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“A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICES REGARDING PREVENTION OF ANAEMIA AMONG REGISTERED PREGNANT MOTHERS ATTENDING ANTENATAL CLINICS IN SELECTED HOSPITALS OF BELGAUM”.

By

Mrs. Anitha. M.

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

In partial fulfillment of the requirements for the degree of

Master of Sciences In Obstetrics And Gynecological Nursing

Under the guidance of Mrs. Sangeeta Kharde M.Sc. (N)

Department of Obstetrics & Gynaecological Nursing

K.L.E Society’s Institute of Nursing Sciences Nehru Nagar, Belgaum-590 010. Karnataka, India.

2005

I

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

KARNATAKA

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation entitled

- “A Study To Assess The

Knowledge And Practices Regarding Prevention Of Anaemia Among Registered

Pregnant Mothers Attending Antenatal Clinics In Selected Hospitals Of Belgaumis a

bonafide and genuine research work carried out by me under the guidance of

Mrs. Sangeeta Kharde M.Sc (N), Asst Professor, Department of Obstetrics &

Gynaecological Nursing, K.L.E.S Institute of Nursing Sciences, Nehru Nagar,

Belgaum – 10.

Date :

Place : Belgaum

Mrs. Anitha. M. Post Graduate Student K.L.E.S. Institute of Nursing Sciences, Nehru Nagar,

Belgaum-10.

II

CERTIFICATE BY THE GUIDE

This is to certify that the dissertation entitled

A Study To Assess The

Knowledge And Practices Regarding Prevention Of Anaemia Among Registered

Pregnant Mothers Attending Antenatal Clinics In Selected Hospitals Of Belgaum

is

a bonafide research work done by

Mrs. Anitha. M. in partial fulfillment of the

requirement for the degree of Master of Science in Nursing.

Guide :

Mrs. Sangeeta Kharde M.Sc (N) Asst. Professor, Department of Obstetrics & Gynaecological Nursing, K.L.E.S Institute of Nursing Sciences, Belgaum.

Date :

Place : Belgaum

Co-Guide :

Mrs. Sudha. A. Raddi M.Sc (N)

Assistant Professor Department of Obstetrics & Gynaecological Nursing, K.L.E.S Institute of Nursing Sciences, Belgaum

III

ENDORSEMENT BY THE HOD, PRINCIPAL,

K.L.E SOCIETY’S INSTITUTE OF NURSING SCIENCES,

NEHRU NAGAR, BELGAUM – 590 010

This is to certify that the dissertation entitled “A Study To Assess The

Knowledge And Practices Regarding Prevention Of Anaemia Among Registered

Pregnant Mothers Attending Antenatal Clinics In Selected Hospitals Of Belgaumis a

bonafide research work done by Mrs. Anitha. M. under the guidance of

Mrs. Sangeeta Kharde., M.Sc (N), Assistant Prof, Department of Obstetrics &

Gynecological Nursing.

Seal & Signature :

Mrs. Sudha. J. Narvekar. M.Sc (N)

HOD, Department of Obstetrics & Gynecological Nursing K.L.E.S Institute of Nursing Sciences, Belgaum.

Date :

Place : Belgaum

Seal & Signature

Mr. R. S. Hooli. MSc. (N)

Principal K.L.E.S Institute of Nursing Sciences, Belgaum

Date :

Place : Belgaum

IV

COPYRIGHT

Declaration by the candidate

I

hereby

declare

that

Rajiv

Gandhi

University

of

Health

Sciences,

Karnataka shall have the rights to preserve, use and disseminate this dissertation

in print or electronic format for academic / research purpose.

Date

:

Place : Belgaum

MRS. ANITHA. M. Post Graduate Student K.L.E.S. Institute of Nursing Sciences, Nehru Nagar,

Belgaum-10.

V

ACKNOWLEDGEMENT

No individual can learn and develop by himself/herself. He/She needs encouragement and assistance. Gratitude can never be adequately expressed in words but this is only the deep perception which make the words flow from ones inner heart.

I am grateful to ‘Almighty God’ for his wisdom, strength, good health support and

blessings throughout this endeavour. His omnipresence has been my anchor through the

fluctuating hard times.

I express my deep sense of gratitude to my esteemed teacher and Research Guide

Mrs. Sangeetha Kharde, Assistant professor, K.L.E.S Institute of Nursing Sciences, Belgaum. Her unconditional support, guidance, valuable suggestions, untiring efforts,

unwavering faith and cooperation has continually motivated me for the successful completion of this dissertation. I have been extremely fortunate to have her as my Guide. Her interest endless patience and continuous encouragement has enable me to complete this study.

It is my pleasure to indebt my sincere gratefulness and genuine thanks to my teacher

and co-guide Mrs. Sudha A. Raddi, Assistant Professor of Department of Obstetrics and

Gynaecological Nursing, K.L.E.S Institute of Nursing Sciences, Belgaum, for her

suggestions, formation of ideas and thought and continuous kneen interest in my dissertation work. I have been extremely fortunate to have her as my co-guide.

I extend my wholehearted thanks to Prof. R.S. Hooli, Principal. K.L.E.S’S

Institute of Nursing Sciences, Belgaum for his motivation, expert advice and his blessings. I am indebted to Prof. Sudha. J. Narvekar, HOD of Obstetrics and Gynaecological nursing and senior faculty members of K.L.E.S Institute of Nursing Sciences, Belgaum for opening the doors of the world to me and for tendering assistance and support, concern, timely guidance, expert advice, encouragement and blessings.

I am extremely thankful to Prof. Smt. Usha. M. Joshi former principal and senior faculty member of K.L.E.S Institute of Nursing Sciences, Belgaum who is a truly an

XII

admirable example to inspire and strive for excellence I am thankful for her concern, timely guidance and blessings.

I am indebted to Prof. David A. Kola, HOD of Community health Nursing of

K.L.E.S Institute of Nursing Sciences, Belgaum who is a light of wisdom, source of

inspiration and hope of humanity. I am thankful for his unconditional support, guidance, valuable suggestions, timely help and co-operation.

I extend my whole hearted thanks to all Research committee members Prof. Usha.

M. Joshi, Prof.

Mrs. S. J. Narvekar

Prof.

R.

S. Hooli,

Prof

Mrs.

Milka

Madhale,

Prof.

David

A.

Kola,

Prof.

Mrs.

Sheela

Williams,

Prof.

Mrs. Sumithra, Assistant Professors Mrs. Vijayalaxmi, Mrs. Sangeetha Kharde, Mrs. Sudha. A. Raddi, Ms. Meenakshi M. Devangamath, Mrs. Suchitra Ratod

for their Expert Guidance, valuable suggestions, formation of ideas and thoughts and their constant help and support has proved a source of inspiration to me in completing this study.

I express my heartfelt gratitude to Dr. M. V. Jali, the Medical Director and Chief Executive and Consultant Diabetologist, K.L.E.S’s Belgaum for extending his Co- operation, Guidance and granting me permission to conduct the study in the hospital (OPD).

I sincerely thank to Professor Mallapure for his Guidance in the statistical analysis and interpretation of the data during the study.

