Bangalore, karnataka profoma for registration of subjects for dessertation



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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PROFOMA FOR REGISTRATION OF SUBJECTS FOR
DESSERTATION



1

NAME OF THE

CANDIDATE AND ADDRESS



Ms. CHINMAYEE NANDA

DAYANANDA SAGAR COLLEGE OF NURSING,

KUMARASWAMY LAYOUT,

BANGALORE- 560 078



2

NAME OF THE INSTITUTION

DAYANANDA SAGAR COLLEGE OF NURSING,

KUMARASWAMY LAYOUT,

BANGALORE- 560 078


3

COURSE OF STUDY

DEGREE OF MASTER OF SCIENCE IN NURSING

4

DATE OF ADMISSION TO COURSE

10-10-2011

5

TITLE OF THE TOPIC

“A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAM REGARDING PREVENTION OF FEMALE FOETICIDE AMONG WOMEN IN SELECTED RURAL COMMUNITY, BANGALORE.

6. BRIEF RESUME OF THE INTENDED WORK

6.1 INTRODUCTION

A FEMALE CHILD IS GOD’S OPINION THAT LIFE SHOULD GO ON”

Woman is God’s greatest creation

India is a vast country. A country which has left behind a number of stigmas and prejudices to move ahead as one nation. A nation with a cultural diversity, one can

always find harmonious existence in a number of cities and towns of India. But, in a number of states, villages, cities and towns, another existence found is that of gender bias. Gender bias at the time when a child is born, leading to female foeticide and female infanticide.1


This problem is not usually found in a number of families belonging to the urban literate class. The problem pertains to the families having a rural or a traditional background (by traditional I mean those who believed in this act). Now after 6 decades of Independence India, or rather Indians are not being able to give up their thoughts. The thoughts which make a girls child a bad omen for a family.1

  A number of reasons lead to this heinous crime. To quote some, want of a male child to carrying the name of the family forward, lighting the funeral pyre to hoping for a bread earner are a few. The most prevalent these days is the fear of the demand for dowry. This has often been noticed that killing an unborn or just born girl child is better than paying a huge sum as dowry at a later stage. This mentality is specifically found in the rural areas and also in a few metropolitan cities. The states of Bangalore, Punjab, Delhi, Himachal, Rajasthan are among others having a high rate of female foeticide cases.1

Sex determination is ever increasing in India even though there are strict laws against it. In 1994, the Government of India passed the Pre- conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act with the aim of preventing female foeticide. The implementation of this Act was slow. It was later amended and replaced in 2002 by the Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act without ever having been properly implemented.1

A study conducted to assess the implementation of the 1994 Act in South Delhi and make recommendations for its improvement. This involved examining the organizational structure, observing 26 clinics, and distributing a questionnaire to patients. The results showed up serious failures in management and implementation, lack of commitment and motivation, widespread corruption, and little knowledge in clinics of the provisions of the Act. The presence of individuals outside the medical profession, in particular those involved with human rights, would have helped to prevent fraternity bias – an unwillingness to bring medical colleagues to account.1

The survey of patient attitudes showed that only 40% of male patients and 30% of female patients were aware of the prohibition of sex determination. While 90% purported to agree with the principle of the Act, they nevertheless maintained that a male child was important for the strengthening of the family.1

Female foeticide is a big problem in India which creates a major imbalance in sex ratio. The girls have not vanished overnight. Decades of sex determination tests and female foeticide that has acquired genocide proportions are finally catching up with states in India. New development in medical technology helped to improve the health care of 121 crores of people, but there is gross misuse of modern technology for detecting the sex of foetus inside the womb of mother which is responsible for female foeticide. The determination of sex of foetus by ultrasound, scanning, amniocentesis has aggravated this situation.2

As a result of selective abortion between 35-40 million of girls are missing from Indian population. In some part of country like Haryana the sex ratio of girls to boys has dropped to 736-1000. The United nation has expressed serious concern about this situation. This is only the tip of the demographic and social problems confronting India in the coming years. Skewed sex ratios have moved beyond the states of Punjab, Haryana, Delhi, Gujarat and Himachal Pradesh. With news of increasing number of female foetuses being aborted from Orissa to Bangalore there is ample evidence to suggest that the next census will reveal a further fall in child sex ratios throughout the country.3

Due to pre natal sex determination, with the intention of preventing female births, women suffer from psychological trauma as a result of forcible repeated abortion . A programme,” Satyamev jayate” Aamir Khan summon the eye witness about a lady from Ahmedabad, Mrs Amisha Yagnik narrated how she was forced to undergo six abortion in eight year without her consent with the doctor “connivance. A social worker says that in his native Alwar district of Rajasthan, an adverse sex ratio has resulted in a thriving market for Bihari brides. He estimates that at least 15,000 are bought every year. The lucky ones are those that stay bought. Many are sold onward. A Jain lady from Bhilwara (Rajasthan) gives a personal attestation: her cousin fetched a wife all the way from Karnataka's Belgaum district. A lady 'protection officer' of Haryana says the degradation is not limited to females in the bridal market. Any woman who speaks out against the practice is questioned about her 'aukath' (worth), when women are 'available' for Rs 10,000 a piece.4

