A Comparative Study of Delivery Practice Among Women in Dalit Community in Ghansikuwa VDC, Tanahun

A COMPARATIVE STUDY OF DELIVERY PRACTICE AMONG
WOMEN IN DALIT COMMUNITY IN GHANSIKUWA

VDC, TANAHUN
By
Monika Barakoti
Symbol No: 3860055
TU Reg. No: 9-2-29-1898-2006
A Thesis
Submitted to the Health and Physical Department in Partial Fulfillment of the
Requirements of Master's Degree in Health Education
TRIBHUVAN UNIVERSITY
FACULTY OF EDUCATION
MAYA DEVI GIRLS COLLEGE
BHARATPUR, CHITWAN
January, 2015
DECLARATION
I hereby declare that to the best of my knowledge this thesis is the result of my original
work. No part of it earlier submitted for the research degree to any university and
educational institution this report is the result of my own research work conducted in
the study area whatever, subject matter I have presented in this thesis is my oritinal
except some cited materials.
Monika Barakoti
Maiya Devi Girls' College
Bharatpur, Chitwan
Date: January, 2015
RECOMMENDATION LETTER
This thesis entitled A Comparative Study of Delivery Practice among Women in

Dalit Community in Ghansikuwa VDC, Tanahun submitted to the Department of
Health Education, Maiya Devi Girls College, Tribhuvan University, by Monika
Barakoti has been completed under my supervision and guidance. I recommend it for
acceptance and examination.
-----------------------(Thesis Supervisor)
Mr. Home Nath Paudel
Department of Health and Physical Education, FoE
Bharatpur, Chitwan
Date:
ii
APPROVAL SHEET
This thesis entitled A Comparative Study of Delivery Practice among Women in

Dalit Community in Ghansikuwa VDC, Tanahun submitted to the Department of
Health Education, Maiya Devi Girls College, Tribhuvan University, by Monika
Barakoti has been approved by the undersigned members of the evaluation committee.
Thesis Evaluation Committee
1.
Signature
Mr. Bhoj Raj Neupane
.............................
Health and Physical Education Department
Member

Bharatpur, Chitwan
2.
Mr. Home Nath Paudel
.............................
Health and Physical Education Department
Supervisor

Bharatpur, Chitwan
3.
Prof. Dr. ...................................
.............................
Health and Population Education Subject Committee,

FOE, TU, Kirtipur
Viva Date:
iii
External
ACKNOWLEDGMENT
I would like to express my heartily appreciation to my thesis supervision Mr. Hom

Nath Poudel programme co-coordinator of Health and Physical Education Department
of Maiya Devi Girls College for his proper guidance, critical suggestion encouragement
support, cooperation and supervision throughout this study.
At the same time I am very grateful to my respected health teacher of Maya Devi Girls
Collage for guiding me whenever it was needed. I am greatly indebted to Secretary of
Ghansikuwa VDC Mr. Ram Raj Neupane Similarly; I would like to say thanks
Chairman of Dalit Community Mr. Amrit Bdr. Nepali.
I would like to express My Sincere thanks to Mr. Krishna Karki for printing and hard
banding of this proposal last but not least my sincere thanks my family member who
have been directly and indirectly helpful in bringing out this research in present form.
Monika Barakoti
iv
TABLE OF CONTENTS
Page No
DECLARATION
RECOMMENDATION LETTER
ii
APPROVAL SHEET
iii
ACKNOWLEDGMENT
iv
TABLE OF CONTENTS
LIST OF TABLES
vii
LIST OF FIGURES
viii
CHAPTER-I: INTRODUCTION
1-6
1.1
Background of the Study
1.2
Statement of the Problem
1.3
Objectives of the Study
1.4
Significance of the Study
1.5
Delimitation of Study
CHAPTER -II: LITERATURE REVIEW
CHAPTER - III: RESEARCH METHODOLOGY
7-11
12-13
3.1
Research Design
12
3.2
Population of the Study
12
3.3
Sampling Size
12
3.4
Sampling Procedures
12
3.5
Tools of Data Collection
13
3.6
Data Collection Procedure
13
3.7
Validations of the Tools
13
3.8
Methods of Analysis Interpretation of the Data
13
CHAPTER-IV: ANALYSIS AND INTERPRETATION OF DATA

4.1
14-42
Demographic and Socio-economic status
14
4.1.1
Occupation
14
4.1.2
Educational Status
16
4.2
4.3
Knowledge about Safe Delivery Kit
17
4.2.1
Use of Safe Delivery Kit in Practice
19
4.2.2
Reasons Behind Non-using Safe Delivery Kit
20
4.2.3
Cord Cutting Instruments
21
4.1.4
Home Delivery Complications
22
4.2.5
Age at Marriage
24
4.2.6
Appropriate marriage age
25
4.2.7
First Pregnancy
27
4.2.8
Birth Spacing
28
4.2.9
Time Duration of Health Check up During Pregnancy 29
4.2.10 Pregnancy Complications
31
4.2.11 Problems Related to Pregnancy
31
Delivery Spot
33
4.3.1
Assistance during Delivery
35
4.3.2
Antenatal Care Provider
37
4.3.3
Cord Cutting Services
38
4.3.4
Types of Food Taking Practices after Delivery
39
4.3.5
Visit Antenatal check up
41
CHAPTER-V: SUMMARY, FINDING, CONCLUSIONS AND

RECOMMENDATIONS
43-47
5.1
Summary
43
5.2
Findings
44
5.3
Conclusions
45
5.4
Recommendations
46
5.4.1
Recommendations for Improvement
46
5.4.2
Recommendation for Future Study
47
BIBLIOGRAPHY
48-50
APPENDIX-I: Questionnaire
51-56
vi
LIST OF TABLES
Page
Table 1:
Occupational Status ..................................................................................15
Table 2:
Educational Status .....................................................................................16
Table 3:
Relationship between Educational Status and Knowledge about Safe

Delivery Kit ...............................................................................................18
Table 4:
Relationship between Educational Status and Using of Safe Delivery Kits

in Practice...................................................................................................19
Table 5:
Reasons behind Non-Using of Safe Delivery Kit .....................................20
Table 6:
Cord Cutting Instruments...........................................................................21
Table 7:
Home delivery Complications ..................................................................23
Table 8:
Education status below 0-5 Children's mother age ....................................24
Table 9:
Appropriate Marriage.................................................................................26
Table 10: First Pregnancy .........................................................................................27

