INTRODUCTION:

India, the second most populous country of the world, comprises 17.5% of the world’s population and only 2.4% of the global land area.¹The population of India has already crossed 1.26 billion and considering the present growth rate, by 2028, the country’s population will be more than China. Though, the population growth rate has slowed down in recent years due to effective implementation of family planning and family welfare programmes, yet the rate is growing at a much faster rate.²In order to improve maternal and child health, the interventions focus on new contraceptives, institutionalization of fixed day quality services, revitalizing Postpartum and Post Abortion Family Planning services, enhanced male participation, and community-based schemes through ASHAs, streamlining and strengthening commodity security, Public Private Partnership etc. IEC and BCC activities through a new focused communications campaign, programme management, quality improvement, evaluation and assessments, feasibility studies, development of resource material and E- learning modules, software development, social marketing, social franchising and provision of skilled human resource are key successful strategies in implementation of the programme.³

BACKGROUND OF STUDY:

No scalpel vasectomy:

No scalpel vasectomy is a vasectomy procedure variant in which a sharp haemostat is used to puncture the scrotum to access the vas deferens instead of giving an incision as in conventional vasectomy.⁴

No scalpel vasectomy was developed and first performed by Dr. Li Shunqiang in 1974in China, aiming to reduce the fear of men related to the incision and increasing vasectomy use in China.⁴A team of Indian surgeons lead by Dr Rcm Kaza visited Chengdu, China, to learn the technique under the aegis of Engender Health and the UN. There after they introduced the procedure in India.

The Government of India in 1992, introduced and accepted No Scalpel Vasectomy as a part of National Family Welfare Programme. This procedure in every district of India is offered to men as an alternative to tubal ligation, who have completed their family, on voluntary basis under national family welfare programme in collaboration with the United Nations Population Fund (UNFPA).⁵

It can be performed in rural hospitals and primary health centers (PHCs) as camp procedure. Hands-on training during the camp can be imparted to doctors working in hospitals and nearby areas.⁶

In a no-scalpel vasectomy, the vas deferens are located under the skin and holded in place, by making one tiny puncture with a special instrument (surgical Li-clamp) under local anaesthesia, outside the scrotum, then gently stretched the opening to reach the vas deferens. The vas is lifted through a tiny key hole, heat sealed and placed back in the scrotum.⁷It is much safer and less expensive than other common contraceptive surgery like tubal ligation. It is a safe, effective minimal access method of vasectomy with low complication(less bleeding, hematoma, infection, and pain, and a shorter operative time). and greater patient compliance.⁸

Widespread publicity is required to remove the social, religious, health, and sexual misconceptions for this simple method to have a greater acceptance.

NEED FOR THE STUDY:

According to the National Family Health Survey-2, National Family Health Survey-3 (NFHS-3), National Family Health Survey-4 (NFHS-4) the current acceptance of NSV in India has declined from 1.9%, to 1%, and 0.3% respectively.⁹

In 2005-2006, according to National Family Health Survey 3 (NFHS-3) female sterilisation accounted for 66 per cent of contraceptive use. The majority of the women (77%) who underwent sterilisation had not used any method before they were sterilised.¹⁰

Gender inequality, rooted in cultural norms, and lack of male involvement, continue to cause poor family planning practices nationwide. There need to be campaigns to promote the adoption of vasectomy, including strategies to break gender stereotypes, dispel myths and position men as responsible partners.¹¹

To popularize NSV, adequate information and effort need to be made to motivate, educate and persuade men to take greater responsibilities for adopting family planning and to ensure that women are safeguarded from adverse health consequences of abortion, tubectomy and contraceptive drugs.¹²It is important to reach out to husbands/fathers with behaviour change communication efforts, encouraging men to be involved in their spouses’ and children’s health care, according to this 2016 study.¹³

The health status of females is poor when compared to males. Majority of women are anaemic due to complications in pregnancy and childbirth. It is felt that involvement of male in family planning will reduce female sterilization and the complications related to tubectomy. Thus, health of the women can be improved.¹⁴