The testimony of Parveen Khan from Morena in the badlands of Bundelkhand, an area known for misplaced machismo, was moving as much from her courage and grace as for the viciousness of the attack she was subjected to. Her face, badly disfigured by a furious husband but surgically reconstructed later courtesy of a doctor in Jaipur, was emblematic of the intense loathing that drives men insane when thwarted in their obsessive quest for the male child. Nor are these instances confined to poor and illiterate families. Khan rattles middle class Indians in their comfort zones. The example of Delhi's Mitu Khurana, herself a doctor, is proof that education need not be ennobling or that wealth is an antidote to greed. Discovered carrying twin girls, she has to face the combined wrath of her husband, an orthopedic surgeon, and in-laws - one a professor of history in Delhi University and the other, a school vice-principal. When born prematurely because of violence-induced shock, the grandmother is gleeful that the girls have a slim chance of survival. And when she kicks the mobile crib carrying one of them two flights down the stairs, it is the mother's prudence and sheer luck that saves the child.4

In Salem district a mostly rural part of Tamilnadu ,for instance signs posted in towns reinforce the societal message” pay 500 rupees and save 50,000 later” ,a suggestion that aborting a female fetus low could save a fortune in wedding expenses in the future.5

Nobody thinks why we kill the girl, he should kill the dowry system .In pockets of India where female infanticide persist, the practice is routed in a complex mix of economic, social and cultural factors. Parents preference for a boy derives from the wide spread belief that a son lighting his parents funeral pyre will ensure that their souls go to heaven, that he will be a provider in their later life, as India has no form of social security so he will preserve the family inheritance .An informal survey by central government however, found that many women would abort rather than have a baby and give her up for adoption6.

In fact do to high occurrence of foeticides, infanticide including new born neglect and abandonment, the world is currently deprived of over hundred millions of women. India, alone are responsible of 80 million missing female. The first warning against this source was voiced in 1990 by Amartya Sen an Indian 1998 Nobel Prize winner in economics though scenes that time the situation was worsened.7

According to the British Medical Journal Lancet (9 January 2006) over ten million female foetus ie, 1 in every 25 have been aborted in India since 1994. The Journal also reports that pre-natal sex selection in India causes the loss of 5,00,000 girls per year.8

The decline in child sex ratio in India is evident by comparing the census figures. In 1991, the figure was 947 girls to 1000 boys. Ten years later in 2001 it had fallen to 927 girls for 1000 boys. In 2011 Bangalore has the lowest sex ratio, at just 908 females per 1,000 males as per Census 2011, as against 965 females in 2001. Karnataka's futile battle against female foeticide has ended up in a paradox. While the state's sex ratio (females per 1,000 male) is highest in 90 years, the child sex ratio (0-6 years) is the lowest in six decades.9

Fresh data from the provisional population totals of Census 2011 shows that over 50% of Karnataka's 30 districts recorded a decline in child sex ratio in the past decade. Three districts -- Koppal, Kodagu and Mandya -- managed to retain the 2001 child sex ratio. In the past 10 years, Karnataka's overall sex ratio improved by three points to 968, while the child sex ratio dropped by three points to 943.9

 In our country a girl is worshiped as a Devi on one hand and denied her existence on the other as if she has no right to live. Time has perhaps come for us to get rid of male chauvinism and treat children as gifts of nature regardless of their gender. We cannot imagine a society in the future where there will be only males and no females. The society will be full of crimes and evils. Only if legislations enacted in this behalf are not sufficient. Orthodox views regarding women need to be changed. The PNDT Act should penalize and punish the violators of this crime strictly. The pernicious acts of female foeticide and coercive abortions have to end before women becomes endangered species .10

Oh, God, I beg of you,  

I touch your feet time and again,  

Next birth don't give me a daughter,  

Give me Hell instead...  

                        ‐‐An old Folk Song From Uttar Pradesh11

6.1 NEED FOR THE STUDY
“Where women are honored

There Gods are pleased

But where they are not honored

No sacred rite yields rewards”

LAWS OF MANU

It speaks of a whole society that has gone corrupt, desiring, destruction of half of its population, Are we secular, social and human. In modern India a woman is regarded as a commodity and marriage has become more of a business alliance than a sacred bond between two souls. Women are murdered all over the world. But in India a brutal form of killing females takes place regularly, even before they have the opportunity to be born. Approximately one million females in India annually are the victims of tragic consequences. The constitution of India gives equality to women. But our patriarchal society gives preference to boys only. Women interest ,experience and concern are often rendered invisible or even inadequate voiced in decision making, effectively excluding them often from key decision that affect the lives of their families.12

The increasing imbalance between male and female is leading to many crimes such as illegal trafficking of women , sexual assaults, polygamy and dehumanization of society .This act increasing the unsafe for women..It is detestable that people who commit crime belong to the educated class, high anxious about male child, population explosion, dowry, burden of family have been good propalents.13

Female foeticide disturbs the natural sex ratio in society and reduces number of women as compared to men in society. Clearly in couple of decades, such sex selective abortions could lead to a situation where men may not find brides to marry. This could lead to trafficking of women, or worse violence against women.14

