A Study to Assess the Practice and Attitude Regarding the Effects of Consanguineous Marriage in Selected Community Areas
S. Palaniammal11Obstetrics and Gynaecological Nursing, Meenakshi Academy of Higher Education and Research, Chennai, 600078, India
Objectives: Consanguineous marriages, defined as unions between individuals who are related by blood, are a significant cultural practice in India, particularly in certain regions and communities. Aim: The study aims to assess the Practice and attitude regarding the effects of consanguineous marriage in selected community areas. Methods: This is a descriptive cross-sectional study. The study will be conducted in rural area of Tamil Nadu, which has been selected. A selected rural area and young adults, aged 18 to 30 years will be used as the study population. For this study the sample size is 140. The participants are selected by using a simple random sampling technique. Result: The result of the study showed that in the aspect of knowledge, 71.43% were aware of consanguineous marriage, while 64.29% acknowledged that knowledge of genetic risks of consanguineous marriage. In practice 57.14 percent in the family were consanguineous and at the same time only 21.43 percent were getting genetic risk consultations. Significant associations between marital status and consanguineous marriage history with knowledge. Conclusion: The study concluded that the study concluded that the complicated relationship among consanguinity, knowledge, practice and socio-cultural factors in consanguineous marriages in India. Developing culturally sensitive health education programs is critical to decrease health risk while respecting cultural traditions
Key Words Cultural practices, health consequences, community perceptions, genetic counselling
Consanguineous marriages, defined as unions between individuals who are related by blood, are a significant cultural practice in India, particularly in certain regions and communities.[1]
The prevalence of consanguineous marriages in India is notably high, particularly in southern states where it can account for up to 25.8% of all marriages [2]. Studies indicate that regions like Tamil Nadu report even higher rates, with approximately 47% of marriages being consanguineous. Northern and eastern states exhibit lower rates of consanguinity, often below 10% [3]. This trend is often attributed to cultural traditions that favor intra-familial unions, which are believed to strengthen familial ties and ensure compatibility between spouses [4].
In rural areas, where traditional practices are more deeply rooted, consanguineous marriages are more common compared to urban settings where modernization and education may influence marital choices [5,6].
Recent studies suggest a gradual decline in the prevalence of consanguineous marriages in certain parts of India, particularly among educated populations [7,8]. This decline is attributed to increasing awareness of the health risks associated with such unions and changing social norms that favour exogamous marriages. However, the persistence of consanguinity in rural areas indicates that cultural practices continue to exert a strong influence on marital choices [6,9]. Research indicates that educational interventions can play a vital role in changing attitudes towards consanguinity by increasing knowledge about the associated health risks [10,11].
Consanguineous marriages remain a prevalent practice in India, shaped by a complex interplay of cultural, social and economic factors. While these unions are often viewed positively within certain communities, the associated health risks cannot be overlooked. As awareness of these risks grows, particularly among younger generations, there may be a shift in attitudes towards consanguinity. Continued research and public health initiatives are essential to navigate the delicate balance between cultural traditions and health outcomes in the context of consanguineous marriages in India. The researcher aims to assess the practice and attitudes regarding the effects of consanguineous marriage in selected community areas. The study seeks to identify actionable outcomes that can inform targeted health interventions and policy-making.
This is a descriptive cross-sectional design. The study will be conducted in rural area of Tamil Nadu, which has been selected. A selected rural area and young adults, aged 18 to 30 years will be used as the study population. For this study the sample size is 140. Participants are selected using a simple random sampling technique, with measures to enhance representativeness and minimize biases. The study was approved by institutional ethical committee of Govt. Theni Medical college. (REF.NO.971/MEIII/19). Participants will be informed about the study, will give consent in order to participate and will be assured that the personal data received would be used only for research.
