INTRODUCTION:

Pregnancy is one of the most special and also the most critical phase in a woman’s life. In India being developing countries 26% global burden maternal mortality rate with nearly 136000, women dying annually UNICEF 2009.¹ Every 7mts 1 women die due to complication in pregnancy or child birth in India². Antenatal care is a type of preventive health care with the goal of providing regular antenatal checkup that allow doctor or midwife to treat and prevent potential health problems throughout the pregnancy while promoting healthy styles that benefits of both mother and baby³.Antenatal checkup is one part of the antenatal care. Antenatal checkup defined that antenatal testing includes any diagnostic procedures performed before the birth of the baby. Ideally expectant mother to visit the antenatal clinic is called as antenatal check up. The WHO recommends that pregnant women should all receive 4 antenatal visits to spot and treat problems and give immunizations. Although Antenatal checkup is important for improving the health and baby, many women do not receive four visits.³Antenatal diagnoses is aspect of antenatal care that focuses on detecting anatomic and physiological problems with the zygote, embryo or fetus before it’s born. Common diagnostic testing procedure includes such as blood sample (sugar, urine, and hemoglobin), amniocentesis, chorionic villus sampling, fetal blood sampling, and ultrasonography including nuchal translucency, serum biomarker testing or genetic testing.³In developing countries, pregnancy and childbirth are one of the leading causes of death for women of reproductive age. The slogan for world health day 2005 “making every mother and child count” reflects the reality that today, government and the community need to make the health of women and children a higher priority^4.The World Health Organization (WHO) estimates that worldwide more than 529,000 women die every year from complications of pregnancy, childbirth and abortion. Ninety nine percent (99%) of these deaths are from the developing countries. Less than 1% of these deaths occur in more developed countries making maternal mortality the health indicator with the greatest disparity between developed and developing countries. According to the WHO report in Karnataka 51/1000 population maternal death has occurred. It is mainly due to lack of maternal health care during pregnancy⁵. Karnataka shows 380 women get pregnancy every minute, out of one hundred and ten have complications, one dies and thirty are near missed cases. So that appropriate health education on antenatal check up and diagnostic measures are needed in pregnant women to ensure normal maternal health. Early registration of pregnancy with a health care provider facilities assessment and nutritional status of the mother and to obtain their baseline information on blood pressure, weight etc. An early contact a with health care provider also helps to screen for complication early and manage appropriately⁶. In Karnataka many studies reveals that, the primi mothers are having lack of awareness about the antenatal check up and its importance. Due to this the maternal mortality rate was high among primi mothers. This initiates the researcher to carry out the study among the primi mothers regarding importance of antenatal check up and diagnostic measures.

_{STATEMENT OF THE PROBLEM:}

A study to evaluate the effectiveness of structured teaching programme on knowledge regarding importance of antenatal checkup and diagnostic measures among primi mother in selected community area at Bangalore.

_{OBJECTIVES OF THE STUDY:}

1. To assess the pretest knowledge score on importance of antenatal checkup and diagnostic measures among primi mothers.

2. To assess the post test knowledge score on importance of antenatal checkup and diagnostic measures among primi mothers.

3. To evaluate the effectiveness of structured teaching programme an importance of antenatal checkup and diagnostic measures among primi mothers.

4. To compare pretest and post test knowledge score on importance of antenatal checkup and diagnostic measures among primi mothers.

5. To find out association between the post test knowledge score with selected demographic variables.

HYPOTHESIS:

H.1. The mean post test knowledge score is significantly higher than the pre test knowledge score on importance of antenatal check up and diagnostic measures.

H.2. There will be a significant association between the post test knowledge scores of the primi mother with their selected demographic variables.

RESEARCH METHODOLOGY:

The evaluative research approach was adopted for this study. A quasi experimental one group pre test and post test group design was undertaken for the present study. The study was conducted in Hegganahalli community area at Bangalore. Target population for the study was primi antenatal mothers. The total antenatal population is 432outof 286 is prim antenatal mothers at hegganahalli community area at Bangalore. The sample size comprised 60 primi antenatal mother who fulfilled the inclusion criteria. Non probability convenient sampling technique was used to select the samples. Structured interview schedule was used to assess the knowledge on antenatal check up and diagnostic measures. The reliability of the tool was established by test retest method to assess the reliability of knowledge questionnaire. After getting the consent permission data collection was carried out. The demographic characteristics were collected by using demographic data sheet. Primi antenatal mother demographic data includes such as age, religion, educational status, occupation, family income, types of family, number of antenatal visit, trimester of pregnancy, source of information. Pre test level of knowledge was assessed by structured interview schedule knowledge. The multiple choice questionnaire was used to assess the knowledge regarding importance of antenatal check up and diagnostic measures. It consists of 40 multiple choice questions with 4 options among one is correct answer and three is wrong answer. On the same day structured teaching given through flash cards and lecture discussion. It was a period of 45mts -1hr.After 7days post test was conducted by the investigator, using the same structured interview schedule. The collected data were tabulated and analyzed by using descriptive statistics and inferential statistics.

