INTRODUCTION:

“Female foeticide remains the gravest of all issues concerning women, every night in a hospital a girl child is aborted in silence.”

Female infanticide has been a common practice in our country since centuries. India’s census has always shown a gender imbalance. This marked gap between boys and girls, which has nationwide implications, is the result of decisions made at the most local level- the family. Sex selective abortion is a fairly recent phenomena but its root can be traced back to the age old practice of female infanticide.

In most of the countries in the world, there are approximately 105 female births for every 100 males. But in 2000, a United Nations report estimated that 79 million females are missing from South Asia alone and attributed this number to sex – selective abortion and infanticide. It is estimated that 30.5 million females are missing from China, 22.8 million in India, 3.1 million in Pakistan, 1.6 million in Bangladesh, 1.7 million in West Asia, six lakhs in Egypt, and two lakhs in Nepal.¹

Census India 2001 reported over 10 million female foetuses have been aborted in India in the past two decades. The sex ratio as per 2001 census the females are 933 per 1000 males. Although a marginal improvement of six points in the overall female to male sex ratio in India from 927 in 1991 to 933 in 2001 is an encouraging development, the massive decline of 18 points in the juvenile sex ratio (age group of 0 to 6) from 945 to 927 in the country after 1981 is what shows the extensive female foeticide in India. Female foeticide and female infanticide continues unabated in Haryana causing the child sex ratio to fall from 879 in 1991 to 820 in 2001 census. Out of 10 districts in India with least child sex ratio in rural areas, three are from Haryana i.e. Sonipat(783), Ambala(784) and Kurukshetra (770).²

In almost every village of Haryana one could find hundreds of boys/men who are not getting married at the suitable age and suitable local brides are becoming fewer in numbers but this has in no way led to any decrease in dowry demands or enhancement of the status of local women. Rather it has led to buying, selling and reselling of women, abduction of women and their sexual exploitation, marriages at a much younger age and implementation of very harsh ‘control measures’ to keep women in subservience and check .³

Therefore, it is evident that the incidence of female foeticide and female infanticide and its associated impacts calls for ongoing programme on prevention of female foeticide and female infanticide.

A study conducted on 100 married couples to assess existing knowledge and attitude towards female foeticide found that the existing knowledge level about female foeticide was low for almost all couples and the attitude of most couples was highly unfavourable towards female foeticide.⁴

The problem of infanticide could be addressed only through a multi dimensional approach, having effective strategies to address the issues of gender equity, community awareness against the killing of girls, means to address the needs of fertility regulation and effective enforcement of the legislation.⁵ It is only by a combination of monitoring, education campaigns and effective legal implementation that the deep-seated attitudes and practices against women and girls can be eroded.⁶

It’s high time we end this barbaric practice. Now is the time to energies efforts to put gender equality at the top of international peace and development agenda. The researcher by extensive review of literature found that very less effort is being implemented to reduce the female foeticide and female infanticide at the grass root level. Hear come the role of sensitized health professional to built awareness in the public regarding the prevention of female foeticide and female infanticide. So the researcher felt need to conduct a study to evaluate the effectiveness of Public Awareness Programme on prevention of female foeticide and female infanticide in terms of knowledge and attitude of adults in a selected community in Ambala, Haryana.

OBJECTIVES:

To assess and evaluate the knowledge as well as attitude of adults regarding prevention of female foeticide and female infanticide before and after the administration of Public Awareness Programme (PAP), to determine the relationship between their knowledge and attitude before and after the administration of PAP and establish relationship of their knowledge and attitude with selected variables.

MATERIAL AND METHOD:

The research approach adopted for the study was evaluative with one group pre-test post-test design. The independent variable under study was Public Awareness Programme and dependent variables were knowledge and attitude regarding prevention of female foeticide and female infanticide. The study was conducted in Budhiya Village of Ambala District, Haryana. Convenient sampling technique was used to obtain an adequate size of sample. The sample comprised of 86 adults of Budhiya village.

