INTRODUCTION:

Pregnancy is a unique, exciting, and often joyous time in a woman's life as it highlights the woman's amazing creative and nurturing powers while providing a bridge to the future. Pregnant woman also needs to be responsible to support the health of her future child. The growing fetus depends entirely on its mother's healthy body for all needs. So, pregnant women must take steps to remain as healthy and well nourished. Pregnant women should consider their health and lifestyle in order for their baby to be healthy.

Lack of nutritional and other factors may cause many of the problems during the antenatal period. One of the major problems can be detected in antenatal mothers in developing countries such as India is anemia during pregnancy.¹

Anemia is a widespread public health problem associated with an increased risk of morbidity and mortality, especially in pregnant women. It has multiple causes, both nutritional (vitamin and mineral deficiencies) and non-nutritional (infection) that frequently occurs. It is assumed that the most common contributing factors are iron deficiency, folic acid deficiency, and vitamin B 12 deficiencies. RBC volume increases by 20 %. There is relative fall in the level of haemoglobin and haematocrit during pregnancy. There is marked demand of extra iron during pregnancy especially in the second half of the pregnancy. Even an adequate diet cannot provide extra demand of iron. Hence there is always physiological iron deficiency during pregnancy. Low serum iron , increased iron binding and increased rate of iron absorption are also contributing factors for physiological iron deficiency anemia.³

Nutritional anaemia is one of the important public health problem not only in India but also in most of the South East Asian countries. About 4 to 16% of maternal death is due to anemia. It also increases the maternal and neonatal morbidity and mortality. It is also a known risk factor for maternal and foetal complications. ⁴Iron, folic acid, and vitamin B 12 deficiencies are more common; the unavailability of nutritious food, food taboos, eating and cooking customs all plays a part. In order to prevent anemia, midwives must not only understand the medical problem but also any social circumstances that give rise to it^{. 5}

Prenatal care is important in preventive obstetrics. The factors responsible for anemia during pregnancy should be identified and eradicated. Iron supplement to prevent anemia in pregnancy is a well-known strategy.

MATERIALS AND METHODS:

Research approach: Quantitative approach.

Research design: Descriptive research design

Sampling technique: Purposive sampling technique

ETHICAL CONSIDERATIONS:

· Formal permission obtained from Institutional review board, Dean - college of nursing, Director Principal.

· Written informed consent from the participants was obtained before conducting the study.

· Participants were reassured that their identity will be kept confidential.

DEVELOPMENT AND DESCRIPTION OF TOOL:

A structured interview schedule was used to assess the of knowledge and attitude regarding prevention and management of anemia among antenatal mothers.

Description of tool:

The structured interview schedule consists of three section

SECTION A:

Socio Demographic variables:

It includes socio demographic variables such as Age, religion, gravida, gestational age, Educational status and Occupation.

SECTION B:

Structured interview schedule on knowledge regarding prevention and management of anaemia among antenatal mothers.

This section of structured interview consist of 15 items related to prevention and management of anemia. Each question has 4 options. “One” score has been 19 allotted to correct answer and score of “zero” for wrong answer. Total score is 15. Total score was graded as follows.

Inadequate knowledge :<50% of score.

Moderately adequate knowledge: 50%-75% of score.

Adequate knowledge :> 75% of score.

SECTION C: 5 point likert scale to assess the attitude regarding prevention and management of anaemia among antenatal mothers.

A five point likert scale was used to assess the attitude regarding prevention and management of anaemia among antenatal mothers. It contains 10 statements. Maximum score will be 50. Reverse scoring was followed for negative statement.

DATA ANALYSIS:

Section-a: distribution of antenatal mothers according to socio demographic variables.

Table1: Frequency and percentage distribution of Antenatal mothers according to socio-Demographicvariables.

n=64

S.no	Demographic variables	Frequency (f)	Percentage (%)
1	Age (in years)
	• 18-24	33	51.6
	• 25 -32	27	42.2
	• 33 –45	4	6.3
2	Religion
	• Hindu	51	79.7
	• Christian	4	6.3
	• Muslim	9	14.1
3	Gravida	34 30	53.1 46.9
3	• Primigravida • Multigravida	34 30	53.1 46.9
4	Gestational age
	• Firsttrimester	12	18.8
	• Secondtrimester	19	29.7
	• Thirdtrimester	33	51.6
5	Education
	• Primary	6	9.4
	• Secondary	16	25
	• Diploma	7	10.9
	• Graduate	35	54.7
6	Occupation
	• Homemaker • Employee	57 7	89.1 10.9

Table 1 reveals the distribution of participants according to demographic variables. Most of the mothers 33 (51.6%) were in the age group of 18-24 years, 51 (79.7%) of mothers were Hindus. Nearly Half of the participants 53.1% wereprimigravida mothers (51.6 %) belongs to third trimester,54.7 % were graduates and 89.1% were homemakers.

SECTION B:

Distribution of antenatal mothers according to level of knowledge and attitude regarding prevention and management of anemia among antenatalmothers.

Figure 2: Distribution of Antenatal Mothers According to Level of Knowledge Regarding Prevention and Management of Anemia.

n=64

The above figure depicts that majority (60.9%) had Moderately adequate knowledge, 25% had Inadequate knowledge and 14.1% had Adequate knowledge on prevention and management of anemia.