A study was conducted on the Declining Sex Ratios; Will it impact Economic Growth in India. According to the census report 2011, the child sex ratio between the age group of 0-6 years is 914 female / 1000 males and it has been recorded that it is declining since 1991. Studies revealed that families resort to various practices such as sex selection techniques, foeticide, infanticide and neglect to do away with the girl child at pre-birth / conception / infancy stage itself and also due to many social reasons like the increasing demand for dowry, increasing violence against women, prevention of division of property etc, to name a few. Woman’s participation in economic activities should be an essential part of the planning process. The stage is set for a coordinate effort of various groups with the intention to establish a mission to reverse the trend of declining sex ratio for the next census. Reversal of the declining trend is a must to ensure stable economic and societal growth.15

UNICEF has warned that the alarming decline in the child sex ratio is likely to result in more girls being married at a younger age, more girls dropping out of education, increased mortality as a result of early child bearing and an associated increase in acts of violence against woman, girls such as rape, abduction, trafficking, etc. Female foeticide is an extreme manifestation of violence against women. In 2011, 15,000 women from Bihar, Odisha, and Andhra Pradesh have been brought and sold in Rajasthan. This is human trafficking in Rajasthan. These women does not have any status and respect in their home, society, and generally treated as sex object.16

No moral or ethical principle supports such a procedure for gender identification. The situation is further worsened by a lack of awareness of women’s rights and by the indifferent attitude of governments and medical professionals. In India, the available legislation for prevention of sex determination needs strict implementation, alongside the launching of programs aimed at altering attitudes, including those prevalent in the medical profession.17

Female foetuses are selectively aborted after pre-natal sex determination, thus avoiding the birth of girls. The practice of selective abortion became popular from the late 1970s. Worryingly, the trend is far stronger in urban rather than rural areas, and among literate rather than illiterate women. In 1994, the Government of India passed the Pre- conception and Pre-natal Diagnostic Techniques (Prohibition of Sex Selection) Act with the aim of preventing female foeticide. The implementation of this Act was slow. It was later amended and replaced in 2002 by the Prenatal Diagnostic Techniques (Regulation and Prevention of Misuse) Act without ever having been properly implemented. Abortion is a lucrative business that many doctors do not want to see curtailed. Abortions are a low-risk, high-profit business. So act of Government should be strictly followed. This violation of a girl’s basic right to life requires urgent attention and action.17

Contravening the provisions of the Act can lead to a fine of Rs 10,000 and up to three years imprisonment for a first offence, with greater fines and longer terms of imprisonment for repeat offenders. The Appropriate Authority informs the central or state medical council to take action against medical professionals, leading to suspension or the striking off of practitioners found guilty of contravening the provisions of the Act.17

Only 86 cases were registered in year 2005 under PC & PNDT Act in India Number of cases of foeticide registered during 2003, 2004 was 57, 86 respectively in the country.18

The main factors that are responsible for the increase in the incidence of female foeticide is the low status of women, son preference, and the practice of dowry across all casts groups and cultural beliefs. The low status of women and girls is due to the material cost they represent to their families. Female foeticide are often practiced in societies where it is believed that having a girl child is culturally and economically less advantageous than having a boy child. Only social awareness of equality of gender will bring a change towards female foeticide.19

The publication and presentation of this report is to coincide with the 51st Session of the Commission on the Status of Women meeting in New York (26 February to 9 March 2007) focusing on the “Elimination of all forms of discrimination and violence against the girl child “. Through this report, the Working Group also calls upon governments to get more involved in developing and promoting effective policies to bring an end to the girls’ human rights violation of girl infanticide, everywhere in the world. 19
According to UNIFEM, 45,000 “Paros” have been sold in and around Haryana (India) in 2006 alone.20 The magnitude of the phenomena of female foeticide and girl infanticide in India, China and other parts of Asia has reached a critical level creating a worldwide demographic imbalance with, in turn, drastic economic and social consequences. Over 100 million women are now missing in Asia which will result in a 12 to 15 percent excess of young men in the next twenty years.20

Birth rate in 2002-2003 and 2003-2004 showed that female foeticide was rampant in few districts of Karnataka. In 2002-2003 only 23,619 births of female babies were recorded as against the birth of 24,226 male babies in rural areas of Karnataka.21

A recent news from Karnataka, Vani Vilas hospital a baby of two month year old Afreen was dead due to female infanticide. She was brutally abused, attacked by her father Abdul farooq because he did not want a female child.22During the interaction with rural women, the investigator observed that many women have less knowledge and unfavorable attitude on female foeticide and there is a huge need of educational programme to make public aware on female foeticide. This motivated the investigator to conduct a structured teaching program on prevention of female foeticide to create awareness among rural women to emphasize the need of female child in society.

