A Study to Evaluate the Effectiveness of Planned Teaching Programme on Knowledge on Prevention and Control of Malnutrition among Mothers of Under Five Children Residing in Vantmuri Primary Health Centre of Belgaum City, Karnataka

Darshan Bevoor¹*, Sangeeta Moreshwar², Milka Madhale³

¹Lecturer, Dept. of CHN, SS Institute of Nursing Sciences, Davangere-05

²Associate Professor, Dept. of CHN, KLE University Institute of Nursing Sciences, Belgaum

³Professor, Dept. of MSN, KLE University Institute of Nursing Sciences, Belgaum

*Corresponding Author Email: darshan.bevoor@gmail.com

ABSTRACT:

Background: It is often stated that children are the world’s most valuable resources and assets, but their rights throughout the world are largely ignored often resulting into tragic outcomes. If a person’s diet does not contain enough nutrients to meet the demands of their body it is known as malnutrition. Malnutrition is responsible for more than one third of all deaths in developing countries. Malnutrition in children is not affected by food intake alone; it is also influenced by access to health services, quality of care for the child and pregnant mother as well as good hygiene practices. About 30 per cent of all newborns have a low birth weight, making them vulnerable to further malnutrition and disease. Objective: To assess the knowledge on prevention and control of malnutrition among mothers of under five children, To assess the effectiveness of planned teaching programme on knowledge on prevention and control of malnutrition among mothers of under five children., To find out the association between pretest knowledge scores of mothers with selected demographic variables. Material and Methods: The study was evaluative in nature and. A convenient sampling technique was used with a total of 65 mothers from the rural area. A tool was prepared and pilot study was conducted. The data collection was done by using a structured knowledge questionnaire. Data collected was analyzed by using Descriptive and Inferential Statistics. Results: The results revealed that the knowledge scores of the mothers of under five children regarding malnutrition were in pre-test majority of the Mothers 47 (72.31%) had average knowledge whereas, in post test 51(78.46%) of Mothers had good knowledge and 14(21.54%) had average knowledge. These scores revealed that majority of the mothers are having average and below average knowledge. Conclusion: The Planned teaching programme administration was effective to enhance the knowledge of subjects on prevention and control of malnutrition.

KEY WORDS: Undernourished, Malnourished, Nutritional deficiency.

INTRODUCTION:

Nutrition is the cornerstone for survival, health and development for current and succeeding generations. Well nourished children grow into healthy adults and in turn give their children a better start in life. Malnutrition children have lowered resistance to infection, they are more likely to die from common childhood ailments like diarrheal diseases and respiratory infections and for those whose survive, frequent illness saps their nutritional status, locking them into a vicious cycle of recurring sickness and faltering growth. Their plight is largely invisible the children who die from causes related to malnutrition were only mildly or moderately undernourished, showing no outward sign of vulnerability [1].In the globe the World Health Organization cites malnutrition as the gravest single threat to the world's public health. There were 925 million malnourished people in the world in 2010. On the average, a child dies every 5 seconds as a direct or indirect result of malnutrition - 700 every hour - 16 000 each day - 6 million each year - 60% of all child deaths [2]. In India 55 million children are under five children of age out of these 35% are malnourished and 40% are under weight babies. One of the major causes of low birth weight babies is the high incidence of anemia among women. Recent studies have shown that the damage is done by the time a child reaches the age of two. The critical age-group is 0-2 and it is this group that needs the maximum attention [3]. In Karnataka the severity of the hunger situation is considered to be alarming. In this state 37.6% of children are underweight, 28.1% of the population is undernourished and 5.5% of children who die under the age of 5 die from hunger [4]. In Belgaum district as per the information obtained from department of health and family welfare, there are 62,510 malnourished under five children [5]. Looking into above facts and figure in community the investigator strongly feels to undertake the study to assess the mother’s knowledge regarding child nutrition and to increase their knowledge with planned teaching programme.

MATERIAL AND METHODS:

Pre Experimental, one group pre test post test design was conducted on 65 mothers of under five children at Vantmuri Primary Health Centre. The study was approved by the ethical committee of KLE University Institute of Nursing Sciences. The study was explained to the mothers and written consent was taken. The subjects were selected based on convenient sampling. The structured questionnaire was administered to the subjects. The pretest was conducted using the structured questionnaire and the planned teaching programme was administered and after week duration the post test was conducted using the same tool. The collected data was organized and analyzed based on the objectives by using descriptive and inferential statistics.

