OBG thesis by mani_mandeep266

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									A STUDY TO EVALUATE THE EFFECTIVENESS OF PLANNED

    TEACHING PROGRAM ON KNOWLEDGE OF PRIMI

       GRAVIDAE REGARDING SELECTED ASPECTS

            OF SAFE MOTHERHOOD IN SELECTED

                       HOSPITALS IN KOLAR,

                             KARNATAKA.

                                     By

                        ANUPAMA TAMRAKAR

                        Dissertation submitted to the
    Rajiv Gandhi University of Health Science, Bangalore, Karnataka.

         In partial fulfillment of the requirements for the degree of,

                       Master of Science in Nursing

                                      In

                 Obstetrics and Gynaecological Nursing


                           Under the guidance of

            Mrs. Nagaseshamma, Professor and HOD

              Obstetrics and Gynaecological Nursing


                        Pavan College of Nursing,
                       Pavan nagar, Kolar- 565101


   (Affiliated to Rajiv Gandhi University of Health Science, Bangalore)

                                    2007

                                                                          i
     RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCE, BANGALORE


                      DECLARATION BY THE CANDIDATE


         I hereby declare that this dissertation / thesis entitled “A Study to Evaluate the

Effectiveness of Planned Teaching Program on Knowledge of Primi Gravidae

Regarding Selected Aspects of Safe Motherhood in Selected Hospitals in Kolar,

Karnataka.” is a bonafide and genuine research work carried out by me under the

guidance of Mrs. Nagaseshamma, Professor and HOD Obstetrics and Gynaecological

Nursing.




Date :                                                       Signature of the Candidate


Place: Kolar                                                 ANUPAMA TAMRAKAR




                                                                                              ii
                      CERTIFICATED BY THE GUIDE



         This is to certify that the dissertation entitled “A Study to Evaluate the

Effectiveness of Planned Teaching Program on Knowledge of Primi Gravidae

Regarding Selected Aspects of Safe Motherhood in Selected Hospitals in Kolar,

Karnataka.” is a bonafide and genuine research work carried out by Anupama

Tamrakar in the partial fulfillment of the requirement for the degree of Master of

Science in Nursing in Obstetrics and Gynaecological Nursing.




Date :                                           Signature of the Guide


Place: Kolar                                     Mrs. S Nagaseshamma

                                                 Professor,

                                                 Department of Obstetrics and

                                                 Gynaecological Nursing.




                                                                                      iii
 ENDORSEMENT BY THE HOD, PRINCIPAL/HEAD OF THE INSTITUTION


        This is to certify that the dissertation entitled   “A Study to Evaluate the

Effectiveness of Planned Teaching Program on Knowledge of Primi Gravidae

Regarding Selected Aspects of Safe Motherhood in Selected Hospitals in Kolar,

Karnataka.” is a bonafide research work done by Anupama Tamrakar under the

guidance of Mrs. Nagaseshamma, Professor and HOD Department of Obstetrics

and Gynaecological Nursing.




Seal & Signature of the HOD                         Seal & Signature of the Principal

Prof. Obstetrics and                                Prof. Mrs. Nagaseshamma

Gynaecological Nursing



Date:                                               Date:

Place: Kolar                                        Place: Kolar




                                                                                        iv
                                     COPYRIGHT


                           Declaration by the Candidate


         I hereby declare that the Rajiv Gandhi University of Health Sciences, Karnataka

shall have the rights to preserve, use and disseminate this dissertation / thesis in print or

electronic format for academic / research purpose.




Date :                                                   Signature of the Candidate


Place: Kolar
                                                         Name: Anupama Tamrakar




         © Rajiv Gandhi University of Health Sciences, Karnataka




                                                                                                v
                              ACKNOWLEDGMENT

     “The blessings of the Lord makes one rich, and he adds no sorrows with it.”

                                                                                     - Bible

          While conducting this study many people have encouraged and provided

invaluable assistance. Though it is not possible to name them all, the investigator owes a

deep sense of gratitude to all those who have contributed to the successful completion of

the study.

          I would like to express my great appreciation and indebtedness to my guide,

Mrs. Nagaseshamma, Principal and Head of the Department of Obstetrics and

Gynecological Nursing, Pavan College of Nursing, Kolar, for her keen interest, guidance,

valuable suggestions and co-operation throughout this study.

          My Sincere thanks and appreciation are due to:

          Dr. G. Nagarathna, Proffesor in Obstetrics and Gynaecology, Sri Devraja Urs’

Medical College¸ Kolar for her expert guidance and assistance and encouragement for the

study as a co-guide.

          Mrs. Shymala Rani, Principal, Pavan College of Nursing, Kolar for her

support, valuable suggestions and guidance to carryout the study.

          Mrs. R. Sreevani, Associate professor, Sri Devraja Urs. College of Nursing,

Kolar for her constant support, guidance, suggestions and encouragement at each step of

this study.

          Mr. Ravi Shankar, statistician, Sri Devraja Urs’ Medical College¸ Kolar for

his expert guidance and assistance in the statistical analysis and valuable suggestions.




                                                                                           vi
            Mrs. Suvarna B. Talwar, Mrs. Lalitha, Mrs. Tilagawathi, Mrs. Silvia and

all the experts for their constructive criticism and suggestions for the content validity of

the tool.

            I also feel deeply obligated to the Director, Hope Health Care, and Director,

Suguna Hospital for their needful help and co-operation.

            In the same way, I am thankful to all the staffs of the Library, Pavan College

of Nursing and Rajiv Gandhi University of Health Science for their help and co-operation

for searching literature for the study.

            My special thanks go to all the participants namely, the primigravidae for their

kind co-operation, without their help it would have been very difficult to complete my

research study.

            I gratefully acknowledge Rajiv Gandhi University of Health Science,

Bangalore, Research Committee and faculty for providing the opportunity to conduct

this research study.

            My deep appreciation and heartfelt gratitude to all my colleagues and to all

those who helped a lot and have been the source of inspiration and helped me tide over

many encumbrances during this study.



                                          Thanks to all,



Date:                                                          Signature of the Candidate

Place: Kolar                                                   Anupama Tamrakar




                                                                                           vii
              LIST OF ABBEVIATIONS USED



BMI      =   Body Mass Index


IEC      =   Information Education and Communication


MCH      =   Maternal and Child Health


PHN      =   Public Health Nurse


PTP      =   Planned Teaching Program


UNFPA    =   United Nation Population Fund


UNICEF   =   United Nation International Children Emergency Fund


WHO      =   World Health Organization




                                                                   viii
                                   ABSTRACT
Statement of the problem

       “A Study to Evaluate the Effectiveness of Planned Teaching Program on

Knowledge of Primigravidae Regarding Selected Aspects of Safe Motherhood in

Selected Hospitals in Kolar, Karnataka.”

Objectives of the study

   1. To assess the pre-existing knowledge of primigravidae regarding selected aspects

       of safe motherhood before planned teaching program.

   2. To plan, develop and to conduct the planned teaching program regarding selected

       aspects of safe motherhood for primigravidae of the experimental group.

   3. To evaluate the effectiveness of planned teaching program regarding selected
       aspects of safe motherhood in terms of gain in posttest knowledge scores of

       primigravidae when compared to their pretest scores.

   4. To compare the knowledge regarding selected aspects of safe motherhood
       between experimental and control groups.

    Methods

       The experimental (pretest-post test control group) design was adopted. Simple

random technique was used to select the hospitals as experimental group and control

group and the same technique was used to select the 100 primigravidae as sample (50 in

control group and 50 in experimental group). Pretest was conducted using structured

interview schedule in both experimental and control groups. Planned teaching program

was conducted in the experimental group only. After seven days, post test was conducted

in both experimental and control groups using as in pretest. The data obtained were

analyzed and interpreted in terms of the objectives and hypothesis of the study.


                                                                                          ix
Descriptive and inferential statistics were used for data analysis; the level of significance

was set at 0.05 levels.


Results

 1. The majority (88% of experimental group and 78% of control group) had

     moderately adequate knowledge. The mean value of knowledge scores of

     experimental group in pretest was 22.98 with SD 3.21 and SE 0.45. The mean value

     of knowledge scores of control group in pretest score was 23.06, SD was 3.63 and

     SE was 0.51, where as in post test mean was 24.1 with SD 3.32 and SE 0.46.

 2. There were significant difference in the pretest and post test scores in the

     experimental group with the demographic variables (P < 0.05). Whereas, in most of

     the control group, there was no significant difference in pretest and post test scores

     (P > 0.05). Most of demographic variables were not significantly associated with

     level of knowledge of primigravida regarding selected aspects of safe motherhood.

 3. There was the significant difference between the knowledge of primigravidae

     between the pretest and post test scores in both groups (t = 20.079, P < 0.000 in

     experimental and t = 2.555, P < 0.014 in control group).

 4. There was no significance in the pretest of the both group (t = 0.115, P > 0.05 and

     z = 0.116, P > 0.05). There was also significant difference between the post test of

     experimental and control group (t = 3.36, P < 0.05 and z = 10.30, P < 0.001).

Interpretation and conclusion

       This study showed that, the primigravidae knowledge regarding selected aspects

of safe motherhood was moderately adequate and planned teaching program is effective

to improve their knowledge.


                                                                                                x
                     TABLE OF CONTENTS


Chapter
 No.                      Contents       Page No.


   I      Introduction                     1-8


  II      Objectives                      9 - 14


  III     Review of Literature            15 - 31


  IV      Methodology                     32 - 41


  V       Results                         42 - 81


  VI      Discussion                      82 - 89


  VII     Conclusion                      90 - 93


 VIII     Summary                         94 - 98


  IX      Bibliography                   99 - 104


  X       Annexure                       105 - 164




                                                     xi
                                 LIST OF TABLES


Table                                Tables                                Page
 No.                                                                       No.
        The frequency and percentage distribution of the primigravidae
 01                                                                         44
        according to Age.
        The frequency and percentage distribution of the primigravidae
 02                                                                         46
        according to Religion.
        The frequency and percentage distribution of the primigravidae
 03                                                                         48
        according to Educational Status.
        The frequency and percentage distribution of the primigravidae
 04                                                                         50
        according to Occupation.
        The frequency and percentage distribution of the primigravidae
 05                                                                         52
        according to Type of Family.
        The frequency and percentage distribution of the primigravidae
 06                                                                         54
        according to Monthly Income.
        The frequency and percentage distribution of the primigravidae
 07                                                                         56
        according to Age at Marriage.
        The frequency and percentage distribution of the primigravidae
 08                                                                         58
        according to pre-existing information regarding Antenatal care.
        The frequency and percentage distribution of the primigravidae
 09                                                                         60
        according to Sources of information regarding to Antenatal care.
        Assessment of level of knowledge of primigravidae regarding
 10                                                                         62
        selected aspects of safe motherhood in pre and post test.
        Area wise mean, mean percentage and standard deviation of
 11                                                                         65
        knowledge regarding antenatal care.
        Item wise Frequency and Percentage of Correct Responses
 12                                                                         66
        regarding General Questions in Antenatal Care




                                                                                  xii
     Item wise Frequency and Percentage of Correct Responses
                                                                            67
13
     regarding antenatal diet.
     Item wise Frequency and Percentage of Correct Responses
14                                                                          70
     regarding Personal Hygiene.
     Item wise Frequency and Percentage of Correct Responses
15                                                                          71
     regarding Antenatal Checkup.
     Item wise Frequency and Percentage of Correct Responses
16                                                                          72
     regarding Immunization..
     Item wise Frequency and Percentage of Correct Responses
17                                                                          73
     regarding other Antenatal Care
     Mean, standard deviation of knowledge score according to
18                                                                          75
     demographic variables and paired ‘t’ value of pretest and post-test.
     Data on association between selected demographic variables of the

19   primigravidae and their knowledge regarding selected aspects of        78
     safe motherhood.
     Comparison of ‘T’ value of pretest and post test scores of
20                                                                          80
     experimental and control group.
     Comparison between the pretests and post tests of experimental
21                                                                          81
     and control group.




                                                                                 xiii
                                 LIST OF FIGURES


Fig                                  Figures                                      Page
No.                                                                               No.

01    Conceptual Framework.                                                        14


02    Schematic Representation of Research Design.                                 33

      Bar diagram representing the percentage distribution of the primigravidae
03                                                                                 45
      according to Age.
      Cylindrical diagram representing frequency and percentage distribution
04                                                                                 47
      of the primigravidae according to Religion.

      Bar diagram representing percentage distribution of the primigravidae
05                                                                                 49
      according to Educational Status.

      Pyramid representing percentage distribution of the primigravidae
06                                                                                 51
      according to Occupation.

      Cone diagram representing percentage distribution of the primigravidae
07                                                                                 53
      according to Type of Family.

      Tubes representing percentage distribution of the primigravidae
08                                                                                 55
      according to Monthly Income.

      Cylindrical diagram representing frequency and percentage distribution
09                                                                                 57
      of the primigravidae according to Age at Marriage.

      Bar diagram representing percentage distribution of the primigravidae
10                                                                                 59
      according pre-existing information regarding Antenatal care.

      Pyramid representing percentage distribution of the primigravidae
11                                                                                 61
      according to Sources of information regarding Antenatal care.
      Cylindrical diagram representing level of knowledge of primigravidae
12                                                                                 64
      regarding selected aspects of safe motherhood.




                                                                                        xiv
                   LIST OF ANNEXURES

Annexure                                                             Page
                               Annexure
  No.                                                                No.
   A       Letter seeking permission to conduct the study             106

           Letter granting permission to conduct the study
   B                                                                  107

   C       Letter seeking permission to conduct the study             108


   D       Letter granting permission to conduct the study            109

   E       Letter to experts for the content validity of the tool   110 - 111

   F       Evaluation Criteria Check List                             112


   G       Certificate of content validity                            113

  H        List of content validators of the tool                   114 - 115


   I       Tools used for the study (English)                       116 - 127

   J       Tools used for the study (Kannada)                       128 - 137

   K       Correct Responses and Scoring key                          138


   L       Scores of Knowledge obtained by primigravidae.           139 - 146

           Lesson plan for planned teaching program
  M                                                                 147 - 157
           regarding selected aspects of safe motherhood.


   N       Formulas used for statistical analysis.                  158 -160

                                                                    161- 164
   O       Visual Aids used for planned teaching program



                                                                                xv
  Chapter-
  Chapter- One

INTRODUCTION
                                1. INTRODUCTION

  “Safe motherhood is a matter of social justice and women’s human rights.”
                                                                              -   Cook RJ

    “Protecting and promoting women’s rights, empowering women to make
                informed choices, and reducing social and economic
                      inequalities are key to safe motherhood”
                                                                   - White Ribbon Alliance


       There is an emerging gap in health sectors between developing countries and

industrialized countries. The greatest one is in respect of health of women in pregnancy

and childbirth. Pregnant women in Africa, South Africa face a risk of very high

maternal mortality which may be up to 200 times more than that of women living in

industrialized countries. Due to early marriage, early pregnancy and lack of health

awareness the life of woman is at risk in developing countries.1

       According to WHO estimates, about 495,000 maternal deaths occurred globally

during the year 2000. Out of these deaths about 143,000 occurs in South Asian countries.

The life-time chances of maternal death in the world are about 1 in 75. In the least

developed countries the chances were about 1 in 16, in the developing countries about

1 in 60 and in the industrialized countries about 1 in 4100. Most maternal deaths and

pregnancy complications can be prevented if pregnant women have access to good

quality of antenatal, natal and postnatal care, and if certain harmful birth practices are

avoided. 1

       Worldwide, every minute, 1 woman dies of pregnancy related complications,

nearly 6,00,000 women die each year, out of these, 99% of death occurs in developing

countries. In India, every 5 minutes, 1 woman dies from complications related to



                                                                                             1
pregnancy and child birth. This adds upto total of 121,000 women per year. Every

pregnancy faces a risk and 15% of women develop life threatening complications

whereas, 65% of deliveries are conducted at home. Only 41% of women have skilled

attendants to assists in childbirth. 2

          More than 60% of maternal death takes place immediately following the

delivery, with more than half occurring within a day of delivery. An estimated 40% or

more pregnant women will die within a year. Each year fifty millions of the women

experience pregnancy related health problems during and after childbirth. Fifteen percent

of these women suffer serious or long-term often debilitating, complications such as

uterine prolapse, fistulae, pelvic inflammatory disease and infertility. 3

          Globally, the major causes of maternal deaths were severe bleeding (25%),

infections (15%), unsafe abortion (13%), eclampsia (12%), obstructed labour (8%), and

other direct causes. In India major causes of maternal mortality were anemia (19.4%),

hemorrhage (23%), toxemia (15%), abortion (11.8%), puerperal sepsis (8.1%), and others

(21.8%). 1 A range of social, economic, and cultural factors also contribute to women’s

poor health before, during and after pregnancy.3

          The maternal mortality rate in India is about 407 per 1, 00,000 live births. The

maternal mortality rate in Karnataka is also high that is 195 per 1, 00,000 in the year

1998. 4

          Mother plays an important role within the family. Hence maternal deaths have

very serious consequences within the family. The death of mother increases the risk to

the survival of her young children.




                                                                                         2
        The road to maternal and infant death is a long one, but it is possible to escape

the tragedy of its end at various points along the route. The challenge is to ensure that

every woman has the chance of safe motherhood.


                                  Safe motherhood

Introduction

       “Safe motherhood means ensuring that all women receive the care they need to be

safe and healthy throughout pregnancy, childbirth and postnatal period.”5 Safe

motherhood includes antenatal care, intranatal care, postnatal care and neonatal care.

       It is a holistic program, with more specific objectives as well as strategies. More

recently, it is incorporated in the Reproductive and Child Health (RCH) Program with

target free approach.

Safe motherhood Initiative

       During 1970’s, safe motherhood initiative groups sought attention of government

and people worldwide for urgent measures to ensure safe motherhood. Following this

decade, during 1987 in Nairobi, International Safe motherhood Conference was held with

emphasis on maternal component in maternal and child health program. First time it drew

worldwide attention in relation to causes, the magnitude and consequences of maternal

morbidity and mortality. Immediately there after safe motherhood launched globally with

the help of WHO, UNICEF, World Bank, Population Council and International Planned

Parenthood Federation. In this context, creation of national safe motherhood program was

urged. As an outcome of this conference, National Child Survival and Safe motherhood

Program came into existence in India in 1992, with active support of international

agencies like World Bank and UNICEF.

                                                                                         3
Goal of Safe motherhood Program

         The ultimate goal of Safe motherhood in India is to bring down the maternal

mortality rate to 2/1000.6

Objectives of Safe motherhood Program

The main objectives of Safe motherhood Program are following:

     •    To decrease the maternal mortality and morbidity through provision of a

          comprehensive health package with emergency obstetric care as its focuses.

     •    To improve the quality, coverage and utilization of basic maternit y services in

          all health facilities.

     •    To strengthen the referral system from village to first referral units in order to

          provide quality obstetric care.

     •    To create a social movement for the prevention of maternal deaths and

          recognition of women’s reproductive rights.

     •    To empower community for demand generation of women and adolescent

          health services and thereby achieve better and effective utilization of services

          including referrals.

Strategies of Safe Motherhood

The strategies of Safe Motherhood include:

     •    Delaying the age of girl’s sexual initiation, marriage and first child birth.

     •    Eliminating the violence against women at home and in work place.

     •    Providing universal access to education, family planning and reproductive

          health services including skilled care during childbirth.

     •    Empowering women to use available services through education, access to

          decision making positions and discrimination against women.

                                                                                          4
Essential Services for Safe Motherhood

   • Community education on safe motherhood

   • Antenatal care and counseling, including the promotion of maternal nutrition

   • Skilled assistance during childbirth

   • Care of obstetric complications, including life-threatening emergencies

   • Postpartum care

   • Services to prevent and manage the complications of unsafe abortion

   • Family planning counseling, information, and services

   • Reproductive health education and services for adolescents

Barriers to Care

A number of barriers limit women’s access to care, including:

   •   Distance and lack of transport: Nearly 80 percent of rural women live more

       than five kilometers from the nearest hospital, and many have no way to get to

       health facilities except by walking – even when they are in labour.

   •   Interactions with providers: Too often health care providers are rude,

       unsympathetic, and uncaring. They often do not respect women’s cultural

       preferences, e.g., for privacy, birth, position, or treatment by women providers.

   •   Socio-cultural factors: Women in many areas of the world lack the power to

       make choices about their health and lives, with negative consequences for

       maternal health. Tradition, family mores and laws limit women’s decision-

       making and rights with regard to childbearing, contraception, initiation of sexual

       relations, and if and when to seek medical care. In some settings, a husband’s

       permission is required for women to receive health services, including life-saving

       care; in others, mothers-in-law decide whether women can use available services.

                                                                                            5
     The modern obstetric nursing, primary focus, is on preventive care of pregnant

women. The main aim of which is to help the mother’s to have a safe and natural

childbirth. Successful antenatal education can better prepare women and families to care

for themselves.

     Complications of pregnancy and childbirth were the leading cause of death and

disability for women in developing countries between the age group of 15-49.6

     “Safe motherhood is an important social and economic investment.” Clearly safe

motherhood benefits individuals- the woman, the child and family members. Safe

motherhood also has important social and economic benefits. 2

     When a mother dies or is disabled, her children’s health, well-being, and survival

are threatened. Her family loses her contribution to household management and the care

she provides for children and other family members. The economy looses her productive

contributions to the work force. 7




Need for the Study

       Addressing maternal health means ensuring that all women receive the care they

need to be safe and healthy throughout pregnancy and childbirth. Safe motherhood

encompasses social and cultural factors, as well as addresses health systems and health

policy. Indicators used to measure maternal health include skilled attendance at birth,

contraceptive prevalence rates and maternal mortalit y and morbidit y. Improving

maternal health is one of the eight Millennium Development Goals, and great efforts

have been put forth to achieve that goal. However, much work has yet to be done to

assure maternal health for women worldwide.



                                                                                       6
       Women in many areas still lack the power to make choices about their health and

lives, with negative consequences for maternal health. They still have lots of traditional

beliefs about the food and regarding the medical seeking.8

       India has the highest incidence of maternal mortality of 5/1000 live births and

an infant mortality rate of 68/1000 live births. In India, the main causes of maternal

death were hemorrhage, sepsis, anemia and toxemia. The incidence of maternal

mortality is observed between the age group of 15-24 years (95.6%). Nearly 50% of

deaths among young women in the reproductive age group could be avoided by timely

identification and treatment or early referral and over 75% of deaths among young

children can be eliminated by the proper implementation of prevention and promotion of

health programs. 9

       Majhi, et al (2001) conducted a retrospective analysis of all maternal death at

R.G. Kar medical college and hospital at Calcutta. The over all maternal mortality rate

was 686.67/1000 live births, the direct causes were toxemia in pregnancy (53.20%),

hemorrhage 16.5%, sepsis 12.31%, severe anemia 6.4%. Maternal mortality was high

among rural (59.6%) and from low socio-economic status (59.6%). The study brought out

the importance underlying factors responsible for maternal mortality was low socio-

economic status and illiteracy. 10

       A study conducted in Delhi slums revealed that a very high proportion of women

had availed of care during pregnancy. Those who had not reported said that they either

“did not know” about antenatal care services or “did not feel the need” to use them.

Awareness ranged from 52 - 82% of all women who had availed the services, only one

sixth had taken care during pregnancy. The main reason for this low utilization was lack



                                                                                       7
of knowledge about services offered, which may in turn be attributed to the high level of

illiteracy and lower accessibility of these institution. 11

                Many women in developing countries receive no antenatal care, almost

half gave birth without a skilled attendant, and the vast majority receives no postpartum

care. Millions of women, especially, women who are poor, uneducated or who live in

rural areas do not have access to good quality of health services during pregnancy and

childbirth. Women in many areas still lack the power to make choices about their health

and lives, with negative consequences for maternal health. They still have lots of

traditional beliefs about the food and regarding the medical seeking.8

        In order to reduce life-threatening risks and reduce mortality, good-quality

maternal health services by trained health workers must be available and must be used.

Therefore, safe motherhood strategies must be comprehensive in nature; even when

quality health services are available, other limiting factors can get in the way of women

using these services, such as social, economic and cultural factors.

        Illiteracy is the greatest barrier for any improvement in the health condition.

Mother’s education level, even within the same socio-economic class is a key

determinant of their children’s health. To improve pregnancy outcomes, education,

motivation and mobilization of pregnant women, families and communities regarding

safe motherhood should be provided. 12

        The research studies reports created an insight that there is more prevalence of

complications related to pregnancy, childbirth among the mothers. Hence the investigator

felt the need to evaluate the effectiveness of a planned teaching program regarding safe

motherhood. This study is aimed to help in ensuring safe motherhood by throwing light

on prevention of complications during pregnancy, delivery and post natal period.


                                                                                        8
 Chapter-
 Chapter- Two

OBJECTIVES
                                 2. OBJECTIVES

Statement of the Problem

“A study to evaluate the effectiveness of Planned Teaching Program on knowledge of

primigravidae regarding selected aspects of safe motherhood in selected hospitals in

Kolar, Karnataka.”




The Objectives of the study are as follows:

 1. To assess the pre-existing knowledge of primigravidae regarding selected aspects of

     safe motherhood before planned teaching program.

 2. To plan, develop and to conduct the planned teaching program regarding selected

     aspects of safe motherhood for primigravidae of the experimental group.

 3. To evaluate the effectiveness of planned teaching program regarding selected

     aspects of safe motherhood in terms of gain in posttest knowledge scores of

     primigravidae when compared to their pretest scores.

 4. To compare the knowledge regarding selected aspects of safe motherhood between

     experimental and control group

Hypothesis:

Null Hypothesis (H0): There will be no significant difference between the knowledge of

primigravidae before and after the implementation of planned teaching program.

Alternative Hypothesis (H1): There will be significant difference between the

knowledge of primigravidae before and after the implementation of planned teaching

program.




                                                                                     9
Operational Definitions

  1. Evaluation: In this study evaluation means evaluating the knowledge of primi

     gravidae by comparing the scores of pre and post assessment.

  2. Knowledge: In this study the knowledge was related to antenatal care.

  3. Effectiveness: In the present study it was assessed on the basis of increase in post

     assessment scores of the primigravidae when compared to their pre assessment

     scores regarding safe motherhood

  4. Planned Teaching Program: A teaching program on safe motherhood designed

     to impart knowledge specifically for primigravidae.

  5. Primigravidae: Women who were pregnant for the first time and who were

     between age group of 20 to 30 years.

  6. Selected aspects: In this study, selected aspects means regarding antenatal care.

  7. Safe motherhood: Safe motherhood is ensuring that all women receive the care

     they need to be safe and healthy throughout pregnancy, childbirth and postnatal

     period.



Assumptions

  1. Primigravidae will have some knowledge regarding safe motherhood.

  2. Knowledge regarding selected aspects of safe motherhood of primigravidae can

     be measured by knowledge questionnaire.

  3. After the conduction of planned teaching program, in the post test, the knowledge

     scores of the primigravidae will be increased.

  4. The post test scores in the control group will be increased than their pretest

     scores.

                                                                                      10
Conceptual Framework

       Concept is defined as a complex mental formulation of an object, property or an

event that is derived from the individual’s perception and experience. 13

       Theories and conceptual models are the primary means of providing a conceptual

context for a study. The aim of the present study is to assess the effectiveness of planned

teaching program on knowledge of primigravidae regarding selected aspects of safe

motherhood.

       Conceptualization is a process of forming ideas, which are utilized, and forms

conceptual framework for development of research design. It helps the researcher to

know what data need to be collected and gives direction to an entire research process.

       Conceptual models can deal with interrelated concepts or abstracts that are

assembled together in some rationale scheme by virtue of their relevance to common

theme. 14

       The conceptual model selected for this study is based on Daniel L. Stufflebeam’s

Context, Input, Process and Product Evaluation Model (CIPP). The CIPP Model’s current

version (Stufflebeam, 2002-a, 2003-a; Stufflebeam, Gullickson, and Wingate, 2002)

reflects prolonged effort and a modicum of progress to achieve the still distant goal of

developing a sound evaluation theory, i.e., a coherent set of conceptual, hypothetical,

pragmatic, and ethical principles forming a general framework to guide the study and

practice of evaluation.

       The model’s core concepts are denoted by the acronym CIPP, which stands for

evaluations of an entity’s context, inputs, processes, and products. The CIPP model

places priority on guiding the planning and implementation of development efforts. The

model’s intent is thus to supply evaluation for users – with timely, valid information of

                                                                                         11
use in identifying an appropriate area for development, formulating sound goals, activity

plans, and budgets, successfully carrying out work plans, periodically deciding whether

and, if so, how to repeat or expand an effort; and meeting a funder’s accountability

requirements.