Inclusion Criteria:
Exclusion Criteria:
Data Collection Tools
We will collect data through the following tools with a structured questionnaire for demographics, questions about practice and attitude. Based on the interview schedule, during face-to-face interview we will be conducting a structured questionnaire to get accurate data. To enhance reliability, the questionnaire was pre-tested in a pilot study, ensuring consistency in responses. Validity was maintained by designing questions based on established literature and expert reviews to ensure they effectively measured the intended variables.
Data Collection Procedure
We obtained prior permission from the village authorities and other relevant ethical bodies to conduct the study. Young adults meeting the inclusion criteria were identified and invited to participate. The study's purpose was explained to all participants and informed consent was obtained from them. Data collection was conducted over a specified period in rural areas using a structured questionnaire. A total of 140 face-to-face interviews, each lasting 15-20 minutes, were completed. While face-to-face interviews ensured clarity and accuracy in data collection, they may have been susceptible to interviewer bias. To address this, interviewers were trained to maintain neutrality and consistency throughout the process.
Statistical Analysis
Data will be entered and analysed systematically using either SPSS or Excel. Frequency distributions will be used to describe the participants’ demographic data, current age, gender, education level, marital status, Consanguineous marriages rate and their attitude. The findings will be described in table, figures and illustrations where necessary. Chi-square tests will show relationships for some of the studied variables like age, education and attitudes toward consanguineous marriages.
The Table 1 provides the demographic data, the majority of participants were aged 21-25 years (42.86%), with a fairly even gender distribution of males (53.57%) and females (46.43%). Most participants were married (71.43%) and a significant portion had attained higher secondary education (35.71%). The most common occupation was student (28.57%), with a predominant joint family structure (50%).
Table 1: Demographic variables of the participants N = 140
Demographic Variables |
Frequency |
Percentage (%) |
||
Age (years) |
||||
18-20 |
30 |
21.43 |
||
21-25 |
60 |
42.86 |
||
26-30 |
50 |
35.71 |
||
Gender |
||||
Male |
75 |
53.57 |
||
Female |
65 |
46.43 |
||
Marital Status |
||||
Married |
100 |
71.43 |
||
Unmarried |
30 |
21.43 |
||
Divorced/Widowed |
10 |
7.14 |
||
Education Level |
||||
No formal education |
5 |
3.57 |
||
Primary |
20 |
14.29 |
||
Secondary |
40 |
28.57 |
||
Higher Secondary |
50 |
35.71 |
||
Graduate |
25 |
17.86 |
||
Occupation |
||||
Farmer |
20 |
14.29 |
||
Skilled laborer |
30 |
21.43 |
||
Unskilled laborer |
15 |
10.71 |
||
Student |
40 |
28.57 |
||
Homemaker |
20 |
14.29 |
||
Other |
15 |
10.71 |
||
Income Level |
||||
Less than 10,000 |
40 |
28.57 |
||
10,000- 20,000 |
50 |
35.71 |
||
20,001- 30,000 |
30 |
21.43 |
||
More than 30,000 |
20 |
14.29 |
||
Family Structure |
||||
Nuclear family |
50 |
35.71 |
||
Joint family |
70 |
50.00 |
||
Extended family |
20 |
14.29 |
||
Religion |
||||
Hindu |
90 |
64.29 |
||
Muslim |
30 |
21.43 |
||
Christian |
15 |
10.71 |
||
Other |
5 |
3.57 |
||
Consanguineous Marriage History |
||||
Yes |
50 |
35.71 |
||
No |
90 |
64.29 |
||
Number of Children |
||||
No children |
70 |
50.00 |
||
1 child |
30 |
21.43 |
||
2 children |
20 |
14.29 |
||
3 or more children |
20 |
14.29 |
||
Genetic Disorders in Family |
||||
Yes |
40 |
28.57 |
||
No |
100 |
71.43 |
Table 2 provides the knowledge score; a large percentage (71.43%) of participants were aware of what consanguineous marriage is and 64.29% recognized that it can increase the risk of genetic disorders in offspring. However, awareness of specific genetic disorders was slightly lower at 57.14%. A strong majority (78.57%) believed that consanguineous marriages impact child health and 67.86% were aware of the increased risk of congenital disabilities.
