http://doi.org/10.33698/NRF0115  Sonika, Kavita Narang, Sushma Kumari Saini

Abstract : There are successful stories and big achievements regarding replacement levels of fertility rates but they are not uniform and create uncertainty in population projection. An exploratory study was undertaken in a low income group resettled colony having 137 large size families. The objectives were to explore functioning, problems and factors responsible for large size families. Results indicated that the factors responsible for large size family were family pressure and self interest for male child, lack of knowledge regarding contraceptives, social pressure, continuing unwanted pregnancies & failure of contraceptive methods. On Multivariable regression analysis number of daughters in a family found positively co-related(p = 0.001, regression coefficient – 0.272), whereas wive’s age at marriage(p=0.004 with regression coefficient -0.068) and educational status of wife (p=.043,regression coefficient – 0.062) were negatively co-related with size of family. These families faced problems like overcrowding, illiteracy unemployment, financial constraints, poor academic performance of children, child labour, overtime at work, altered nutritional level, incomplete or unimmunization of children, chronic illnesses, poor compliance with treatment, drug addiction and quarrels and fights among different groups of family members. The functioning of large size family was altered as the couples were managing these problems like finances related to education, house rent, social relations, management of installments of savings or loan, household work, clothings with difficulty and buying food items just before meals or as per finances permits whereas daily routine was altered too as very few were involved in physical fitness activities. TV was the main source of recreation and majority stayed at home in holidays. It was concluded that despite of all the developments attitude of people for gender preference for male child still remains same. The study recommends the target areas to be tackled are the behavior modification towards gender preference, educating women, IEC activities and basic motivational and behavioral research are needed to be done for limiting size of family.

Key words :Large size families, eligible couples.

Correspondence at :SonikaSister grade -II, Nehru Hospital, PGIMER, Chandigarh

Introduction:Fertility is a biological phenomenon. Some demographers prefer to use the word natality in place of fer tility.1It is the actual performance in childbearing and so is variable from one individual to another and from one group of people to another. Bir th control, family planning or fer tility control means limitation of pregnancy and family size and hence control of population.2 India, officially The Republic of India is a country in South Asia. It is 7th largest country by geographical area.3Population growth has long been a concern of the government, and India has a lengthy history of explicit population policy. So in 1952, the Indian Government formulated a National Family Planning Programme, which was later expanded with an objective of reducing birth rate to the extent necessary for stabilization of population at a level consistent with requirement of National economy.Every decade after this was marked by pioneering works. The planning commission too gave considerable importance to health programs in the five year plans.Since then approaches for reducing population growth have taken a variety of forms.4 The approaches changed with passage of time. Introduction of modern and emergency contraceptives under Family Welfare Program in 2002-03 was another boon to the program. Legislation being considered in fields related to family planning included raising the marriage age. This raising the age at marriage had shown a great decline on fertility rates. 5The program was backed by adequate financial resources which have been rising through the successive Five Year Plan periods. From a meager Rs 0.1 crores in the early 50’s to Rs. 3,256.25 crores during 7th Plan and rose to Rs.27125.00 in 10th Plan. This phenomenal increase in the allocation of resources is an indication of the earnestness with which Indian government considers its population problem.Seeing the poor performance at the grass root level NRHM (National Rural Health Mission) was launched on 5th April 2005 for a period of 7yrs.The mission is to improve rural health care delivery system. This integrated multiple programs in it.1It is not that these all efforts had gone in vain as researchers had found decline in fertility rate but still there are considerable interstate, and inter-religion variations in fertility trends.6In addition to all these factors another factor is the unmet need which is one of the factors that affect fertility.In India there are many studies in which couples observed to have a strong preference for sons over daughters.7-9Other studies found that fertility is influenced by a number of factors like, religion, place of bir th, rural and urban areas,age at marriage of women, educational status of both wife and their husbands, occupation,spouse age difference etc. 10 These large sized families face a number of problems. Many researchers have shown that children from large family have altered nutritional level. 11Over breeding contributes to a number of problems like relationship between family size and child mental disorders and mental retardation.12, 13A study in Ghana illustrated the impact of size of the family on quality of life of people. It concluded that large size families culminates into poor health , lower incomes, lower social life and status , economic life and available quantity and quality of environmental resource hence quality of life.14Kanjilal B et.al revealed that family size is one of the barrier to access immunization services.15Another study showed that children born into large families have poorer verbal skills and receive less education than children from small families, regardless of the family’s social or economic status. 16 Effor ts of population control are continued since the time of independence but population is still a big challenge in front of India .There are successful stories & big achievements but they are not uniform. So there is a need for an adequate understanding of the factors influencing the large sized families among women in any cultural setting. It has been observed by the investigator that the area used for field experience by nursing students had many large size families. The area is a low income group community which is a resettled colony and is situated in the periphery of Chandigarh,where all health facilities are available. The people living there have diversity among themselves as they have migrated from different states of India, even from some neighbouring countries also. In spite of lot of effort from government and non-government side for reducing the fertility rate (IEC activities, cafeteria approach ofbirth control methods to limit the size of families) still the families are large in this area.This made the researcher curious to know about the significant factors responsible for large size family, problems faced and their functioning in the rising cost of living with large number of children. So the researcher decided to explore these families as this will help in ruling out the factors responsible for large size families so as to promote the target based intervention while approaching the families for adopting the family planning which will ultimately lead to reduce the family size in future and hence control population