Context evaluations: Context evaluations assess needs, problems, assets and

opportunities to help decision makers define goals and priorities and help the broader

group of users judge goals, priorities, and outcomes.

       The present study is carried out to determine the effectiveness of planned teaching

program in terms of gain in knowledge of primigravidae regarding selected aspects of

safe motherhood. Based on the findings of the various studies it is assumed that

primigravidae have inadequate knowledge regarding selected aspects of safe motherhood.

Input Evaluations: Input evaluations assess alternative approaches, competing action

plans, staffing plans, and budgets for their feasibility and potential cost-effectiveness to

meet targeted needs and achieving goals. Decision makers use input evaluations in

choosing among competing plans, writing funding proposals, allocating resources,

assigning staff, scheduling work, and ultimately in helping others judge an effort’s plans

and budget.

   In this study input evaluation refers to:

   •   Development of tools to assess knowledge regarding selected aspects of safe

       motherhood and establishment of content validity and reliability of the tools.

   •   Development of planned teaching program regarding selected aspects of safe

       motherhood and preparing appropriate teaching aids.

   •   Selection of samples.

   •   Establishing research design.

                                                                                         12
Process evaluation: Process evaluations assess the implementation of plans to help staff

carry out activities and later help the broad group of users’ judge program performance

and interpret outcomes.

In this study the process evaluation refers to:

   •   Conducting pilot study.

   •   Assessing primigravidae knowledge regarding selected aspects of safe

       motherhood before conducting the planned teaching program.

   •   Conducting planned teaching program regarding selected aspects of safe

       motherhood.

   •   Assessing primigravidae knowledge regarding selected aspects of safe

       motherhood after conducting the planned teaching program.

Product evaluations: Product evaluations identify and assess outcomes – intended and

unintended, short term and long term – both to help a staff keep an enterprise focused on

achieving important outcomes and ultimately to help the broader group of users gauge the

effort’s success in meeting targeted needs.

       In the present study product evaluations refers to comparison of pretest and post

test knowledge scores of primigravidae regarding selected aspects of safe motherhood.

       The product evaluation leads to recycling decisions, need for modification or

termination, etc. In this study, recycling decision is not included.




                                                                                        13
        Fig. 1 CONCEPTUAL MODEL OF STUFFLEBEAN’S CIPP EVALUATION MODEL

                                                     Planning Process
Context Evaluation                                   Formulation of objectives: To evaluate the
Inadequate knowledge of primigravidae
                                                     effectiveness of PTP on knowledge of
regarding selected aspects of safe motherhood.
                                                     primigravidae regarding selected aspects of safe
                                                     motherhood.


 Structuring Design
 Establishment of content validity of tools,       Input evaluations
 lesson plan for PTP & research design.             • Development of appropriate tools & PTP regarding
                                                      selected aspects of safe motherhood. establishment
                                                      of content validity, reliability of the tools.
                                                    • Selection of samples, establishing research design
Process Evaluation                                     and preparing teaching aid.
 • Conducting pilot study.
 • Assessing primigravidae knowledge before PTP.
 • Conducting PTP regarding selected aspects of
    safe motherhood.                                      Implementing decision
 • Assessing primigravidae knowledge after PTP.           Implementation of planned teaching program
                                                          as per research design.




           Recycling decisions                      Product Evaluation
           continue to modify.                      Comparison of pretest and post test knowledge
                                                    scores of primigravidae regarding selected
                                                    aspects of safe motherhood.

          - Not included in the study



                                                                                                           14
 Chapter-
 Chapter- Three

LITERATURE
  REVIEW
                            3. REVIEW OF LITERATURE
       “Review of Literature is an important source for development of research project.

It helps to gain insight into the research problem and provide information of what has

been done previously. It helps the researchers to be familiar with the existing studies,

provide basis for future investigation and helps to develop the methodology, tools for

data collection and research design.”15

   An extensive search of literature was done by the investigator to elicit factual

information about knowledge assessment of primigravidae regarding selected aspects of

safe motherhood. The related literature has been organized and presented under the

following headings:

              Literature related to knowledge regarding antenatal care

              Literature related to antenatal care practice

              Literature related to planned education for antenatal mothers on safe

              motherhood

Literature related to knowledge regarding antenatal care

       Massawe S, Urassa E, Lindmark G, Nystrom I. (1996), conducted a study to

assess the pregnant women’s knowledge and attitude towards anemia on 310 women

from three MCH clinics in suburban Dar-es-Salaam. Findings showed that over 85% of

mothers were aware of the causes and ways of preventing anemia. Among them more

than 90% were aware of the advantages of early booking for antenatal care. None of them

had received any ferrous supplements during current pregnancy. The irregular and

inadequate supply of haematinics in antenatal clinics was far more important to the

implementation of anemia prevention program than the knowledge and attitude of the

mothers. 16

                                                                                     15
       El-Sherbini AF, el-Torky MA, Ashmawy AA, Abdel-Hamid HS. (1993),

conducted a study to assess the knowledge, attitudes and practices on 50 expectant

mothers in relation to antenatal care in Assiut governorate. The results revealed that one

quarter of the study sample (25.5%) lacked basic and essential knowledge about antenatal

care, most of older women (88.2%) were more likely to have poor knowledge in relation

to antenatal care, the higher educated women (66.7%) were more likely to have good

knowledge about antenatal care compared to 33.5% of lower educated women. It was

also observed that the majority of working women (90%) were more likely to have good

antenatal care knowledge compared to housewives (10%). Most of the primigravida

women (88.2%) were more likely to have poor knowledge in relation to antenatal care

compared to 11.8% of women whose gravidity was less than 5.17

       Madi BC, Crow R. (2003), conducted a qualitative study to explore the level of

information regarding childbirth among pregnant women. Thirty-three pregnant women

from south-east of England participated in the study. Data was collected using

unstructured interviews with the help of tape recorder. Findings revealed that pregnant

mothers had lack of information regarding services available to them. 18

       Hasan TJ, Nisar N. (2002), conducted a study to assess the knowledge of women

on obstetrical complications and care in Karachi. By using a systematic sampling

technique, 329 married women of reproductive age were selected from the coastal

community of Karachi. Data was collected using a structured questionnaire. Results

showed that half of them had no antenatal care in their last pregnancy and 75% of them

delivered at home. The findings indicated the women had poor knowledge on pregnancy

related complications. Only 5% of the women perceived absent/decreased fetal

movements as a danger sign of pregnancy. Other reported danger signs included

                                                                                       16
premature uterine contraction by 3%, premature rupture of membranes by 3% and

convulsion by 13%. About 86% of women thought that a case of antepartum hemorrhage

should be examined internally and 50% thought that no precaution is required to sterilize

the instruments for cutting the cord. The study suggested that the mothers need to have

awareness regarding obstetrical complications. This can be achieved by health education

interventions. 19

        Kumbani L, Mc. Inerney P. (2002), conducted a descriptive study to determine

knowledge regarding obstetrical complications at health centre, Malaw. Data was

collected by using interview method from 33 primigravidae. Finding displayed that

participants were more aware of obstetric complications that could occur in pregnancy

than the complications that may occur during and after delivery. Participants had limited

knowledge of complications that may need immediate treatment during all three periods.

Eighty-two percent (95% CI: 67 to 96) of the primigravidae had some knowledge and

could make an informed decision to go to a health facility with complication after

delivery. These findings have critical implications for the provision of information on

obstetric complications. The information given should cover all three periods, with

emphasis on those obstetric complications that require immediate treatment. 20

        Rautava P, Erkkola R, Sillanapaa N. (1991), conducted a study on

primigravidae regarding knowledge of childbirth, their effect on the outcome and

experiences of pregnancy and labour on 1,238 mothers using questionnaire. The mothers

were divided into two groups according to their basic child birth knowledge. Findings

showed that at birth, conditions of newborns were equal in both groups when judged by

apgar scores. The low knowledge level group had small for gestational aged babies more

frequently and these babies were also treated in the pediatric ward more frequently than

                                                                                      17
those in the high knowledge group. The latter group was significantly more critical

towards the staffs of the delivery room and the postnatal ward: the fathers of knowledge

level group were significantly more unwilling to have another pregnancy in the near

future or ever. The results indicated that low child birth knowledge is associated with the

poor pregnancy outcome. This study suggested that the health care professionals need to

provide education to mothers to improve their knowledge regarding child birth process,

because low knowledge regarding childbirth may imply a set of problems. 21

       Soltani. MS, Sakouhim, Blguith Z, Ben Salam K, Gacem H, Behir A. (1999),

conducted a cross-sectional survey to evaluate the knowledge of pregnant women in the

Monastic region. Data was collected by the questionnaire method in 915 pregnant

mothers. Findings divulged that the majority of the women (95%) were aware of the

importance of the prenatal surveillance, 12% did not have any knowledge of

recommended number of prenatal visits, concerning contraception, tetanus vaccination

and post natural consultation. Roughly only one third of mothers used contraception

before their current pregnancies and only 70% had both doses of tetanus vaccination.

Health education on preventive care received by the mothers helped to increase

knowledge and probability practices as well. The increased in mother’s knowledge

happens with appropriate initial and continue training in health education, provided by

the health professionals and with the reinforcement of educational activities during each

contact with the mother both during her pregnancy and in periods where she is not

pregnant. 22

       Rautava P, Sillanpaa M. (1989), conducted a survey to determine the level of

knowledge about pregnancy and childbirth in 1443 nulliparous pregnant women from a

Finnish province, maternity health care clinics selected by using cluster sampling

                                                                                        18
technique. Participants were questioned about their knowledge of pregnancy and

childbirth using 28 questions sets. Result revealed that the largest knowledge gaps were

present about alcohol intake and nutritional aspects of pregnancy and lactation.

Knowledge of normal and abnormal delivery was relatively complete. It was concluded

that differences still occur in knowledge levels among nulliparous pregnant women and

particular guidance and care is needed for less advantaged mothers to ensure that they

deliver healthy full term babies. 23

        Agarwal OP, Rakesh Kumar, Anitha Gupta, Tiwari RS. (1988), conducted a

cross-sectional study to assess the utilization of antenatal care services in periurban areas

of Delhi. Data was collected by pre-structured semi open ended questionnaire. Out of

276 women, 7.6% were teenager and three quarter were aged between 20- 30 years.

Almost all of them were housewives, nearly half being literate and only 40% were

graduate and 74.3% mothers got themselves registered at one of the medical care centers.

Results demonstrated that mothers, who were mostly illiterate, did not receive iron and

folic acid tablets, tetanus toxoid immunization and 95.8% of them delivered at home. The

study suggested that attempt should be made to register all antenatal mothers so that they

come under the umbrella of MCH care package for ensuring safe motherhood and better

survival of the children. 24

        Khan M, Mwaku RM, Mc. Clamroch K, Kinkela DN, Vanrie A. (2005),

conducted a study to assess knowledge, beliefs and barriers to timely antenatal care at

antenatal clinics in the Democratic Republic of Congo. Using structure interview, data

was collected from 206 women at their first antenatal visit. The results explored that

about 75% of women believed antenatal care should start before the end of the fourth

month, as recommended by WHO but only 22% were present at that time. The important

                                                                                          19
barriers were financial (37%) and lack of knowledge about appropriate timing (35%).

Gravidity was associated with gestational age at first visit (p < 0.001). Average

gestational age at first visit was 4.7 months in primigravidae and 5.9 months in women

with > or = 2 previous pregnancies. Most women in Kinshasa begin antenatal care later

than recommended by WHO. Educating women on the importance of timely antenatal

care and improving its financial accessibility should be priorities for maternal and child

health programs in the Democratic Republic of Congo. 25

       Bener A, AI Maadid MG, Al-Bast DA, Al-Marri S. (2006), conducted a cross-

sectional survey in selected 1480 women (18-45 years) using multi-stage sampling

technique to assess the knowledge, attitude and practice on folic acid intake among Qatari

women. The findings showed that 53.7% reported they had heard about folate. Of these

only half of the subjects knew that folate was something important. Overall, 20.3% of the

respondents took folic acid. The most common information sources on folate were

physicians (63.4%), and newspaper/magazine/ books (21.7%). From those who heard of

folate (53.7%), only 14% knew that it can prevent birth defects. Among the subjects

40.6% who heard of folate were aware that green leafy vegetables were fortified with

folic acid. In univariate analysis, awareness of folic acid was significantly associated with

education of mother. Again, higher educated women (41.3%) knew more about folic acid

and used it more often in the periconceptional and first trimester period. The study

concluded that awareness and use of folic acid was less prevalent among Qatari women.

Educated women were aware of the importance of the intake of folic acid and suggested

to increase awareness program in intake of folic acid. 26




                                                                                          20
       Fidanza AA, Fidanza R. (1986), conducted a survey in full term pregnant

women using the anthropometric evaluation and questionnaire including information on

eating habits, life styles, nutrition knowledge, food preferences and aversions during

pregnancy, use of oral contraceptives, and cigarette smoking. Sampling group was a

subset of pregnant women who was examined periodically from the beginning of the

second trimester until the end of the pregnancy. In the same hospital the anthropometric

measurements of 83 newborns were taken. Results showed that in some cases there was a

relatively small weight gain in body fat during pregnancy (6.3 kg) with obvious effects

on the weight of their respective newborn. Conclusion was, eating habits showed notable

quantitative and qualitative irrationalities and nutrition knowledge was poor, oral

contraceptives were not widely used. 27

       Yadav RJ, Padam Singh. (1998), conducted a cross sectional study both in rural

and urban areas of Bihar to study the coverage of immunization, antenatal care and intake

of iron and folic acid tablet. Using stratified random sampling technique 375 mothers

were selected for the sample. The result showed that, overall immunization coverage

among pregnant mothers was 42%. Coverage was high (60%) in urban areas compared to

rural areas (40%). Coverage was low among females of SC/ST category. Similar trend

was observed for antenatal care and intake of iron and folic acid tablets. Lack of

awareness and lack of motivation are main reason for non immunization among SC/ST

mothers as compared to the others. Lack of awareness was also found as a common for

non immunization among illiterate mothers. 28




                                                                                      21
        Alam AY, Qureshi AA, Adil MM, Ali H. (2005), conducted a cross-sectional

survey among 200 married women between the age group of 15-49 years with the

objective of comparing the knowledge, attitude and practices of women utilizing and

non-utilizing antenatal care facilities during their previous pregnancy. The results

revealed that pallor was significantly lower in women utilizing antenatal care (57%) as

compared to those who were not (77.6%), (O.R=0.38, CI = 0.18-0.81, p < 0.02). Tetanus

toxoid coverage was higher among utilizing antenatal care (92%) compared to those who

were not (52.2%) (O.R=10.8, 95%, CI 4.5-26.2). Knowledge about danger signals in

pregnancy and realization of the importance of eating a healthy diet during pregnancy

was significantly higher among women utilizing antenatal care. They concluded that

lesser prevalence of anemia and better tetanus toxoid coverage was seen among women

attending antenatal care facilities. Identification of danger signals in pregnancy and

recognition of nutritional demands of pregnancy are better understood by women

utilizing antenatal care facilities. 29

        Cwiek D, Luczynska V, Jurczak A, Augustyniuk K. (2004), conducted a study

to analyze of sources of women's knowledge preparing to maternity at schools of

childbirth and without such form of education in Maternity Ward at Department of

Obstetrics and Perinatology of Pomeranian Medical University in Szczecin.

Investigations were taken over 129 women after delivery school as an experimental group

and control group was 165 women, who did not take any antenatal education.

Investigations appeared that women participating in activities of the delivery school more

often read professional magazines and books, watching films preparing to birth control.

This is probably the result of frequent higher education in this group as well as the




                                                                                       22
projection of educational films in delivery school. Moreover woman without preparation

in delivery school more often had the need of the help of hospital staff during delivery. 30

       Paredes I, Hidalgo L, Chedrauni P, Palma J, Eugenio J. (2005), conducted a

survey in 1,016 pregnant women in a hospital of Ecuador to determine factors associated

with inadequate prenatal care among low socio-economic circumstances.

       The findings revealed that prenatal care was considered adequate in 24.5% and

inadequate in 75.5% of cases. Knowledge regarding the importance of prenatal care and

the effects of poor prenatal care was lower among women who had received inadequate

prenatal care. The women who had adequate prenatal care had at least one visit, and they

were more often cared by a specialist than women who had inadequate prenatal care. The

three most important reasons for inadequate prenatal care in this series (n = 769), were:

(i) economic difficulties (ii) having to care for a small child, and (iii) transportation

difficulties. Logistic regression analysis determined that women with undesired

pregnancies who resided in rural areas and were para 5 or higher had an increased risk of

inadequate prenatal care. On the other hand, an adverse outcome to a prior pregnancy

(abortion, intrauterine fetal demise, or ectopic pregnancy) decreased this risk. Marital

status and educational level were confounding factors. The study concluded that although

prenatal care was free in that hospital, adequacy of prenatal care was low and the main

factor associated with poor prenatal care were mostly conditions related to poverty. 31

Literature related to antenatal care practice

       Baldo MH, al-Mazrou YY, Farag MK, Aziz KM, Khan MU (1995), conducted

a survey to assess attitudes and practices regarding antenatal care among married women

in Saudi Arabia. Clustered random sampling technique used to select 1,050 pregnant

women. Data was collected by using interview questionnaire schedule. Results showed

                                                                                          23
that antenatal care attendance was 86%. Frequencies of one or two visits were 37% and

three or four visits were 25%, those checked by the physicians were 85%, while 88%

attended government facilities. Those with timely attendance believed that they did not

need antenatal care. Though, utilization of antenatal care service is already high, it has to

be further increased through education and publicity, emphasizing the couple’s role.32

       Magadi MA. (2000), conducted a study on frequency and timing of antenatal care

in Kenya explaining the variation between women of different communities. Using a

three level linear regressions model data from the 1993, Kenya demographic and health

survey were analyzed to determine the frequency and timing of use of antenatal care

services. The result exhibited that the median number of antenatal care visits is four and

the first visit occurs in the fifth month of pregnancy of average. Use of antenatal care

started later and is less frequent for unwanted pregnancy. 33

       Griffiths AN, Woolley JL, Avasarala S, Roy M, Wiener JJ. (2005), conducted

a survey to assess motivators to stop tobacco smoking, women’s knowledge of fetal and

maternal risk of smoking in the third trimester in pregnancy and to assess the

acceptability of nicotine replacement products use in pregnancy. Data was collected from

145 pregnant women. The findings showed that pregnant women knew about the

maternal risks of smoking but their knowledge is deficient about fetal risks. The

knowledge of the association of cot death risk and tobacco smoking appears to be the

greatest motivator to stop smoking. Overall, 74% wished to stop smoking in pregnancy

and 68% accepted a nicotine replacement product.34




                                                                                          24
       Afridi NK, Hatcher J, Mahmud S, Nanan D. (2005), conducted a cross-

sectional study to estimate the coverage and determine the factors associated with tetanus

toxoid vaccination status among 646 females of reproductive age (15-49) years selected

from both urban and rural areas of Peshawar. A pre-tested structured questionnaire was

administered to females. Two logistic regression models were built, one for all females

and one for married females only.

       The findings flaunted that overall 65% females were vaccinated (95% confidence

interval (CI 61.3%, 68.6%). For all females, the variables that were significantly

associated with vaccination status were marital status (OR= 8.5, 95% CI 4.7, 15.6),

source of information regarding tetanus toxoid (TT) vaccination, knowledge regarding

TT vaccination, visits of lady health worker to a household (OR = 2.3, 95% CI 1.4, 3.9)

and restriction on TT vaccination (OR = 28.7, 95% CI: 3.5, 237.9). For the married

females, the variables that were significantly associated with vaccination status were

source of information; visits of LHW to a household (OR = 2.8, 95% CI: 1.5 to 5.2) and

an interaction between knowledge regarding TT vaccination and antenatal care visits. The

study recommended that maternal and neonatal tetanus vaccination campaigns should

include lady health workers at implementation stage. 35

       Kaim I, Penar A, Sochacka-Tatara E, Galas A, Jedrychowski W. (2004),

conducted a study to describe pharmacological supplements during pregnancy. Data was

collected from 406 nonsmoking women, residents of Krakow.

        The findings revealed that multivitamins supplements were taken by 79.1%, folic

acid by 41.4%, magnesium by 23.9% and iron only by 14.5% of the study group. The

result confirmed that vitamin and mineral supplements, folic acid and magnesium in




                                                                                       25
particular, were inadequate in comparison to recommended intakes. Women with lower

education (secondary school or lower) failed to supplement diet with multivitamins

(OR= 5.74; 95% CI: 1.41-23.5) and folic acid (OR= 2.11; 95% CI: 1.22-3.66).

Otherwise, health problems during the previous pregnancies and nulliparity have lowered

pharmacological folic acid supplements (OR= 0.45; 95% CI: 0.21- 0.97 and OR= 0.57;

95% CI: 0.32-0.99). This finding showed that diet assessed for pregnancy period does not

meet the nutritional requirements. Pharmacological supplementary intake of vitamins and

minerals is also insufficient. Recommendations were made to popularize education

concerning necessity and usefulness of vitamin and microelement supplementation

during medical examinations in the childbearing age. 36

       Goharoro EP, Igbafe AA. (2000), conducted an analytical study in a teaching

hospital of Nigeria to determine areas where changes could be made to improve service

uptake. About 378 pregnant women were interviewed using a structured questionnaire.

The results revealed that majority (52.1%) were middle class, while (87.5%) have a

secondary or tertiary education. The mean age of mothers was 29.7 years, and a mean

parity of 1.3 primigravidae constituted 32% of the patients. The mean gestational age at

booking was 23.7 weeks. The sixth month was the peak period for the initiation of

antenatal care. The decision to attend for antenatal care was taken by the husband alone

in 52% of the cases. Late booking was because of the ignorance and financial constraints

observed in 41.5% and 25% of the patient respectively. They concluded that initiation of

antenatal care is late due to ignorance and financial constraints. Male dominance

influences patient’s adequate utilization of antenatal services. 37




                                                                                     26
       Ekele BA, Audu LR. (1998), conducted a cross-sectional study between January

1995 and December 1996 to determine the gestational age at which women book for

antenatal care. The average gestational age at first antenatal visit for the 2,304 women in

the survey group was 23.5 +/- 6.0 weeks. The difference between the gestational ages at

first attendance for the literate subgroup (24.2 +/- 6.1 weeks) was not statistically

significant (P > 0.05). The gestational age at booking among the grand multiparous

women was significantly higher than that of the primigravidae (25.30 +/- 5.9 versus

23.1 +/- 6.1 weeks; P < 0.05). In 71% of cases there was no specific reason for electing

the time for antenatal booking. Health education, with emphasis on the benefits of

booking in the first trimester of pregnancy is advocated. Service providers should also

develop a referral system for those pregnant women relocating to new stations. 38

       Breganza, Lorraine. (1978), conducted a study in D.D. Chawl, Worli, Mumbai

to assess the dietary intake of pregnant mothers by 24 hours recall method. Result of this

study showed that calorie, protein and iron intake was marked by inadequate among these

mothers, calcium and vitamin B was severely lacking in their diet. Low carbohydrate diet

was contributing factor for nutritional shortfall though no frank sign of deficiency was

observed. Fatigue and lethargy were most common complaints among them. 39

       Abdulghani N. (1994), conducted a study “Mother’s death means baby is likely

to die too” for the University of London School of Hygiene and Tropical Medicine. The

study included 224 maternal deaths in ten hospitals between May, 1987, and April,

1989. Nine out of ten mothers who died were illiterate.

       Findings disclosed that only 1/5 had received prenatal care. The inaccessibility of

health services, the poor quality of care and facilities, and a lack of faith in a system that

humiliates women were given as reasons for failure to seek medical care. Causes of death

                                                                                           27
in order of frequency were hepatitis, hemorrhage, infection, and toxemia. 3/4 of the

women died postpartum. 1/5 of the babies were stillbirths. 1/5 of the mothers had a

history of maternal complications. 1/5 had chronic disease. 2/3 of the women had begun

their pregnancies within 1 year of their last childbirth. 1/2 of the women had symptoms

ranging from vomiting and fatigue to jaundice and vaginal bleeding.

        Recommendations of the study included: 1) programs to prevent and treat

hepatitis and; 2) an information, education, and communication (IEC) community

campaign on the signs of maternal complications. Personnel should also continue the

ir training and research activities. 40

Literature related to planned education for antenatal mothers

        Baglio G, Spinelli A, Donati S, Grandolfo ME, Osborn J. (2000), conducted a

study to assess knowledge, attitude and practice regarding care during pregnancy,

delivery and postnatal period among women in Italy. About 9004 women were

interviewed, 23% had attended antenatal classes. The findings revealed that women who

attended antenatal classes were able to apply the knowledge to reduce the risk of being

dissatisfied with the experience of childbirth (O.R. = 0.72) whereas, the others have an

increased risk of dissatisfaction (O.R = 1.87). 41

        Shantha Kumari K. (1996), conducted an experimental study to assess the

effectiveness of planned health education for safe motherhood in primigravidae at

Mangalore, Karnataka. About 50 mothers were selected by using purposive sampling

technique. Out of 50 primigravidae, 25 were in the experimental group and 25 were in the

control group. They were given a pre and post test with the prepared structured

questionnaire and health education was provided to the study group only. The results

showed that primigravidae who received health education had developed adequate

                                                                                     28
knowledge in safe motherhood. The study concluded that health education was

required for pregnant women to reduce maternal mortality and prevent complications.42

       Nuraini E, Parker E. (2005), conducted an experimental study to ascertain a new

approach to antenatal care can improve pregnant women's knowledge of its benefits on

60 pregnant women from 10 cluster villages. The intervention group received the new

approach to antenatal care, while the control group received routine antenatal care. The

findings showed that the improvement of knowledge in the intervention group is

significant particularly in the knowledge about healthy pregnancy (P = 0.012), pregnancy

complications (P = 0.01), safe birth (P = 0.01) and care of the newborn (P = 0.012). The

improvement of knowledge was significantly influenced by the respondents' educational

back ground (P = 0.002) and socio-economic status (P = 0.027). This study recommended

that the new approach to antenatal care be considered to educate pregnant women

regarding safe birth and it is considered as one of the strategies that may be adopted to

reduce maternal mortality. 43

       Valadez Rigueroal, Alfaro N, Celis de la., Rosa A. (2005), conducted an

analytical study to assess the knowledge of pregnancy and the antenatal care program,

attitudes towards institutional medical care of pregnancy on 2,955 women leaving

hospital early who had had at least 2 antenatal consultations in the hospitals of Mexico.

The results showed that there is the strong association of positive attitudes and sufficient

knowledge in achieving satisfactory antenatal care. They concluded that undoubtedly,

women’s educational background plays a major role. This obliges the health services to

strengthen their educational programs by adjusting them to women’s culture. 44




                                                                                         29
       Ohnishi M, Nakamura K, Takano T. (2005), conducted a study to determine

the factors that influence the improvement in maternal health literacy in Paraguay. The

study was conducted on pregnant women who did not complete compulsory education

but participated in a community-based antenatal care program. Structured interviews

were used to evaluate the pregnant women’s maternal health literacy during their first,

second and third visits to the program. The association between individual maternal

health knowledge scores and its gains, healthcare personnel capabilities, available health

facility equipment, community social network, and living environment were analyzed by

multiple regression analysis. The mean maternal knowledge score from 124 women

who completed three-consecutive assessments increased between the first and third

interviews.

       Higher capabilities of healthcare personnel and better living environment were

significantly related to gains in the maternal health knowledge score (P < 0.01). The

study recommended wider application of a community-based antenatal care program to

meet the needs of those who are functionally illiterate in the standard language of the

country, training for community healthcare personnel to improve capabilities, and

resources for social network in the community would contribute to the improvement in

maternal health literacy. 45

       Cwiek D, Grochans E, Sowinska-Glugiewiez I, Wysiecki P. (2004), conducted

an experimental study to compare some pro-health behaviors of women who had taken a

course regarding antenatal care and women who did not have this antenatal educational

course. The control group contained 165 women and the experimental group contained

129 samples. The results showed that the woman attending classes at school of childbirth

were highly aware of pro-health behaviors during pregnancy; they often changed their

                                                                                       30
lifestyle during pregnancy, they smoked less frequently, they had more appointments

with their obstetricians and they earlier had their first medical visit. This study

recommended intensifying the classes of nourishing during pregnancy, educating every

pregnant woman of the hygiene, nourishing and stimulant abuse during pregnancy not

only at schools of the childbirth, but also during obstetric consultation. 46

       All the review of literature enlightened that there is lack of knowledge regarding

antenatal care among the women. This lack of knowledge has resulted in the poor

utilization of the antenatal services and ill practice. It also helped to gain an

understanding regarding non-utilization of antenatal services by pregnant mothers were

due to ignorance, illiteracy and were from poor socio-economic status. The above

mentions literature also revealed that the education regarding antenatal care improves

their knowledge. Midwives have a crucial role to play. Several studies have indicated that

the nurse can perform roles involving the receiving and giving of information to

concerned person far more effectively than physicians.

