HOUSEHOLDS AND RESPONDENTS BACKGROUND CHARACTERISTICS

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1 Chapter 3 HOUSEHOLDS AND RESPONDENTS BACKGROUND CHARACTERISTICS This chapter presents a profile of the demographic and socioeconomic characteristics of households and sample respondents. It also describes facilities and services that are available in the selected villages of Patna, Varanasi and Vaishali districts. The chapter also includes some comparisons with the National Family Health Survey (IIPS, 2000). 3.1 AgeSex Distribution of the Household Population and Composition The survey does not include detailed information (education and marital status) about individuals living in households, because its aim is to study gallbladder diseases by interviewing all males and females above 30 years along with their socioeconomic characteristics. However, population by sex and broad age groups was collected in the household questionnaire. Table 3.1 shows the population in the selected districts by broad age groups and sex. Around 35 per cent population is found below 12 years of age and 30 per cent of the population is above 30 years of age. The present study and NFHS2 age distribution are similar for broad age groups. Table 3.2 shows the percentage distribution of household by various characteristics of the household head, religion, caste/tribe, main source of income, household type and the number of usual household members. Socioeconomic characteristics are not analysed separately for the head of the household, but they are included in the respondent characteristics. Majority of the household heads are Hindu (97%). Half of the heads of the household belong to other backward castes and 27 per cent are from scheduled castes. The general population constitutes 17 per cent and the tribal population in the sample is negligible. On an average, the household size is around seven persons per household. In Varanasi, the average number of persons per household is more than seven and onefifth of this household comprise more than 10 persons. 11

2 3.2 Housing Characteristics Table 3.3 provides information on housing characteristics by districts. Regarding type of house construction, 45 per cent in Varanasi, twofifths in Patna and onethird in Vaishali, live in houses that are Kachha (made from mud, thatch, or other lowquality materials). In Patna and Vaishali, the majority of households, live in semipucca houses (partly lowquality and partly highquality materials). Around 28 per cent in Varanasi, followed 13 per cent in Patna and 10 per cent in Vaishali live in pucca houses (highquality materials throughout, including roof, walls and floor). The percentage of pucca houses in NFHS2 is higher in the case of Bihar and lower in Uttar Pradesh (IIPS, 2000). Water sources and sanitation facilities have an important influence on the health of household members. Only a small number of households use tap (piped) water. In all three districts, the majority of the households get water from hand pumps. A significant proportion of the households use well and river water. In Varanasi, the sources of drinking water for around 30 per cent of the households are wells, river, ponds and lakes. Most of the wells in the sample villages are surrounded by concrete walls. Besides the wells are not cleaned regularly or systematically; once in a while potash is used to clean the well. The source of lighting is electricity in 50 per cent of the households in Varanasi, 27 per cent in Patna and less than 10 per cent in Vaishali. The remaining households in the respective districts use kerosene for lighting. Twentysix per cent of the households in Varanasi, majority of the households in Vaishali and Patna (68 per cent and 66 per cent respectively) do not have kitchens and they use open spaces for cooking. Around 28 per cent of the households in Varanasi and below 10 per cent in Vaishali and Patna cook in the living room and this may cause pollution. Regarding sanitation facilities, most of the households in the three districts have inadequate toilet facilities. Less than 15 per cent of the households have a toilet or latrine facility. Stagnated water in the vicinity of the household is dangerous for the health of the people who are living in this environment (within 30 kilometres). Half of the households in Vaishali, onethird in Patna and onefourth in Varanasi have stagnated water or sewage within a radius of 30 km. The proportion of households owning agricultural land or sharing agricultural land for 12