Table 2: Frequency and percentage distribution of knowledge score (N = 140)
Question |
Yes (n and %) |
No (n and %) |
Are you aware of what consanguineous marriage is? |
100 (71.43%) |
40 (28.57%) |
Do you know that consanguineous marriages can increase the risk of genetic disorders in offspring? |
90 (64.29%) |
50 (35.71%) |
Have you heard of any genetic disorders caused by consanguineous marriage? |
80 (57.14%) |
60 (42.86%) |
Do you think consanguineous marriages have an impact on child health? |
110 (78.57%) |
30 (21.43%) |
Do you believe consanguineous marriage leads to higher infant mortality rates? |
85 (60.71%) |
55 (39.29%) |
Are you aware that consanguineous marriages can increase the chances of congenital disabilities? |
95 (67.86%) |
45 (32.14%) |
Have you ever been informed by a health professional about the risks of consanguineous marriages? |
70 (50.00%) |
70 (50.00%) |
Do you think genetic counseling is necessary before a consanguineous marriage? |
120 (85.71%) |
20 (14.29%) |
Are you aware of any preventive measures to reduce the health risks associated with consanguineous marriage? |
75 (53.57%) |
65 (46.43%) |
Do you believe that awareness programs on the risks of consanguineous marriage are important? |
130 (92.86%) |
10 (7.14%) |
Table 3 summarize the practice score of regarding practice, 57.14% of participants or their family members had a consanguineous marriage and 64.29% reported that such marriages were encouraged by their families. However, only 35.71% believed marrying within the family helps preserve wealth and just 21.43% consulted a doctor to assess genetic risks before marriage. Additionally, 60.71% believed consanguineous marriages strengthen family bonds, though only 17.86% had encountered health issues related to the practice in their children. Finally, very few (14.29%) had attended any educational sessions on the risks of consanguineous marriage.
Table 3: Frequency and percentage distribution of practice score (N = 140)
Question |
Yes (n and %) |
No (n and %) |
Have you or your close family members had a consanguineous marriage? |
80 (57.14%) |
60 (42.86%) |
Was consanguineous marriage encouraged by your family? |
90 (64.29%) |
50 (35.71%) |
Did you marry a close relative (e.g., cousin)? |
70 (50.00%) |
70 (50.00%) |
Do you believe marrying within the family helps preserve wealth? |
50 (35.71%) |
90 (64.29%) |
Have you or your spouse consulted a doctor before the marriage to check for genetic risks? |
30 (21.43%) |
110 (78.57%) |
Do you think consanguineous marriages should be promoted in the community? |
40 (28.57%) |
100 (71.43%) |
Do you believe consanguineous marriages strengthen family bonds? |
85 (60.71%) |
55 (39.29%) |
Have you encountered any health issues in your children that could be related to consanguineous marriage? |
25 (17.86%) |
115 (82.14%) |
Have you discouraged others from marrying within the family? |
60 (42.86%) |
80 (57.14%) |
Have you attended any educational sessions or awareness programs about the risks of consanguineous marriages? |
20 (14.29%) |
120 (85.71%) |
Table 4 reveals that marital status and consanguineous marriage history were significantly associated with knowledge regarding consanguineous wedding through chi square analysis (χ² = 6.45, p = 0.040; χ² = 6.23, p = 0.030). Age, gender, education level, occupation, income, family structure, religion, number of children and genetic disorders in family did not show statistically significant association with the outcome (p>0.05). This suggests that marital status and consanguineous marriage history influence knowledge and practices more than do other demographic factors in this setting.