Table 11: Births Spacing Practices ............................................................................28
Table 12: Time Duration o of Health Check Up During Pregnancy..........................30
Table 13: Pregnancy Complications ..........................................................................31
Table 14: Problems Related to Pregnancy .................................................................32
Table 15: Relationship between Educational Status and Delivery Spot ....................33
Table 16: Relationship between Educational Status and Assistance during Delivery . 36
Table 17: Get Antenatal Check Up during pregnancy period ....................................37
Table 18: Cord Cutter Assistants of Damai and Kami Community ..........................38
Table 19: Food Taking Practices after delivery ........................................................40
Table 20: Health Checks up During pregnancy ........................................................41
vii
LIST OF FIGURES
Page
Figure 1: Occupational Status ..................................................................................15
Figure 2: Relationship between Educational Status and Knowledge about Safe
Delivery Kit ...............................................................................................18
Figure 3: Cord Cutting Instruments...........................................................................22
Figure 4: How delivery Complications .....................................................................23
Figure 5: Education status below 0-5 Children's mother age ....................................25
Figure 6: Appropriate Marriage.................................................................................26
Figure 7: Problems Related to Pregnancy .................................................................32
Figure 8: Cord Cutter Assistants of Damai and Kami Community ..........................39
Figure 9: Health Checks up During pregnancy .........................................................42
viii
CHAPTER-I
INTRODUCTION
1.1
Background of the Study
Health is an important part of human life. Unhealthy people are inactive and are hardly
anything more than burden for the country, in its strict sense. For growth, both personal
and nonpersonal, people should get rid of diseases and attempt to live a healthy life.
Healthy people are the true foundation of the development of a country.
Towards the western region of Nepal, Tanahaun District is located. In the Context of
world this VDC spreads from 26.95. to 28.01 towards north latitude and 84.31 to 84.41
towards east longitude. In the east ward of the this VDC Bandipur, Barbhanjyan and
Banu VDC in west buys Municipality and towards north Barbnhanjyan and Tahanue
sur VDC and south direction Kesabtar as well as Pokhiri bhanjyan VDC are located.
According to the political division calculation this VDC is No. 1 constitutional area. In
this VDC there are 9 ward and 35 residences which are divided into administrative
office with word no. 4 are located in Ghasikuwa VDC (Gashikuwa VDC, 2067).
Governments have a responsibility for the health of their people which can be fulfilled
by providing adequate health and social measures. Primary health care is the key to
attain this target in the spirit of social justice.
Primary health care is defined as essential health care based on practical, scientifically
sound and socially acceptable methods and technologies which are to be made
universally accessible to individuals and families in the community through their full
participation and at a cost that the community and the country can afford to maintain at
every stage of development in the spirit of self determination (Almaata Declaration
1978).
Reproductive right embraces certain human rights. Reproductive right of all couples
and individual includes the right to decide freely and responsibly numbers, spacing and
timing of their children and to have the information and means to attain the highest
standard of sexual and reproductive health. A few decades ago religious beliefs and
culture also used to directly guide reproductive practices in the society. The new
2
paradigm of reproductive health , that emerged through the ICPD 1994 has put human
right human development and individual well being at the center of the programmed
polices (CBS, 2003).
Nepal is one of the least developed countries in the world. It has been facing various
problems in the economic as well as health sectors. The major health problems of Nepal
are the lack of health education, rapid population grog growth, malnutrition, problems
of sanitation, prevalence of communicable diseases and high mortality rate. Besides,
reproductive health is also a serious problem in the country; due to lack of knowledge
about reproductive health. Of all the pregnancy related women deaths in the country,
30 percent women die in pregnancy period, 13 percent die at the time of delivery and
65 percent die after delivery due to high bleeding and reproductive tract infections. Not
only this, 24 percent woman die in health institution due to lack of good treatment and
qualified health personnel (CBS, 2011).
Education plays a vital role in the upliftment of society, community or nation as a
whole. It is considered a basic component of each and every nation. No any country
can dream for the upliftment without education- especially countries which have high
illiteracy rate. So education is the key element of every aspect of the development.
Nepal is a multi ethnic, multi religious multi lingual country; there are various ethnic
groups some of which are regarded as higher caste. Just like Brahmins, cherries also
have comparatively higher literacy rates. Not only do they enjoy higher economic status
but they also command higher social status. On the other hand, some castes are thought
to be inferior. These ethnic group are backwarded in all respects in comparison together
non-dalits. The socio-economic status and literacy rate of these castes are very low.
Dalit castes have their own social norms, and values. They depend on tradition, social,
and culturural practices because they are illiterate.
In this condition education is the most important factor which can affect behavior and
knowledge related to delivery practice.
"Damai and Kami": these two "Dalit" castes have own social norms and values as well.
They also depend on their own traditions, social and cultural values because most of
3
them are illiterate. In this situation, education is the most important factor, which affects
behavior and knowledge related to delivery practice in these communities.
The selected castes Damai and Kami are determined by their occupation that is specific
to their caste. For instance, Damai are generally involved in clothes sewing and
stitching works. Now aday's Dalit community is involved in many modern occupations
as well. They work as migrant workers. Damais are also involved in sewing the saddles,
shoes and bag. These occupations are based on traditional system. That way their
economic status is lower than those of higher caste community. They have no sufficient
money to spend the health facilities. As a result, the people in selected communities
face many health problems. No study has been undertaken about these backward castes
although it becomes quite necessary to study all aspects of their social standing;
including socio-economic and educational status to make further future plan to uplift
their status.
Adolescence is the period of physical, psychological and social metamorphosis of life
from childhood to adulthood-a period of important transition. Generally, the term
adolescence refers to persons between 10-19 age group and the term youth refers
to individual between the age of 15-24 years, while young people covers the entire
age range from age 10-24 years (WHO, 1998). The adolescence period is divided
broadly into two stages: early (10-14 years) and late (15-19 years).
Principle of the eighth Program of Action adopted at ICPD in Cairo, 1994 states that
everyone has the right to the enjoyment of the highest attainable standard of physical
and mental health. States should take all appropriate measures to ensure on a basis of
equality of men and women universal access to health care, including those related to
reproductive health care, which includes FP and sexual health. Reproductive health care
programme should provide the widest range of services without any form of coercion.
All couples and individuals have the basic right to decide freely and responsibly the
number and spacing of their children and to have information, education and means do
so (UN, 1994).
Reproductive health is an area which adolescents are particularly vulnerable. Rapidly
changing urbanization, earlier physical maturity, shifting standards of behavior and
increasing penetration of international mass media are leading in most developing
4
countries to earlier sexual activity among adolescents. Adolescents face a large number
of unplanned pregnancies due to traditional barriers to information with regard to sexual
health. Contraceptive and FP risk including STD/HIV and inaccessibility of services
cause adolescents to suffer terrible consequences and some of them may end up with
illegal abortion and various infections.
Young people of ages 10-19 years comprise 1.2 billion of the world total population.
Among them, some 14 million women and girls between ages of 15 and 19 years, both
married and unmarried, give birth each year. Women who start having children during
adolescence tend to have more children overall and at shorter intervals than those who
start later. In Bangladesh, more than half of the women have their first child at age 19.
In other developing countries, between one quarter and one half of all young women
give birth before 18 years (UN FPA, 2003).
According to a survey conducted by the Ministry of Health in 1996, adolescent
population comprises about one fifth of the total population and 50 percent of them get
married before the age of 15 years. Among them 40 percent bear their first child
between age 15-19 years in which a woman is not fully well matured to become a
mother, physically and mentally. The knowledge of contraceptive among adolescents
is 98 percent (MOH, 1996). But the current use of modern contraceptive method is 9
percent for married adolescents (MOH, 2001). It shows that the knowledge of
contraceptives among adolescents is high but the use of contraceptive is low which
leads to higher fertility in adolescence. Higher fertility in adolescenct period enhances
the risk of higher maternal mortality. In addition, there is a risk of overall health
problems. No use of contraceptives among adolescents invites the various reproductive
track infections like HIV/AIDS and others. These problems are the burning issues in
the world and in Nepal too.
Keeping this case in mind, the present study was carried out to discover the reasons
behind this situation. At Ghasikuwa VDC of Tanahun district there live many castes.
Bramine, Chhetri, Gurung , Dalit and others inhabit the locality. But this research has
been restricted to only 2 castes, Damai and Kami, and their delivery practices have
been compared.
5
1.2
Statement of the Problem
In recent years, there has emerged a growing concern on reproductive health; a new
program, rather a new approach, which seeks to strengthen safe motherhood, family
planning, and prevention of sexually transmitted diseases, prevention and controll of
HIV/AIDS, and child survival strategies that covers nutritional and disease prevention
measures with a holistic approach.
Although they grow fresh fruits and vegetables, pregnant women aren't allowed to
consume them, due to the prevailing superstition that fresh fruits and green vegetables
are harmful for pregnant and women who have recently given birth.
Damai, and Kami have similar economic conditions in that they have knowledge they
survivals their reliefs culture and behavior attitudes, hence to know about the status and
their practices. It is necessary to compare their practice.
Infant and mother death is still the problem of these community they have por. These
dalit communities have not sufficient knowledge about health. They have no
information encases knowledge of prenatal stage, delivery and post natal care. They
these casts are suffering from many superstations.
Thus I selected the topic related to reproductive health are among Damai and Kami in
Ghasikuwa V.D.C Tanahun. The problem of states a comparative study of delivery
practices in Damai and Kami community Ghasikuwa V.D.C Tanahun.
1.3
Objectives of the Study
The specific objectives of this study are to compare the delivery practice in backward
community the general objectives are:1.3.1
To identity the socio-economic status of Dalit Community.
1.3.2
To find out the problem of delivery practice among these community women.
1.3.3
To examine the delivery practice between Damai and Kami community.
6
1.4
Significance of the Study
The significance of the study is as follows:

1.4.1
The study will be helpful to find out the problem of delivery women and
delivery practice of the community.
1.4.2
The study will be useful to identify the socio-economic status of Dalit

Community.
1.4.3
It will be helpful to solve the health problems related to the delivery.
1.4.4
This study would be useful to educate women to care of their own health during
the progeny.
1.4.5
This study will be useful to provide information for new research.
1.4.6
This study will be useful for researcher, planner policy, maker's social workers
and educator to improve safe delivery programmed for this area and other
similar community and delivery.
1.4.7
This type of study will help to know the Ghasikuwa V.D.C Tanahun to find out
their delivery practice on their community and to improve their bad habits and
unhealthy behavior to care their delivery women.
1.5
Delimitation of Study
Because of time boundary available researchers and skill, the study is limited in
following areas:
1.5.1
This study included Damai and Kami community of Ghansikuwa VDC

Tanahun.
1.5.2
This study was delimited to education status of women and it is impact on

