RELIGION CHANGE AND ITS REFLECTION ON DEMOGRAPHIC BEHAVIOR Commented [M1]: Title: Affects of Demographic Factors on

Use of Contraceptives among the Santals of Dinajpur District.

TO THE SANTALS IN DINAJPUR DISTRICT, BANGLADESH Commented [M2]: It is better to use “among” instead of ‘to’
Commented [M3]:
ABSTRACT

The aim of this study was to represent the socio economic condition of Santals population Commented [M4]: Put capital S for writing Santals

and to identify the determinants of uses of contraception to the santals community in

Bangladesh. For this, total of 100 santals population of age 23 to 49 years were interviewed

through a structured questionnaire. Both the bivariate and multivariate analyses were used to

analyze data. Bivariate analysis has been performed to show the association between the use

of contraception with some demographic and socio economic characteristics. In multivariate

analysis, logistic regression analysis was used to determine the dominant factors which affect

the use of contraception. The result revealed that, about 62.0% of the total respondents have

used different sorts of contraception. Higher rate of contraception use was found in the

nuclear families (67.50%) with having the economic crises (74.30%). The respondents having

the conscious of health have used different form of contraception more and use of

contraception vary among the male (79.70%) and female (11.50%). We recommended to Commented [M5]: (Rewrite the sentence) General education
for common people and restructure of present reproductive and
contraception service delivery system were recommended.
make the common people educated and to restructure the present reproductive health and

contraception service-delivery system.

Key words: Santals population, contraception using pattern, binary logistic regression

analyses, Bangladesh

INTRODUCTION

With about 160 million people in a land area of 1,47570 square km Bangladesh is one of the

most densely populated country in the world (PRB, 2010; BBS, 2011). People of this country

are known as the hard working with proven capability to preserve mental strength in the

event of unexpected extensive loss due to natural calamities such as food , cyclones, Commented [M6]: insecurity

1
epidemics, etc. and followed the strong religious and community bindings. By tradition,

people of the different religious and races have been lived here with peace and they can share Commented [M7]: religions
Commented [M8]: races
their culture with one another. Among of them tribal population is the most smallest and have Commented [M9]: delete

a different life culture. The proportion of tribal population in the 64 districts varies from less

than 1% (Rahman et al., 2013) and in majority of the district to 56% in Rangamati, 48.9% in Commented [M10]: districts

Kagrachiri and 48% in Bandarban in the Chittagong Hill Tracts (GoB, 2008). This tribal Commented [M11]: GB

groups are further divided secondarily into 45 different tribal groups (GoB, 2011) according Commented [M12]: GB

to the unique language, culture, traditions, religious and the customs that are primary based

on Sino-Tiben ancestry (Chowdhury , 2002). Among of them, santals are one of the most Commented [M13]: Tibetan
Commented [M14]: Santals
disadvantage and vulnerable indigenous communities (Samad, 2012). About 0.40 % (0.607

miliion) of the total population are santals (BBS, 2011) and they are distributed across 64 Commented [M15]: million
Commented [M16]: is
districts in Bangladesh.

Though Bangladesh is quite rich in ethnic culture but for a hundred of years, they have been

facing serious violations of human rights. The state promises to be the protector of its people

and providing the necessary safety and security but santals population are often face the Commented [M17]: Santals
Commented [M18]: Delete are
land-grabbing, threats, evictions and killings. Also over the years, displacement and Commented [M19]: problems of

acculturation of the santals population have brought about dramatic change in their life styles

and value system (Rahman, 2012). Besides, political disturbances and civil strife during

1974-1996 largely prevented the undertaking of any meaningful development activity in the

santals community (Ahmed, 2005). The isolation from mainstream development activities,

together with a high level of poverty and difficult accessibility to the existing health facilities

made the santals communities specifically vulnerable to the various reproductive health

related problem. People in this community are unaware about the reproductive health and the

use of contraception. But research on tribal health has predominantly focus on the prevalence Commented [M20]: focused

of morbidity, health provision coverage, profiles of illness (Karim et al., 2005; Barkat et al.,

2
1999; Chowdhury et al., 2003) rather than people’s knowledge, practices, attitude, opinion

towards the reproductive health and the use of contraception. Relatively few studies have

predominantly focused about the reproductive health and the contraception use pattern in the

santals population of Bangladesh. However it is necessary to qualitative about their Commented [M21]: to undertake qualitative research about
..................

knowledge and attitudes about the reproductive health and the risk factors which may affect

the use of contraception.