The National Health Policy 2017 recognises that improved access, education and empowerment would be the basis of successful population stabilization. policy imperatives are to increase the proportion of male sterilization from less than 5% currently, to at least 30% and if possible much higher.¹⁵

No Scalpel Vasectomy is a simple, gentle and elegant office procedure, that many studies shows significant advantages. It has fast recovery time, is safer and can be virtually pain free.¹⁶

Though vasectomy is a safer, quicker and easier option, several studies have suggested that Indian men do not undergo the procedure as they are worried about losing their virility.¹¹

I observed that in spite of Govt. efforts in organizing No-Scalpel Vasectomy camps for one week, the number of vasectomies performed were only 3-4, that was very less and indicates very little participation of male partner in sterilization. It has been accounted due to lack of knowledge, fear, mis-concepts, myths and beliefs.

For the above reasons, my study intends to assess and enhance knowledge and attitude among married men regarding No Scalpel Vasectomy through Self Instructional Module.

PROBLEM STATEMENT:

“A pre-experimental study to assess the effectiveness of Self- Instructional Module on knowledge and attitude regarding No-Scalpel Vasectomy among married men in selected urban area of Delhi.”

OBJECTIVES:

· To assess the knowledge of married men regarding No-Scalpel Vasectomy.

· To assess the attitude of married men regarding No-Scalpel Vasectomy.

· To assess the effectiveness of Self- Instructional Module on level of knowledge and attitude regarding No-Scalpel Vasectomy.

· To determine the association between post-test knowledge score regarding No-Scalpel Vasectomy with selected demographic variables.

· To determine the association between post-test attitude score regarding No-Scalpel Vasectomy with selected demographic variables.

HYPOTHESES:

H₁: There will be significant difference between mean pre-test knowledge scores and post-test knowledge scores regarding No Scalpel Vasectomy among married men as evident by structured knowledge questionnaire at 0.05 level of significance.

H₂: There will be significant difference between mean pre-test attitude scores and post-test attitude scores regarding No Scalpel Vasectomy among married men as evident by Likert attitude scale at 0.05 level of significance.

H₃: There will be significant association between post-test knowledge scores regarding No Scalpel Vasectomy with selected demographic variables among married men at 0.05 level of significance.

H₄: There will be significant association between post-test attitude scores regarding No Scalpel Vasectomy with selected demographic variables among married men at 0.05 level of significance.

Operational definitions:

Assess:

It refers to examining responses in order to judge or evaluate the knowledge and attitude of married men regarding No-Scalpel Vasectomy through structured questionnaire.

Effectiveness:

It refers to the capacity to bring about the changes in the level of knowledge and attitude score of married men through Self- Instructional Module on No Scalpel Vasectomy.

Self-Instructional Module:

It refers to the educational material that helps individualized learning to provide knowledge on No Scalpel Vasectomy to the married men.

Knowledge:

It refers to the information, awareness, and understanding to give correct response to the items in a structured knowledge questionnaire related to No Scalpel Vasectomy by the married men.

Attitude:

It involves thinking, believes, feelings, values and disposition about No-Scalpel Vasectomy.

No-Scalpel Vasectomy:

It refers to an advanced surgical procedure of vasectomy by using a tiny puncture instead of scalpel cut to reach the vas deferens in the scrotum. Under local anaesthesia a small surgical clamp is used outside the scrotum, to hold the vas deferens. The vas is lifted through a tiny key hole made on the skin, heat sealed and placed back in the scrotum. It is effective as the conventional approach.

MATERIAL AND METHOD:

Research approach:

Quantitative research approach using the pre-test and post-test was adopted for this study.

Research design:

Pre-experimental one group Pre-test, Post- Test research design.

Variables under study:

Three types of variables were identified in this study.

