The legacy of public action and gender-sensitivity of the pandemic response in Kerala State, India.

Kerala State, India has received global attention in its response to the Covid-19 pandemic. Its response effectively attended to the health pandemic and focussed on economic relief. This paper attempts to understand how gender-responsive Kerala's policies were. Kerala's success was due to its historical preparedness and contemporary policy innovations. Over the years, public action was able to ensure that the state and the society were equipped to meet the challenges of a disaster, such as of the pandemic. In the 1990s, when India sought to limit state intervention and promote market-based solutions, public policy in Kerala shifted gears to deepen state intervention by promoting community participation and empowering women. As in other Indian States, the pandemic in Kerala too led to losses of female employment, rise in gender-based violence, a deterioration of women's mental health and rise in unequal care burdens. But Kerala's response was distinctive. Several policy interventions had foregrounded women's needs, which helped ensure gender-sensitivity in Kerala's pandemic response. Kerala's economic relief package included cash support, employment, free food provision and zero-interest loans to women. Through helplines, the government reached out and helped women report instances of violence and mental stress. The gender-sensitivity of Kerala's pandemic response is a rich guide as a demonstration of its possibilities and a reminder of the essential pre-requisites to achieve it.

Analysis of birth intervals in India's Uttar Pradesh and Kerala States.

Life tables of birth intervals and median birth intervals in two Indian states, Uttar Pradesh and Kerala, were computed for several subgroups of the study population. Multivariate hazards modelling technique was used to examine the net effect of each of the variables studied. The results show a substantial effect of socioeconomic variables in child-spacing after controlling for the major intermediate variables.

PIP: Child spacing patterns have been found to be reflected in the interaction between a variety of biological and social factors in India. Birth intervals differ from Western patterns: long lengths of postpartum amenorrhea and prolonged breast feeding. Cox proportional hazards models and descriptive statistics are used to examine birth intervals among 3514 households in the Varanasi district of Uttar Pradesh state in 1978, and among 3000 households from 3 districts in Kerala state in 1980. Women using contraception or who were sterilized were excluded from the analysis. Birth spacing among Urrar Pradesh women was 44 months from marriage to first birth and 32 months between subsequent births. In Kerala, the first birth interval was 20 months and subsequent intervals were up to 30 months. In Uttar Pradesh, the median birth interval declined as age at marriage increased; in the sample populations, age-at-marriage groups differed widely in their birth intervals. Birth intervals also varied with household economic status. Based on the social status index and educational status of husband and wife in Uttar Pradesh, differences in median birth intervals were minimal but large for the extent of childbearing. 28% of higher class women had a 5th child compared to 2% among low status groups. When controlling for marriage age and other variables, the proportional hazards model showed that all groups, other than the high status group, had a statistically significant higher risk of a birth. When using education as the status measure in Kerala, the findings on birth interval were similar, but the proportion having a 2nd birth was higher among lower status groups. Husband's education did not have much effect on birth interval. Religion did not strongly affect the risk of birth other than for first births in Uttar Pradesh. In Kerala, there were shorter birth intervals among Muslims and a higher probability of parity progression to the next birth. Muslims and Christians versus Hindus had a significantly higher adjusted risk of birth. Infant mortality shortened birth intervals for women in Uttar Pradesh by 9 months, and the adjusted risk of a next birth was 2 times higher. Kerala results were similar, but replacement was less likely with higher order births. Both states had slightly longer birth intervals after a male child.

Family size, sex composition of children and contraceptive use: a case study of Kerala.

PIP: With the sudden decline of fertility it was particularly interesting to examine the situation in Kerala, regarding parental sex preference in formulating family planning policies for the rest of India with high fertility and son preference. The 1980 Kerala Fertility Survey included nearly 3000 households with about 2700 ever married women in reproductive age. Maternity history and fertility regulation data were collected. Data from 2500 currently married women were used, cross-classified by the number of male and female living children and contraceptive use status. A multiplicative model was used to study various interaction effects and to construct standardized rates of contraceptive use. Measures adjusted for both male and female composition and differential use of contraceptives among male-female combinations were obtained by the model to avoid arbitrariness in choosing rates and to preclude objections raised in previous research on Arnold's index. The model was generalized to facilitate simultaneous effects of the number of male and female children and family size on contraceptive use. Initial analysis showed that the effect of sex preference on contraceptive acceptance was rather negligible. However, there was a significant male-female interaction effect on contraceptive use. Contraception was high when the family size was large, with children of the same sex. With the effect of family size removed, the contraceptive use rate seemed to be in the inverse direction of the number of male or female children. This was possibly the result of two factors: 1) high contraception rate with large families of the same sex, and 2) low use of contraception among large families with a high number of children of both sexes. The Kerala situation partly supports McClelland's theory that couples already having proportionally more daughters may terminate fertility earlier. In Kerala such termination also occurs when couples have proportionally more sons, and family size also plays an important role in fertility cessation.^ieng

Age at return marriage and timing of first birth in India's Uttar Pradesh and Kerala states.