Considering the socio culture, geographical location, and topographical uniqueness of the Commented [M22]: socio-econo-politico culture

santals population in Bangladesh, their attitude and opinion about reproductive health and the

pattern of using contraception may differ from plain land Bengalis population. Thus it is Commented [M23]: delete

challenging the present reproductive health services delivery system and the contraception

facilities that have largely been based on the pattern and needs formulated by the plain land

population. Thus this paper aimed to explore the context, attitude, pattern and opinion about

the reproductive health and the contraception using pattern. The specific objectives were to:

(a) explore the demographic and socio economic condition of the santals population; (b)

identify the associated factors of contraception use and (c) identify the risk factors of

contraception use in the santals community of Bangladesh.

DATA AND METHOD Commented [M24]: Methodology

Data for this study was collected from 100 santals population of age 23 to 49 years. To

collect data, the interview method was conducted during February 5, 2017 to March 8, 2017

of Mominpur Union under Parbatipur upazila and Dinajpur district in Bangladesh.

Respondents were interviewed using the standard questionnaire. Bengali version of the

questionnaire was used for more accurate data collection. Responses were then converted to

English for data entry and analysis with Statistical Package for Social Sciences (SPSS)

version 16.0. Both univariate and multivariate analyses were performed for this study. In Commented [M25]: used

univariate analysis, the percentage of the respondents with some selected demographic and

3
socio-economic characteristics are shown. Again by using the bivariate analysis, proportions Commented [M26]: have been

were compared by using chi square   test

2
to analyze the significant association of

demographic and socio variables and the use of contraception and conversion of religion. The

logistic regression technique was used to evaluate the effects of the selected group of

variables on the use of contraception.

Variable selection

The dependent or response variable in this analysis are the use of contraception (0=No, Commented [M27]: were

1=Yes). To examine the determinants of use of contraception several independent variables

were include that have been highly associated with use of contraception and conversion of Commented [M28]: were

religion. The independent variables were age (0= ≤30, 1=31-40, 2= >40), gender (0=male,

1=female), religion (0=Sonaton, 1=Christian), types of family (0=Single, 1=Joint), Commented [M29]: neuclear

educational status (0=illiterate, 1=literate), respondents occupation (0=agriculture, 1=others),

family income (0= ≤2000,1=>2000), manage economic crises (0=Loan, 1=Others), family

planning services (0= No, 1=Yes), family economic condition (0=Others, 1=Good) and Commented [M30]: poor

consciousness of health (0=No, 1=Yes).

RESULT AND DISCUSSION

The demographic and socio economics characteristics of the santals population are presented

in Table 1. Among the total respondents, 37.0% are in the age group >40 years and 27.0% are

in the age group ≤ 30 years. Majority of the respondents are male (74.0%) and 26.0% are

female. Male respondents on average the same for all age groups (≤ 30= 33.78%, 31-40= Commented [M31]: The table shows that all the age groups of
male respondents were proportionately equal (........) whereas
about one half of the female respondents fell in the category of 31-
31.08%, >40= 35.13%) whereas about half of the female respondents in the age groups 31-40 40 years.

years. All the male respondents in the survey time had found in the still marital union. The Commented [M32]: marital status

opposite picture found in the female respondents. The study results revealed that, majority of

the female respondents (88.47%) have had currently separated from their formal union due to

the death of husband, divorced and others and only 11.53% of the total female respondents

4
(26) had found to be formal marital union. Santals populations are mainly Christian and

Hindu. Analysis reveals that, about half (49.0%) of the total santals respondents are Christian Commented [M33]: a half
Commented [M34]: were
(male= 47.30%, female= 53.84%) and 51.0% (male= 52.70%, female=46.15%) are Hindu Commented [M35]: were

(sonaton). Though education has found to be very important factors about the practices of

contraception and improvement of the socio economic condition in the santals community,

but reality is that most of the santals populations are uneducated (74.0%) and they have not

enough knowledge about the reproductive health and the different form of contraception.