Attribute variables:

Attribute variables in this study were Age in years, Education status, Duration of marriage, Number of live children, Religion, Monthly income, Source of knowledge received regarding No-Scalpel Vasectomy.

Independent Variables:

In the present study, independent variable was Self -Instructional Module on No-Scalpel Vasectomy.

Dependent Variables:

In the present study, dependent variables were the Knowledge and attitude of married men regarding No Scalpel Vasectomy.

Setting of the study:

The present study was conducted at selected urban area (Nand Nagari community) of Delhi.

Population:

The population of study was married men between the age group of 21 - 40 years.

Sampling technique:

Non-probability convenient sampling technique was used to collect the data.

Sample and sample size:

In present study sample comprised of 50 married men, from selected urban area (Nand Nagari community) of Delhi.

Inclusion criteria for sampling:

The study included married men in selected urban area (Nand Nagari community) of Delhi and who were:

· Available at the time of data collection.

· Willing to participate.

· Between the age group of 21 - 40 yrs.

· Able to speak, read and write Hindi.

Exclusion criteria for sampling:

The study excluded married men in selected urban area (Nand Nagari community) of Delhi and who were:

· Not available at the time of data collection.

· Not willing to participate.

· Age group of below21 and above 40 yrs.

· Not able to speak, read and write Hindi.

Description of the tool:

The tool consists of three sections

Section I: Socio demographic data

Section II: Structured knowledge questionnaire regarding no scalpel vasectomy

Section III: Likert Rating Scale to assess the attitude regarding no scalpel vasectomy

Section I: Socio demographic data:

This section consists of demographic variables such as age in years, education status, duration of marriage, number of live children, religion, monthly income and source of knowledge received. This section has seven items.

Section II: Structured knowledge questionnaire regarding no scalpel vasectomy

Structured knowledge questionnaire comprised of two parts.

Part 1: Knowledge on Advanced Technique (No-Scalpel Vasectomy). Total items-14.

Part 2: Knowledge on Health Services. Total items-6

Knowledge questionnaire comprises of twenty questions with the minimum score of 0 to maximum score of 20.

Section III: Likert Rating Scale to assess the attitude regarding no scalpel vasectomy

This section contains the 3 points Likert Scale consisting 10 items related to positive and negative attitude on No-Scalpel Vasectomy. Totally a maximum of 20 marks were given.

Reliability of the tool:

Reliability of structured knowledge questionnaire:

The structured knowledge questionnaire having 20 items, to assess the knowledge regarding No-Scalpel Vasectomy was administered to married men. The reliability coefficient was calculated byKuder Richardson-20 Formula and was found 0.76, Thus the tool was found reliable.

Reliability of structured Likert Rating Scale:

The 3 points Likert Scale consisting 10 items, to assess attitude regarding No-Scalpel Vasectomy was administered to married men. The reliability coefficient was calculated by Cronbach’s alpha, the reliability was found to be 9.37. Thus the tool was found reliable.

Pilot study:

Pilot study was conducted on 10 married men in Bisrakh community to find out the feasibility of the study. Formal permission was obtained from the authority before conducting the study.

Ethical consideration:

· Formal Permission was obtained from the principal of “Nightingale Institute of Nursing, Noida

· Formal Permission was obtained from selected health care setting. (Medical Officer In charge, B-4 MCH Centre Nand Nagari, New Delhi as shown in appendix 3.

· The informed consents were obtained from samples. Confidentiality and privacy of participants has been maintained as shown in appendix 8.

Procedure of final data collection:

a. Formal administrative approval was sought from selected health care setting. (Medical Officer In charge, B-4 MCW Centre Nand Nagari, New Delhi to conduct study from17^th of December 2018 to 31^st of December 2018.

b. The investigator personally met the subjects and self- introduction was given and rapport was established.

· The nature of the study was explained to obtain free and frank response.

· The informed consent was taken from each sample.