Objectives

  • To develop and validate the guidelines to study the ‘large sized families’ of eligible couples
  • To use the guidelines to explore the ‘large sized families’ in terms of factors responsible, problems faced and overall

Methodology:It is an exploratory study on ‘large sized families’ among eligible couples residing in Dadu Majra Colony,UT, Chandigarh. This colony is situated on nor thwest corner of Chandigarh and is at a distance of 5km from National Institute of Nursing Education (NINE), P.G.I, Chandigarh.There are about 2670 houses with a population of about 18,000. The residents of Dadu Majra Colony are migrant from various states. The residents are mainly Safai Karamchari, peons, others are daily wagers, rickshaw pullers, petty businessmen, few are drivers, teachers or engaged in technical works. The study was carried out in the month of November and December in which survey was done in Dadu Majra Colony, Chandigarh to identify the target population. Total 4000 eligible couples were residing there and 151 eligible couples had large sized families( having 5 or more children) which as a whole taken as study sample. Firstlyguidelines were prepared, on the basis of which tool for assessing factors, problems faced and functioning of large sized families was constructed. Tool was validated from 10 exper ts from different depar tments like Nursing, Public health, Sociology & Psychology. After validation Pilot study was conducted for assessing reliability of the tool and feasibility of the study in Village Dhanas. Results of pilot study indicated that study was feasible. Interview schedule was valid and provided the needed information.Then data was collected after prior permission from Principal (NINE) Chandigarh, and Medical Officer of the area was informed. The families were approached, explained about the purpose of the study and were told that data so collected will be kept confidential & will be used only for research purpose. They were given full autonomy to participate in the study were interviewed after verbal consent. Wives were interviewed with the help of semi-structured interview schedule. Each interview took 40- 60 min. Height and weight of all family members were recorded. The families were revisited on Sundays for measuring height and weight of those family members who were not available at home on the day of interview. The total sample was reduced to 137 after excluding the couples who refused for participating in the study, shifted from the area and families where 1st wife had died and had 2nd wife .The data was analyzed using descriptive and inferential statistics. Analysis was carried out with the help of Microsoft excel and statistical package for social science (SPSS-16) program. The findings are interpreted and presented with the help of tables and graphs.