I extend my sincere thanks to the faculty of K.L.E.S’s Institute of Nursing Sciences

for their encouragement and support. My heartfelt thanks to all experts for validating the tool and providing their valuable

suggestions. I extend my whole hearted thanks to Madam. Meenakshi and Madam

Sangeetha, Mr. Prakash Dr. Anjali Joshi, Mr. Neeraj Dixit, Mrs. Shivaleela, Mr.

Prakash who helped in Kannada and Marathi translations of the tool.

I have a special work of appreciation to Mr. Babujaan for critically editing the manuscript.

XIII

I wish to express my sincere thanks and appreciation to Mr. Satish, and his team

Ms. Rajeshwari, Ms. Vaishali, Mr. Kaleem of Sheegra Designing and Printing

Solutions and his staff for their excellent and skillful typing and printing of manuscript. My sincere thanks to our Librarians Mr. Prakash Mr. Mahindra Mrs. Shivaleela for permitting and facilitating me to make use of the reservoir of knowledge. I shall always be grateful to all registered antenatal mothers for their co-operation in making my study possible. My vocabulary fall short of right words to express my immense debts to my dear mother, father, brothers Arun and Anand who are the reason. For this hard work and study, their faith has always given me strength, support, encouragement and abundant blessings. The analogy will not be complete if I don’t mention the loving support extended by my beloved husband Dr. N. Saravanakumar M.P.T. His constant prayer, love, sacrifice, encouragement and support without which this study would not have been possible. Last but not the least, my sincere gratitude and thankfulness to all well wishers, friends and relatives for their help and best wishes which helped me to carry out my study. My heart felt thanks to one and all.

XIV

Mrs. Anitha. M

LIST OF FIGURES

Figures

Particulars

Page No.

1

Conceptual frame work

11

2

Research process

28

LIST OF GRAPHS

Graphs

Particulars

Page No.

1

Distribution of mothers according to sociodemographic data

33

2

Distribution of mothers according to base line data

36

3

Distribution of subjects according to level of knowledge of disease aspects and prevention of anaemia

38

4

Distribution of mothers according to various aspects of anaemia

40

5

Distribution of mothers according to knowledge on causes

42

6

Distribution of mothers according to knowledge on signs and symptoms of anaemia

44

7

Distribution of mothers according to practices regarding diet

50

8

Distribution of mothers according to hygienic practices

52

9

Distribution of mothers according to practices regarding treatment

54

X

TABLE OF CONTENTS

Chapter

Particulars

Page No.

I

INTRODUCTION

1

Need for the study

Statement of the problem

Objectives of the study

Operational definitions

Hypotheses

Assumptions

II

REVIEW OF LITERATURE

12

Literature related to prevalence of anaemia in pregnant mothers

Literature related to knowledge and practices of anaemia in pregnant mothers

Literature related to treatment of anaemia in pregnant mothers

III

RESEARCH METHODOLOGY

21

Research Approach

Research Design

Setting of study

Population

Sample size & sampling technique

Method of data collection

Development & description of tool

Validity

Reliability of the tool

Procedure of data collection

Pilot study

Plan of data analysis

Research process

VI

Chapter

Particulars

Page No.

IV

ANALYSIS AND INTERPRETATION OF DATA

29

V

MAJOR FINDINS, DISCUSSION, MAJOR FINDINGS, SUMMARY & CONCLUSION

60

VI

BIBLIOGRAPHY

78

 

APPENDICES

84

 

ABSTRACT

129

 

ABBREVIATIONS

132

VII

LIST OF TABLES

Table No

Particulars

Page No

1

Distribution of mothers according to sociodemographic data

31

1b

Distribution of mothers according to base line data

34

2

Mean, median and standard deviation of knowledge scores of the registered pregnant mothers regarding prevention of the anaemia

37

3

Distribution of subjects according to level of knowledge of disease aspects and prevention of anaemia

37

4a

Distribution of mothers according to knowledge on various aspects of anaemia

39

4b

Distribution of mothers according to knowledge on causes

41

4c

Distribution of mothers according to knowledge on signs and symptoms of anaemia

43

5a

Distribution of mothers according to knowledge on sources of iron rich foods

45

5b

Distribution of mothers according to knowledge on personal hygiene

46

5c

Distribution of mothers according to knowledge on treatment

47

6a

Distribution of mothers according to practices regarding diet

48

6b

Distribution of mothers according to hygienic practices

51

VIII

Table No

Particulars

Page No

6c

Distribution of mothers according to practices regarding treatment

53

7

Mean and standard deviation of practices scores regarding prevention of anaemia among registered pregnant mothers

53

8a

Association between knowledge and age

55

8b

Association between knowledge and Women’s Education

55

8c

Association between knowledge and Family income

56

8d

Association between knowledge and Gravid status of mothers obstetric score

56

9a

Association between practices and age

57

9b

Association between practices and women’s education

57

9c

Association between practices and family income

58

9d

Association between practices and gravid status of mothers obstetric score

58

10

Association between knowledge and practices regarding prevention of anaemia among registered pregnant mothers

59

IX

LIST OF APPENDICES

Appendix

Particulars

Page No.

A

Letter requesting opinion and suggestions from experts

84

B

Blue print

86

C

Tool for data collection

87

D

Content validation proforma

113

E

Criteria checklist for evaluation of tool requesting suggestions and opinions from the experts

116

F

List of experts

120

G

Certificate of validation

121

H

Letter seeking permission to conduct study

126

I

Master chart

127

XI

Abbreviations

CHAPTER I

INTRODUCTION

“Maternal death is an avoidable tragedy : we can prevent it” 1

- The White Ribbon Alliance

“Out of sheer love, affection and compassion, the would be mother bears

all the agony to protect the child with grace and dignity, that is really the greatness

of MOTHERHOOD” – Maharishi Kashyap.

Pregnancy, motherhood and childbirth are not at all romance and dreamy

nostalgia but it is a serious reality which has its own inherent risks to health and

survival both for the woman and for the infant she bears, which are present in

every society and in every setting. 32

Anaemia in pregnancy exists world wide but it is a very common problem

in most of the developing countries, India being one of them. An estimated 60% of

all pregnant women in developing countries all over the world have anaemia, out

of which 40% of maternal deaths are related to anaemia. 32

“BE ALERT NOT ALARMED”. Every five minutes, one woman in India

dies from complications related to pregnancy and childbirth. This adds upto a total

of 130,000 women. It was also estimated that 200 women die each year in

pregnancy and childbirth due to anaemia related complications which means six

out of every 10 pregnant women selected are anaemic. 1

In

country

like

India,

anaemia

is

frequently

severe

and

contributes

significantly to maternal mortality and reproductive health morbidities. In India it

contributes upto 16% of maternal deaths and among all anaemias, nutritional

Abbreviations

anaemia is the most common one. It is one of the major public health problem in

our country. The reason is that majority of women in reproductive age group have

limited iron stores, 40% have small stores and 20% have none. Secondly, their diet

does not contain adequate iron or iron absorption is hampered by various factors.

Lastly, increased iron requirement during pregnancy causes mobilization of iron

stores which leads to iron deficiency anaemia. 2

Prevention of anaemia in pregnancy is still a dream for much of India and

particularly, for its rural areas. About 80% of our population live in the villages.