· The knowledge scores among married men regarding No-scalpel Vasectomy assessed through structured knowledge questionnaire. (Pre-test)

· The attitude scores among married men regarding No-scalpel Vasectomy assessed through three-point structured Likert Attitude Scale at 0.05 level of significance. (Pre-test)

· As intervention Self- Instructional Module on No-scalpel Vasectomy administered.

· Assessed the effectiveness of Self- Instructional Module on level of knowledge and attitude regarding No-scalpel Vasectomy. (Post-test)

Data analysis:

The data is analysed as follow

Section-I:

Finding related to frequency and percentage distribution of married men in terms of demographic variables.

Section-II:

Assessment of knowledge of married men regarding No-Scalpel Vasectomy before and after administration of Self- Instructional Module.

Section-III:

Assessment of attitude of married men regarding No-Scalpel Vasectomy before and after administration of Self- Instructional Module.

Section-IV:

Findings related to association of post-test knowledge scores regarding No-Scalpel Vasectomy with selected demographic variables.

Section-V:

Findings related to association of post-test attitude scores regarding No-Scalpel Vasectomy with selected demographic variables.

Descriptive and inferential statistics is used to analyse and interpret obtained data as follow:

Descriptive statistics:

The descriptive statistics is used to assess the knowledge of selected demographic variables by using:

· Frequency, percentage distribution

· Mean, mean percentage and Standard deviation.

Inferential statistics:

Inferential statistics “Z” test is used to find out the effectiveness of Self-Instructional Module.

· Chi-square with Yates correction is used to find association between the level of knowledge and attitude regarding vasectomy among married men with their selected demographic variables.

RESULTS:

Section-I- Findings of socio-demographic characteristics of married men:

The study consists of 50 samples. The data obtained describes the characteristics pertaining to their age in years, education status, duration of marriage, number of live children, religion, monthly income and source of knowledge received regarding No-Scalpel Vasectomy. This section has seven items. Frequency and percentage was computed for describing the sample characteristics.

· Data revealed that majority 23 (46%) of subjects were in the age group of 31-35 years, 13 (26%) were in 36-40 years, 9 (18%) in 26-30 years and 5 (10%) in 21-25 years.

· As per educational status majority of the subjects 17 (34%) were educated up to senior secondary education, 16 (32%) up to graduate, 12 (24%) middle school and 5 (10%) were educated up to primary school.

· As per data 20 (40%) of subjects had the duration of 1-5 years, 20 (40%) had 6-10 years, 5 (10%) had 11-15 years and only 5 (10%) had 16-20 years duration of marriage.

· As per data number of children majority 23 (46%) of them had two children, 18 (36%) had one child, 8 (16%) had three children, and 1(2%) had four or more children.

· As per religion majority of the samples 48 (96%) belonged to Hindu religion and 2 (4%) belong to Muslim religion and no one falls in Christian & any other religion.

· According to data individual monthly income of selected samples is found that majority of them 24 (48%) were in the income group of Rs.5001-10000, 14 (28%) were in income group Rs.10001- 15000, 7 (14%) of them in income group Rs.15001 and above, only 5 (10%) of subjects had income less than Rs.5000.

· As for sources of knowledge received on No Scalpel Vasectomy majority of them 24 (48%) of subjects got through Multimedia like T.V, Newspaper, magazine, 15 (30%) from health personnel, 7(14%) through Relatives and 4 (8%) by Neighbour.

Section II-Findings related to knowledge of married men regarding no-scalpel vasectomy before and after administration of self- instructional module.

This section deals with findings related to frequency and percentage distribution of knowledge scores of married men regarding No-Scalpel Vasectomy.

Table -1 shows that in pre-test 41(82%) of the population had inadequate knowledge regarding No-Scalpel Vasectomy, 8(16%) had moderate and only 1(2%) had adequate level of knowledge regardingNo-Scalpel Vasectomy.

In post-test only 2(4%) of the population had inadequate knowledge and 26(52%) of population had moderate knowledge, 22(44%) percent had adequate level of knowledge regardingNo-Scalpel Vasectomy.