Results:A total of 137 wives were interviewed in which age of wives ranged from 27-49yrs with mean age 41.9+5.6 . Nearly one fourth (28.5%) of them were in age group of 36-40 yrs. Likewise age of husbands ranged from 28-61yrs with mean age 45.8+6.4. One fourth (27%) of them was in age group 41-45yrs. Regarding the age at marriage of wives, it ranged from 5-22yrs with mean age 15.4+ 2.6. More than half(56.8%) of wives were married in age group of 5- 15 yrs who reported early marriage in which marriage was ceremonised early and post marriage (Gauna) was done after reaching menarche. Similarly for husbands age at marriage ranged from 11- 36 with mean age 20.29+ 3.7. More than half(60%) of husbands were married before legal age of marriage i.e in age group 11-20yrs. Regarding educational status almost three fourth of the wives( 74%) were either illiterate or just literate whereas among husbands 45.9% were either illiterate or just literate ( can sign, read and write ). Almost half of wives 52.6% were housewives. Among husbands 32.1% were in govt. job and most of them were sweepers or class IV, 36.5% were engaged in petty business or petty jobs. The majority (89%) of the couples were Hindu and 72.3% of them belonged to SC/ST category. It emerged that almost all eligible couples were from North India with U.P contributing 42.3%. Most of the eligible couples (71.5%) belonged to rural areas and nearly two third of couples had nuclear families and only one third had joint families. Regarding income,per-capita income per month ranged from Rs150/- to Rs 5000/-with mean per- capita income of 1360.4/- ±8. Among them Half (50.3%) of the large size families had per capita income ranging from Rs501/- to Rs1500/-.Obstretic history of women in large size families Regarding the Obstretic history Table-I depicts that women’s parity ranged from 5- 11 and child birth ranged from 5-9. One third of women(33.6%) conceived 5 times and another nearly one third (29.9%) 6 times. Half of wives (51.1%) had given 5 live births, another 33.6% had given 6 live births. Among the eligible couples 5.1% women had a history of one still birth and 32.8% women had a history of abortions ranging from 1 to 3 which included both spontaneous (18.2%) and induced abortions (16.7%). Apart from this 5 couples had undertaken female feticide. It was observed that 32 families had the history of 37 deaths among children in which 25 were males and12 were females and main causes of death were respiratory problems ( 29.7%), diarrhea (8.1%), low birth weight (5.4), cancer (5.4%), accidental fall ( 2.7%), suicide (2.7%) and congenital malformation(2.7%).Sixty one couples reported 90 unwanted pregnancies.The   cause   of   unwanted pregnancies  were  repor ted  as  failure  of contraceptives  (6.4%)  [condoms,   oral contraceptives and emergency contraceptives] conception  during   lactation  amenorrhea (70.3%), fear of using contraceptives (8.1%). Among them 46 women continued  unwanted pregnancies.   Reasons   for   continuing unwanted  pregnancies  were  repor ted  as refusal of  doctor  to  abor t(40%),  consider abor tion  as  sin  (26.6),  family  refused  for abortion (15%), tried aborting the fetus but remain unsuccessful (11.6% ), fear of abortion (5%), ultrasound showed fetus as son

Table-1:Obstretic history of women in large size families         N=137

 

1 2 3 4 5 6 7 8 9 10 11
Total Conception 46(33.6) 41(29.9) 28(20.4) 15(10.9) 3(2.2) 2(1.5) 2(1.5)
Live birth 70(51.1) 46(33.6) 13(9.5) 7(5.1) 1(0.7)
Still birth 7(5.1) –         –              –            –            –              –             –          –
Abortions 28(20.4) 13(9.5) 4(2.9) –         –              –            –            –              –             –          –
Spont.abortion 18( 13.1) 5(3.6) 2(1.5) –         –              –            –            –              –             –          –
*Induced abortions 15(10.9) 7(5.1) 1(0.7) –         –              –            –            –              –             –          –
Deaths among Male child  

19(13.8)

 

3(2.2)

 

 

–         –              –            –            –              –             –          –

Deaths among female child  

9(6.6)

 

 

1(0.1)

 

–         –              –            –            –              –             –          –

Obstretic Events                Total frequency of obstretic events among wife:-

Induced abortions:- 23eligible couples had 32 induced abortions in which 3 couples had one female feticide and one eligible couple had two and one had three female feticide. So total female feticide which were induced were 8.

Contraceptive methods adopted by the couple It was reported that majority of the couples had adopted permanent birth control method i.e tubectomy (64.2%), followed by condoms(4.4), coitus interruptus(2.2), Cu- T(1.5), oral contraceptives(1.5), emergency contraceptive(0.7) and men didn’t have much participation in adopting permanent method of birth control as only one husband had undergone Vasectomy. Abstinence was reported by 36.6% couples and 16% couples did not use any contraceptive method. In spite of having large size families various reasons were reported for not using any birth control methods like fear of using any contraceptive method (33.3%).One was pregnant after 6 daughters in want of a son. There were 14.2% couples who were not using birth control measures due to previous side effects, 9.5% didn’t adopt due to religious belief of not controlling birth. One had some gynaecological problem so couldn’t conceive and 14.2% wives believed that they would not conceive now. 19.5% wives didn’t give any specific reason.

