INTRODUCTION:

We are responsible for what we are, and whatever we wish ourselves to be; we have the power to make ourselves. If what are now has been the result of our own past actions, it certainly follows that what we wish to do in future can be produced by our present action; so we have to know how to act.’’

Swami Vivekananda

In World Health Organization, iron deficiency anaemia is the second leading cause of disability-adjusted life years lost for females aged 15- 44 years (Tolentino et al, 2007).

Anaemia during pregnancy is a major public health problem throughout the world, particularly the developing countries. Diminished intake and increased demands of iron, disturbed metabolism, pre-pregnant health status and excess iron demands as in multiple pregnancies, women with rapidly recurring pregnancies, blood loss during labour, heavy menstrual blood flow, inflammation and infectious diseases are important factors which lead to development of anaemia during pregnancy (Dutta, 2004; Tolentino et al, 2007). ¹

The reported incidence of anaemia varied from 40 to 90% in various states of India and contributed to 10 to 15% of the direct maternal deaths (Mudaliar et al, 2005). Anaemia is directly responsible for 20% maternal death and is an associated cause in another 20% (Dutta, 2004).²

The prevalence of anaemia in urban areas, rural areas and endemic areas of hook-worm infestation is 40 to 50%, 50 to 70% and 90%, respectively. A high prevalence of anaemia in pregnancy was observed (96.5%), of which 22.8% had mild, 50.9% had moderate and 22.8% had severe anaemia in a study conducted in Delhi (Virender et al, 2002). Latent iron deficiency is known to alter brain iron content and neurotransmitters irreversibly in foetal life and postnatal babies (Agarwal, 2001; Kapur, 2002).³

Contrary to the above studies, the National Family Health Survey, 1998-1999 data (NFHS, 2002) using hemocue system reported prevalence of anaemia as 49.7% in pregnant women; 56.4% in breastfeeding non pregnant; and 50.4% among non-pregnant non breastfeeding women. Screening for anaemia, treatment of anaemic women, and availability of food fortification (wheat flour with iron and folic acid), milk sugar and salt with iron to build long term iron stores remains the key to reduce anaemia. Even cooking in cast iron utensils improves iron content in diet (Kapur, 2002).

ICMR district nutrition survey 1999-2000 also reported prevalence of anaemia as 84.2% with 13.1% with severe anaemia in pregnancy (Toteja G et al, 2001). ⁴

The WHO defines anaemia as haemoglobin below 13g/dL in men over 15 years, below 12g/dL in non-pregnant women over 15 years, and below 11g/dL in pregnant women (WHO, 2001).

Anaemia is particularly prominent in South Asia. In India for example, upto 88% of pregnant women are affected (World Health Organization, 2001). ⁵

In a study of the Indian Council of Medical Research (ICMR, 1989), prevalence of anaemia in 4181 pregnant rural women of 11 States was estimated and it was demonstrated that 87.6% women had haemoglobin (Hb) <10.9g/dl. Further, ICMR in 1992 (ICMR, 1992) reported that in 6 States supplementation of iron-folate tablets to control anaemia (women with haemoglobin < 7.0g/dl were excluded) had 62% women as responders (anaemic-those responding to haematinic therapy by showing rise in haemoglobin). Even after consuming 90 tablets, 37.8% women had haemoglobin less than 10.0 g/dl and 19.4% had less than 9.0g/dl. During 1986-1991 haemoglobin estimations in rural pregnant women in Varanasi showed 94.5, 95.3 and 95.9% prevalence of anaemia in I, II and III trimesters (Agarwal et al, 2000).⁶

NEED FOR STUDY:

Anemia can be due to inability to buy adequate and good quality food or due to poor eating habits (Saleem, 2012).10

Pregnancy related complications affect many women and infants but they are most likely to affect those women and infants with unfavourable health conditions and lower socio economic status (Shen et al, 2008).¹¹

The prevalence of anaemia ranges from 33% to 89% among pregnant women and is more than 60% among adolescent girls with wide variations in different regions of the country (Toteja et al, 2006).

The estimated high prevalence of anaemia in the country, five major surveys, National Family Health Survey (NFHS), IIPS National Family Health Survey (1998-99), and IIPS National Family Health Survey (2005 06).¹²

About one third of the global population (over 2 billion) are anaemic (WHO. 2004). Prevalence of anaemia in all the groups is higher in India as compared to other developing countries. India contributes to about 80% of the maternal deaths due to anaemia in South Asia (Ezzati et al, 2002).