delivery practice.
1.5.3
This study is delimited to married women having one child aged between zeros
to five years.
1.5.4
This delivery practice is influenced by many factors but this study was delimited
to prenatal and postal care factors.
1.5.5
This study is based on primary secondary information data.
7
CHAPTER -II
LITERATURE REVIEW
This chapter deals with related literate of delivery practices among women in Dalit
community in Ghansikuwa VDC, Tanahun. Literate review is the most important
functions of development any research which provides deeper knowledge experiences
and other ideas to the researcher on the concern of this study book and other related
literature.
According to ICPD, united national (1994) important programmer has been made in
reducing infant and child mortality rates everywhere. Improvement in the survival of
children have been the main components of the overall increasing in average life
expectancy in the world over the past century first in the developed countries and over
the past fifty years in developing countries.
According to the 1995 UNICEF survey in Bangladesh women's access to reproductive
health care is also limited with only 5% of these expected to have obstetric complication
attending medical facilities, only 35% of women are going in for institutional delivery
only medical personal and just 27.5% of women receiving some antenatal care. Trained
birth attendants are used by 26% of women (WGNRR, 1996).
Nepal family health survey 1996 shows that the mother received antenatal care from a
doctor 12.7% from nurse or midwife 11% from VHW 10% from MCHW 4% from other
health persons 2% from TBA 1% from mothers did not receive any antenatal care for
majority of their birth about 56% in Nepal. According to Nepal multiple indicators
surveillance, 1997 showed that in Nepal 9 out of 10, 91% women deliver their babies
at home. A number of the variables are related to the place of delivery.
Meena (1997) in her study found that more than 86 percent women and 61 percent of
man were married before they were 25 years of age mean age of marriage nevertheless
has been increasing steadily since 1961. For women it increased from 15.4 years in
1961 to 18 years in 1991 the change is most pronounced among young girls between
10-14 years. In 1961 almost 25 percent of girls in this age group were already married
in 1991 of only 7.4 percent of such girls were in the married category.
8
NRHS (1998) reported that about 82 percent of the birth of occurred during the last 5
years received no antenatal care, only 25% received antenatal care by trained health
personnel and 9 out of 10 birth were delivered at home.58% woman who gave birth in
past 5 year had not received in injection .
WHO (1998) reported that in world wide more than 10 percent of the total fertility was
due to adolescent child bearing. The contribution of adolescent fertility to TFR in
African asset up was the highest in Central Africa 16 percent, intermediate in east
Africa 13 percent and the rest pats of Africa represented about 7 percent. Every year, at
least 60, 000 adolescents' women were found to die from health problems related to
pregnancy and child birth.
According to FPAN 1999 on Nepal fertility, family planning and health survey have
reported that infant mortality rate is higher among children than women who did not
receive any antenatal care services. During pregnancy and child birth who received
either antenatal or delivery services from the health person has reduced maternal and
child mortality and morbidity.
Pradhan et.al. (1999) reported that significant association between maternal illiteracy
and risk of child mortality, which is not accounted for by socio-economic status whether
of low of high socio-economic status literate women experience less child mortality
then to illiterate women. The protective low and high socio-economic status mother for
poorer women, there is an overall 65 percent reduction in significantly less child
mortality then illiterate mothers across socio-economic status.
Bhatta (2001) on his study found that 27.4 percent people have the practice of early
marriage 57 percent get married in the age of 15.20 years, 4 percent people in the age
of 20.22 years and only 2 percent in the age of above the 22 years onwards. Compared
to non literate women. The study reported that literate women experience.
Devkota, B (2006), in his study mentioned that 40.3 percent women have made
deliveries at health facilities hospital, health center, private nursing home. However,
home delivery is highest in mountain region 76 percent findings from the interview and
FGDs from Mustang and Solukhumbha districts reveal that the tendency of calling
health workers for delivery assistance at home is no rise.
9
Singh (2006) in her study mention that only 50% women were able to visit ANC check
up. The majority 85% women never visit health post, health center and hospital, ANC
check up.48.34 women had and experience of women giving birth at their home.45%
women give birth in a cowshed 1.66 women had and experience of have been child
birth in farm of jungle and only 5% women had goes go hospital during delivery,
majority of the responded 45.66% had supported by neighbor woman.
36.66% gave birth the two babies with help of their mother in law. Their husband
supported only 13.34% woman had given birth to baby with the help of TBA.
After the delivery 75% woman having full rest 16 to 25 days, 20% women having rest
11 to 15 days, only 1.66% woman got an opportunity of rest above 26 days, majority
of responded 26.67% were suffering from abdominal pain, 8.34% woman were
suffering from excessive bleeding and 4.60 woman were suffering from anemia in
delivery period.
PRB (2009), reported that the fertility of women with similar levels of education differ
from country to country. The average number of children is of higher educated women
is 5.6 in Nepal and this number is 6.8 in Zambia and 4.5 columbia. Likewise, the
average number of children of primary level and non-educated mother is 10 and 7.4
percent in Columbia. Education levels of women help to determine the number of
children.
NDHS, (2011) Antenatal care (ANC) from a skilled provider is important to monitor
the pregnancy and reduce the risk of morbidity for mother and baby during pregnancy
and delivery. The quality of antenatal care can be monitored through the content of
services received and the kind of information mothers are given during their visit.
Information on ANC coverage was obtained from women who gave birth in the five
years preceding the survey. Among women with two or more live birth during the five
years period, data refer to the most recent birth only the percent distribution of mothers
in five years preceding the survey by source of antenatal care received during
pregnancy, according to the selected characteristics. Women were asked to report on
all persons they saw for antenatal care for their last birth. However, if a women saw
more than on provider, only the provider with the highest qualification was considered
in the tabulation of results.
10
From the above literature we concluded that complication of pregnancy and delivery
are major causes of disability and death among woman of reproductive age en less
developed countries and illiterate communities.
It concluded that the practice of delivery practice is not satisfactory in Nepal delivery
practices are related to the different area of maternal health care.
Similarly, Nepal Fertility and Family Health Survey (2068) indicated a few coverage
of pregnant with family planning and maternity care. Only 20 percent of women have
received antenatal care, 27 percent of deliveries were attended by trained TBAs and 94
percent deliveries occupied at home.
Preliminary results from a World Health Organization (WHO) Multi country study on
womens health and Domestic violence indicate that between 12 to 25%of women have
been forced by an intimate partner or ex-partner to have sex at some time in their lives.
Similarly, sexual violence against women in refugee camps and perpetuates ethnic
cleansing. A review of studies that in 20 countries found that prevalence of sexual abuse
of girls ranged from 7 to 36 %. Most abusers are men known to the victim (WHO, 1998
as cited in Kafle, Rameshwore 2006).Poudel, Khim Kumari 2004 a study on problem
of Damai community of Pokhara. Sub metropolitan city reports that 70% of deliveries
are conducted at home and 36.6% have received post natal service.
K.C. (2011) In his study mentioned that about 35 percent women had been married in
the age of 17-18 years about 27 percent women had been married in the age of 19-20
years and only 1.5 percent women were married after the 23 years. Study also shows
that 66 percent women were being first pregnant at the age between 15-20 years. Only
31.2 percent women were being first pregnant at age between 21-25 years. No any
women were being first pregnant after the 30 years.
On the basis of above reviewing of literature, it is concluded that complication for
pregnancy and delivery are major causes of disability and illiterate communities. It can
be further concluded that the practice of delivery practices is not satisfactory in Nepal
and its territory. The delivery practices have been found low in quality in comparison
to other countries. The delivery practices are influenced by various factors. Beside
these, the about relevant literature review helped the researcher to sensitize about the
11
problem of the study, selecting variable necessary for the study, conceptualizing of the
study, selecting the methodology and interpreting and analyzing the result of data.
No study had been concluded previously in the topic" a comparative study of delivery
practice among the woman in Ghasikuwa, VDC Tanahun" the researcher believed that
this study will be proved to be a significant and valuable empirical assessment on this
regard hence the researcher has selected the above topic to fulfill the researcher gape to
some extent.
Khadka, (2012), "Delivery care practice among Dotei community" is a descriptive and
quantitative type of study which collects primary data by using Purposive sampling. It
shows 86 percent respondent had given birth to their child in cowshed, 4 percent
respondent had an experience of giving birth at their home and 15 percent respondent
had gone to health institution for delivery. Study also shows 64 percent delivery place
was darkroom and about 39 percent delivery place was clean and well ventilated. 72
percent respondents had assisted by mother- in -law, about 14 percent respondents gave
birth to baby with the help of health worker, 7 percent respondents had supported by
physician 7.9 percent respondents supported by husband and 5 percent respondents
given birth without any support.
12
CHAPTER - III
RESEARCH METHODOLOGY
3.1
Research Design
Research methodology is most important to achieve the objective of the study. It makes
us easy to fulfill the objectives this describes how the research goes systematically to
meet the target. This research was descriptive type.
3.2
Population of the Study
Damai, and Kami community of Ghasikuwa VDC (Appendix- II) According to VDC
profile of the Dali Ayoga. Were selected for the purpose of this study. The total
population of Dalit Damai, Kami Sarki, Gaine, Kasai) in Gashikuwa VDC are 1827.
The total population of Dami is 324 out of which are 154 males and 170 are female.
The populations of Damai women having one child aged between 0-to 5 years are 35.
Similarly the total population of Kami is 672 out of which are 331 male and 341 female.
The population of Kami women having one child aged between 0-to 5 years are 71.
3.3
Sampling Size
Sampling and sample size determine fulfillment of the research objective. There may
so many complications in research so, sample size would be appropriate as well as fact.
in this research work, researcher had selected the sample size of 106 women. The exact
number of sample size is from Damial 35 and Kami 71.
3.4
Sampling Procedures
The population of dalit (Dami, Kami, Sarki Gaene, Kasai) in Ghasikuwa VCD are 1827;
among them Damai and Kami are 996 in total under this household family with children
below o to 5 years are 106. The study sample is purposive and limited to this no of
household only. This research work considers 100 percent sample size for the selected
area.
13
3.5
Tools of Data Collection
The main tool of this study will be questionnaire to collect reliable and valid the
questionnaire schedule must be concentrated on so socio has economic demographic
characteristic of woman who had at least one child aged between 0 to 5 yrs as well as
practice. The interview schedule and observation check list were developed with the
consultation of reference book, magazine, reports, thesis paper and also the adviser.
The researcher directly involved in this researcher.
3.6
Data Collection Procedure
The researcher, I took the letter of HPE department and it was submitted to the office
of Ghasikuwa VDC for of obtaining permission of research in the Ghasikuwa VDC
after them researcher will go to Dalit aayog in Damauli to get information about Dalit.
Interview was conducted with the sample responded and necessary information were
collected based on our questionnaire.
3.7
Validations of the Tools
After the preparation of the research tools it was pretested to 20 mothers in Purkot VDC,
ward no.7, Deurali Tar. Having at least one child aged between 0 to 5 yrs age for its
validity Objectivity and reliability. According to the supervisor's suggestion and trial
test it was modified before making final.
3.8
Methods of Analysis Interpretation of the Data
The main objective of the study will be to find out delivery practice in dalit community
and to compare the delivery practice in Damai and Kami. The objective of the study
required data information will be collected after the collection of required details will
be tabulated into master chart. Collected data and information were placed in different
tables and they were analyzed according to the percentage. Mainly tables, charts, graphs
and percentage developed to analyze and interpret data.
14
CHAPTER-IV
ANALYSIS AND INTERPRETATION OF DATA
This chapter is mainly concerned with the analysis and interpretation of data, which
were collected from the respondents. After collecting data they were tabulated and put
in serial order to make them easy to analyze. In order to analyze and interpret them, the
information has been classified in terms of socio-economic status, educational impact
on women delivery practices and problems relating to it. The analysis and interpretation
were made on the basis of tables to make the presentation clear.
4.1
Demographic and Socio-economic status
Our health depends upon the several factors. Out of them socio-economic status is one
of the important factors. Socio-economic condition and human health is interrelated
with each other depends upon the socio-economic condition women delivery practices.
So the researcher is very keen to know about the socio-economic status of the
respondents. In this study researcher collected data relating to occupational status,
educational status, age of marriage and other factors relating to economy which is
briefly discussed in this section.
4.1.1
Occupation
Occupation is very important factor for human being, which shapes the behavior and
way of life. It is determine by their choice, interest, qualification, inclination and their
cultural concepts. It also leads them towards certain direction. As a result their life
becomes more comfortable and enjoyable. Hence the occupational status of respondents
is found out.
The major occupation of Damai and Kami community of Ghasikuwa VDC is
agriculture. They are also involved in there other traditional occupation. The following
data represents different occupations adopted and practiced by them.
15
Table 1: Occupational Status
Occupation
Selected Castes
Damai
Kami
Total
Agriculture
22.85
19
26.76
27
25.47
Metal working
18
5.14
18
16.98
Gold working
11.42
3.77
Cloth swing
28
39.43
28
26.41
Ladder shoes
8.57
10
14.08
13
12.26
Zink working
Services
5.71
0.56
5.66
Total
35
100
71
100
106
100
Figure 1: Occupational Status

30
Damai
Kami
25
20
15
10
5
0
Table 1 reveals that the major occupation of the respondents is agriculture. According
to the data 25.47 percent (27 out of 106) of the selected population adopted in
agriculture. Besides agriculture, they have been adopting and practicing other
occupation it such as laborer, carpentry, metalwork, clothes swing etc. and their
involvements in mentioned occupations is clear by mentioned the table. As a traditional
occupation, Damai are involved in clothes swing work while Kami are involved in
metalwork. percentage of their involvement in mentioned occupations is 18 and 16.98
16
percent respectively. But the study shows that the percentage of their involvement in
government service is very lo which is 6 (5.66 percent) only. Because of the totally
dependent on agriculture and their traditional occupations, the percentage of their
involvement in government service is very low. Now only but due to the lack of good
educational status their involvement in government services is very low.
4.1.2
Educational Status
Education is the foundation and basic requirement of development. it is essential for

socio and economic development. Illiteracy of the people affects to the development of
community and nation directly or indirectly. Not only in development, had it affected
in their living style and behavior also. Due to the illiteracy they can't raise their status
in society and they may unable to raise their economic condition. Due to the poverty
and illiteracy they become victim of different diseases. Besides this, high maternal and
child mortality rate directly related with illiteracy and property of people. Education
makes positive changes for the social as well as national development. Sound
educational status of community reflects the level of aware lessens and superstitions of
the people. It is also helpful to raise their condition high in society. As a result
community also gets change to develop by which development of nation also possible.
By these reason. It is necessary to study about educational status of selected groups. So
researcher is very keen to identify to study about educational status of selected groups.
So researcher is very keen to identify their educational status and the study carries out
the following data about it.
Table 2 : Educational Status
Educational Status
Education status below 0-5 Children's mother age