Only 26.0% of the total respondents have at least a minimum level of education. Education

level on average the same among male (uneducated= 72.97%, at least a minimum level of

education= 27.03%) and female (uneducated= 76.93%%, at least a minimum level of

education= 23.07%) respondents. Generally santals populations are more interested to live in

nuclear family as compared to the joint family. Analysis reveals that, about fourth fifth Commented [M36]: revealed
Commented [M37]: fifths
(80.0%) of the total respondents are lived in nuclear family (male= 83.78%, female= 69.23%) Commented [M38]:

and only 20.0% of the total respondents live in joint family (male= 16.22%, female= Commented [M39]: lived

30.77%). The average household size of the respondents is 4.02. Majority of the families Commented [M40]: was
Commented [M41]: Most
(70.0%) have the family member less than 4 (male= 67.57%, female= 76.93%) and only Commented [M42]: had

30.0% of the total respondents lived with had family members more than 4 (male= 32.43%, Commented [M43]: delete

female=23.07%). Male are head of the most of the santals family. In total of 74.0% of the Commented [M44]: Most of the santal families had male head

total family are managed by male respondents and only 26.0% of the total family manage by Commented [M45]: were
Commented [M46]: fmilies were managed
female respondents. Agriculture is the primary source of income in the santals population. Commented [M47]:

Analysis revealed that about 70.0% of the total respondents are currently involve in Commented [M48]: were
Commented [M49]: involved
agricultural works (male= 32.43%, female= 23.07%) and only 26.0% of the total respondents
Commented [M50]: were

are currently work as a labor (male= 67.57%, female= 76.93%). Santals population live in Commented [M51]: delete worked
Commented [M52]:
Bangladesh have the little family income. It shows that, the average household income of the Commented [M53]: living
Commented [M54]: Data in the table
respondents is 1880 TK. About fourth fifth (78.0%) of the total respondents (male= 74.32%,
Commented [M55]: was
Commented [M56]: fifths

5
female= 88.46%) are live with family income less than 2000 TK and only 22.0% of the Commented [M57]: had

respondents (male= 25.68%, female= 11.54%) are live with family income more than 2000 Commented [M58]: had

TK. Majority of the respondents take loan to remove the financial crises and to meets the Commented [M59]: took loan.to meet financial crisis and
family needs......

others needs (male= 78.38%, female=46.16%) whereas only 30.0% of the total respondents

meet their needs (male= 21.62%, female= 53.84%) by other ways ( to received help from Commented [M60]: met

neighbors, relatives and others). In total of 36.0% of the respondents have no cultivated land Commented [M61]: received
Commented [M62]: had
(male= 32.44%, female= 46.15%), whereas 28.0% (male= 29.73%, female= 23.08%) of the

total respondents have the cultivated land more than 30 decimal and 36.0% (male= 37.83%, Commented [M63]: had

female= 30.77%). Majority of the respondents (56.0%) are not consciousness about their Commented [M64]: were

health (male= 52.71%, female=65.38%) and only 44.0% of the respondents are conscious Commented [M65]: more than two fifths .of the respondents
were.conscious....

about their health (male= 47.29%, female= 34.62%). Commented [M66]:

The contingency analysis between the use of contraception and others characteristics are

presented in Table 2. Total of 62 (62.0%) respondents have record that they are presently Commented [M67]: delete

used different types of contraception and the respondents sex, head of the family, types of

family, economic crises, ways to remove economic crises, maintain family with income and

health consciousness are significantly associated with the use of contraception. Commented [M68]: were

In this study, males are found to be more user of contraception than females. Analysis

revealed that, about 79.70% of the total male respondents are currently using different types Commented [M69]: were

of contraception whenever this percentage is only 11.50% among female. Head of the family Commented [M70]: was

are also plays the significant role of using the contraception. Analysis shows that, the families Commented [M71]: delete
Commented [M72]:
whose are manages by the male respondents are used more contraception as compared to the Commented [M73]: played
Commented [M74]: which were administered by the
families whose are manages by the female. About 79.70% of the total families whose head
Commented [M75]: which were headed by males were
using......
are male are presently using different types of contraception. On the other hand, about

