Toward an assessment of the social role of rural midwives and its implication for the family planning program: an Iranian case study

An axiom of family planning programming is the importance of culturally-appropriate communicators and motivators. Traditional midwives seem ideal for this task but few studies have been done to verify this assumption by analyzing the midwife's social role as perceived by the community. 325 married women and 81 unmarried girls from a "model village" near Shiraz were interviewed by female undergraduates. 82.5% of the women are of childbearing age; 66% married before 14 years; 33% use contraception, mostly the pill, but most want large families because they expect high child mortality rates. Most of the older women are able to assist in childbirth but none, except the village's one recognized midwife, who is considered to have divine backing, will do so except in an emergency. The midwife's activities cause her to be held in low esteem by the community because 1) she has contact with a woman's sexual parts and this fact is public; 2) she has contact with vaginal excretia which are, in Islam, polluting; and 3) she is paid for her services, which labels her as a woman "without shame". The midwife is, however, widely used since women and their husbands fear the trip to the hospital and treatment by a male doctor much more than a midwife-supervised birth. The midwife in the study village had been there only 2 years and feels that she is not fully trusted. She is not consulted on birth control at all, because women expect the pill to be dispensed by doctors and consider other methods as a matter strictly between husband and wife. The midwife's role seems to complement that of the government health authorities rather than compete. The midwife's low status and circumscribed sphere of activity, the weak respect in which her advice is held and the pattern of having only 1 recognized midwife in a village at a time make the midwife a poor agent for family planning services. Her effectiveness as an agent of social change could be improved by training her in hygienic practices of childbirth and by redefining her role-relationship with the community. Studies should be done to identify the areas where traditional birth attendants are the best family planning communicators and those where that role is best left to others.     

Migration, remittances and rural development: findings of a case study in the Indian Punjab

Rural household survey data in the Ludhiana district of the Indian Punjab was used to study the nature and role of remittances in rural development. Of the 1646 outmigrants from the area since 1961, the 949 women who migrated for marriage and children under 12 years old were excluded from the study. Nearly all husbands who outmigrated had sent remittances. Parents and grandparents were 2nd and 3rd most likely to remit, but their numbers were small. Education did not correlate with remittance. Distance and time since emigration did not affect remittance. The frequency and the size of remittances are discussed. Remittances to outmigrants were insignificant. The remittances from outmigrants seem to raise the incomes and the levels of living of rural households. The remittances serve the purpose of redistributing income from urban to rural areas. Remittances also widened the gap between rich and poor in the rural areas because the better-off groups were more likely to receive remittances than the poorer groups. Most of the money sent from outmigrants was spent on consumable goods, food and clothing. Only a small proportion was spent on productive investment. This was usually done by farming families who invested in land or farm necessities. It is concluded that remittances from outmigrants can have a positive effect on the rural economies. Investment opportunities for nonagricultural families must be provided.     

The old-new distinction and naturalization: 1900

The author analyzes differences in naturalization baetween "old" groups of migrants coming primarily from Northern and Western Europe and "new" migrants from Southern and Eastern Europe. The primary focus is on naturalization as a measure of assimilation into the United States. Reasons for differences between the two groups are discussed     

Perceived morbidity, utilisation of health services and factors affecting it in a rural area

A survey of perceived morbidity was carried out in rural population in eight villages and four wards of Saoner town, covering a total population of 8,876. The nature of illness was assessed by weekly visits to the families. History regarding treatment taken for disease and its source was taken. The overall incidence of perceived morbidity was 176.35 spells of sickness per 1000 population per month. Health care agency was contacted for 36.7 per cent spells of sickness. Utilisation of health services was found to be affected significantly by factors like age (chi 2 = 138.36), literacy (chi 2 = 14.123), type of occupation (chi 2 = 433.74), nature of illness (chi 2 = 83.578) and accessibility of health services. A health behaviour model of the population has also been discussed in this paper.