Damai
Kami
Total
Illiterate
14.28
4.22
7.54
Primary
22
62.85
35
49.29
57
53.77
Secondary
14.28
18
25.35
23
21.69
Higher level
8.57
15
2.11
18
16.98
Total
35
100
71
100
106
100
Table 2 show that in the selected area majority of respondents are illiterate. According
to data 14.28 percent females of Damai and 4.22 percent females of Kami are illiterate.
17
The percentage of illiterate Kami compare with Damai, Kami women are more
illiterate. According to the study of level wise educational status is approximately equal
of both castes, but secondary and higher secondary educational status is very poor of
them. According to data it is clear that Damai women had got 21.69 secondary level
educations and 16.98 percent had got higher-level education. Similarly 5 percent Kami
women had got secondary level education and 1.67 percent had got higher-level
education. Also comparing the literacy percent of Damai female 35 percent and that of
Kami female 26.67 percent with national literacy female percentages 42.50 percent
their percentage is not satisfactory. According to the study we conclude that
involvement of selected castes in the field of getting education is very low. So that we
concluded that it is necessary to raise involvements in educational fields by treating
their their drawbacks. For this, government should pay attention towards their
educational status.
4.2
Knowledge about Safe Delivery Kit
Delivery Kit is composed of midwife, haemostatic forceps, and container for collecting
blood, glove for medical and so on. The calico of Delivery Kit is made of pure natural
textile; all kinds of metal is stainless steel; container for collecting bold so made of the
macromolecule material and it has clear graduation, gatherzation pipe for woman and
impulsive glove for medicine are made of silica gel and natural latex. Before using,
sterilize the gatherization pipe, impulsive glove, aspiration sputum tube and container
for collecting blood in the delivery kit with neutral disinfector registered by nation or
sterilize them according to the manual. Other parts are sterilized under high temp and
high-pressure condition. fetal monitpr, Vento use, Forceps, Curette and Surgical Kit etc
are the key instruments of the delivery kits.
Uses of the clean home delivery kit play and important role in reducing neonatal tetanus
and other infections. It is easy to use and freely distributed in governmental health
organizations. But most of the women of rural area haven't knowledge about safe
delivery kit and its advantages by using it. Therefore I wanted to collect some
information from women of selected area about delivery kit, which is presented from
the following table:
18
Table 3: Relationship between Educational Status and Knowledge about Safe
Delivery Kit
Educational Status
Knowledge about Delivery Kit
Total
At home
At Health post
Total
Illiterate
7.44
18
90.00
26
16
53.33
28
68.29
44
Primary
26.66
10.00
26.66
19.51
19
L.Sec
1.33
13.33
12.19
Sec
6.66
6.66
Higher
--
15
100
20
35
30
41
100
71
Total
At home
At Health post
Kami
Damai
Figure 2: Relationship between Educational Status and Knowledge about Safe

Delivery Kit
Damai at home
Damai at Health post
Kami at home
Kami at Health post
30
25
20
15
10
5
0
Illiterate
Primary
L.Sec
Sec
Higher
Table 3 shows that only 42.85 percent (15 out of 35) Damai women and 42.25 percent
(30 out of 71) Kami women have knowledge about safe delivery kit whereas most of
19
the Damai and Kami women haven't knowledge about it whose percent is 57.14 percent
(20 out of 35) and 57.74 (41 out of 71) respectively. Comparatively, Kami women are
more ignorant about safe delivery kit than Damai women, which is clear from above
data. From the data it also shows that educational level positively depend upon their
knowledge about safe delivery kit. It means that the women who are more education
have more knowledge about safe delivery kit than uneducated women. Reason behind
this is that illiterate women haven't knowledge about reproductive health being beyond
the school life. Being illiterate, they also unable to understand the advertisement given
by electronic media about safe delivery kit. On the other hand the women who can
understand about advertisement they have no time to listen. To solve these problems,
non-formal education programmed should conduct in local language about the
advisement of safe delivery kit and they should be made aware about using it.
4.2.1
Use of Safe Delivery Kit in Practice
The status of using safe delivery kit of the selected women is presented in the following
table.
Table 4: Relationship between Educational Status and Using of Safe Delivery
Knowledge about Delivery Kit
Total
Yes
No
Total
Illiterate
21.42
14
66.66
17
36.84
38
73.07
45
Primary
42.85
19.04
10
36.84
11
21.15
18
L.Sec
21.42
14.28
15.78
5.76
Sec
14.28
16.52
Higher
35
19
52
100
71
Total
Yes
Kami
No
Damai
Educational Status
Kits in Practice
14
21
Table 4 shows that the information's about use of the clean home delivery kit by the
Damai and Kami women both literate and illiterate. According to data, 40 percent (14
20
out of 35) Damai women and 60 Percent Kami women had use local have delivery kit
which are both literate and illiterate where are the percentage of Damai and Kami
women who haven't use the clean home delivery kit is 59.09 percent (21 out of 35)
respectively. Comparatively, It is seen than that the percentage of Damai women in
using clean home delivery kit is higher than that of Kami women. It is also revels from
data that of percentage of women in using clean home delivery kit is increases according
to their educational level. It is wonderful fact that most of the women of selected area
had knowledge about delivery kit but they didn't use it.
4.2.2
Reasons Behind Non-using Safe Delivery Kit
The reason behind this is given in the following table:

Table 5: Reasons behind Non-Using of Safe Delivery Kit
Lack of time
Lack of using
knowledge
Difficult to get it
Total
12
24
68.57
25
28
53
74.64
Primary
25.71
12
15
21.12
L.Sec
5.71
4.22
Sec
Higher
10
18
35
33
40
71
100
Total
10
18
35
100
31
40
71
100
Lack of using
knowledge
Illiterate
Lack of time
Kami
Total
Damai
Difficult to get it
Educational Status
Reasons behind non-using of safe delivery kit
Table 5 shows that many of illiterate Damai and kami women haven't knowledge about
use of clean home delivery whose 51.42 percent (18 out of 35) respectively. One the
other hand 28.57 percent (10 out of 35) of Damai women and 43.66 percent (31 out of
71) of Kami women haven't time to bring safe delivery kit. It is also clear 40 percent of
Damai women and same percent of Kami women having primary level education had
lack of knowledge about using of safe delivery kit.
21
Reason behind this is that there is a lack of sufficient health facilities and health workers
by, which they are unable to get knowledge about using of clean and safe delivery kit.
There is not regular field visit by the health workers because of the rural and remote
area and carelessness towards low castes. Thus there are so many factors responsible in
using of clean and safe delivery.
To solve these problems, INGOs, NGOs and other health relating organizations should
conduct effectively different programmed to make them aware about using of delivery
kit. Especially these programmed must be conducted for married women to make them
careful about safe delivery and reproductive health in selected area.
4.2.3
Cord Cutting Instruments
Cord cutting instrument is closely with infant mortality because using the bad
Instrument of dirty instrument there is the possibility of infection different diseases in
which tetanus is common in them. So it is necessary to know about the instrument using
in cord cutting. So Researcher collected much information about it, which is present in
following data.
Table 6 : Cord Cutting Instruments
Cord Cutter Assistants
Selected Delivery Cord Cutting Instruments

Damai
Kami
Total
Old Blade
5.71
4.22
4.71
New Blade
14.28
12.26
13
1.22
Knife
5.71
5.63
5.66
Sterilize blade
23
65.71
54
76.05
77
72.64
Sizor
8.57
2.81
4.71
Total
35
100
71
100
106
100
22
Figure 3 : Cord Cutting Instruments
Damai
60
Kami
50
40
30
20
10
0
Old Blade
New Blade
Knife
Sterilize
blade
Sizor
Table 6 shows that there is a majority of Damai women, which had use new blade for
cutting cord likewise, Kami women had also use new blade whose percentage are 14.26
percent and 12.26 percent respectively. According to data only 65.71 percent Damai
women and 76.05 percent Kami women had used sterilize blade for cutting cord. On
the hand 5.71 percent Damai women and 4.22 percent Kami women had used old blade
for cutting cord.
Reason behind this is that they haven't knowledge about the infection of different
diseases by using dirty or non-sterilize instruments and sharp things for cord cutting
practice. To solve this problem it is necessary to make them aware about the infection
of such diseases and risky factors relating to it.
4.1.4
Each year increasing the percentage of births delivered in health facilities is important
for reducing deaths arising from complications of pregnancy. The expiration is that if
complications arise during delivery in a health facility, a skilled attendant can manage
the complication or refer the mother early to the next level of care. Hence, Nepal is
promoting safe motherhood through initiatives such as providing financial assistance
through maternity incentives schemes to women seeking skilled delivery care in a
23
health facilities Subsidies are also provided to health institution on the basis of
deliveries conducted. So, the researcher wants to know about home delivery
complications during delivery and after delivery which is show in the following table:
Table 7 : Home delivery Complications
Educational Status
Bleeding
Fever
No Complication
Total
Bleeding
Fever
No Complication
Total
Illiterate
13
19
54.28
31
15
47
66.19
Primary
22.85
12
16.90
L.Sec
17.14
12
16.90
Sec
5.71
4.22
Higher
25
35
45
71
100
Total
Damai
Kami
100
Figure 4 : How delivery Complications

Damai Bleeding
Damai No complication
Kami Fever
50
45
40
35
30
25
20
15
10
5
0
Illiterate
Primary
L.Sec
Damai Fever
Kami Bleeding
Kami No complication
Sec
Higher
Total
24
Table 7 shows that higher population of literate and illiterate Damai and Kami women
had bleeding complication during delivery which is 71.42 (25 out of 35) and 63.38 (45
out of 71) percentage respectively. According to table it is also clear that both literate
and illiterate women of both castes during delivery had same complications. On the
other hand, comparing these data with national level data, these data are significant
because acceding to national data 32.14 percent women have bleeding complication
during delivery.
4.2.5
Age at Marriage
The median age at first birth is about 20 years across all cohorts, indicating virtually no
change in the age at first birth over the past two decades. More than 70 percentage of
women in all age cohorts had their first birth by age 22; with the proportion of women
having their first birth by age 22 decline with increasing age of the mother. About 90
percent of Nepalese women have pregnant with their first child. The proportion of
teenage women (13-20 years) who have started childbearing increases from 1
percentage among women age 15 to 41 percentage among women age 19 (NDHS,
2013). the age at marriage is determined by the socio- economic condition and cultural
concepts of the community. The age at marriage of female in selected castes can be
tabulated below.
Table 8 : Education status below 0-5 Children's mother age
Age at marriage

