SOCIO-ECONOMIC FACTORS AFFECTING THE
HEALTH STATUS OF MUSAHAR WOMEN
Final Report
Submitted To :
SIRF Secretariat, SNV Nepal
Bakhundole, Lalitpur,
Kathmandu,
Nepal
Submitted By:
Ram Narayan Mahto
March, 2007
1
Acknowledgements
I have received valuable help and support from many persons for my
research work. I express sincere thanks for their time and favorable cooperation provided to me for this work. At first, I would like to acknowledge
Surendra Mishra Lecturer, Sociology/Anthropology Department, T.U.,
Kirtipur for his continual guidance and suggestions.
I would like to express sincere thanks and hearty gratitude to Sita Rana
Magar Social Inclusion Research Associate SNV, Nepal for her continual
encouragement and guidance for the completion of this research work. I feel
pleasure to result my research work through which I enjoyed her unbound
inspiration and cosseted guidance and her encouragement and crucial
comments in various ways during this research work.
I am grateful to research assistant and selected respondents who were
hearty co-operated by providing essential information for this study.
It will be injustice if I forget to thanks my other friends for their help
during this work.
Ram Narayan Mahto
i
APPROVAL LETTER
The report entitled “Socio-Economic Factors Affecting the Health Status of
Musahar Women” is completed by Ram Narayan Mahto under my guidance.
The report has been approved as a final report for SIRF, SNV, Nepal.
…………………….
Mr. Surendra Mishra
Lecturer
Central Department of Sociology/Anthropology
Tribhuvan University
Kathmandu, Nepal
ii
TABLE OF CONTENTS
Page No.
Acknowledgements
Approval Letter
Table of Contents
List of Tables
List of Figures
List of Photos/Snaps
Abbreviations, Glossary and Definition of the Important Terms Used
i
ii
iii-iv
v
v
xi-ix
x-xi
CHAPTER - I
INTRODUCTION
1.1 Background of the Study
1.2 Musahars “An Untouchable Caste”
1.3 Statement of the Research Problem
1.4 Objectives of the Research
1.5 Significance of the Study
1.6 Conceptual Framework
1-6
1
2
3
5
5
5
CHAPTER - II
REVIEW OF LITERATURE
2.1 Settlement Patterns of the Musahars
2.2 Origin of the Musahars
2.3 General Health (Primary Health Care Service)
2.4 Reproductive Health
7-12
7
8
9
11
CHAPTER – III
RESEARCH METHODOLOGY
3.1 Research Site and Rationale of the Study
3.2 Sources of Data
3.3 Research Design
3.4 Sampling Procedures
3.5 Tools of Data Collection
3.6 Data Analysis and Interpretation
3.7 Limitations of the Research
13-16
13
13
14
14
15
16
16
CHAPTER - IV
GENERAL INTRODUCTION OF THE STUDY AREA
4.1 Physical Profile
4.2 Demographic Profile
4.3 Educational Attainment/Composition
4.4 Natural Resources
iii
17-20
17
17
19
19
4.5 Drinking Water
4.6 Village Economy
19
20
CHAPTER – V
ANALYSIS AND INTERPRETATION OF FINDINGS
21-45
5.1 Demographic Aspects of the Musahars
21
5.1.1 Household, Population and Sex Ratio of the Musahars
21
5.1.2 Statement of Age and Sex Structure of the Musahar
21
5.1.3 Marital Status of the Musahar Population over 15 years of age in
this VDC
22
5.1.4 Age at Marriage and Fertility of Musahar Women
23
5.1.5 Mean Age at Marriage
26
5.2 Social Aspects of the Musahars
27
5.2.1 Education and Fertility
27
5.2.2 Sex preference and Fertility
29
5.3 Economic Aspects of the Musahar
29
5.3.1 Land holding and Agriculture of Musahar
29
5.3.2 Seasonal Labour
30
5.3.3 Income and Fertility
32
5.3.4 Occupation and Fertility
33
5.3.5 Employment in Other Area
34
5.3.6 Service
34
5.3.7 Livestock
34
5.3.8 Earth Cutting/Digging
35
5.3.9 Family Shelter
35
5.4 Health of Married Musahar Women of Reproductive Ages and Sanitation 35
5.4.1 Knowledge of Family Planning Devices and Fertility
35
5.4.2 Health of Musahar Women in Pregnancy Period.
37
5.4.3 Food Habit and Health
38
5.4.4 Food Consumption Among the Musahar
39
5.4.5 Care of Delivery and Primary Health Care
41
5.4.6 Care of New Born Baby and Primary Health Care
42
5.4.7 Latrine Use and Cleaning Habits
43
5.4.8 Treatment of Sickness
43
5.4.9 Health Post and Sub-Health Post
45
CHAPTER - VI
Summary OF Findings, conclusion and recommendations
6.1 Summary of Findings
6.2 Conclusion
6.3 Recommendations
REFERENCES
ANNEXES
iv
46-49
46
47
48
50
52
LIST OF TABLES
Page No.
Table No. 1:
No. of Selected Reproductive Age Group of Married Musahar
Women
15
Table No. 2:
Ethnic Group Composition of Baramajhiya VDC
18
Table No. 3:
Literacy Status (6 years and above) in Baramajhiya VDC
19
Table No. 4:
Population (6 years of age and above) by status of school
attendance in Baramajhiya VDC
19
Table No. 5:
Age and Sex Structure of the Population of Musahar
21
Table No. 6:
Marital Status of the Respondents
23
Table No. 7:
Age at Marriage and Fertility of Respondents
23
Table No. 8:
Average age of marriage
25
Table No. 9:
Mean Age at Marriage of currently married Musahar Women
26
Table No. 10:
Educational Attainment of Musahar (Over 5 years)
27
Table No. 11:
Educational ratio of Madhesi Dalits
28
Table No. 12:
Preference of Son in Musahar
29
Table No. 13:
Occupation of Musahars economically active
30
Table No. 14:
Occupation of Musahars Economically Active
31
Table No. 15:
Average Annual Income and Their Sources of Musahar
Households
32
Table No. 16:
Average Annual Expenditure of the Musahars
33
Table No. 17:
Knowledge of Family Planning Devices and Fertility
36
Table No. 18:
Health Education and Primary Health Care During Pregnancy
37
Table No. 19:
Food Sufficiency Among the Musahar
40
Table No. 20:
Current Situation of PHC in Study Area.
41
Table No. 21
Primary Health care of pregnant women and new born baby
42
Table No. 22:
Treatment of Sickness / Illness
44
LIST OF FIGURES
Page No.
Figure No. 1:
Conceptual Framework
18
v
LIST OF PHOTOS/SNAPS
Musahar women going to forest for fire wood collection
Researcher with respondents
vi
A couple with small family
An old Musahar with family member
vii
A couple with their big family members
Children of Musahar
viii
A couple with their family members
ix
ABBREVIATIONS, GLOSSARY AND DEFINITION OF
THE IMPORTANT TERMS USED
PHC
: Primary health Care.
FP
: Family Planning
TT
: Tetanus Toxid (injection which is given to
pregnant women and new born babies)
DPT
: Diphtheria Pertusis tetanus which is given against
whooping cough, diphtheria & tetanus.
BCG
: Bacilli Chalmette Guerin. BCG vaccine is given to
prevent T.B. (Tubercle Bacillus).
NHRC
: Nepal Health Research Council.
MOE
: Ministry of Health.
MCHW
: Maternal Child Health Worker.
Adhiya
: Half Sharing of crops between landowner and
land cultivators.
Tantra-Mantra
: Spellbound by Fait healer on patients.
Jayaladri
: The amount of works for worker by landowner.
Girhus
: The master who provide service for someone
(Noker) in his home is called Girhus.
Bhagat
: The faith healer is Musahar community.
Dhami-Jhankri
: Faith healer who treats the patient.
Mother in low
: The mother of husband.
Livestock
: Animals kept for use or profit.
Wage
: Payment made or received (usually weekly) for
works or services (cf salary, fee)
x
Mid-wife
: Women trained to help women in childbirth.
Witch
: Women said to use magic, especially for evil
purposes.
Nutrition
: The
process
of
supplying
and
receiving
nourishment the science of food values.
Contraceptive devices
: The materials which helps to prevent to be
pregnancy.
Intoxicate
: Make stupid as the result of taking, alcoholic
drink, excite greatly, beyond self control.
Polio
: The drop of liquid medicine against infectious
diseases.
Seasonal Labour
: The labour who gets works in particular season for
land to month.
xi
CHAPTER - I
INTRODUCTION
1.1
Background of the Study
Nepal is a small landlocked south-Asian Himalayan country, which is in
transition and bonafide member of least developing countries. It is situated between
two giant neighbours, China and India. Various caste groups, ethnic minorities and
untouchable caste groups along with tribal group live in. Each caste ethnic minorities,
tribal communities have their own written or unwritten language and literature,
religious customs and tradition.
Many of such communities are still backward and little known. They are yet to
be brought to a national mainstream a task impossible without fully knowing about
their different socio-economic condition, religious and cultural background.
The health status is reflection of the social well being and economic strength
of the people it is lighted by various factors, such as the level of income, standard of
living, housing, sanitation, occupation, education, employment, health care delivery
services, religious belief and cultural acts. Therefore, the word socio-economic
includes various meaning of social and economic characteristics which affect human
behaviour in all respects.
Health status of women is one of the most important factors affecting the
socio-economic development of a country. In the context of Nepal due to conservative
tradition, illiteracy, poverty and superstitious beliefs women use considered to be born
to serve their male counterparts. The social myth also indicates that women were
basically interior and their labours, efforts, social right, role in decision making are
less valuable than men (Dhakal 1995).
The term “health status” has been considered as a multidimensional concept
including education, occupation, income, ethnicity, land holding, age at marriage etc.
But in regard to the “status of women” it is closely related to reproductive health and
fertility behaviour of the women (Ibid, 1995).
1
In developed countries women are equal to men. Mostly they are educated and
employed. Therefore, their social status in also very high. But in the context of
developing countries like Nepal, the socio-economic status of women is not equal to
men. Women are less educated, under employed and have lower social status in
comparison to men. Low health status of women, low awareness of family planning
devices. Low cost of bringing children etc. are some of the leading factors of high
fertility. The major cause of high fertility is socio-cultural norms of Nepali society
and compulsion for women to give birth to at least one son to take care of her during
old age. Women have no access to the level of the parental priority, their access to
property in their husband’s household work is conditional on her reproductive
behaviour and her capacity to breed sons. There is no social or economic incentive for
a women to desire to control her fertility.