Table-2 Mean, standard deviation and z test value of pre-test and post-test knowledge scores of married men regarding no-scalpel vasectomy. (N=50)

Knowledge score

mean

Mean difference

Standard deviation

z test value

Pre- test

7.36

7.74

3.43

2.83

12.308*

Post test

15.1

*At 0.05 level of significance 96.

Table -2 shows that mean post-test knowledge score 15.1 is higher than the pre-test knowledge score 7.36. and difference was found to be statistically significant as evidence from “Z” test score value is 12.308 which is greater than table value (1.96) at 0.05 level of significance.

Fig 8 Bar Diagram Showing Mean Pre-Test and Post-Test Knowledge Score on No-Scalpel Vasectomy

Section III: Findings related to attitude of married men regarding no-scalpel vasectomy before and after administration of self- instructional module.

This section deals with findings related to frequency and percentage distribution of attitude scores of married men regarding No-Scalpel Vasectomy.

Table-3 Showing frequency and percentage of pre-test and post-test attitude score of married men regarding no-scalpel vasectomy (N=50)

Attitude Level	Grading	Pre-test		Post-test
Attitude Level	Grading	Frequency	Percentage	Frequency	Percentage
Un favourable attitude	(0-10)	8	16	0	0
Neutral attitude	(11-15)	31	62	19	38
Favourable attitude	(16-20)	11	22	31	62

Table -3 shows thatin pre-test 8 (16%) of the married men had unfavourable attitude regarding No-Scalpel Vasectomy, 31 (62) percent had neutral and only 11(22%) had favourable attitude regardingNo-Scalpel Vasectomy.

In Post-test none (0%) of the married men had unfavourable attitude, 19 (38%) of population had neutral attitude, 31 (62%) percent had favourable attitude regardingNo-Scalpel Vasectomy.

Table 4: Mean, standard deviation and z test value of pre-test and post-test attitude scores of married men regarding no-scalpel vasectomy. (N=50)

Attitude score	Mean	Mean difference	Standard deviation	Z test value
Pre- test	13.1	2.9	3	5.503*
Post test	16	2.9	2.21	5.503*

*at 0.05 level of significance z = 1.96

Table -4 shows thatmean post-test attitude score 16 is higher than the pre-test attitude score of 13.1 and difference was found to be statistically significant as evidence from “Z” test score value is 5.503 which is greater than table value (1.96) at 0.05 level of significance.

Fig 9 Bar Diagram Showing Mean Pre-Test and Post-Test Attitude Score on No-Scalpel Vasectomy

Section IV-Findings related to association of post-test knowledge scores with selected socio- demographic variables.

This section describes the findings related to association of post-test knowledge scores regarding No-Scalpel Vasectomy with selected socio-demographic variables: age in years, education status, duration of marriage, number of live children, religion, monthly income and source of knowledge received regarding No-Scalpel Vasectomy among married men in selected urban area of Delhi. To determine the association was calculated using Chi-square with Yates correction test.

It is evident that there was a significant association between post-test knowledge score with educational status and source of knowledge received regarding No Scalpel Vasectomy as p value obtained was 0.001 and 0.005 respectively which is less than 0.05.

Section V-Findings related to association of post-test attitude scores with selected demographic variables.

This section describes the findings related to association of post-test attitude scores regarding No-Scalpel Vasectomy with selected demographic variables: age in years, education status, duration of marriage, number of live children, religion, monthly income and source of knowledge received regarding No-Scalpel Vasectomy among married men in selected urban area of Delhi. The chi-square with yates correction test was used to find out the association between the post-test attitude score with the demographic variables. It was found that there is no significant association between the post-test attitude scores with these variable as the p value obtained is greater than 0.05.

DISCUSSION:

Present study conducted to assess the effectiveness of Self- Instructional Module regarding No-Scalpel Vasectomy in terms of knowledge and attitude among married men in selected urban area of Delhi. A number of studies have been included in the chapter dealing with review of literature.