Factors responsible for the large sized family:-It is evident from table-2 that 16% of the couples reported self-interest as the cause for large size family in which majority (77.2%) wanted male child. More than half of the couples reported family pressure mainly for preference for male child (82.7%). One third of the couples (33.5%) repor ted lack of knowledge of contraception and only few reported failure of contraceptive (3.6%) and social pressure (2.1%).

Table-2: Factors responsible for large size family N=137  
Reasons of large size family     n (%)
Lack of knowledge of contraception     46 (33.5)
Self interest     22 (16.0)
Gender preference(male child) (N=22)   17 (77.2)
Gender preference(female child) (N=22)   1 ( 4.5)
More children (N=22)   4 (18.1)
Family pressure for     81 (59.1)
Gender preference(male child) (N=81)   67 (82.7)
Gender preference(female child) (N=81)   2 ( 2.4)
More children (N=81)   12 (14.8)

**Social pressure                                                                                  3 ( 2.1)

Failure of contraceptive methods                                                                       5 ( 3.6)

*More than one response was given by 18 women.

**Social pressure:-Religious beliefs and pressure from neighbours.

Table-3 brings to fore the various reasons for gender preference. One third couples (37.2%) wanted one son. The reasons given for this were for continuing family lineage (41.1%), old age security (29.4%),status symbol (15.6%), social security for daughters (13.7%). Almost one fourth( 24%) of the couples wanted two sons because of uncertainty about survival of one son (60%), sharing responsibilities( 29.4% ) and social status (8.8%). Apart from this only 2.1% of couples reported that they wanted female child as they are the care taker of family, maintain dignity of family and are beauty of house. The multivariate analysis is done to rule out the most impor tant factors in which number of children were taken as dependent variable and 8 other variables were taken as independent variables. Table-3 indicatesthat among the eight variables taken educational status of wife, age of wife at marriage in a family are significantly negatively co-related with the total number of children. The most significant factor is number of daughters in a family which is positively co-related where the p value is .001.This means as the educational status and age at marriage of wives increases the size of family decreases while more number of daughters in the family larger the size of family.

Table-3 : Multivariable regression analysis of variables is influencing the total number of children in a family.

 

Educational status of wife -.062 -2.041 .043*
Background -.158 -1.307 .194
Age of wife at marriage -.068 -2.917 .004**
State belong to .011 .459 .647
Type of family .069 .597 .552
Age husband at marriage .027 1.648 .102
Occupation of husband .034 1.153 .251
Number of daughters .272 5.605 .001**

Variables                                         Regression coefficient        t-value        p-value

Problems faced by large sized families:-

Table-4 illustrates the problems faced by the large sized families .

Environment:-More than half (69.3%) of the total families had overcrowding in their houses as per WHO experts guidelines of overcrowding but only one third (38%) wives felt overcrowding. Among eligible couples 17.5% wives reported difficulty in sleeping, 8% felt difficulty only when the guests comes, 4% reported no privacy either for children or parents and 8% had difficulty in studying.

Economic:-The financial condition of the couples were such that more than half 54.7% couples had taken loan for various reasons whereas and were facing problems while paying monthly instalments of loan i.e.