6.2 REVIEW OF LITERATURE
A hospital-based cross-sectional study was conducted in Delhi on knowledge, attitude and practice of pregnant women on gender preference, prenatal sex determination and female feticide. Study was carried out to find out the attitude toward gender preference and knowledge as well as practice toward prenatal sex determination and female feticide among pregnant women. A majority (66.0%) of the pregnant women did not show any gender preference, followed by male preference (22.2%) and female preference (11.8%). A high proportion, i.e. 84.7% and 89.7%, of the total subjects were aware that prenatal sex determination and female foeticide is illegal, respectively.23

A study was done on Census 2011 : Survey in Delhi, Noida reveals male child preferred by 44%. The study has found that as many as 85% women aged between 18 and 40 years in the city are highly aware of this evil as compared to their husbands and mothers / mothers – in - law. In fact, 90% of nearly 200 married men and women surveyed across Delhi and Noida said their religion didn't allow foeticide; but 3% admitted to have gone for a sex determination test on the sly, mostly because their in-laws insisted. As many as 92% respondents agreed that a constant decrease in the number of girls will lead to an increased crime rate. Majority of respondents were aware about the illegality of sex determination under PNDT Act, but 97% of them didn't know that it could lead to imprisonment for three years. 65% respondents had them as their source of awareness; only 30% of them depended on doctors and mid-wives. The government should regularly monitor technology used for such matters. There is this hand-held machine that could be used for sex determination. It could prove to be disastrous. 24

A study was conducted on Female foeticide more prevalent among the middleclass in Punjab. The researcher claimed to have interviewed women from more than 90 families in the city. The women were in the age group of 15-35 years. The study found that in the middle class where the size of the family has to be restricted, cases of female foeticide were more. The study also found that it is usually the older women in the house who influence the vital decision. It is a tragedy that women, whose lives are most battered by frequent child birth are hardly allowed to take decision. 25

A study was conducted on Decreasing Sex Ratio and Pregnant Women's Attitude towards Female Foeticide in Ludhiana, Punjab. A descriptive study approach was used to conduct the study, which was conducted in Antenatal OPD of Christian Medical College and Hospital, Ludhiana. Purposive random sampling technique was used for selection of sample. The population consisted of 50 pregnant women attending OPD. The technique and methods used were structured questionnaire developed based on review of literature. Majority of the clients were in the age group of 21-30 years (72%) followed by 24% in the age group of 3 1 -40 years and only 4% above 40 years. 48% of them were the academic qualification of plus two and above, 30% were illiterate and 22% had passed 10th class. Most of women were Hindus (48%), followed by Sikhs 32%, Christians 14% and Muslims only 6%. Majority of women (76%), were housewives and 24% were professionals. Maximum numbers of women (66%) were married for 1-9 years, 30% of women married for 10-19 years and 4% married for more than 20 years. 54% of them were having family income Rs. 5001-10000, 36% had income less than Rs. 5000 and only 10% were with income more than Rs. 10,000. Most of women (72%) resided in urban area and 28% belonged to rural areas. For 62%, source of information was mass media and 38% got information from relatives. Analysis shows that the knowledge level of many women were found to be average about causes of female foeticide but inadequate about affects of decreasing sex ratio and lowest about meaning of sex ratio and decreasing sex ratio. Mean attitude score of pregnant women towards female foeticide was 3.5. Pregnant women between the age group of 21-30 years obtained highest mean attitude score (84.42). Women with qualification plus two and above scored higher (89.2) as compared to other groups. Qualification plus two and above scored higher (89.2) as compared to other groups. Hindus scored higher (94.6) as compared to other religions. Mean attitude score was higher (89.0) in housewives. Women married for 1-9 years scored higher (84.8). Women with family income more than Rs. 10, 000 had highest mean attitude score (87.4). Pregnant women from urban areas had high mean attitude score (84.6%) as compared to women living in rural areas. Women who watched TV scored higher (92.6%) as compared to other sources of information. The study suggests that steps should be taken to educate women to make them aware about the same. Planned health education programmes by health professionals should be made on an ongoing process in Antenatal OPD, General OPD, Pediatric OPD/ Wards and the community setting. 26



A study was done on Female foeticide, a danger to society in India. The study speaks about amniocentesis and also son preference in India. The incidence of using amniocentesis as a method which allows identification of sex is revealed by the presence of an adverse sex ratio in many states. While pregnancy may be legally terminated in India up to 12 weeks' gestation, amniocentesis takes place at 16 weeks. The study found that in some states, parents who cannot afford amniocentesis were continuing the practice of female infanticide. The study concluded with the suggestion that the Indian government should act immediately to control female feticide, Amniocentesis should take place only within government-run institutions, and the sex of the child should never be revealed to parents and also a massive educational effort to modify believes. 27

A study was conducted to assess the effectiveness of planned teaching programme regarding female foeticide among primigravida mothers in selected hospital of Erode, Tamil Nadu. Sixty primigravida mothers were selected for this study using a convenient sampling technique. A structured interview was conducted. The majority of primigravida mothers have inadequate knowledge regarding female foeticide. Significant difference was seen in the pre-test mean score value 44.10 and post test mean score value 58.89% and obtained ‘t’ value was 10.70. This indicates that the planned teaching programme was effective.28