The knowledge scores of married men in pre-test was assessed which revealed 41(82%) of the population had inadequate knowledge regarding No-Scalpel Vasectomy, 8(16%) had moderate and only 1(2%) had adequate level of knowledge regardingNo-Scalpel Vasectomy.

The knowledge scores of married men in post-test was assessed which revealed that only 2(4%) of the population had inadequate knowledge and 26(52%) of population had moderate knowledge, 22(44%) percent had adequate level of knowledge regardingNo-Scalpel Vasectomy.

The attitude scores of married men in pre-test was assessed which revealed 8 (16%) of the married men had unfavourable attitude regarding No-Scalpel Vasectomy, 31 (62) percent had neutral and only 11(22%) had favourable attitude regardingNo-Scalpel Vasectomy.

The attitude scores of married men in pre-test was assessed which revealed that none (0%) of the married men had unfavourable attitude, 19 (38%) of population had neutral attitude, 31 (62%) percent had favourable attitude regardingNo-Scalpel Vasectomy.

CONCLUSION:

The study concluded that the Self-Instructional Module was effective in improving the level of knowledge and attitude scores of married men regarding No-Scalpel Vasectomy.

NURSING IMPLICATIONS:

Nursing practice:

· Nursing professional can create awareness about advantages of No Scalpel Vasectomy among community people and encourage men to adapt No Scalpel Vasectomy as permanent method of family planning.

· Evidence based nursing practice on No Scalpel Vasectomy can be encouraged.

Nursing education:

Nursing educator can always play a major role by planning and giving inputs for the in-service education program (seminar/ workshop) for nurses regarding No Scalpel Vasectomy and it practice.

Nursing administration:

· The nursing administrator can take part in development and designing of refresher courses on No Scalpel Vasectomy.

· Nursing administrator can mobilize the available resources and the periodical teaching program on No Scalpel Vasectomy to be conducted for community level workers e.g. ANM, Multi- purpose workers, ASHA workers, Anganwadi workers.

· Nursing administrator can use their potentials to organize manpower, money and materials for conducting health education programme and continuous display of information regarding No Scalpel Vasectomy at Primary Health Centre, ANC clinics, MCH centres, labour room, post-natal wards and paediatric OPD and wards etc.

Nursing research:

· The research study will help to motivate researches on No Scalpel Vasectomy.

· It emphasizes many research work that need to be conducted related to the problem of No Scalpel Vasectomy and practice of No Scalpel Vasectomy which could provide current information on No Scalpel Vasectomy.

LIMITATION OF THE STUDY:

· Initially the men were not ready to participate in study.

· The wives of the participants were apprehensive and demonstrated reluctant attitude towards participation of their husbands in the study.

· Fear of becoming forced victim of vasectomy was the main concern.

RECOMMENDATIONS:

Based on the findings of the present study the following the recommendation are made

· A similar study can be done on married couples.

· An experimental study can be conducted to assess the effectiveness of Structured Teaching Programme on practice of No Scalpel Vasectomy.

· A similar study can be done with audio and video assisted teaching.

· Research can be conducted on life experience of No Scalpel Vasectomy users and view of their wives using qualitative research design.

· A comparative study between urban and rural men on knowledge and attitude on No Scalpel Vasectomy can be conducted.

REFERENCES:

1. Park k, Text book of preventive and social medicine.23^rded. Jabalapur. M/S Banarasidas Bhanot, 2015 p.481.

2. Rumani Saikia Phukan. Family-planning in India, its history, programmes, importance and impact. [Internet]. April 2015[cited 2018 July 6] available at https://www.mapsofindia.com/my-india/society/family-planning-in-india-its-history-programmes-importance-and-impact

3. Centre for Health Informatics (CHI) of the National Health Portal (NHP), by the Ministry of Health and Family Welfare (MoHFW), Government of India. [Internet]. August 2017 [cited 2018 July 8] National family planning programme available at https://humdo.nhp.gov.in/about/national-fp-programme/

4. M David Stockton, No scalpel vasectomy. [Internet]. Jan 2016 [cited 2018 July 9] available athttps://emedicine.medscape.com/article/148512-overview.