       Therefore, the investigator selected this study to evaluate the effectiveness of

Planned Teaching Program on knowledge of primigravidae regarding selected aspects of

safe motherhood in selected hospitals of Kolar, Karnataka.




                                                                                       31
  Chapter-
  Chapter- Four

METHODOLOGY




                  32
                                4. METHODOLOGY

        This section deals with the methodology adopted for the study. The methodology

of the investigation is of vital importance. “Research methodology is a way to solve

problems. It is a systematic procedure in which the researcher starts from initial

identification of the problems to final conclusions.” 15

        The methodology of research indicates the general pattern of organizing the

procedure it gathers valid and reliable data for the problem under the investigation.

        This chapter includes research approach, research design, setting of the study,

population, sampling technique, sample size, sampling criteria, instrument, validity, and

reliability, pilot study, method of collection of data, plan for data analysis and

interpretation and ethical implications in the study.

Research Approach

        “Research approach is an umbrella that covers the basic procedure for conducting

research.” 15

        The research approach selected for this study is experimental.

        “Experimental research is one in which the researcher makes changes in

independent variables and studies their effects on dependent variables under controlled

conditions.” 15

Research Design

        The research design refers to “the researcher’s overall plan for obtaining answer

to the research question and it spells out strategies that the researcher adopted to develop

information that is accurate, objective and interpretable.” 15

The research design adopted for this study is shown in the figure 2.



                                                                                         33
                     Fig – 2. Schematic Representation of Research Design

                     Design: Experimental (pretest – post test control group) design


                    Purpose: To evaluate the effectiveness of PTP on knowledge
                    of primigravidae regarding selected aspects of safe motherhood.


                    Study Settings: Suguna Hospital and Hope Health Care, Kolar


                                          Target population
                   All primigravidae (second trimester) of Kolar district, Karnataka

                      Sample: 50 primigravidae for experimental group and 50
                      primigravidae for control group.
                      Sampling Technique: Simple Random Sampling technique
   Randomized




                                                                                              Randomized
                    Independent                           Dependent variable:
                    variable: PTP on                      Knowledge score
                    selected aspects of                   regarding selected aspects
                    safe motherhood.                      of safe motherhood.

    Experimental
   Group (Suguna                      Data collection Instrument               Control Group
      Hospital)                        Knowledge Questionnaire               (Hope Health Care)


                Pretest                                                                Pretest

                                After seven days                           After seven days
Planned Teaching                                       Post Test
    Program


              Data Analysis (Both Experimental and Control Group)
 • Frequency and percentage of demographic variables.
 • Frequency, percentage mean, mean percentage and SD of knowledge score.
 • Analysis of mean, SD of knowledge score according to demographic variables
   and paired “t” value of pretest and post test.
 • Chi-square test between the selected demographic variables and knowledge
     scores
 • Test of significance (paired and unpaired “t” test and “z” test

                                                                                                   34
Variables under the study

       “A variable is a measurable or potentially measurable component of an object or

event that may fluctuate in quantity and quality or that may be different in quantity and

quality from one individual object or event to another individual object or event of same

general class.”15

Two types of variables were identified in this study. They are as follows:

         • Independent variable

         • Dependent variable

Independent variable

     “The independent variable is the phenomenon in the hypothesis that, in the

experimental study to test, the hypothesis, is not manipulated by the investigator. It is the

variable that is manipulated by the researcher, in order to study the effect upon the

dependent variable.” 15

     The independent variable in this study is planned teaching program on selected

aspects of safe motherhood.

Dependent variable

       “The dependent variable is the variable the researcher is interested in

 understanding, explaining or predicting.” 14

       The dependent variable in this study is knowledge scores regarding selected

aspects of safe motherhood.




Setting of the study

“Setting is a physical location and condition in which data collection takes place.” 15


                                                                                          35
        The investigator selected two hospitals of Kolar district for the present study.

Kolar district comprises of 12 towns and 3311 villages. It has an area of 8223.00 sq kms

and a population of 253,606. (As per the census 2001) Samples were selected from

Suguna Hospital and Hope Health Care situated in Kolar.

Description of the hospitals

        Suguna Hospital is a 100 bedded hospital, 20 beds for Obstetrics and Gynecology

section. At least 15 to 20 antenatal cases attend out patient department in this hospital.

        Hope Health Care is also a 100 bedded hospital, 25 beds for Obstetrics and

Gynecology section. At least 25 to 30 antenatal cases attend out patient department in this

hospital.




Population

        “Population refers to a total category of persons or objects that meets the criteria

for study established by the researcher, any set of persons, or objects or measurements

having an observable characteristics in common.” 15

        The population of this study were primigravidae (second trimester) who attended

antenatal clinic in Hope Health Care and Suguna Hospital of Kolar, district, Karnataka.




Sample

        “A sample is a selected proportion of the defined population. It is a subset of a

population of interest.” 15

        The samples in this study were fifty primigravidae of second trimester for

experimental group and fifty primigravidae of second trimester for control group.


                                                                                             36
Sampling Technique:

       “Sampling is the process of selecting representative units of a population for study

in a research. It is a process of selecting a subset of a population in order to obtain

information regarding a phenomenon in a way that represents the entire population.” 15

       In this study, simple random sampling technique is used for selecting the samples.

       “Simple random sampling technique is the one in which each possible sample of

“n” different units has an “equal” chance of being selected, which also implies that every

member of the population has an equal chance of selection into the sample.” 15




Criteria for Selection of Samples:

   1. Inclusive Criteria

           •   Primigravidae who were in second trimester.

           •   Primigravidae who were between the age group 20 - 40 years.

           •   Primigravidae who were married.

           •   Mothers who can understand Kannada, English and Hindi.

           •   Mothers who are willing to participate in the study.

   2. Exclusive Criteria

           •   Primigravidae who were having high risk pregnancy (eclampsia,

               preeclampsia, mothers with cardiac disease, mothers who had previous

               abortion and mothers suffering with mental illness.)

           •   Primigravidae who were not willing to participate in the study.

           •   Primigravidae who were below 20 years and above 40 years of age.




                                                                                         37
Development of Tool:

       “The instrument is a vehicle that could best obtain data pertinent to the study and

at the same time adds to the body of general knowledge in the discipline.” 15

       The investigator developed a structured interview schedule to assess the

effectiveness of planned teaching program on knowledge of primigravidae regarding

selected aspects of safe motherhood.

The following steps were carried out preparing the tool:

           Review of related literature

           Based on experts opinion

           Investigator’s personal experience




Description of the tool:

       A structured interview schedule to assess the effectiveness of planned teaching

program on knowledge of primigravidae regarding selected aspects of safe motherhood.

Tool consists of two sections:

            a. Section A

            b. Section B.

a. Section-A

       Section-A consists of 9 items of demographic variables such as age, religion,

education, occupation, types of family, family income, age at marriage, information

regarding safe motherhood and sources of information.




                                                                                       38
b. Section-B

       Section-B consists of 39 items regarding antenatal care which was divided into

the following groups:

         General questions (Q. No. 1 to 5)

         Questions regarding diet during pregnancy (Q. No. 6 to 17)

         Questions regarding personal hygiene (Q. No. 18 to 20)

         Questions regarding antenatal checkup (Q. No. 21 to 25)

         Questions regarding immunization (Q. No. 26 to 31)

         Questions regarding other antenatal care (Q. No. 32 to 39)

       For each questionnaire, four options were given and only one correct answer. For

each correct answer, the score was 1. If answer was wrong, the score was given as 0. The

highest score was 39.

       Based on the percentage gained by the primigravidae, the knowledge of the

respondents was arbitrarily categorized in the following groups:

       i. Inadequate:                Below 50%

      ii. Moderately adequate:       50%-75%

      iii. Adequate:                 Above 75%




Content Validity:

       “Validity refers to whether a instrument accurately measures what it is supposed

to measure. When an instrument is valid, it truly reflects the concept, it is supposed to

measure.” 15

       The prepared instrument along with the statement of the problem, objectives,

scoring key, lesson plan for teaching, criteria checklist were submitted for validation to

                                                                                       39
the ten experts to establish the validity. List of the experts are given in the annexure.

Suggestions given by the experts were subsequently incorporated into the tool.

       Some of the tools’ options had “all of the above” which was removed and made

only one correct options. Arrangements of the options were done in a proper way

according to the suggestions given by the experts. The tool was finalized and was

translated into local language (Kannada) by a translator.




Reliability

       “Reliability is defined as the extent to which instrument yields the same results on

repeated measures. Reliability is then concerned with consistency, accuracy, precision,

stability, equivalence and homogeneity.” 14

       In order to establish the reliability of the tool split-half method was used. The tool

was administered to 20 subjects and the test was first divided into odd and even scores

halves. The reliability co-efficient of the whole test was then estimated by Spearman-

Brown Prophecy Formula.

       The reliability of the tool was R= 0.98 for the knowledge. So the tool was found

to be highly reliable for the data collection.




Pilot Study:

       “Pilot study is the study carried out at the end of the planning phase of research,

in order to explore and test the research elements.” 15

       The data for the pilot study was collected from 10 primigravidae mother from

Suguna Hospital, Kolar from 1st February to 9th February 2007. The samples were


                                                                                          40
selected by random sampling. The purpose of this study was explained to primigravidae

and confidentiality was assured prior to data collection. After pilot study the tool was

found to be feasible, practicable and acceptable. Some of the questions and responses

found to be difficult to ask, so some of the words of the questions were changed. The

calculated paired “t” value between the pretest and post test of the experimental group

was 3.52 and control group was 3.23 (P < 0.05). Hence there was significant difference in

the knowledge of primigravidae before and after the PTP in the experimental group and

in the knowledge of primigravidae in pretest and post test of control group. The

investigator than proceeded to the main study.



Data Collection Process

       The data collection was scheduled from 12th February to 11th March 2007 for a

period of 4 weeks. Before the data collection, the investigator obtained the formal

permission form the concerned authority of the selected hospitals, introduced her to the

staffs and explained the purpose of the study. They were also assured about the

confidentiality of the data obtained by them. Primigravidae attending Suguna hospital

were taken as the experimental group and primigravidae attending Hope Health Care

were taken as the control group. Simple random technique was used for selecting the

samples. Respondents were explained about the purpose of the study and consent was

obtained from them prior to the data collection. Approximately 20 to 25 minutes were

taken to complete the questionnaire.

       In control group, pretest was conducted daily for 4-5 selected primigravidae. In

experimental group, pretest was conducted for selected 4-5 respondents from 1:30 pm to

3:40 pm and on the same day, 3:45 pm to 4:30 pm; planned teaching program was

                                                                                      41
conducted for them. Teaching was given in one session, lasting for 45 minutes on

selected aspects of safe motherhood. After 7 days post test was conducted for both

groups.




Plan for data analysis

          The data was planned to be analyzed on the basis of objectives and hypothesis of

the study by using descriptive and inferential statistical tests.

The plan for data analysis is as follows:

       a. Section-A: Frequency and percentage distribution of demographic variables

       b. Section-B: Data on knowledge of the primigravidae

                  Assessment of level of knowledge

                  Area wise frequency, percentage mean, mean percentage and SD of

                  knowledge score

                  Item wise Percentage of the correct responses regarding selected aspects

                  of safe motherhood.

                  Analysis of mean, SD of knowledge score according to demographic

                  variables and paired “t” value of pretest and post test.

                  Analysis of association between the selected demographic variables and

                  knowledge scores (Chi-square Test).

                  Mean and Standard deviation of pretest and post test scores.

                  Test of significance (paired t-test, unpaired t-test and z-test)




                                                                                       42
Chapter-
Chapter- Five

RESULTS




                43
                                      5. RESULTS

       The data themselves do not provide us with answer to our research questions. In

order to answer the research questions meaningfully, the data must be presented and

analyzed in some orderly, so that the relationship can be discerned.

       Analysis is described as “categorizing, ordering, manipulating and summarizing

the data to obtain answer to research questions.”15

       The purpose of analysis is to reduce the data to an intelligible and interpretable

form so that the relation of research can be studied.

       This section presents the analysis and interpretation of data collected from

primigravidae (50 in experimental group and 50 in control group) in order to assess the

effectiveness of planned teaching program regarding selected aspects of safe motherhood.

The data collected were organized, tabulated, analyzed and interpreted by means of

descriptive and inferential statistics. The data collection was done based on the objectives

of the study.

The main objectives are:

   1. To assess the pre-existing knowledge of primigravidae regarding selected aspects

       of safe motherhood before planned teaching program.

   2. To plan, develop and to conduct the planned teaching program regarding selected

       aspects of safe motherhood for primigravidae of the experimental group.

   3. To evaluate the effectiveness of planned teaching program regarding selected

       aspects of safe motherhood in terms of gain in posttest knowledge scores of

       primigravidae when compared to their pretest scores.

   4. To compare the knowledge of experimental and control group regarding selected

       aspects of safe motherhood.

                                                                                         44
The data were presented under the following sections:

Section –I

       Data on demographic variables of the primigravidae

Section – II

Data on knowledge of the primigravidae regarding selected aspects of safe motherhood.

   a. Assessment of level of knowledge of primigravidae regarding selected aspects of

       safe motherhood in pre and post test.

   b. Area wise frequency, percentage mean, mean percentage and SD of knowledge

       score

   c. Item wise percentage of correct responses regarding selected aspects of safe

       motherhood in pre and post test.

Section – III

   a. Analysis of mean, SD of knowledge score according to demographic variables

       and paired “t” value of pretest and post test.

   b. Data on association between selected demographic variables of the primigravidae

       and their knowledge (Chi-square test) regarding selected aspects of safe

       motherhood.

Section – IV

       Analysis for the test of significance of the hypothesis




                                                                                    45
                                      Section – I

           Data on demographic variables include age, religion, educational status,

occupation, type of the family, family income per month, age at marriage, information

regarding the antenatal care and the sources of the information regarding antenatal care.


                                         Table – 1

       Frequency and percentage distribution of the primigravidae

                                  according to Age.
                                                                               (N= 50)
                               Experimental Group                Control Group
 S.N      Age in Years
                            Frequency       Percentage      Frequency      Percentage

   1          20-24             37               74              43             86

   2          25-29             12               24              6              12

   3          30-34              1               2               1               2

   4          35-40              -               -                -              -

              Total             50              100              50            100


           The above table reveals that 74% of the respondents were between the age

group of 20-24 years, 24% of them were between the age group of 25-29 years and only

2% were between the age group of 30-34 years in the experimental group. Whereas in the

control group, 86% of the respondents were between the age group of 20-24, 12% of

them were between the age group of 25-29 years and only 2% were between the age

group of 30-34 years. None of them were between the age group of 35-40 years in both

groups. (Fig.-3)


                                                                                         46
                                Figure – 3


           Bar diagram representing the frequency and percentage
             distribution of primigravidae according to their age.


           90          86

           80    74
           70
           60                                                        Experimental
           50                                                        Group
Percentage
           40                                                        Control Group
           30                  24
           20
                                     12
           10
                                               2      2     0        0
            0
                 20-24         25-29          30-34        35-40
                                    Age in years




                                                                                    47
                                          Table – 2

Frequency and percentage distribution of the primigravidae according to Religion.


                                                                           (N= 50)
                               Experimental Group                Control Group
 S.N        Religion

                            Frequency        Percentage      Frequency   Percentage

   1          Hindu              49              98              49         98

   2        Christian             -               -              -           -

   3         Muslim               1               2              1           2

   4         Others               -               -              -           -

              Total              50              100             50         100




           The above table shows that 98% of the primigravidae in the both experimental

and control group was Hindu and only 2% were Muslim. None of the respondents were

Christian and other participants in both of the group. (Fig-4)




                                                                                      48
                                         Figure – 4




             Cylindrical diagram representing the distribution of primigravidae
                                   according to Religion

             100    98    98
              90
              80
              70
Percentage




              60
              50                                                          Experimental
              40                                                          group
              30                                                          Control group
              20
              10                  0             2     2       0
                                        0                           0
               0
                     Hindu       Christian     Muslim        Others
                                       Religion




                                                                                      49
                                        Table – 3

            Frequency and percentage distribution of the primigravidae
                            according to Educational Status.


                                                                            (N= 50)
                                 Experimental Group             Control Group
S.N    Educational Status

                               Frequency     Percentage    Frequency      Percentage

 1           Illiterate             4             8             7             14

 2      Primary education          37            74             29            58

 3      Higher secondary            7            14             6             12
       Graduation and post
 4         graduation               2             4             8             16

              Total                50            100            50            100




          The data presented in the above table depicts that in experimental group,

74% of the respondents had completed primary education , 14% had completed higher

secondary, 8% were illiterate and only 4% had completed graduation and post graduation.

In control group 58% had completed primary education, 16% had completed graduation

and post graduation, 12% were having higher secondary & 14% were illiterate. (Fig-5)




                                                                                       50
                                                 Figure – 5



                   Bar diagram representing the distribution fo primigravidae
                               according to educational status.
             80                 74
             70
                                                                    58
             60
Percentage




             50

             40

             30

             20                        14                     14                   16
                                                                            12
                        8
             10                                  4
              0
                            Experimental group                     Control group
                                            Educational Status

                  Illiterate                          Primary education
                  Higher secondary                    Graduation and post graduation




                                                                                        51
                                        Table – 4

            Frequency and percentage distribution of the primigravidae
                              according to Occupation.


                                                                              (N= 50)
                               Experimental Group              Control Group
   S.N     Occupational
              Status
                             Frequency     Percentage     Frequency      Percentage

    1       Housewife            34             68             32              64

    2       Agriculture          14             28             14              28
            Government
    3        employee             1              2             1                2
              Private
    4        employee             1              2             3                6

               Total             50            100             50              100




           Table – 4 illustrates that in the experimental group, about 68% of the

primigravidae were housewives and 28% were doing agriculture. Only 2% were working

in government office and private sector. Whereas, in the control group, 64% of the

primigravidae were housewives, 28% were doing agriculture, 6% were working in

government office and only 2% were working in the private sector. (Fig – 6)




                                                                                        52
                                 Figure – 6



         Pyramid representing distribution of primigravidae
                     according to occupation

                     68
             70                                  64
             60

             50

             40
Percentage                 28                          28
             30

             20

             10                   2     2                           6
                                                              2
              0
                  Experimental group              Control group
                                 Occupational Status

     Housewife    Agriculture   Government employee    Private employee




                                                                          53
                                     Table – 5

         Frequency and percentage distribution of the primigravidae
                         according to Type of Family.


                                                                           (N= 50)
                              Experimental Group               Control Group
S.N    Type of Family

                            Frequency     Percentage      Frequency     Percentage

   1        Single              22             44             22             44

   2         Joint              27             54             28             56

   3       Extended              1              2              -              -

             Total              50            100             50             100




         The data presented in the table 5 discloses that in experimental group,

majority of primigravida (54%) were living in joint family, 44% were living in single

family and only 2% were living in the extended family. Similarly, in primigravidae of

control group, 44% of them were from the single family and 56% were living in joint

family. None of them were living in the extended family in control group. (Fig - 7)




                                                                                      54
                                      Figure – 7




             Cone diagram representing the percentage distribution
                         according to Type of Family


             60                                             56
                              54

             50        44                            44

             40
Percentage




             30

             20

             10
                                        2                           0

              0
                   Experimental group               Control group
                                   Type of family


                             Single     Joint   Extended




                                                                        55
                                          Table – 6

             Frequency and percentage distribution of the primigravidae
                              according to Monthly Income.


                                                                           (N= 50)
                                  Experimental Group             Control Group
 S.N    Family income per
             month
                                Frequency     Percentage     Frequency   Percentage

  1     Less than Rs. 1,000          3            6              4           8

  2       Rs. 1,001-5,000           40           80             30          60

  3      Rs. 5,001-10,000            6           12             10          20

  4        More than Rs.             1            2              6          12
             10,001

               Total                50           100            50          100




           Table 6 divulges that in experimental group, 80% of the respondents have

monthly income Rs. 1,001-5,000, 12% earned Rs. 5,001-10,000 per month, 6% earned

less than Rs. 1,000 and only 2% earned more than Rs. 10,001. It also explores that in

control group, 60% of have Rs. 1,001-5,000 monthly income, 20% have income in a

month Rs. 5,001-10,000 income per month, 12% earns more than Rs. 10,001 and only

8% earns less than Rs. 1,000. (Fig – 8)




                                                                                     56
                                                   Figure – 8



                       Tubes representing percentage distribution of primigravidae
                                     according to Monthly Income

                        More than Rs.


                                         12
                                          2
                           10,001
                                         12

                      Rs. 5,001-10,000        20
M on th ly In com e




                                                     80




                                                                              60
                       Rs. 1,001-5,000


                        Less than Rs.
                                         6
                                         8




                           1,000


                                         0                50                100         150
                                                               Percentage
                                                   Experimental group   Control group




                                                                                          57
                                         Table – 7

            Frequency and percentage distribution of the primigravidae
                             according to Age at Marriage


                                                                              (N= 50)
                               Experimental Group               Control Group
 S.N      Marital Age

                             Frequency     Percentage     Frequency      Percentage

  1     Less than 20 years       25            50             25              50

  2        20-24 years           23            46             23              46

  3        25-29 years            2             4              2               4

  4        30-34 years            -             -              -               -

              Total              50            100            50             100




       The data presented in the table 7 exhibits that, in experimental group, 50% of the

respondents got married in less than 20 years, 46% respondents’ marital age was between

age group of 20-24 years, 4% of them got married between the age group of 25-29 years.

At the same time it also flaunted that in control group, 50% of the respondents married in

less than 20 years, 46% in between age group of 20-24 years and 4% of them married

between the age group of 25-29 years. None of them got married between the age group

of 30-34 years in both groups.(Fig-9)




                                                                                        58
                                         Figure - 9




             Cylindrical diagram representing percentage distribution
                     of primigravidae according to Marital age

                        50                            50
                             46                            46
               50

               40
Percentage




               30

               20

               10                   4                           4
                                           0                         0
                0
                    Experimental group            Control group
                                        Age in years

             Less than 20 years   20-24 years    25-29 years    30-34 years




                                                                              59
                                        Table – 8

       Frequency and percentage distribution of the primigravidae according
                to pre-existing information regarding to Antenatal care


                                                                          (N= 50)
                           Experimental Group                  Control Group
S.N        Responses

                        Frequency      Percentage     Frequency       Percentage

  1           Yes           37             74             22              44

  2           No            13             26             28              56

             Total          50            100             50              100




           Table 8 displayed that in experimental group, 74% of the primigravidae had

heard about antenatal care and 26% had not heard about it. Whereas, in control group,

56% of the primigravidae had not heard about antenatal care and 44% had heard about it.

(Fig-10)




                                                                                    60
                                                    Figure - 10




                          Bar diagram representing the pre-existing information
                                regarding antenatal care in primigravidae
                    120

                    100
                                      26
                     80
P e rc e n ta g e




                                                                  56
                     60                                                           No
                                                                                  Yes
                     40               74

                     20                                           44


                      0
                               Experimental group            Control group
                                                Responses




                                                                                       61
                                         Table – 9

       Frequency and percentage distribution of the primigravidae according
                to sources of information regarding to Antenatal care


                                                                              (N= 50)
                                Experimental Group                  Control Group
 S.N        Sources of
           Information
                               Frequency     Percentage    Frequency       Percentage

  1         Mass media.             -             -                 7         31.8

  2      Health personnel          12           32.4                3         13.6

  3     Elders and relatives       25           67.5            11             50

  4            Others               -             -                 1          4.5

               Total               37            100            37             100




           The above table parades that the sources of information regarding antenatal

care among the respondents of experimental group who had heard about antenatal care

were respectively 67.5% the elders and relatives and 32.4% the health personnel. The

table also exhibits that the sources of information regarding antenatal care among the

respondents of control group who had heard about antenatal care were 50% from the

elders and relatives, and 31.8% from the mass media, 13.6% from the health personnel

and 4.5% from the other media (internet) respectively. (Fig – 11)




                                                                                        62
                                           Figure - 11



                Pyramid representating the sources of imformation regarding
                              antenatal care in primigravidae

                70                              67.5

                60
                                                       50
                50
P ercen tag e




                40
                          31.8    32.4
                                                                       Experimental
                30
                                                                       group
                20                                                     Control
                                         13.6
                                                                       group
                10                                               4.5
                      0                                      0
                 0
                     Mass         Health   Elders and       Others
                     media.      personnel relatives

                              Sources of information




                                                                                  63
                                     Section – II

        Data on knowledge of the primigravidae regarding selected
                            aspects of safe motherhood.
       The knowledge of the primigravidae regarding selected aspects of safe

motherhood was assessed by a structured questionnaire consisting of 39 items. Each

correct response was given score of one. The highest score was 39. According to the total

score obtained by each subject, knowledge was classified into three categories.

         Inadequate:                 Below 50% (0 – 20)

         Moderately adequate:        50%-75% (21 – 29)

         Adequate:                   Above 75% (30 – 39)

                                      Table - 10

    a. Assessment of level of knowledge of primigravidae regarding

              selected aspects of safe motherhood in pre and post test.

                                                                                (N = 50)
                                Experimental Group               Control Group

 Level of        Range of       Pretest       Post test      Pretest       Post test
Knowledge         scores
                              No.     %     No.     %      No.     %      No.       %

 Inadequate       0 – 20        4     8       -      0      10     20       5       10

 Moderately      21 – 29      44      88     21     42      39     78      42       84
  adequate
 Adequate        30 – 39        2     4      29     58       1      2       3       6

                  Total       50     100     50     100     50     100     50      100




                                                                                           64
           The pretest scores displayed in the table 10 disclosed that majority (88% of

experimental group and 78% of control group) had moderately adequate knowledge,

about 8% of experimental group and 20% of control group had inadequate knowledge

and about 4% of experimental group and 2% of control group had adequate knowledge

regarding selected aspects of safe motherhood.

           Similarly, the post test scores depicted that in experimental group majority

(58%) had adequate knowledge, 42% had moderately adequate knowledge and none of

them had inadequate knowledge regarding selected aspects of safe motherhood. This

result showed that the scores were increased due to the conduction of teaching

programme. Where as in the control group, majority (84%) had moderately adequate

knowledge, about 10% had inadequate knowledge and only about 6% had adequate

knowledge regarding selected aspects of safe motherhood.




                                                                                    65
                                         Figure – 12

             Cylindrical diagram representing level of knowledge of primigravidae
                         regarding selected aspects of safe motherhood

             90         88
                                                                                        84
             80                                                    78

             70

             60                                          58
Percentage




             50
                                            42
             40

             30
                                                              20
             20
                                                                                   10
             10    8                                                                                6
                                  4                                          2
                                        0
              0
                        Pretest




                                             Post test




                                                                   Pretest




                                                                                        Post test
                       Experimental Group                              Control Group
                                            Knowledge Scores


              Inadequate              Moderately adequate                        Adequate




                                                                                                        66
                                                  Table-11

           b. Area wise mean, mean percentage and standard deviation of

                                    knowledge regarding antenatal care.

                                                                                                 (N = 50)
Areas                            Experimental Group                         Control Group
              Full Marks




                                                                                            Post test
                                 Pretest              Post test          Pretest
                           M       M       SD   M      M      SD   M      M%       SD M         M       SD
                                   %                   %                                        %
General          5         3.5     70      1.01 4.3    87.6 0.5    3       60      1.2    3.6   72 1.03
Questions
Antenatal      12          6.5    54.1 1.5 8.8         73.5 1.5    6.6     55      1.9    6.6 55.6 1.5
Diet
Personal         3         2.1    70.6 0.7 2.5         85.3 0.8    1.4    48.6     0.8    1.8   60   0.8
Hygiene
Antenatal        5         3.1    62.8 0.8 3.7         74.4 0.7    3.1     62      1.05   3.2   64   0.8
Check-up
Immuni-          6         3.2     54      1.1 4.4     74.6 0.9    3.7    62.3 1.08       3.6   60   0.9
zation
Others           8         4.4    30.2 1.2 6.3         78.7 1.2    5.1    64.5     1.3    5.1 64.7 1.4
questions


        The data presented in the above table represented that in experimental group the

in pretest the area wise mean and standard deviation were respectively 3.5 +/- 1.01, 6.5

+/- 1.56, 2.12 +/- 0.70, 3.14 +/- 0.85, 3.24 +/-1.16, and 4.48 +/- 1.26; where as in post test

it was 4.48 + 0.57, 8.82 + 1.53, 2.56 + 0.88, 3.72 + 0.78, 4.48 + 0.90, and 6.3 + 1.23 in

area first to sixth.