  • % felt difficulty in running livelihood with instalments, 20% had discontinued Apart from these 38.7% couples sold their proper ty or jewellery, land or household goods to return debt or loan and 12% couples kept their valuables on mor tgage. There were 8 families who reported child labour wherein the children were engaged in rag picking & 16 families reported working overtime to meet both ends.In spite of facing financial problems18.2% families repor ted unemployment.Education:-It could be seen that 26.2% parents reported that children >5yrs were not going to school or had dropped out. Among the school going children almost 73.7% parents reported poor performance of their children in studies. Reasons reported for not studying were: not interested in studies, financial constraints, successive failures, cultural belief’s, gender inequality as girls were not allowed to study, illness, elder sibling is to take care of younger one and few wives reported that the children stopped studying as moved from their native place.Health-Regarding health families reported malnutrition problem in all the ages, no immunization, illnesses both acute and chronic and drug abuse. It was observed that (table-5) 13 families had undernourished children falling in grade I-II & grade III whereas 41 families had one or more 6 yrs- 18 yrs children underweight even adults were underweight too in 29.9% families. Children of age 6yrs-18yrs were overweight in (7.2%) families and 38.6% families had overweight adults. 15.3% of families repor ted incomplete immunization and 16.6% families not immunized their children at all. 65 families had chronic health problems among which 23 families had no compliance with treatment whereas 12 families had acute illnesses. Drug abuse was common among husbands (53.3%) followed by wives (7.9%) and sons (7.9%). The problems reported after drug abuse were verbal quarrel (16.8%) and sometimes had both physical and verbal quarrel (7.3%). (Table-5) Table4 : Problems faced by eligible couples related to environment and economic conditions and education of children   N = 137

Problem areas Problems faced by large size families                                                                n(%) Environment                       Overcrowding:-

Wife’s opinion                                                                                         52(38.0)

Factual data( as per WHO expert group guidelines)                             95(69.3)

Problems faced due to overcrowding :-

Difficulty in sleeping                                                                             24(17.6)

Difficulty only when guests comes                                                         11( 8.0)

No privacy for children as well as parents                                            6( 4.4)

Difficulty in studies                                                                              11( 8.0)

No overcrowding felt by wife                                                                85(62.0)

Economic           Taken loan or debt from different sources                 75(57.4)

Problems faced while paying monthly instalments of loan* N=75

Difficulty in running livelihood with instalments                                     37(49.3)

Discontinued instalments                                                                     15(20.0)

Sold property or jewellery, land or household goods                            29(38.7)

Kept things on mortgage                                                                       9(12.0)

 

Child labour                                                                                         8( 5.8)

Overtime:-Engaged in  work after routine job                                      16(11.7)

Unemployment                                                                                    25(18.2)

Education          Children >5yrs not sent to school                              36(26.2)

Families in which one or more children poor in studies                        101(73.7)

 

Reasons for not studying among children* N=137  
i. Children not interested in studies   76(55.4)
ii. Financial constraints   38(27.7)
iii. Successive failures   24(17.5)
  1. Girls not sent to school or not allowed to pursue higher education 6( 3)
  2. Cultural belief of not sending children to school 6( 3)
  3. Moved from native village and didn’t joined school 6( 3)
  • Illness of family member 11( 1)
  • * More than one problem was faces by few couples
    Elder children have to take care of younger sibling 2( 5)

 

Table 5 :- Health problems in large size families                                                        N=137

 

Health related

spheres

Problems faced by large size family n(%)
Nutritional status Child under-6:-                                  Undernourished 13 ( 9.4)
  Children of age 6-18yrs:                     Underweight 41 (29.9)
  Overweight 10 ( 7.2)
  Adults:-                                             Underweight 41 (29.9)
  Overweight 53 (38.6)
Immunization Incomplete immunization 21 (15.3)
  Not immunized at all 23 (16.6)
Illness Acute illness 12 ( 8.7)
  Chronic illness 65 (47.4)
  Compliance with treatment not present.            N=65 23 (35.3)
Drug abuse Drug abuse:-                                     Husband 90 (65.6)
  Wife 11 ( 7.9)
  Son 11 ( 7.9)

Problems created after addiction:-

Quarrel verbally                                                               23 (16.8)

Physical assault to family members                                         10 ( 7.3)