Damai
Kami
Total
Below 15 Years
62.85
8.45
0.75
15-20 years
22.85
18
25.35
26
24.52
20-22 years
21
2.85
35
49.29
56
5.28
22 years above
11.42
12
16.90
16
15.09
Total
35
100
71
100
106
100
25
Figure 5 : Education status below 0-5 Children's mother age
Damai
Kami
40
35
30
25
20
15
10
5
0
Below 15 Years
15-20 years
20-22 years
22 years above
Table 8 shows that most of the females of selected castes get married at the age of below
15 years which is 21.35 percent. The percentage of female who get married at the age
below or above is very low which is clear from data comparatively, the percentage of
getting married of kami at the age of below 15 years is higher than that of Damai. But
according to national data only 11.45 percent female get married at the age of below 15
castes who get married below 20-22 years is very higher than that of national level data.
On the basis of above data it is clear that age at marriage is determined by the various
factors such as socio-economic status, traditional concepts, lack of knowledge about
the effects of early marriage etc. Due to these reasons they cannot determine their
appropriate age traditional concepts and superstitions.
4.2.6
Appropriate marriage age
Age at first marriage is defined as the age at which the respondent began living with
her or is first spouse/partner. Marriage occurs relatively early in Nepal; among women
age (25-49) 55 percent were married by age 18. and 74 percent were married by age 20.
The median age at first marriage among women age 25-49 is 18 percentage years. The
proportion of women married by age 15 declines from 24 percent among those ages 4549 to 5 percent among age at first marriage among men age 25-49 is 22 percen years.
26
34 percent of men age 25-29 were married by age 20, compared with 69 percent of
women in the same age group. Only 11 percent men age 20-24 were married by age 18,
as compared with 41 percent of women in the same age group. By age 25, 80 percent
of men age 45-49 are married, compared with 95 percent of women. 15-19 indicating
clear evidence of a rising age at first marriage (NDHA, 2013) The appropriate marriage
age according to female of selected castes is tabulated as below;
Table 9 : Appropriate Marriage
As at marriage

Damai
Kami
Total
15-20 years
10
28.57
38
53.52
48
45.28
20-22 years
21
47.42
22
3.09
43
40.56
22 years above
6.00
11
15.49
15
14.15
Total
35
100
71
100
106
100
Below 15 Years
Figure 6 : Appropriate Marriage

Damai
40
Kami
35
30
25
20
15
10
5
0
Below 15 Years
15-20 years
20-22 years
22 years above
Table 9 shows that majority of women respondents are on the support of below 15 years
and minorities of them are above. 22 years for appropriate age at marriage. On
comparing these castes to each other, high percentage of Kami gave their opinions about
27
early marriage than that of Damai. The main reason behind this is that, Kami women
are more illiterate than that the Damai women and they are involving in metal works
where they feel the shortage of workers. To wipe out this problem, it is necessary to
alter their attitudes bounded by superstitions and they should be aware in related field.
Marriage may be solemnized according to the customs and usages of the individual's
religion, castes, community or family provide that those customs do not violate any of
the law's provisions. The minimum legal age for marriage in Nepal is 21 for men and
18 for women. Men and women is at least 18 and women is at least 18 and women is at
least 16 years of age.
4.2.7
First Pregnancy
The onset of childbearing at an early age has a major effect on the health of both mother
and child. It also lengthens the reproductive period, there by increasing the level of
fertility. In this thesis shows the median age at first birth and the percentage of women
who gave birth by exact ages, according to current age. The median age at first birth is
20 years for the youngest cohort of women (age 25-29) for whom a median age can be
computed. Almost one-quarter of Nepalese women 23 percentage have given birth
before reaching age 18, while about half given birth age 20. The median age at first
birth is about 20 years across all age cohorts, indicating virtually no change in age at
first birth over time.
Table 10 : First Pregnancy
Age at marriage

Damai
Kami
Total
15-20 years
10
28.57
38
53.52
48
45.28
20-22 years
21
47.42
22
3.09
43
40.56
22 years above
6.00
11
15.49
15
14.15
Total
35
100
71
100
106
100
Below 15 Years
Table 10 shows that all of the Damai and Kami women having first baby around the
15-20 years which percentages are 28.57 and 53.52 percent respectively. On comparing
these data, with each other higher percentage of kami women have get first baby in
28
early ages than Damai women. The median age at first birth is slightly higher in urban
areas than is rural areas. Likewise, median age at first birth is slightly higher in the hill
zone than in the other ecological zones. Median age at first birth is highest in the eastern
region. 21 years and lowest in the Dar-western region (20 years. women living in the
Far-western terai sub region have the lowest media age at first birth 20 years. Median
age at first birth increases with education. with the impact of education more obvious
among women with an SLC or higher education. Women with a primary education or
no education give birth to their first child four years earlier than women who have an
SLC or higher education (NDHS,2011).
On the basis of above data, it can be concluding that social and cultural norms are
responsible for determining early marriage. To avoid this problem, they should be made
aware about the appropriate age marriage and which age is suitable for to get first baby
by conducting different programmed and avoiding the traditional concepts from them
by giving different examples.
4.2.8
Birth Spacing
Birth interval is the length of time between two successive live births. Information on
birth internals provides insight into birth spacing patterns, which affect fertility as
wellas maternal, infant, and childhood mortality. Studies have shown that short birth
intervals as associated with increased risk of death for mother and baby, particularly
when the birth interval is less than 24 months.
Table 11: Births Spacing Practices
Birth spacing (Year)

Damai
Kami
Total
One year
5.71
5.63
7.54
Two- three
13
37.14
24
33.80
37
34.90
Three-four
11
31.42
32
45.07
43
40.56
Above Five
25.71
11
15.49
20
18.86
Total
35
100
71
100
106
100
Above data clear that selected groups of women prefer for birth spacing three to four
years. Which percentage are 31.42 percent and 45.07 percent respectively ? the percent
29
distribution of first births in the five years preceding the survey by number of months,
since the preceding birth according to background characteristics. The median birth
interval in Nepal is 3 years, an increase from 2 years 6 months in 2011. Median number
of months since a preceding birth increases significantly with age, from 2 years 6
months among age 20-29 to 4 years among Mother age 40-49. There is no marked
difference in the length of the median birth interval by birth order or sexes of the
preceding birth. Studies have shown that the death of a preceding child leads to a shorter
birth interval than when the preceding child survived. The median birth interval is
almost 11 months shorter among births in which the previous sibling is dead than among
births in which the previous sibling is alive here. This Difference in birth interval may
be due to the desire of parents to replace a dead child as well as the loss of the fertility
delaying effects of breast feeding. Five years gaping is due to the shifting husband to
abroad which in proof by research.
According to the 2011 NDHS data, birth intervals are slightly longer in urban 3 years
than in rural areas. There are no make differences in median birth intervals by
ecological zones. The median birth interval is longest in the Western region. Birth
intervals are longer in the western terai and western hill sub regions than in the other
sub regions. Birth interval increases with education from 3 years among women with
no education to 3 years 6 months among women with an SLC or above. Similarly birth
interval increases with wealth. the birth interval for the highest wealth quintile is nearly
4 years, where as for all other quintiles it is 2 years or less (NFHS,2011).
4.2.9
Time Duration of Health Check up During Pregnancy
Regular antenatal care is helpful in identifying and preventing adverse pregnancy

outcomes when it is thought early in the pregnancy and is continue through delivery.
Who recommends that a woman should have at least four ANC visits? It is possible
during these visits to detect health problems associated with a pregnancy. In the even
of any complications, more frequent visit are advised and admission to a health facility
may be necessary (NDHS,2013).
Reminding this fact, the researcher very eager to know about duration of health check
up during pregnancy and had collected information's about it, which can be, represent
in the table.
30
Table 12: Time Duration o of Health Check Up During Pregnancy
Time Duration of Health
Education status below 0-5 Children's mother
check up During Pregnancy
age
Damai
Kami
Total
One time
15
42.85
23
32.39
38
35.84
Two time
25.71
17
38.02
36
33.96
Three time
20.00
12
16.90
19
17.92
Four time
11.42
97.10
13
12.26
Total
35
100
71
100
106
100
Table 12 shows that most of women of Damai and Kami had checked up their health
one or two times during the pregnancy. According to above data 42.82 percent and
32.39 percent Damai and Kami women had checked up their health only one times
during pregnancy. Comparatively, the percentage of Damai women is higher than that
of Kami women in checking up health during pregnancy. In selected area, only 11.42
percent Damai and 97.10 percent Kami women had checked up their health four times
during pregnancy. The number of anternatal visits and the timing of the first anteratal
visit for the most recent birth in the five years preceding the survey. The findings show
that 50 percent of pregnant women make four or more anternatal care visits during their
entire pregnancy. Urban women 72 percent are more likely to have had four or more
anternatal visit than rural women 48 percent. Fifty percent of women made their first
anternatal care visit before the 4 months of pregnancy. The median duration of
pregnancy at the first anternatal care visit was 3.7 months (3.4 months in urban areas
and 3.8 months in rural areas). Over the pat 15 years, there has been a five-fold increase
in the percentage of women with four or more anternatal visit during their pregnancy.
Besides these, they have so many other problems by which they are unable to check up
there during pregnancy period. To solve these problem s, governmental and nongovernment organizations should conduct special programmed for married women,
which are beyond the school education.
31
4.2.10 Pregnancy Complications
500,000 women each year 210 million women become pregnant around the world and
more than are estimated to have death in after delivery and child birth because of their
low health practice during pregnancy many problems are created at the time of delivery
and child birth (DHS, 2000). Keeping this mind, I want to know about complications
during pregnancy which is show in the following table.
Table 13: Pregnancy Complications
Pregnancy Complication

Damai
Kami
Total
Yes
10
28.57
21
29.57
31
29.24
No
25
7.14
55
77.46
80
75.47
Total
35
100
71
100
106
100
Table 13 shows that there is the most of the people of selected casts having no
complication of pregnancy 75.49 (89 out of 106) and having complication of pregnancy
which is 29.24 percent. Comparatively, the Damai women have more complication of
pregnancy than Kami women which is 13.3 percent and 12.5 percent respectively. But
both ethics have lack of knowledge about the pregnancy, the reason behind this is that
they are people of back warded community and on any programmed were conducted in
they selected area to promote their knowledge about pregnancy.
4.2.11 Problems Related to Pregnancy
Selected community of selected area is very back warded. There are many effective
factors relating to pregnancy, which are responsible for the maternal and child death.
So, researcher had collected information's about problems relating to pregnancy period
are presented in the following table:
32
Table 14: Problems Related to Pregnancy
Pregnancy Complication