5. Dr Vijayant Govinda Gupta. No scalpel vasectomy in India. [Internet]. June 2017 [cited 2018 July 10]. Available at https://drvijayantgovinda.com/family-planning-male-sterilization-vasectomy/

6. Ministry of Health & Family Welfare Government of India, Reference Manual for Male Sterilization (No scalpel vasectomy). [Internet] Nov 2013 [cited 2018 July 9]. Available at http://cghealth.nic.in/dhs/New%20 offerings- FP%20 guidelines /Reference % 20Manual%20for%20Male%20Sterilization-NSV-Oct% 2023, % 202013-.pdf.

7. R. C. M. Kaza, “No scalpel vasectomy—an overview,” Journal of the Indian Medical Association. [Internet] April 2006 [cited 2018 July 9]. Vol. 104, no. 3, pp. 129–141. Available at https://www.researchgate.net/publication /6877875 No scalpel vasectomy an overview

8. Y. R. Sheynkin, “History of vasectomy,” Urologic Clinics of North America, [Internet] August 2009 [cited 2018 July 9]. vol. 36, issue 3, pp. 285–294. Available at Google Scholar.

9. International Institute for Population Studies, Mumbai. Ministry of Health and Family Welfare, Government of India. “National Fact Sheet India 2015-2016 National Family Health Survey 4 (NFHS-4) [Internet] Dec.2017 [cited 2018 July 10]. Available at http://www.rchiips.org/NFHS/pdf/India.pdf.

10. International Institute for Population Studies, Mumbai. Ministry of Health and Family Welfare, Government of India. “National Fact Sheet India 2005-2006 National Family Health Survey 3 (NFHS-3). [Internet] 1909[cited 2018 July 10]. Available at http://www.rchiips.org/NFHS/pdf/India.pdf.

11. Swagata Yadavar. It is necessary to involve men in the family planning in a big way. [Internet]April 22, 2017[cited 2018 July 10]. Available at http://www.indiaspend.com/indias-great-challenge-health-sanitation/it-is-necessary-to-involve-men-in-the-family-planning-programme-in-a-big-way-51583

12. Srilakshmi Battula. A study to assess the effectiveness of Video Assisted Teaching on No-Scalpel Vasectomy among industrial workers at Deepak Nitrate Industry Hyderabad, Andhra Pradesh. .[Internet] 2018 [cited 2018 July 16]. International Journal of advance research and development, volume 3 issue1. Available at https://www.ijarnd.com/manuscripts/v3i1/V3I1-1155.pdf.

13. Damodar Sahu¹, Tapati Dutta²et al. Effects of Women’s Autonomy and Male Involvement on Reproductive and Child Health (RCH) Service Utilization in Uttar Pradesh. [Internet] 2016 [cited 2018 July 16]. Open Journal of Preventive Medicine Vol.06 No.11(2016), Article ID:72190. Available at https://file.scirp. org/Html/2-1340524_72190.htm

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15. Ministry of Health and Family Welfare, Government of India. National Health policy2017, [cited 2018 July 16]. available at http://cdsco.nic.in/ writereaddata/ National-Health-Policy.pdf

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Received on 04.09.2019 Modified on 18.09.2019

Int. J. Nur. Edu. and Research. 2019; 7(4): 517-525.

DOI: 10.5958/2454-2660.2019.00114.5

Knowledge Level	Grading	Pre-test		Post-test
Knowledge Level	Grading	Frequency	Percentage	Frequency	Percentage
Inadequate knowledge	(0-10)	41	82	2	4
Moderate knowledge	(11-15)	8	16	26	52
Adequate knowledge	(16-20)	1	2	22	44