        Similarly in the control group, pretest the area wise mean and standard deviation

were respectively 3 +/- 1.21, 6.6 +/- 1.96, 1.46 +/- 0.80, 3.1 +/- 1.05, 3.74 +/-1.08, and

5.16 +/- 1.38; where as in post test it was 3.6 +/- 1.03, 6.68 +/- 1.53, 1.8 +/- 0.83, 3.2 +/-

0.83, 3.6 +/- 0.92, and 5.18 +/- 1.45 in area first to sixth.

                                                                                                        67
            c. Item wise percentage of correct responses regarding selected

                      aspects of safe motherhood in pre and post test.

                                             Table - 12

             Item wise Frequency and Percentage of Correct Responses regarding
                               General Questions in Antenatal Care

                                                                                     (N = 50)
                                                      Experimental          Control Group
                                                          Group
 Item No.




                                                     Correct Response     Correct Response
                           Items
                                                    Pretest   Post test   Pretest Post test
                                                    No % No         %     No % No %
            Antenatal care is a care given in the
 1          period from conception till             47   94   50   100    42    84    47   94
            delivery.
 2          Antenatal care is given to provide
                                                    15   30   42    84    19    38    31   62
            necessary advice to the mother.
 3          Pregnancy is a state of a woman
                                                    44   88   47    94    31    62    35   70
            from conception till delivery.
 4          Pregnancy is confirmed by doing
                                                    44   88   46    92    42    84    45   90
            urine test and immunological test
 5          The first fetal movement is felt by
                                                    45   90   34    68    16    32    22   44
            4-5 months by the mother.

                 The above table displays that in the pretest, 94% of the primigravidae gave the

correct response about the meaning of antenatal care and 90% knew that when the first

fetal movement is felt. Among them, 88% knew about how pregnancy is confirmed and

definition of pregnancy is while only 30% reason for the need of antenatal care.

                 Where as, in post test, 100% of the primigravidae gave the correct response

about the meaning of antenatal care and 94% knew the meaning of pregnancy. Among

them, 92% knew about how pregnancy is confirmed and. When asked about the

importance of antenatal care, 84% gave the correct answer while only 68% answered

correctly about the first fetal movement during the pregnancy.


                                                                                             68
                                           Table – 13

                        Item wise Frequency and Percentage of Correct
                               Responses regarding antenatal diet
                                                                                 (N = 50)
                                                     Experimental       Control Group
                                                        Group
Item No.




                                                   Correct Response    Correct Response
                          Items
                                                   Pretest   Post test Pretest Post test
                                                  No    %    No % No % No %
           Balanced diet is necessary during
6          antenatal period to maintain health    42   84    45   90   44   88   40   80
           of mother and baby.
           High iron, calcium protein and
7          vitamin contained diet is best         42   84    47   94   33   66   34   68
           during antenatal period.
           Extra protein contained diet is
8          necessary for growth of the fetus
                                                  25   50    41   82   21   42   29   58
           and development of new cells in
           the mother.
           The sources of proteins are meat,
9                                                 27   54    33   66   15   30   21   42
           fish, poultry and dairy products.
           Extra iron is necessary during
10         antenatal period for the formation     23   46    38   76   11   22   20   40
           of hemoglobin to carry oxygen.
           Green leafy vegetables, meat, eggs
11                                                33   66    44   88   37   74   31   62
           and dried fruits are rich in iron.
           Calcium rich diet is necessary
12         during pregnancy for skeletal          44   88    46   92   45   90   41   82
           growth of the fetus.
           The sources of calcium are milk,
13         cheese, tofu and green leafy           16   32    22   44   12   24   11   22
           vegetables.
           Vitamin C is necessary for the
14                                                32   64    43   86   35   70   37   74
           development of fetus.
           The sources of vitamin C are citrus
15         fruits, tomatoes, cabbage and          02   04    30   60   30   60   25   50
           potatoes.
           Vitamin A is necessary during
16         pregnancy for the growth and           36   72    33   66   38   76   32   64
           development of the fetus.
           The sources of vitamin A are butter,
17                                                03   06    19   38   09   18   13   26
           cheese and yellow vegetables.

                                                                                       69
        The data presented in table 13 explores that 84% of primigravide in the

experimental group and 88% of the control group gave the correct answer regarding the

need of the balance diet in pretest while 90% in the experimental group and 80% in the

control group gave the correct answer for the same question in the post test. Among

them, 84% in experimental group and 66% in control group told the correct response

when asked about the best diet during pregnancy in pretest, which increased to 94% and

68% respectively in the post test.

        In experimental group, 50% only answered correctly in pretest about need of extra

proteins which was increase to 82% in post test. In pretest, 54% knew about the sources

of protein but in post test 66% knew about it. Where as in control group, 42% responded

correctly about the reason for extra protein diet in pretest which was increase to 58% in

post test. In pretest, 30% knew about the sources of protein but in post test 42% knew

about it.

            In pretest, 46% in experimental group and 22% in control group knew about the

reason for taking extra iron; 66% in experimental group and 74% in control group knew

about the sources of iron. While in post test, 76% in experimental group and 40% in

control group knew about the reason for taking extra iron; 88% (experimental group) and

62% in control group knew about the sources of iron.

        In experimental group, when asked for the reason for taking calcium rich diet

during antenatal period, 88% only responded correctly in pretest which was increase to

92% in post test. In pretest, 32% knew about the sources of calcium whereas in post test,

44% knew about it. But in control group when asked for the reason for taking calcium

rich diet during antenatal period, 90% only responded correctly in pretest which was



                                                                                      70
increased to 82% in post test. In pretest, 24% knew about the sources of calcium but the

score in the same item reduced to 22%.

       In experimental group, 64% only knew the reason for vitamin C diet in pretest

which was increase to 86% in post test. In pretest, 4% knew about the sources of vitamin

C but in post test 60% knew about it. In control group, when asked for the reason for

taking vitamin C in diet during antenatal period, 70% only responded correctly in pretest

which was increase to 74% in post test. In pretest, 60% knew about the sources of

vitamin C but in post test 50% knew about it.

       In experimental group, 72% knew the reason for taking vitamin A content diet

during antenatal period, only responded correctly in pretest where as 66% responded

correctly in post test. In pretest, 6% knew about the sources of protein but in post test

38% knew about it. In the same way, 76% knew the reason for taking vitamin A content

diet during antenatal period, in pretest which was decrease to 64% in post test. In pretest,

18% knew about the sources of protein but in post test 26% knew about it.




                                                                                         71
                                            Table - 14

                   Item wise Frequency and Percentage of Correct Responses
                                    regarding Personal Hygiene

                                                                                  (N = 50)
                                                     Experimental        Control Group
                                                         Group
 Item No.




                                                    Correct Response   Correct Response
                          Items
                                                   Pretest Post test   Pretest Post test
                                                   No % No %           No % No %
            A pregnant mother should wear
18          supportive and comfortable cotton      24   48   43   86   11    22    20   40
            clothes during pregnancy.
            A pregnant mother should take bath
19                                                 47   94   45   90   39    78    41   82
            once a day.
            During pregnancy, breast care is
20          done to clean the breast and prepare   35   70   40   80   23    46    29   58
            for lactation.


             Above table exhibits that, in experimental group, in pretest, 48% knew about the

type of clothes to wear during pregnancy, 94% knew taking bath and 70% knew about the

importance of breast care during pregnancy. Whereas, in the post test, 86% knew about

the type of clothes they should wear, 90% knew that once a day they should take bath and

80% knew about the importance of breast care during pregnancy.

             Likewise, in control group, in the pretest, 22% of the primigravidae knew about

the type of clothes that they have to wear during pregnancy, 78% knew that one a day

they should take bath and 46% only knew about the importance of breast care during

pregnancy in pretest. Where as in the post test 40% knew about the type of clothes that

they have to wear during pregnancy, 82% knew that one a day they should take bath and

58% only knew about the importance of breast care during pregnancy.




                                                                                          72
                                            Table – 15

                  Item wise Frequency and Percentage of Correct Responses
                                  regarding Antenatal Checkup

                                                                                  (N = 50)
                                                     Experimental         Control Group
                                                         Group
 Item No




                                                    Correct Response      Correct Response
                          Items
                                                   Pretest   Post test   Pretest Post test
                                                   No % No %             No % No %
           All pregnant women need
21                                                 43   86   46    92    40   80   36   72
           antenatal checkup.
           After first missed period the mother
22         should visit the doctor for the first   47   94   43    86    44   88   41   82
           time during the pregnancy
           Once a month a pregnant mother
23         should go for antenatal checkup         45   90   45    90    40   80   43   86
           during first 7 months.
           Twice a month she should go for
24         antenatal check up during 7-9           21   42   32    64    27   54   27   54
           months during pregnancy.
           Once a week she should go for
25         antenatal check up after 9 months       01   02   20    40    04   08   13   26
           during pregnancy


            Table 15 reveals that, in experimental group, 86%, 94% and 90% respectively

gave correct response for item number 21, 22 and 23. But only 42% correctly answered

item number 24 and 2% for item number 25 in pretest. In post test, 92%, 86% and 90%

respectively gave correct answer for item no. 21, 22 and 23. In item no. 24, 64% gave

correct response and only 40% got correct for item number 25.

            In control group, 80%, 88% and 80% respectively gave correct response for item

number 21, 22 and 23. 54% correctly responded item number 24 and only 8% got correct

for item number 25 in pretest. In post test, 72%, 82% and 86% respectively gave correct

response for item number 21, 22 and 23. 54% correctly responded item number 24 and

only 26% got correct for item number 25.

                                                                                        73
                                           Table – 16
                   Item wise Frequency and Percentage of Correct Responses
                                    Regarding Immunization
                                                                                 (N = 50)
                                                   Experimental     Control Group
                                                      Group
Item No.




                                                 Correct Response Correct Response
                          Items
                                                 Pretest Post test Pretest Post test
                                                 No % No % No % No %
           Pregnant mother should take tetanus
26                                               47     94   44   88   48   96   39    78
           toxoid immunization.
27 Inj TT is given to prevent from tetanus. 42          84   48   96   44   88   45    90
   Three doses of injection TT should be
28                                               29     58   44   88   14   28   19    28
   taken in first pregnancy.
   Two doses of injection TT should be
29                                               08     16   26   52   26   52   27    54
   taken in subsequent pregnancy.
   The first dose of TT should be taken
30                                               14     28   33   66   19   38   23    46
   between 4-6 months of pregnancy.
   The interval between the two doses of
31                                               22     44   29   58   36   72   32    64
   TT is 4-6 weeks.


           The above table parades that, in experimental group, 94% correctly answered item

number 26; 84% and 58% gave right answer of item 27, and 28 whereas, 16%, 28% and

44% correctly answered item 29, 30 and 31 respectively in pretest. In post test, 88% gave

correct respond in item number 26, 96% answered correctly item 27, 88% and 52% knew

about item number 28 & 29 respectively. Only 66% & 58% were correct in item 30 & 31.

           In control group, 96% gave correct response of item number 26; 88% and 28% was

correct about item number 27, & 28 where as 52%, 38% and 72% correctly answered

item number 29, 30 & 31 respectively in pretest. In post test, 78% gave correct respond

of item 26, 90% responded correctly item number 27, 28% & 54% answered correctly

about item 28 and 29 respectively. Only 46% and 64% were correct in item 30 and 31.




                                                                                        74
                                            Table – 17

                 Item wise Frequency and Percentage of Correct Responses
                                 regarding other Antenatal Care
                                                                                (N= 50)
                                                    Experimental        Control Group
                                                       Group
Item No




                                                  Correct Response     Correct Response
                         Items
                                                  Pretest Post test    Pretest Post test
                                                  No % No %            No % No %
          A pregnant mother should take at
          least 8 hours at night 2 hours at day
32                                                30   60   33   66    35   70   32   64
          time rest and sleep during
          pregnancy.
          A pregnant mother should avoid
33        traveling during first trimester and    16   32   38   76    21   42   27   54
          last 6 weeks in third trimester.

          Pregnant mother should avoid
34                                                41   82   43   86    45   90   40   80
          heavy lifting during pregnancy.
          Sexual intercourse should be
          avoided during first trimester and
35                                                13   26   32   64    21   42   21   42
          last 6 weeks in third trimester of
          pregnancy.
          Self medication should be avoided
36        during pregnancy because it may         14   28   34   68    31   62   31   62
          bring fetal abnormalities.

          Vaginal bleeding, swelling of face,
37        arm and feet are warning signs          15   30   37   74    13   26   19   38
          during pregnancy.
          Report to the doctor immediately if
38        vaginal bleeding occurs during          48   96   48   96    47   94   44   88
          pregnancy.

          The fetal well being can be ensured
39                                                47   94   50   100   45   90   45   90
          by regular check up.




                                                                                           75
       Table 17 demonstrates that in pretest in experimental group, 60% of

primigravidae knew about the resting period, only 32 % knew about when they should

avoid traveling, 82% knew about what physical activities they should avoid and only

26% correctly answered item 35. 28% only knew warning signs, 30% responded

correctly item 37 and most of them (96% and 94%) gave the correct response of item

number 38 and 39. In the post test, 66% of primigravidae knew about the resting period,

only 76 % knew about when they should avoid traveling, 86% knew about what physical

activities they should avoid and only 64% correctly answ red item 35. 68% only knew

warning signs, 74% responded correctly item 37 and most of them (96% and 100%) gave

the correct response of item 38 and 39.

       In control group, in pretest, 70% of primigravidae knew about the resting period,

only 42 % knew about when they should avoid traveling, 90% knew about what physical

activities they should avoid and only 42% correctly answered item 35. 62% only knew

warning signs, 26% responded correctly item number 37 and most of them (94% and

90%) gave the correct response of item number 38 and 39. In the post test, 64% of

primigravidae knew about the resting period, only 54 % knew about when they should

avoid traveling, 80% knew about what physical activities they should avoid and only

42% correctly answered red item number 35. 62% knew warning signs, 38% responded

correctly item 37 and most of them (88% and 90%) gave the correct response of item

number 38 and 39.




                                                                                     76
                                         Section – III

a. Analysis of Mean, SD of knowledge score according to demographic
              variables and paired “t” value of pretest and post test.
                                           Table - 18
                                                                                          (N= 50)
                                 Experimental group                           Control group




                                                           Resp. No.
                 Resp. No.
  Variables                  Pretest   Posttest   Paired               Pretest     Posttest Paired
                              M SD      M     SD “t”                    M      SD M SD “t”
                                                  value                                     value
 1. Age
       20-24       37 22.8 3.5 30.3 2.7 17.3** 43 22.9 4.05 24 3.4 6.9**
       25-29       12 23 1.5 29.6 2.1 9.6**       6   23 1.08 24 2.6 2.9*
 2. Religion
       Hindu       49 22.9 3.2 30.2 2.6 19.6** 49 23.08 3.6 24.0 3.3 7.7*
 3. Education
 Illiterate       4 22.7 2.0 29.7 3.7 4.4** 7        20.2 3.4 23.1 2.2 6.9*
 Primary           37 22.4 6 3.2 29.9 2.4 16.9** 29  23.5 3.2 24.4 2.9 4.8*
 education
 Higher            7 24.5 1.9 30.8 2.0 9.7** 6       21.6 4.7 22.6 4.3 3.06*
                                       3
 secondary & 2 28.9 2.1 35.5 0.7 19.7** 8
 Graduation                                          22.8 4.5 23.7 4.23 3.9*
 PG
 4. Occupation
    Housewife     34 23.2 2.9 30.2 2.4 17.6** 32 22.2 4.6 24.3 2.8 3.7*
   Agriculture 14 21.8 3.4        30  2.9 10.1** 14  23.5 3.1 24.4 3.02 6.4*
 5. Type of Family
      Single      22 22.5 2.9 30      2.1 14.5** 22 22.5 3.4 23.1 3.7 0.8 NS
       Joint      27 21.8 3.4 30.6 2.9 10.1*** 28 23.4 3.7 24.8 2.1 4.1**
 6. Monthly Income
    Rs.1,000       3 23.3 0.5 31.6 3.05 5.7*      4   20  5.2 24.6 0.5 1.7 NS
Rs.1,001-5,000 40 22.9 3.2 30.1 2.7 17.9** 30         24  3.5 24.02 3.4 1.3 NS
Rs.5,001-10,000 6      22 3.5     30  1.6 5.3*    10 22.5 3.5 23.5 3.8 1.7 NS
 7. Age at Marriage
     20 yrs       25 22.8 3.2 30.3 2.3 13.7** 25 23.3 3.8 23.9 3.3 1.3 NS
 20-24 yrs        23 22.8 3.2 30.04 2.8 15.8** 23 22.6 3.4 24.1 3.2 2.07 NS
 25-29 yrs         2 26.5 2.1 31.5 3.5 17.7** 2      24.5 3.5 25.5 4.9 1.0 NS
 8. Pre-existing Information
        Yes       37 23.8 2.8 30.5 2.5 18.1** 22 24.2 3.2 23.2 3.7 2.2*
        No        13 20.4 2.8 29.4 2.7 11.8** 28 22.6 3.3 23.5 3.7 1.2 NS
 9. Sources of Information
 Health           12 23.3 1.5 29.5 1.8 13.4** 3      24.1 3.3 24.2 3.08 0.08 NS
 personnel
 Elders &         25 24.1 3.3 31.04 2.7 13.9** 11 21.7 4.9 22.5 3.2 2.7**
 relatives
 * – Significant at 0.05 level.              ** – Significant at 0.001 level and 0.000 level
NS – Not Significant at 0.05 level.

                                                                                              77
       Table 18 imparts the mean, standard deviations and ‘t’ values showing the

relationship between the selected demographic variables and the knowledge levels of the

primigravidae regarding the selected aspects of safe motherhood.

       The table reveals that, in experimental group, the computed values on knowledge

of primigravidae regarding safe motherhood significantly differed with mean scores of

pretest and post tests while comparing with age (t = 17.3 in the age group of 20-24

years & t = 9.6 in the age group of 25-29 years), religion (t = 19.6 in Hindu only) and

education (t = 4.4 in illiterate, t = 16.9 in primary level group, t = 9.7 in higher secondary

group & t = 19.7 in above the graduation level). Similarly, the computed values of the

knowledge of primigravidae regarding safe motherhood significantly differed with mean

scores of pretest and post tests while comparing with the occupation (t = 17.6 in

housewives and t = 10.1 in those who were doing agriculture), type of family (t = 14.5 in

those from single type of family and 10.1 in those from joint family) and monthly income

(t = 5.7 in those who having monthly income less than Rs.1,000, t = 17.9 in those who

had monthly income Rs. 1,001- 5,000 and t = 5.3 in those whose monthly income was

Rs. 5,001 to 1,0000). Likewise, the knowledge of             primigravidae regarding safe

motherhood significantly differed with mean scores of pretest and post tests while

comparing with their age at marriage (t = 13.7 in marital age below 20 years, t = 15.8 in

marital age was between the age group of 20-24 years and t = 17.7 8 in those whose

marital age was between 25-29 years), pre-existing information (t = 18.1 in those who

had pre-existing information on safe motherhood and t = 11.8 in those who did not have

pre-existing information on safe motherhood) and sources of information (t = 13.4 in

those whose source of information was health personnel and t = 13.9 in those whose




                                                                                           78
source of information was elders and relatives). All the above mentioned values were

found to be statistically highly significant at 0.05 and 0.001 level of significance.

     In control group, the computed ‘t’ values were, between knowledge scores and

age were (t = 6.9 in the age group of 20-24 years and t = 2.9 in the age group of 25-29

years), religion (t = 7.7 in Hindu only) and education (t = 6.9 in illiterate, t = 4.8 in

primary level group, t = 3.06 in higher secondary group and t = 3.9 in above the

graduation level). Similarly, the computed values of the knowledge of primigravidae

regarding safe motherhood significantly differed with mean scores of pretest and post

tests while comparing with the occupation (t = 3.7 in housewives and t = 6.4 in those who

were doing agriculture), type of family (t = 4.1 in those from joint family), pre-existing

information (t = 2.2 in those who had pre-existing information only) and sources of

information (t = 2.7 in those whose source of information was elders and relatives). They

were found to be statistically highly significant at 0.05 and 0.001 level of significance.

Whereas, in other remaining variables like, monthly income, age at marriage, single type

family, absence of pre-existing information were found to be statistically not significant

at 0.05 and 0.001 level of significance.




                                                                                        79
                                            Table - 19

b. Data on association between selected demographic variables of the primigravidae
          and their knowledge regarding selected aspects of safe motherhood


                                                                         (N = 50).
                        Experimental Group                    Control Group
 Demographic
  Variables
                   Pretest               Post test        Pretest      Post test

                      χ 2 Value         χ 2 Value        χ 2 Value     χ 2 Value
Age                     34.0*             61.1**          34.4 NS       27.5 NS

Religion                6.2 NS             2.9 NS         9.1 NS         5.3 NS

Education              24.2 NS             72.2*          23.7 NS       24.8 NS

Occupation              60.2**             66.0*          24.6 NS       28.4 NS

Family Income           43.7*             78.0**          49.9 NS       47.7 NS



   Note
          •    NS - Not Significant at 0.05 level.

          •    *   - Significant at 0.05 level.

          •    ** - Significant at 0.001 level.




                                                                                     80
        Table 19 discloses the chi-square values showing the association between the

selected demographic variables (age, religion, education, occupation and family income)

and the knowledge levels of the primigravidae regarding the selected aspects of safe

motherhood.

        It is seen in table that in the experimental group, the chi-square values computed

between knowledge scores and age (χ                  2
                                                         = 34.0 in the pretest and         χ    2
                                                                                                    = 61.1 in the


post test), occupation (χ       2
                                    = 60.2 in the pretest and          χ   2
                                                                               = 66 in the post test), family


income (χ 2 = 43.7 in the pretest and χ 2 = 78 in the post test) and education (χ 2 = 66 in

the post test only) were found to be statistically highly significant at 0.05 and 0.001 level

of significance.

        It is evident from the table 19 that, in the experimental group, the chi-square

computed between knowledge scores and religion (χ                  2
                                                                       = 6.2 in the pretest & χ 2 = 2.9 in


the post test) and education (χ         2
                                            = 24.2 in the pretest) were found to be statistically not

significant at 0.05 level of significance.

        In the control group, it is observable that the chi-square values computed between

knowledge scores and age (χ             2
                                             = 34.4 in the pretest and           χ 2=   27.5 in the post test),


religion (χ 2 = 9.1 in the pretest & χ 2 = 5.3 in the post test), education (χ 2 = 23.7 in the


pretest and   χ   2
                      = 24.8 in the post test), occupation (χ          2
                                                                           = 24.6 in the pretest and in the


post test   χ 2 = 28.4) and     family income (χ         2
                                                             = 49.9 in the pretest and      χ       2
                                                                                                        = 47.7 in the

post test) and were found to be statistically not significant at 0.05 level of significance.




                                                                                                                  81
                                         Section – IV

              Analysis for the test of significance of the hypothesis

                                           Table - 20
                  Comparison of “T” Value of Pretest and Post test Scores
                            of Experimental and Control Group
                                                                                   (N= 50)
                    Experimental Group                         Control Group

              M       SD    S. E       T- value   M       SD      S. E      T value
                                     t = 20.07                                 t = 2.55
Pretest      22.9     3.2   0.4        d f = 49   23.06   3.6      0.5
                                                                               d f = 49
 Post                                P < 0.000            3.3      0.4
             30.2     2.6   0.3                   24.1                      P value < 0.014
 test                                   Sig                                       Sig.


 M: Mean                           N: Total number of observations       Sig: Significant
 SD: Standard deviation            S. E: Standard error         df: degrees of freedom
          The above table presents that the mean value of knowledge scores of experimental

group in pretest score was 22.9, SD was 3.and SE was 0.45, where as in post test mean

was 30.26, SD was 2.63 with SE 0.37. It also reflected that the mean value of knowledge

scores of control group in pretest score was 23.06 with SD 3.6 SE 0.5. Where as in post

test mean was 24.1 with SD 3.3 and SE 0.4. The calculated “t” value in experimental

group was 20.07 (in 49 degrees of freedom) which is greater than table value (P < 0.000).

Hence the null hypothesis was rejected. So there is the significant difference between the

knowledge of primigravidae before and after the implementation of planned teaching

program. The calculated “t” value in control group was 2.55 (in 49 degrees of freedom)

which is greater than table value (P < 0.014). Hence there is also significant difference

between the knowledge of primigravidae in pretest and post test of control group




                                                                                              82
                                        Table - 21

                  Comparison between the Pretests and Post tests of
                        Experimental group and Control group.
                                                                                   (N= 50)
                                   Pretest                           Post test

                        T- test               z- test       T- test              z- test
                      (unpaired)                          (unpaired)
     Value               0.115                0.116         t = 3.36        Z = 10.30
  (calculated)

   Degrees of           d f = 49                 -          d f = 49                -
    freedom

 Value (table)           1.96                  1.96          2.641               3.291

                       P > 0.05              P > 0.05    P < 0.01         P < 0.001
 Significance
                       Not Sig.              Not Sig.         Sig.                Sig.



       The data in the table 21 shows that there is no significance in the pretests of the

both group. The calculated t-value in pretest was 0.115 (in 49 degrees of freedom) which

is less than table value (P value > 0.05 level). At the same time the calculated z value for

pretest was 0.116 which also was less than table value (1.96) and the P value > 0.05 level.

Hence there is no difference in the pretests of experimental and control groups.

       The data also exhibits that there is significant difference between the post tests of

experimental and control group. The calculated “t” value in post test was 3.36 which is

greater than table value (P < 0.05). At the same time the calculated z value for pretest

was 10.30 which also was greater than table value (3.291) and the P < 0.001 level. Hence

there is significant difference in the post test of experimental and control groups




                                                                                             83
 Chapter-
 Chapter- Six

DISCUSSION
                                    6. DISCUSSION
        The present study was conducted to evaluate the effectiveness of planned teaching

program on knowledge of primigravidae regarding selected aspects of safe motherhood.

In order to achieve the objectives of the study, experimental (pretest-post test control

group) design was adopted. Simple random technique was used to select the hospitals for

experimental group and control group and the same technique was used to select the

hundred samples (50 in control group and 50 in experimental group). Data was collected

by using structured interview schedule. The questionnaire consisted of two parts, i.e.

demographic data and knowledge questionnaire regarding selected aspects of safe

motherhood. The findings of the study have been discussed with the reference to the

objectives and hypothesis and with the findings of the other studies. The data was

organized, analyzed and presented under four following headings.

I.   Data on demographic variables of the primigravidae.

II. Data on knowledge of the primigravidae regarding selected aspects of safe

     motherhood.

     a. Assessment of level of knowledge of primigravidae regarding selected aspects of

        safe motherhood in pre and post test.

     b. Area wise mean, mean percentage and standard deviation of knowledge regarding

        antenatal care.

     c. Item wise percentage of correct responses regarding selected aspects of safe

        motherhood in pre and post test.

III. Mean, SD of knowledge score according to demographic variables and paired “t”

     value of pretest and post test of experimental and control group.




                                                                                      82
IV. Chi-square values showing the relationship of knowledge scores of primigravidae

     with the selected demographic variables.

V. Analysis for the test of significance of the hypothesis.

I.   Data on demographic variables of the primigravidae.

        Majority of the primigravidae were between the age group of 20-24 years and

the least of them (2%) of the respondents were between the age group of 30-34 years in

the experimental and control group. None of the respondents were between the age group

of 35-40 years in both groups. Majority of the respondents in both experimental and

control groups were Hindu and only 2% of them were Muslim.

        In the experimental group, maximum of the primigravidae (74%) were having

primary education and only 4% graduation and post graduated. Similarly, in control

group majority (58%) had completed primary education and the least of them 12% had

completed higher secondary. Majority of the respondents were housewives and only few

of them were working in private sector in both groups.