A descriptive study was carried out to assess the attitude of women towards birth of son, use of contraception methods and sex determination methods in rural village Kasurdi in Pune district. Out of 110 respondents interviewed, 62.7% felt that male child is necessary in the family. The difference between family sizes when compared with the sex of first child was statistically significant signifying that if the first child is a male then it hardly matters whether the second child is male or female, but if the sex of first child is female then the families land up with bigger family size. On an average most of the respondents favors two children with an equal share of male and female children. 29

A cross-sectional study was undertaken with 195 pregnant women who attended the antenatal clinic of G.G. Hospital attached to M.P. Shah Medical College, Jamnagar, and Gujarat. A pre-tested and pre-structured questionnaire was used to collect information on their knowledge and attitudes towards gender preference and female feticide. The study result was as such; of the 195 pregnant women selected for the study, 70.3% were from urban area and 29.7% from rural area. It was discovered that 20.5% were illiterate and 79.5% were literate. Out of 195 women studied, 114 (58.5%) gave preference to male child; the major reasons for this being social responsibilities are carried out by males (42.5%), for propagation of family name (23%), dependable in the old age (16%), pressure from family (11%), to perform cremation (4%), dowry (3%) and females are economic liability (3%). Our study revealed that socio-demographic factors affect gender preference. Preference to male child was higher among rural women (70.68%) than that of the urban women (53.28%). The association was statistically significant. Preference to male child was higher in women who had no male child previously (65.28%) than those who already had a male child (42.50%). This difference was also statistically significant. Of the 195 women, 40 (20.51%) admitted that they will go for female feticide. The inclination to female feticide was higher in women who showed son preference. One hundred and ten (54.4%) women were aware about consequences of female feticide. Consequences of female feticide expressed by these women were: ‘men won’t find bride’, ‘families can’t be run’, lead to an all-male family and increase in violence against women. The awareness of consequences of female feticide grew with literacy status. It was 35% among illiterate women, 53.4% in primary level literacy and 73.13% in secondary and above. The difference was statistically significant. The study revealed that residential area and sex of the previous child affect a woman’s preference for her next child, while education increases awareness regarding the consequences of adverse sex ratio. 30

A cross sectional, Community based, Descriptive study was undertaken to assess the Knowledge, Attitude and Practice regarding gender preference and female feticide among teachers population in Hassan. Participants were interviewed with the help of predesigned, semi-structure Performa. Data was analyzed in terms of proportions. Out of 127 participants, 73% said that Ultrasound is the technique for Pre Natal Sex Determination Test (PNDT). 80% said that Private hospital is the area for sex determination test. While asked reasons for son preference, 38.5% said they carry the name of the family, 27.5% said that source of income or dowry.52% of them aware regarding PNDT Act. 90% have got the information regarding female feticide and gender preference from the media. 31

A recent study based on a survey conducted across 6 villages in Ludhiana having sample of 200 participants, Jat-Sikh mothers-in-law and daughters-in-law on the issue of female foeticide had the following to report of the mothers-in-law surveyed, 78% accepted female foeticide social evil but said that it would not cause gender imbalance in the society. They also said it was better for women not to be born than to lead a life of sorrow and misery. 12% said that it was okay to practice female feticide 10% were against the practice. Of the daughters-in-law surveyed, 77% disapproved of female feticide (Only those daughters-in-law were surveyed who already had a girl child and wanted to have another child).32

A population-based cross-sectional inquiry was carried out in Delhi to assess the practice of fetal sex determination, sex-selective abortions and awareness about the related law. A total of 1514 respondents, selected through multistage cluster sampling from all across Delhi, were interviewed using a pretested, semi structured questionnaire. Legal awareness (73.6%) was significantly better among the male and urban respondents. Only 39 (2.6%) of the respondents had ever gone for fetal sex determination. In 17 (43.6%) of them, it was done in spite of being aware of its unlawfulness, and in 33 (84.6%), the couple had one or more living male children. Frequency of fetal sex determination was comparable for slum and urban areas. Fifty-six additional cases of fetal sex determination, occurring in the neighborhood of the respondents, were also reported. A total of 28 cases of female feticide were reported. Awareness about the illegality of fetal sex determination has improved, compared with the 1997-1998 data collected from East Delhi (55.3-73.6%). However, this comparison also shows a marginal increase in the practice of fetal sex determination (2.1-2.6%). In all cases of feticide, a qualified doctor was involved. A number of couples abandoned the abortion plan midway, even after detecting that the fetus was female, and there were occasional cases where the doctor refused to abort the female fetus.33

Cross sectional population survey done in November 2005 ,Setting all of China's 2861 counties population 1% of the total population, selected to be broadly representative of the total. Results 4 764 512 people under the age of 20 were included. Overall sex ratios were high across all age groups and residency types, but they were highest in the 1-4 years age group, peaking at 126 (95% confidence interval 125 to 126) in rural areas. Six provinces had sex ratios of over 130 in the 1-4 age group. The sex ratio at birth was close to normal for first order births but rose steeply for second order births, especially in rural areas, where it reached 146 (143 to 149). Nine provinces had ratios of over 160for second order births. The highest sex ratios were seen in provinces that allow rural inhabitants a second child if the first is a girl. Sex selective abortion accounts for almost all the excess males. One particular variant of the one child policy, which allows a second child if the first is a girl, leads to the highest sex ratios. In 2005 males under the age of 20 exceeded females by more than 32 million in China, and more than 1.1 million excess births of boys occurred. China will see very high and steady worsening sex ratios in the reproductive age group over the next two decades. Enforcing the existing ban on sex selective abortion could lead to normalization of the ratios.34