Most of the pregnant women live where poverty, illiteracy, malnutrition, poor

sanitation, hygiene, gender bias, unequal feeding practices from a young age,

religious taboos and lack of awareness regarding availability of medical facilities

render them prone to health hazards which are preventable. 40

Though there is a knowledge explosion, scientific advancement, and

technological development in medicine and health care, our people are still

holding their belief on traditional practices. Some practices are effective but

certainly, some are harmful or ineffective which is based on superstition, false

beliefs, customs and traditions that are deterrent to health. 33

Thus, in view of the importance to enhance the knowledge and practices

regarding dietary regulations, iron supplementation and personal hygiene to

prevent anaemia, the nurse plays a vital role in preventing anaemia through health

education and enhance the mother’s knowledge and practices to prevent further

maternal and fetal complications during pregnancy, labour and puerperium and

maintenance of health in prolonging life by a healthy mother and a healthy baby.

Abbreviations

NEED FOR THE STUDY

"PREVENTION IS BETTER THAN CURE"

Prevention of anaemia is a major public health concern throughout the

world. Anaemia in pregnancy is one of the leading causes responsible for maternal

and

perinatal

morbidity

and

mortality.

According

to

WHO,

in

developing

countries the prevalence of anaemia among pregnant women averages 56% that is

ranging between 35 to 100% among different regions of the world. India reported

the prevalence of anaemia to be between 33% to 100%. 9 In India anaemia is the

2 nd most common cause of maternal deaths, accounting for 20% of total maternal

deaths. About half of the worlds anaemia women, live in the Indian sub continent

and 88% of them develop anaemia during pregnancy that is atleast 1.3 crore

women. 3

Anaemia affects mainly the women in child bearing age group. During

pregnancy the women undergoes certain physiological changes, while the growing

fetus draws its nutrients from maternal blood leading to the demand of additional

nutrients. If the demands are not met it leads to mal-nutrition. A study carried out

in the intensive field practice area of Urban Health Centre of Government Medical

College, in Miraj (1992) by Naik K.R. revealed that (68.18%), pregnant women

were found to be anaemic. 46

The consequences of anaemia in pregnancy are very dangerous. If anaemia

is left untreated and uncared; It leads to increased morbidity due to development

of complications like abruption placenta, preterm labour, intra uterine growth

retardation, inter-current infection, heart failure and post-partum haemorrhage,

Abbreviations

pulmonary puerperal venous thrombosis, puerperal sepsis, sub involution, failing

lactation,

etc. 45

The

investigator

during

her

community

field

experience

in

Tamilnadu came across many pregnant mothers with anemia. She felt that the

pregnant women were unaware about the importance of balance diet. They

generally cooked food keeping in mind the taste and preference of family

members. The lady of the house took the food which is left over after consumption

by the family members, which is insufficient for the pregnant mother. Nutrition

taboos also impose favorable, unfavorable impact on pregnancy. Pregnant women

are not given certain food items which are considered to be hot foods leading to

abortions for eg: Jaggery, dates, pappaya, mangoes and eggs. 39 A study conducted

by Atiktriratnawati (2000), on "socio-cultural dimensions of anaemia among

pregnant women in rural areas of Java-Indonesia" shows that, during pregnancy

pregnant women should give attention to foods that they eat and cannot eat,

because they thought that baby will gain weight and it leads to difficult labour.

Among people they had their own way to reduce anaemia by eating some animal's

blood; beside Jamu and Iron tablet. But iron tablet acceptance among pregnant

women seemed to be very low, because of feeling bored and forgetting in taking

regularly. 5

The investigator has also gone through the antenatal clinic OPD records of

“K.L.E.S. Hospital and district hospital Belgaum”. It revealed that prevalence of

anaemia in K.L.E.S. hospital was 40%. and district hospital records revealed 80-

90%. After going through the records of community medicine department JNMC

Belgaum

(2003)

in

Shindolli

Village

of

Belgaum

rural

field

showed

that

prevalence of anaemia in pregnant women was (69.23%).

Abbreviations

Knowledge and practices are always related. The social values prevailing in

the community were also important contributory factors of anaemia. Every society

has its own traditional belief and practices. People have taken pleasure in using

them. A study was conducted by Nugraheni SA, Dasuk Djaswadi, Ismail Djauhar;

(2003) on "Knowledge, attitude and practice of pregnant women in correlation

with anaemia" it revealed that the lower knowledge about anaemia in pregnant

women

increased

anaemia

risk

‘five

times’

and

the

worse

practice

about

prevention of anaemia in pregnant women increased anaemia risk ‘six times’; So

the potential risk factors that indicated to increase anaemia were knowledge and

practices about anaemia in pregnant mothers. 4

Therefore, the investigator strongly felt the need to study the knowledge

and prevailing practice regarding prevention of anaemia among pregnant mothers

and also to appraise them of how far these practices were beneficial to the

mothers.

Abbreviations

STATEMENT OF THE PROBLEM

A study to assess the knowledge and practices regarding prevention of

anaemia among registered pregnant mothers attending antenatal clinics in selected

hospitals of Belgaum.

OBJECTIVES OF THE STUDY

To assess the knowledge regarding prevention of anaemia among registered

pregnant mothers.

To identify the practices regarding prevention of anaemia among registered

pregnant mothers.

To

find

out

the

relationship

between

knowledge

and

selected

variables

regarding

prevention of anaemia among registered pregnant mothers.

To

find

out

the

relationship

between

practices

and

selected

variables

regarding

prevention

of

anaemia among registered pregnant mothers.

To find out the relationship between knowledge and practices regarding

prevention of anaemia among registered pregnant mothers.

Abbreviations

OPERATIONAL DEFINITIONS

Knowledge:

Responses given by the mothers regarding prevention of anaemia on

questionnaire prepared by the investigator.

Practice :

In this study it refers to the mothers verbal responses given by the mother

regarding

certain

activities

performed

by

the

mother

during

pregnancy

for

prevention of anemia on structured interview with the help of check list.

Prevention of Anaemia :

In this study it refers to methods adopted by pregnant mothers in terms of

dietary intake and iron supplementation to prevent occurrence of anemia during

pregnancy and have an optimum haemoglobin level of l0gm/dl.

Registered pregnant mother :

The mothers whose pregnancy is confirmed and who has completed 12

weeks attending antenatal clinics.

HYPOTHESIS

1. There is significant relationship between knowledge and practices among registered pregnant mothers attending antenatal clinics regarding prevention of anaemia at 0.05 level of significance.

2. There

is

significant

relationship

between

knowledge

and

selected

demographic

variables

among

registered

pregnant

mothers

attending

Abbreviations

antenatal

significance.

clinics

regarding

prevention

of

anaemia

at

0.05

level

of

3. There is significant relationship between practices and selected demographic variables among registered pregnant mothers attending antenatal clinics regarding prevention of anaemia at 0.05 level of significance.

ASSUMPTIONS

The registered pregnant mothers have some knowledge regarding prevention of

anaemia.

The

registered

pregnant

mothers

prevention of anaemia.

perform

certain

INCLUSION CRITERIA

activities

regarding

All the registered pregnant mothers, those are attending the antenatal

clinics in K.L.E.S Hospital & MRC, and District Hospital, Belgaum.