1.2
Musahars “An Untouchable Caste”
Nepal is a multi-ethnic society with a complex caste structure sustained by
age-long traditional and a civil code (Muluki Ain). The Caste originally represented
the occupation of the group of people, but superstition and hereditary traditions in the
Hindu Society have led to a rigid vertical Caste structure with the Brahmins on top
followed by Chhetris, Vaishya and Shudras. Brahmins were supposed to perform
priestly function, the Chhetries were rulers with a propensity to fight, the Vaishyas
were craftsmen, tradesmen and cultivators and the Shudras were to serve the people
higher caste. (Sharma, 1994) But in the course of perverse traditions the Shrdras have
been severely mistreated and sighted as untouchable by the higher castes. Cox has
also explained in his article about Hindu Caste system that there are four Varnas
including Brahman, kshrtriya, Caishya and Shudra. In the Nepali caste system,
however, there are only three categories: Tagadhari (twice born), Matwli (liquor
drinking), and Pani Na Chalne (untouchable) caste Nepalis are considered to be
ritually polluting. According to the rules of orthodox Nepali Hinduism Brahman,
Chhetris and Thakuris cannot accept cooked rice or water from an untouchable (Cox,
1994). He has divided the untouchable castes of Nepal into three different categories:
i.
Living primarily in the southern plains of Nepal (Terai) including Dum,
Teli, Sundi, Musahar and Dusadh.
2
ii.
Castes that are predominantly found in the middle hills. These include
Kami, Damai and Sarki.
iii.
Newar untouchable castes known as an ethnic group. These include kasai,
Pode, Chyame, Kapali, Kusle.
Among these untouchable, Musahar is the indigenous people dwelling found
in the Terai belt of Nepal from very beginning as an indigenous group. In the
traditional Hindu Caste hierarchy they belong to Shudra class and they are treated as
untouchables. They eat rats; speak Maithali, Bhojpuri, Abadhi, Hindi and Nepali.
Some Musahar take Maithali as their native language and do not ever know Nepali
(Cox, 1994).
Musahar meaning
mouse eater in the name of Utter Pradesh who are
categorized under untouchable caste as Harijan of Bihar (India) and known as a field
labourers (Ghyure ,1979).
Gautam and Thapa in their study (1993) noted that “The mushahars have no
land registered under their name. Their main source of subsistence is working in
others land on lease and as hired laborers”. The Musahar women also work hard as
labourers and add to the family income. They are employed on daily wage basis by
landowners for various domestic work, as making cow dung-cake, planting paddy,
harvesting crops and threshing and so forth (Verma,1991).
The health status of the Musahar women is highly affected by their illiteracy,
early marriage, food deficiency, malnutrition and other various Socio-economic
factors.
1.3
Statement of the Research Problem
The Musahars are landless, backward and untouchables, their health status is
very poor. They are so poor that they do not have sufficient food to eat, clothes to
wear, shelter to live in, educate their children and do not have basic health facilities
for their families. Their livelihood depends only on the seasonal labor and mercy of
local landlords. Due to caste based discrimination and socio-economic exploitation by
3
higher caste and classes, they could never get out of the vicious circle of poverty. In
such a situation, we can assess the health status and socio-economic level of the
Musahars who are landless and live by agricultural boundary.
Due to landlessness and illiteracy the Musahars can neither hope to get job
opportunities nor hope to get rid of poverty. Therefore, the health of Musahar women
are found to be very poor and bad They live in dirty slums in which new diseases are
always making their life mercible. There is no medical provision for them since high
caste doctor becomes impured mercy by touching them (Kumar, 1992).
The relation of socio-economic condition to fertility behaviour and the status
of women’s health particularly in rural backward areas, among the lower/untouchable
caste has not been fully understood. In other words, the health status of women cannot
be fully understood unless the socio-economic factors affecting the health of women
is correlated. Therefore to find out the relation between socio-economic factors and
health status of Musahar women, this study is intended to answer the following
research questions.
What are the socio-economic factors affecting the health of Musahar women?
Why Musahar go to Dhami-Jhakri (faith healer) instead of a doctor who is
available at the near by health post, at the time of sickness?
The condition of people in rural areas as well as the socio-economic condition
of the Musahar and their families’ health status is very weak, due to poverty and
educational backwardness, socio-economic factors always deteriorates their lives.
Being born and raised in rural Terai village I am familiar with their culture, customs
and languages etc.
Therefore, the problem is stated as “Socio-economic factors affecting the
health status of Musahar women” or so I think that the socio-economic factors and
health status of Musahar women should be better for me to do research work.
4
1.4
Objectives of the Research
The main objectives of this study are:
1.
To find out the socio-economic factors affecting the health status of Musahar
women in particular.
2.
To explain the impact of socio-economic factors such as education, occupation,
income, preference for son, age at marriage, use of family planning devices as an
independent variables and the fertility behaviour as a dependent variable as to
how these factors are affecting the health of Musahar women.
1.5
Significance of the Study
Women’s health is affected by various social, economic and demographic
factors such as level of education, social position, economic affluence, age at
marriage, caste based tradition etc. amongst these, age at marriage is one of the major
factors which directly affects the fertility behaviour of women. According to study
(Dhakal, 1995) about 92.6% Musalers are illiterate people. Both sexes, either male or
female do not use contraceptives. At the time of illness, they go to a Jhankri, not to a
doctor, even though the health posts and medical facilities are available nearby.
Besides, there are number of other factors which directly or indirectly affect the health
of mother and infant. For example: illiteracy, poverty, unemployment, malnutrition
and environmental factors always compel society to go backward. The conditions of
Baramajhiya VDC, Saptari is the same so this study is fruitful for researchers,
planners, policy makers of governmental and non governmental organizations to
derive some useful insights for effective and suitable health policies to upliftment of
Musahars of this VDC
1.6
Conceptual Framework
In this study, two sets of variables will be used. Socio-economic variables
such as women’s education, occupation, income, age at marriage, use of family
planning devices and sex preference will be used as independent variables. In this
conceptual framework the researcher will try to show the impact of socio-economic
variables on fertility behaviour of Masahar women. The figure below clearly shows
5
the future framework about the effect of independent socio-economic variables and
fertility behaviour as a dependent variable upon the health status of Musalar women.
Figure No. – 1
Conceptual Framework
Independent Socio-Economic
Variable
Education
Fertility behaviour as
dependent variable
Sex
Age of
Marriage
Occupation
Health status of
women
Income
6
Knowledge
about family
planning
devices
CHAPTER - II
REVIEW OF LITERATURE
The review consists of the studies related to socio-economic factors affecting
the health status of women and facility behaviour in the Nepalese situation. Some of
the facts, opinion and study reports directly or indirectly related to this study are
reviewed and presented below:
2.1
Settlement Patterns of the Musahars
Musahars live in Terai of Nepal. Their main habitats are found in Jhapa,
Morang, Sunsari, Udaypur, Paptari, Siraha, Dhanusha, Mahottari, Sarlahi, Rauthat,
Bara, Parsa, Chitwan, Nawal Parasi and Rupandehi districts of Nepal (Gautam and
Thapa, 1993). As per census of 2001 the population of Saptari is 570282 of which
291409 (51%) are male and 278873 (48.9%) are female. The population of
Baramajhiya VDC is 4476 of which 2285 (51%) are male and 2191 (48.9%) are
female. As per 2001 census in Nepal Musahars is 172434 which is 0.73% of the total
population of the country. The Musahar’s population of Baramajhiya VDC according
to field survey is 578 comparising of 285 male and 293 female in 70 households. But
as per census of 2001 the population of Musahars in Baramajhiya VDC was 451.
Though their number is small they are spread over several Tarai districts. Even
in the villages where they live, the settlement is found separate from that of other
castes. Generally it is separated from an inhabited area intending to prohibit
frommingling with them. The most striking feature of Musahar settlement is its
separateness and isolation from one rest of the village as indicated above. Their
locality is called Musahari, literally locally of the Musahars. They settle at a place
which is at a considerable distance from the house of other castes. This indicates not
only a Sharp Caste division but also the low status that have been traditionally given.
The distance and exclusiveness of the Musahar settlement emphasizes an
important fact that other caste groups place the Musahars on a low and untouchable
status, and want to keep them away to avoid all kinds of contact with them. Since the
Musahars live at on unusual distance, from a community even children of other castes
do not have any chance to mix with and play with the Musahar children. So,
7
separately within the village known to every body but little frequent3ed by other caste
members except when they need to hire a Musahar men or women as a farm labourer
or for some other manual work not involving any social, religious and cultural
interrelation.
The settlement is also a striking one. One family’s house touches the roof of
other family’s house like two or three households. All the houses with overlapping
roofs look like a long hut. These are built by most inexpensive and easily available
materials like bamboo, fodder, straw, wheat stalk, hay made rope and hay etc. The
hey walls are coated/plastered with mud and cow dung mixture. Their houses are
hardly found in the size of 10 X 15 ft. in width and length and nearly 8 to 10 ft. in
height. So usual width and length of house in nearly 8 X 12 ft. and height is early 8 ft.
in the middle.
2.2
Origin of the Musahars
From the available literature on the Musahars their origin, ancestral residence,
who they one, where come from, in which part of Nepal they used to live, what they
do and what is the position of their community in the society, can be assessed.
Through there are no historical documents about Musahars dealing their
origin and migration, yet per oral tradition and stories which exist these people they
migrated seven centuries ago and settled down permanently in Terai region of Nepal
(Moktan, 1997).
Ghyure G.S.(1992) in his book “Caste and Race in India”, claimed that the
Musahars ancestral aborigine is Uttar Pradesh and Bihar of India. Oral tradition
suggest that they were ancient hunting tribal. They claim that they are the descendants
of great sage Valmiki, the author of religious epic Ramayan .
Dhakal (1995): in his study “Fertility and the status of women of Baijnathpur
VDC of Morang district” has pointed out that female education helps to reduce
fertility level, but very low literately rate was found in this VDC. Among the
Musahars in this VDC 92.6% women were found illiterate. Musahar women were
illiterate had more children and less awareness of using family planning methods.
Musahars are not aware about education and fertility. Their socio-economic status is
8
very low compared to other ethnic groups. He indicated that lower age at marriage,
farm occupation and preference for son, helps to increase fertility level of women.
Gautam and Thapa (1992): in their book “Tribal Ethnography of Nepal” have
thrown light on the Musahars. But no analytical research has been done in health
status of Musahars in general and Musahar women in particular. However, a study
conducted on current socio-economic situation of the lowest status caste and tribal
communities in Nepal by serve the children US, included Musahars as untouchable
caste group. This study concluded that education, economy, health and caste based
discrimination are major interrelated variables which play a vital role to deprive to
access a higher social status for lower caste people.
Bista (1976): provides, only the general information of Musahars. Their health
aspect has not been studied.
Karna U.L. (1993) has thrown light on the social, economic, educational and
religious aspects of Musahars. He has explained that the Musahars women are very
laborious but they are treated as inferior and second class labors by local landlords
and village masters.
Verma A.K.(1991) in his study about “A social, economic and cultural study
of the Musahars of Nepal terai” has revealed that landlessness, unemployment, low
income etc are the main cause of poverty among the Musahars. The vicious circle of
poverty, malnutrition, diseases and ignorance impedes their progress for a better
future. However, he does not talk about the health aspect of the Musahars.
2.3
General Health (Primary Health Care Service)
The term ‘health’ defines not only health problems or health services, it
includes all the aspects of development of human life i.e. social, economic, political,
physical, environmental, biological and interrelation to totality (NHRC, 1997).