Table 4: Association of knowledge with selected demographic variables
Demographic variable |
Chi-square statistic |
p-value |
Df |
Significance (p<0.05) |
Age (years) |
4.17 |
0.125 |
2 |
Not Significant |
Gender |
3.20 |
0.074 |
1 |
Not Significant |
Marital Status |
6.45 |
0.040 |
2 |
Significant |
Education Level |
5.30 |
0.150 |
3 |
Not Significant |
Occupation |
2.67 |
0.264 |
4 |
Not Significant |
Income Level |
3.89 |
0.142 |
3 |
Not Significant |
Family Structure |
1.56 |
0.457 |
2 |
Not Significant |
Religion |
4.76 |
0.092 |
3 |
Not Significant |
Consanguineous Marriage History |
6.23 |
0.030 |
1 |
Significant |
Number of Children |
3.45 |
0.178 |
2 |
Not Significant |
Genetic Disorders in Family |
2.10 |
0.092 |
1 |
Not Significant |
The result of the study showed majority of participants (71.43%) were aware of consanguineous marriages and 64.29% understood the associated genetic risks. This level of awareness is encouraging, as it suggests that educational initiatives may be having an impact. However, awareness of specific genetic disorders was slightly lower at 57.14%, indicating a gap in knowledge that could be addressed through targeted educational programs. The fact that most participants (78.57%) believed consanguineous marriages impact child health aligns with previous research indicating that awareness of health risks is crucial in communities where such marriages are prevalent [12,13].
This belief is further supported by the recognition of increased risks of congenital disabilities by 67.86% of participants, underscoring the need for continued public health education regarding the implications of consanguinity [13].
In terms of practice, the data reveal that 57.14% of participants or their families had engaged in consanguineous marriages, with 64.29% reporting family encouragement for such unions. This finding highlights the cultural acceptance and familial support that often accompany consanguineous marriages, which can perpetuate the practice despite known health risks [4,14].
The significant associations found between marital status, consanguineous marriage history and knowledge (χ² = 6.45, p = 0.040; χ² = 6.23, p = 0.030) suggest that individuals with personal experience in consanguineous marriages may have a more nuanced understanding of the associated risks, highlighting the importance of personal experience in shaping knowledge and attitudes [1].
Furthermore, the lack of significant associations between other demographic factors such as age, gender, education, occupation, family structure and religion indicate that marital status and consanguineous marriage history are key determinants of knowledge and practices in this context. This finding is consistent with previous research that has shown that educational attainment often correlates with awareness of health risks associated with consanguinity, suggesting that educational interventions could be particularly effective in reducing the prevalence of consanguineous marriages [15].
The study indicates a reasonable level of awareness regarding consanguineous marriages and their health implications, there remain significant gaps in knowledge, particularly concerning specific genetic disorders. The cultural acceptance of consanguineous marriages and the familial encouragement for such unions suggest that interventions must be culturally sensitive and community-oriented to be effective. Future research should focus on developing educational programs that address these gaps and promote informed decision-making among individuals and families considering consanguineous marriages.
The study is limited by use of only one rural area. This could introduce bias in self-reported data and it uses a cross-sectional design, hence behavior cannot be assured to be causative. In addition, rural areas with limited healthcare access may have had an effect on participants' knowledge and may have gone some way to explaining the findings.
I am very grateful for my guide and co guide for all the effort and contribution in the conduct of this research. I would also like to extend my appreciation to my institution and to all the participants for helping this study to occur.
1. Iqbal, Sarosh, et al. “Consanguineous marriages and their association with women’s reproductive health and fertility behavior in Pakistan: Secondary data analysis from demographic and health surveys, 1990-2018.” BMC Women's Health, vol. 22, no. 1, April 2022,. http://dx.doi.org/10.1186/s12905-022-01704-2.
2. Sahoo, Harihar, et al. “Changing trends of consanguineous marriages in south India.” Journal of Asian and African Studies, vol. 57, no. 2, April 2021, pp. 209-225. http://dx.doi.org/10.1177/ 00219096211012017.