EXCLUSIVE CRITERIA

Antenatal mothers :

Admitted in antenatal wards.

Who are not registered.

Associated with the complications i.e., Bad, obstetric history, systemic

disease, high-risk pregnancies.

DELIMITATION

The study is delimited only to the registered pregnant mothers attending

antenatal clinics of selected hospitals in Belgaum.

Abbreviations

THEORETICAL FRAMEWORK

The conceptual framework in the present study is based on the ‘health

promotion model’ proposed by Dr. Nola J Pender in the year 1996.

The model was developed as a complement to other health protecting

models like the health belief model.

The health promotion model explains the

likelihood that healthy life style patterns or health promoting behavior will when

those are intervened with additional modified knowledge.

Health promotion model identified three variables, which are as follows :

1. INDIVIDUAL CHARACTERISTICS AND EXPERIENCES :

The component consists of prior related behaviour which is solely based on

personal factors, available knowledge and practices. Prior related behavior is a

behavioral factor having direct and indirect effects. It is consistent with the focus

on perceived self-efficacy that future behavior is influenced by success or failure

with prior attempts at similar acts.

In the present study, prior related behavior

refers to the existing knowledge and practices of antenatal mothers regarding

prevention of anaemia in the following areas such as :

Knowledge regarding disease aspects of anemia

Knowledge regarding prevention of anemia

Practices regarding prevention of anemia. Personal factors are nothing but

biological,

Psychological

and

socio-cultural

factors

such

as

age,

women’s

education, family income, dietary pattern, obstetric score, Hb level are considered

to influence the future behavior leading to success or failure of health promotion.

Abbreviations

2. ACTIVITY RELATED AFFECT :

It consists of the subject’s positive or negative feeling associated with a

particular behavior that directly influence the performance of the behavior and

indirectly influence it, by enhancing self efficacy.

3. COMMITMENT TO A PLAN OF ACTION :

It includes the concept of intention with a planned strategy that causes the

intention to be formalized into a commitment to oneself or to another. 41

That is the planned teaching programme on preventive measures of anemia

leading to health promotion and the desired behavior outcome.

Abbreviations

Abbreviations

CHAPTER II

REVIEW OF LITERATURE

Review of literature is an important step in the development of research. It

involves identification, location, scrutiny and summary of written materials that

contain information on research problems. 42

The literature relevant to this study was reviewed and arranged in the

following sections.

I. Prevalence of anaemia in pregnant mothers.

II. Knowledge and practices of anaemia in pregnant mothers.

III. Treatment of anaemia in pregnant mother.

I. LITERATURE

RELATED

PREGNANT MOTHERS :

TO

PREVALENCE

OF

ANAEMIA

IN

Brabin L, Nicholas S, Gogate A, Gogate S and Karande A (1995)

undertook a study on prevalence of anaemia among women in Mumbai, India. In

this study the Haemoglobin levels of 2.813 women living in inner city Mumbai

was measured and the prevalence of anaemia among pregnant women was

(63.5%). 6

Meda N., Mandelbert L., Cartoux M., Dao B., Ovangre A. and Dabis

F., (1995-96) undertook a study on, “Anaemia during pregnancy in Burklnafaso,

West Africa prevalence and associated factors”. The study revealed that, the

overall prevalence of anaemia was 66%. The prevalence of mild anaemia was

30.8%, moderate anaemia was 33.5% and severe anaemia was 1.7%. Most (i.e.

Abbreviations

74%) of these anaemia’s were not accompanied by any morphological changes in

circulating erythrocytes and 22% were hypochromic (mean cell haemoglobin

concentration <32 gm/dl with microcytosis (5071) 8071). 7

Verhoeff

F.H.

(1999)

carried

out

a

study

on

“An

analysis

of

the

determinants of anemia in pregnant women in rural Malawi area and a basis for

action”. The results revealed that peak prevalence of moderately severe anaemia (8

gm Hb/dl) was between 26-30 weeks. Factors which were significantly associated

with increased risk were illiteracy and poor nutritional status. The basis of

anaemia prevention in this population of pregnant women was found to be malaria

control and haematinic supplementation. 8

Saxena V, Srivastava V.K., Idris M.Z., Mohan U., and Bushan V.,

(1997) conducted a study on “Nutritional status of rural pregnant women”. In this

study four hundred pregnant women were studied. The results showed that 38%

women were found to be suffering from anaemia out of which 3.7% women were

severely anaemic from mild and moderate degree of anaemia. 29.5% women were

taking less calories than recommended because of many socio-cultural reasons

such as illiteracy, poverty and wrong beliefs. 9

Kapil U, (1999) conducted a study in urban slum communities of Delhi.

Anaemia was noted in 78.8% of pregnant women and among them 47.8% were

moderately anaemic, 29.4% were mildly anaemic and 2.0% had severely anemic. 10

Vanden Broek N.R., Conya C.N., Mhango E. and White S.A. (1999)

conducted a study on “Diagnosing anaemia in pregnancy in rural clinics assessing

the potential of the haemoglobin colour scale in Malawi”. The study results

Abbreviations

revealed the distribution of (Hb) measurements obtained by colour counter in the

population

of

729

antenatal

women

examined.

Percentage

prevalence’s

for

categories of anaemia were 58.1% for (Hb) 8.0gm /dl, only 3 women had an

(Hb) of 6.0 gm/dl and 49.5% of values obtained were in the range of 10.0 – 11

gm/dl. 11

Awasthi. A., Thakur, R., Dave A and Goyal V., (2001) carried out a

study on “Maternal and Perinatal out come in cases of moderate and severe

anaemia”. The study comprised of 200 anaemia cases and non-anaemia (control

cases) out of 200 cases 71.5% had moderate anaemia and 28.5% had severe

anaemia. 12

Bentley

ME

and

Griffiths

PL,

(2003)

conducted

a

study

on

the

“Prevalence and determinants of anaemia among women in Andhra Pradesh”. The

results showed that prevalence of anaemia was high among all women. Out of it,

(32.4%) of pregnant women had mild anaemia, (14.19%) had moderate anaemia

and 2.2% had severe anaemia. 13

II. LITERATURE RELATED TO KNOWLEDGE AND PRACTICES OF

ANAEMIA IN PREGNANT MOTHERS :

Massawe S; Urassa E, Lindmark G and Nystram L; (1995) conducted a

study on "Anaemia in pregnancy perceptional of patients in Dar-es-salaam". A

total of 310 women were interviewed from three MCH clinics. In all these three

clinics more than 90% were aware of the advantages of early booking for antenatal

care but none of the mothers had received any ferrous supplements. The findings

revealed that there was lack of awareness between pregnant mothers related to

anaemia. 14

Abbreviations

Ziauddin Hyder. S.M., (1997) carried out a study to investigate the

prevalence of anaemia and the associated factors among pregnant women in two

rural areas of Bangladesh. The results of the study showed that 54% of the women

had anaemia. According to the WHO criteria, area of residence. Literacy and iron

tablet in take were significantly associated with prevalence of anaemia (P < 0.05).