        In experimental group, majority of primigravida (54%) were living in joint

family, where as in control group most of them (44%) were living in single family. Very

few were living in the extended family in both experimental and control group.

        Majority of the respondents had monthly income ranging from Rs. 1,001-5,000 in

both experimental and control groups, 8% had their monthly income less than Rs. 1,000

in experimental group and only 2% earned more than Rs. 10,001 in control group.

        In both groups, the majority of primigravidae were married less than 20 years

and none of them were married in between the age group of 30-34 years.

        Majority of primigravidae in experimental group had heard about antenatal care.

Their major source of information was the elders and relatives. By contrast, in control


                                                                                    83
group majority of the primigravidae had not heard about antenatal care. Very few of them

heard regarding antenatal care from mass media.

II. Data on knowledge of the primigravidae regarding selected aspects of safe

motherhood.

a. Assessment of level of knowledge of primigravidae regarding selected

   aspects of safe motherhood in pre and post test.

          The findings of the study revealed that, majority had moderately adequate

knowledge whereas, only few of the primigravidae had adequate knowledge regarding

selected aspects of safe motherhood in pretest. The post test scores depicted that in

experimental group, more than half primigravidae had adequate knowledge and none of

them had inadequate knowledge regarding selected aspects of safe motherhood. Whereas,

in the control group, there was no such increase in the knowledge scores regarding

selected aspects of safe motherhood in post test of primigravidae. The study conducted

by El-Sherbini AF, el-Torky MA, Ashmawy AA, Abdel-Hamid HS (1993) also

revealed that most of the primigravidae had poor knowledge in relation to antenatal care.

          The mean knowledge scores in pretest of experimental group were 22.98 and in

control group was 23.06. In post test mean score in experimental group was 30.26 and in

control group was 24.1. This evidenced that there was a significant increase in the scores

in post test of experimental group when compared to pretest. Whereas, in control group,

there is no significant difference in the knowledge scores between pretest and post test

scores.

          So, we can summarize that the knowledge was increased after planned teaching

program. Shantha Kumari K (1996) in her study flaunted that primigravidae who had




                                                                                       84
received health education had developed adequate knowledge in safe motherhood.

b. Area wise mean, mean percentage and standard deviation of knowledge

regarding antenatal care.

       On area-wise analysis regarding antenatal care, the inference was drawn from the

statistical and descriptive analysis. Results paraded that in experimental group, the

maximum percentage of knowledge was regarding personal hygiene and general

questions. But there was lack in the knowledge regarding antenatal diet, antenatal visit,

immunization and other questions regarding antenatal care.

       Truly speaking, we can see that in the experimental group the mean score in post

test in all the areas were increased than in the pretest but in the control group there was

no significant differences in the mean scores in all the areas. The results coincides with

the study done by Ohnishi M, Nakamura K, Takano T (2005) which also showed that

the knowledge scores of the woman attending antenatal program was increased.

b. Item wise percentage of correct responses regarding selected aspects of safe

   motherhood in pre and post test.

       On item-analysis regarding antenatal care the inference was drawn from the

statistical and descriptive analysis. The findings imparted that there was the lack of

knowledge regarding the reason for giving antenatal care in both groups in the pretest.

But in the post test almost all the primigravidae had adequate knowledge from item

number 1-5.

       Maximum of the respondents of both groups knew the best type of diet during

antenatal period. But there was the lack in the knowledge of sources of diet in the pretests

of the both group. The knowledge was increased in the post tests in most of the items.




                                                                                         85
This study’s findings concurred with the results of a study conducted by Rautava P,

Sillanpaa M (1989), which evidenced that the largest knowledge gaps were present in

nutritional aspects of pregnancy and lactation and those areas need guidance.

       The study illustrated that there was the lack of knowledge regarding type of

clothes that should be worn during pregnancy. Unexpectedly, most of the respondents

had knowledge regarding breast care in the experimental group but in control group only

some of them know about the breast care during pregnancy.

       There was the lack of knowledge regarding timings of antenatal visits in third

trimester. A study by Khan M, Mwaku RM, Mc. Clamroch K, Kinkela DN, Vanrie A

(2005) also evidenced that there was lack of knowledge regarding timings of the

antenatal visits. The knowledge was increased in the post test.

       The study regarding the immunization explored that most of the primigravidae

knew that tetanus toxoid has to be taken during pregnancy. But only few of the

respondents knew about the doses, timings and intervals between two doses of tetanus

toxoid. Yadav RJ, Padam Singh (1988), in their study had concluded that there was

inadequacy in receiving tetanus toxoid immunization in the women who were not

attending antenatal clinic. Against such a background it seemed paradox that, even

though the mothers who were visiting the antenatal clinics, they were unaware of the

doses and timings of tetanus toxoid immunization. In the post test, the knowledge was

increased.

       Maximum of the respondents had adequate knowledge regarding ensuring of

fetal well being, to avoid heavy lifting and to take rest if occurrence of vaginal bleeding

during pregnancy. But there was lack of knowledge regarding the period to avoid coitus

and traveling, consequences of self-medication, and the danger signs during pregnancy.

                                                                                        86
The results opposes studies conducted by Alam AY, Qureshi AA, Adil MM, Ali H

(2005) and Kumbani L, Mc. Inerney P (2003) in which the findings had showed that

knowledge about warning or danger signals in pregnancy was high. Whereas, in the

post test the knowledge in all the items in this area has increased.

III. Mean, SD of knowledge score according to selected demographic variables and

     paired “t” value of pretest and post test of experimental and control group.

       The knowledge of         primigravidae regarding safe motherhood significantly

differed with mean scores of pretest and post tests while comparing with their age

groups, religion, educational status and occupation in both groups. This may be due to

their curiosity and learning nature. Whereas, in other demographic variables (type of

family, monthly income of the family, age at marriage, pre-existing information

regarding safe motherhood and the sources of information), there was significant

difference in the mean scores of pretest and post test of the experimental group and some

of the control group. This may be due to the implementation of planned teaching

program. A study conducted by Nuraini E, Parker E (2005), revealed that the

improvement of knowledge in the experimental group was significant particularly about

knowledge of healthy pregnancy. The results is also supported by the study done by

Ohnishi M, Nakamura K, Takano T (2005) which also showed that the knowledge

scores of the woman attending antenatal program was increased.

IV. Chi-square values showing the relationship of knowledge scores of

   primigravidae with the selected demographic variables.

       The results exhibited that only few of the variables (age, occupation and family

income) of the experimental group had significant association with the knowledge scores

of primigravidae. A study conducted by Agarwal OP, Rakesh Kumar, Anitha Gupta,

                                                                                      87
Tiwari RS (1988) found that mostly illiterate mothers ignores antenatal visit. By

contrast, in the present study, even the education of mothers has no significant

association with the knowledge scores. So as to conclude that in spite of their higher

education, most of the primigravidae had lack of knowledge regarding antenatal care.

       It is clear from the inference drawn from the study results that most of the other

selected variables like religion, type of family, age at marriage, exposure to information

and sources of information also have no significant relationship. The findings of the study

are supported by Bratati Banerjee (2003) study, in which the results showed that poor

scoring were obtained and significantly more for housewives than working women and

illiterates than literates, least being with those most highly educated.53

V. Analysis for the test of significance of the hypothesis.

       The findings of the study rejected the null hypothesis and supported the

alternative hypothesis formulated by the investigator stating that there will be the

significant difference between the knowledge of primigravidae before and after the

implementation of planned teaching program. Each of the findings of the study has been

proved to be true.

       In the experimental group, there was significant rise in the knowledge scores of

primigravidae in post test than in pretest and showed greater significance (P < 0.000).

Meanwhile, in control group also slight increase had been seen in the post test scores than

the pretest scores. This may be due to the repetition of the same questionnaire and

learning attitude of the mothers.

       While comparing the pretest scores of experimental group with the pretest scores

of control group by using inferential statistics (unpaired “t” test and “z” test), no




                                                                                        88
significant difference was found in the results. Hence, there was no difference in the

pretest of experimental and control groups.

        In comparison between the post test scores of experimental group with control

group, significant was found. A study conducted by Nuraini E, Parker E (2005),

revealed that the improvement of knowledge in the experimental group was significant

particularly by the knowledge about healthy pregnancy.

        To sum up, planned teaching program has greatly influenced and increased the

knowledge scores of primigravidae. So we can claim that planned teaching program was

effective.




                                                                                   89
 Chapter-
 Chapter- Seven

CONCLUSION




                  90
                                 7. CONCLUSION

       Education enlightens the darkness of the life through the public awareness,

increases knowledge and brings change in the people’s unhealthy practices. The major

goal of nursing practices is to impart the knowledge and encourage the healthy practices.

The following conclusion was drawn from the present study:

   1. The study revealed that primigravidae had moderately adequate pre-existing

       knowledge about selected aspects of safe motherhood.

   2. This study disclosed that there was no significant association between the level of

       knowledge and the demographic variables.

   3. There was significant difference between the knowledge of primigravidae before

       and after the implementation of planned teaching program.

   4. At the same time it is also reflected that there was significant difference between

       the knowledge of primigravidae in pretest and post test.

       All these indicated that planned teaching program is effective to raise the

knowledge level in primigravidae. Hence effective health education on safe motherhood

must be instituted in all communities with a view to bring about public awareness in safe

motherhood.




Nursing Implications

       The findings of the study have several implications for nursing education, nursing

practice, nursing administration and nursing research. The implications which have made




                                                                                       91
in the present study are of vital concern to the professional nurse practitioners, nursing

instructors, nursing administrators and nurse researchers.

Nursing Education

 1. In-service and continuing education programs should be organized for nurses

     regarding safe motherhood to update their knowledge regarding safe motherhood.

     This aids to prepare the nurses to raise the public awareness.

 2. Nursing curriculum should be updated and safe motherhood related topics should be

     integrated at different levels to impart adequate knowledge to the future nurses.

 3. Nursing instructors need to lay emphasis on the safe motherhood; especially the

     health education regarding antenatal care through skill training.

Nursing Practice

 1. Good supervision and appreciation of safe motherhood practices need to be

     encouraged by senior nurses in the hospitals and the community health centers.

 2. Nurse as a women and competent professionals have responsibilities to promote

     health information and healthy practices regarding safe motherhood among the

     pregnant women in the society.

 3. All nurses should disseminate the proper information regarding safe motherhood to

     increase public awareness which will help to promote healthy practices, positive

     attitudes, and increase in the utilization of antenatal services. This further leads to

     reduction in the maternal mortality and morbidity rates and also reduces the risk

     of complications.

 Nursing Administration




                                                                                         92
   1. Nursing administrators should take the initiative in organizing in-service and

      continuing educational programs for nurses regarding safe motherhood.

   2. Appropriate teaching-learning materials regarding safe motherhood need to be

      prepared and make them available for nurses in health settings and community

      settings to provide information regarding safe motherhood effectively.

   3. The administrators should take into consideration about facilities and supplies of

      all resources made available for safe motherhood in all the health care institutions.

   4. Clear policies and protocols related to safe motherhood should be developed by

      the authorities and the nursing personnel should be aware regarding the current

      policies and protocols.

Research

   1. Research on nurses’ knowledge regarding safe motherhood should be carried out

      continuously to assess the knowledge and practices on safe motherhood for

      upgrading their knowledge and practices.

   2. The study also divulged that there is lack of knowledge regarding safe

      motherhood in primigravida. Compared to other aspects of health, there is a need

      for extended an intensive nursing research on all the areas of the safe motherhood.

      The data presented in this study can help in the future studies.

   3. At the same time awareness about the importance of conducting research in the

      safe motherhood can be created among the nurses who were working in the

      clinical and community areas.




Limitations



                                                                                        93
The following limitations were identified during this study :

 1. The size of the sample was small. Hence it restricted the generalization.

 2. The samples were drawn only from the two selected hospitals of Kolar district,

     Karnataka. So the wider generalization was limited.

 3. Only knowledge was assessed and no attempt was made to identify other attributes

     like attitudes and practices.

 4. The samples were drawn from primigravidae in second trimesters which limited

     generalization of findings to other primigravidae in other health institutions.

 5. The study was limited to urban areas.




Recommendations

On the basis of the study findings the following recommendations were made for further

research:

 1. There is a scope of a similar study to be conducted on a large sample regarding all

       aspects of safe motherhood covering all primigravidae attending all the health

       institutions, there by findings can be generalized.

 2. A study can be conducted to find out the practices and attitudes of primigravidae in

       safe motherhood.

 3. A long term follow-up studies can be conducted to find out the effectiveness and

       consequences of knowledge, attitudes and practice regarding safe motherhood.

 4. A comparative study can be conducted among urban and rural primigravidae on

       knowledge, attitude and practice regarding safe motherhood.




                                                                                       94
5. A comparative study can be conducted among primigravidae and multigravidae on

     knowledge, attitude and practice regarding safe motherhood.

6. A similar study can be done to develop the health education packages on safe

     motherhood and to evaluate its effectiveness.

7. A comparative study between the knowledge and attitude of health professional

     women and non-health professional women towards safe motherhood.




                                     Chapter-
                                     Chapter- Eight

                                     SUMMARY




                                                                             95
                                   8. SUMMARY

       The experimental (pretest-post test control group) design was adopted to study the

effectiveness of planned teaching program on knowledge of primigravidae regarding

selected aspects of safe motherhood in selected hospitals in Kolar, Karnataka. The data

was collected from 100 primigravidae (50 in control group and 50 in experimental group)

by using structured interview schedule.

The findings of the study can be summarized as follows:

I. Findings regarding demographic variables of the primigravidae

   •   Maximum of the primigravidae 74% in the experimental group and 86% in the

       control group were between the age group of 20-24 years, while the least of them

       2% were between the age group of 30-34 years in both groups.

   •   In both groups, 98% were Hindu and only 2% of them were Muslim.




                                                                                      96
•   In the experimental group, most of the primigravidae (74%) completed primary

    education and only 4% graduated and post graduated. In control group, 58% had

    completed primary education and only 12% had completed higher secondary.

•   Majority of experimental (68%) and control group (64%)          respectively were

    housewives and only 2% were working in private sector in both groups.

•   In experimental group, majority of primigravida (54%) were living in joint

    family, where as in control group most of them (44%) were living in single

    family. Very few, 2% were living in the extended family in experimental group

    but one of them was living in the extended family in control group.

•   A large number of the respondents (80% in experimental 60% in control group)

    have income Rs. 1,001-5,000 per month and 8% earned less than Rs. 1,000 in

    experimental group and only 2% earned more than Rs. 10,001 in control group.

•   In both groups, most of the respondents (50%) got married in less than 20 years

    and few (4%) of them got married between the age group of 25-29 years.

•   Most of primigravidae in experimental group (74%) had heard about antenatal

    care but in control group, only 44% have heard about it.

•   Among the respondents who have heard about antenatal care, the major source

    was the elders and relatives respectively 67.5% and 50% in experimental and

    control group, 32.4% was the health personnel in experimental group. Very few

    (4.5%) heard from the other media (internet) in control group whereas, none of

    them heard regarding antenatal care from mass media and other sources in

    experimental group.




                                                                                   97
II. Findings regarding the level of knowledge of primigravidae on selected aspects of

safe motherhood

   •   Majority of the respondents (88% of experimental group and 78% of control

       group) had moderately adequate knowledge and about 4% of experimental group

       and 2% of control group had adequate knowledge in the pretest. But in the post

       test, in experimental group majority (58%) had adequate knowledge, 42% had

       moderately adequate knowledge while in the control group, majority (84%) had

       moderately adequate knowledge and only about 6% had adequate knowledge

       regarding selected aspects of safe motherhood.

   •   The mean value of knowledge scores of experimental group in the mean pretest

       score was 22.9 with SD 3.2 and SE 0.4, where as in post test mean was 30.2 with

       SD 2.6 and SE was 0.3. Similarly, the mean value of knowledge scores of control

       group in pretest, the mean score was 23.06 with SD 3.6 and SE 0.5, whereas, in

       post test mean was 24.1 with SD 3.3 and SE 0.4.



III. Findings regarding Mean, SD of knowledge score according to demographic

   variables and paired “t” value of pretest and post test of experimental and

   control group.

 • In the experimental group, the computed values on knowledge of primigravidae

    regarding safe motherhood significantly differed with mean scores of pretest and

    post tests while comparing with all the demographic variables. The calculated ‘t’

    values of all the demographic variables (age, religion, occupation, type of family,

    monthly income, age at marriage and sources of information) were greater than the




                                                                                    98
   table value (P< 0.05 and 0.001 level). So the values were found to be statistically

   highly significant at 0.05 and 0.001 level of significance.

 • In control group the computed ‘t’ values between knowledge scores and age,

   religion, education, occupation joint family and       respondents who had pre-existing

   information were greater than the table value (P< 0.05 and 0.001 level). They were

   found to be statistically highly significant at 0.05 and 0.001 level of significance.

   Whereas, in other remaining variables like, monthly income, age at marriage, single

   type family, absence of pre-existing information were found to be statistically not

   significant at 0.05 and 0.001 level of significance.




IV. Findings regarding Chi-square values showing the relationship of knowledge

   scores of primigravidae with the selected demographic variables.

 a. There was no significant association between the knowledge score and the religion

    of the primigravidae. Chi-square values were in experimental group, pretest 6.2 &

    post test 2.9 where as in control group, pretest 9.1 & post test 5.3. “P” value is

    greater than 0.05 level in all scores.

 b. There was no significant association between the knowledge level and the

    educational status in most of the tests except in post test of experimental group. The

    chi-square values were: in experimental group, pretest 24.2, (P > 0.05) and post test




                                                                                       99
     72.2 (P < 0.05). In control group, the values were 23.7 (P > 0.05) in pretest and

     post test 24.8 (P > 0.05).

 c. There was no significant association between the knowledge score and type of the

     family. Chi-square values in experimental group were 24.2 (P > 0.05) in pretest

     and post test 20.1 (P > 0.05). In control group, it was, in pretest 24.4 (P > 0.05) and

     post test 18.4 (P > 0.05).

 d. There was no significant association between the knowledge score and their family

     income except in experimental group in post test. Chi-square values in experimental

     group were 43.7 (P > 0.05) in pretest and in post test 78.04 (P < 0.05). In control

     group values were, 49.9 (P > 0.05) in pretest and 47.7 (P > 0.05) in post test.

 e. There was no significant association between the knowledge score regarding the

     selected aspects of safe motherhood and their marital age except in post test of

     experimental group. Chi-square values in experimental group were, 23.02 in pretest

     (P > 0.05) and in the post test 49.1, (P < 0.05). Similarly, in control group, the

     values were, in pretest 16.7 (P > 0.05) l and post test 17.5 (P > 0.05).

 f. There was no significant association between the knowledge scores regarding the

     selected aspects of safe motherhood and responses for presence of information. Chi-

     square values were 9.6 (P > 0.05) in pretest and post test 11.4 (P > 0.05) in

     experimental group. In control group, the values were, in pretest 11.4 (P > 0.05) and

     post test 8.5 (P > 0.05).



V. Findings regarding the analysis for the test of significance of the hypothesis

(effectiveness of planned teaching program)




                                                                                        100
 a. There was significant difference between the knowledge of primigravidae before

    and after the implementation of planned teaching program (t = 20.079, P < 0.000

    level) in the experimental group. Similarly, there was also significant difference in

    pretest and post test in control group (t = 2.555, P < 0.014 level).



VI. Findings regarding the comparison the knowledge in experimental and control

groups

 a. There was no significant between the pretests of the experimental and control group

    (t = 0.115, P > 0.05 level and z = 0.116, P > 0.05 level).

 b. There was significant difference between the post test of experimental and control

    group (t = 3.36, P < 0.05 level and z = 10.30, P < 0.001 level).




                                                                                     101
                                  Chapter-
                                  Chapter- Nine

                            BIBLIOGRAPHY




                            9. BIBLIOGRAPHY

1. Park K. Textbook of Preventive and social medicine. 17th ed. Jabalpur (India):

   Banarsidas Bhanst Publishers; 2003




                                                                             102
2. White Ribbon Alliance for Safe motherhood, Awareness, mobilization and action

   for   safe   motherhood:   A   Field   Guide,   No.   1   2000.   Available   from

   www.geocities.com/white_ribbonalliance/ www.ngonetworks.org

3. WHO and UNICEF Revised 1990 Estimates of Maternal Mortality: A New

   Approach, Geneva: 1996.

4. Registrar General of India. SRS Bulletin 1999; 33

5. Myles. Textbook for Midwives. 14th ed. China: Churchill Livingstone; 2004

6. Cook, R.J. Advancing Safe motherhood through human rights. Presentation at Safe

   motherhood technical consultation, Sri Lanka, October 1997

7. World Development Report 1993: Investing in Health. World Bank, Washington,

   DC: 1993

8. World Health Organization: Reduction of Maternal Mortality. A Joint WHO/

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                                                                                  108
 Chapter-
 Chapter- Ten

ANNEXURES




                109
                               10. ANNEXURE

List of Annexure

  A.   Letter seeking permission to conduct the study

  B.   Letter granting permission to conduct the study

  C.   Letter seeking permission to conduct the study

  D.   Letter granting permission to conduct the study

  E.   Letter to experts for the content validity of the tool

  F.   Evaluation Criteria Check List

  G.   Certificate of content validity

  H.   List of content validators of the tool

  I.   Tools used for the study (English)

  J.   Tools used for the study (Kannada)

  K.   Correct Responses and Scoring key

  L.   Scores of Knowledge obtained by primigravidae.

  M.   Lesson plan for planned teaching program regarding selected aspects of safe

       motherhood.

  N.   Formulas used for statistical analysis.

  O.   Visual Aids used for planned teaching program.




                                                                                110
                                      Annexure-A

                  A Letter seeking permission to conduct the study

To,

        The Managing Director,

        Hope Health Care,

        Kolar.



                 Subject: Permission to conduct a study in selected hospitals of Kolar.

Sir/Madam,

        This is to introduce Ms. Anupama Tamrakar a final year student in our college.

She has to conduct a research project which is to be submitted to the Rajiv Gandhi

University of Health Sciences, Karnataka in partial fulfillment of University

requirement for the award of MSc (N) Degree.

        Topic: “A study to evaluate the effectiveness of Planned Teaching Program

on knowledge of primigravidae regarding selected aspect of safe motherhood in

selected hospitals in Kolar, Karnataka.”

        The student is in need of your esteemed help and co-operation as she is interested

in conducting her study in your hospital. Hence, I request you to kindly grant permission

and do the needful.

                                      Thanking you,

                                                                   Yours Faithfully,

Place: Kolar

Date:



                                                                                       111
                                  Annexure-B

                Letter Granting Permission to Conduct Study



From,

The Managing Director,

Hope Health Care,

Kolar, Karnataka.




               Subject: Permission granted to conduct a study in our hospital.



               With reference to the previous letter it has been informed that

Ms. Anupama Tamrakar, final year M.Sc Nursing student of Pavan College of

Nursing, granted permission to conduct her study in our hospital of Kolar district.



Thank you,



Place: Kolar                                                    Managing Director,

Date:                                                           Hope Health Care,

                                                                Kolar.




                                                                                      112
                                      Annexure-C

                  A Letter seeking permission to conduct the study

To,

        The Managing Director,

        Suguna Hospital,

        Kolar.



                 Subject: Permission to conduct a study in selected hospitals of Kolar.

Sir/Madam,

        This is to introduce Ms. Anupama Tamrakar a final year student in our college.

She has to conduct a research project which is to be submitted to the Rajiv Gandhi

University of Health Sciences, Karnataka in partial fulfillment of University

requirement for the award of MSc (N) Degree.

        Topic: “A study to evaluate the effectiveness of Planned Teaching Program

on knowledge of primigravidae regarding selected aspect of safe motherhood in

selected hospitals in Kolar, Karnataka.”

        The student is in need of your esteemed help and co-operation as she is interested

in conducting her study in your hospital. Hence, I request you to kindly grant permission

and do the needful.

                                      Thanking you,

                                                                        Yours Faithfully,

Place: Kolar

Date:



                                                                                      113
                                Annexure-D

               Letter Granting Permission to Conduct Study

 From,

 The Managing Director,

 Suguna Hospital,

 Kolar, Karnataka.



               Subject: Permission granted to conduct a study in our hospital.



               With reference to the previous letter it has been informed that

 Ms. Anupama Tamrakar, final year M.Sc Nursing student of Pavan College of

 Nursing, granted permission to conduct her study in our hospital of Kolar district.



Thank you,



Place: Kolar                                                   Managing Director,

Date                                                           Suguna Hospital,

                                                               Kolar.




                                                                                  114
                                           Annexure-E

             Letter to Experts to for the Content Validity of the Tool

From,
        Ms. Anupama Tamrakar,

        II Year MSc (N),

        Pavan College of Nursing, Kolar.

To,

        -------------------------------------------------------------

                 -------------------------------------------

                          ----------------------------

                 (Through the Principal, Pavan College of Nursing, Kolar.)

Respected Sir/Madam,

        Subject: Requesting the opinion and suggestions of experts for establishing

        content validity of the tool.

        I Ms. Anupama Tamrakar, II year M.Sc Nursing student in Pavan College of

Nursing, Kolar, humbly request you Madam/Sir to go through the tool which is to be

used for data collection for “A study to evaluate the effectiveness of Planned Teaching

Program on knowledge of primigravidae regarding selected aspect of safe motherhood in

selected hospitals in Kolar, Karnataka.” for further study.

The objectives of the study are the following:

 1. To assess the pre-existing knowledge of primigravidae regarding selected aspects of

      safe motherhood before planned teaching program.

 2. To plan, develop and to conduct the planned teaching program regarding selected

      aspects of safe motherhood for primigravidae of the experimental group.


                                                                                   115
 3. To evaluate the effectiveness of planned teaching program regarding selected

       aspects of safe motherhood in terms of gain in post-test knowledge scores of

       primigravidae when compared to their pretest scores.

 4. To compare the knowledge regarding selected aspects of safe motherhood between

       experimental and control group.

Here with I am enclosing a copy of

   a. Pretest Questionnaire

   b. Post test Questionnaire

   c. Lesson plan for planned teaching program on antenatal care

   d. Correct responses and scoring key

   e. Evaluation Criteria

   f. Content validity certificate

        I request you to kindly give your valuable suggestions regarding the

appropriateness of the tool, which I have enclosed.

        I also request you to kindly sign the certificate stating that you have validated the

tool. Your kind co-operation and your expert judgment will be very much appreciated.



                                         Thanking you,

                                                                     Yours faithfully,

                                                                     Anupama Tamrakar

Place : Kolar

Date    :




                                                                                         116
                               Annexure-F

                    Evaluation Criteria Checklist

  Areas         Opinion           Item No.          Suggestions



                Relevant



 Section A     Relevant to
Demographic   certain extent
   Data



              Not relevant




                Relevant




Section B      Relevant to
Knowledge     certain extent
 regarding
 antenatal
    care



              Not relevant




                                                                  117
                                Annexure-G


                       Certificate of Content Validity


   This is to certify that the tool developed by Ms. Anupama Tamrakar, final year

M.Sc Nursing student of Pavan College of Nursing, Kolar (affiliated to Rajiv Gandhi

University of Health Science) is validated by undersigned and can proceed with this

tool and conduct the main study for dissertation entitled “A study to evaluate the

effectiveness of    Planned Teaching Program on knowledge of primi gravidae

regarding selected aspect of safe motherhood in selected hospitals in Kolar,

Karnataka.”




Date:                                                               Signature

Place: Kolar




                                                                                118
                                   Annexure-H

               List of Content Validators of the prepared tool



Mrs. Suvarna B. Talwar
Lecturer,
Department of OBG
Government College of Nursing
Bangalore-2


Mrs. Lalitha H.
Lecturer,
Department of OBG
Government College of Nursing
Bangalore-2


Mrs. Tilagavathy
Lecturer,
Department of OBG
Oxford College of Nursing
J.P. Nagar, Bangalore-2


Mrs. Silvya
Lecturer,
Department of OBG
Tamaka, Kolar.


Mrs. Swapna Tom
MSc OBG
Vice-Principle
Co-operative College of Nursing,
Nattoor, P.O. Thalassery, Kerela




                                                                 114
Dr. G. Nagarathna
Professor,
Department of OBG
Sri Devraja Urs’ Medical College
Tamaka, Kolar.


Dr. S.R. Sheela
Professor,
Department of OBG
Sri Devraja Urs’ Medical College
Tamaka, Kolar.