Functioning of large size families:-This part of analysis describes the functioning of the large sized families. Table- 6 represents the management of different day today issues. Regarding education of children more than half of the couples (54.7%) manage or managed easily as the children were going to govt. school or college and others were suppor ted financially by grandparents or elder son (8.7%), some NGO/ Employer(1.5%), 29.1% couples were not able to manage and 2.2% couples took loan for educating children. Few couples (2.9%) were so keen for educating children that wife engaged herself in petty jobs.Total 17 couples were living in rented accommodation. Among those half of the couples (52.8%) were able to pay the rent regularly whereas nearly half (47%) were not able to manage and the rent was piling. Regarding saving half (49.6%) of the couples reported that they were saving some money. Among them 73.5% were paying regular instalments of saving schemes and only one family could not manage whereas 25% wives reported that they were not involved in saving matters, only husbands know about it. Apart from this 17 families had taken loan from bank and majority were paying instalments regularly and one family could not manage and one wife was not knowing about management of loan instalments. It is evident that the wives were helped by various family members in household chores. Majority (89%) of wives were helped by their daughters, followed by husbands (58%) and sons (29.1%) and very few (15.3%)by other members which include mother-in-law, neighbours and niece. Regarding dietary pattern 89 couples bring ration, 32 buy food items before meals and 16 couples buy as per availability of money. Families response pattern was good in the times of illness as majority (73.7%) approach health facility as soon as first sign appear, 26.2% keep on managing at home and approach only when illness become unmanageable. Majority of couples (81%) preferred going to private practitioner.It was further observed that majority (82%) of couples participate in social functions of their family and neighbourhood and 17.5% couples do not participate at all because they follow castism(45.8% ),and they didn’t like to mix–up with others and remain at home whereas few(12.5%) didn’t like their neighbours. The couples helped their neighbours at the time of illness in numerous ways like half of the couples accompany the sick to hospital, one fourth take care of sick and similar per cent of couples just visited to see the sick person. Only 13.1% provided monetary help to the needy neighbour at the time of illness and 17.5% provided all possible help needed during sickness.Regarding management of clothing for children as well for the couple majority of couples bought clothes on occasions for children (65.6%) and for themselves(54.%) and few buy seasonal or annually (19.7%). Few couples (8.0%) were totally depend on gifts from parents whereas some (12.4%) buy according to the finances and rest were not able to buy new clothes so they buy or used old clothes

Table-6:- Functioning of large size family N=137  
Areas                          Ways of management   n(%)
Education of                 Govt.school so managed easily

children                       Supported financially by:

Grandparents / elder sibling

  75 (54.7)

 

12 ( 8.7)

NGO/employer   2 ( 1.5)
Taken loan   3 ( 2.2)
Wife started petty jobs for educating children   4 ( 2.9)
Not able to manage   40 (29.1)
House Rent                   Paid regularly                                                               N=17   9 ( 52.8)
Rent was piling   8 ( 47.0)
Savings                       Had monetory savings

Management of installments of savings:-                            N=68

Regularly paid

  68 (49.6)

 

50 (73.5)

Irregularly paid   1 ( 1.4)
Husband don’t tell about savings   17 (25.0)
Loan                           Had taken loan from bank

Management of installments of loan:-                                N=17

Not started installments yet

  17(12.4)

 

1 ( 5.8)

Regularly paid   15 (88.2)
Husband don’t tell about money matters   1 ( 5.8)
Household work             Household work were supported by:- Management                      Husband    

58 (42.3)

Son   40 (29.1)
Daughters   122 (89.0)
Mother-in-law/sister-in-law/daughter-in-law   18 (13.1)
Neighbors   3 ( 2.1)
Diet management         Rationing   89 (65.0)
Buy food items just before preparing meals   32 (23.4)
Buy food items according to availability of money   16 (11.7)
Sickness                    Response pattern in illness:-

management                      Manage at home till illness start disturbing self & others 36(26.2) Take as soon as the first sign appear

   

 

101 (73.7)

Health care facility preferred:-

Govt.  hospital/ Dispensary

   

26 (19.7)

Private doctor   111 (81.0)
Social relations              Participate in social function   117 (85.4)
Not participate at all

Reasons for not participating :-

  24 (17.5)
Follows castism N=24   11(45.8)
Not social   10 (41.6)
Neighbors are not good   3 (12.5)
Share things with neighbor *Ways of helping neighbours in illness   103 (75.5)
Offer whatever they needed   24 (17.5)
Monetory help   18 (13.1)
Accompany the sick to hospital   69 (50.3)
Take care of sick   43 (24.1)
Visit in case of sickness   33 (24.1)