The illiterate women had higher prevalence (60%) than the literate women (23%),

the women who reported to take iron tablet had lower prevalence (36%) than the

women who did not (60%). 15

Saibaba A, Sarma DS, Balakrishna N and Raghuram, (1999) conducted

a

study

on

"utilization

of

IEC

by

middle

level

health

personnel

in

the

implementation of national nutrition programmes". The findings revealed that, to

identify the vulnerable groups prone for anaemia, only 27.0% of respondent’s

mentioned pregnant women, with regard to the target group at whom the anaemia

prophylaxis programme was aimed; only 7.6% answered correctly while 64.0%

gave partially correct answers and it reveals that awareness among public and

pregnant mothers were found to be very low and also they lacked knowledge

regarding the anaemia prophylaxis programme. 16

Horner RD, Lackey CJ, Kolasak and Warren K, (1999) undertook a

study on “Pica practices of pregnant women”. The study revealed that the

evidences suggests that pica during pregnancy results in anaemia and may have

serious effects particularly; anaemia on mother and infant. 17

Lindsay H.A., (2000) published an article regarding anaemia and iron

deficiency effects on pregnancy out come. An article indicates that maternal iron

deficiency in pregnancy reduces fetal iron stores, perhaps, well into the first year

Abbreviations

of life. The study explains that infants develop iron deficiency anaemia; so the

study concludes that routine iron supplementation during pregnancy is necessary. 18

Kaur N and Singh K (2000) conducted a study on “Effect’s of health

education on knowledge, attitudes and practices; about anaemia on knowledge,

attitudes and practices; about anaemia among rural women in Chandigarh”. The

study revealed that socio-economic and demographic characteristics of both the

intervention and control groups were similar. All women in the intervention group

could specify atleast one correct cause of anaemia and identified a sign and

symptom of anaemia, where as, 73.3% and 46.6% women in the control group did

not specify the cause, signs and symptoms of anaemia respectively (P < 0.001).

The knowledge about methods of anemia prevention was significantly, higher in

intervention group compared to control group (P < 0.001). The results showed that

there was significant change in knowledge and attitude of women who received

health education. They concluded that a co-ordinated communication strategy is

required to improve anaemia prevention practices in the community. 19

Ejidokun OO (2000) conducted a study on "community attitudes to

pregnancy, anaemia, iron and folate supplementation in urban and rural lagos,

south western Nigeria. The findings revealed that maternal anaemia is not

perceived as a priority health problem by pregnant women. Knowledge of the

signs and symptoms of anaemia is limited among rural pregnant women. The

recognition of maternal complications associated with anaemia is low. To continue

taking iron tablets and communicating of the local beliefs, attitudes and practices

regarding pregnancy is needed to design more and more effective methods of

health education for pregnant women to improve their knowledge. 20

Abbreviations

Galloway R, et al; (2002) conducted a study on "women's perceptions of

iron deficiency and anemia prevention and control in 8 developing countries". The

result revealed that while women frequently recognize symptoms of anemia, they

do not know the clinical term for anemia. Half of the women in all countries

consider these symptoms to be priority health concern that requires action and half

do not. Those women who visit prenatal health services are often familiar with

visit

prenatal

health

services

are

often

familiar

with

iron

supplements

but

commonly do not know why they are prescribed. The pregnant women believes

that taking too much of iron may cause too much blood or a big baby, making

delivery

more

difficult.

Most

of the

knowledge regarding anaemia prevention. 21

women were

not having adequate

Ursell, Bernie (2003) published an article in clinical and laboratory

haematology regarding management of iron deficiency in pregnancy by using

iron-rich

spa

water

(spatone)

as

a

prophylaxis

against

iron

deficiency

in

pregnancy. The results showed that out of 102 patients, 31% of the patients, raised

their ferritin levels during trial period compared with 11% in the control group. 22

Mah-e-munir A., Mohammad A.A. and Misbahul I.K., (2004) conduced

a study on “Anaemia in pregnant women of railway colony, Multan”. The results

showed had microcytic hypochromic anaemia observed in 76% women, 64%

never used hemantinics, and no women had good dietary habits. The study

concluded that a comprehensive approach is required regarding health education

and management of anaemia in pregnant population. 23

Miaffo et al., (2004) carried out a study “Malaria and anaemia prevention

in pregnant women of rural Burkinafaso”. It is a cross sectional qualitative survey

Abbreviations

among 225 antenatal women of 8 villages. The results revealed that malaria and

anaemia were considered to be the biggest problems during pregnancy knowledge

using bed nets and good nutrition was less prominent. There was an urgent need to

implement malaria and anaemia prevention programmes on a large scale. 24

III.

LITERATURE

RELATED

TO

PREGNANT MOTHERS:

TREATMENT

OF

ANAEMIA

IN

Ekstrom EL, Hyder. Z, Choudhary AM.R, Lonnerdal. B and person

L.A (1998) conducted a study on “In a trial comparing weekly and daily

supplementation of iron”. According to WHO classification, pregnant mothers

were classified into mild, moderate and severe categories. The results showed that

after 12 weeks of supplementation, haemoglobin (Hb) increased in all three

categories. In the two highest haemoglobin categories (mild and moderate), a

maximum response was achieved after about 50 tablets. A maximum response in

the two lowest categories did not produce a normal haemoglobin, resulting in a

high remaining prevalence of anaemia after twelve weeks of supplementation. 25

Grover V, Aggarwal OP, Gupta A, Praveen Kumar and Tiwari RS;

(1998) conducted a study on "Effect of daily and alternate day iron and folic acid

supplementation to pregnant females on the weight of the New born" the findings

revealed that a total of 200 pregnant women were enrolled for the study out of

which only 120. Of these 120 women, 64 were given iron and folic acid tablets

daily (Group-1) and 56 were given iron and folic acid tablets on alternate days

(Group II). Most of these belonged to lower middle socio-economic group; Nearly

60% of these women were illiterate. The findings has been roved for a long time

Abbreviations

that regular iron supplementation during pregnancy is very helpful in increasing

the favorable outcome of the pregnancy in the form of decreased maternal

morbidity and mortality decreased fetal loss, increased weight and better survival

of the new born. 26

Sharma JB, Arora BS, Kumar. S, Goel. S and Hamija. A., (2002)

carried out a study on “Helminth and protozoan intestinal infections; an important

cause for anaemia in pregnant women”. The study revealed that intestinal

infections were directly proportional to the severity of anaemia out of 110 anaemic

pregnant women, 26.66% cases were in haemoglobin (Hb) 10-11gm% group,

43.54% were in Hb, 8 to 9.9 gm% group and 72.72 % were in Hb, 6 to 7.9 gm%

group and 90.90% were in Hb less than 6gm% group. The study concludes that

routine screening and treatment for all pregnant women is necessary to prevent

anaemia. 27

Alamgirmurshidi (2002) undertook a study on “Assessment of iron

supplementation activities among pregnant women in an Upazila of Bangladesh”.