LEVEL OF ATTITUDE:

Undesirable Neutral Desirable

Figure 3: Distribution of level of attitude regarding prevention and management of anemia among antenatal mothers

The above figure depicts that majority 54.7% had Desirable attitude , (45.3)% had Neutral attitude and none of them had Undesirable attitude regarding prevention

SECTION C:

Association between the level of knowledge and attitude regarding prevention and management of anemia among antenatal mothers with socio demographicvariables.

Table 2: Association Between the level of knowledge regarding prevention and management of anemia among an mothers with socio demographic variable n=64

S. No	Socio Demographic Variable	KNOWLEDGE LEVEL							Fisher‟ s Exact Test	P value
		Inadequate Knowledge		Moderately Adequate		Adequate Knowledge
		F	%	F	%	F		%
1.	Age (in years)
	18-24	11	17.2	18	28.1	4		6.25	6.990	0.100 NS
	25-32	4	6.25	20	31.25	3		4.6
	33-45	1	1.56	1	1.56	2		3.12
2.	Religion
	Hindu	12	18.8	31	48.4	8		12.5	2.465	0.637 NS
	Christian	1	1.56	2	3.12	1		1.56
	Muslim	2	4.7	6	9.37	0		0
3.	Gravida
	Primigravida	9	14.06	20	31.25	5		7.81	0.214	0.938 NS
	Multi gravida	7	10.9	19	29.7	4		6.25	0.214	0.938 NS
4.	Gestational Age
	First trimester	4	6.25	8	12.5	0		0	2.69	0.635 NS
	Second trimester	4	6.25	12	18.75	3		4.68
	Third trimester	8	12.5	19	29.68	6		9.37
5.	Education
	Primary	3	4.68	3	4.68	0		0	13.25	0.018 S
	Secondary	4	6.25	11	17.18	1		1.5
	Diploma	5	7.81	2	3.12	0		0
	Graduate	4	6.25	23	35.93	8		12.5
6.	Occupation
	Home maker	16	25	35	54.6	6	9.3		5.505	0.033 S
	Employee	0	0	4	6.25	3	4.68		5.505	0.033 S

Fisher„s exact test, S* - Significant, NS^**-Non significant

IMPLICATIONS:

Nursing practice:

Nurses plays an important role in providing adequate knowledge and attitude to the antenatal mothers about prevention and management of anemia.

Nursing Education:

The nursing students should be aware of the prevention and management of anemia and its importance in nursingeducation. Providing knowledge about Prevention and management of anemia among antenatal mothers helps to prevent the complications duringpregnancy.Teacher can motivate the student todo more project among various groupssuchas adolescent girls on prevention and management of anemia.

Nursing Administration:

The findings of the study helps the administrator for decision making policy and protocol formulation regarding prevention and management of anemia among antenatalmothers.

Nursing Research:

Findings of the study suggests that education and researchers should encourage nurses to read, discuss and conduct research studies. So as to enable the nurses to make data based decision rather than intuitive decisions.

RECOMMENDATIONS:

The study can be conducted on largersamples.

The study can be conducted among antenatal mothers attending antenatalOPD.

The study can be conducted in antenatal OPD Pondicherry Institute of MedicalSciences.

CONCLUSION:

The present study assessed the level of knowledge and attitude on prevention and management of anemia among antenatal mothers. Here in this study reveals that majority (60.9%) had moderately adequate knowledge, (14.1%) had adequate knowledge, (54.7%) had desirable attitude and (45.3%) had neutral attitude. The knowledge among antenatal mothers has to be improved. So that the mother will gain more knowledge on prevention and management of anemia.

REFERENCES:

1. Ashly Baby et. al. knowledge on management of anemia during pregnancy Achieves of Medicine and Health Sciences (AM&HS) [Cited 2019 feb4];4(2):140-144 Available from http://amhsjournal. org/text.asp?2014/2/2/140/144308

2. Aruna Jothi. Rajiv Gandhi College of Nursing, A study to assess the knowledge and attitude of mother regarding nutrition anaemia in selected hospital [cited2019feb5] Available from http:// rguhs.ac.in.> onlinedc>uploads

3. Minakshisingh. et. al, knowledge attitude practices regarding anaemia in pregnancy, government hospital Dehradun (nov 2018) European Journal of Pharmaceutical and Medical Research. [Cited 2019 jan 21]: 67-70 Available at http://ejpmr.com. Keneniberhanu et al.

4. Assessment of knowledge and practice towards prevention of anaemia among pregnant women attending antenatal care.Ethopian journal of health, medicine and science, (2018)[cited 2019 feb2] volume 50, JIMMA University Available athttp://iiste.org.

5. Indra. A study to assess the knowledge of antenatal mother on prevention of nutritional anaemia in selected hospital. International Journal of Nursing Education and Research 3 (2), April-June 2015; Thrissur [cited 2019 Jan 29] available athttp://anvpublication.org.

6. World health organisation micronutrient deficiencies [cited 2019 jan23] available athttp://who.int/nutrition/topic/idea.

Received on 24.12.2019 Modified on 12.01.2020

Int. J. Nur. Edu. and Research. 2020; 8(2):262-265.

DOI: 10.5958/2454-2660.2020.00057.5