Dr. Deepa K.V.
Professor,
Department of OBG
Sri Devraja Urs’ Medical College
Tamaka, Kolar.


Dr. Aparna M.V.
MBBS. PG (OBG)
Rama Krishna Nursing Home
Chintamani.


Mr. S. Ravi Shankar
Assistant Professor of Bio-Statistics
Department of Community Medicine
Sri Devraja Urs’ Medical College
Tamaka, Kolar.




                                        115
                                    Annexure-I
Code No.:
   Tool to Assess the Knowledge of Primigravidae regarding selected
                  aspects of safe motherhood (Questionnaire)

 Note: I, Ms. Anupama Tamrakar doing M.Sc Nursing final year at Pavan College of

 Nursing Kolar, as a part of my course requirement have taken up a research project, the

 completion of which depends upon your co-operation in the form of answering to this

 interview schedule. I will promise you that all the information collected from you will

 be kept very confidential and will be used for my study purpose only.

 Instructions: There are two sections in the questionnaire. Section A consists of

 demographic data and section B consists 39 items, related to the knowledge regarding

 the antenatal care. Each of the items has four responses. Researcher will read out the

 statements and responses. You are requested to responds with the correct response.

                           Section - A (Demographic Data)

   1. Age in year

            a. 20-24

            b. 25-29

            c. 30-34

            d. 35-40

   2. Religion

            a. Hindu

            b. Christian

            c. Muslim

            d. Others, specify……………………………..

                                                                                      116
3. Educational Status

       a. Illiterate

       b. Primary education (1-10th standard)

       c. Higher secondary (11-12th standard)

       d. Graduation and post graduation

4. Occupational Status

       a. Housewife

       b. Agriculture

       c. Government employee

       d. Private employee

5. Type of Family

       a. Single

       b. Joint

       c. Extended

6. Family income per month

       a. Less than Rs. 1,000

       b. Rs. 1,001-5,000

       c. Rs. 5,001-10,000

       d. More than Rs. 10,001

7. Age at marriage

       a. Less than 20 years

       b. 20-24 years

       c. 25-29 years

       d. 30-34 years

                                                117
8. Have you ever heard about antenatal care?

       a. Yes

       b. No

9. Sources of information

       c. Mass media

       d. Health personnel

       e. Elders and relatives

       f. Others, specify……………………………..

   Section-B (Questionnaire regarding selected aspects of Safe motherhood)

General Questions

1. What do you mean by antenatal care?

       a. Care given during delivery.

       b. Care given in the period from conception till delivery.

       c. Care given after the baby is born.

       d. Care given during illness in pregnancy.

2. Why antenatal care should be given?

       a. To provide measles vaccine to the mother.

       b. To provide medications for mother.

       c. To give care for the baby.

       d. To provide necessary advice to the mother.

3. What is pregnancy?

       a. A state of a woman from conception till delivery.

       b. A state of a woman from marriage till delivery.

       c. A state of a woman from first delivery to second delivery.

       d. A state of a woman during reproductive age.
                                                                             118
4. How can pregnancy be confirmed?

       a. By measuring blood pressure.

       b. By measuring height and weight.

       c. By doing urine test and immunological test

       d. By measuring pulse rate.

5. When will you feel fetal movement for the first time during pregnancy?

       a. 1-3 months.

       b. 4-5 months.

       c. 6-7 months

       d. 8-9 months

Questions regarding diet during pregnancy

6. Why diet is necessary during antenatal period?

       a. To treat the diseases in the mother.

       b. To prevent from nausea and vomiting.

       c. To prevent from hypertension.

       d. To maintain health of mother and baby.

7. Which type of diet is best during antenatal period?

       a. Low iron and calcium contained diet.

       b. Low protein and low calorie diet.

       c. Low salt and low spicy contained diet.

       d. High iron, calcium protein and vitamin contained diet




                                                                            119
8. Why extra protein contained diet is necessary during antenatal period?

       a. To increase the height of the mother.

       b. For growth of the fetus and development of new cells in the mother.

       c. To shorten the duration of pregnancy.

       d. To treat the diseases in mother and baby.

9. What are the sources of proteins?

       a. Meat, fish, poultry and dairy products.

       b. Green leafy vegetables.

       c. Fruits and dried fruits.

       d. Wheat and grains.

10. Why extra iron is necessary during antenatal period?

       a. For the formation of haemoglobin to carry oxygen.

       b. For the growth of the mother.

       c. To prevent constipation.

       d. To prevent mother from nausea and vomiting.

11. What are iron rich foods?

       a. Fish and sea food.

       b. Rice, tomato and milk.

       c. Green leafy vegetables, meat, eggs and dried fruits.

       d. Pulses, legumes and wheat.

12. Why calcium rich diet is necessary during pregnancy?

       a. To increase height of the mother.

       b. For skeletal growth of the fetus.

       c. To prevent from morning sickness.

       d. To prevent mother from headache
                                                                                120
13. What are the sources of calcium?

       a. Legumes, bread and fruits.

       b. Milk, cheese, tofu and green leafy vegetables.

       c. Nuts, cereals, grain, margarine and meat.

       d. Fish, liver, egg and pulses.

14. Why vitamin C is necessary during pregnancy?

       a. To increase the uterine size.

       b. To increase the milk secretion.

       c. To shorten the duration of pregnancy.

       d. For the development of fetus.

15. What are the sources of vitamin C?

       a. Meat, egg, milk and fish.

       b. Grains, cereals and legumes.

       c. Beans, carrot, ladies finger and radish.

       d. Citrus fruits, tomatoes, cabbage and potatoes.

16. Why vitamin A is necessary during pregnancy?

       a. To prevent jaundice.

       b. To prevent mother from nausea and vomiting.

       c. For the growth and development of the fetus.

       d. To increase height of the mother.




                                                           121
17. What are the sources of vitamin A?

       a. Grains and cereals

       b. Fruits and vegetables.

       c. Milk, curd and eggs

       d. Butter, cheese and yellow vegetables

Questions regarding personal hygiene

18. What type of clothes you should wear during pregnancy?

       a. Supportive and comfortable cotton clothes.

       b. Comfortable polyester clothes.

       c. Tight polyester clothes.

       d. Loose clothes.

19. How many times you should take bath during pregnancy?

       a. Once a day.

       b. Twice a day.

       c. Three times a day.

       d. Four times a day

20. What is the importance of breast care during pregnancy?

       a. To increase the milk secretion.

       b. To observe the size of the breast.

       c. To express the milk from the breast.

       d. To clean the breast and prepare for lactation.




                                                              122
Questions regarding antenatal checkup

   21. Who needs antenatal checkup?

          a. High risk mothers.

          b. All pregnant women.

          c. Women who has health problems.

          d. Women who are uneducated

   22. When should you visit the doctor for the first time during the pregnancy?

          a. After first missed period.

          b. After second missed period.

          c. After third missed period.

          d. After labor pain starts.

   23. How often you should go for antenatal checkup during first 7 months during

      pregnancy?

          a. Once a month.

          b. Twice a month.

          c. Three times a month

          d. Four times a month

   24. How often you should go for antenatal check up during 7-9 months during

      pregnancy?

          a. Once a month.

          b. Twice a month.

          c. Three times a month

          d. Four times a month




                                                                                    123
25. How often you should go for antenatal check up after 9 months during

   pregnancy?

       a. Four times in a week

       b. Three times in a week.

       c. Twice a week

       d. Once a week

Questions regarding immunization

26. What immunization you should take during pregnancy?

       a. Tetanus toxoid

       b. BCG

       c. DPT

       d. Measles

27. Why should you take injection TT?

       a. To prevent from Tuberculosis.

       b. To prevent form cold and cough.

       c. To prevent from headache.

       d. To prevent from tetanus.

28. How many doses of injection TT should be taken in first pregnancy?

       a. One

       b. Two

       c. Three

       d. Four




                                                                           124
29. How many doses of injection TT should be taken in subsequent pregnancy?

       a. One

       b. Two

       c. Three

       d. Four

30. When should the first dose of TT be taken during pregnancy?

       a. 1-3 months

       b. 4-6 months

       c. 7-9 months

       d. After 9 months

31. What is the interval between the two doses of TT?

       a. 3-4 weeks

       b. 4-6 weeks

       c. 6-8 weeks

       d. 8-10 weeks

Questions regarding other antenatal care

32. How many hours minimum you should take rest and sleep during pregnancy?

       a. 7 hours at night and 1 hour at day time.

       b. 7 hours at night 2 hours at day time

       c. 8 hours at night and 2 hours at day time.

       d. 8 hours at night and 3 hours at day time.




                                                                              125
33. When should you avoid traveling during pregnancy?

       a. During first and second trimester

       b. During second and third trimester

       c. During first and third trimester

       d. During first trimester and last 6 weeks in third trimester.

34. What physical activities you should avoid during pregnancy?

       a. Regular walking

       b. Regular household works

       c. Heavy lifting.

       d. Taking care of previous child

35. When should you avoid sexual intercourse during pregnancy?

       a. During first and third trimester

       b. During first trimester and last 6 weeks in third trimester.

       c. During second and third trimester

       d. During first and second trimester

36. Why should you avoid self medication during pregnancy?

       a. It may bring allergy to the mother.

       b. It may bring allergy to the fetus.

       c. It may bring maternal health problems.

       d. It may bring fetal abnormalities.




                                                                        126
37. What are warning signs during pregnancy?

       a. Bleeding through vagina.

       b. Swelling of face, arm and feet.

       c. Severe vomiting

       d. Vaginal bleeding, swelling of face, arm and feet are warning signs during

           pregnancy.

38. What should you do immediately if bleeding through vagina occurs during

   pregnancy?

       a. Take bed rest.

       b. Report to the doctor.

       c. Just wait till it stops.

       d. See a priest.

39. How can you know the fetal well being?

       a. By increase in the weight of the baby.

       b. By abdominal enlargement of the pregnant woman.

       c. By being healthy.

       d. By regular check up.




                                                                                127
                                                   Annexure-J

                                                     ¥Àæ±ÉßUÀ¼À
¸ÀÆZÀ£ÉUÀ¼ÀÄ:
           F ¥Àæ±ÉßUÀ¼À ¥ÀÄlUÀ¼À°è 39 «zsÀªÁzÀ jÃwAiÀÄ°è UÀ©üÃðtÂAiÀÄ DgÉÊPÉAiÀÄ §UÉÎ PÉýzÁgÉ,
DzÀgÀ°è         MAzÉÆAzÀÄ ¥Àæ±ÉßUÀÆ £Á®ÄÌ «zsÀªÁzÀ GvÀÛgÀUÀ½gÀÄvÀÛªÉ. ¸ÀA¨ÉÆÃzsÀ£ÉUÁgÀgÀÄ EzÀ£ÀÄß
N¢, CzÀPÉÌ ¤ÃªÀÅ vÀPÀÌAvÉ ¸ÀjAiÀiÁzÀ GvÀÛgÀ ¤ÃqÀ¨ÉÃPÁV PÉÆÃjzÉ.
       J-ªÀUÀð(d£ÁAUÀzÀ ªÀåPÀÛAiÀÄ §UÉÎ ªÀiÁqÀĪÀ ¸ÁªÀiÁfPÀ CzsÁåAiÀÄ£À zÁR¯ÉUÀ¼ÀÄ)
1. ªÀAiÀĸÀÄì ªÀµÀðUÀ¼À°è

           J.       20-24

           ©.       25-29

           ¹.       30-34

           r.       35-40

2. ªÀÄvÀ
           J.       »AzÀÄ
           ©.       PÉæöʸÀÛgÀÄ
           ¹.       ªÀÄĸÀ¯Áä£ÀgÀÄ
           r.       EvÀgÀgÀÄ. «ªÀj¹......................

3. «zsÁå¨sÁå¸À
           J.       C£ÀPÀëgÀ¸ÀÜ
           ©.       ¥ÁæxÀ«ÄPÀ ²PÀët [1-10£Éà vÀgÀUÀw]
           ¹.       G£ÀßvÀ ²PÀët [11-12£Éà vÀgÀUÀw]
           r.       ¥ÀzÀ« ªÀÄvÀÄÛ ¥ÀzÀ« £ÀAvÀgÀzÀ ²PÀët




                                                                                             128
4. GzÉÆåÃUÀ
         J.       ªÀÄ£É MqÀw
         ©.       ªÀåªÀ¸ÁAiÀÄ
         ¹.       ¸ÀPÁðj £ËPÀgÀ
         r.       SÁ¸ÀV £ËPÀgÀ

5. PÀÄlÄA§zÀ ªÀiÁzÀj
         J.       Man [«§PÀÛ]
         ©.       C«§PÀÛ [MlÄÖ PÀÄlÄA§]
         ¹.       ªÀÄÄAzÀĪÀgÉzÀ

6. PÀÄlÄA§zÀ ªÀiÁ¹PÀ DzÁAiÀÄ
         J.       1000 QAvÀ PÀrªÉÄ
         ©.       1001-5000
         ¹.       5001-10000
         r.       10001 QAvÀ ºÉZÀÄÑ

7. ªÀÄzsÀĪÉAiÀiÁzÀ ªÀAiÀĸÀÄì
         J.       20 ªÀµÀðQÌAvÀ PÀrªÉÄ
         ©.       20 jAzÀ 24 ªÀµÀð
         ¹.       25 jAzÀ 29 ªÀµÀð
         r.       30 jAzÀ 34 ªÀµÀð
8. ¤ÃªÀÅ AiÀiÁªÁUÁzÀgÀÄ UÀ©üðtÂAiÀÄzÀ DgÉÊPÉAiÀÄ §UÉÎ PÉý¹ PÉÆAr¢ÝgÁ?
         J.       ºËzÀÄ
         ©.       E®è




                                                                         129
9. ºËzÀÄ CAzÀgÉ, ªÀiÁ»wAiÀÄ ªÀÄÆ®
        J.     vÀAvÀæeÁÕ£ÀzÀ ªÀiÁ»w
        ©.       DgÉÆÃUÀÛ PÁAiÀÄðPÁj ªÀUÀð
        ¹.       zÉÆqÀتÀgÀÄ ªÀÄvÀÄÛ §AzsÀÄUÀ¼ÀÄ
        r.       EvÀgÀgÀ «ªÀj¹

                                 ªÀUÀð-© (¸ÁªÀiÁ£Àå ¥Àæ±ÉßUÀ¼ÀÄ)
1. UÀ©üðtÂAiÀÄ DgÉÊPÉ JAzÀgÉãÀÄ?
        J.       ¥Àæ¸ÀªÀ ¸ÀªÀÄAiÀÄzÀ°è PÉÆqÀĪÀ DgÉÊPÉ
        ©.       UÀ¨sÀðzsÁgÀuɬÄAzÀ ¥Àæ¸ÀªÀzÀ ¸ÀªÀÄAiÀĪÀgÉUÀÄ PÉÆqÀĪÀ DgÉÊPÉ
        ¹.       ªÀÄUÀÄ ºÀÄnÖzÀ £ÀAvÀgÀ PÉÆqÀĪÀ DgÉÊPÉ
        r.       UÀ©üðtÂAiÀÄ PÁ¬Ä¯É ¸ÀªÀÄAiÀÄzÀ°è PÉÆqÀĪÀ DgÉÊPÉ

2. UÀ©üðtÂAiÀÄ DgÉÊPÉAiÀÄ£ÀÄß KPÉ PÉÆqÀ¨ÉÃPÀÄ
        J.       vÁ¬ÄUÉ ¹qÀÄ§Ä ZÀÄZÀÄѪÀÄzÀÄÝ PÉÆqÀ®Ä
        ©.       vÁ¬ÄUÉ OµÀ¢üAiÀÄ£ÀÄß PÉÆqÀ®Ä
        ¹.       ªÀÄUÀÄ«£À DgÉÊPÉ ªÀiÁqÀ®Ä
        r.       vÁ¬ÄUÉ ¨ÉÃPÁzÀ ªÀiÁ»w PÉÆqÀ®Ä

3. UÀ¨sÁðªÀ¸ÉÜ JAzÀgÉãÀÄ?
                 J.       UÀ¨sÀðzsÁgÀuɬÄAzÀ ¥Àæ¸ÀªÀzÀªÀgÉV£À ¸ÀªÀÄAiÀÄ
                 ©.       ¹ÛçÃAiÀÄ ªÀÄzÀĪɬÄAzÀ ¥Àæ¸ÀªÀzÀªÀgÉV£À
                 ¹.       ¹ÛçÃAiÀÄ ªÉÆzÀ®£É ¥Àæ¸ÀªÀ¢AzÀ JgÀqÀ£Éà ¥Àæ¸ÀªÀzÀªÀgÉV£À ¸ÀªÀÄAiÀÄ
                 r.       ¥ËæqsÁªÀ¸ÉÜ/vÀgÀÄuÁªÀ¸ÉÜAiÀÄ ªÀAiÀĸÀÄì

 4. UÀ¨sÁðªÀ¸ÉÜAiÀÄ£ÀÄß ºÉÃUÉ zÀÈrüÃPÀj¸À§ºÀÄzÀÄ
                 J.       gÀPÀÛzÉÆvÀÛqÀ ¥ÀjÃPÉë¬ÄAzÀ
                 ©.       GzÀÝ ªÀÄvÀÄÛ vÀÆPÀ¢AzÀ
                 ¹.       gÀPÀÛ ªÀÄvÀÄÛ ªÀÄÆvÀæ ¥ÀjÃPÉë¬ÄAzÀ
                 r.       £Ár «ÄrvÀ¢AzÀ


                                                                                              130
5. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è ªÀÄUÀÄ«£À ¸ÀAZÀ®£ÉAiÀÄ£ÀÄß AiÀiÁªÁUÀ ¸Àé²ð¸À§ºÀÄzÀÄ
                J.      1 jAzÀ 3 wAUÀ¼ÀÄ
                ©.      4 jAzÀ 5 wAUÀ¼ÀÄ
                ¹.      6 jAzÀ 7 wAUÀ¼ÀÄ
                r.      8 jAzÀ 9 wAUÀ¼ÀÆ
UÀ¨sÁðªÀ¸ÉÜAiÀÄ DºÁgÀzÀ §UÉÎ ¥Àæ±ÉßUÀ¼ÀÄ

6. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è DºÁgÀzÀ ¥ÁæªÀÄÄRåvÉ K£ÀÄ?
                J.      vÁ¬ÄAiÀÄ PÁ¬Ä¯ÉAiÀÄ£ÀÄß ¤ªÁj¸À®Ä
                ©.      ªÁAw ªÀÄvÀÄÛ ªÁPÀjPÉ ¤°è¸À®Ä
                ¹.      C¢üPÀ gÀPÀÛzÉÆvÀÛqÀ PÀrªÉÄ ªÀiÁqÀ®Ä
                r.      vÁ¬ÄAiÀÄ ªÀÄvÀÄÛ ªÀÄUÀÄ«£À DgÉÆÃUÀå PÁ¥ÁqÀ®Ä

7. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è Cw ±ÉæõÀתÁzÀ DºÁgÀ AiÀiÁªÀÅzÀÄ
                J.      PÀrªÉÄ PÀ©âuÁA±À ªÀÄvÀÄÛ PÁå°ìAiÀÄAAiÀÄÄPÀÛ DºÁgÀ
                ©.      PÀrªÉÄ ¥ÉÆæÃn£ï ªÀÄvÀÄÛ PÁå®jAiÀÄÄPÀÛ DºÁgÀ
                ¹.      PÀrªÉÄ G¥ÀÄà, ªÀÄvÀÄÛ PÀrªÉÄ ªÀĸÁ®AiÀÄÄPÀÛ DºÁgÀ
                r.      C¢üPÀ PÀ©âuÁA±À, PÁå°ìAiÀÄA, ¥ÉÆæÃn£ï ªÀÄvÀÄÛ «l«Ä£ïAiÀÄÄPÀÛ DºÁgÀ

8. UÀ©üðuÁªÀ¸ÉÜAiÀÄ C¢üPÀ ¥ÉÆæÃn£ïAiÀÄÄPÀÛ DºÁgÀ KPÉ ¨ÉÃPÀÄ?
                J.      vÁ¬ÄAiÀÄ vÀÆPÀ ºÉaѸÀ®Ä
                ©.      ªÀÄUÀÄ«£À ¨É¼ÀªÀtÂUÉ ªÀÄvÀÄÛ vÁ¬ÄAiÀÄ ºÉƸÀ fêÁtÄUÀ¼À GvÀéwÛUÁV
                ¹.      UÀ¨sÁðªÀ¸ÉÜAiÀÄ ¸ÀªÀÄAiÀĪÀ£ÀÄß PÀrªÉĪÀiÁqÀ®Ä
                r.      vÁ¬Ä ªÀÄvÀÄÛ ªÀÄUÀÄ«£À PÁ¬Ä¯ÉUÀ¼À£ÀÄß ¤ªÁj¸À®Ä

9. ¥ÉÆæÃn£ïUÀ¼À ªÀÄÆ®UÀ¼ÀÄ AiÀiÁªÀŪÀÅ?
                J.      ªÀiÁA¸À, «ÄãÀÄ, PÉÆý ªÀiÁA¸À, ªÀÄvÀÄÛ ºÁ°£À GvÀé£ÀßUÀ¼ÀÄ
                ©.      ºÀ¹gÀÄ vÀgÀPÁjUÀ¼ÀÄ ªÀÄvÀÄÛ ¸ÉÆ¥ÀÄà
                ¹.      MtºÀtÄÚUÀ¼ÀÄ ªÀÄvÀÄÛ ºÀtÄÚUÀ¼ÀÄ
                r.      UÉÆâü ªÀÄvÀÄÛ zsÁ£ÀåUÀ¼ÀÄ


                                                                                             131
 10. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è PÀ©âtAiÀÄÄPÀÛ DºÁgÀ KPÉ ¨ÉÃPÀÄ?
                J.       gÀPÀÛPÀgÀtUÀ½AzÀ DªÀÄèd£ÀPÀªÀ£ÀÄß ¸ÁV¸À®Ä
                ©.       vÁ¬ÄAiÀÄ ¨É¼ÀªÀtÂUÉUÁV
                ¹.       ªÀÄ®§zÀÞvÉAiÀÄ£ÀÄß vÀqÉAiÀÄ®Ä
                r.       vÁ¬ÄAiÀÄ£ÀÄß ªÁAw ªÀÄvÀÄÛ ªÁPÀjPÉ vÀqÉAiÀÄ®Ä

 11. PÀ©âtAiÀÄÄPÀÛ DºÁgÀUÀ¼ÀÄ AiÀiÁªÀŪÀÅ?
                J.       «ÄãÀÄ ªÀÄvÀÄÛ PÀqÀ®Ä/¸ÀªÀÄÄzÀæzÀ DºÁgÀ
                ©.       CQÌ, mÉÆêÀiÁmÉÆ ªÀÄvÀÄÛ ºÁ®Ä
                ¹.       ºÀ¹gÀÄ ¸ÉÆ¥ÀÄà vÀgÀPÁjUÀ¼ÀÄ, ªÀiÁA¸À, ªÉÆmÉÖ ªÀÄvÀÄÛ MtºÀtÄÚUÀ¼ÀÄ
                r.       UÉÆâü, zsÁå£Àå ªÀÄvÀÄÛ ¨ÉüÉUÀ¼ÀÄ

 12. PÁå°ìAiÀÄAAiÀÄÄPÀÛ DºÁgÀ UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è KPÉ ¨ÉÃPÀÄ?
                J.       vÁ¬ÄAiÀÄ GzÀÞ/ ºÉaѸÀ®Ä
                ©.       ªÀÄUÀÄ«£À ªÀÄƼÉ/ C¹ÜAiÀÄ ¨É¼ÀªÀtÂUÉUÁV
                ¹.       ªÀÄÄAeÁ£ÉAiÀÄ D¸Àé¸ÀÜ        [ªÁPÀjPÉ & ªÁAw] vÀqÉAiÀÄ®Ä
                r.       vÁ¬ÄAiÀÄ£ÀÄß vÀ¯É£ÉÆë¤AzÀ gÀQë¸À®Ä

13. PÁå°ìAiÀÄA£À ªÀÄÆ®UÀ¼ÀÆ AiÀiÁªÀŪÀÅ?
                J.       zsÁ£ÀåUÀ¼ÀÄ & ºÀtÄÚUÀ¼ÀÄ
                ©.       ºÁ®Ä, PÉ£É ªÀÄvÀÄÛ ºÀ¹gÀÄ ¸ÉÆ¥ÀÄà vÀgÀPÁjUÀ¼ÀÄ
                ¹.       PÁ¼ÀÄUÀ¼ÀÄ, zsÁ£ÀåUÀ¼ÀÄ ªÀÄvÀÄÛ ªÀiÁA¸À
                r.       «ÄãÀÄ, ªÉÆmÉÖ, zsÁ£ÀåUÀ¼ÀÄ ªÀÄvÀÄÛ AiÀÄPÀÈvï/¦vÀÛ d£ÀPÁAUÀ [°ªÀgï]

14. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è ¹-fêÀ¸ÀvÀézÀ ¥ÁæªÀÄÄRåvÉ K£ÀÄ?
                J.       UÀ¨sÀðzÀ C¼ÀvÉ ºÉaѸÀ®Ä
                ©.       ºÁ°£À GvÀéwÛ ºÉaѸÀ®Ä
                ¹.       UÀ¨sÁðªÀ¸ÉÜAiÀÄ ¸ÀªÀÄAiÀÄ PÀrªÉĪÀiÁqÀ®Ä
                r.       ªÀÄUÀÄ«£À ¨É¼ÀªÀtÂUÉUÁV




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15. ¹-fêÀ¸ÀvÀézÀ ªÀÄÆ®UÀ¼ÀÄ AiÀiÁªÀŪÀÅ?
                  J.       ªÀiÁA¸À, ªÉÆnÖ, ºÁ®Ä ªÀÄvÀÄÛ «ÄãÀÄ
                  ©.       PÁ¼ÀÄUÀ¼ÀÄ ªÀÄvÀÄÛ zsÁ£ÀåUÀ¼ÀÄ
                  ¹.       PÉA¥ÀĪÀÄÆ®AV, ¨ÉAqÉPÁ¬Ä, ºÀÄgÀ½PÁ¬Ä ªÀÄvÀÄÛ ©ÃmïgÉÆmï
                  r.       ºÀĽ¬ÄgÀĪÀ ºÀtÄÚUÀ¼ÀÄ, mÉƪÀiÁmÉÆ, J¯ÉPÉÆøÀÄ ªÀÄvÀÄÛ D®ÆUÀqÉØ

 16. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è J-fêÀ¸ÀvÀézÀ ¥ÁæªÀÄÄRåvÉ K£ÀÄ?
                  J.       PÁªÀiÁ¯ÉAiÀÄ£ÀÄ vÀqÉAiÀÄ®Ä
                  ©.       vÁ¬ÄAiÀÄ£ÀÄß ªÁPÀjPÉ ªÀÄvÀÄÛ ªÁAw¬ÄAzÀ vÀqÉAiÀÄ®Ä
                  ¹.       ªÀÄUÀÄ«£À ¨É¼ÀªÀtÂUÉUÁV
                  r.       vÁ¬ÄAiÀÄ GzÀÝ ºÉaѸÀ®Ä

 17. J-fêÀ¸ÀvÀézÀ ªÀÄÆ®UÀ¼ÀÄ AiÀiÁªÀŪÀÅ?
                  J.       PÁ¼ÀÄUÀ¼ÀÄ ªÀÄvÀÄÛ zsÁ£ÀåUÀ¼ÀÄ
                  ©.       ºÀtÄÚUÀ¼ÀÄ ªÀÄvÀÄÛ vÀgÀPÁjUÀ¼ÀÄ
                  ¹.       ºÁ®Ä, ªÉƸÀgÀÄ ªÀÄvÀÄÛ ªÉÆmÉÖ
                  r.       ¨ÉuÉÚ, PÉ£É ªÀÄvÀÄÛ ºÀ¼À¢ vÀgÀPÁjUÀ¼ÀÄ
ªÉÊAiÀÄQÛPÀ ¸ÀéZÀÒvÉAiÀÄ §UÉÎ ¥Àæ±ÉßUÀ¼ÀÄ