A qualitative study by a team from the University of California, San Francisco, describes the narratives of immigrant women from India in the US who underwent sex-determination tests and subsequent sex-selective abortion. 65 immigrant women from India living in the US and with a history of sex selection participated in the study. Of the 65 women selected for the study, 51 were not aware of the sex of their fetus at the start of the study. The other 14 knew beforehand that they were carrying male fetus (in fact, these 14 had chosen methods to ensure a male fetus). During the study, the other 51 unaware-participants used ultra-sound to determine sex of their fetus. Of these 51 women, 24 women learned that they were carrying a male fetus and chose to continue with their pregnancy. Of the rest 27 women who found out that they were carrying a female fetus, 24 aborted their pregnancy and only 3 women carried their pregnancy to deliver a female child. The women who participated in the study came from various religious and educational backgrounds. They had an average of 2 living children; 62 of 65 women had only female children. All 65 participants sought a male child.35



STATEMENT OF PROBLEM:

“A study to assess the effectiveness of structured teaching programme on knowledge regarding prevention of female foeticide among women in selected rural community, Bangalore,


6.3. OBJECTIVES OF THE STUDY:

1. To assess the pre-test knowledge of women regarding prevention of female foeticide.

2. To determine the effectiveness of structure teaching programme on prevention of female foeticide among women.

3. To find out the association between pre-test and post-test knowledge scores of women with selected demographic variables.



6.4 OPERATIONAL DEFINITIONS:

1. ASSESS: It refers to determine the effects of structured teaching program regarding prevention of female foeticide among women.

2. EFFECTIVENESS: It refers to the extent to which the structured teaching programme has measured the desired outcomes in terms of knowledge scores.

3. STRUCTURED TEACHING PROGRAM: It refers to systematically developed teaching module designed for educating the women regarding female foeticide.

4. KNOWLEDGE: It refers to appropriate response received from women to the items elicited through a structured knowledge questionnaire.

5. FEMALE FOETICIDE: It is an act that causes the death of a female fetus.

6.5 ASSUMPTION:

1. Women may have some knowledge regarding female foeticide.

2. Women may have interest to know more about the prevention female foeticide.

6.6. HYPOTHESIS:

Ho1: There will be no significant difference between pre-test and post-test knowledge scores of women regarding prevention female foeticide

Ho2: There will be no significant association between pre-test and post-test knowledge scores of women with selected demographic variables.
6.7. RESEARCH VARIABLES

INDEPENDENT VARIABLES: Structured teaching program on prevention of female foeticide.

DEPENDENT VARIABLES: Knowledge of women regarding prevention female foeticide.

6.8 DELIMITATION:

The study is delimited to women in a selected rural community, Bangalore.



7.0 MATERIALS AND METHODS

7.1 SOURCE OF DATA

Data will be collected from women in a selected rural community, Bangalore.



7.2 METHOD OF COLLECTION OF DATA:-

The data will be collected by using structured knowledge questionnaire schedule on prevention of female foeticide. The contents will be validated by the experts and will be pre-tested and standardized through pilot study.


7.2.1 RESEARCH DESIGN:

Quasi-experimental, one group pre-test post-test design



7.2.2. RESEARCH APPROACH:

Evaluative approach will be adopted.



7.2.3. RESEARCH SETTING

Study will be conducted in selected rural community, Bangalore.



7.2.4. POPULATION:-

The population of present study comprises of women in selected rural community, Bangalore.



7.2.5. SAMPLE SIZE:

The sample at the study consists of 50 women in selected rural community, Bangalore.



7.2.6. SAMPLING TECHNIQUE:-

Purposive sampling technique.



7.2.7. SAMPLING CRITERIA:-

INCLUSIVE CRITERIA:-

  1. Women who are available during the time of data collection.

  2. Women who are willing to participate in the study.

  3. Women who are above 21years.

  4. Women who know Kannda, Hindi, English.


EXCLUSIVE CRITERIA:-

1. Women who are not available during the time of data collection.

2. Women who are not willing to participate in the study.

3. Women who do not know Kannda, Hindi, English.
7.2.8. TOOL FOR DATA COLLECTION:-

Structure knowledge questionnaire which consists of two parts



Part I : Items on selected demographic variables like age, education, parity, family income and source of information etc.

Part II : Knowledge item on prevention of female foeticide.

7.2.9. DATA ANALYSIS METHOD:

Data analysis will be through descriptive and inferential statistics.



DESCRIPTIVE STATISTICS: Percentage, mean, mean percentage and standard deviation will be used to explain the demographic variables and compute pre-test and post test knowledge scores.

INFERENTIAL STATISTICS:

PARAMETRIC TEST: Paired‘t’ test will be used to compare pre and post test knowledge and attitude scores.