*More than one response was given by women for ways of helping neighbours in illness.Table-7 illustrates the routine activities of large size families. As all were daily wagers who worked till late evening and some do extra jobs or over time for running livelihood.More than half of large size family slept between 10pm to 12 pm, 43% slept between 8pm to 10pm the rest 5.1% slept after 12 mid-night. Majority (91.9%) woke up at 5 to 7am, 4.3% woke up before 5am and 3.6% woke up after 7am. Regarding physical activities, only 29.9% families were engaged in physical activities like morning walk/ evening walk (51.2%), yoga/ exercise (48.7). More than half (64.9%)of the families stayed at home during holidays, in 24.8% families only children goes for outing or to meet relatives and rest do shopping(1.5%), and 5.8% whole family goes for outing or to village,1.5% goes for satsang or temple others invite married daughters home(.7%), goes out only if finances allow(.7%).Majority (92.7%) of the large size families recreate themselves by watching TV and listening to music and rest just chat, dance or play with each other.

Table-7 :- Routine activities of large size families. N=137  
Routine Activities   n(%)
*Time of Sleeping

8-10 pm

   

59 (43.0)

10-12 pm   71 (51.8)
>12 am   7 ( 5.10)
**Time of getting-up

Before 5 am

   

6 ( 4.3)

5-7 am   126 (91.9)
After 7 am   5 ( 3.6)
Families engaged activities for physical fitness Activities done for physical fitness (N=41)

Morning walk/ Evening walk

  41 (29.9)

 

21 (12.4)

Yoga/ Exercise   20 ( 9.4)
Activities for celebrating holidays    
Stay at home 89 (64.9)
Shopping 2 ( 1.5)
Children goes for outing/relatives 34 (24.8)
Goes for outing together/village 8 ( 5.8)
Goes for Satsang/ Temple 2 ( 1.5)
Invite married daughters home 1 ( 0.7)
Goes out only if finances allow 1 ( 0.7)
Activities done for recreation by large size families    
Watch TV and listen to music 127 (92.7)
Chatting 7 ( 5.1)
Dance /play 3 ( 2.1)