3 irrigation purposes in all three districts is 50 per cent. Keeping livestock in rural areas is very common and nearly 65 per cent of the households own livestock in the three selected districts. The possession of durable goods is an indicator of a household's socioeconomic status. Use of durable goods also gives exposure to the outside world (television, radio, and vehicle), better health (fan) and protection of foods (refrigerator). Table 3.3 gives a summary of household measures called the standard of living index (SLI), which is calculated by adding the following scores to the household characteristics and durable goods in the household: House type: 4 for pucca, 2 for semipucca 0 for kachha. Toilet facility: 4 for own flush toilet, 2 for public, shared flush, or own pit toilet, 1 for shared or public toilet, and 0 for no facility. Source of drinking water: 2 for pipe, hand pump, or well in residence/yard/plot, 1 for public tap, hand pump or well, 0 for other water sources. Separate room for cooking: 1 for yes, 0 for no. Ownership of agriculture land: 2 if household owns at least some land, 0 for no land. Ownership of livestock: 2 if owns livestock that is more than two cows or buffalos or oxen or more than 5 goats or sheep, or poultry farm, 1 if owns livestock but less than two cows or buffalos or oxen or less than 5 goats or sheep or less than 15 hens, 0 if does not own livestock. Ownership of durable goods: 4 each for a car or tractor, 3 each for a moped or scooter or motorcycle, telephone, refrigerator, or colour television, 2 each for a bicycle, electric fan, radio or transistor, sewing machine, black and white television, water pump, bullock cart, or thresher, 1 each for a pressure cooker, chair. Index scores range from 010 for a low SLI, 1120 for a medium SLI, and 2159 for a high SLI. Threefifths of the households of the selected sample have a low standard of living, onethird have a medium standard of living and the remaining households that is less than 10 per cent have a high standard of living. Several studies have shown that chemical exposure and use of fertilisers have a negative impact on the health of exposed persons and that some chemicals cause cancer at different sites 13

4 of the human body (Dikshith et al 1989b; Kalra and Chawla, 1985). In this study, we have collected information about use of fertilisers, type of fertiliser, use of pesticides and type of pesticide. Majority of the households use fertilisers (96.5 per cent), as at least one person in every household is a farmer or an agricultural labourer. Around half of the households use Urea as fertiliser. Phosphate is another choice and more than onefifth of the households use this. The Sarpanch and a few other persons were interviewed, and it was found that different biochemical fertilizers were used for different types of crops. As the fertilisers are expensive, people prefer to keep it inside the house to protect it. This may cause health hazards to persons living in the household. Use of pesticides for protecting the crop or food grains is also very high in the districts of Patna and Vaishali (84 and 71 per cent respectively), while onefourth of the households in Varanasi also use pesticides. The use of harmful pesticides like DDT and Gamaxine is also prevalent in these districts. 3.3 Availability of Facilities and Services in the Villages Village facilities and other service details were collected from the Sarpanch, other village officials, and knowledgeable persons in the village. The main source of water for irrigation is pumps followed by rainwater. Only one village in Patna had underground sewage facility, the rest of the villages had either open drainage or no facility. There is little or no provision of health facilities in the villages as most of the villages have only a dai and four villages have informal providers of health. Out of the sixty villages selected, a subcentre was available only in one village. As the study is epidemiological, questions were addressed to the village official to examine the bad effect of hazardous industries in the villages or in the vicinity of villages. The area was surveyed to trace the existence of any industry in the vicinity of villages. Five villages of Varanasi have saree weaving factories, and one village in Varanasi and Patna have a brick kiln factory. Another seven villages have smallscale agricultural based products factories. Fourteen villages in each district are in the influence zone of rivers or their tributaries (map scale based). In the study based on hospital data, it is found that people living near the Gangetic belt have gallbladder diseases (Anupama et al, 2001b). This study attempts to examine the prevalence of gallbladder diseases among people who are living under the influence of rivers within a radius of five km. (Chapter 5). Distance from the villages to river is estimated based on a map scale. 14