In order to develop the “health status’ the concept of basic health service and
the provision of basic minimum needs were included during the period of 6th and 7th
five years plans (1980-90). In this connection, necessary attention was given to launch
several programmes like nutritive food, safe drinking water, public hygiene,
environmental health and appropriate health educaiotn (Ibid, 1993).
9
To achieve the targeted health status, since 1st five year plan, the process of
establishing Health Posts and Sub Health Posts are still continuing and special
attention have been given to strengthen primary health care service through the
establishment of Sub Health Posts in each VDC throughout the country within the 8th
five year plan period. Therefore, present health policy has targeted to establish one
Sub-Health Post in each VDC in order to facilitate the rural people with all primary
health care services.
During the 5th plan, a long term health plan was announced with 15 years
perspective plans and policies on health which covered 5th – 7th plan period with the
objective of Preventive, Promotive and Curative health services with various
components as a basic health and services to deliver by the health post. Preventive
Health Services were provided for the preventive of disease. Promotive Health
Services enables individuals and communities to live a healthy life. The programme
under this services are: health-education and information, nutrition and environmental
health. Curative Health Services are treatment of general disease, general laboratory
services and referral services.
In short, the health services to be provided by the health post in the Primary
Health Care (PHC) which is essential as first level treatment and it is concerned with
basic health problem of the community (Upadhyaya, 1993).
Nepal Health Research Council (NHRC) was established on 12th April, 1991
under Ministry of Health (MOH) with objective of making an effort ot provide the
basic health care to the masses specially to the deprived and underprivileged groups
after realizing that the health goal can be achieved only the education, agriculture,
income generation, environment etc. Therefore, the NHRC at present has started
various programmes in order to improve the basic health care in the field of
education, agriculture, income generation and environment (Pandey, 1995).
There are many Governmental Organization (GOs), Non Governmental
Organizations (NGOs) and International Non Governmental Organizations (INGOs)
working in the field of health system as well as the Primary Health Care Project
(PHCP), Family Planning/Material Child Health Services and so forth. Very few
research have been done on the health status of the Musahar Women.
10
Health status of women is directly affected by fertility, and fertility is
influenced by various social and economic factors such as education, age at marriage,
occupation, income, preference for sons and decision making power (Dhakal, 1995).
2.4
Reproductive Health
A person’s health is influenced by four factors i.e. income, lifestyle,
environmental population and occupational risks and the quality of available health
care (World Development Report, 1996).
Health of women and fertility is inversely related to each other. So there are
two general explanations put forward for high fertility in some countries. The first
explanation is that high fertility is a fundamental adjustment to high mortality and that
high fertility is necessary for group survival when mortality is high. When infant and
child mortality is high, this consideration becomes more important. To have large
number of children in those circumstances, it becomes necessary in view of the fact
that chances of survival of child to adulthood are weak. Even when infant and
children mortality rates begin to decline following improved health services, this fact
does not become immediately evident to the people (Bhende and Kanitkar, 1996).
The other explanation is that, high fertility is also an adjustment “to the central
importance in community life. In pre-industrial societies, all activities are centered
around kinsmen and children and a great deal of occupational co-operation is required
for them for the large task that are to be carried out. In fact, in such societies,
economic and social relationship overlap” (Ibid, 1996).
In such a social structure children have a great economic, social, cultural as
well as religious value. They become economically useful by the age of six or seven
and therefore, are not an economic liability for their parents, but are, in fact, economic
assets. They produce various types of goods and a wide range of services:- they fetch
water, fuel, care for cattle, look after their younger siblings, sweep etc. When they
grow up, these children help their parents and look after them in sickness and old age.
In such a society, great importance is attached to the procreation of male children to
extend the family line. Among the Hindus, a son is essential, for only he can
ceremoniously kindle the funeral pyre and thus affect the salvation of his parents soul.
He is also responsible for performing religious services for his ancestors. Children are
11
generally considered to add to the wealth and prestige of the family, for with the
increase in number of children and consequent increase in relatives and grand children
bring additional economic resources for the family. Even when children migrate to
urban areas, they continue to add to the family income (Ibid, 1996).
In most traditional societies, a fatalistic attitude to life is also known as a
reason of high fertility. It is for this reason that, when the people asked how many
children they would like to have, they are sometimes known to have replied: “it is not
for us to decide’, “children are the gifts of god”, etc. Therefore, religious institutions
also generally promote high fertility. This type of value definitely incorporated in the
tenets of Hinduism and supported by the low level of economic and social
development (Ibid, 1996).
Thus, due to social-cultural norms and value, the women have more children
and as a result their health status becomes very weak.
From the literature review mentioned above the conclusion is derived that
Musahar migrated from Bihar and Uttar Pradesh of India as a nomadic tribe seven
centuries ago and settled down permanently in Terai region of Nepal. Their health as
well as socio-economic condition is very poor.
To improve socio-economic condition and health status of rural people Nepal
government, NGOs and INGOs have been implementing different kinds of program
such as Minimum basic needs, self-help program, Income Generating Activities,
Primary Health Care Project, Family Planning and Maternal Child Health Care
Project etc. from 1st five years plan in grass root level. But no remarkable change in
the targeted area could be seen. Nepal Government has formulated the policy of
establishing on Sub-health Post in each VDC throughout the country aiming to
facilitate the health of rural people by 5th years plan but it is not progressed
effectively.
The fertility behaviour always directly affect the primary health of women and
reproductive health is affected by socio-economic factors. Therefore, the researcher
has derived a conceptual framework i.e. education, occupation, income, sex
preference, age at marriage, knowledge and use of family planning devices etc. as
socio-economic variables and how these variables are affecting the health of Musahar
women.
12
CHAPTER – III
RESEARCH METHODOLOGY
3.1
Research Site and Rationale of the Study
The researcher decided to conduct his research in Baramajhiya VDC of
Saptary district. As per SNV Nepal’s demand I have applied my proposal aiming the
topic of research on the health of Musahar women in Baramajhiya VDC of Saptary.
Being born and raised in rural Terai Village I was familiar with the local customs and
cultures of village people. So, I thought that a rural area should be a better place for
me to do my research work.
Musahar community is one of the lesser known marginalized from mainstream
of Nepal and background community of Terai. Due to this reason it is basically
essential to undertake a study about tribal group called Musahar. It is observed that
the socio-economic condition of Musahar at Baramajhiya VDC of Saptari is
degrading day by day if the situation is not improved, the existence of Musahar will
be at stake.
The study is able to identify some health problems of reproductive age’s
women and socio-economic factors which affecting the health status of Musahar
women.
If the purpose of the study is fulfilled, it will be a preliminary information to
policy makers, planners, politicians, beurocrates, development practioner to formulate
policy and programmes for upliftment of Musahar community.
3.2
Sources of Data
The study is based on both primary and secondary sources of data. Both
quantitative as well as qualitative data will be used in this study.
Primary Source
•
Documents, registers, files, and other relevant papers from VDC will be
consulted to take the secondary data.
13
•
Documents, register working report from Health posts, sub-health posts,
Family planning/Maternal child Health and Primary Health Care Projects will
be consulted.
•
Related books, articles and other publications will be consulted.
Secondary Source
•
Documents, registers, files and relevant papers from VDC were consulted to
take the secondary data.
•
Documents register working report from health-post, sub health post, family
planning/maternal child health and primary health care project were consulted.
•
Related books, articles and other publications from central library, NGOs,
INGOs and CBS offices were consulted.
3.3
Research Design
In this study, exploratory and descriptive research design has been applied to
describe the findings. It is exploratory, in the sense that this study is an endeavor to
explore the relationship of the fertility behaviour of Musahar women. On the other
hand, it is description in the sense that all the variables used for the study will be
elaborately described.
3.4
Sampling Procedures
To find out the socio-economic condition of Musahars, at first I took the
household census of 70 households and informants were recorded. Among which 285
were males and 293 were female. In order to find out the health status of women of
reproductive age group(15-49), 102 married women of reproductive age group (1549) were selected. Among 293 females, 102 married women were of reproductive age
group, out of 102 reproductive age group women, 20 respondents were selected
through stratified random sampling i.e. seven groups of women at their reproductive
ages (15-49). There were 102 such married women between 15-49 age group. Among
them 20% (20 women) from each reproductive age group were selected through
14
lottery for random sampling and this sampling was interviewed. For more details the
number of selected respondents have been given below in table no. - 1.
Table No. - 1:
No. of Selected Reproductive Age Group of Married Musahar Women
Age group
No. of women in the age
group
No. of sampled
respondents
15-19
10
2
20-24
12
2
25-29
19
4
30-34
20
4
35-49
13
3
40-44
16
3
45-49
12
2
Total
102
20
Source: Field Survey 2006.
3.5
Tools of Data Collection
In the field, household census will be taken initially to find out their
population composition and socio-economic status as tools of data collection. To take
the household census, the researcher and assistants will go door to door of every
household. Structured questions were used to interviewed the household heads to find
out their socio-economic factors such as education, occupation, land holding, family
income and expenditure family size.
Structure questions were used to interviewed the selected women of
reproductive age which included both open and close questions to find out their age
at marriage, fertility history, fertility behaviour, concepts on the child bearing and
rearing, decision making power, health condition, knowledge and use of contraception
sex preference for baby, family planning etc.
To obtain essential information from respondents structure, unstructured,
crossed and mixed questions were used. At the end, I interviewed 5 persons of 50
years and above from the same community to find out there cultural norms and value,
religious beliefs and socio-economic condition of the study area as key informants.
15
3.6
Data Analysis and Interpretation
The presentation and analysis of information and data collected through
interview, household census and field survey have been done in both description and
analytical ways. Quantitative data sheet like population structure, age-sex
composition, and marital status by age group, land occupancy income and expenditure
deficit etc. will be transformed orderly and then necessary tabulation was done.
Characteristics of the respondents were analyzed through the use of frequency,
percentage, mean etc.
The qualitative data such as value system, decision-making power of women,
position and role of women in society were analyzed descriptively.
3.7
Limitations of the Research
This is study of Baramajhiya VDC of Saptari district based on the following
limitations.
•
It is studies only one ethnic caste i.e. Musahar settlement in Terai, Nepal.
•
Only six selected socio-economic factors as independent variables and fertility
behaviour as a dependent variable is taken into consideration as the
measurement of health status among the Musahar women.
•
Other aspects such as religious behaviour and cultural acts are included in this
study.
16
CHAPTER - IV
GENERAL INTRODUCTION OF THE STUDY AREA
The general introduction of the study area including physical profile,
demographic profile, population of Musahar, ethnic group composition, educational
composition, natural resources, drinking water, village economy of Baramajhiya VDC
are presented in this chapter.
4.1
Physical Profile
The study area, Baramajhiya VDC is one of the 115 village development
committee of Saptari district and it is one of the district of Sagarmatha zone which
lies eastern development region. This district covering an area of 1363 sq. km.
bordering between Udaypur district to the north, Sunsari to the east, Siraha to the west
and Bihar state of India to the south. Total population of this district is 570282 of
which 291409(51.09%) are male and 278873 (48.90%) are female (CBS, 2001).
