Clinical examination of pregnant women by paramedical and medical personnel: an assessment of consistency of findings in a field study.

BACKGROUND: As a part of a project to improve the maternal and child health services in 4 primary health centres (PHCs) in Bellary and Raichur districts of Karnataka, we assessed the consistency in recording symptoms, signs and some clinical observations of pregnant women by three examiners-the junior health assistant, medical officer of the PHC and a private medical practitioner. METHODS: One hundred seventy-four pregnant women were examined independently by the three examiners on the same day for 4 symptoms reported by the women themselves, 4 signs assessed by the examining person and 9 simple clinical observations. Agreement rates in each examiner pair for each parameter were assessed. RESULTS: We found poor rates of agreement in assesment of various parameters by each observer pair. The disagreement rates were lower between the two doctors compared with those between the junior health assistant and each doctor. CONCLUSION: The agreement rates between various healthcare personnel in assessing pregnant women are low. There is a need for measures to correct this situation.

Couple's literacy level and acceptance of family planning methods: Lorenz curve analysis.

PIP: The authors study the acceptance of family planning methods according to the level of couple's literacy in 14 states in India during 1986-87, using the Lorenz curve. The Gini Concentration Ratio and Index of Dissimilarity were calculated by level of couple's literacy for vasectomy, tubectomy, IUD, and all method combined. Firstly, analysis found literates to have accepted vasectomy and IUD more than tubectomy. Secondly, among the 3 methods, a high Gini Concentration Ratio was found for vasectomy when the wife was literate. Moreover, when the wife was literate, the Gini Concentration Ratio of IUD acceptance was higher than the acceptance of IUD by the wife whose husband was literate. Thirdly, the same trend was observed when the husband was illiterate. It is therefore clear that the level of a woman's literacy is a key factor in securing the acceptance of male or female methods of family planning. Planners should therefore concentrate on literacy programs for females independently of their age. Increasing the level of female literacy may ultimately help improve the understanding of family planning methods, while these women may also motivate their husbands to undergo vasectomy which will ultimately foster the success of the family planning program.^ieng

Socio-economic variables influencing mean age at marriage in Karnataka and Kerala.

"In this paper an attempt was made to study the influence of certain socio-economic variables on the male and the female age at marriage in Karnataka and Kerala [India] for the year 1971. Step-wise regression method has been used to select the predictor variables influencing mean age at marriage. The results reveal that percent female literate...and percent female in labour force...are found to influence female mean age at marriage in Kerala, while the variables for Karnataka were percent female literate..., percent male literate..., and percent urban male population...."