 22.7 and 21.5				ghabrahat (a generic term used for anxiety, fear,
% of the respondents earn below Rs. 500 and				restlessness, trepidation, etc.), pallor, low backache and
between Rs. 1001 and 1500 respectively. A significant				burning of palms and feet. Thus poverty, illiteracy and
number of respondents i.e. 20 % obtaining monthly				social backwardness complete the subordination of
income is in the range of Rs. 501 – 1000 while				women. In reality, therefore, most women carry a
only 12.7% claimed their income was over Rs. 2000.				tremendous degree of mental anguish and agony due
This village consist very good fertile lands, There is just				to the improper beliefs and practices.
below half of the respondents i.e. 84 (46.4%) have not				However, practices existed to over come or to tune
possess any land on their own. There are 35 (19.3%)				with the problems, which may be physical,
of the respondents possess land between 1- 2.19				psychological, cultural and environmental. Subsequently
acres. A significant number of respondents i.e. 28				practices are to be strengthen in order to persisting as
(15.5%) and 20 (11.04%) are having land between 2.20				the beliefs. Once, belief is to be got its own identity; the
– 4.39 acres and 5 – 9.39 acres				existence of practice should automatically come by
respectively. A considerable number of respondents i.e.				the deeds of the victims or followers. Sometimes
14 (7.7%) are owned land 10 and above acres.				belief might be deteriorate due to the business, cost
Social Dogmatism on Menstruation				effective and the rationalism should also vanish the
Patriarchal societies have tended to control women by				irrational beliefs so that we can eventually conclude
first announcing menarche (the onset of menstrual				beliefs exist by the practices which may takes place
cycle in a young girl) to the world in an apparently				to over come the problems or to adjust with the
celebratory fashion while thereafter attempting to				nature.
control the implied fertility and sexual power by monthly				References:
rites of pollution, restriction and isolation of the				1.
menstruating woman.				2. Giger, J.N., & Davidhizar, R. E. (2004):
The various names for menstruation or 'periods' point				“Transcultural nursing: Assessment and
to its polluting quality. For instance in Telugu, it is called				intervention” (4th ed.). St. Louis: Mosby
samurta or peddamanshi meaning attaining maturity.				publication.
Menstrual blood is believed to be polluting. There are				3. Spector, R. E. (2004): “Cultural diversity in
varying restrictions put on a girl due to this belief such				health & illness” (5th ed.). Upper Saddle
as not touching people or hanging washed clothes out				River, NJ: Pearson Prentice Hall Health publication..
to dry; not touching certain flowering plants lest they				4. Bundek, N. I., Marks, G., & Richardson, J. I. (1993):
die or not fruit; sleeping on a jute bag or woollen				“Role of health locus of control beliefs in cancer
blanket away from others. A woman cannot touch her				screening of elderly Hispanic women”. Health
child during menstruation. If she has to, the child must				Psychology, 12(3), 193-1999.
first be unclothed completely or made to wear silken				5. Pachter, L. M. (1994) “Culture and clinical care:
clothes. Visiting or touching images of gods, temples,				Folk illness beliefs and behaviors and their implications
religious scriptures is also prohibited. A fear is				for health care delivery”. Journal of the
inculcated in the adolescent that she will sin if she				American Medical Association, 271(9), 690-694.
breaks these taboos. Restrictions are also placed on				6. Roberson, M. H. (1987): “Folk health beliefs of
diet. These pollution taboos result in many women				health professional”. Western Journal of Nursing
getting an enforced rest for at least these three days				Research, 9(2), 257-263.
of the month since they are barred from carrying out				7. Treistman, J. (1988): “Health beliefs in
their normal activities.				socio-cultural perspective”. In G. Caliandro &
Not only is menstrual blood supposed to be dirty, but				B. L. Judkins (Ed.), Primary nursing practice (pp. 119-133).
evil too. A menstruating girl should not let her shadow				Glenview, IL: Scott, Foresman and Company.
fall on a child with measles lest the child turn blind. The

Lapsi

Beliefs and Practices in Women Health