RESULTS:

Findings Related to Socio Demographic Variables: Majority of mothers 35(53.85 %) were in the age group of 21-25, 23(35.38%) mothers completed primary and secondary education, 23(35.38%) mothers belonged to a nuclear family, 16 (24.62%) mothers had an income below Rs.1000 per month, 17(26.16%) had an income between 1001-2000 and 22(33.84%) had an income of Rs. 2001-3000 per month whereas 10(15.38%) had an income of Rs. 3001-6500. Majority 37(56.93%) had a vegetarian diet and Majority 51(78.47%) had no past history of malnutrition of their children (Table 1).

Findings related to knowledge of mothers of under five children regarding malnutrition: The findings of the present study revealed that over all knowledge regarding malnutrition, In the pre –test, out of 65 subjects, 18 (27.69%) had poor knowledge, none had good knowledge, 47(27.69%) had average knowledge scores on prevention and control of malnutrition. In the post test 51 (78.46%) had good knowledge, 14 (21.54%) had average and none had poor knowledge scores on prevention and control of malnutrition (Table 2)

Findings related to effectiveness of Planned Teaching Programme: There was a significant increase in knowledge after the administration of planned teaching programme (t=44.54, p<0.05) (Table 3).

Association between knowledge score of mothers on malnutrition with selected socio demographic variables: In the present study there is no association between pre-test knowledge of Mothers of under five children and Age (χ²=0.36), Type of family (χ²=0.22), History of Malnutrition (χ²=2.04), Diet (χ²=2.19), Family income (χ²=1.11) and Education of mother (χ²=1.9). Here all calculated value was lesser than the tabulated value. Hence there was no association between knowledge score of mothers on malnutrition with selected socio demographic variables (Table 4).

Table – 1: Frequency distribution of mothers of under five children according to sociodemographic data (n=65)

Sr. No

Socio demographic variables

Frequency (f)

Percentage (%)

Age:

21-25

26-30

53.85

46.15

Education of mother:

1. Illiterate

2. Primary education

3. Secondary education

29.24

35.38

Type of family:

1. Nuclear

2. Joint

3. Extended

35.38

33.85

30.77

Family income:

Below Rs 1000/mth

1001-2000/mth

2001-3000/mth

3001-6500/mth

24.62

26.16

33.84

15.38

Diet:

Vegetarian

Non Vegetarian

Mixed

56.93

43.07

History of Malnutrition:

Yes

21.53

78.47

Table - 2: Frequency and percentage distribution of knowledge scores of mothers of under five children (n=65)

Knowledge Score	Pre test		Post test
Knowledge Score	Freq	%	Freq	%
Good (Mean + SD) (32-65)	--	--	51	78.46
Average (Mean + SD) and (Mean – SD) (10-31)	47	72.31	14	21.54
Poor (Mean – SD)(0-9)	18	27.69	--	--

Table - 3: Mean difference, Standard Error of Difference (SED), (n=65)

Mean Difference (d)	Standard Error Difference (SEd)	Paired ‘t’ Values
		Calculated	Tabulated value
22.47	0.50	44.54	1.960

Table – 4: Association between the existing pre-test knowledge of Mothers of under five children on Prevention and Control of Malnutrition and selected demographic variables (n=65)

Sr. No

Socio demographic variables

Good

Average

Poor

χ2 CAL.VAL

χ2 TAB VAL

Age:

21-25

26-30

0.36

3.841

Education of mother:

1. Illiterate

2. Primary education

3. Secondary education

1.9

5.991

Type of family:

1. Nuclear

2. Joint

3. Extended

0.22

5.991

Family income:

Below Rs 1000/mth

1001-2000/mth

2001-3000/mth

3001-4000/mth

1.11

7.815

Diet:

Vegetarian

Non Vegetarian

Mixed

2.19

3.841

History of Malnutrition:

Yes

2.04

3.841

DISCUSSION:

Findings related to socio demographic variables: In this present study 65 mothers of under five children were selected for the study from Vantmuri PHC, Belgaum. Among the study groups, 29.24% were illiterates 35.38% had primary education and 35.38% had secondary education. Hence the literacy level of the mothers could have a profound influence on knowledge level of malnutrition. Higher the education betters the knowledge.