The tools used for data collection were structured interview schedule consisted 50 knowledge questions and likert’s five point attitude scale consisted 30 items (15 postive and 15 negative). The reliability of the structured interview schedule was established by KR-20 and was found to be 0.83 and for attitude scale, it was calculated by cronbach’s alpfa and was found to be 0.86. The Public Awareness Programme was structured for enhancing the knowledge and developing favourable attitude of adults toward prevention of female foeticide. A set of posters and a role play was prepared for conducting Public Awareness Programme. The content validity of the tools, Public Awareness Programme and the posters and script of role play was established by nine experts seven from the field of Nursing, a NGOs and a District programme manager.

The pilot study was conducted from 7-11-2009 to 15-11-2009 in the Mullana village to find out the feasibility of the study. Since the interview to determine knowledge and attitude took long time (60min for structured knowledge interview schedule and 30 min for attitude scale), the researcher planned to involve the co- investigator in the final study data collection.

Formal administrative permission was obtained from the Sarpanch of Budhiya village. Data were collected from 17^th December 2009 to 11^th January 2010. Self introduction and introduction to the nature of the study were given to the adults of the selected community. Rapport was established with the subjects. Informed consent was obtained from the subjects and was assured about the confidentiality of their responses to obtain free and frank response. Finally interview was done and at the same time recording in the tool was also done.

The houses with even house number were selected and an adult in the house was selected using convenient sampling method. The data was collected from morning 9 am to 6 pm. From the day 1-10 the structured interview schedule was conducted for 100 sample subjects followed by pre test attitude test.

Public Awareness Programme was administered to the study subjects in the Aanganwadi of the Budhiya village on 11^th day. Only 86 sample subject attended the PAP. From day 23^rd -26^th, post test knowledge and post test attitude were conducted from the 86 sample subject who attended the PAP in order to evaluate the effectiveness of Public Awareness Programme. No attempt was made to control the extraneous variable

RESULTS:

The findings of the study showed that male preference was practiced in the selected community as evident by the sex ratio of 740 shown in table 1.

Table 1:Frequency Distribution of Married Adults According to No. of Children and Gender Wise Distribution of Children and Sex Ratio

No. of children	Married adults f	Total no. of Male child f	Total no. of Female child f	Sex ratio
0	06	-	-	740
1	14	9	5
2	32	41	23
3	20	35	25
4 and more	05	11	18
Total	77	96	71

The area wise mean percentage of pre test and post test knowledge scores obtained by adults on structured interview schedule are presented in figure 1. The bar graph shows that there is gain in knowledge in all the content areas after the administration of Public Awareness Programme on prevention of female foeticide and female infanticide.

KA1: Concept of Female Foeticide and Female Infanticide;

KA2: Causes of Female Foeticide and Female Infanticide

KA3: Impact of Skewed Sex Ratio; KA4: Prevention of Female Foeticide and Female Infanticide

FIGURE 1: Bar Graph Comparing the Mean Percentage of Pre test and Post test Knowledge Scores in Specific Content Areas Obtained by Adults.

In order to determine the significance of the difference between means of pre test and post test knowledge scores, t value was computed for correlated means.

Table 2: Significance of difference between means of knowledge

Knowledge test	Mean	Mean_D	SD_D	SE_MD	t value

Pre test	28.19
		11.30	5.13	0.38	29.54*
Post test	39.48

‘t’ (85) = 1.99 at 0.05 level of significance

*significant at 0.05 level

The data presented in Table 2 showed that t value was significant at 0.05 levels for df 85. The computed t value, t (85) = 29.54, P 0.05 indicated that significant difference between the pre test knowledge scores and post test knowledge scores was true difference and not by chance indicating that Public Awareness Programme on prevention of female foeticide and female infanticide was effective method for increasing the knowledge of adults regarding prevention of female foeticide and female infanticide.