Damai
Kami
Total
Bleeding
22.85
16
22.53
24
22.64
Shock
12
34.28
24
33.80
36
33.96
Headache
14.28
10
14.08
15
14.15
All of above
10
28.57
21
29.57
31
29.24
Total
35
100
71
100
106
100
Figure 7: Problems Related to Pregnancy

Damai
30
Kami
25
20
15
10
5
0
Bleeding
Shock
Headache
All of above
Table 14 shows that there is a literate illiterate Damai and Kami women had headache
complication during pregnancy which is 22.64 percent and 33.96 percent respectively.
According to data it is also clear that both literate and illiterate women of both castes
during pregnancy had some complications. it is the matter of sorrow that most of the
selected are had different types of complications during pregnancy. Reason behind this
is that they were all most the uneducated so they haven't knowledge about the problem
related to pregnancy. To solve this problem it is necessary to make them aware about
the complication of pregnancy.
33
4.3
Delivery Spot
Increasing the percentage of birth delivered in health facilities is important for reducing
deaths arising from complications of pregnancy. The expectation is that if complication
arise during delivery in a health facility, a skilled attendant can manage the
complication or refer the mother early to the next level of care. Hence, Nepal is
promoting safe motherhood through initiatives such as providing financial assistance
through maternity incentives schemes to women seeking skilled delivery care in a
health facility. Subsidies are also provided to health institutions on the basis of
deliveries conducted.
Delivery spot plays vital role delivery to save the life of mother and child. So the
appropriate selection of delivery spot is necessary. The spot used by the mothers of
selected castes during delivery is present with the help of following data:
Table 15 : Relationship between Educational Status and Delivery Spot
At Health post
Total
42.85
7.14
58.33
15
25.42
22
Primary
28.57
17.85
25.00
10
23.72
13
L.Sec
14.2
21.42
8.33
15
25.42
16
Sec
14.2
25.00
8.33
15
25.42
Higher
7.14
6.77
Total
100
28
100
35
12
100
59
100
71
Illiterate
At home
At home
Kami
Total
Damai
At Health post
Educational Status
Delivery Spot of Selected Castes
Table 15 revels that there is majority of Damai and Kami women had delivered at home
both literate and illiterate. According to the presented data in word (37 out to 37) in
8.57 percent and 14.28 percent illiterate Damai women had delivered at home and
hospital respectively. Where the percentage of illiterate Kami women had delivered at
34
home and health post is 9.85 and 21.12 percent respectively. Comparatively, the
delivery practice of Damai women is better than of Kami women, comparing these data
with national level data, only thirty-five percent of births take place in a health facility:
26 percent are delivered in a public -sector health facilities, 2 percent in a nongovernmental facility and 7 percent in private facility. Still two-thirds of births take
place at home. Delivery in a health facility is more common among mothers less than
age 34 percent (35-41%) and mothers of first order births. Children in urban areas are
more than twice as likely 71 percent to be delivered in an institutional setting as children
born in rural areas 32 percent. Delivery in a health facility varies widely by ecological
region, being lowest in the mountain zone 19 percent and highest and Mid-western
regions to a high of 40 percent in the eastern region and they are most frequent in the
eastern Terai sub region, where one of two mothers has a facility- based delivery. There
is a strong association between health facility delivery, mother's education and wealth
quintile. The proportion of deliveries in a health facility is nearly four times higher
among births to mothers with an SLC and higher education 75 percent than among
births to mothers with no education 19 percent. A similar pattern is seen in terms of
wealth quintile: delivery at a health facility is significantly lower among births in the
lowest wealth quintile 11 percent than in the highest wealth quintile 78 percent (NDHS,
2011).
To raise their percentage in taking health facilities during their delivery practices, it is
necessary to raise their economy status by conducting different programmed relating to
it. Similarly, it sis equally important exterminate their traditional and cultural concepts
about delivery by different ways. Not only these, but government should conduct
different programmed relating to delivery case by sending skilled health personnel. it
is also necessary to make them aware about risky factors during delivery and good
effects by attempt delivery practice at hospital by conducting different types of
interesting programmed. By doing so, it is hoped that they became fully aware about
their health and their inclination may be increased in attempt their delivery practices at
hospital rather than at home.
35
4.3.1
Assistance during Delivery
Assistance by skilled health personal during delivery is considered to be effective in the

reduction of maternal and neonatal mortality. Births delivered at home are usually more
likely to be delivered without assistance from a health professional, whereas births
delivered at health facilities are more likely to be delivered by health personnel with a
least minimum training in the provision of normal delivery services (CBS, 2013).
Obstetric care form a health professional during delivery is recognized at home are
usually more likely to be delivered without assistance from a trained prodder, whereas
children delivered at a health facility are more likely to be delivered by trained health
professional. Delivery assistance by type of provider according to background
characteristics, More than one-third (36 percentage) of births take place with the
assistance of a skilled birth attendant(SBA), which includes doctor, nurse or midwife.
Health assistants or AHWs assist in the delivery of 4 percentage of births, FCHVs assist
in 3 percentage, and traditional births to mothers less than age 20 and first-order births
(42 percentage and 55 percentage, respectively) are more likely to be assisted by an
SBA. Not surprisingly, substantially more births delivered in a health facility than births
delivered elsewhere are attended by a SBA. Seventy- three percent of urban births are
assisted by an SBA, compared with 32 percentage of births in rural areas. Births in the
terai and particularly in the eastern terai sub region are more likely to be attended by an
SBA than births in other areas. The percentage of births assisted at delivery by an SBA
has almost doubled in the last five years (from 19 percent in 2006 to 36 percent in 2013),
while the percentage of births assisted by relatives and others has declined (from 50
percent to 40 percent). Also noteworthy is the fact that delivery assistance by an SBA
in rural areas has more than doubled in the last five years, from 14 percent to 32 percent,
(NDHS, 2013).
There are many assistants like health personnel family member, neighbor and sudheni
or Traditional Birth Attendants (TBA). The Damai and Kami women had taken
assistances by different persons during delivery, which is presented in the following
table.
36
Table 16: Relationship between Educational Status and Assistance During
Delivery
Neighbor
Total
Percentage
Family Member
TBA
Neighbor
Total
Percentage
Kami
TBA
Damai
Family Member
Educational Status
Use of Delivery Place
Illiterate
14
23
65.71
21
26
59
7.04
Primary
22.85
10
14.08
L.Sec
8.57
8.45
Sec
2.85
1.40
Higher
Total
10
20
35
35
21
12
38
71
100
Table 16 shows that all of the women of Damai and Kami community had delivered by
the assistance of family member, relatives, neighbors and TBAs, In one had delivered
by the assistance of health personnel. According to above data, it reveals that (5 out of
35) 14.28 percent Damai women and (21 out of 71) 29.57 percent Kamai women had
delivered by the assistance of family members. Whereas 28,57 percent (10 out of 35)
Damai and 16.90 percent (12 out of 71) Kami women had delivered by the assistance
of traditional birth attendants.
In The selected area, there is only some of Damai and Kami women had delivered by
the assistance of neighbor and relatives, which is 57.14 percent (20 out of 35) and 53.52
(38 out of 71) Kami respectively. Comparing these data with national level data 57.5
percent women delivery with the assistance of friends and relatives. So these data are
seen significant. The reason behind this is that in that their first deliver at the age of 16
to 30. They should their shyness to take assistance by their family member as well as
health personnel during their delivery.
37
4.3.2
Antenatal Care Provider
Antenatal care is of vital important to a pregnant woman. These preventative checks

throughout the forty weeks of pregnancy are of prime importance to ensure and
wellbeing of not just the baby so health check up during pregnancy is necessary for the
health of the mother as well as fetus.
58 percent of mothers received antenatal care from a skilled provider (a docter, nurse,
or midwife) for their most recent birth in the five years preceding the survey. In
addition, 26 percent of mothers received antenatal cer from trained health workers such
as a health assistant or auxiliary health worker (AHW), a maternal and child health
worker (MCHW), or a village health worker (VHW), Less than 1 percent of women
received anternatal cares from a female community health volunteer (FCHV),
(NDHS,2013).
Table 17: Get Antenatal Check Up during pregnancy period
Get ANC check up from

Damai
Kami
Total
Doctor
24
68.57
46
64.78
72
67.92
CHW
20.00
16
22.53
22
20.75
Sudheni
5.71
9.85
8.49
Others
5.71
2.81
3.77
Total
35
100
71
100
106
100
Table 17 shows that 40 percent Damai women had check up during the pregnancy
period from the Doctor and 68.57 Damai women had check up during the pregnancy
period from the Doctor. But only 64.78 percent of Damai and Kami women have check
up during the pregnancy period from the CHW. 20 percent women in selected 8are
having ANC check up during the pregnancy period depends on CHW and 8.49 percent
to checkup Sudhani. There are large differences in the use of antenatal care services
between urban and rural women. Eighty-eight percent of urban mothers received
antenatal care from a skilled provider, compared with only 55 percent of mothers in the
hill zone and 52 percent of rural mothers. Sixty three percent of mothers living in the
terai received antenatal care from a skilled provider, compared with 53 percent of
38
mothers in the hill zone and 52 percent of mothers in the mountain zone. About 60
percent of mothers living in the far-western, Eastern, and western regions received
antenatal care from a skilled provider. Less than 55 percent of more living in the Midwestern region received antenatal care from a skilled provider. The proportion of
women who received an antenatal care from a skilled provider was lowest in the Midwestern hill sub region and highest in the western terai and far western terai sub regions.
The use of antenatal care services from a skilled provider is strongly related to the
mother's level of education. Women with a school leaving certificate and higher are
more than twice as likely to received antenatal care from a skilled provider as women
with no education similarly, women in the highest wealth quintile are also not there
times as likely to received care from a skilled provider as women in the lowest wealth
educational. The proportion of women receiving antenatal care from a skilled provider
has more than doubled in the past 15 years, from 24 percent in 1996 to 58 percent in
2011 (NDHS, 2011).
4.3.3
Cord Cutting Services
It is necessary to cut cord after the birth of baby. But it should be done carefully because
it is a risk and there may be possibility of infection different kinds of disease. It is
necessary that cord cutter assistance have sufficient knowledge about cutting cord.
Point of view reproductive health, health personnel having sufficient knowledge about
it to remove possible risks and infection of different diseases should cut the cord. So I
am very keen to know about cord cutter assistance of neonatal taking birth at home,
which is given with the help of following data.
Table 18: Cord Cutter Assistants of Damai and Kami Community
Cord Cutter Assistants
Selected Castes
Damai
Kami
Total
Family Member
1.42
7.04
10
9.43
Sudheni
10
28.57
16
22.53
26
24.52
Neighbors
14.28
4.22
7.54
Health worker
42.85
47
66.19
62
58.49
Total
35
100
71
100
106
100
39
Figure 8: Cord Cutter Assistants of Damai and Kami Community
50
Damai
45
Kami
40
35
30
25
20
15
10
5
0
Family Member
Sudheni
Neighbors
Health worker
Table 18 shows that there is a majority of Damai and Kami women in cutting cord by
the assistance of their relative neighbors both literate and illiterate whose percentage
are 14.28 and 4.22 percent respectively. Likewise 40 percent Damai and 20 percent
Kami women having their family member are cord cutting assistants. According to data
it is also clear that 28.51 percent Damai and 22.53 percent Kami women have taken
assistance by Sudheni in cord cutting practice. Comparatively, there is same practice in
cord cutting of both castes. Reason behind is that they are unknown about risky factors
of cord cutting practices.
To solve this problem, it is necessary to make them about risky factors relating to cord
cutting practices and possibility of infection of different dangerous diseases by
conducting different programmed by field visit of skilled health personnel.
4.3.4
Types of Food Taking Practices after Delivery
Generally, women needs balance food after delivery for good health of mother and
child. But in case of our country, especially in village and rural area women after
delivery are not allowed to take balance food like meat, fish, fruits and different kinds
of deals etc. They show the negative effect towards these foods. On the other hand due
to poor economic status they are unable to take such expensive foods. So there is the
40
majority of women and birth child, which become the victim of malnutrition. Keeping
these things in mind, researcher had collected information about the food taken after
delivery by the women of selected area, which are present in the following table:
Table 19: Food Taking Practices after delivery
Educational Status
Balance Food
Simple Food
without salt
Others
Total
Balance Food
Simple Food
without salt
Others
Total
Food Taking Practices During Delivery