Rajbiraj is one municipality of this district. It has five parliamentary electoral
constituencies. The district headquarter is located at Rajbiraj municipality. This
district is known as bread basket of the country because it is one of the food grain
producing district of Nepal.
The east west highway from Bhardaha to Kanchanpur (south-north) is running
through the centre of this VDC. There are non graveled sub road which links the
village with the main road. Sundardhar and Bokardhar two small river joint together
and running along with main river Mahuli dahr and together passed by the side of this
VDC. Only in the rainy season it has full of water over flood which is curse for
Musahar village which is situated by the side of this river. To save the village from
flood every year constructed there dam (bandha) by District Development Committee
and Gtz.
There are three ponds in Baramajhiya VDC constructed by local people for the
purpose of fishing, cattle and for even bathing and washing the clothes.
4.2
Demographic Profile
As per census of 2001, the total population of Baramajhiya VDC is 4476 of
which 228.5 are male and 2191are female. The total population of Musahars in this
17
VDC was 451. But as per household census taken during my field work in JanuaryFebruary, 2007, there were 578 Musahars in this VDC.
Inhabitants of this VDC are mixed races belonging to different castes and
tribes. They are Tharu, Muslim, Musahar, Kumhar, Tatma, Haluwai, Baniya,
Brahmin, Yadav, Teli, Chamar, Dhanuk, Khatwe, Sanyasi, Rajput, Kami, Mali,
Sudhi, Dom, Thakur, Brahmin-T, Kumar, etc. living together peacefully even though
they come from different religious and cultural background. They all speak Maithili
as mother tongue and Hindi and Nepali as the record language. People in Baramajhiya
VDC are found to be affiliated with Hindu and Muslim religious. Total population of
this VDC is 4476 according to National Census 2001.
Table No. – 2:
Ethnic Group Composition of Baramajhiya VDC
Ethnic Group
Tharu
Muslim
Musahar
Kumhar
Tatma
Halwai
Baniya
Brahman-Hill
Yadav
Teli
Chamar
Dhanuk
Khatwe
Sanyasi
Rajput
Kami
Mali
Sudhi
Dom
Thakur
Brahman-Terai
Kamar
Unidentified
Others
Total
Total
767
467
451
437
365
289
280
276
241
206
180
149
91
90
43
29
22
21
19
18
12
9
6
8
4476
Source: CBS 2001.
18
Percent
17.14
10.43
10.08
9.76
8.15
6.46
6.26
6.17
5.38
4.60
4.02
3.33
2.03
2.01
0.96
0.65
0.49
0.47
0.42
0.40
0.27
0.20
0.13
0.18
100
Table No. – 2 shows that the population of Musahar is third highest (10.08%)
in the study area whereas the population of Tharu is highest (17.14%).
4.3
Educational Attainment/Composition
There are six schools in the study area. Among them three are lower secondary
schools and three are private English Boarding schools. According to National Census
2001, the literacy status and school attendance of 6 years and above age in
Baramajhiya VDC as below.
Table No. – 3:
Literacy Status (6 years and above) in Baramajhiya VDC
Particulars
Total
Male
Female
Can’t read and write
1958
732
1226
Can read only
109
41
67
Read and write
1621
1123
498
64
59
6
Not started
Source: CBS, 2001
Table No. – 4:
Population (6 years of age and above) by status of school attendance in
Baramajhiya VDC
Status
Total
Male
Female
Currently attending
888
498
390
Currently not attending
598
378
220
Source: CBS, 2001
4.4
Natural Resources
Except the Mahuli River which is shined as silver in the days after rainfall and
plane agricultural land, there are not any natural resources in this VDC.
4.5
Drinking Water
It is absolutely true that human health is greatly shaped by the source of
drinking water. Three types of water sources were found at the study area i.e. hand
19
pump and well. Almost every where the hand pump was found popular and accessible
in the study area. Well was also found in using coning and ponds were used for cattle
and for even bathing and washing the clothes of the villagers.
Well for drinking water was found made by local people’s participation and
VDC’s financial support and about so to go hand pump (tubewells) were provided by.
4.6
Village Economy
Most of the households in the study area produced the usual crops like paddy,
wheat, millet, maize, jute, sugarcane etc. They also cultivated green vegetables and oil
seeds for the household use. But according to the report of Baramajhiya VDC over
90% people are engaged in farming rest 10% population are engaged in political
activities, services, business, small enterprises, shop keeping and other jobs for their
earning.
The households of this area have raised various livestock. It seem that crop
farming is a major field of occupation while livestock farming is second major field of
occupation. But livestock farming is not found very fruitful and no income from it
could be seen to add to the family income.
20
CHAPTER – V
ANALYSIS AND INTERPRETATION OF FINDINGS
5.1
Demographic Aspects of the Musahars
5.1.1 Household, Population and Sex Ratio of the Musahars
Population of the Musahars in Baramajhiya VDC is 578 of which 285 are
male and 293 are female. Their households were 70.
5.1.2 Statement of Age and Sex Structure of the Musahar
Age and sex structure of the population directly influence the fertility,
marriage and mortality of any society. Table shows age and sex composition of the
Musahar in Barmajhiya VDC.
Table No. – 5:
Age and Sex Structure of the Population of Musahar
Age group
Total
Population
%
Male
Population
%
Female
Population
%
0-4
97
16.84
47
8.13
50
8.65
5-9
103
17.82
48
8.30
55
9.51
10-14
66
11.41
26
4.49
40
6.92
15-19
63
10.89
24
4.15
39
6.74
20-24
43
7.43
31
5.36
12
2.07
25-29
38
6.57
19
3.28
19
3.28
30-34
40
6.92
20
3.46
20
3.46
35-39
28
4.84
15
2.59
13
2.24
40-44
32
5.53
16
2.76
16
2.76
45-49
24
4.15
12
2.07
12
2.07
50-54
20
3.46
11
1.90
9
1.55
55-59
7
1.21
5
0.86
2
0.34
60-64
8
1.38
6
0.76
2
0.34
65-69
3
0.51
1
0.17
2
0.34
70+above
6
0.76
4
0.69
2
0.34
Total
578
100
285
49.30
293
50.69
Source: Field Survey, 2006.
21
Table No. 5 indicates that 0-5 years population of Musahar is high in
Barmajhiya VDC. It is because of the unawareness of the family planning methods
and son performance and discriminatory attitude towards the girls children.
5.1.3 Marital Status of the Musahar Population over 15 years of age in
this VDC
“The legal union of persons of opposite sex, the legality being established by
Civil, religious, or other means according to the customs and laws of each country is
known as marriage. Many demographic measures and research strategies have been
based on the assumption that marriage is a necessary and sufficient condition for child
bearing and these do not adapt well to more complex situations” (Sweet, 1982). Cox
(1993), says that marriage has been defined by the statistical commission of the UNO
as, “the legal union of persons of opposite sex. The legality of the Union may be
established by the Civil, religious or other means as recognized by the laws of each
country” (Cox, 1993). Therefore, it is known that marital status means to come in
sexual union through the marriage between two opposite sex, i.e. male and female and
begin a new life as a couple. Demographers are in the opinion that at least 15 years of
age of any female is capable to give birth and the capacity of fecund remains till 49
years of age. Therefore 15-49 years of age is taken as a reproductive age. But in the
study area it was fount that 14-16 or 17 years for a girl was considered an appropriate
age for marriage and almost all girls by 17 years of age were found married and some
had already become mother.
Within the Musahars, the parents while selecting spouses for their
son/daughter was found mostly higher than the sons/daughters selecting their own
spouses by personal choice. Due to the system of early marriage among the Musahars
the boys and girls can not select their own spouse of their choice. For more details
table has been given below:
22
Table No. 6:
Marital Status of the Respondents
Age
group
Married
Divorced
Widow/er
Male
Female
Male
Female
Male
Female
15-19
18
9
-
-
-
-
20-24
21
12
-
-
-
-
25-29
19
19
-
-
-
-
30-34
20
20
-
-
-
-
35-39
15
13
2
-
-
-
40-44
16
16
-
-
-
-
45-49
12
12
-
-
-
-
50-54
11
9
-
-
-
-
55-59
2
2
-
-
3
-
60-64
2
2
-
-
-
4
65-69
1
1
-
-
-
2
70+above
-
-
-
-
4
2
Total
137
115
2
-
7
8
Source: Field Survey 2006.
5.1.4 Age at Marriage and Fertility of Musahar Women
In Nepal legally accepted age at marriage of boy and girls is 20 and 18 years
respectively, but early marriage is still being practiced in rural society due to different
socio-cultural norms and values.
Table No. – 7:
Age at Marriage and Fertility of Respondents
Age at
marriage
14
14
15
16
17
17
18
Total
No. of
Respondent
2
1
3
6
4
3
1
20
Age of husband at the Age at started to
time of marriage
live with husband
17
15
18
16
17-18
16-17
17-19
16-18
17-19
17
18-20
19
18-20
19
Source: Field Survey 2006.
23
Age at the first
baby born
16
17
16-17
16-18
18
19
19
According to National census 2001 age at marriage of female is found 16
years but in my field study it was found 14 years of age. Those who were married at
14 years of age started to live with her husband at 15 years of age and bear the first
child at 16 years of age. It indicated the social value and norms of Musahar society
which directly affect the health status of women. Early marriage increases the fertility
and decreases the health status. Among the Musahars, appropriate age of marriage is
15-19 for boys and 14-16 for girls. Therefore, it was found in the field survey that
higher proportion of girls in the age group 14-16 and boys 15-19 age group were
married.
Reason behind it that due to landlessness and unemployment the Musahar,
parents begin to think that the daughters are extra burden. Due to poverty the young
girls go out in order to work and to get a job in others farm, parents are anxious about
their daughter whether their daughters were raped by higher castes or neighbouring
boys. Some times this types of cases happening among Musahar. Those who were
raped did not take any action against them. Therefore, due to fear of rape the parents
wanted to marry their daughters at an early age. According to my study a few person
know very well that this system of early marriage is not good, however they all
accepted that daughter is other's property. Therefore, not to be late to marry them,
when they became young. An early marriage helps to increase the fertility and high
fertility always affect the women’s health.
It is also said that if the girls are not married when they become young then
the parents of bride will not like bridegroom and they suspect on her character too.
Therefore, most of the Musahar parents want to marry their daughters in early age.
Age of marriage is one of the most important factors affecting health and
fertility behaviour of a women specially in rural areas of Nepal where early marriage
is mostly practiced. Age at marriage is closely related to fertility. Duration of
marriage life and the stability of marriage and it is inversely related to fertility so long
as marriage occurs within the child bearing period and not before it for a long period
of marriage life, women marrying at an younger age tend to have the higher fertility.
Studies show that after early age at marriage started to bearing the number of
children. It can be said that a positive relationship between women’s age at marriage
24
and family size. In this way, it can be said that the lower health status of women in
Nepal. Therefore, early marriage helps to increase the fertility and high fertility helps
to decrease the health status of women.