RESULTS:

Table 1.Frequency and percentage distribution of primi mothers according to their Demographic variables (N=60)

S.No	Demographic variables	No	%
1	Age ( In Years)
	a. 18-20 Years	10	16.7
	b. 21-23 Years	24	40.0
	c. 24-26 Years	12	20.0
	d. 27-29 Years	8	13.3
	e. 30 and above	6	10.0
2	Religion
	a. Hindu	45	75.0
	b. Christian	6	10.0
	c. Muslim	9	15.0
	d. Others	0	0.0
3	Educational status
	a. Illiterate	7	11.7
	b. Primary school	38	63.3
	c. Middle Secondary	9	15.0
	d. Graduate	6	10.0
	e. Post graduate	0	0.0
4	Occupational Status
	a. House wife	52	86.7
	b. Coolie	4	6.7
	c. Self employed	0	0.0
	d. Government	0	0.0
	e. Private	4	6.7
5	Monthly income of the family (In Rs)
	a. Below 3000	0	0.0
	b. 3001—6000	15	25.0
	c. 6001—9000	20	33.3
	d. Above 9001	25	41.7
6	Type of family
	a. Nuclear family	47	78.3
	b. Joint family	13	21.7
7	Number of antenatal visit
	a. First antenatal visit	11	18.3
	b. Second antenatal visit	20	33.3
	c. Third antenatal visit	15	25.0
	d. Above third antenatal visit	14	23.3
8	Trimester of pregnancy
	a. First trimester	14	23.3
	b. Second trimester	27	45.0
	c. Third trimester	19	31.7
9	Did you receive any information?
	a. Yes	34	56.7
	b. No	26	43.3
10	If yes, what is the source of information
	a. Health personal	10	29.4
	b. Family members	6	17.6
	c. Relatives	4	11.8
	d. Friends	8	23.5
	e. Mass media	6	17.6

Table 1. Majority of the primi mothers, 24 (40.0%) belonged to the age group of 21-23 years , 45 (75.0%) were Hindus , 38 (63.3%) had primary school education, 52(86.7%) are housewives,25 (41.7%) had on family income is above Rs.9001/-,47 (78.3%) belonged to nuclear family, 20 (33.3%) were visited the hospital at second antenatal visit, 27 (45.0%) primi mothers were in second trimester, 34 (56.7%) received information on antenatal check up and diagnostic measures, 10 (29.4%) received information through health personnel.

Table2.Aspect wise distribution of pretest knowledge score regarding importance of antenatal checkup and diagnostic measures among primi mothers n=60

Aspects wise Knowledge	Level of Knowledge
Aspects wise Knowledge	Inadequate (< 50%)		Moderate (50--75%)		Adequate (>75%)
First trimester	60	100	0	0	0	0
Second trimester	60	100	0	0	0	0
Third trimester	60	100	0	0	0	0
Overall	60	100	0	0	0	0

Table 2. Pre test shows that all primi mothers are having inadequate knowledge on importance of antenatal checkup and diagnostic measures in first trimester, second trimester, and third trimester 60(100%).

Table 3. Aspect wise distribution of post test knowledge score regarding importance of antenatal checkup and diagnostic measures among primi mothers

Aspects wise Knowledge	Level of Knowledge
Aspects wise Knowledge	Inadequate (<50%)		Moderate (50--75%)		Adequate (>75%)
First trimester	0	0.0	5	8.3	55	91.7
Second trimester	0	0.0	16	26.7	44	73.3
Third trimester	0	0.0	42	70.0	18	30.0
Overall	0	0.0	20	33.3	40	66.7

Table 3. Post test shows that aspect wise distribution of the knowledge scores regarding importance of antenatal checkup and diagnostic measures among primi mothers, 20(33.3%) had moderate adequate knowledge and 40 (66.7%) are had adequate knowledge.

Table 4 Shows that area wise distribution of knowledge score regarding antenatal checkup and diagnostic measures among primi mothers pretest mean was 8.84 and SD was 1.65, the mean percentage was 22.1 and post test mean was 31.89 and SD was 1.32.The mean percentage was 79.7. Compared paired ‘t’ value for degree of freedom 59, ‘t’ value is 2.39.The calculated ‘t’ values are 31.2,18,21, 36.4 respectively in the aspects of first trimester, second and third trimester. Level of significant at p<0.01. So that structured teaching programme was effective in improving the knowledge on importance of antenatal check up and diagnostic measures in first trimester, second trimester, and third trimester.

Aspects of Knowledge	Pre test			Post test			Enhancement			Paired 't' test
Aspects of Knowledge	Mean	SD	Mean%	Mean	SD	Mean%	Mean	SD	Mean%	Paired 't' test
First trimester	4.43	1.09	22.2	17.28	3.4	86.4	12.85	3.2	64.3	31.2**
Second trimester	2.11	0.98	21.1	6.58	1.9	65.8	4.47	2.5	44.7	18**
Third trimester	2.3	0.94	23.0	8.03	2.64	80.3	5.73	2.4	57.3	21**
Overall	8.84	1.65	22.1	31.89	1.32	79.7	23.05	4.8	57.6	36.4**