Table 3: Frequency and percentage distribution of attitude scores in terms of range of attitude score

Range of Attitude score	Pre Test		Post test
Range of Attitude score	f	%	f	%
Un favourable(30-70)	-	-	-	-
Moderate favourable (71-110)	47	54.65	44	51.16
Favourable (111-150)	39	45.34	42	48.84

Minimum score= 30,

Maximum score= 150

The data presented in Table 3 showed that in the Pre test 54.65 % of adults had moderately favourable attitude and 45.34 % of adults had favourable attitude toward prevention of female foeticide and female infanticide whereas in the post test 51.16% of adults had moderately favourable attitude and 48.84% had favourable attitude toward prevention of female foeticide and female infanticide.

The data on area wise mean percentage of pre test and post test attitude scores obtained by adults is shown in figure 2 which shows that their was gain in attitude score in all the content areas.

In order to determine the significance of difference between means of pre test and post test attitude scores t value was computed for correlated means, shown in Table 4

Table 4 : Significance of difference between means of Attitude

Attitude test	Mean	Mean_D	SD_D	SE_MD	t value
Pre test	108.15
		1.63	13.9	0.26	6.16
Post test	109.78

‘t’ (85) = 1.99 at 0.05 level of significance

*significant at 0.05 level

AA1: Causes of Female Foeticide and Female Infanticide

AA2: Impact of Skewed Sex Ratio

AA3: Prevention of Female Foeticide and Female Infanticide

FIGURE 2: Bar Graph Comparing the Mean Percentage of Pre test and Post test Attitude Scores in Specific Content Areas.

The data presented in Table 4 showed that the mean post test attitude score of adults was 109.78 and mean pre test attitude score was 108.15 with a mean difference of 1.63, which was found to be significant as evident from ‘t’ value, t (85) = 6.16. Therefore it can be said that the difference obtained in the mean pre test and post test attitude scores was true difference and not by chance.

It indicated that the Public Awareness Programme on prevention of female foeticide and female infanticide was an effective method for developing favourable attitude of adults regarding prevention of female foeticide and female infanticide.

To determine the relationship between pre test knowledge and attitude score as well as post test knowledge and attitude scores, coefficient of correlation was computed and is presented in table 5

Table 5: Correlation between Knowledge Scores and Attitude Scores Obtained by Adults

Test	Knowledge score		Attitude score		r
	Mean	SD	Mean	SD
Pre test	28.18	5.98	108.1	14.07	0.266*
Post test	39.48	4.27	109.8	13.69	0.338*

r (84) ≥ 0.205, p=0.05 *significant at 0.05 level

The findings in Table 5 showed that coefficient of correlation between pre test knowledge and attitude scores was 0.266, suggesting a low correlation between pre test knowledge and attitude scores of adults regarding prevention of female foeticide and female infanticide. The computed r value (0.266) indicated that positive correlation between the pre test knowledge scores and attitude scores was significant at 0.05 levels.

Findings in Table 5 also revealed that coefficient of correlation between post test knowledge scores and attitude scores is 0.338 indicating a significant relationship between the post test knowledge scores and attitude scores at 0.05 level of significance. The findings suggested that therewas positive significant relationship between the post test knowledge scores and attitude scores of adults regarding prevention of female foeticide and female infanticide.

In order to determine the association of post test knowledge and attitude scores with the selected demographic variables chi square was calculated and was found that no significant relationship exist between adults gain in post test knowledge and gain in attitude score and the selected variables. Thus adult’s knowledge gain and favourable attitude towards prevention of female foeticide and female infanticide was independent of their age, gender, religion, caste, education, economic status, occupation, type of family, and marital status.

DISCUSSION:

The findings of the study revealed that the sex ratio in the selected community was found to be 740 which show male preference. The finding is supported by the 2001 census which reported that out of 10 districts in India with least child sex ratio in rural areas, three are from Haryana (Sonipat, Ambala and Kurukshetra).

The public awareness programme was effective in enhancing the knowledge and developing favourable attitude toward the prevention of female foeticide and female infanticide. The findings of the study was similar to the study conducted by Nilima V. S. which showed the usefulness of planned teaching was effective and helped to acquire knowledge and modify attitude regarding female foeticide and helps in creating awareness about adverse effects of female foeticide.⁷ On contrary the print media package on female foeticide developed by Ghosh E. A to evaluate its effectiveness and impact on knowledge and attitude on married couple was found to be significant on knowledge but not on attitude.