Accourding to “Tukee” magazine (Sawan-Kartik, 2062 B.S.) published by
Health Research Centre, age at marriage is not the biological event as birth and death
but it is sociological event which is determined by society and in the society. Age at
marriage affect the fertility rate so that it has demographic value too. Therefore which
age is appropriate for marriage and when it would be depend on strength
determination of society but not determination of own.
Research shows that marriage depends on society of different ethnic/caste
group, and it is controlled by generation/tradition. Therefore to break this system it
will take the time and it takes the time to change the age at marriage too. After
increasing the educational status and urbanization and awareness programme from
electric media continually change in age at marriage. When change in fertility rate in
any nation there also change in age at marriage. These changes happen after social
and economical development. The table no. 8 below clear this concept.
Table No. – 8:
Average age of marriage
Age
Female
Male
20-24
18.8
18.7
25-29
16.9
20.0
30-34
16.7
20.1
35-39
16.6
20.3
40-44
16.4
20.1
45-49
16.1
19.9
Total
16.6
19.7
Source: Nepal Demographic Health Survey, 2001.
In the context of Nepal change in socio-economic status, there are changes in
various areas. Child marriage is ended, it is going to end the tradition of parents’
25
decision about their sons or daughters agreement. But even cannot change in age at
marriage particularly.
Age at marriage is increasing slowly. Data clearly shows that age at marriage
is increasing in the age group of 15 to 24. Average age of age at marriage is shown in
table above that 16.6 for female and 19.7 for male.
5.1.5 Mean Age at Marriage
Mean age at marriage means the average age at which individuals marry for
the first time. Age at marriage is one of the most important demographic
characteristics of the age of the bride and the bridegroom. The mean age at marriage
is also an important variable of fertility. In several studies it is found that the mean
age at marriage is negatively related with fertility i.e. higher the age at mirage lower
the fertility. Early marriage system is highly practiced in rural area even in the study
areas. Thus, the early marriage always helps to increase population and due to birth at
early age the health of women deteriorates.
Table No. – 9:
Mean Age at Marriage of currently married Musahar Women
Age group
No. of Respondents
Mean age at marriage
15-19
2
16
20-24
2
15
25-29
4
15
30-34
4
16
35-39
3
16
40-44
3
16
45-49
2
16
Total
20
Source: Field Survey 2006.
Table No. 9 clearly shows that the mean age at marriage among Musahar is
15.3. In this respect, I have used the method of mean deviation to obtain the mean age
at marriage I calculated age at first marriage by single years of age selected
respondents of each group and divided it by total number of selected respondents
group. For example there were 2 respondent women of 15-19 years age group. Their
26
age at first marriage is 32. In other words, the summation of x i.e. age at marriage is
32. This summation by the total respondents i.e. 2, gives 16 mean age at marriage the
calculation can be expressed into formula as,
X = 16, 18
∑ X = 32
N=2
∴ Mean =
5.2
∑ X = 32 = 16
N
2
Social Aspects of the Musahars
5.2.1 Education and Fertility
Education can be considered as a master key to all compartment of
development and education of women is one of the most important factor for lowering
fertility as well as instant mortality rate and maternal mortality rate. Women’s
education influences the age at marriage and family size because educated women are
more aware of the issue of quality of health and children than that of non educated
women. Education change the behaviour of women in every aspect of life i.e.
economic, politics, family and society but low socio-economic status of women
inspires them to have a large family size. The general status of education of Musahar
in the study area was found to be very much below the national average. The literacy
rate of population at National level (6 years and above) is 54.1% but literacy rate of
Musahars (6 years and above) is 7.28%. The table has been shown the educational
attainment in Musahars (over 5 years) male and female in Baramajhiya VDC, Saptari.
Table No. – 10:
Educational Attainment of Musahar (Over 5 years)
Education Level Total No.
Illiterate
Primary
L. Secondary
S.L.C.
Total
437
40
3
1
481
%
Male No.
%
90.86
8.31
0.62
2.27
100
202
32
3
1
238
84.87
13.44
0.42
2.77
100
Source: Field Survey 2006.
27
Female
No.
235
8
243
%
96.70
3.29
100
Table no. 10 has shown the educational attainment in Musahar male and
female. The illiteracy rate is found 84.87% (percent) for male and 96.70% for female.
Very few 9.14% for male and 3.29% for female were found literate. None of the
Musahar women had passed secondary education. The number female mentioned in
above table were considered to be the new students who are studying in school. It can
be said that neither Musahar male nor female are intended in education.
Table no. 10 show that the Musahars caste are not aware about education and
they are not encouraged for education. Their position in society is deteriorating today.
Female education is one of the main determinants of fertility and health, because it
directly affects the fertility behaviour of women. The mean number of children born
among literate women was 2.3% compared to 3.3% among illiterate women (National
Planning Commission, 1998). There is an inverse relationship between fertility and
education. Many demographers in the opinion that higher the education lower the
fertility and lower the education higher the fertility would be.
The table below glimpes the educational status of Musahars (Madhesi Dalits).
Table No. – 11:
Educational ratio of Madhesi Dalits
Dalits
Primary
Secondary
S.L.C.
P.C.L. and
above
Dushadha
4.2
1.8
0.3
0.1
Musahar
1.2
0.4
0.0
0.0
Chamar
4.8
1.9
0.2
0.1
Khatbe
5.4
2.4
0.4
0.1
Dhobi
8.8
5.3
0.9
0.7
Source: National Dalit Commission 2060 B.S.
Struggling with malnutrition, hunger and poverty the children of the Madhesi
Dalits spend their valuable time by cow, buffalo, goats, animal husbandry in the field
of landowner. Very few used to go schools. There is an assumption that the Dalit
students don’t be study, if so then cannot get job. (Himal Khabar magazine, 18 Oct.- 1
Nov., 2006)
28
The table above shows the educational standard of Musahars is very low in
position. It is concluded that due to not available of good opportunity, the Musahar
people struggle with poverty and hunger, in this situation they select either to be
servant or to be hunger. In this deplorable condition they don’t concentrate their mind
for study.
It is clear that due to economic reason most of the lower caste’s children
cannot afford to go to school not because they have to pay for education but they have
to work for their family.
5.2.2 Sex preference and Fertility
Table No. – 12:
Preference of Son in Musahar
Preference
No. of Respondent
Percentage
Preference to birth of son
20
100%
Prerequisite son as to carry family mane
18
90%
Ideal for a family
15
75%
Source: Field Survey 2006.
Above table show that the son preference is deeply rooted in Musahar caste.
They born baby till son is to born so that it can be said that son preference affects
fertility behaviour of women. The composition of the living children affects the
preferred desire for additional children. From the above table shows that 100% of the
selective women respondents have preferred for son 90% respondents expressed that
son as to carry family name and 70.5 women respondents responded that son is a ideal
for a family. Therefore, it is concluded that deep preference for son the female have to
give more birth, consequently the health status of the female became poor.
5.3
Economic Aspects of the Musahar
5.3.1 Land holding and Agriculture of Musahar
According to field survey all of the households are found landless. Among 70
households 7 households constructed their house by the side of broaded road and
remaining 63 households constructed their house in block land (not registered to
anyone).
29
Unfortunately (not to be clever as high caste) these Musahars people did not
get the opportunity to register even the land where they constructed their houses.
Almost all Musahars are landlessness however 3% of the Musahar depend on
agricultural activities. Due to lack of landholding capacity very few of the Musahar
people of the study area were found cultivating other’s land on the basis of half
sharing of crops (Adhiya) of as a tenant. Due to not own agricultural land is forcing
Musahars to depend on various others occupations to solve their hand to mouth
problems. Musahars does many things for livelihood on shown in occupation.
Table No. – 13:
Occupation of Musahars economically active
S.N.
Particular
Total
%
Male
%
Female
%
population
1
Agricultural work
10
2.82
5
1.41
5
1.41
2
Seasonal work
267
75.42
103
29.09
164
46.32
3
Industries
9
2.54
9
2.54
-
0
4
Home services
50
14.12
39
11.01
11
3.10
5
Traditional work
18
5.08
18
5.08
-
0
Total
354
100
174
49.15
180
50.84
Source: Field Survey 2006.
5.3.2 Seasonal Labour
Seasonal work is livelihood of most of Musahars. Seasonal labour depends on
seasonal works such as sloughing and leveling the field for planting the rice, millet,
maize, wheat, tobacco, farming, making ridge in fields, cutting and threshing the
harvested crops etc. which will be available only for 6 to 7 month from June to
December. For the rest of remaining days they go to Kathmandu, Punjab (India) and
elsewhere in search of seasonal work. Among the economically active women, only
1.41% were found involved in agricultural work and 46.32% were involved in
seasonal work as labourers like planting rice, millet and other seasonal crops and
harvesting etc. and 3.10% involved in home services. The Musahar women, usually
go to landlords and master’s (Girhus) home and make the cow-dung cakes for fuel
30
purpose. Their work include sweeping the country and washing clothes of landlord’s
families, carrying paddy, millet, wheat and other consumable goods for grinding,
beating and threshing in local mills. Children also look after the buffaloes, cows,
goats etc. of the landlords and masters. They get food, clothes and other consumable
goods in exchange of their services. Some of them lived in the landlord’s home as a
servant on salary basis.
Musahar men and women go to the forest to collect fire woods to sell in the
market for extra income, whenever they have desire. For more detail occupation of
the Musahar is given below table no. 14.
Table No. – 14:
Occupation of Musahars Economically Active
S.N.
Particular
Total
%
Male
%
Female
%
10
2.82
5
1.41
5
1.41
267
75.42
10
29.09
164
46.32
population
1
Agricultural
work
2
Seasonal
work
3
3
Industries
9
2.54
9
2.54
-
0
4
Home
50
14.12
39
11.01
11
3.10
18
5.08
18
5.08
-
0
354
100
174
49.15
180
50.84
services
5
Traditional
work
Total
Source: Field Survey 2006.
Musahars are landless, background, poor and jobless. Due to landlessness they
have no chance to earn property. Always they paid as labourers on other’s farm.
Mushahars who depends on agricultural work are very few (1.41%) man and (1.41%)
women too. Found involved in agricultural occupation. This indicator points out that
Musahars are landless. They don’t raise livestock and due to illiteracy and being an
untouchable caste there is no chance of employment and service. For hand to mouth
31
they have to work in the landlords house as a bonded labour. They get very little
salary on grain basis on the other hand among the economically active population
only 5.08%are found engaged in their traditional occupation. Musahar men were
found in seasonal labour. 14.12% are engaged in house service but not in the
governmental services, about 2.54% are working in carpet industries in Kathmandu.
5.3.3 Income and Fertility
Income is also an important factors affecting fertility as well as health of
women. The family, who have strong income source were found to be healthier and
held high social status. In this regard, Dhakal (1995) stated that a study conducted by
CEDA (1972) on population development policy in Nepal had found that higher the
social status (i.e. higher the standard of a family in relation to other families as
represented by income, education etc.) lower the fertility of the family and lower the
income is higher the infertility.