Total 236 pregnant women were selected. Out of it 95 (40.3%) received iron from

any source. Pregnant women with formal education and working in garments had

significantly high rate of intake of iron supplements as compared to those who

were illiterate and women who were housewives (P < 0.05), 22% were not at all

aware of taking iron tablets. The iron supplementation activities among the

pregnant

women

was

very

unsatisfactory

in

Sreepur,

Upazila

of

Gaziapur

District. 28

Abbreviations

Ringels, et al; (2003) conducted a study on "Awareness of folic acid for

neural tube defect prevention among Israeli women”. The study shows that out of

920 women interviewed, only 51 (5.5%) had heard of folic acid and 27 (2.8%)

were reported to have taken it. Awareness of folic acid was significant among

women aged 17-29 years, among women who were aware of folic acid, only non-

religious women tended to take it. The study is evident about poor level of

awareness among women. 29

Moulessehoul S, Demmouche A, Chafi Y and Benali M (2004) carried

out a longitudinal study on “Effect of iron supplementation among pregnant

women”. The study showed that 31 out of 83 (37.3%) women had severe anaemia

(Hb < 11 g/110ml), 16 had moderate anaemia (7gm/dl < or = Hb <10gm/dl) and

15 had mild anaemia (10gm/dl < or = Hb < 11 gm/dl). The prevalence of anaemia

fell from 34.1% in the first trimester before supplementation to 6.3% in the third

trimester. These findings suggested that iron supplementation is a good strategy

for treating and preventing anemia during pregnancy. 30

Ma AG, Chen XC, Wang Y, XuRx, Zheng MC and Lijsi (2O04)

conducted a study on "The multiple vitamin status of Chinese pregnant women

with anaemia and non-anemia in the last trimester". They founded that the subjects

with iron deficiency anaemia had much higher rates of vitamin C, foliate and

vitamin B12 deficiencies than those in non anaemia subjects and the deficient rates

reached

64.04%.

The

findings

revealed

that

multiple

vitamin

deficiencies,

especially ascorbic acid, retinol and folic acid may be associated with anaemia or

iron deficiency in pregnant women in the last trimester. 31

Abbreviations

CHAPTER III

RESEARCH METHODOLOGY

Methodology of research includes the general pattern of organizing the

procedure for gathering valid and reliable data for problem under investigation

(Polit and Hungler, 1991). 42

This chapter deals with the description of the research methodology

adopted by the investigator to study and analyze the knowledge and practice

regarding preventions of anemia among registered pregnant mothers.

The various steps undertaken to conduct the study includes research

approach, research design, setting, population sample and sampling techniques,

pilot study and plan for data analysis.

Research approach:

Since, the present study is aimed at identifying the knowledge and practices

regarding prevention of anemia among registered pregnant mothers, a descriptive

research method is felt to be appropriate and thus used for the study.

Research design:

The research design spells out the basic strategies. The research adopts to

develop information that is accurate and interpretable and incorporates some of the

most important methodological decisions that to research makes in conducting a

research study (Polit and Hungler, 1991). 42

In this study, non-experimental descriptive design was adopted to find out

the level of knowledge and practices regarding prevention of anemia among

registered, pregnant mothers.

Abbreviations

Research setting:

The study was conducted in the “Obstetrics and Gynecological Out Patient

Department, of K.L.E.S Hospital and MRC, Belgaum”.

Population:

In this study the population were registered pregnant mothers attending

antenatal clinics in the obstetrics and gynecological unit of K.L.E.S Hospital and

MRC, Belgaum.

Sample size:

The sample cluster consisted of 105 registered pregnant mothers attending

antenatal clinics.

Sampling technique:

Polit and Hungler, (1995) states that “Sampling refers to the process of

selecting the samples for the study”. 42

A technique of purposive (non-probability) sampling was adopted.

Criteria for sample selection:

i. Inclusion criteria:

All the registered pregnant mothers attending the antenatal clinics in

K.L.E.S Hospital and MRC, Belgaum.

Abbreviations

ii. Exclusive Criteria:

Antenatal mothers :

Admitted in antenatal wards.

Who are not registered.

Associated with the complications such as systemic disease and high-

risk pregnancies.

METHODS OF DATA COLLLECTION:

A formal permission to conduct the study was obtained from the authorities

of the hospital.

A structured interview schedule with the option of ‘yes’, ‘no’, or ‘do not

know’ and a checklist with the option ‘yes’ or ‘no’, was developed after extensive

review of related literature and in consultation with experts in the field of

Obstetrics and Gynaecological Nursing, statistics in order to assess the knowledge

and practices regarding prevention of anemia among registered pregnant mothers

attending antenatal clinics.

Development and description of the tool:

To prepare the tool the following steps were carried out which are as follows :

1. Literature review

2. Preparation of blueprint

Literature review:

Literature review from books and journals were reviewed and were used to

develop the tool.

Abbreviations

Preparation of blue print:

The Blue Print

(Appendix B) pertaining to the domain of learning i.e,

knowledge and practices were prepared.

Description of the tool:

To achieve the set objective of the tool was organized in following 3

sections :

Section I :

Elicits the sociodemographic and baseline data of the mothers such as age,

religion,

marital

status

and

educational

status.

Family

income,

occupation,

obstetric score, hemoglobin level etc. There were totally 13 items in this section.

Section II :

It is divided into 2 subsections for the convenience of getting required

information.

A. Elicits the knowledge regarding anemia.

B. Elicits the knowledge regarding prevention of anemia. Totally there were

36 questions which were divided into A and B

Each question had 3 options, yes / no /do not know. Those mothers who

gave correct answer were given score ‘1’. Those who gave wrong answer were

given score ‘0’ and it was graded as

1.

2.

3.

< X -1 SD – poor knowledge

it was graded as 1. 2. 3. < X -1 SD – poor knowledge X –

X – 1 SD to + 1SD – average knowledge

>X + 1SD – Good knowledge

Abbreviations

Section III :

The practices in registered pregnant mothers regarding prevention of

anemia were found out with the help of checklist with the options of (yes or No ).

Totally, there were 23 Questions. Which were divided into diet, hygiene and

treatment.

The common responses were grouped.

Those mothers who give

correct answers were given score ‘1’. Those who gave wrong answer were given

score ‘0’ and it was graded as:

1. Beneficial practices

2. Non-beneficial practices.

Content validity :

The tool, and the blueprint were submitted to the experts for content

validity.

The experts (Appendix F) were from the field of nursing, medicine and

research.

The experts were requested to review and verify the items for adequacy,

clarity, appropriateness and meaningfulness. Some modification of the items were

done on the basis of suggestions and comments given by the experts. The tool was

translated into Kannada and Marathi (Appendix C).

Suggestions given to change were:

1. Items on knowledge:

a. Q. No: 17 “Palpitation and breathing difficulty are the important symptoms

of anemia”, was corrected to “palpitation and breathing difficulty are the

signs of anemia “

b. Q. No 26 was included for e.g. “Iron tablet should not be taken along with

milk or any hot drinks.”

Abbreviations

c. This question was added “Dates and dry grapes” are rich sources of iron.

d. “Intake of papaya during pregnancy leads to abortion.” This question was

deleted.

2. Items on practices :

One question was included i.e. “Do you wash the vegetables before

cutting?”

Reliability of the tool :

The reliability of the tool was tested by introducing the tool among 16

pregnant

mothers,

attending

antenatal

clinics.