NON-PARAMETRIC TEST: Chi-square test will be used to study the association between pre-test and post-test knowledge and attitude score with selected demographic variables. The results are considered statistically significant when P value is ≤ 0.05.
7.3 DOES THE STUDY REQUIRE ANY INVESTIGATIONS OF INTERVENTIONS TO BE CONDUCTED ON PATIENT OR OTHER HUMANS OR ANIMALS?

Yes, structured teaching program is scheduled among women in selected rural community, Bangalore.



7.4 HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION?

1. Permission will be obtained from the Institute Ethical Research Committee of Dayananda Sagar College of Nursing, Bangalore.

2. Informed consent will be taken from the women who are willing to participate in the study.

3. Permission letter will be taken from the PHC in selected community area in Bangalore.

8. LIST OF REFERENCES

1. Ansul Tiwari. FEMALE FOETICIDE IN INDIA: A harsh reality

Posted by YouthKiAwaaz [Online] March 26, 2009 [Cited April 16 2012] Available from :URL.http://www.youthkiawaaz.com/2009/03/female-foeticide-a-harsh-reality/



2. Kaur, Manmeet : Female Foeticide – A Sociological Perspective. The Journal of

Family Welfare.[Serial online] March 1993. 39(1). p. 40-43. [Cited 2012 April 10];

AvailablefromURLhttp://www.womenstudies.in/elib/sex_selection/ss_female_foeticide.pdf

3. Indu Grewal and J. Kishor , , Female Foeticide inIndia.

MayInternationalHumanistNews [serial on line] on 1 May, 2004[Cited2012 Apri10]Available from URL.http://www.iheu.org/female-foeticide-in-india

4. Amir Khan [Serial online],On May 18, 2012.Available from

URL: http://www.deccanherald.com/content/247332/in-satyamev-jayate-aamir-deals.html

5. Rohini Mohan, CNN IBN 20064 [Online]. [Cited on 12 May, 2012];Available from:URL:http://presscouncil.nic.in/AR_08_09.pdf

6. Informal survey by CSG[Online]. [Cited on 12 May,2012]; Available from:URL:



http://www.unicef.org/southafrica/SAF_resources_childsupport.pdf

7. Rohini Pande, Anju Malhotra . Son preference and daughter neglect in India[Online] 2006 [Cited2012 April 10];Available from: URL: http://www.icrw.org/publications/son-preference-and-daughter-neglect-india

8. British Medical Journal LANCET [Online] 9 January 2006 [Cited on 12 May, 2012];

Available from: URL:

http://www.lifesitenews.com/news/archive/ldn/2006/jan/06010909

9. Neonatal and infant demographic.[online] .[Cited2012 April 10]Available from URL

http//en.wikipedia.org/wiki/demographic of India

10. Foeticide [online].[Cited2012 April 10]; Available from: http;//www.legalservice India.com/article/1292-female foeticide.html.

11. See Me and Let Me Awake: A #Poem on Female Foeticide

YouthKiAwaaz [online] November 14, 2011[Cited2012 April 10]; Available from URL http://www.youthkiawaaz.com/2011/11/see-me-and-let-me-awake-a-poem-on-female-foeticide/

12. Dr Sujnanedra Mishra:female foeticide[Online][Cited 2012 April 10] Available from: URL:.http/www.scribd.com/dRsujnanedra/d/19661230-female foeticide.

13. Pranav Khanna .Reference to Legal Senario [Online] Ludhiana 2008[Cited on April22 2012]; Available from:URL:http:// www.scribd.com female foeticide.

14. Essay on Female foeticide; a hall of shame [Online]. [cited on April 20 2012 ] Available from: URL;http://www.merionline.com/index.php? Female foeticide essay f/DN1115.pdf

15. Sardna MMK. Declining sex ratios; will it impact economic growth? ISID discussion notes. [Online] .[Cited on April 15,2012];Available from: URL: http://www.isid.org.in/pd.

16. 17 UNICEF, 2007 op.cit.[Online];[Cited on 20 April 2012];Available from URL//  



www.ifuw.org/advocacy/reports/2007-girls_infanticide.pd
17. PC AND PNDT ACT IN INDIA. [Online] [Cited on 20 April 2012];Available from: URL: http://www.medicalgeek.com/lecture-notes/8898-pcpndt-act.htm

18. TIMES OF INDIA.[Online] Sunday, August 26, 2007 [Cited on 20 April 2012] ; Available from; URL// http://articles.timesofindia.indiatimes.com/2007/aug/01


19. Son Preference and Daughter Neglect in India, International Center for Research on Women [online] 2006 [cited on 25 April2012]; Available from: URL: http// www.ifuw.org/advocacy/reports/2007-girls_infanticide.pdf

20. Isabelle Attane.op.sit [online].[Cited on 23 April2012]; Available from:URL:http//www.ifuw.org/advocacy/reports/2007-girls_infanticide.pdf

21. Demographics of India [online]. [cited on April 23 2012 ]; Available from: URL: http://en.wikipedia.org/wiki/Demographics_of_India#Neonatal_and_infant_demographis