5 Villages falling within a fivekilometer zone were identified as area under the influence of a river or a tributary. Forty per cent of the households in Varanasi and around 30 per cent in Patna are under the influence of the river Ganga. Around 66 per cent of the households are under the influence of River Gandak in Vaishali district, and onefourth of the households are under the influence of River Punpun in Patna district. Water and soil samples were collected only from the villages of Patna and Vaishali. Soil was collected from three randomly selected places. The water sample was collected from the three sources that are mainly used for drinking water in the village by most of the people. In cases where people got drinking water from their own well or pumps, the water sample was collected from three randomly selected places during the month of JulyAugust Testing of soil and water was done at the Lucknow centre. The levels of Nitrate, Cadmium and Chromium in the water and soil were tested in the centre. The DDT level in water and soil was also examined. 3.4 Respondent Characteristics Table 3.4 presents the percentage distribution of males and females of age 30 and above by marital status, education, religion, caste/tribe and standard of living. Respondents in the age group 3039 years contribute maximum percentage to total sample. As the age increases, the percentage share at each age declines. Mean age of respondents for males is higher than that for females for three selected districts as well as for the total sample. Ninetyone per cent of male respondents and eightyfive per cent of female respondents are currently married. Seven per cent of the male respondents and thirteen per cent of the female respondents are widowed. Percentage of respondents divorced and separated is negligible. The educational levels have an important influence on demographic and health seeking behaviour. Sixtyfive per cent males and only eighteen per cent females are literate in the three selected districts. The educational situation, especially for females in the selected area, is not very encouraging. Majority of respondents belong to the Hindu religion. The remaining religions Muslims, Sikh and Christian, constitute only a small percentage of all respondents (3 per cent males and 4 per cent females). Onefourth of the respondents belong to scheduled castes. A large proportion 15

6 of the sample (55%) belongs to other backward classes. The scheduled tribe population is negligible (below one per cent). Around 20 per cent among male as well as female respondents do not belong to scheduled castes, scheduled tribes or other backward classes. Fortyfive per cent of the respondents have a low standard of living followed by thirtynine per cent who are medium households. Only seventeen per cent of the respondents are from households with a high standard of living. Table 3.1: Household Population by Age and Sex Age Patna Varanasi Vaishali Total group Male Female Total Male Female Total Male Female Total Male Female Total Below Total (N) Table 3.2: Percent Distribution of Households by Religion and Caste of Household Head and Household Size Characteristics Religion of household head Hindu Sikh Muslim Caste of household head Scheduled caste Scheduled tribe OBC General Do not know Number of usual members District Patna Varanasi Vaishali Total Mean household size

7 Table 3.3: Percent Distribution of Households in the Districts by Housing Characteristics Characteristics Patna Varanasi Vaishali Total Type of house Pucca Semi pucca Kachha Source of drinking water Piped (residence) Piped (public) Hand pump Well, river & others Source of light Electricity Kerosene Gas, oil & others Separate room for cooking Inside living room Separate room Separate room in the compound Open space Toilet facility Own toilet (flush toilet) Public/shared (flush toilet) Own pit toilet Shared/public pit toilet No facility (bush/field) Any stagnated water pool/sewage near the house, 30 mts Any own livestock Own or sharing agricultural Land SLI Low Medium High Use of fertilizer for the crop Use of Urea Fertilizer Use of Sulphur Fertilizer Use of DAP Fertilizer Use of Dye Fertilizer Use of phosphate Fertilizer Use of pesticides for farm/house/food grains Influence of Ganga river Influence of Punpun river Influence of Darbha river Influence of Bisuhi river Influence of Varuna river Influence of Gomati river Influence of Gandak river Total Households (N)

8 Table 3.4: Demographic and Socioeconomic Characteristics of Sample Population Characteristics Age group MeanAge Education Illiterate Literate Marital Status Never married Currently married Widow Divorce Separate Occupation Not working Agr.farmer/Lab Labourer Service/Business Religion Hindu Others Caste SC ST OBC Others Don t know SLI Low Medium High Male Female Patna Varanasi Vaishali Total Patna Varanasi Vaishali Total Total (N)