DISCUSSION:Family size is a reflection of personal considerations which is influenced by a number of factors like socio-cultural practices, educational and economic status, religious beliefs, customs, values etc. The size of the family further determines the facilities or type of life one will enjoy. More number of children require more consumption of resources. The principle “Quality reduces with quantity” applies well to large size families. It is been half a century that government is working to decrease the fertility rate as large size family are not only burden to the family members or society but for the country as a whole.Though overall fer tility have come down still there are varied variations in different regions and large size families still exist in low-income group communities i.e. slums and sub-urban areas. Researcher too observed large size families in the area of work i.e.Dadu Majra Colony, UT Chandigarh which is a low income community. Hence the need was felt to explore the factors associated with large size families in this scenario of time.On analysis the factors responsible for large size families were self-interest and family pressure for gender preference (male child). Multivariate regression analysis showed gender preference for male child as the most important positively significant(p=.001 with regression coefficient 0.272) factor for increasing the size of family.Present study signifies that 37.2% eligible couples preferred for a son for continuing family lineage, old age security, status symbol, & social security for daughters whereas 24% of the couples wanted 2 sons as due to uncertainty of first son where either the son had expired or remains sick. Similar results were obtained in NFHS-2. The  study undertaken also showed that there were total 25 deaths among male children and 12 deaths among female children, so increased mortality among male child can be one of the factors of increasing the size of family. Some feels that two sons will share responsibilities and more sons add to status. Only 3 families stated to have large size family in want of daughter as they feel daughter is the beauty of house, she is the care taker and maintains dignity of the family.The other reasons which were statistically significant(negatively co-related) were wives’age at marriage (p=.004 with regression coefficient -0.068) and educational status of wives (p=.043 with regression coefficient -0.062).Regarding age at marriage, early age at marriage gives more fertile years which is a major factor responsible for increasing fertility.Apart from these factors which were stated by the wives for the large size family were lack of knowledge of contraceptives among 33.5% of couples. The present study showed that in spite of having large size families still the couples were having unmet need (16.1%), they were depending on unreliable methods of contraceptives like coitus interrupts, emergency contraceptives. Despite of introduction of modern techniques like NSV (Non-scalpel Vasectomy) and increased incentives for male adopting permanent family planning methods, male participation was found negligible in the study area and only females had adopted permanent method of birth control. Unmet needs of birth control methods also led to 60 unwanted pregnancies which were continued and contributed in increasing the size of families. Other reasons which had minor contribution for increasing the size of families were the social pressure which include cultural beliefs and pressure from neighbourhood and failure of contraceptives.In spite of lot of effor ts against female feticide like amendment of PNDT ACT, 1994 brought into operation in 1996, was enacted for the prohibition of sex selection, before or after conception for the prevention of their misuse for sex determination leading to female feticide still there were 8 female feticide reported by the wives.Though many studies showed that Muslim community had higher fertility rates but the study area was a Hindu dominated society which showed that 89%Hindus had large size family. Family size determines to a larger extent the type of life one will enjoy the present study the eligible couples stated a number of problems related to environment, education of children, economic conditions, health etc. In the environmental sphere more than half of the families were having overcrowding 69.3% (as perguidelines by WHO expert group)but only 38% wives felt overcrowding. Though they repor ted difficulty in sleeping, lack of privacy for parents and children etc. but they didn’t realize that there was overcrowding. They were so adjusted to that lifestyle and were managing in that.As most of the couples were daily wagers, they had financial constraints which were met by of loan or debt (75 wives reported). They were further facing problems in repayment of loan.In some families children were working and adults were engaged in extra work or do overtime for running livelihood. Unemployment and seasonal unemployment in some of the families has further added to economic problems.Education of children was another area which was suffering as few children from 20.4% families had gone or going to school and others dropped out in between because of various reasons like financial constraints, illnesses, successive failures etc. Among school going children, almost 75% family’s children were performing poorly as majority (76%) were not interested. Government had been working in providing education to all children since long and recent introduction of Sarv Siksha Abhiyan in 2001 had made the people easy to manage the basic elementary education. Millennium development goals too had one such goal of universalization of primary education. Different nutritional programs are also integrated by the govt to reduce the dropout rate but still there were 5.8% families who didn’t sent their children to school at all in study area.On exploring the immunization status of children despite of a government Dispensary, a number of private practitioners, IEC activities in the study area still 15.3% of families repor ted incomplete immunization and 16.6% families had even not immunized their children at all. Malnourishment was present in every age group of children and even the adults.As instead of bringing ration on weekly or monthly basis few families were buying just before cooking meals and even few bought as per the availability of money. There were families who reported of missing one or two meals per week which might be responsible for the under nutrition of children and adults in these families.Regarding buying of other necessities like clothes, the families bought clothes for children more frequently than for self. Most of them bought clothes yearly, on occasions, sometimes seasonally others by choice and need & those who not able to buy new clothes used old clothes. Some families just depend on the gifts as clothes sent from wives parents as could not afford buying themselves. About half of families living in rental accommodation were not able to manage and their rent was pilling. Apart from these problems mortality among children was also present in these families. Thirty seven deaths were recorded among children of 32 families where main cause of death was respiratory problem. Health problem chronic as well as acute were reported by families and for chronic problems compliance for treatment was lacking because of financial constraints. Families’ response pattern was good at the times of acute illnesses as majority 73.7% of them approach health facility as soon as first sign appear but maximum prefer to go to private practitioner. Apart from it drug addiction was prevalent among different family members and after addiction verbal quarrel and physical quarrel had been reported. Majority of the families with drug addiction had not taken any measures for managing addiction.Family size is an important determinant of how well the family function which include housing facility, clothing, financial conditions, family response pattern , social relations with family & society, dietary pattern and routine activities. Majority of the families were social as participate actively in social functions of their family and neighbours and shared things with neighbours also. Only few couples were able to do savings. Some had taken loan from bank for some or the other financial need. Household work was managed well as wives were helped by family members especially daughters, other took help of husbands, sons, mother-in-law, daughter-in-law and rarely by neighbours. The study concluded that despite of all the developments attitude and behaviour of people for gender preference for male child still remains same. Educational status of women and wives’ age at marriage significantly affect the size of family. Other related factors were background of the couple, state to which belong, lack of knowledge, socio-cultural practices etc. These families had to face many problems but they get adjusted to such problems and learn how to manage with most of them except few. The study recommends behaviour modification and attitude towards gender preference. There is great need to increase women literacy for empowering women, IEC activities to limit the size of families. Personalized counselling, guidance and follow up regarding bir th control measures. Lot of motivational and behavioural research are needed to be done for adopting small family norm.

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