  18. AiÀiÁªÀ vÀgÀºÀzÀ GqÀÄ¥ÀÄ/§mÉÖUÀ¼À£ÀÄß UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è zsÀj¸À¨ÉÃPÀÄ?
                  J.       ¸ÀÄgÀPÀëuÉ ªÀÄvÀÄÛ ¸ËRå GuÉÚ§mÉÖUÀ¼À£ÀÄß zsÀj¸À¨ÉÃPÀÄ
                  ©.       ¸ËRå ¥Á°¸ÀÖgï GqÀÄ¥ÀÄUÀ¼ÀÄ
                  ¹.       ©VAiÀiÁzÀ ¥Á°¸ÀÖgï GqÀÄ¥ÀÄUÀ¼ÀÄ
                  r.       ¸Àr®ªÁzÀ GqÀÄ¥ÀÄUÀ¼ÀÄ

 19. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è JµÀÄÖ ¸À® ¸ÁߣÀ ªÀiÁqÀ¨ÉÃPÀÄ
                  J.       ¢£ÀPÉÌ MAzÀÄ ¨Áj
                  ©.       ¢£ÀPÉÌ JgÀqÀÄ ¨Áj
                  ¹.       ¢£ÀPÉÌ ªÀÄÆgÀÄ ¨Áj
                  r.       ¢£ÀPÉÌ £Á®ÄÌ ¨Áj


                                                                                             133
  20. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è ªÉƯÉAiÀÄ DgÉÊPÉAiÀÄ ¥ÁæªÀÄÄRåvÉ K£ÀÄ?
                J.       ºÁ°£À GvÀéwÛ ºÉaѸÀ®Ä
                ©.       ªÉƯÉAiÀÄ C¼ÀvÉAiÀÄ£ÀÄß ¥ÀjÃQë¸À®Ä
                ¹.       ªÉƯɬÄAzÀ ºÁ®£ÀÄß vÉUɸÀ®Ä
                r.       ªÉƯÉAiÀÄ£ÀÄß ¸ÀéZÀÒUÉƽ¸À®Ä ªÀÄvÀÄÛ ºÁ°£À GvÀéwÛUÁV
UÀ¨sÁðªÀ¸ÉÜAiÀÄ ¥ÀjÃPÉëAiÀÄ §UÉÎ ¥Àæ±ÉßUÀ¼ÀÄ

 21. UÀ¨sÁðªÀ¸ÉÜAiÀÄ ¥ÀjÃPÉë AiÀiÁjUÉ ¨ÉÃPÀÄ?
                J.       ºÉaÑ£À C¥ÁAiÀÄ«gÀĪÀ vÁAiÀÄA¢jUÉ
                ©.       J®è UÀ©üðtÂAiÀÄjUÉ
                ¹.       DgÉÆÃUÀå vÉÆAzÀgÉUÀ½AzÀ vÁAiÀÄA¢AiÀÄjUÉ
                r.       C£ÀPÀëgÀ¸ÉÜ vÁ¬ÄUÉ

22. UÀ©üðtÂAiÀiÁVzÁÝUÀ AiÀiÁªÁUÀ ªÉÆzÀ®¨ÁjUÉ ªÉÊzÀågÀ£ÀÄß ¨sÉÃnAiÀiÁUÀÄwÛÃj?
                J.       ªÉÆzÀ® ªÀÄÄlÄÖ vÀ¦àzÀ/¤AvÀ £ÀAvÀgÀ
                ©.       JgÀqÉ£É ªÀÄÄlÄÖ vÀ¦àzÀ £ÀAvÀgÀ
                ¹.       ªÀÄÆgÀ£É ªÀÄÄlÄÖ vÀ¦àzÀ £ÀAvÀgÀ
                r.       ºÉjUÉ £ÉÆë£À ¥ÁægÀA¨sÀzÀ £ÀAvÀgÀ

 23. UÀ¨sÁðªÀ¸ÉÜAiÀÄ ªÉÆzÀ®Ä 7 wAUÀ½£À°è JµÀÄÖ ¸À® ¥ÀjÃPÉëUÉ ºÉÆÃUÀ¨ÉÃPÀÄ?
                J        wAUÀ½UÉ MAzÀÄ ¸À®
                ©.       wAUÀ½UÉ JgÀqÀÄ ¸À®
                ¹.       wAUÀ½UÉ ªÀÄÆgÀÄ ¸À®
                r.       wAUÀ½UÉ £Á®ÄÌ ¸À®

  24. UÀ¨sÁðªÀ¸ÉÜAiÀÄ 7 jAzÀ 9 wAUÀ½£ÀªÀgÉUÉ JµÀÄÖ ¸À® ¥ÀjÃPÉëUÉ ºÉÆÃUÀ¨ÉÃPÀÄ?
                J.       wAUÀ½UÉ MAzÀÄ ¨Áj
                ©.       wAUÀ½UÉ JgÀqÀÄ ¨Áj
                ¹.       wAUÀ½UÉ ªÀÄÆgÀÄ ¨Áj
                r.       wAUÀ½UÉ £Á®ÄÌ ¨Áj


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  25. UÀ¨sÁðªÀ¸ÉÜAiÀÄ 9£Éà wAUÀ½£À°è JµÀÄÖ ¨Áj ¥ÀjÃPÉëUÉ ºÉÆÃUÀ¨ÉÃPÀÄ?
                J.       ªÁgÀPÉÌ MAzÀÄ ¨Áj
                ©.       ªÁgÀPÉÌ JgÀqÀÄ ¨Áj
                ¹.       ªÁgÀPÉÌ ªÀÄÆgÀÄ ¨Áj
                r.       ªÁgÀPÉÌ £Á®ÄÌ ¨Áj

26. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è AiÀiÁªÀ ®¹PÉAiÀÄ£ÀÄß vÉUÉzÀÄPÉƼÀî¨ÉÃPÀÄ?
                J.       mÉmÁ£À¸ï mÁPÁìAiÀiïØ
                ©.       ©. ¹. f.
                ¹.       r. ¦. N
                r.       «ÄøÀ®ì [zÀqÁgÀ]

   27. n. n ®¹PÉAiÀÄ KPÉ vÉUÉzÀÄPÉƼÀî¨ÉÃPÀÄ?
                J.       PÀëAiÀÄgÉÆÃUÀªÀ£ÀÄß ¤ªÁj¸À®Ä
                ©.       £ÉUÀr ªÀÄvÀÄÛ PɪÀÄä£ÀÄß ¤ªÁj¸À®Ä
                ¹.       vÀ¯É£ÉÆêÀ£ÀÄß ¤ªÁj¸À®Ä
                r.       mÉmÁ£À¸ïC£ÀÄß ¤ªÁj¸À®Ä

   28. ªÉÆzÀ®£É UÀ¨sÁðªÀ¸ÉÜAiÀÄ JµÀÄÖ n. n. ZÀÄZÀÄѪÀÄzÀÄÝ        PÉÆr¹PÉƼÀî¨ÉÃPÀÄ?
                J.       MAzÀÄ
                ©.       JgÀqÀÄ
                ¹.       ªÀÄÆgÀÄ
                r.       £Á®ÄÌ

  29. vÀgÀĪÁAiÀÄ/£ÀAvÀgÀzÀ UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è JµÀÄÖ n.n. ®¹PÉ vÉUÉzÀÄPÉƼÀî¨ÉÃPÀÄ?
                J.       MAzÀÄ
                ©.       JgÀqÀÄ
                ¹.       ªÀÄÆgÀÄ
                r.       £Á®ÄÌ




                                                                                       135
 30. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è ªÉÆzÀ® n.n ZÀÄZÀÄѪÀÄzÀÝ£ÀÄß AiÀiÁªÁUÀ PÉÆr¹PÉƼÀî¨ÉÃPÀÄ?
             J.       MAzÀjAzÀ ªÀÄÆgÀÄ wAUÀ¼ÀÄ
             ©.       £Á®ÌjAzÀ DgÀÄ wAUÀ¼ÀÄ
             ¹.       K¼ÀjAzÀ MA§vÀÄÛ wAUÀ¼ÀÄ
             r.       MA§vÀÄÛ wAUÀ¼ÀÄ £ÀAvÀgÀ

31. JgÀqÀÄ n.n. ZÀÄZÀÄѪÀÄzÀÄÝUÀ¼À £ÀqÀÄ«£À CAvÀgÀ J¶ÖgÀ¨ÉÃPÀÄ?
             J.       3-4 ªÁgÀUÀ¼ÀÄ
             ©.       4-6 ªÁgÀUÀ¼ÀÄ
             ¹.       6-8 ªÁgÀUÀ¼ÀÄ
             r.       8-10 ªÁgÀUÀ¼ÀÄ

32. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è JµÀÄÖ UÀAmÉUÀ¼À PÁ® «±ÁæAw ªÀÄvÀÄÛ ¤zÉÝ ¨ÉÃPÀÄ?
             J.       gÁwæAiÀÄ°è 7 UÀAmÉ ªÀÄvÀÄÛ ºÀUÀ®°è 1 UÀAmÉ ºÉÆvÀÄÛ
             ©.       gÁwæAiÀÄ°è 7 UÀAmÉ ªÀÄvÀÄÛ ºÀUÀ®°è 2 UÀAmÉUÀ¼À PÁ®
             ¹.       gÁwæAiÀÄ°è 8 UÀAmÉ ªÀÄvÀÄÛ ºÀUÀ®°è 2 UÀAmÉUÀ¼À PÁ®
             r.       gÁwæAiÀÄ°è 8 UÀAmÉ ªÀÄvÀÄÛ ºÀUÀ®°è 3 UÀAmÉUÀ¼À PÁ®

33. UÀ¨sÁðªÀ¸ÉÜAiÀÄ ¥ÀæAiÀiÁtªÀ£ÀÄß AiÀiÁªÁUÀ vÀqÉAiÀĨÉÃPÀÄ?
             J.       ªÉÆzÀ®£É 3 wAUÀ¼À°è ªÀÄvÀÄÛ £ÀAvÀgÀzÀ 3 wAUÀ¼À°è
             ©.       JgÀqÀ£É 3 wAUÀ¼À°è ªÀÄvÀÄÛ PÉÆ£ÉAiÀÄ 3 wAUÀ¼À°è
             ¹.       ªÉÆzÀ®£É ªÀÄvÀÄÛ PÉÆ£ÉAiÀÄ 3 wAUÀ¼ÀÄUÀ¼À°è
             r.       ªÉÆzÀ®£É 3 wAUÀ¼ÀÄ ªÀÄvÀÄÛ PÉÆ£ÉAiÀÄ 3 wAUÀ¼À°è 6 ªÁgÀUÀ¼À°è

34. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è AiÀiÁªÀ ¨sËwPÀ ZÀlĪÀnPÉUÀ¼À£ÀÄß vÀqÉAiÀĨÉÃPÀÄ?
             J.       ¤gÀAvÀgÀ NqÁl
             ©.       ¤gÀAvÀgÀ ªÀÄ£É PÉ®¸À
             ¹.       ¨sÁgÀ/ vÀÆPÀ JvÀÄÛªÀÅzÀÄ
             r.       ªÉÆzÀ® ªÀÄUÀÄ«£À DgÉÊPÉ




                                                                                     136
35. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è AiÀiÁªÁUÀ ¸ÀA¨sÉÆÃUÀªÀ£ÀÄß ¤°è¸À¨ÉÃPÀÄ?
              J.       ªÉÆzÀ® ªÀÄÆgÀÄ ªÀÄvÀÄÛ PÉÆ£ÉAiÀÄ 3 wAUÀ¼ÀÄ
              ©.       ªÉÆzÀ® ªÀÄÆgÀÄ wAUÀ¼ÀÄ ªÀÄvÀÄÛ PÉÆ£ÉAiÀÄ 3 wAUÀ¼À 6 ªÁgÀUÀ¼ÀÄ
              ¹.       JgÀqÀ£É ªÀÄÆgÀÄ [3-6 wAUÀ¼ÀÄ] ªÀÄvÀÄÛ PÉÆ£ÉAiÀÄ 3 wAUÀ¼ÀÄ
              r.       ªÉÆzÀ® ªÀÄÆgÀÄ ªÀÄvÀÄÛ JgÀqÀ£É ªÀÄÆgÀÄ wAUÀ¼ÀÄ

36. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è ¸ÀéAvÀ aQvÉìAiÀÄ£ÀÄß KPÉ vÀqÉAiÀĨÉÃPÀÄ?
              J.       EzÀjAzÀ vÁ¬ÄUÉ vÀÄjPÉ/ ¥ÀæwQæAiÉÄ §gÀ§ºÀÄzÀÄ
              ©.       EzÀjAzÀ ªÀÄUÀÄ«UÉ C®fð
              ¹.       EzÀjAzÀ vÁ¬ÄUÉ PÁ¬Ä¯ÉUÀ¼ÀÄ §gÀ§ºÀÄzÀÄ
              r.       ªÀÄUÀÄ«UÉ CAUÀ«PÀ®vÉ §gÀ§ºÀÄzÀÄ

37. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è£À JZÀÑjPÉAiÀÄ aºÉßUÀ¼ÀÄ AiÀiÁªÀŪÀÅ?
              J.       d£À£ÁAUÀ¢AzÀ gÀPÀÛ¸ÁæªÀ
              ©.       ªÀÄÄR, PÉÊPÁ®ÄUÀ¼À HvÀ
              ¹.       C¢üPÀ ªÁAw
              r.       ªÉÄð£À J®è

38. UÀ¨sÁðªÀ¸ÉÜAiÀÄ°è d£À£ÁAUÀzÀ gÀPÀÛ¸ÁæªÀzÀ vÀPÀët K£ÀÄ ªÀiÁqÀ¨ÉÃPÀÄ?
              J.       «±ÁæAw vÉUÉzÀÄPÉƼÀî¨ÉÃPÀÄ
              ©.       ªÉÊzÀåjUÉ w½¸ÀĪÀÅzÀÄ
              ¹.       ¤®èªÀªÀgÉUÀÄ PÁAiÀÄĪÀÅzÀÄ
              r.       ¥ÀArvÀgÀÄUÀ½UÉ w½¸ÀĪÀÅzÀÄ.

39. ªÀÄUÀÄ«£À AiÉÆÃUÀPÉëêÀĪÀ£ÀÄß ºÉÃUÉ w½AiÀħºÀÄzÀÄ?
              J.       ªÀÄUÀÄ«£À vÀÆPÀ ºÉZÁÑUÀĪÀÅzÀjAzÀ
              ©.       UÀ©üðt vÁ¬ÄAiÀÄ ºÉÆmÉÖAiÀÄ ¸ÀÄvÀÛ¼ÀvɬÄAzÀ
              ¹.       DgÉÆÃUÀåªÁVgÀĪÀÅzÀjAzÀ
              r.       ¤gÀAvÀgÀ ¥ÀjÃPÉë¬ÄAzÀ.




                                                                                       137
                     Annexure-K

           Correct Responses and Scoring Key
Item No.       Correct response            Score
   1                  b                        1
   2                  d                        1
   3                  a                        1
   4                  c                        1
   5                  b                        1
   6                  d                        1
   7                  d                        1
   8                  b                        1
   9                  a                        1
  10                  a                        1
  11                  c                        1
  12                  b                        1
  13                  b                        1
  14                  d                        1
  15                  d                        1
  16                  c                        1
  17                  d                        1
  18                  a                        1
  19                  a                        1
  20                  d                        1
  21                  b                        1
  22                  a                        1
  23                  a                        1
  24                  b                        1
  25                  c                        1
  26                  a                        1
  27                  d                        1
  28                  c                        1
  29                  b                        1
  30                  b                        1
  31                  b                        1
  32                  c                        1
  33                  d                        1
  34                  c                        1
  35                  b                        1
  36                  d                        1
  37                  d                        1
  38                  b                        1
  39                  d                        1


                                                   138
                                                                                                                            ANNEXURE - L

                 Section- A (Demographic data)                                                                                             Pre Test Score of Experimental Group




                                                                                                              Information
                                                                                                                on ANC
                                                                                           Age at marriage
                                                          Type of Family
Respondent No




                                                                           Family Income
                                             Occupation
                                 Education
                      Religion
                Age
                                                                                                                                  General
                                                                                                                                 Questions                          Questions regarding Diet




                                                                                                                   Source
                                                                                                             P/A
                                                                                                                            1    2    3    4    5    6    7    8     9    10   11   12 13   14    15 16   17
1                A       A           B           A              A               A                B            A       C     0    1    1    1    1    1    1    1     1    0    1    1   1   1     1   0   0
2                A       A           D           A              B               B                B            A       C     1    0    1    1    0    1    1    0     0    1    1    1   0   1     0   0   0
3                B       A           B           A              A               B                B            A       C     1    0    1    1    1    1    1    1     1    1    1    1   0   0      0 0    0
4                A       A           B           A              A               B                B            A       B     1    0    1    1    0    1    1    1     1    1    0    1   0   0     0   0   0
5                A       A           B           A              B               B                B            A       B     1    1    0    1    0    1    1    1     1    0    1    1   0   0     0   1   0
6                A       A           C           A              C               A                A            A       B     1    0    1    1    0    1    1    1     1    1    1    1   0   0     0   1   0
7                B       A           B           A              B               B                B            A       B     1    0    0    1    1    1    1    1     1    0    1    1   0   0     0   1   0
8                B       A           B           A              B               B                B            A       B     1    0    1    1    1    0    1    0     0    0    1    1   1   1     0   0   0
9                A       A           B           B              B               B                A            A       B     1    1    1    1    0    0    1    1     1    0    1    1   0   0     0   1   0
10               A       A           B           A              A               B                A            A       B     1    1    1    1    0    1    1    1     1    1    1    1   1   1     0   1   0
11               A       A           B           A              B               B                B            A       C     1    0    1    1    0    1    1    1     1    1    0    1   0   0     0   0   0
12               A       A           B           A              A               B                A            B       -     0    0    0    0    0    1    1    1     0    1    1    1   0   1     0   0   1
13               C       A           C           B              B               D                C            A       C     1    0    1    1    0    1    1    1     0    1    1    1   1   1     0   1   0
14               A       A           C           A              B               B                B            A       B     0    0    1    1    1    1    1    1     1    1    1    1   1   0     0   1   0
15               A       A           C           A              A               C                A            A       C     1    0    1    1    0    1    1    1     1    1    1    1   1   0     0   1   0
16               A       A           B           B              B               B                B            A       C     1    0    0    1    0    0    1    1     1    1    1    0   1   0     0   1   1
17               B       A           B           B              A               B                B            B       -     1    0    1    1    0    1    1    0     0    0    1    1   0   0     0   1   0
18               A       A           B           B              A               B                A            B       -     1    0    0    1    1    0    0    1     1    0    1    0   0   0     0   1   0
19               A       A           B           A              B               B                A            A       C     1    0    1    1    0    1    0    0     1    1    0    1   0   1     0   1   0
20               A       A           B           A              A               B                A            A       C     1    1    1    1    1    0    1    1     0    0    1    0   1   1     0   1   1
21               A       A           B           A              B               A                A            A       C     1    1    1    1    1    1    1    0     1    0    0    1   1   1     0   1   0
22               B       A           B           D              A               B                B            A       C     1    1    1    1    1    1    0    0     1    0    0    1   0   1     0   1   0
23               A       A           D           C              B               B                B            A       C     1    0    1    1    1    1    1    1     1    1    1    1   0   0     0   1   0
24               A       A           B           A              B               B                A            B       -     1    0    1    0    1    1    1    1     0    0    0    1   0   1     0   0   0
25               A       A           B           B              B               C                B            B       -     1    0    1    1    0    1    1    0     0    1    0    0   0   1     0   0   0
26               A       A           B           A              A               B                A            A       C     1    1    1    0    0    0    1    0     0    0    0    1   1   0     0   1   0
27               B       A           B           B              B               B                B            A       C     1    1    1    1    1    1    0    0     1    0    0    1   0   1     0   1   0
28               A       A           B           A              B               B                A            A       C     1    0    1    1    1    1    1    0     0    0    1    1   0   1     0   1   0
29               A       A           A           A              B               B                A            B       -     1    0    1    1    0    1    1    0     0    1    1    1   0   1     0   0   0
30               A       A           B           B              B               B                A            A       B     1    0    1    1    1    1    1    0     0    0    1    1   1   1     0   1   0
31               A       A           B           A              A               B                A            B       -     1    0    1    1    1    1    1    0     0    0    0    1   0   1     0   1   0
32               A       A           C           A              A               B                B            A       C     1    0    1    1    1    1    1    1     1    1    1    1   0   1     0   1   0
33               A       A           B           B              B               C                A            B       -     1    0    0    1    0    1    1    0     1    0    1    1   0   1     1   1   0
34               B       A           C           A              B               B                B            A       C     1    1    1    1    1    1    0    0     1    0    0    1   0   1     0   1   0
35               A       A           B           A              A               B                B            A       B     1    1    1    1    1    1    0    0     1    0    0    1   0   1     0   1   0
36               A       A           B           A              B               B                A            A       C     1    1    1    1    0    1    0    0     1    0    0    1   0   1     0   1   0
37               A       A           B           B              B               B                A            A       C     1    1    1    1    1    1    0    0     1    0    0    1   0   1     0   1   0
38               B       A           B           A              A               B                A            B       -     1    0    1    1    1    1    1    0     0    0    0    1   0   1     0   1   0
39               A       A           A           A              A               B                B            B       -     1    0    1    1    1    1    1    0     0    0    1    1   0   1     0   1   0
40               B       A           B           B              A               B                B            A       C     1    0    1    1    0    1    1    0     1    0    1    1   0   1     0   0   0
41               A       A           A           A              B               B                A            A       C     1    1    1    1    1    1    1    0     1    1    0    0   1   1     0   0   0
42               A       A           A           B              B               B                A            B       -     1    0    1    1    0    1    1    1     0    1    0    1   1   0     0   1   0
43               A       A           B           A              B               B                A            A       C     1    0    1    1    1    1    1    1     1    1    1    1   0   1     0   1   0
44               A       A           B           A              B               C                A            A       B     1    0    1    1    0    1    1    0     0    0    1    1   1   1     0   0   0
45               A       A           B           A              A               B                A            A       C     1    1    1    1    1    1    1    0     0    1    1    1   0   0     0   1   0
46               B       A           B           B              A               B                B            A       C     1    0    1    0    0    1    1    1     0    1    1    1   1   0     0   1   0
47               A       A           B           B              A               B                B            B       -     1    0    1    0    0    0    1    0     0    0    1    1   0   1     0   0   0
48               B       A           B           A              B               C                C            A       B     1    0    1    1    0    1    1    1     0    1    1    1   0   1     0   1   0
49               B       C           C           A              A               C                B            A       C     1    0    1    1    0    1    1    1     0    0    1    1   0   1     0   1   0
50               A       A           B           A              A               B                A            B       -     1    0    1    0    1    0    1    1     0    1    1    0   1   0     0   1   0
                                                                                                                            47   15   44   44   25   42   42   25    27   23   33   44 16   32     2 36   3


                                                                                                                                                                                                 139
                                                 Pre Test Score
 Questions
  regarding
  Personal        Questions regarding          Questions regarding          Questions regarding Other Antenatal
   Hygiene        Antenatal Checkup               Immunization                             Care
18 19 20        21 22 23 24 25            26   27 28 29 30           31   32 33 34 35 36 37 38 39                   Total
0     1     1   1    1    1     0     0   1     1    0     0    1    0    0    0    0     0    0    0     1     1    23
0     1     1   1    1    1     1     0   1     1    1     1    0    1    1    1    1     0    1    1     1     1    27
1     1     1   1    0    0     0     0   1     1    1     0    1    0    0    0    1     0    1    1     1     1    24
0     1     1   1    1    1     1     0   1     1    0     1    0    1    1    0    1     0    0    1     1     0    23
1     1     1   0    1    1     1     0   1     1    1     0    0    1    1    0    1     0    0    0     1     1    24
1     1     1   1    1    1     1     0   1     1    0     0    0    0    0    1    0     0    0    1     1     0    23
1     1     1   1    1    1     0     0   1     1    0     0    0    0    1    0    1     0    0    1     1     1    23
1     1     1   1    1    0     1     1   1     1    0     0    0    0    1    1    0     0    0    0     1     1    22
1     1     0   0    1    1     0     0   1     1    1     0    0    0    1    1    1     0    0    0     1     1    22
1     1     0   1    1    1     0     0   1     1    1     0    0    0    1    1    0     0    0    0     1     1    26
0     1     1   1    1    1     1     0   1     1    0     1    0    1    1    0    1     0    0    1     1     1    24
1     0     1   0    0    0     0     0   0     0    0     1    1    1    0    0    1     0    0    0     0     0    14
1     1     1   1    1    1     1     0   1     1    1     0    0    0    1    1    1     0    1    0     1     1    28
1     1     1   1    1    1     0     0   0     1    0     0    0    1    0    0    1     0    1    0     1     1    24
0     0     1   1    1    1     0     0   1     1    1     1    1    1    0    0    1     0    0    0     1     1    25
0     0     0   0    0    1     0     0   0     0    0     1    0    1    0    0    0     1    0    0     0     1    15
1     1     0   0    1    1     0     0   1     0    0     0    0    0    1    1    0     1    1    0     1     1    19
1     1     0   1    1    1     0     0   1     1    1     0    0    0    1    0    1     1    1    0     1     1    21
0     1     1   1    1    1     0     0   1     1    1     0    0    0    1    0    1     0    0    0     1     1    21
1     1     1   1    1    1     1     0   1     1    0     0    0    0    0    0    1     1    1    0     1     1    26
0     1     1   1    1    0     1     0   1     1    1     0    0    0    1    0    1     0    0    0     1     1    24
0     1     1   1    1    1     1     0   1     1    1     0    0    1    1    0    1     0    0    0     1     1    24
1     1     1   1    1    1     0     0   1     1    1     0    1    1    1    1    1     0    1    1     1     1    30
1     1     0   1    1    1     0     0   1     1    1     0    0    0    1    1    0     1    1    1     1     1    23
0     1     0   0    1    1     0     0   1     0    1     0    0    0    1    1    0     0    0    0     1     1    16
0     1     1   1    1    1     1     0   1     1    1     0    0    0    1    1    1     0    0    0     1     1    21
0     1     1   1    1    1     0     0   1     1    1     0    0    1    1    0    1     0    0    1     1     1    24
0     1     0   1    1    1     0     0   1     1    0     0    1    1    0    0    1     1    0    0     1     1    22
0     1     0   1    1    1     0     0   1     1    0     0    1    1    1    0    1     0    0    0     1     1    21
0     1     1   1    1    1     0     0   1     1    0     0    1    1    0    0    1     1    0    0     1     1    24
0     1     0   1    1    1     0     0   1     1    0     0    1    1    1    1    1     0    0    0     1     1    22
0     1     1   1    1    1     0     0   1     1    0     0    1    1    0    0    1     1    0    0     1     1    26
0     1     0   0    1    1     1     0   1     0    1     0    0    1    0    1    0     1    1    0     1     1    22
0     1     1   1    1    1     0     0   1     1    1     0    0    0    1    0    1     0    0    0     1     1    22
0     1     1   1    1    1     1     0   1     1    1     0    0    0    1    0    1     0    0    1     1     1    24
0     1     1   1    1    1     0     0   1     1    1     0    0    1    1    0    1     0    0    0     1     1    22
0     1     1   1    1    1     1     0   1     1    1     0    0    0    1    0    1     0    0    0     1     1    23
0     1     1   1    1    1     0     0   1     1    0     0    1    1    1    0    1     0    0    0     1     1    22
0     1     0   1    1    1     0     0   1     0    0     0    1    1    0    0    1     1    0    0     1     1    21
1     1     1   1    1    1     0     0   1     1    1     1    0    0    0    0    1     0    1    1     1     1    24
0     1     1   1    1    1     1     0   1     1    1     0    0    0    1    0    1     0    0    0     1     1    24
1     1     1   1    1    1     1     0   1     1    0     1    1    1    0    0    1     0    0    0     1     1    25
1     1     1   1    1    1     1     0   1     1    1     0    1    1    1    1    1     1    1    1     1     1    33
1     1     0   1    1    1     0     0   1     0    1     0    0    0    1    0    1     0    0    0     1     1    20
1     1     0   1    1    0     1     0   1     1    1     0    0    0    0    0    1     0    1    1     1     1    24
1     1     0   1    1    1     1     0   1     1    1     0    0    0    0    1    1     0    0    0     1     1    23
1     1     1   1    1    1     1     0   1     1    0     0    0    0    0    0    1     1    1    0     1     1    20
1     1     1   1    1    1     0     0   1     1    1     0    0    0    1    1    1     0    0    0     1     1    25
1     1     1   1    1    1     0     0   1     1    1     0    0    0    0    0    1     1    0    1     1     1    24
0     1     1   1    1    1     1     0   1     0    0     0    0    0    0    0    1     0    0    1     1     1    20
24 47 35        43 47 45 21           1   47   42 29       8   14    22   30 16 41 13 14 15 48 47