The baseline data of Operations Research, a UNICEF project in Tamil Nadu, documented a 95% prevalence of anaemia in Dindigul and 48% in Tirupura among the urban poor. When compared to the prevalence in other countries, the prevalence in a rural population of Tamil Nadu is similar. The National Family Health Survey (NFHS-2) states that 52% of women in India are suffering from anaemia, mainly nutritional. Incidence of anaemia among women is as high as 60% in Assam, Bihar, Orissa and West Bengal. Whereas the prevalence of anaemia is around 54% in Karnataka and only 23% in Kerala (NFHS, 2002).¹³

District Level Household Survey (DLHS), Indian Council of Medical Research (ICMR) Micronutrient Survey (Toteja et al, 2004) and Micronutrient Survey conducted by National Nutrition Monitoring Bureau (NNMB, 2002) were undertaken to estimate prevalence of anaemia in the country. All these showed that over 70% of preschool children were anaemic. NNMB, DLHS and ICMR surveys showed that over 70% of pregnant women and adolescent girls in the country were anaemic. Data from DLHS showed that prevalence of moderate and severe anaemia was high even among educated and higher income groups. Prevalence of anaemia is high in all the States, though there are considerable variations between States in prevalence of moderate and severe anaemia.¹⁴

STATEMENT OF THE PROBLEM:

“A Study to Assess the Effectiveness of Structured Teaching Programme on Knowledge Regarding Prevention of Iron Deficiency Anemia Among the Primigravida Mother in Selested Hospital Mehsana.”

OBJECTIVES OF STUDY:

1. Assess the pre-test knowledge of primigravida mothers regarding prevention of anemia

2. Administer a structured teaching programme

3. Assess the post-test knowledge of primigravida mothers regarding prevention of anemia after administering structured teaching programme

4. Evaluate the effectiveness of structured teaching programme

HYPOTHESIS:

H0: There is no significant difference in the knowledge of primgravida mother regarding prevention of anemia and structured teaching programme.

H1: There is significant difference in the knowledge of primgravida mother regarding prevention of anemia and structured teaching programme.

METHODOLOGY:

An Survey research approach was adopted for this study. The Research design selected was Pre-Experimental Research exploratory design the study was conducted in selected of mehsana district. and the sample size for the present study will be 30. non probability Convenient sampling technique will be used for the present study collection done after obtaining permission from authority. Self structured knowledge questionnaire was used to collect data regarding 1st trimester primigravida mothers. In the present study, the investigator has described to assess the knowledge about iron deficiency anemia among the primigravida mothers.

RESULTS:

Demographic data was analyzed using frequency and percentage. Frequencies, percentage, mean, median, mean percentage and standard deviation was used to determine the knowledge score. Finding related to demographic data.

Major study findings include: Among the primigravida mothers included in the study, most of them were had completed age, sex, education status, religion, Economical status, Marital status are included in this study.

SECTION A: Findings related to demographic variables.

SECTION B: Analysis of data related to the knowledge regarding prevention of anemia among the primigravida mother.

SECTION C: Analysis of data to find relation between knowledge of prevention of anemia and selected variables such as age, education, religion, type of family, monthly income, dietary pattern.

SECTION A:

4.1. Analysis and Interpretation of Demographic Data: Gender, Religion, Area of Residence, Any Previous Knowledge Regarding Post Exposure Prophylaxis, Awareness Hospital Pep Policies.

Table 1: Frequency and percentage wise distribution of demographic data of the mothers. (N=30)

S. No.

Selected socio-demographic variable

frequency

Percentage

Age

20-24

25-29

30-34

35-39

56.66%

40%

3.33%

Religion

Hindu

Muslim

Christian

Other

73.33%

23.33%

3.33%

Education

Illiterate

Primary

Secondary

Graduation

36.66%

40%

23.33%

The table shows that the majority of the mothers, (i.e.) 56.66% belonged to age group of 20-24 years of age, whereas 0% belonged to the age group of 35 -39 years of age, 40% of mothers are of 25-29%. In religion, 73.33% belonged to Hindu religion and 23.33% belonged to Muslim religion, whereas 0% Christians and other religion mothers are 3.33%. In education Out of 30 mothers, 46.66% mothers are illiterate while only 6.66% mothers are graduate, 36.66% mother has primary education and 10% mother are having secondary education. In occupation, out of 30 mothers,46.66% are housewife while 43.33% mothers are engaged in labour work, 3.33% mothers had government jobs and 6.96% mothers had private jobs. In family type, out of 30 mothers 66.66% mothers lives in joint families while 30% mothers Lives in nuclear family,3.33% mothers Lives in extended families. In dietary pattern, out of 30 mothers 70% mothers are vegetarian while 30% mothers are non-vegetarian.

