A Study to assess the Knowledge regarding Weaning among under five children mothers at Waghodia, Vadodara, Gujarat with a view to develop Health Education Programme

 

Naho Edgie, Varia Anjali, Varia Khevna, Prajapti Anita, Mackwana Prinkal, Thakor Mayuri, Tadvi Nehal, Jaydeep, Jayesh1, Tejas Pandya2

1GNM Students, Parul Institute of Nursing, Parul University, Vadodara  

2Assistant Professor, Department of Child Health Nursing, Parul Institute of Nursing, Parul University, Vadodara

*Corresponding Author E-mail: tejaspandya1988@gmail.com

 

ABSTRACT:

Introduction: Breast feeding provides an unparalleled manner to supply complete and ideal nourishment for the infant in the beginning of life. Although, some studies show that exclusive breast feeding for more than 6 months may also increase malnutrition. At this age breast-milk alone is not enough to meet the needs of infant. Ideally, an infant should be exclusively breast fed for 6 months followed by additional foods being gradually introduced. Objectives of the study 1. To assess the existing knowledge of mothers on weaning. 2. To find out the association between knowledge of mothers and selected demographic variables on weaning. 3. To develop health education program. Hypothesis: H1: There will be significant difference in the knowledge regarding weaning under-five children’s mother.H2: There will be significant association between pre-test knowledge of mothers with their selected demographic variables. Material and Methods: In this research study descriptive research approach is used. Non probability purposive sampling technique was used to select the 30 samples of mothers of under five children. Data was analyzed by using descriptive and interferential statistics such as mean, standard deviation and chi square. Result: The data from the above table shows that, in pre-test under-five children’s mothers were having on average 29.5%3% knowledge regarding weaning and mean score was 5.9±2.57.It is observed from the present study that the Mean, Standard deviation and Mean difference of aspects of knowledge of under-five children’s mothers. It reveals that the subjects had a maximum mean of 1.76 with a standard deviation of 1.19 and mean percentage of 8.80% for qualities and principles of weaning. The mean score of 1.06 with standard deviation of 1.14 and mean percentage of 5.30% for introduction and weaning at different age. The mean score of 0.26 with a standard deviation 0.44 and mean percentage of 1.30% for Definition of weaning.

 

KEYWORDS: Breast feeding, Exclusive breast-feeding, Malnutrition, Infant.

 

 

 

 

 

 

 

INTRODUCTION:

Breast feeding provides an unparalleled manner to supply complete and ideal nourishment for the infant in the beginning of life. Although, some studies show that exclusive breast feeding for more than 6 months may also increase malnutrition. At this age breast-milk alone is not enough to meet the needs of infant. Ideally, an infant should be exclusively breast fed for 6 months followed by additional foods being gradually introduced1.

 

Need for study:

The children of today are citizens of tomorrow. Unless the nutritional needs of the children are adequately met, we cannot ensure healthy citizens of future. The death rate is highest in the age group 0-4 years. This is result of malnutrition and infection. About 21% of total deaths are estimated to be in the age group 0-1 year. On the basis of unit body weight, the infant as well as the young child has need for the greater amounts of nursing food than adult(2).Growth faltering at this age may occur as the child outgrows its mother's capacity to produce breast milk and to provide adequate supplementation. In introducing weaning foods, there may be diverse effects from timing, such as early or late weaning, and from the types of foods used. This process also has great geographic and cultural variations. Improving feeding and weaning practices like appropriate timing and quality of weaning foods, adequate in protein, high content of vitamins A and D, iron, and zinc should be emphasized. To prevent diarrhea caused by bacterial contamination, freshly cooked or freshly peeled foods should be used. Proper feeding and weaning practices have three focal levels: family, community, and commercial. Communities must be given the tools and guidance to monitor children's growth and nutrition status and to produce and distribute appropriate supplementary foods to combat malnutrition and the means to secure resources that can maintain innovative community nutrition activities(3).