Table No. – 15:
Average Annual Income and Their Sources of Musahar Households
S.N.
Source of income
Average annual
Percentage
income/households
1
Agricultural work
164
1.09%
2
Livestock
141
0.93%
3
Traditional work
107
0.71%
4
Seasonal labour/wages
14450
96.22%
5
Service
90
0.59%
6
industries
65
0.43%
15017
100%
Total
Source: Field survey, 2006.
32
Table No. -16:
Average Annual Expenditure of the Musahars
S.N.
Expenditure annually
Amounts (Rs.)
Percent
1
Fooding
13941
89.30%
2
Clothing
603
3.86%
3
Medicine
399
2.55%
4
Education
29
0.18%
5
Social/Religious Ritual
639
4.09%
15611
100%
Total
Source: Field Survey, 2006.
Table No. 15 and 16 above has clearly shows the annual income and
expenditure of Musahars in Baramajhiya VDC. To find out the socio-economic
background of the Musahars on the basis of income and expenditure, total income and
expenditure has been accessed and divided by sample (20) households. Thus average
income and expenditure of last year for each household was calculated. Above
mentioned table no. 15 and 16 show the difference between their income and
expenditure which was Rs. ( – ) 780.55 to each household. Therefore, this table
indicates that the Musahars of study area absolutely poor and maintaining their living
by doing farm labour or other physical labour, the ratio of expenditure is high to
income level.
5.3.4 Occupation and Fertility
Occupation and fertility is also an inversely related variables of health of
women. Dhakal (1995) has presented that UN report on population of Japan (1980)
has indicated that women who are gainfully employed have lower birth than other
unemployed married women. Further more he started that higher the status of women
as represented by work outside the homes, income earned and such indication as
professional status of the family the lower, the fertility (CEDA, 1972).
The Musahar women were found neither educated nor in a economically good
condition. Due to illiteracy they are unable to get better job and due to poverty, they
are unable to conduct the domestic industries as well as cottage industries as income
generating activities from their own side. Therefore, the question of Musahar women
33
has occupation is very complex. Women who were imployed or engaged in any
desired occupation had less fertility and the decreasing of fertility is symbol of
healthy life.
5.3.5 Employment in Other Area
Musahars have not a forced job according the time they were engaged other
economic activities such as wage carning activities, working as servant and small
scale business for their subsistence basically their daily activities, include doing a
hard work in the agricultural fields of their masters. In return they get only one killo
rice and 35-40 rupees per day. That is insufficient for feeding their children so they
try to earn some more money by working as a labour in the field of construction and
other kinds of work in the cities, usually such kinds of work are done by the male
members. Basically women and children are engaged in household works and live as
servants for the rich people. Through the Musahar people are not directly linked in
traders they sell their agricultural products such as rice, vegetables and other things in
the market and buy clothes and other necessary items of daily use such as salts, oil,
spices etc. So their main source of subsistence is agriculture rather than trade. Trade is
their occasional subsidiary occupation.
5.3.6 Service
Most of the Musahar people are illiterate, so they are ubable to get higher level jobs in
the government sector most of them work as wage labour, servant in the house of high
caste, as driver of tractor on salary basis and servant as animals husbandry.
5.3.7 Livestock
Very few householders were raised livestock such as chickens, goat, cow and
buffaloes. Very little cash can be earned by selling these types of livestocks. So the
livestock raising is not found to be suitable. Those who have livestock have no
separate cowshades to raise the livestock and unable to provide the feed, grass, straw,
etc. No time can be given to look after the livestock of other rich villagers. Thus,
these communities have fallen into a vicious circle of poverty. In order to reduce their
poverty, income generating activities should be enhanced to increase employment,
job security by making bamboo basket, straw mat, hey rope etc.
34
5.3.8 Earth Cutting/Digging
According to the respondents (key informants) Musahar are known as earth
cutters. Their traditional occupation is cutting and digging the earth, ditch, ponds,
well, drain, carrying the soil and leveling the field etc. However change in it by
overtime. They are not at fixed for works by the over time they doing seasonal works
more. They have been doing such works for generations. Now a days such works is
more or less carried out with the help of modern machine. Due to availability of
modern machine like loader, durmper instead of menial work of digging, cutting,
leveling and carrying the soil from one place to another, the Musahar are facing a
great problem.
5.3.9 Family Shelter
Out of total 70 householders, 63 households were constructed their houses in
Block land and remaining 7 households were constructed their houses by the side of
broaded village road. It can be said temporary shelter because they have no land
registered in their own name. All the houses of the respondents were found to have a
house with thatched with ingle entrance. Many people accommodated in a single
room. In many instances they shared the room with some livestock. So, in reality the
hygienic conditions of most of the houses are deplorable due to not strong of
economic condition.
5.4
Health of Married Musahar Women of Reproductive Ages and
Sanitation
5.4.1 Knowledge of Family Planning Devices and Fertility
Data about knowledge and use of family planning devices by the
respondents were collected in the field survey. Contraception using is one
reliable means to check birth. But in the study area in the Musahar
community, it is found in a very low percentage. Very few male Musahar was
found to be using the contraceptives. Among the Musahar female very few
were found using the FP devices.
35
Table No. – 17:
Knowledge of Family Planning Devices and Fertility
Particulars
Response
No of respondent
Percentage
Yes
15
75%
No
5
25%
Yes
6
30%
No
14
70%
Use of FP devices by
Yes
2
10%
husband
No
18
90%
Knowledge
about
FP
devices
Use of FP devices
Source: Field Survey 2006.
Table no. 17 has clearly shown that 75% have knowledge about the
family planning and 25% have no knowledge about it. Among the 75% who
had knowledge of FP devices, only 30% were found using the family planning
devices and 70% were not using the same. Only 10% of male user of FP found
in study area. 75% of the respondent have knowledge about family planning
devices they know it is used for to space the pregnancy and have the baby on
own desire but due to economically poorness they were unable to use it.
The reason of not using of FP devices was lack of many to buy it,
problem of getting it free of cost for from health post, not allowed to go
outside the home without permission of their husband to get the FP devices.
Lack of information about it and barriers of socio - cultures norms and values
etc on the other hand the respondents, Musahar Women never want to go
Sub-health post to take any kind of suggestion about their health. Therefore
there are various problems with in this caste relating to their health which
deteriorating each day.
Through the field survey the, Sub-health post was found near the
study area. The distance of Health Post is at least 1 kilometer from the study
area which is not so far established.
36
5.4.2 Health of Musahar Women in Pregnancy Period.
Pregnant period of a women take nine month. During this period a
women need more care for her and her baby in pregnant. In this period she
need health education about complications in pregnancy. Conditions might
occure during pregnancy that may endanger the life of the pregnant women
and her unborn infant. Hence, early detaction and prompt care can save lives.
Health and surrival of the mother and child in pregnancy and child birth
depends mostly upon early detection of complications, availability of abstric
first aid and referral of women to a health facility where they (mother and
baby) can get appropriate emergency obstric care.
Health education during pregnancy should emphasize on Importance
of proper balanced nutrition and use of iodized salt, adequate rest, tetanus
toxid immunization, personal hygiene, breast care and breast feeding,
harmful effects of smoking, alcohol intake and indiscriminate use of drugs
during pregnancy, deciding about the place of delivery and clean delivery
practices. Therefore health education should be given to married women. But
in the study area it is found vast difference about health education and
Primary Health Care during pregnancy of Musahar women which is
tabulated below.
Table No. – 18:
Health Education and Primary Health Care During Pregnancy
Particular
Consult
health
worker
during pregnancy
Take
injection
during
pregnancy
Addition
food
practice
during pregnancy
Response
No of Respondent
Percentage
Yes
6
30%
No
14
70%
Yes
9
45%
No
11
55%
Yes
-
-
No
20
100%
Source: Field Survey 2006.
37
Due to economically poorness, lack of knowledge and not aware the
family members about pregnant health, women are facing reproductive
health problem during pregnancy. Only 30% of the Musahar women
consulted to health worker and check-up their health condition during
pregnancy period. This is due to lack of knowledge and not aware of their
pregnant health.
5.4.3 Food Habit and Health
In the survey all the respondents were found to be rice and bread
eaters. They eat the rice, bread, dhindo and potato as a daily diet. They also
eat pulse, meat, fish, pickle and so forth. Also they are to be found habituated
of alcoholic drink, smoking of cigarette, tobacco etc. But these food too not at
time and regularity and lack of nutrition in these food the health condition of
Musahar is going to be pitiable at present.
According to “Himal Khabar Magazine” (page 20, 18 Oct.,– 1Nov.,
2006) addiction and smoking is the most essentially for Madhesi Dalits, After
taking dinner or working or at the exhausted (tried) time they smoke
whenever they like smoking is pretending for resting at the time of land
owner’s work. Cleaver landowner allow mariguna and nicotine, tobacco etc
managed for agricultural labour. After smoking they became intoxicated and
work a lot in the short time, so the Musahar’s health is measurable.
Among the Madhesi Dalit, the life expectancy is extremely short not
more than 45-50 years. In the village of Musahar Dhami-Jhakri are more
valued than doctors. Because of economic crisis, they can’t go to doctor and at
the end they are obliged to depend on Dhami-Jhakri. The blind believes and
evils is here and there. Musahar often seems as if elder in the adolescence
because of malnutrition, hunger, poverty, unhealthy living and dinner at
time.
38
5.4.4 Food Consumption Among the Musahar
Food play a vital role to keep the body health and in better condition.
In the period of pregnancy women should take nutritional and balanced food
for herself and the unborn baby. Therefore every pregnant women should
take additional food more than daily use, supply to the body nutritional and
balanced diet. But in the study area it is not found in practice due to
economically poorness condition.
The world health Organization has calculated that, an average adult
men and women need at least 2200 calories per day to lead productive lives.
However, pregnant women need at least 2500 calories per day. Depending on
what type of work they do. In general, people who get less than 2100 calories
a day are considered to be suffering from impaired diets. Only 20 - 40 percent
of all women of child bearing age in the developing world receive a daily diet
of 2200 calories or more.
For many, dietary deficiency starts from childhood and effect the
whole course of their lives, Girls who get inadequate diets grow into
malnourished women and suffer from anemia and protein deficiency. Their
physical development may be impaired making child birth difficult and
dangerous. Women in poor health are at high risk of conflictions during
pregnancy and child birth.
Half of all pregnant women in the developing world suffer form iron
deficiencies and low weight. Malnourished women are in turn, at a greater
risk of poor general health and more vulnerable to infection. FAO report that
over the course of time during the past two decades the amount of iron
deficiency in developing country in south Asia and South East Asia has
actually fallen (UNFPA, 1996).
But the situation of Musahar, women is quite different. They are living
between life and death. Sometimes they have to live only by eating half
stomach full of food and sometime they have to live without even during the
39
period of delivery. So it will be better not to ask about callory and protein of a
Musahar women for, more than 90% Musahar people are surrounded by the
vicious circle of food insufficiency problems.