SECTION B:

4.2 Analysis and Interpretation of the Samples According to Knowledge Regarding Prevention of Anemia Among the Primigravida Mother

Table 2 shows that the frequency and percentage wise distribution of mothers according to knowledge of prevention of anemia among the primigravida mothers. The pre test scores show that majority 60% (18) mothers having satisfactory knowledge score (6 - 10), 3.33% (01) having good knowledge score and 36.66% (11) had poor knowledge scores (0 - 5) and not a single mother had excellent score (16 - 20).

SECTION C:

Analysis of Data Related to Effect of Structure Teaching on Knowledge Score In Study Group:

There were 30 women‟s in sample. Each of them answered 20 questions. Their pre test and posttest answer were recorded mean, median and standard deviation of test score obtained as below

Table 3:

TEST	MEAN	MEDIAN	SD
PRE-TEST	6.5	153.5	2.16
POST-TEST	13.5	122.75	2.26

MAJOR FINDING OF STUDY:

Major finding of the study Were based on the objectives of the study. There is significant association between the knowledge and demographic variable such as age, religion dietary pattern, type of family, monthly income, occupation, education There is no significance association between demographic vriable for the primigravida mothers

CONCLUSION:

The main conclusion from this present study is that most of the primigravida mothers of selected hospitals had inadequate and moderate level of knowledge regarding Prevention of anemia among the primigravida. In pre-test and their level of knowledge regarding primigravida had improved to a knowledge. This shows the imperative need to understand the utilities of in improvement of knowledge regarding primigravida mothers of selected hospitals of mehsana district.

REFERENCES:

1. Annama Jacob “Textbook of Midwifery and Gynecologycal Nursing” Jaypee Brothers Medical Publishers, 3rd Edition 2007, pg no: 323 to 328

2. B.T. Basvanthappa, “Nursing Research” Jaypee Publication, 2nd Edition -2007, pg no: 278 to 299

3. B.T. Basvanthappa (2006), “Textbook of Midwifery and Reproductive Health Nursing” 1st edition, Jaypee Brothers Publication, pg no: 528 to 530

4. B.T. Basvanthappa, “Medical Surgica Nursing”, 2nd edition -2009, Jaypee Brother Publication, Pg No: 898 to 899

5. Bharat Parekh, “A Textbookof Nursing Research and Statastic”, Peeve Publication, 3rd Edtion -2012, pg no: 125 to 130

6. Brunner and Suddharth’s, “Textbookof Medical Surgical Nursing” 11th Edition, Volume-2, Medical Publisher, Pg no: 1045 to 1055

7. Carlo L Macnees and Susan MC Cabe, “Undestaning Nursing Research”, 2nd edition 2008, Pp: 417-425.

8. D.C Datta, “Text Book of Obstetrics”, 7th Edition Pp: 306-312.

9. Elizabeth Steepp Gilbert, “Manual of High Risk Pregnancy and Delivery”

10. K. Viswerwara Rao, “Biostatasics In Breef Made Easy”, 1ST edition 2010, Jaypee Brothers Publication, pp no:110 to 113.

11. http://ajcn.nutrition.org/content/71/5/1280s.short

12. http://jn.nutrition.org/content/131/2/590S.short

Received on 10.05.2020 Modified on 29.06.2020

Int. J. Nur. Edu. and Research. 2020; 8(4):488-491.

DOI: 10.5958/2454-2660.2020.00107.6

Sr. No.	Knowledge scores		Pre - test scores		Post - test scores
	Levels of Knowledge	Score	Frequency (f)	(%)	Frequency (f)	(%)
1.	Poor	0 - 5	11	36.66%	00	0%
2.	satisfactory	6 - 10	18	60%	02	6.66%
3.	Good	11 - 15	01	3.33%	21	70%
4.	Excellent	16 - 20	00	00	07	23.33%