Damai
Kami
Illiterate
17
22
62.85
18
23
32.39
Primary
1.70
16
1.40
L.Sec
11.42
12
22
0.28
Sec
8.57
20
28.16
Higher
4.71
10
14.08
Total
24
35
100
28
45
71
100
Table 19 shows that higher population of Damai and Kami women in taking simple
food without salt without salt both literate and illiterate whose total 106 women Damai
and Kami cast's (45 out of 71) 42.45 percent Damai respectively and (only 8 out of 35)
1.54 percent Kami women had taken balance food after delivery, which is very low
percent. On the study of data, it is shown that the educational status of delivered women
is positively related with their food taking practice after delivery. But it is also found
that only educational status is not sufficient for this practice because most of the
illiterate women had taken balance food after their delivery. The reason behind this is
that most of the people of selected area had poor economic status, traditional and
cultural concepts about taking food after delivery and lack of knowledge about taking
food and selection of food during this period also responsible for this practice. The
opinion of most of the people selected area is that meat, eggs, fruits etc. are harmful for
delivered women and birthing child. Women and they had poor economic status. To
raise their percentage in taking food during delivery period they should be made aware
41
about their health condition during delivery period, good effects by taking more food
and bad effects by undoing so during delivery period.
4.3.5
Antenatal care (ANC) from a skilled provider is important to monitor the pregnancy
and reduce the risk if morbidity for mother and baby during pregnancy and delivery.
The quality of antenatal care can be monitored through the content of services received
and the kind of information mothers are given during their visit. Information on ANC
coverage was obtained from women who gave birth in the fie years preceding the
survey. Among women with two or more live births during the five years period, data
refer to the most recent birth only. Health check up during pregnancy is very important
for the health of mother and fetus. it is necessary from conception to delivery. The who
recommends that a woman without complications have at least four ANC visit to
provide sufficient antenatal care. It is possible during these visit to detect health
problems associated with a pregnancy. The percentage of woman made four or more
antenatal visits during their pregnancy tripled during 10 years, from 9 percent in 1999,
14 percent 2005 and 29 percent in 2013 (NDHS, 2013).
Table 20: Health Checks up During pregnancy

Damai
Kami
Total
Sub- help post
11.42
12.67
13
12.26
Health post
20.00
16
22.53
23
21.69
Hospital
24
68.57
46
64.78
70
66.03
Total
35
100
71
100
106
100
42
Figure 9: Health Checks up During pregnancy
50
Damai
45
Kami
40
35
30
25
20
15
10
5
0
Sub- help post
Health post
Hospital
On the basis of table 20 we can say that there is the most of women having ANC check
up at the Hospital which is 66.03 (46 out of 106) comparatively, Kami women having
more health ANC check up in the Hospital than Damai women whose percentage is
68.78 (24 out of 35) percent 64.78 (46 out of 71) respectively. According to above data,
it reveals that 30.8 percent Damai women and 12.5 percent Kami women having ANC
check up at the health post. Where as only 18.57 percent Damai women and 64.78
percent Kami women having ANC check up at the Health post. Reason behind there is
a lack of sufficient health facilities so all are having ANC check up at the Hospital.
43
CHAPTER-V
SUMMARY, FINDING, CONCLUSIONS AND RECOMMENDATIONS
5.1
Summary
Safe delivery practices is the most maternal and child health. By the appropriate
delivery practices maternal and infant mortality rate should be reduced. But socioeconomic status, cultural concepts, educational status and others various factors affects
on safe delivery practices by which the rate of maternal and infant mortality is
increased.
Nepalese women are suffering from many problems related to prenatal and postnatal
care; such problems affect the status of Nepalese women. Most of the rural women are
illiterate and their access to health facilities is negligible.
The presented study is the comparative study of educational status of women and its
impact on delivery practices. It was conducted in Damai and Kami women of
Ghasikuwa VDC, Tanahun district. The main objective of study was to find out
educational impact on delivery practices in Damai and Kami women.
In this study, the researcher has applied descriptive types and the study was based on
primary data. The researcher had applied purposive sampling method to collect data.
The researcher had selected (35 to 71=106) women respondents of both castes. The
researcher had made door-to door visiting in order to collect necessary information with
the help of interview method.
The researcher had collected the essential information's regarding socio-economic
status antenatal case delivery practices problems related to delivery.
After collecting all the necessary data, they were tabulated on master chart and were
later analyzed and interpreted with the help table.
44
5.2
Findings
On the basis of data analysis and interpretation, the following major findings have been
found.
5.2.1 There is the majority of Damai and Kami are entire dependent of agriculture.
The main sources of income are derived from agriculture.
5.2.2 It is found that there is the majority of illiteracy of Damai and Kami. According
to data 56.67 percent Damai women and 71.60 percent Kami women are
illiterate. Comparatively, Dami women are more illiterate than Kami women.
5.2.3 Most of the female of selected castes had god married at the age of below 15
years, which is 53.30% where percentage of Damai is 43.33 below 15 years,
which is 53.30 percent where percentage of Dama is 43.33 and percentage of
Kami is 63.33 percent. Comparatively; the percent age of Kami getting married
at the age of 15 years is higher than that of Dami.
5.2.4 There is the majority of respondents giving their opinions about the appropriate
age of marriage is below 15 below 15 years, which is 35.00 percent of both ethics
and 20,00 percent said is 20-22.
5.2.5 In the sleeted area, It is found that there is majority of Damai and Kami women
bearing her child at the age 15-20 years, which is 15-20 years which is 18.22
percent and 64 percent are 58 percent respectively. The percentage of child
veering below 15 years is also high which 8 percent of Damai and Kami is
comparatively, Kami women had bearded child below 15 years than that of
Damai.
5.2.6 In the selected area, most of the Damai and Kami women had knowledge about
family planning which percentage is in total 80 percent.
5.2.7 There are majority people in the selected area no using family planning which is
80 percent Damai and 60 percent area no using family which 73 percent
5.2.8 Damai and 60 percent Kami women. Comparative. Kami women have no use
family planning due to the shame.
5.2.9 In the selected area, most of the Damai and Kami women had check up their
health during their pregnancy at the health-post which percent is 49.20.
45
5.2.10 Most of the women of selected area are unable to check up their health during
pregnancy our to the shame and lack of knowledge which percentage are 46.11
and 49.21 percent respectively.
5.2.11 In the selected area, only 12.26 (13 out of 106) Damai and Kami women had
checked up their health four times during their pregnancy.
5.2.12 It is found that, most of the Damai and Kami women have taken T.T. vaccine
during pregnancy which is 44.2 percent and 38.35 percent respectively. Most of
the literate women had also taken T.T. vaccine during pregnancy period.
5.2.13 In the selected area, there is the majority of Damai and Kami in delivering their
babies at home where percent is 42.85 (3 out of 7) and 58.33 (7 out of 12) percent
respectively. On the basis of data analyzing it is also clear that educational status
of women effects of their delivery practices because most of the higher education
women had delivered their babies at hospital.
5.2.14 In the selected area, most of the respondent had reported that mother in -Low
and Sudheni helped then at the time of delivered which percentage is 5.71
percent and 9.85 respectively.
5.2.15 In the study area, most of the Damai and Kami women had knowledge about
safe delivery for taking then in hospital whose percent is 68.57 and 64.78 Damai
and Kami .
5.2.16 Most of the Damai and Kami women had used new blade for cutting purpose,
which is 14.28 percent where most of the Kami women had used sharp things
for purpose which is 12.26 percent.
5.2.17 In the selected area, 62.85 (22 out of 35) Damai and 32.39 (23 out of 71) Kami
women had taken more food during their delivery period than usual.
Comparatively, Damai women had taken more food during their delivery period
than Kami women.
5.3
Conclusions
5.3.1 In the study area most of the people depend on agriculture but some of the people
also depend on their traditional occupations on the basis of this statement we can
conclude that their economic status is very low.
46
5.3.2 In the study area, most of the male and female of selected castes are illiterate .By
the reasons they are ignorance about modern health practices.
5.3.3 Few of the women of selected castes had consulted health workers during
pregnancy both literate and illiterate but comparatively the percentage of
illiterate. Most of the women had checked up their health only once or twice
during pregnancy. On the basis of this statement it is concluded that educational
and economic status is most responsible doing so.
5.3.4 Most of the literate and illiterate women got married at the age of below 15 years
of both castes. By which they are facing various health problems relating to the
reproductive health.
5.3.5 In the study area, most of the women had used unutilized blade and sharp things
for cord culling purpose of their baby .Most of the illiterate Kami had used sharp
things for this purpose.
5.3.6 Most of the women had feed colostrums to their newly born babies. On the other
hand, most but literate women had long duration of breast milk feeding practices.
5.3.7 Most of the women had immunized their babies but they havent given all
immunizations to them due to lack of knowledge and lack of health facilities.
5.3.8 In the study area, it is found that most of the women had lack of knowledge about
safe delivery both literate and illiterate.
As a conclusion. We can say that literate women had good delivery practices than
illiterate women. Comparatively, Damai women had good delivery practices than Kami
because of their because of their good economic status and educational status and
educational status than Kami.
5.4
Recommendations
5.4.1
Recommendations for Improvement
On the basis of the study, following recommendations are given below:

i.
This type of study should be concluded to provide the information about the
modern health facilities practice.
ii.
The research could be conducted to aware the people for bad effect of the early
marriage.
47
iii.
This type of study should be concluded to find out the delivery practices in
different parts or among different community of the country.
iv.
The research could be conducted at health post and hospital to find out available
facilities and their co-operation.
v.
The research could be conducted among women and TBAS who help during
delivery to find out their knowledge and perception about safe delivery.
vi.
Study on promoting MCH care and delivery practices should be conducted in

the selected area.
vii.
Public awareness programs should be launched especially for women related to

their individual and community health.
This type of study should be concluded to change the traditional habits related to
delivery practices.
5.4.2
Recommendation for Future Study
The similar study can be conducted in other area or VDC.