88.50% of the total families whose heads are female are not using any types of contraception. Commented [M76]: were
Commented [M77]: were

6
Types of the families also play the significant role of the use of contraception. Generally the

members of the joint family are less interested to use any contraception and want to more

children in his/her reproductive live. The opposite picture found in the nuclear families. The

members of the nuclear families are so conscious about their health and want to limited Commented [M78]: were
Commented [M79]: limit
number of child in his/her reproductive life time. Analysis shows that, 67.5% of the total Commented [M80]: children

nuclear family members presently using the different sorts of contraception whereas only two

fifth (40.0%) of the total joint family members are presently using the different sorts of Commented [M81]: were

contraception. There is also having a significant association of the economic crises and the

use of contraception. Generally more children in reproductive time required the more food

and others facilities. Respondents clearly understood this term and higher contraception using

rate are found in the families (74.30%) with free from economic crises. Similar results were Commented [M82]: were

also found in the families who were taken the loan (75.70%) from different organizations and Commented [M83]: took

rather than normal to maintain the family. with income (66.67%). Health consciousness also Commented [M84]: Delete
Commented [M85]: delete
plays the significant role of the use of contraception. Generally the couples whose are so Commented [M86]: played
Commented [M87]: who were
conscious about their health, want a limited number of child in his/her reproductive time.
Commented [M88]: wanted
Commented [M89]: children
Analysis shows that, three fourths (75.0%) of the total respondents who are conscious about
Commented [M90]: were

their health are presently used different sorts of contraception. Commented [M91]: were using

Impacts of the associated factors on use of contraception is identified by the binary logistic Commented [M92]: was

analysis are presented in Table 3. The characteristics of the respondents were sex, head of Commented [M93]: delete

family, types of family, economic crises, maintain family with income and health

consciousness are found to be very important factors for use of contraception.

Our findings demonstrate that sex of the respondents is highly significantly associated with Commented [M94]: was

the use of contraception. The female respondents are 98% (OR= 0.022, 95% CI= 0.004- Commented [M95]: were

0.125) less interested in the use of any form of contraception than their male counterpart.
Commented [M96]: maitained
Female, who are maintain the family and involve with different occupations are generally
Commented [M97]: involved
Commented [M98]: delete

7
wanted the limited number of children in her life time. Analysis reveals that, families with Commented [M99]: revealed

female household head are 1.0345 (OR= 1.0345, 95% CI= 0.303-1.890) times more using Commented [M100]: were

contraception as compared to the family whose are manage by the male. Commented [M101]: who were managed

Although the members of the joint family are generally less interested to use contraception Commented [M102]: were

and want more child in his/her life time by traditions. Analysis reveals that, member of the Commented [M103]: wanted
Commented [M104]: children
joint families are 57.20% (OR= 0.428, 95% CI= 0.102-1.796) less use the different form of Commented [M105]: revealed
Commented [M106]: were
contraception than member of the single family.

Economic crises of the family are plays the most significant impact on the use of Commented [M107]: played

contraception. Analysis showed that, the families with different form of economic crises are Commented [M108]: delete

20.055 times (OR= 20.055, 95% CI= 0.862-466.362) more use contraception as compared Commented [M109]: used more

with the families with free from any kind of economic crises. The similar results were also

found in the ways to remove economic crises and maintain with family income. Analysis also

showed that, the rate of contraception use was 60.80% (OR= 0.392, 95% CI= 0.021-7.254)

less among the families whose members are getting help from the neighbors and others to Commented [M110]: were

removing the economic crises in the families. Also contraception use rate was 1.153 times

(OR= .153, 95% CI= 0.338-3.939) higher among the families whose member followed

different alternative ways (loan, neighbor etc.) for removing poverty in the family. Our result

also revealed that, contraception use rates were 2.885 (OR= 2.885, 95% CI= 0.835-9.962)

times higher in the families whose member were so conscious about their health.

CONCLUSION Commented [M111]: Rewrite the conclusion accrding to your

objectives and results.