                                                                                                                       140
                                    Post test Scores of Experimental Group
Respondent No                                        Post test Scores
                                                                                                         Questions
                                                                                                     regarding Personal
                General Questions                       Questions regarding Diet                          Hygiene
                1     2   3     4    5    6    7   8     9   10   11   12   13   14   15   16   17   18     19     20
 1              1     1   1     1    1    1    1   1     1   1     1    1    1    1   1     0   0    1       1      1
 2              1     1   1     1    1    1    1   1     0   1     1    1    1    1   1     1   1    1       1      1
 3              1     1   1     1    0    1    1   1     0   1     1    1    0    1   1     1   0    1       1      1
 4              1     1   1     1    1    1    1   1     1   1     1    1    0    1   1     0   0    1       1      1
 5              1     1   1     1    1    1    1   1     1   1     1    1    0    1   1     1   1    1       1      1
 6              1     1   1     1    0    1    1   1     1   1     1    1    0    1   0     0   0    1       1      0
 7              1     1   1     1    1    0    1   0     0   1     1    1    0    1   0     0   0    1       1      1
 8              1     0   1     1    1    1    1   1     1   0     1    1    1    0   1     0   0    1       1      1
 9              1     1   1     1    1    0    1   1     0   1     1    1    0    1   0     0   1    1       1      1
 10             1     1   1     1    1    1    1   1     1   1     1    1    0    1   1     1   1    1       1      1
 11             1     1   1     1    0    1    1   1     1   1     1    1    1    1   1     1   0    1       1      1
 12             1     1   0     1    1    1    0   1     1   1     1    1    0    0   1     0   1    0       1      1
 13             1     1   1     1    1    1    1   1     1   0     1    1    0    1   1     0   1    1       1      1
 14             1     1   0     1    0    1    1   1     0   1     1    0    1    1   0     0   1    1       1      1
 15             1     1   1     1    0    1    1   1     0   0     1    1    0    1   1     0   1    1       1      0
 16             1     1   1     0    0    1    1   1     0   0     1    1    1    0   1     1   0    1       1      0
 17             1     1   1     1    0    0    1   1     1   1     1    1    1    1   1     1   1    1       0      0
 18             1     1   0     1    1    1    1   0     0   0     1    1    1    1   1     1   0    1       0      0
 19             1     1   1     1    0    1    1   0     1   1     1    1    0    1   0     1   0    1       1      1
 20             1     1   1     1    1    1    1   1     1   1     1    1    1    1   1     1   1    1       1      1
 21             1     1   1     1    1    1    0   1     1   0     1    1    1    1   1     1   1    1       1      0
 22             1     1   1     0    1    0    1   0     1   1     1    1    0    1   1     0   0    1       1      1
 23             1     1   1     1    1    1    1   1     1   1     1    1    1    1   0     1   1    1       1      1
 24             1     1   1     1    1    1    1   1     0   1     1    1    1    1   1     0   1    1       1      1
 25             1     0   1     1    1    1    1   0     0   1     0    1    0    1   0     1   0    1       1      1
 26             1     1   1     1    1    1    1   1     1   0     1    1    1    0   0     1   1    1       1      1
 27             1     1   1     1    1    1    1   1     1   1     0    1    1    1   0     1   0    1       0      1
 28             1     0   1     1    1    1    1   1     1   1     1    1    0    1   0     1   0    1       1      0
 29             1     1   1     1    0    1    1   0     1   1     0    1    0    1   1     0   0    1       1      1
 30             1     1   1     1    1    1    1   1     1   1     1    1    1    1   0     1   0    1       1      1
 31             1     1   1     1    0    0    1   0     1   1     1    1    1    1   1     1   1    1       1      0
 32             1     1   1     1    1    1    1   1     1   1     1    1    1    1   1     1   0    0       1      1
 33             1     1   1     1    1    1    0   1     1   0     1    1    0    1   0     1   0    1       1      1
 34             1     1   1     1    0    1    1   1     1   0     0    1    1    1   1     0   0    1       1      1
 35             1     1   1     1    1    1    1   1     1   0     0    0    0    1   0     1   1    1       1      1
 36             1     1   1     1    0    1    1   1     1   0     1    1    0    1   0     1   0    1       1      1
 37             1     1   1     1    1    1    1   0     1   1     1    0    0    1   1     1   0    1       1      0
 38             1     1   1     1    1    1    1   1     1   1     1    1    0    1   0     1   0    1       1      1
 39             1     0   1     1    1    1    1   1     1   1     1    1    0    1   0     1   0    0       1      1
 40             1     1   1     0    1    1    1   1     0   1     0    1    0    1   1     0   0    1       1      1
 41             1     1   1     1    0    1    1   1     0   1     1    1    0    0   1     0   0    1       1      0
 42             1     1   1     1    0    1    1   1     1   1     1    0    1    1   1     1   1    0       1      1
 43             1     1   1     1    1    1    1   1     1   1     1    1    0    1   1     0   1    1       1      1
 44             1     0   1     1    0    1    1   0     1   1     1    1    0    1   0     1   0    1       0      1
 45             1     0   1     1    1    1    1   1     0   1     1    1    1    1   1     1   0    0       1      1
 46             1     0   1     1    0    1    1   1     0   1     1    1    1    0   0     1   0    1       1      1
 47             1     1   1     1    1    1    1   1     0   1     1    1    0    1   0     1   0    0       1      1
 48             1     1   1     1    1    1    1   1     0   1     1    1    0    1   1     1   0    1       0      1
 49             1     1   1     0    1    1    1   1     1   0     1    1    1    1   0     1   1    1       1      1
 50             1     0   1     1    1    1    1   1     0   1     1    1    0    0   1     1   0    0       1      1
                50   42   47   46   34   45   47   41   33   38   44   46   22   43   30   33   19   43     45     40




                                                                                                                          141
                                        Post test Scores

    Questions
regarding Antenatal       Questions regarding               Questions regarding Other
     Checkup                Immunization                         Antenatal Care
21   22   23   24   25   26   27   28   29   30   31   32    33   34   35   36   37   38   39   Total
1    1    1    0    0    1    1    0    1    1    0    1     0    1    0    1    1    1    1     31
1    1    1    1    0    1    1    1    1    0    1    1     1    1    0    1    1    1    1     35
1    1    1    1    0    1    1    1    0    1    0    0     1    1    0    1    1    1    1     30
1    1    1    1    0    1    1    1    0    0    0    0     1    1    1    1    1    1    1     31
0    1    1    1    1    1    1    1    0    1    1    1     0    1    0    0    0    1    1     32
1    1    1    1    0    1    1    1    1    1    0    0     1    1    0    1    1    1    1     29
1    1    1    0    0    1    1    1    0    0    0    1     1    1    1    1    1    1    1     27
1    1    1    1    1    1    1    0    1    0    0    1     1    0    0    0    1    1    1     28
1    1    1    0    0    1    1    1    0    0    0    1     1    1    0    1    1    1    1     28
0    1    1    1    0    1    1    1    0    0    1    0     1    1    0    1    1    1    1     32
1    1    1    0    0    1    1    1    0    1    1    0     1    1    1    1    0    1    1     32
1    0    1    0    1    0    1    1    0    1    1    1     1    0    1    1    0    1    1     27
1    1    1    0    1    1    1    1    1    1    0    1     1    1    1    1    1    1    1     34
1    1    1    1    1    1    1    1    1    1    1    0     0    1    0    0    0    1    1     28
1    0    1    0    1    0    1    1    1    1    1    1     1    1    1    1    1    1    1     30
1    1    0    1    1    1    1    1    0    1    1    1     0    1    1    1    1    0    1     28
1    1    0    1    1    1    0    1    0    0    1    1     0    1    0    1    0    0    1     27
1    1    1    1    0    0    1    1    1    1    0    0     1    0    0    0    1    1    1     25
1    1    1    0    0    1    1    1    1    0    0    1     0    1    0    0    1    1    1     27
1    1    1    1    0    1    1    1    1    0    0    1     0    1    1    1    0    1    1     34
1    1    1    1    1    1    1    1    1    1    1    1     1    1    1    0    1    1    1     35
1    1    0    0    0    1    1    1    1    1    1    0     0    1    1    1    1    1    1     28
1    1    1    1    1    1    1    1    0    1    1    0     1    1    1    1    1    1    1     36
1    1    0    1    0    1    1    1    0    1    1    0     1    1    0    0    0    1    1     30
1    1    1    1    0    1    1    1    0    1    1    0     1    1    1    1    1    1    1     29
1    1    1    1    1    1    1    1    0    0    0    1     1    1    0    0    1    1    1     31
1    1    1    1    1    1    1    1    0    1    1    0     1    1    1    1    1    1    1     33
1    1    1    1    0    1    1    1    0    1    1    0     0    1    1    1    1    1    1     30
1    1    1    0    0    0    1    1    0    1    1    1     1    1    0    0    1    1    1     27
1    1    1    0    0    1    1    1    1    1    1    0     0    1    1    0    1    1    1     32
0    1    1    1    1    0    0    0    1    1    1    1     1    0    0    0    1    1    1     28
1    1    1    1    0    1    1    0    0    1    1    0     0    1    1    1    1    1    1     32
1    0    1    1    1    1    1    1    1    1    0    1     1    1    1    1    1    1    1     32
1    0    1    1    1    1    1    1    1    0    0    1     1    1    1    1    1    1    1     31
1    0    1    0    1    1    1    1    1    0    0    1     1    1    1    1    1    1    1     30
1    0    1    0    0    1    1    1    1    0    0    1     1    0    1    1    1    1    1     28
1    1    1    0    0    1    1    1    0    0    0    1     1    1    0    1    1    1    1     28
1    1    1    1    0    0    1    1    1    1    1    0     1    1    1    1    1    1    1     33
1    1    1    0    1    1    1    1    1    0    1    1     1    1    0    0    1    1    1     30
1    1    1    1    0    1    1    1    0    1    1    0     0    1    1    0    1    1    1     28
1    1    1    0    1    1    1    1    0    1    1    1     1    0    1    0    0    1    1     27
1    1    1    1    1    1    1    0    1    1    1    1     1    1    1    1    1    1    1     35
1    1    1    0    1    1    1    1    1    1    1    1     1    1    1    0    1    1    1     35
1    1    1    0    0    1    1    1    1    0    1    1     1    1    1    1    0    1    1     28
1    1    1    1    0    1    1    1    0    1    0    1     1    1    1    1    0    1    1     31
1    1    1    1    0    1    1    1    1    1    1    1     1    1    1    0    0    1    1     30
1    1    1    1    0    1    1    1    1    0    0    1     1    1    1    1    1    1    1     31
0    0    1    1    0    1    1    1    0    1    0    1     1    1    1    1    0    1    1     29
1    1    0    1    0    1    1    0    1    1    1    1     1    0    1    1    1    1    1     32
1    1    1    1    0    1    1    1    0    1    0    1     1    1    1    1    0    1    1     29
46   43   45   32   20   44   48   44   26   33   29   33    38   43   32   34   37   48   50




                                                                                                        142
143
144
145
146
                                 Annexure- M

LESSON PLAN FOR PLANNED TEACHING PROGRAMME ON
                ANTENATAL CARE


Topic of teaching: Antenatal care

Place of teaching: Antenatal OPD of selected hospitals

Time duration: 45 minutes

Types of learners: Educated and uneducated

Name of the student teacher: Anupama Tamrakar

General Objectives: At the end of the teaching, learners will be able to acquire

knowledge regarding antenatal care.

Specific Objectives: At the end of the teaching, learners will be able to:

       Define antenatal care.

       List out the aims of antenatal care.

       Define pregnancy

       Recall the confirmation of pregnancy.

       Explain about the diet during pregnancy.

       Brief about the types of clothes, personal hygiene during pregnancy.

       State about the antenatal checkup during pregnancy.

  .    Review about the immunization during pregnancy.

       Brief about the rest, sleep and activities during pregnancy.

       Discuss about when to avoid traveling, sexual intercourse, type of physical

       activities and self medication during pregnancy.

       Identify the warning signs during pregnancy.



                                                                                     147
S   Time     Specific                       Contents                    Teacher’s activities      Learner’s        A/V     Evaluation
N           Objectives                                                                              activities     Aids
1     1    Introduction   Introduction of self and the topic.          Wishes the group and       Learners         Flip         -
    min                                                                introduces self. We are    listen.          chart
                                                                       going to discuss about
                                                                       pregnancy and
                                                                       antenatal care.
2     1    Defines        The care given from the period of            Teacher tells the          Learners         Flip    What is
    min    antenatal      conception till the delivery is called       definition with the help   listen and       chart   pregnancy?
           care.          antenatal care.                              of flip chart.             participate in
3     4    Lists the      The aims of antenatal care are following:    Teacher explains with      Learners         Flip    How can
    mins aims of              To screen the high risk cases.           the help of flip chart.    listen and       chart   pregnancy
           antenatal          To prevent or to detect any                                         participate in           be
           care.              complications.                                                      discussion.              confirmed?
                              To provide the necessary advice to the
                              mother about antenatal care.
                              To have healthy mother and the healthy
                              baby.
                              To discuss with the mother regarding
                              physiological changes, minor disorders
                              and danger signs during pregnancy.


                                                                                                                                148
S   Time       Specific                 Contents                 Teacher’s           Learner’s activities         A/V    Evaluation
N            Objectives                                          activities                                       Aids


4     1    Defines the      Pregnancy is a state of a       Teacher explains        Learners listen and          Flip    What is
    min    pregnancy.       woman from conception till      with the help of flip   participate in discussion.   chart   pregnancy?
                            delivery.                       chart.                  They ask the doubt if
                                                                                    any.
5     1    Recalls how to   Pregnancy can be confirmed      Teacher explains        Learners listen and          Flip    How can
    min    confirm the      by doing urine test and         with the help of flip   participate in discussion.   chart   pregnancy
           pregnancy.       scanning.                       chart.                  They ask the doubt if                be
                                                                                    any.                                 confirmed?
6     1    Restates about   The pregnant mother feels       Teacher explains        Learners listen and          Flip    What is
    min    when the         fetal movement by 4-5           with the help of flip   participate in discussion.   chart   pregnancy?
           quickening.      months for the first time.      chart.                  They ask the doubt if
                                                                                    any.
7     1    Explains the     A healthy diet is necessary     Teacher explains        Learners listen, see         Flip    Why diet is
    min    importance of    for a pregnant woman to:        with the help of flip   chart and participate in     chart   necessary
           diet during          maintain the health of      chart.                  discussion.                          during
           pregnancy.           the mother,                                         They ask the doubt if                pregnancy?
                                 fulfill the baby’s need.                           present.




                                                                                                                                  149
SN   Time       Specific                        Contents                      Teacher’s       Learner’s          A/V       Evaluation
              Objectives                                                      activities        activities       Aids

8     1     Discuss about      The pregnancy diet should be light,          Teacher         Learners listen      Flip    Which type of
     min    the best type of   nutritious and easily digestible. The diet   explains with   and participate in   chart   diet is best
            diet during        should be rich in protein, minerals          the help of     discussion.                  during
            antenatal          (especially calcium and iron) and vitamins flip chart.       They ask the                 pregnancy?
            period.            (vitamin C and vitamin A).                                   clarification.
9     1     Illustrates the    During pregnancy, extra protein diet is      Teacher         Learners listen      Flip    Why extra
     min    need of extra      necessary for the growth of the fetus and    explains with   and see chart.       chart   protein is
            protein during     the development of new cells in the          the help of     They ask the                 necessary during
            pregnancy.         mother.                                      flip chart.     clarification.               pregnancy?

10    1     Reviews the        The good sources of protein are meat, egg, Teacher           Learners listen      Flip    What are the
     min    sources of         and dairy product.                           explains with   and ask the          chart   sources of
            protein.                                                        the help of     clarification.               protein?
                                                                            flip chart
11    1     States the         Iron rich food is necessary during the       Teacher         Learners listen      Flip    Why extra iron
     min    necessity of       pregnancy for the formation of               explains with   and see the chart.   chart   is necessary
            iron rich food     hemoglobin to carry oxygen from the          the help of     They ask the                 during
            during             mother to the fetus.                         flip chart      doubt.                       pregnancy?
            pregnancy.


                                                                                                                                    150
S               Specific                      Contents                     Teacher’s           Learner’s          A/V          Evaluation
     Time


N              Objectives                                                   activities           activities       Aids
12    1     Names the good      The good sources of iron are meat,     Teacher explains.   Learners listen, see   Flip    What are the
     min sources of iron.       eggs, green leafy vegetables, dried                        the chart and ask      chart   sources of iron?
                                fruits and grains.                                         doubts.
13    1     Explains the need   During pregnancy, calcium rich         Teacher explains    Learners listen, see   Flip    Why calcium rich
     min of calcium food        food is necessary for the skeletal     with the help of    the chart and ask      chart   diet is necessary in
            in pregnancy.       growth of the fetus.                   flip chart          clarifications.                pregnancy?
14    1     Reviews the good    The good sources of calcium are        Teacher explains    Learners listen and    Flip    What are the
     min sources of             milk, cheese, tofu and green leafy     with the help of    participate in         chart   sources of calcium?
            calcium.            vegetables.                            flip chart          discussion.
15    1     Why vitamin C is    During pregnancy, vitamin C            Teacher explains.   Learners listen and    Flip    Why vitamin C is
     min necessary during       contained diet is necessary for the                        see the chart. They    chart   necessary in
            pregnancy.          development of the fetus                                   ask the doubts.                pregnancy?
16    1     Lists the good      The good sources of vitamin C are      Teacher explains    Learners               Flip    What are the
     min sources of             citrus fruits, cabbage and potatoes.   with the help of    participate in         chart   sources of vitamin
            vitamin C.                                                 flip chart.         discussion and ask             C?
                                                                                           doubts.
17    1     Discusses the       During pregnancy, vitamin A            Teacher explains    Learners               Flip Why vitamin A is
     min need of vitamin A      contained diet is necessary for the    with the help of    participate in         chart   necessary in
            in pregnancy.       fetal growth and development.          flip chart.         discussion. They ask           pregnancy?
                                                                                           the doubts if any.

                                                                                                                                         151
SN          Specific Objectives                    Contents                    Teacher’s         Learner’s          A/V       Evaluation
     Time


                                                                               activities         activities        Aids

18     1    Reviews the good        The good sources of vitamin A are       Teacher            Learners listen      Flip    What are the
     min    sources of vitamin A. butter, cheese, yellow vegetables, fish   explains using     and participate in   chart   sources of
                                    liver oils and dark green leafy         flip charts.       discussion.                  vitamin A?
                                    vegetables.
19     1    Explains the types of   During pregnancy the pregnant           Teacher            Learners listen      Flip    What type of
     min    clothes they should     woman should wear supportive and        explains using     and participate in   chart   clothes you
            wear during             comfortable cotton clothes. The         flip charts.       discussion.                  should wear in
            pregnancy.              clothes should be clean.                                                                pregnancy

20     1    Briefs about the        A pregnant mother should daily take     Teacher            Learners listen      Flip    How many
     min    personal hygiene        bath (once in a day).                   explains with      and participate in   chart   times you
            during pregnancy.                                               the help of flip   discussion.                  should take bath
                                                                            charts.                                         in pregnancy?
21     2    States the importance The importance of breast care during      Teacher            Learners listen      Flip    What is the
     min    of breast care during pregnancy are as follows:                 explains with      and participate in   chart   importance of
            pregnancy.                  To observe for the abnormalities.   the help of flip   discussion.                  breast care
                                        To clean the breast.                chart                                           during
                                        To correct the nipples and                                                          pregnancy?
                                        prepare for lactation.



                                                                                                                                     152
SN            Specific                      Contents                        Teacher’s     Learner’s         A/V         Evaluation
     Time

            Objectives                                                      activities      activities      Aids
22    4     Describes     All pregnant mothers need antenatal checkup.      Teacher       Learners          Flip    -Who needs ante -
     min    about the     For the first time the pregnant mother should     explains      listen, see the   chart   natal checkup?
            antenatal     visit the doctor after the first missed period.   with the      chart and                 -When should see
                                                                                                                    the doctor for the
            check up.     Till seven months the pregnant mother should      help of       participate in
                                                                                                                    first time during
                          attend antenatal checkup once in a month.         flip chart    discussion.               pregnancy?
                          During 7-9 months the pregnant mother should                    They ask the              -How often you
                          attend antenatal check up twice in a month.                     doubts if any.            should go for
                          After 9 months the pregnant mother should                                                 checkup in second
                                                                                                                    and third trimester?
                          attend antenatal check up once in a week.
23    4     Explains      All the pregnant mothers should take injection    Teacher       Learners          Flip    What immunization
     min    about the     TT during the pregnancy to prevent the mother     explains      listen, see the   chart   should be taken in
            immuniza-     and the baby from tetanus.                        with the      chart and                 pregnancy and
                                                                                                                    why?
            tion during   In first pregnancy, the mother should take 3      help of       participate in
            pregnancy.    doses and in subsequent pregnancy she should      flip chart.   discussion.               Explain about the
                          take 2 doses of injection TT.                                   They ask the              immunization in
                          The first dose should be taken between 4-6                      doubt.                    pregnancy.
                          months. The interval between the two doses
                          should be 4-6 weeks.



                                                                                                                                153
SN                Specific                      Contents                      Teacher’s         Learner’s         A/V        Evaluation
     Time
                 Objectives                                                   activities         activities       Aids
24     1    Briefs about the rest The pregnant woman should take            Teacher          Learners listen      Flip    How many hours
     min    and sleep during      rest and sleep at least for eight hours   explains using   and participate in   chart   minimum you
            pregnancy.            at night and two hours at day time.       flip chart.      discussion.                  should take?
25     1    Discusses about the   The pregnant woman should avoid           Teacher          Learners listen,     Flip    When should you
     min    traveling during      traveling during the first trimester      explains with    see the chart and    chart   avoid traveling
            pregnancy.            and last six weeks in the third           the help of      participate in               during
                                  trimester during pregnancy.               flip chart.      discussion.                  pregnancy?
26     1    Expresses about the   The pregnant mother can do all the        Teacher          Learners listen,     Flip    What physical
     min    physical activities   regular household activities during       explains with    see the chart and    chart   activity you
            during pregnancy.     pregnancy. She should avoid heavy         the help of      participate in               should avoid in
                                  lifting during pregnancy.                 flip chart.      discussion.                  pregnancy?
27     1    Discusses about the   The pregnant woman should avoid           Teacher          Learners listen,     Flip    When should you
     min    sexual intercourse    sexual intercourse during the first       explains with    see the chart and    chart   avoid coitus
            during pregnancy.     trimester and last six weeks in the       the help of      participate in               during
                                  third trimester during pregnancy.         flip chart.      discussion.                  pregnancy?
28     1    Gives reason about    Pregnant mothers should avoid self        Teacher          Learners listen,     Flip    Why should you
     min    the avoidance of      medication during pregnancy               explains with    see the chart and    chart   avoid self
            self medication       because it may bring fetal                the help of      participate in               medication during
            during pregnancy      abnormalities.                            flip chart       discussion.                  pregnancy?



                                                                                                                                       154
SN          Specific Objectives                   Contents                       Teacher’s        Learner’s        A/V         Evaluation
     Time


                                                                                 activities        activities      Aids
29    3     Lists the warning     The warning signs during pregnancy are      Teacher            Learners          Flip    What are the
     min signs (danger signs)     as follows:                                 explains using     listen, see the   chart   warning signs
            during pregnancy.         Vaginal bleeding                        the flip chart.    chart and                 during pregnancy?
                                      Edema of face or hands                                     participate in
                                      Severe vomiting                                            discussion.
                                      Leakage of fluid from vagina
                                      Change or absence of fetal
                                      movement.
30    1     Explains the          During pregnancy, if any above listed sign Teacher             Learners          Flip    What should you do
     min immediate action to      is occurred, immediately they should        explains will      listen, see the   chart   immediately if any
            be taken if any of    report to the doctor. The pregnant mother   the help of flip   chart and                 warning sign is
            above warning         should be taken to the doctor.              chart.             participate in            occurred?
            signs occurs during                                                                  discussion.
            pregnancy.
31    1     Briefs the way of     During pregnancy, the pregnant should       Teacher            Learners          Flip    How can you know
     min knowing fetal well       know about her fetal is well or not. This   explains using     listen and        chart   the fetal well
            being.                can be known by regular checkup with the    flip chart.        participate in            being?
                                  doctor or midwife.                                             discussion.



                                                                                                                                       155
SN   Time      Specific                             Contents                             Teacher’s     Learner’s     A/V     Evaluation
              Objectives                                                                 activities     activities   Aids
     2 mins                Summary:                                                    Teacher         Learners      Flip        -
                           All pregnant mothers need care during the pregnancy         explains with   participate   chart
                           period which is called antenatal care. All pregnant         the help of     in
                           women should eat food rich in protein, vitamins A and       flip chart.     discussion.
                           vitamin C, iron and calcium. They should take bath daily,
                           take care of their breast and need antenatal visits. They
                           should take immunization (TT vaccine). They should
                           avoid heavy lifting, should sleep at least eight hours at
                           night and two hours at day time. Traveling and sexual
                           intercourse should be avoided during first trimester and
                           last six weeks. The warning (danger) signs during
                           pregnancy are vaginal bleeding, edema of face or hands,
                           severe vomiting, leakage of fluid from vagina and change
                           or absence of fetal movement. If any of these occur, they
                           should immediately report the doctor.




                                                                                                                               156
Bibliography

1. Annamma Jacob. A Comprehensive Text Book of Midwifery. New Delhi:

   Jaypee Brothers,medical publishers (P) Ltd, 2005, 102-120



2. Burroughs’. Maternity Nursing. Philadelphia London Toronto: W.B.

   Saunders Company, 7th edition, 1998, 93-105.



3. D.C. Dutta. Text Book of Obstetrics. Calcutta: New Central Book Agency

   (P) Ltd, 6th edition, 2004, 100-103.



4. Diane M. Fraser Margaret A. Cooper. Myles Text Book of Midwives. China:

   Churchil Livingstone, 14th edition, 2003, 252-272.




                                                                       157
       FORMULAS USED FOR STATISTICAL ANALYSIS

Spearman-Brown Prophecy Formula for Reliability Test

                2r
   rl =
              1+r

where, r is the correlation co-efficient completed on the split half.

r l = estimated reliability of the entire test.

For calculating the correlation co-efficient (r),

           ∑xy
r =
        √ ∑x2 ∑y2

Calculation of Mean, Standard Deviation and Standard Error

                        ∑Xi
 Mean (M) =
                         N

Where ∑ = The symbol used for summation

       Xi = Value of ith item

       N = Total number of items

                                    √ ∑ ( Xi – X ) 2
 Standard Deviation (SD) =
                                           n–1

where ∑ = The symbol used for summation

       Xi = Value of ith item

       X = Mean of the ith items

       N = Total number of items




                                                                        158
                                 S (σ )
 Standard Error (SE) =
                                 √n

where, S (σ ) is the sample standard deviation and n is the size of that sample.


Calculation of Person’s Chi-square Value

                              ∑(O–E )2
Chi-square (χ 2) =
                                 E

where ∑ = The symbol used for summation

       O = The observed frequencies

       E = The expected frequencies



Calculation of Paired ‘t’ , Unpaired ‘t’ and ‘z’ Values


                     | d |
Paired ‘t’ =
               SE of difference values

where | d | = The symbol used for mean of the differences (i.e., Xi – Yi)

                               σd
SE of difference values =
                               √n

         ∑di 2 – (∑di) 2/ n
σd =
       √    n-1

where σd = standard deviation of d (X1 – X2)

       ∑di 2 = summation of d2 or (X1 – X2) 2

       (∑di) 2 = square of summation of d or (X1 – X2)

        n       = total number of items


                                                                                   159
 Calculation of Unpaired ‘t’ Test

                          | X1 – X2 |
   Unpaired ‘t’ =
                     S √ 1/n1+ 1/n2

   where X1 = Mean of first observations

          X 2 = Mean of second observations

           n1 and n2 are = Total number of observations



Calculation of ‘z’ Test

              | X1 – X2 |
   z =
            √ σ1/n1 + σ2 /n2

   where X1 = Mean of first observations and σ1 is the standard deviation for it.

          X 2 = Mean of second observations and σ2 is the standard deviation for it.

           n1 and n2 are = Total number of observations




                                                                                       160

								
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