The PAP was effective in enhancing the knowledge and development of favourable attitude irrespective of the demographic variables i.e age, gender religion, caste, education, economic status, occupation, type of family, and marital status. Whereas the study conducted by Ghosh E. A. found factors to be significantly associated with knowledge were monthly income, mass media contact and education and factors found to be significantly associated with the attitude of couples were monthly income and mass media contact. Kulkarni S. brought to light the fact that the overwhelming majority of ‘patients’, most of whom were from middle or upper middle class, were only interested in knowing the sex of the foetus⁸. The study conducted by Voluntary Health Association of India, New Delhi observed that even educated women went in for sex-selective abortions, leading to increase in female foeticide⁹. Far from occurring only among the poor and illiterate, sex selection also appears to be most prevalent in regions that boast high levels of educational attainment and relative prosperity¹⁰.

RECOMMENDATION:

Based on the findings, the following recommendations are proposed for future research - the study can be replicated on a larger sample of adults selected from different communities for wider generalization of the findings. A similar study may be conducted with an experimental research approach and pre test post test control group design. A longitudinal study can be conducted to assess effectiveness of series of PAP in terms of incidence of female foeticide and female infanticide and sex ratio in the community.

A follow up study may be conducted to evaluate the effectiveness of Public Awareness Programme on practice of female foeticide and female infanticide. A study can be carried out by using other teaching strategies like video films, pamphlets and puppet show. A teaching manual should be developed for the health care workers especially for nursing personnel as disseminator of information on the female foeticide. A comparative study should be undertaken to compare the knowledge and attitude of males with female regarding prevention of female foeticide and female infanticide. A comparative study should be undertaken to compare the knowledge and attitude regarding prevention of female foeticide and female infanticide in urban and rural community. A study should be undertaken to evaluate the adults in community as a change agent regarding the prevention of female foeticide and female infanticide. A study should be conducted to evaluate the effectiveness of mass awareness programme on adolescent in terms of knowledge and attitude regarding prevention of female foeticide and female infanticide.

CONCLUSION:

The PAP was effective in enhancing knowledge and developing favourable attitude of adults regarding prevention of female foeticide and female infanticide.

REFERENCES:

1. Soundari M. “Right to be born: A study on femicide”. Vaigarai Publications, New Delhi.2008

2. Census of India 2001, www.censusindia.net

3. Rathe M. ”Eradicate Scourge of Female Foeticide”, People’s Democracy, 2005;25,39: 30

4. Ghosh E. A. Attitude and knowledge of rural couples regarding female foeticides: abstract. Hisar: Chaudhury Charan Singh Haryana Agricultural Univ., College of Home Science, Dept. of Extension Education. 2003.

5. Khanna A. Female infanticide in Rajasthan: History in Practice. Journal of Social Development. 2003; 3, 1: 84-94.

6. Grewal, I and J. Kishore. “Female Foeticide in India.” International Humanist and Ethical Union.2004. http://www.iheu.org/female-foeticide-in-india.

7. Nilima V. S. Effect of planned teaching on knowledge and attitude regarding female foeticide among college students of Mumbai, The Nursing Journal of India, 2010; 3: 63-65.

8. Kulkarni S. Pre-natal Sex Determination Tests and Female Foeticide in Bombay City. The Foundation for Research in Community Health, Bombay. 1986

9. Voluntary Health Association of India. Darkness at noon: female foeticide in India. VHAI. New Delhi. 2003: 52

10. Patricia L. “Silent Spring: The Tragedy of India’s Never Born Girls”.2005. http://www.unfpa.org/swp/2005/presskit/docs/india.doc

Received on 08.02.2014 Modified on 22.04.2014

Int. J. Nur. Edu. and Research 2(2): April- June 2014; Page 126-130