The findings were supported by the study done by Nahar B, Ahmed T, Brown K H, Hussain I at Dhaka, Bangladesh confirm the well known association of lack of maternal education and breast feeding to severe malnutrition of their children [6].

The findings were supporting by the study done by Mishra V K, Retherford R D to establish the rate of women’s education on children nutrition in India based on W.H.O standards. The study revealed that maternal education had the strongest independent influence on child malnutrition [7].

In the present study the families monthly income of the study group was 10(16.7%) belong to Rs. 2000 per month, 15(25%) belong to 4001-6000 per month, and remaining 2(3.3) belongs to 6000 per month. The knowledge level of the mother was influenced by the income. Higher the family income betters the knowledge.

These findings supported by graduate students and senior lecturers conducted a study in Sri Lanka. As per the probability analysis nutritional awareness of the mothers, household income significantly affects the child’s nutritional status [8].

Finding related to knowledge of the mothers of under five children regarding malnutrition:

The findings of the present study revealed that over all knowledge regarding malnutrition in the pre –test, out of 65 subjects, 18 (27.69%) had poor knowledge, none had good knowledge, 47(72.31%) had average knowledge scores on prevention and control of malnutrition. Whereas in the post test among 65 subjects 51 (78.46%) had good knowledge, 14 (21.54%) had average and none had poor knowledge scores on prevention and control of malnutrition.

Among 65 subjects, the calculated paired ‘t’ = 44.54 which indicated that there was significant increase in the post - test knowledge score through planned teaching programme at the level of p<0.05 level of significance Therefore, planned teaching programme on prevention and control of malnutrition was more effective to improve the knowledge of the subjects.

Association between knowledge score of mothers on malnutrition with selected socio demographic variables:

In the present study there is no association between pre-test knowledge of Mothers of under five children and Age (χ²=0.36), Type of family (χ²=0.22), History of Malnutrition (χ²=2.04), Diet (χ²=2.19), Family income (χ²=1.11) and Education of mother (χ²=1.9). Here all calculated value was lesser than the tabulated value.

The above study finding were supported by the following study that is a descriptive study was conducted on prevalence of malnutrition and effects of maternal age, education and occupation among pre-school children attending health centers in a semi urban areas of south western Nigeria. The relationship of the age, education and occupation of the mothers and the nutritional status of the children was ascertained. The age, occupation and education of the mothers did not appear to determine the nutritional status of the children [9].

ACKNOWLEDGEMENT:

The authors gratefully acknowledge the support and cooperation of the Medical Officer and Staff of Vantmuri Primary Health Centre. We also thank the authorities of KLE University Institute of Nursing Sciences for their support.

REFERENCES:

1. Malnutrition the challenge. A review Available from: URL: http://www.nutritionatoz.com/Malnutrition.html

2. Wikipedia, the free encyclopedia. Malnutrition community report. A Review. Available from: URL: http://en.wikipedia.org/wiki/Malnutrition

3. Sparsh. Child malnutrition in India. 2010 Apr 28. A review. Available from: URL: http://www.awareindiaonline.com/2010/04/28/child-malnutrition-in-india/

4. Wikipedia, the free encyclopedia. Malnutrition in Karnataka. Available from: URL: http://en.wikipedia.org/wiki/Malnutrition in Karnataka

5. In a conversation with Muragod A, DHO (Dec. 2011)

6. Nahar B, Ahmed T, Brown K H, Hussain I. Risk factors associated with severe underweight among young children reporting to a diarrhea treatment facility in Bangladesh. J Health Popul Nutr 2010; 28(5):476-83.

7. Mishra VK, Retherford RD. Women’s education can improve child nutrition in India. Natl Fam Health Surv Bull 2000; (15):1-4.

8. Ekanayake S, Weerahewa J, Ariyawardhana A. Role of mothers in alleviating child malnutrition: evidence from Srilanka [Ph.D. thesis]. Departmental of Agricultural Economics and Business Management, University of Peradeniya.

9. Adefami SA, Musa OI. Intestinal helminthes infestation among pupils in rural and urban communities of Kwara state, Nigeria. Afr J Clin Exper Microbiol 2006; 7(3): 208-11.

Received on 02.06.2015 Modified on 30.06.2015

Int. J. Nur. Edu. and Research 3(3):July-Sept., 2015; Page 317-320

DOI: 10.5958/2454-2660.2015.00014.9