The study investigates the relationship between age at marriage and the length of first birth interval in two states of India: Uttar Pradesh and Kerala. Life tables of first-birth intervals and median first-birth intervals are computed for several subgroups of the study population. Multivariate hazards modelling technique is used to study the net effect of age at marriage, controlling for a multiple of socioeconomic factors. The result shows that the average first-birth interval varies by age at marriage and is much longer in Uttar Pradesh than in Kerala.

PIP: Data from the Uttar Pradesh Rural Development and Population Growth Survey in 1978, the Determinants of Fertility Survey in Eastern Uttar Pradesh in 1987, and the 1980 Kerala Fertility Survey were used to examine the demographic and socioeconomic characteristics of fertility. Specifically, attention focused on the timing of first births in Uttar Pradesh (UP) and Kerala and its relationship with age at first marriage as well as the determinants of the fertility decline. Controls were indicated for religion (Hindu, Muslim, and Christian), education (illiterate or literate for husband and wife), year of marriage (before or after 1970), work status (working or nonworking), and birth cohort ( or 25 years). Women were grouped into those aged up to 13 years of age, 14-15 years, 16-18 years, and 19 and over years. The mean age at marriage increased by .9 from 1978 to 1987 in UP, which was 2 years lower the mean age at marriage in 1980 in Kerala. In both states, mean age of marriage was lower when both husband and wife had little education, and in Kerala when women married before 1970, were nonworking, and were Muslims. The average time of first birth, without a correction for age at marriage, decreased with the increase in age from preadolescent to postadolescent in both states. The median first birth interval was 2 times as long in UP as in Kerala in every age group. Between 1978 and 1987, the median first birth interval varied by .3 months but was greater than in Kerala by 23.6-23.9 months. The overall mean birth interval in Kerala was 20.3 months. The proportion of women not conceiving within 10 years was 3% in Kerala and 10% in UP. In the proportional hazards models, the relative risk of first birth in 1978 in UP was .38, .60, and .68 for the age at marriage groups 13 years, 14-15 years, and 16-18 years. The relative risk in Kerala as almost the same. A number of reasons were given to explain the average delay in the first birth interval according to age at first marriage and the length of first birth interval. One reason was the joint family system prevalent in rural areas, where marriages are arranged and residence within the joint family limits chances for coitus.

Fertility decline and gender preference--an experience of Kerala.

PIP: Using data from 1980 Fertility Survey from Kerala, India, researchers analyzed responses from 2242 women to ascertain if gender preference existed. Acceptance of contraception differed among the 3 districts from 70.33% in Ernakulam, 68.05% in Alleppey, and 24.45% in Palghat. The acceptance rate was higher among women who had only 1 son than among those who had only 1 daughter. Further, the rate for women in Palghat with only 1 son (13.12) was almost 2 times higher than that of those with only 1 daughter (6.9). The extent of son preference was lowest in Alleppey. Generally, couples who had the preferred number of sons were more likely to choose sterilization as their method of birth control while those who continued to have daughters without the desired number of sons chose nonterminal methods. The differences between the averages of sons and daughters in terms of total family size are not very wide, however, therefore the degree of son preference has not greatly changed either family size or its composition, especially in Alleppey and Ernakulam. Even though son preference is generally strong among Hindus, the Hindus in both Alleppey and Ernakulam do not demonstrate a strong preference for sons index. On the other hand, the Hindus in Palghat are quite conservative and do demonstrate a high son preference index. Mothers who have attended a formal school for at least 5 years show little discrimination against a daughter. Ernakulam has reached the stage in the transition from a noncontracepting society to a contracepting society when the number of children of the same sex outnumber the other, couples decide to have no more children to maintain small size norms. In Alleppey, the deisre for small size families was the primary consideration for contraceptive use and son preference was secondary.^ieng

An index of gender preference.

PIP: This paper suggests a new index to measure the acceptance of the gender composition of a family based on contraceptive acceptance rate. Data from the Kerala Fertility Survey are used to calculate the new index. The sex of the living children by order of birth of each currently married woman and her contraceptive status are sufficient to construct the index. Size preference is measured in terms of the % of persons accepting contraception on the assumption that 1 uses contraception when desired family composition is achieved. For this particular sample, it is found that son preference is low. Size preference is stronger than son preference in many cases, though son preference is stronger than daughter preference. Heterogeneity in sex preference was also evident in the sample.^ieng