The main aim of this study was to look at the pattern of contraception use and the risk factors Commented [M112]: Risk factor was not studied, so delete it
or change the objective

that affect the use of contraception within the santals community in Bangladesh. The study

result shows that, about 62.0% of the total respondents use the different from of

contraception. Sex, head of the family, types of family, economics crises, way to remove

economic crises, maintain family with income and health consciousness were significantly

8
associated with the risk of contraception use. So it is necessary to be educated general people

about the dire effect of high fertility on health and the country by giving the special priority

on the female and members in the joint families. It is also recommended to restructure the

present reproductive health and contraception service-delivery system.

Funding sources

There is no funding source for this study.

Acknowledgement

The author gratefully acknowledged the Department of Population Science, Jatiya Kabi Kazi Nazrul

Islam University, Mymensingh, Bangladesh where this study was conducted. Commented [M113]: No need to present funding sources and
acknowledgement

References:

1. Population Reference Bureau (PRB) (2010). World population data sheet. Washington

DC, USA.

2. Rahman AS, Kielmana T, McPake B, Normand C, (2012). Healthcare-seeking Behavior

among the tribal people of Bangladesh: Can the Current Health System Really Meet Their

Needs?.J health populnutr, 30(3):353-365

3. Government of Bangladesh (GoB) (2011). Tribal/ethnic Health Population and Nutrition

Plan for the Health, Population and Nutrition Sector Development Program (HPNSDP)

2011 to 2016. Ministry of Health and Family Welfare,Government of Bangladesh.

4. Chowdhury BH (2002). Building lasting peace: issues of the implementation of the

Chittagong Hill Tracts accord. Champaign, IL: Program in Arms Control, Disarmament,

and International Security, University of Illinois at Urbana-Campaign.

5. Samad MD, (2012). The santals in Bangladesh: Problems, Needs and Development

Potentials.

9
6. Government of Bangladesh (GoB) (2008). Implementation of Tribal Health, Nutrition anf

Population Services Plan. Ministry of Health and Family Welfare

(MOHFW),Government of Bangladesh.

7. BBS (2011). Population census 2011.preliminary report. Bangladesh Bureau of Statistics,

Ministry of Planning, Dhaka, Bangladesh.

8. Ahmed SM, Tomson G, Petzold M, Kabir ZN (2005). Socioeconomic status overrides age

and gender in determining health-seeking behaviour in rural Bangladesh. Bull World

Health Organ, 83:109-17.

9. Karim F, Rafi M, Begum SA (2005). Inequitable access to immunization and vitamin A

capsule services: a case of ethnic minorities in three hill districts of Bangladesh. Public

Health, 119:743-6.

10. Barkat-e-Khuda, Roy NC, Rahman DMM (1999). Unmet contraceptive need in

Bangladesh: evidence from the 1993/94 and 1996/97 Demographic and Health Surveys.

Asia Pac Popul J, 14:37-50.

11. Chowdhury AMR, Bhuiya A, Mahmud S, Salam AKMA, Karim F (2003). Immunization

divide: who do get vaccinated in Bangladesh? J Health PopulNutr, 21:193-204.

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Variable Sex Total (%)

Table 1: Demographic and socio economic characteristics of the respondents

11
 Male (%) Female (%)
Age (in years)
≤ 30 25(33.78) 2(7.69) 27(27.0)
31-40 23(31.08) 13(50.0) 36(36.0)
>40 26(35.13) 11(42.31) 37(37.0)
Marital status
Married 74(100) 3(11.53) 77(77.0)
Others 0(0.0) 23(88.47) 23(23.0)
Religion
Sonaton 39(52.70) 12(46.15) 51(51.0)
Christian 35(47.30) 14(53.84) 49(49.0)
Educational Status
Uneducated 54(72.97) 20(76.93) 74(74.0)
At least a minimum level of education 20(27.03) 6(23.07) 26(26.0)
Types of family
Nuclear 62(83.78) 18(69.23) 80(80.0)
Joint 12(16.22) 8(30.77) 20(20.0)
Household size
At most 4 50(67.57) 20(76.93) 70(70.0)
More than 4 24(32.43) 6(23.07) 30(30.0)
Head of family
Male 74(100) 0(0.00) 74(74.0)
Female 0(0.00) 26(100) 26(26.0)
Occupation
Farmer 24(32.43) 6(23.07) 70(70.0)
Labor 50(67.57) 20(76.93) 30(30.0)
Family income (in Taka)
≤2000 55(74.32) 23(88.46) 78(78.0)
>2000 19(25.68) 3(11.54) 22(22.0)
Ways to remove financial crises
Loan 58(78.38) 12(46.16) 70(70.0)
Others 16(21.62) 14(53.84) 30(30.0)
Cultivate land (in decimal)
≤30 28(37.83) 8(30.77) 36(36.0)
>30 22(29.73) 6(23.08) 28(28.0)
No land 24(32.44) 12(46.15) 36(36.0)
Consciousness of health
Yes 35(47.29) 9(34.62) 44(44.0)
No 39(52.71) 17(65.38) 56(56.0)
Total 74(74.0) 26(26.0) 200(100)