This

was

done

by

critically

evaluating the questions based on difficulty index and discriminative to index. To

estimate the reliability for the entire test, co-efficient of co-relation was done by

estimating coefficient of correlation and applying Spearman’s “Brown proficiency

formula and Yules (Q) test”, for coefficient and research was found to be r =1.

Procedure for data collection :

A formal permission to conduct the study was obtained from the authorities

of the hospital.

The nature of the study was briefly explained to them and it was ensured by

the investigator that the normal routine of the hospital would not be distrupted. A

time schedule was planned which is as follows, 10.00am to 1 noon and 3 pm to 4

pm.

The mothers who fulfilled the criteria laid down for study, were selected.

After selection of the samples, the pregnant mothers were made to sit down in any

available quite place.

The pregnant mothers were interviewed personally, by the

Abbreviations

investigator.

The interview was taken for about 30 to 45 minutes.

Everyday 5-6

mothers were interviewed, totally 105 clients were interviewed from 05.08.05 to

05.09.05

Pilot study :

The main aim of study is to find out practicability, feasibility and reliability

of the study. (Polit and Hungler 1991). 42

The pilot study was conducted on 16 patients in the Obstetrics and

Gynaecological OPD of K.L.E.S Hospital and MRC Belgaum from 1.08.2005 to

3.08.2005 for 3 days with the purpose of testing the proficiency of the instrument

to be used for data collection. Samples were collected from obstetrics and

antenatal

OPD

of

K.L.E.S

Hospital

Belgaum.

During

the

pilot

study

the

investigator noticed that it was necessary to modify the tool; because the medical

terms were not understood by the patients. The time taken to complete the tool

was 30 minutes for each patient.

Plan for analysis :

1. The data was collected and analyzed by using descriptive and inferential

statistical method according to the objectives.

2. The responses on different items were tabulated in a master sheet.

3. The scores were expressed through percentage for meaningful and easy

handling of calculation.

4. Statistical treatment used for the analysis were :

Mean Median Standard deviation Chi-square test

Abbreviations

RESEARCH PROCESS

Target population Registered pregnant mothers attending antenatal clinics Sample size 105 in number
Target
population
Registered pregnant mothers
attending antenatal clinics
Sample size
105 in number

Sampling

Instrument

Purposive sampling

size 105 in number Sampling Instrument Purposive sampling Structured interview Data Collection Socio-demographic

Structured interview

Sampling Instrument Purposive sampling Structured interview Data Collection Socio-demographic variable Knowledge
Data Collection Socio-demographic variable Knowledge regarding anaemia Knowledge regarding prevention of anaemia
Data Collection
Socio-demographic variable
Knowledge regarding anaemia
Knowledge regarding prevention
of anaemia
Practices regarding prevention of
anaemia
Analysis
Descriptive and
inferential statistics

Abbreviations

CHAPTER IV

ANALYSIS AND INTERPRETATION OF DATA

The purpose of the data analysis is to reduce the data to manageable and

interpretable form, so that the research problems can be st udied and tested. 44

Abedellah and Levine (1979) state that “Interpretation of tabulated data can

bring to light the real meaning of the findings of the study”.

This chapter deals with analysis and interpretation of data collected to

assess the knowledge and practices regarding prevention of anaemia among

registered pregnant mothers attending antenatal clinics in selected hospitals of

Belgaum.

The analysis and interpretation of the data of this study were based on, data

collected

through

structured

interview

schedule

and

checklist

of

registered

pregnant mothers attending antenatal clinics, (N = 105).

The results were computed using descriptive and inferential statistics based

on the objectives of the study. The data has been organized and analyzed under the

following headings :

1. The demographic and baseline data in relation to age, women’s education,

husband’s education, religion, type of family, women’s occupation, family

income, diet, registration, obstetric score, menstrual history and birth

spacing between previous pregnancies and hemoglobin level.

2. Item-wise analysis of subjects regarding knowledge of anemia and its

prevention of anaemia.

3. Item-wise analysis of subjects regarding practices related to prevention of

anaemia.

Abbreviations

4. Distribution of level knowledge according to selected variables, that is age,

women’s education, family income and Gravida.

5. Distribution of classification of practices according to selected variables,

that is age, women’s education, family income and Gravida.

6. Association between the knowledge and practices regarding prevention of

anaemia among registered pregnant mothers.

Abbreviations

SECTION I :

TABLE NO. 1A

Distribution of mothers according to sociodemographic data

N = 105

S.No

Variables

Frequency (f)

Percentage (%)

1

Age :

   

15-19 yrs 20-24 yrs 25-29 yrs 30 yrs and above

21

20.00

56

53.33

24

22.85

4

3.80

2

Women’s education :

   

No formal education Primary education Secondary education Higher secondary education Graduate

35

33.33

16

15.23

30

28.57

12

11.42

12

11.42

3

Husband’s education :

   

No formal education Primary education Secondary education Higher secondary education Graduate

6

5.71

22

20.95

34

32.38

24

22.85

19

18.09

4

Religion :

   

Hindu

71

67.61

Muslim

27

25.71

Christian

5

4.76

Any other

2

1.90

5

Type of family :

   

Nuclear family

58

55.23

Joint family

47

44.76

6

Woman’s occupation :

   

House wife

100

95.23

Labourer

3

2.85

Professional

2

1.90

7

Family’s income :

   

Below Rs. 2000/ month Rs. 2001 – 3000/ month Rs. 3001 – 4000/ month Rs. 4001 – 5000/ month Rs. 5001 & above

23

21.90

41

39.04

28

26.66

12

11.53

1

0.95

8

Diet :

   

Vegetarian

28

26.66

Mixed

77

73.33

Abbreviations

Table no. 1A describes that majority i.e. 56 (53.33%) of mothers belonged

to 20-24 years of age, only 4 (3.80%) were in the age group of 30 years and above.

According to educational status, maximum 35 (33.33%) of the mothers had

no formal education while 12 (1142%) had higher secondary education and also

12

(11.42%)

were

graduates.

Husband’s

educational

status

revealed

that

34

(32.38%)

had

secondary

education

and

only

6

(5.71%)

had

no

formal

education.

Regarding religion majority 71 (61.61%) of mothers belonged to Hindu

religion, 27 (25.71%) of the mothers belonged to Muslim religion, 5 (4.76%) of

the mothers belonged to Christian religion and only 2 (1.9%) of the mothers

belonged to other religion.

Further, the table shows that majority 58 (55.23%) of the mother’s

belonged to nuclear family and only 47 (44.76%) belonged to joint family.

Regarding occupational status of women majority 100 (95.23%) of the

mother’s were Housewives and 2 (1.90%) were professionals.

From the financial point of view, the family income indicates that majority

41 (39.04%) of the family income ranged between Rs. 2001-3000 per month and 1

(0.95%) ranged between Rs. 5001 and above per month.

Regarding diet majority 77 (73.33%) of the mothers were taking mixed

diet, whereas 28 (26.66%) of the mothers were taking vegetarian diet.