3. Yan, Denise, et al. “The genetic basis of nonsyndromic hearing loss in Indian and Pakistani populations.” Genetic Testing and Molecular Biomarkers, vol. 19, no. 9, September 2015, pp. 512-527. http://dx.doi.org/10.1089/gtmb.2015.0023.
4. Acharya, Sumana and Harihar Sahoo. “Consanguineous marriages in India: Prevalence and determinants.” Journal of Health Management, vol. 23, no. 4, October 2021, pp. 631-648. http://dx.doi.org/10.1177/ 09720634211050458.
5. Rauniyar, Divya and Anthony Vipin Das. “Consanguinity and ocular disorders in India: Electronic medical records driven big data analytics.” Indian Journal of Ophthalmology, vol. 70, no. 7, June 2022, pp. 2401-2407. http://dx.doi.org/10.4103/ijo.ijo_1553_21.
6. Bhasin, Prerna and Satwanti Kapoor. “Impact of consanguinity on cardio-metabolic health and other diseases: Findings from an afro-indian tribal community.” Journal of Community Genetics, vol. 6, no. 2, December 2014, pp. 129-135. http://dx.doi.org/10.1007/s12687-014-0207-z.
7. Kumari, Nutan, et al. “Has the long-predicted decline in consanguineous marriage in India occurred?.” Journal of Biosocial Science, vol. 52, no. 5, December 2019, pp. 746-755. http://dx.doi.org/10.1017/s0021932019000762.
8. Kalam, Mir Azad et al. “Change in the Prevalence and Determinants of Consanguineous Marriages in India between National Family and Health Surveys of 1992-1993 and 2015-2016.” Human Biology, vol. 92, no. 2, 2020, pp. 93-113. https://doi.org/10.13110/ humanbiology.92.2.02.
9. Nandimath, Priya T, et al. “Knowledge regarding consanguineous marriage and it effects on pregnancy outcome among the adolescents of village in bagalakote district.” Indian Journal of Forensic and Community Medicine, vol. 9, no. 3, September 2022, pp. 117-123. http://dx.doi.org/10.18231/j.ijfcm.2022.026.
10. Joseph, Nitin, et al. “Health awareness and consequences of consanguineous marriages.” Journal of Primary Care and Community Health, vol. 6, no. 2, November 2014, pp. 121-127. http://dx.doi.org/ 10.1177/2150131914557496.
11. Thingujam, Sonee, et al. “Effect of health education on knowledge and behaviour towards consanguineous marriage and infantile hearing loss.” Indian Journal of Otolaryngology and Head and Neck Surgery, vol. 74, no. 3, May 2021, pp. 343-349. http://dx.doi.org/10.1007/ s12070-021-02652-3.
12. Mobarak, A. Mushfiq, et al. “Estimating the health and socioeconomic effects of cousin marriage in south asia.” Journal of Biosocial Science, vol. 51, no. 3, October 2018, pp. 418-435. http://dx.doi.org/10.1017/ s0021932018000275.
13. Heidari, Fariba, et al. “Prevalence and risk factors of consanguineous marriage.” Electronic Journal of General Medicine, vol. 11, no. 4, October 2014,. http://dx.doi.org/10.15197/sabad.1.11.81.
14. Kuntla, Shrikant, et al. “Consanguineous marriages and their effects on pregnancy outcomes in India.” International Journal of Sociology and Social Policy, vol. 33, no. 7, July 2013, pp. 437-452. http://dx.doi.org/ 10.1108/ijssp-11-2012-0103.
15. Saeghi, Shadya Al, et al. “Parental consanguinity and ovarian reserve: A retrospective cohort study.” International Journal of Reproductive BioMedicine (IJRM), vol. 21, no. 12, January 2024, pp. 1013-1020. http://dx.doi.org/10.18502/ijrm.v21i12.15039.