Table 2: Chi square test for measuring the association between use of contraception
method and some selected variables

Variables Use of contraception P value

12
 Yes (%) No (%) Total (%)
Age (in years)
≤ 30 19(70.40) 8(29.60) 27(100)
31-40 24(66.70) 12(33.30) 36(100) 0.233
>40 19(51.40) 18(48.60) 37(100)
Sex
Male 59(79.70) 15(20.30) 74(100) 0.000
Female 3(11.50) 23(88.50) 26(100)
Religion
Sonaton 33(64.70) 18(35.30) 51(100) 0.570
Christian 29(59.20) 20(40.80) 49(100)
Head of family
Male 59(79.70) 15(20.30) 74(100) 0.000
Female 3(11.50) 23(88.50) 26(100)
Types of family
Nuclear 54(67.5) 26(32.5) 80(100) 0.023
Joint 8(40.0) 12(60.0) 20(100)
Household size
At most 4 40(57.10) 30(42.90) 70(100) 0.126
More than 4 22(73.30) 8(26.70) 30(100)
Educational Status
Uneducated 43(58.10) 31(41.90) 74(100) 0.176
At least a minimum level of education 19(73.10) 7(26.90) 26(100)
Occupation
Farmer 20(66.70) 10(33.30) 30(100) 0.529
Labor 42(60.0) 28(40.0) 70(100)
Family income (in Taka)
≤2000 50(64.10) 28(35.90) 78(100) 0.415
>2000 12(54.50) 10(45.50) 22(100)
Economic crises
Yes 55(74.30) 19(25.70) 74(100) 0.000
No 7(26.90) 1973.10) 26(100)
Way to remove economic crises
Loan 53(75.70) 17(24.30) 70(100) 0.000
Others 9(30.0) 21(70.00 30(100)
Maintain family with income
Normal 26(56.52) 20(43.48) 46(100) 0.000
Others 36(66.67) 18(33.33) 54(100)
Health consciousness
Yes 33(75.0) 11(25.0) 44(100) 0.018
No 29(51.80) 27(48.20) 56(100)
Total 62(62.0) 38(38.0) 100(100)

Table 3: Result of logistics regression analysis of use of contraception by some selected

characteristics

Characteristics Use of contraception 95% CI

Regression co- Standard Odds Lower Upper

13
 efficient (β) error of β Ratio
Sex
Male® ……….. 1
Female -3.798 0.879 0.022*** 0.004 0.125
Head of family
Male ® ……….. 1
Female 0.449 0.432 1.0345** 0.303 1.890
*
Types of family
Nuclear ® ………… 1
Joint -0.849 0.732 0.428*** 0.102 1.796
Economic crises
No® ………… 1
Yes 2.998 1.605 20.055** 0.862 466.36
Way to remove economic crises
Loan ® ………… 1
Others -0.937 1.489 0.392*** 0.021 7.254
Maintain family with income
Normal® ………….. 1
Others 0.142 0.627 1.153*** 0.338 3.939
Health consciousness
No® ……….. 1
Yes 1.059 0.632 2.885** 0.835 9.962
Note: ** = Significant at P <0.05, *** = Significant at P <0.01 and Odd Ratio (OR) 1 represent
reference category and ®) represent the Reference Category

14