Table No. – 19:
Food Sufficiency Among the Musahar
Food consumption
No of household
Percent
Insufficient
63
90%
Sufficient for 6 month
4
5.71%
Sufficient for 9 month
3
4.28%
Sufficient for 12 month
-
-
70
100%
Total
Source: Field Survey 2006.
Among the respondents more than 90% are suffering from
insufficiency of food grain, Food grain needed to feed the family members for
one year is not sufficient. To fulfill the insufficiency of food grain they used to
go to the forest for collecting the fire wood for selling. In order to cope with
the food insufficiency they go to the landlords for farming and labouring
otherwise not the time of seasonal work they go to asking or to take 5 kilo rice
in argue returning of 71/2 kilo rice. Example:- for 1 kilo rice they have to return
the price of 1 1/2 kilo rice to landlord. After agree this criteria only get the rice
for hand to mouth.
Otherwise not the time of seasonal work they go to asking landlord
(Grihas) for rice and they bring rice or wheat for fooding is return of it they
have to paid to (Grihas) lord the value of 11/2 kilo rice equal to 1 kilo rice.
They also go even out of the village for 5 to 6 months, to fulfill their food
insufficiency.
The percentage of respondents who can maintain only for less than 6
months of their food requirement from their agricultural product is 5/71%,
less than 9 months of their food requirement from their agricultural product is
40
4.28% and no one is capable of feeding their family members for 12 months.
No one has surplus food production. They who were not cultivating other's
land even on the basis of half sharing of crops (Adhiya) are known as
absolutely poor, hungry and landless. In term of efficiency and surplus in
food production Tharus, Sundi, Yadav Rajput are better. On the other end of
the spectrum the Dum, Dusadh, Khatwe and other miner communities are
found to have no food of their own as they only work on other's land as
labourers like the Musahars.
5.4.5 Care of Delivery and Primary Health Care
A pregnant women should never be left alone to deliver by herself. The
family members should request help from a trained health worker (trained
TBA, ANM, MCHW) as soon as laborer begins. If a trained health worker is
anavailable, the family members should assist the mother during child birth.
When labour begins, the family should call a trained birth attendant, if
available but in the study area it was found vast different. Family members
did not call any trained health workers. The table bellows is shows clearly
about delivery care.
Table No. – 20:
Current Situation of PHC in Study Area.
Home
Delivery in
95 %
Health post
Hospital
5%
Mother in low
Delivered by
Mid-wife
Health worker
100%
Self
Habit of
Smoking
60%
Alcoholic drinks
35%
None
5%
Source: Field Survey 2006.
41
Above mentioned table shows that Primary Health situation of
Musahar women in the study area is very bad. According to field survey the
respondents who delivered at home were found 95% and not availability of
trained birth attended, pregnant women delivered by mother in law found
100% too. In such a cash, the possibilities of maternal and child mortality
would be high. The respondents who were habituated of smoking are found
in high ratio.
Which is injurious to health, especially at the period of
pregnancy. From the above table, we can come to the conclusion that due to
negligence of health care, the condition of the health of the mother goes
down.
5.4.6 Care of New Born Baby and Primary Health Care
Primary Health care play a vital role to keep the mother and new born
baby healthy and safe from infectious disease. Here is the information about
PHC which is collected from field study. The table is as below:
Table No. – 21
Primary Health care of pregnant women and new born baby
Particular
Response
Percent
T.T at the time of pregnancy or after
Yes
35%
delivery
No
65%
T.T injection to child after birth
Yes
40%
No
60%
Polio, BCG, DPT vaccination to child
Yes
40%
according to their age
No
60%
Feed colostrums to new born
Yes
60%
No
40%
Yes
-
No
100%
Feed others milk too
Source: Field Survey 2006.
42
The table indicates that the ratio of respondents who didn't receive the
T.T. injection before or after delivery is high (65%) whereas the percentage of
women receiving TT injection is very low (35% only). The proportion of
children who don't take TT injection, polio drops, BCG and DPT
immunization according to age also is very high 60% respectively, colostrums
milk which has vital for baby is unknown by 40% of women because they
afraid of child being sick. Most of the Musahar women don't know about
Sarbottam Pitho ko Lito. From the above table and due to economically
poorness they con not feed other milk to their baby. They feed own milk till
one year then they used to feed Jaulo to baby after weaning. We can come to
the conclusion that due to lack of knowledge and negligence of health care,
the child mortality is increased, as a result the fertility rate is high and the
condition of the health of mother goes down.
5.4.7 Latrine Use and Cleaning Habits
All of the households have reported that they have not toilets. The use
of toilet was found among the higher caste group living in market areas.
Musahar people went to open fields and bank of river away from village for
latrine purpose. All the household except lower and poor classes used water
for washing hands after the use of toilet. From the field observation, it was
noted that many of the lower caste families, particularly among the children
non-use of water could be noticed distinctly. Most of them used leaves grass
and wood etc for cleaning after toilet.
5.4.8 Treatment of Sickness
Most of the Musahars people believes on traditional healer for
treatment of sickness. In the study area in Baramajhiya VDC almost all the
household consulted Dhami/Jhankri (traditional healers) for treatment. Very
few of them who were economically better tried to go to hospital, health post
or sub health posts. Who were economically poor and not aware about true
43
treatment, used to go to Dhami/Jhankri. It is because traditional healers are
easily available in the village and most of the people have faith in them and
another reason is that Dhami did not take money as fee as a doctor.
Table No. – 22:
Treatment of Sickness / Illness
At the time of sickness
Dhami / Jhakri (healer)
90%
usually go for treatment
Hospital / Health Post
0.0%
Dhami (healer ) & Doctor
10%
Source: Field Survey 2006.
Above mentioned table no. 22 shows that 90% of the total respondents
reported that they always consulted Dhami (Traditional healer) at the time of
illness, 10% of respondents reported that they consulted both traditional
healer and hospital. The reason behind not go to hospital is like this, "due to
behalf in supernatural power of god and ghost they want to a Dhami". Many
people believe that Dhami/Jhankri can easily diagnose if a patient has been
influenced by a witch or some evil sprit. If a Dhami's diagnosis is positive, he
takes the evil influence out and may refer a case to a doctor. The belief is that
if a patient in under an evil influence and takes oral medicines, such
medicines may be ineffective and have side effect. A Dhami is supposed to
know the deity and the divine sprit, because it is believed that Dhami
forecasts about the causes of illness and treatment methods for curation
through super natural power (i.e Tantra Mantra). They have Dhami of their
own caste who is called ‘Bhagat’ who do not take money as fee. Sometimes
they take money and goods as fee form some of patients whereas the doctor
and health assistant take money as fee from patients. Due to fear of fee not
because of doctors, due to lack of money of medicines they usually don’t go to
hospital for treatment.
44
5.4.9 Health Post and Sub-Health Post
There are VDC level Sub-Health post and clinic for village people to
serve. Area level Health post which is at Kancanpur VDC, which is not so far
away from this Baramajhiya VDC. There is also transportation facilities to go
there easily. The health post which is 6 km far but not difficult to reach there.
Even though the Sub-Health post is not so far, the Musahar women are not
found to be aware of their health care. The Musahar women are not so free as
other higher caste women. They are not allowed to go outside of their home
without their husbands permission even for health care at the time of
sickness. At the day their husbands have to work on other's land and farm
and the women had to work in their own home or landlord's home and
other's farm. So, due to shortage of time they don't go to health posts.
45
CHAPTER - VI
SUMMARY OF FINDINGS, CONCLUSION AND
RECOMMENDATIONS
6.1
Summary of Findings
In Nepal high fertility is one of the major problems for rapid
population growth. Low literacy rate of women, low economic status, low
employment outside their homes, ignorance about health and health care
services are the major factors affecting the health status of women.
Baramajhiya is one of the VDC of Saptari district of Eastern
Development region in Nepal. Very few health facilities are available within
this VDC. Due to lack of knowledge and unaware about health and health
care practices, low education and socio-economic status of women, sociocultural belief and lack of knowledge about family planning methods most of
the Musahar women are unaware about primary health care services.
The study was based on primary and secondary data. Stratified
random sampling was done for collecting socio-economic data of the Musahar
purposive random sampling was applied to select the women in their
reproductive age group ( 15- 49 ) to find out about their reproductive health.
The study was limited to the married Musahar women of reproductive age
group 15-49 years only. Interview was the major tool for obtaining necessary
information on socio-economic factors affecting the health of Musahar
women. Women’s health status was assessed in relation to fertility which is
affected by socio-economic variables such as education, occupation, age at
marriage, knowledge of family planning methods and delivery practices.
Majority of the respondent women belonged to the age group 24-25
and 30-34 years which is considered as highly fertile age group. None of the
Musahar women had passed primary level of education. According to field
survey they were found 96.70% illiterate. Majority of respondents (14.12%)
46
and (75.12%) were involved in housework and seasonal labour respectively
and very few (2.82%) engaged in agricultural accupation. Income generating
activities such as livestock raising, home services etc. were not effectively
done by Musahars. Among the total selected respondents ( 15%) were
married at the age of below 15 years and remaining 85% married at the age of
15-19 years. Only 30% of the respondenty reported that they had health
check-up during their pregnancy. Only 35% of the respondents were taken TT
injection during pregnancy. All of the respondents had their delivery in their
homes, and all were delivered by not trained birth attendant but by their
mother in law. About 40% of the respondents reported that their children
were immunized against disease, according to their age. Majority of
respondents (100%) desired at least 1 or 2 son child over daughter due to
cultural and religious belief. 75% respondents had knowledge about FP and
the rest 25% had no knowledge about it but only 30% use family planning
devices. Most of the respondents were engaged in house work and seasonal
labourer work. Literacy rate of Musahar is 7.28% which is very low with
comparison to National average (54.1% ).
6.2
Conclusion
On the basis of the above findings of the research it is concluded that
there are facilities of health check-up but due to lack of money, poorness, lack
of knowledge and not aware of their health they used go to Dhami/Jhakri at
the time of illness, because they are available nearly the village. The Primary
Health care service do not sufficiently facilitate. Therefore, to reduce the high
motality and fertility better primary health care sevices should be conducted.
Fertility level of the women of the study area can be decreased with
increasing the knowledge and use of family planning devices. It is also true
that education helps to reduce the fertility. The respondents of the study are
almost illiterate. So fertility rate of the study area can be reduced through
increasing the level of female education.
47
The furnishing shows that age at marriage in helping to increase the
fertility level of women and early marriage. System is highly sustaining in the
study area. Thus, age at marriage must be high to reduce high fertility. To
increase the age at marriage the opportunity of employment, better income
source, fruitful occupation, vocational education, practical knowledge etc.
should be increased status of low socio-economy contributes to the lower
health status of Musahar women. Therefore, the socio-economic status of
Musahar women of the study area is absolutely poor and their health status is
also poor and pitiable.
6.3
Recommendations
On the basis of conclusion of this study, the following recommendations
are suggested.