i.
In-depth study can be contended relating to single socio-economic variable to

observe the level of impacts to fertility by education.
ii.
Such study can be conducted in specific caste in this area or VDC.
iii.
This is quantitative research but qualitative research can conduct in this area.
iv.
Other types of mathematical test can be done for such research.
v.
Comparative study on pregnancy and delivery practice on adult and young

women can be done.
48
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Kathmandu" Unpublished Master's thesis submitted to HPPW, FOE, T.U.
Kirtipur.
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MOH (2001). Nepal Demographic and Health Survey. Family Health Division,
Department of Health, Ministry of Health: Kathmandu
MoHP (2008). Annual Report. MoHP, Nepal.
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NDHS (2001). Nepal Demographic and Health Survey. New Era, Central Bureau of
Statistics (2001). Population Census 2001. National Report, Kathmandu.
NDHS (2006). Executive Summary of Annual Report.
Ogunlayi, M.A. (2005). An assessment of the awareness of sexual and reporudctive
right among adolescents in South Western, WHARC. Retrieved: January,
21, 2010 from (http://;law.jrank.org/pages/1249/reproductive right.htm/).
Pokhrel, S. (2006). School based sex education in western Nepal. In Reproductive
Health Matters. Vol. 14.
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UNICEF
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7, 2010 From (www.womendelivery.org/youth/pdf/asia.pdf).
51
Appendix-I
Questionnaire
A Comparative Study of Delivery Practice among Women in a Dalit Community
Ghasikuwa VDC Tanahun
Interview date:
House hold no.
Name of the house head:
Education
Ward no.
1.
Illiterate
Age
2.
Literate
Name of the respondent
3.
Primary
Occupation
4.
Lower
Religion.
5.
Secondary
6.
Higher
A.
Socio-economic Aspect
a.
Individual Questions
1.
How old are you?

Years .. Months
2.
3.
What is your caste?

(i) Bharmin
(ii) Chhatri
(iii) Dalit
(iv) Ethnic Groups
What is your educational attainment?

i) Primary
4.
(ii) No
If yes, in which age did you get married?

(i) 15 -20
6.
(iii) Higher
Are you married?

(i) Yes
5.
(ii) Secondary
(ii) 20 25
(iii) 25 -30
How many children live with you?
7.
What is the best child bearing age of women?
52
8.
Where do you live?

..
9.
How far is your home from hospital?

(i) Less than 1 hrs.
(ii) 2-3 hrs.
(iii) More than 3 hrs.

10.
If you have a child which age did you give birth?

(i) 20 22
11.
(ii) 23- 25
Have you heard about and check?

(i) Yes
(ii) No
B.
Knowledge and Practice Level Aspect
1.
When did you get first pregnant after marriage?
2.
(i) 1 years
(ii) 2- 3 years
(iii) 4-5 years
(iv) above 5 years
Do you want to terminate or continue this pregnancy?

(i) Terminate
3.
4.
5.
(ii) Continue
Why did you terminate this pregnancy?

(i) Suggestions from husband
(ii) I am studying
(iii) I am not married
(iv) others
Why did you continue the pregnancy?

(i) Wanted a child
(ii) Religious reasons
(iii) Husband interest
(iv) Others
Have you heard about FP methods?

(i) Yes
6.
(iii) 25-30
(ii) No
From where did you get the information about the avertable contraceptives?
(i) Husband
(ii) Radio
(iii) Friends
(iv) Others
(v) Health Works
53
7.
Which method of FP did use during this period?

(i) Natural method withdrawal (ii) Temporary method condom/pills/ depo/
(iii) Emergency contraceptive
8.
9.
Did you have any problem when you FP method?

(i) Headache/ nausea
(ii) Menstrual disorder
(iii) Fear of Pregnancy
(iv) Vaginal discharge
Where did you check ANC?

(i) Sub-health post
(i) Hospital
(ii) Health post
(iv) Others.
(10) How long time have you been labour pain?

a)
Within 24 hours
b)
After one day
c)
After 21 day
d)
Others.
(11) In delivery period did you get help from your husband?
(a) Yes
(b) no
(12) In delivery period did you get any critical problem?

(a) yes
(b) no
(13) It yes, then what happened?

a)
Excessive bleeding
b)
High blood pressure.
c)
Shock.
d)
All of the above
(14) Where did you gave birth to baby?

a)
At home
b)
At hospital
c)
On the way
d)
Others.
54
(15) If you are in the home who help you?
a)
Sudani
b)
Nurse
c)
Family members
d)
Nobody
(16) If you are in the hospital who help you to gave a birth.
a)
Nurse
b)
Cma
c)
Anm
d)
Sudeni
(17) Did you get TT vaccine during the pregnancy period?

(a) Yes
(b) No
(18) If you have not get then why didn't you get?
a)
Unknown
b)
Busy
c)
Careless
d)
Lack of knowledge
(19) If, yes how many times did you takes?

(a)
One times
(b) two times
(20) When you are delivery did you used home delivery kit?
(a) Yes
(b) No
(21) If you don't use it why?

a)
Ignorance
b)
Unknown
c)
Lack of knowledge
d)
Unknown.
(22) In delivery period did you use sterilizer instrument or not?

(a) Yes
(b) No
55
23) Whish type of instrument did you used.
a) Yourself home instrument
b) New blade
c) Stelizer blade
24) Who associate you for cutting chord?
a) Family members.
b) Sudeni
c) Relative
d) Health workers
25) When you gave a birth a baby after that how long time you feed breast to your
baby?
a) Half hour
b) One Hour
c) 1 and half hour
d) 2 hour
26) Did you feed colostrums to the new born baby?
a) Yes
b) No
27) If you know why you didn't feed colostrums to your baby?
a) Lack of knowledge
b) Superstation
c) The fear of child being sick
d) Others
28) Do you have knowledge about vaccination to give it baby
a) Yes
b) No
29) If not why you did not immunize your children?

a) Lack of knowledge
b) Superstation
c) Customs
d) Others
56
30) After Six Month gave a birth to child did you feed additional food
a) Yes
b) No
31) How many times you feed breast to your new born baby?
a) UP to one month
b) Up to 6 month
c) Up to 2 Years
d) Up to above 2 year.
32) Gave a birth baby how long different two baby?
a) 2 year
b) 3 Year
c) 4 Year
d) 4 years above
33) In your prudency period did you eat additional food?
a) Yes
b) No
34) Did you get any training about delivery care?

a) Yes
b) No
35) It is necessary to take training for prudency period?

a) Yes
b) No
36) Have you heard about family planning?

a) Yes
b) No
37) Is if east to use family planning devices?

a) Yes
b) No
38) Which family planning device did you used?

a) IUD
b) Pills
c) Norplant
d) Depo
39) How long time did you used family planning device gave a birth baby?
a) After 6 Month
b) After 1 Years
Thank You.

A Comparative Study of Delivery Practice Among Women in Dalit Community in Ghansikuwa VDC, Tanahun

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A COMPARATIVE STUDY OF DELIVERY PRACTICE AMONG

WOMEN IN DALIT COMMUNITY IN GHANSIKUWA

This thesis entitled A Comparative Study of Delivery Practice among Women in

This thesis entitled A Comparative Study of Delivery Practice among Women in

Thesis Evaluation Committee

Mr. Bhoj Raj Neupane

Health and Physical Education Department

Maiya Devi Girls' College

Mr. Home Nath Paudel

Health and Physical Education Department

Maiya Devi Girls' College

Prof. Dr. ...................................

Health and Population Education Subject Committee,

I would like to express my heartily appreciation to my thesis supervision Mr. Hom

Background of the Study

Statement of the Problem

Objectives of the Study

Significance of the Study

CHAPTER -II: LITERATURE REVIEW

CHAPTER - III: RESEARCH METHODOLOGY

Population of the Study

Tools of Data Collection

Data Collection Procedure

Validations of the Tools

Methods of Analysis Interpretation of the Data

CHAPTER-IV: ANALYSIS AND INTERPRETATION OF DATA

Demographic and Socio-economic status

Knowledge about Safe Delivery Kit

Use of Safe Delivery Kit in Practice

Reasons Behind Non-using Safe Delivery Kit

Cord Cutting Instruments

Home Delivery Complications

Appropriate marriage age

Time Duration of Health Check up During Pregnancy 29

4.2.10 Pregnancy Complications

4.2.11 Problems Related to Pregnancy

Assistance during Delivery

Antenatal Care Provider

Cord Cutting Services

Types of Food Taking Practices after Delivery

Visit Antenatal check up

CHAPTER-V: SUMMARY, FINDING, CONCLUSIONS AND

Recommendations for Improvement

Recommendation for Future Study

Occupational Status ..................................................................................15

Educational Status .....................................................................................16

Relationship between Educational Status and Knowledge about Safe

Relationship between Educational Status and Using of Safe Delivery Kits

Reasons behind Non-Using of Safe Delivery Kit .....................................20

Cord Cutting Instruments...........................................................................21

Home delivery Complications ..................................................................23

Education status below 0-5 Children's mother age ....................................24

Table 10: First Pregnancy .........................................................................................27

Background of the Study

Statement of the Problem

Objectives of the Study

To identity the socio-economic status of Dalit Community.

To examine the delivery practice between Damai and Kami community.

Significance of the Study

The significance of the study is as follows:

The study will be useful to identify the socio-economic status of Dalit

It will be helpful to solve the health problems related to the delivery.

This study will be useful to provide information for new research.