Abbreviations

Graph - 1

Distribution of mothers according to sociodemographic data

Abbreviations

TABLE NO. 1 B

Distribution of mothers according to base line data

N = 105

S.No

Variables

Frequency (f)

Percentage (%)

9

Registered during 1 st trimester 2 nd trimester 3 rd trimester

59

56.19

38

36.19

10

9.52

10

Obstetric score Primigravida Multigravida

33

31.42

72

68.57

11

11.1 Menstrual history Less than 3 days Between 3 to 5 days More than 5 days

4

3.80

97

92.38

4

3.80

 

11.2 Amount of blood flow

   

Heavy & regular

41

39.04

Heavy & irregular

3

2.85

Scanty & regular

58

55.23

Scanty & irregular

3

2.85

12

Birth spacing between previous pregnancies

   

< 2 years

18

17.14

2 – 3 years

49

46.66

> 3 years

7

6.66

13

Haemoglobin level (According to WHO classification :

   

Mild degree (9.1 – 11 gm/dl)

53

50.47

Moderate degree (7.1 – 9.0 gm/dl)

29

27.61

Severe degree (<7.0 gm/dl)

3

2.85

The data presented in table 1b reveals that 59 (56.19%) of mothers were

registered during 1 st trimester, where as 38 (36.19%) of mothers were registered

during 2 nd trimester, only 10 (9.52%) of the mothers were registered during 3 rd

trimester.

Abbreviations

Regarding obstetric score majority 72 (68.57%) of the mothers were

multigravida, where as only 33 (31.42%) of the mothers were primigravida. From

the menstrual history, majority 97 (92.38%) of the mothers had menstrual flow

ranging between (3-5 days and 4 (3.80%) of the mother had less than 3 days and

also 4 (3.80%) of the mothers had more than 5 days. Regarding the amount of

blood flow shows that maximum 58 (55.23%) of the mothers had scanty and

regular flow, 41 (39.04%) of them had heavy and regular periods, 3 (2.85%) of

them had heavy and irregular periods, 3 (2.85%) of them had scanty and irregular

periods.

It was also observed that, Birth spacing between previous pregnancies

shows that majority 49 (46.66%) of the mothers had the range between 2-3 years,

18 (17.14%) of the mothers had > 2 years and 7 (6.66%) of the mothers had < 3

years.

According to WHO classification; the haemoglobin of the mothers shows

that majority 53 (50.47%) of them had mild anaemia, where as 29 (27.61%) of

them had moderate anaemia, only 3 (2.85%) of them had severe anaemia.

Abbreviations

Graph - 2

Distribution of mothers according to base line data

Abbreviations

SECTION II :

KNOWLEDGE REGARDING ANAEMIA AND ITS PREVENTION

TABLE NO. 2

Mean, median and standard deviation of knowledge scores of the registered pregnant mothers regarding prevention of the anaemia

N = 105

Mean

Median

SD

18.142

53

4.84

Table No. 2 shows that, the Mean, Median and SD of knowledge scores regarding disease aspects and prevention of anaemia among registered pregnant mothers attending antenatal clinics, the mean 18.142, median 53, SD 4.84.

TABLE NO. 3

Distribution of subjects according to level of knowledge of disease aspects and

prevention of anaemia N = 105 Level of knowledge Frequency Percentage % <X-1SD (<13) Poor
prevention of anaemia
N = 105
Level of knowledge
Frequency
Percentage %
<X-1SD (<13) Poor
16
15.23
X – 1SD to X + SD (13 + 21) average
76
72.38
>X + 1SD (>21)-Good
13
12.38
Total
105
100
Above table shows the level of knowledge scores regarding. Disease
aspects and prevention of anaemia among registered pregnant mothers.
The level of knowledge was categorized on the obtained mean and
standards deviation of total correct knowledge scores. Out of which 12.38%
mothers had high or good knowledge (X+1SD), 72.38% mothers had average

knowledge (X-1SD to X+1SD), 15.23% mothers had poor knowledge (X-1SD).

Abbreviations

Graph – 3

Distribution of subjects according to level of knowledge of disease aspects and

prevention of anaemia

Abbreviations

TABLE NO. 4 A

Distribution of mothers according to knowledge on various aspects of anaemia

N = 105

I

VARIOUS ASPECTS OF ANAEMIA

 

Frequency (f)

Percentage (%)

1

Pregnancy creates large demand of iron

 

95

90.47

2

Increase Hb% in the blood is anaemia

 

31

29.52

3

Anaemia is a nutritional disorder

 

55

52.38

4

Haemoglobin

value

in

pregnancy

is

iron

31

29.52

8gm%

5

Iron required for Hb formation

 

46

43.80

The above table reveals that 95 (90.47%) of mothers know that pregnancy

creates a large demand of iron, whereas 55 (52.38%) of mothers responded

correctly that anaemia is a nutritional disorder; 46 (43.80%) of mothers responded

correctly that elemental iron is important for haemoglobin formation, whereas

only 31 (29.52%) of mothers were aware of what is anaemia and knew the normal

value of haemoglobin.

Abbreviations

Graph - 4

Distribution of mothers according to various aspects of anaemia

Abbreviations

TABLE NO. 4 B

Distribution of mothers according to knowledge on causes

N = 105

S.

Causes

Frequency (f)

Percentage

No

(%)

1

Obesity in pregnancy

18

17.14

2

Hook worm infestation and malaria

24

22.85

3

Haemorroids during pregnancy

18

17.14

4

History of heavy menstrual flow

20

19.04

5

Bleeding disorders

25

23.80

6

Repeated pregnancies

41

39.04

7

Recurrent abortions

64

60.95

8

Twin pregnancy

17

16.19

9

Faulty dietary habits

91

86.66

From the above table, it is observed that 91 (86.66%) of mothers knew that

faulty dietary habits causes anaemia, 64 (60.95%) of mothers responded correctly

that recurrent abortions causes anaemia. Whereas 41 (39.04%) mothers knew that

repeated pregnancies leads to anaemia, 25 (23.80%) of mothers knew that

bleeding disorders in previous pregnancy labour and puerperium causes anaemia,

24 (22.85%) of them knew that hookworm infestation and malaria is the leading

cause for anaemia. Twenty

(19.04%) of the mothers responded correctly that

history of heavy menstrual flow causes anaemia, only 18 (17.14%) were aware

that obesity in pregnancy and harmorroids causes anaemia.

Abbreviations

Graph - 5

Distribution of mothers according to knowledge on causes

Abbreviations

TABLE NO. 4 C

Distribution of mothers according to knowledge on signs and symptoms of

anaemia

N = 105

S. No

Signs And Symptoms

Frequency (f)

Percentage (%)

1

Tiredness and weakness

84

80.00

2

Pallor of the face, eyes, lips, tongue and

57

54.28

nails

3

Palpitation and breathing difficulty

11

10.47

The above table shows that, majority 84 (80%) of the mothers knew that

tiredness and weakness are the symptoms of anaemia and 57 (54.28%) of mothers

knew that pallor of the face, eyes, lips, tongue and nails are the important signs of

anaemia; only 11 (10.47%) of mothers were aware that palpitation and breathing

difficulty are the signs of anaemia.

Abbreviations

Graph - 6

Distribution of mothers according to knowledge on signs and symptoms of anaemia

Abbreviations

TABLE NO. 5A Distribution of mothers according to knowledge on sources of iron rich foods

N = 105