22. Death of baby Afreen: Karnataka’s shame [online] Apr 13, 2012 [Cited on April13];

Available from: URL: http://indiatoday.intoday.in/story/bangalore-battered-baby- afreen-dead/1/183900.html
23. Kansal R, Maroof KA, Bansal R, Parashar P. A hospital-based study on knowledge, attitude and practice of pregnant women on gender preference, prenatal sex determination and female feticide. Indian J Public Health [serial online] 2010 Oct-Dec; 54(4):20912[Cited2012April10];Availablefrom:URL:http://www.ncbi.nlm.nih.gov/pubmed/21372370

24. Census 2011: survey in Delhi, Noida reveals male child preferred by 44%. The economic times, Politics/ Nation. 2011 April[Cited on 22 April 2012];

25. Sandhu Khusboo. Female foeticide more prevalent among the middle class. TheIndian express[Online] 2008 February[Cited on 20 April2012]; Available from: URL: http://www.indianexpress.com

26. Saran, Kamala. Decreasing sex ratio and pregnant women’s attitude towards female foeticid in Ludhiana[Online] 2007 March. [Cited on 18 April 2012]; Available from:URL:http://www.foeticide.blogspot.com/2007.

27. Kaur G B. Female foeticide. A danger to society in India. The Nursing Journal of India 2004[Online] [Cited on 18 April 2012];Available from URL:http:// www.mendeley.com/.../impossibility-justice-female-foeticide.. - United States

28. Merlin M B. Assessment of the effectiveness of planned teaching programme regarding female foeticide among primigravida mothers. University of Chennai. Tamil Nadu. 2005.

29. Patrikar SR, Bhalwar R Col, Datta A Col, Basannar DR. Gender Inequality: Is the National population policy’s objective of two child norm heading the correct way? Medical journal of armed forces India. [Online] 2008 64(3) 221-23. [Cited on 18 April 2012]; Availablefrom:URL:http://www.rguhs.ac.in/cdc/onlinecdc/uploads/05_N005_30307.doc

30. Vadera BN, Joshi UK, Uadakat SV, Yadav BS, Yadav Sudha. Study on knowledge

attitude and practices regarding gender preference and female foeticide among

pregnant women. Indian Journal of community medicine. [Online] 2007 October-December; 32(4). [Cited on 18 April 2012]; Available from:URL: http://www.ijcm.org.in/article.asp?issn=0970-0218.

31. Siddharam S. metri, VenkteSh G.m., thejeShwari h.L. Awareness Regarding Gender preference and Female Foeticide among Teachers in the Hassan District, South India [Online]. [Cited on 18 April 2012]; Available from:URL: http://www.jcdr.net/articles/PDF/1675/28%20-%203427_f.pdf

32. Niharika Joshi , Dr. Ashu Kalaraman at the Punjab Agricultural University 78% mothers-in-law apathetic towards female foeticide:PAUsurvey [Online]. [Cited on 18 April 2012]; Available from: URL:http://daily.bhaskar.com/article/PUN-LUD-78-mothers-in-law-apathetic-towards-female-foeticide-pau-survey-1843609.html

33. Chaturvedi S, Chhabra P, Bharadwaj S, Smanla S, Kannan . Fetal sex-determination in Delhi: a population based investigation Trop Doct [serial online] 2007 Apr;37(2):98-100 . [Cited on 18 April 2012]; Available from:URL:http//www.ncbi.nlm nih.gov/pubmed/17540092

34. Zhu WX, Lu L, Hesketh T. China's excess males, sex selective abortion, and one child policy: analysis ofdata from 2005 national intercensus survey.BMJ [serial online] 2009 Apr 9;338:b1211. doi: 10.1136/bmj.b1211. [Cited on 18 April 2012];

Available from: URL: http//www.ncbi.nlm nih.gov/pubmed/19359290

35. Puri, S; Adams, V; Ivery, S; Nachtigal, R.D. [MAY 28, 2011]. “There is such a thing as too many daughters, but not too many sons”: A qualitative study of son preference and fetal sex selection among Indian immigrants in the United StatesSocial Science and Medicine [serial online] 2011 May;72(7): 1169-1176[Cited on 18 April 2012];

Available from:URL: http://mistersingh.wordpress.com/2011/05/28/female-feticide-in-the-us-by-immigrant- women-from-india/

9. SIGNATURE OF THE STUDENT:

10. REMARKS OF THE GUIDE: The research topic is relevant as the study

empowers the knowledge of women

regarding prevention of female foeticide.

11. NAME AND

DESIGNATION OF : N.RUKMINIYAMMA

THE GUIDE ASSISTANT PROFESSOR and HOD

Department of Community Health

Nursing

Dayananda Sagar College of Nursing



Kumaraswamy layout

Bangalore -560078



11.2 SIGNATURE :
11.3 CO-GUIDE ( IF ANY) :
11.4 HEAD OF THE

DEPARTMENT : N.RUKMINIYAMMA

ASSISTANT PROFESSOR and HOD

Department of Community Health Nursing

Dayananda Sagar College of Nursing

Kumaraswamy layout

Bangalore -560078


11.5 SIGNATURE :

12.1 REMARKS OF THE PRINCIPAL: The study is feasible to be conducted in selected rural community and has been forwarded.
13. SIGNATURE OF THE PRINCIPAL:


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