•
To reduce the poverty making bamboo basket, bamboo broom, straw
mat, hay rope etc. Should be conducted as basic income generating
activities in this area.
•
Education and age at marriage are strongly associated both with the
individual as well as at the societal level. Women with secondary level
education is considerably less likely to marry during adolescence.
Therefore highest priority should be placed on female education.
•
The education and literacy of the Musahar should be improved
immediately. For this : training programme should be launched on the
importance of education, effects and impacts of education of daily life,
health education, awareness, sanitation and public health. Primary
schools should be opened in, each settlement site of the Musahar
community to get primary education in their mother language so that
it would be easy for them. Books, Stationary and dress should also be
provided freely to the Musahar children by this government. The
higher secondary and University level education should also be made
free for the children of Musahar.
48
•
Proper attention should be paid for preserving, upgrading and
documenting the cultural practice of Musahar community. For this: the
Musahar should be united and organized for their social development,
the government / NGO / INGO should also provide necessary
assistance and launch programme at grass root level, all Musahar in
this VDC are landless and they do not have land even for residential
purpose. They should provided with residential land immediately.
Furthermore, Musahars are mud digger and their tradition occupation
is agro labour nad digging land for many purpose. Though they are
keenly interested in cultivation they are landless, So they should be
provide with land for cultivation, the Musahar should get priority for
employment
opportunity
of
government
/
semi
government
organization.
•
Primary health care practices and family planning were not effective in
these caste women. So special attention should be given to the lower
caste female groups to improve their awareness to health care.
•
Governmental organization programme should be implemented to
raise the income of Musahar involved in traditional caste occupations
such as making bamboo basket, bamboo broom, straw mat hay rope
etc. And employment which help to reduce fertility and thereby
improve women’s health condition.
•
Programmes should be conducted to improve Musahar as well as
untouchables traditional and business management skills. In addition,
Musahar including other untouchable should also be encouraged to
form themselves into co-operative saving groups to finance their
individual income generating activities.
•
The government should generate the programmes which increase them
to adjust by skillful work.
•
At least five Katha land should be distributed by Government to
increase themselves by cultivation on own land.
49
REFERENCES
Acharya, M (1981) The Maithali women of Siraha the status of women in
Nepal, vol. – II, CEDA, T.U.
Bhende, A.A. and T. Kanitkar, (1996) Principles of Population Studies, 7th
edition Himalaya Publishing House, Bombay.
Bista, D.B. (1976) “People of Nepal” 3rd editon.
Cox T. (1994) the current socio-economic status of Untouchables in Nepal,
Occassional paper vol. IV, T.U. Kathmandu
Cox, P.R. (1993) Demography, 5th edition Universal Book Stall, New Delhi.
Dhakal (1995) “Fertility and the status of women of Baijanathpur VDC,
Morang district”.
Gautam and Thapa ( 1992) “Tribal Ethnography of Nepal”.
Ghyure G.S. (1992) “Caste and Race in India”.
Health Communication, Nepal National Health Education Council, Itahari,
Sunsari – 2063.
‘Himal Khabar’ magazine (18 Oct. – 1 Nov., 2006)
‘Jijivisa’ monthly magazine (Kartik 2062 BS.) year – 9, Number – 19
Karna U.L. (1993) “An Introduction of Musahar and their role in agricultural
economy”.
Moktan (1996) Socio-economic and Health Status of Musahr women,
Badahara Mal VDC. Siraha district”.
National Maternity Care Guidelines Nepal, Family Health Division, Ministry
of Health and UNICEF 1996.
50
Nepal at a Glance, 2006, C.B.S., Kathmandu.
Nepal in Figures – 2006, C.B.S.
Population of Nepal, Central Bureau of Statistics 2001.
Sweet, J.A. (1982) Marriage and Divorce, International Encyclopedia of
Population, J.A. Ross (ed) New York Free Press.
‘Tukee’ Magazine (Sawan-Kartik 2062 B.S) year 23, number – 70.
Verma A.K. (1991) “A social economic and cultural study of the Musahars of
Nepal Terai”.
51
APPEDICES
SAMPLE QUESTIONS FOR FIELD RESEARCH
This research has been based on household survey along with socioeconomic survey, semi-structured questions applied for married women of
reproductive age group of 15-49. To get the information about Primary health
care services, fertility history and as the key informants for respondents of 50
years over ages of same caste were taken. Therefore, questionnaire was
divided into 3 sections ABC respectively.
Annex A
Questionnaire for household survey
1.
Socio-economic Information
S.
Name of the
Relation to the
N.
family members
household
Sex Age
Marital
Occupation
status
head
1.
2.
3.
4.
5.
6.
7.
2. How much land do you have?
…………………Bigha, ………………..Katha, …………….Dhur
3. Is your agricultural production is enough for your family throughout this
year? Yes/No.
If Yes, how many months? ................................................
If No, then how you managed to survive? ....................................
4. What is the main source of your income?
agriculture/ service/ labor /business/ others
52
Education
Primary Secondary
5. What is the average income per annum?
-Livestock selling………………………..Rs.
-Sale of agricultural product…………….Rs.
-Services………………………………... Rs.
-Business/ trades……………………….. Rs.
-Daily wags…………………………….. Rs.
-Traditional job………………………….Rs.
-Others………………………………….. Rs.
---------------------------------------------------------Total
6. How far is the market from your residence?
market…………………., distance ( kilometer … meters ……)
7. Which is your major festivals?
8. Annual average expenditure:
- festival (Dashain / Deepawali) or feast……………Rs.
- traditional religious occasion……………………..Rs.
- guest entertainment……………………………….Rs.
- clothing…………………………………………...Rs.
- medicines…………………………………………Rs.
- education………………………………………….Rs.
- annual expenses in fooding ( whole family)……...Rs.
- others contingencies………………………………Rs.
Total
9. Have you supports from NGO’s/ INGOs for/on what - education, agriculture,
animal husbandry ?
facilities……………………………………………………….
10. Where is your house constructed ?
on the own land/ on the other’s land
- If other’s, whose land of this ?
government/ landlord/ relatives
- If other’s land, what do you do him ?
…………………………………………………………………………..
53
11. Types of house:
- bamboo +mud + thatched
- bamboo+ mud +tile
- wooden + tin
12. Water resources
Wells
Tube wells
Pipe/tape
khola
others
Drinking
Cleaning
For cattle
13. Do you have any kind of latrine in your house?
If Yes, what kind? ......................................................................
-If No, where do you go to toileting?...........................................
54
Remarks
Annex B
Questionnaire for married Musahar women of reproductive ages
1.
No. of selected household:
2.
Name of respondent:
Occupation:
Education:
Date of Birth:
Current age:
3.
Age at marriage:
4.
Age at started to live with husband:
5.
Age of life partner at the time of marriage?
6.
How old were you when you had your first baby?
7.
How many children were born to you?
son………………..
daughter………………..
alive………………
dead………………………
Ö What was the age when died?
Ö What was the cause of death?
.........................…………………………………………………………
8. Do you/ Does your husband or both, wants more children? Yes/ No.
Ö If yes, what is the reason for having more children?
son not enough/ daughter not enough/ to own property
Ö If you don’t want more why?
Already enough/ no time to care / due to physically weakness condition.
Ö If you want more children, how many?
son……………….
daughter………………..
9. In your opinion how many children would be ideal for a family?
son……………….. daughter……………………..
10. Do you consider that son as a prerequisite to carry family name? Yes/No.
11. Where did you have deliveries? /is the baby born in your family?
home/health post/ hospital
12. Who delivered you?
nurse/ mid-wife/ health worker/ dhami / self
13. How many years should be better for birth spacing? ………………
55
14. Did you consult any health workers during pregnancy? Yes/No.
Ö
If no, why?
lack of knowledge/ lack of facility/ lack of money /others
15. Did you take any injection at the time of pregnancy or other delivery? Yes/No.
Ö If no, why?......................................................
16. Did you make your child take any injection, vaccination or oral suspension?
Yes/No.
Ö If yes, what medicines were given?
T.T., BCG, DPT, Polio.
17. Do you have additional food practice during pregnancy? Yes/ No.
Ö -If yes, what types of additional food?
green vegetable, milk/curd, meat/egg, rice/pulse, fruits, bread / dhido,
cereal, if any……………..
Ö If no, why?
ignorance/economic problem/felt it unnecessary/ others
18. How long do you breast feed to your baby?
19. Did you feed colostrums to the newly born baby? Yes/No.
Ö If no, why?
afraid of child being sick/ customs/ advised by others not to feed /others.
20. Do you feed others milk too?
21. What do you feed the child after weaning?
usual adult meal / jaulo / porridge / cerelace / others.
22. Do you know about Sarbottam pitho ko lito? Yes/ No.
Ö If yes, how do you prepare it?..............................................
23. Have you immunized your children according to their age? Yes/ No.
Ö If no, what are the causes?
-due to the lack of knowledge about immunization.
-due to the lack of facilities.
-felt it unnecessary.
-due to the distant location of hospital/ health post
24. Do you have any problem of reproductive health? Yes/No.
Ö If yes, what types of problems?
MCH care/ family planning/others.
56
25. Where do you take the sick person in case of emergency?
health post / clinic/ hospital/ dhami – jhankari / baidya / others.
26. Have you ever heard about pregnancy termination of family planning devices?
Yes/ No.
27. Did you ever use family planning contraception for delaying pregnancy? Yes/No.
Ö If yes, specify the name and duration…………………………..
Ö If no, why?
- due to lack of knowledge of family planning contraception.
- due to lack of money to buy it.
- problem to get it due to far of health post.
- no permission from husband.
28. Does your husband use contraception? Yes/No.
29. Are you using family planning devices nowadays? Yes/No.
Ö If yes, which device is used? ………………………………………
30. What are the main reasons to using the contraception?
- to materialize the small family norms.
- to space the pregnancy and have the baby on own desire.
- simple to use and free of cost.
31. Did you discontinue the family planning contraception?
Ö If yes, what are the reasons?
. have bleeding during the menses.
. due to lower abdominal pain.
. due to backache, headache and weakness.
. due to displeasure of sexual behavior.
32.What kind of habits do you have?
Smoking / alcoholic drinks
33. At the time of sickness/illness where do you usually go for treatment?
hospital/ health post / dhami (healer)
Ö If you don’t go to hospital or health post, what is the reason?...................
…………………………………………………………………………
Ö If you go to healer, what is the reason? .................................................................
57
Annex C
Questionnaire for Key Informants:
1. No. of selected household:
Ward No.:
2. Name of respondent:
Occupation:
Education:
Date of Birth:
Current age:
3. What is the reason for child marriage?
4. What is the reason for not sending their children to school particularly daughter?
5. What is the reason for not sending the bridge to her husband’s home immediately
after marriage?
6. What is the cultural and religious significance (taboo) and how they practices?
7. What are the traditional occupation and how it change in overtime?
8. How much expenditure in the celebration of ceremonies?
9. What are the reasons for all the Musahars are landless and poor?
10. In your opinion how the Musahars can improve themselves socio-economically?
58