 

Objectives of the study:

1. To assess the existing knowledge of mothers on weaning.2. To find out the association between knowledge of mothers and selected demographic variables on weaning. 3. To develop health education program.

 

Hypothesis:

H1:     There will be significant difference in the knowledge regarding weaning under-five children’s mother.

H2:     There will be significant association between pre-test knowledge of mothers with their selected demographic variables.

 

Research Approach:

A descriptive survey research approach was considered the best to assess the knowledge.

 

Research design:

The investigator selected non-experimental descriptive design to assess knowledge of under-five children’s mothers regarding weaning at Waghodia, Vadodara, Gujarat.

 

Setting:

The geographical area of the waghodia taluka which is under district vadodara and gujarat state and investigator collected the data from the aaganwadi under the waghodia taluka. 

 

Variable:

Independent variables:

In this present study health education programme on weaning.

 

Dependent variable:

In this present study knowledge level of under-five children’s mothers.

 

Sample:

The samples for the present study were students studying in under-five children mothers at waghodia.

 

Sample size:

In the study the sample size constitutes of 30 under-five children’s mothers at waghodia.

 

Sampling Technique:

The samples of the study will be selected by using non-probability purposive sampling technique according to inclusive criteria as availability of samples.

 

Inclusion criteria:

1.Willing to participate in the study.2.Able to understand Guajarati or hindi.3.Available during the period of data collection.

 

Exclusion criteria:

Age more than 5 years of children.

 

Description of tool:

On modifying the tool as per the expert’s suggestion the final tool consists of two parts.

 

Part i:                

Age, religion, educational status, occupation, family income, number of children, source of information.

 

Part ii:

Structured knowledge questionnaire consisting 30 items on knowledge about weaning.

All items are given score of one for each correct answer and zero for wrong answer.

 

Scoring interpretation:

Excellent             above 80%

Good                    65-79%

Average                             51-64%

Poor                      below 50%

Reliability:

The tool after validation was subjected to test for its reliability. The questionnaire was administered to three under five children mothers. The reliability was established by using split half technique and spearman’s brown prophecy formula. Co – efficient of correlation of knowledge test was found to be r = 0.80. So tool was found to be highly reliable for data collection.

 

Pilot study:

Pilot study was conducted on 10 under five children’s mother at parul seva aarogya hospital vadodara,

 

Plan for data analysis:

Data analysis is the systematic organization and synthesis of the research data and testing of research hypothesis using the data.

 

The plan of data analysis is as follows:

·        Organize data in master sheet / computer.

·        Frequency and percentage for the analysis of demographic data.

·        Mean standard deviation scores.

·        Chi square test would be applied to determine the significance of the difference between mean score of pretest and posttest subjects.

·        Classification of knowledge by using following formula.

 

Obtain score

--------------------×100

Maximum score

 

Structured Knowledge Questionnaire:

A score of “1” was awarded to correct response while a score of “0” was awarded to in correct response of structured knowledge questionnaires.

 

Analysis and interpretation:

Section: A

Description of Sample Characteristic

Baseline data containing sample characteristics would be analyzed using frequency and percentage.

 

SECTION: B

Assessment of Pre Test Knowledge Score of under-five children’s mother Analysis of existing knowledge of under-five children’s mothers regarding weaning.

 

SECTION: C

Association of demographic variable with the level of pre-test knowledge score of under-five children’s mothers.

 

Section a: description of the demographic variables of under-five children’s mothers  (n=30)

SR. NO

CHARACTERITIC

CATEGORIES

FREQUENCY

PERCENTAGE%

1

Age

20-25 years

26-30 years

31-35 years

6

21

3

20.00%

70.00%

10.00%

TOTAL

30

100%

2

Religion

Hindu

Muslim

Christian

Others

24

5

1

0

80.00%

16.66%

3.33%

0.00%

TOTAL

30

100%

3

Educational Status

Illiterate

Primary

Secondary

High school

Graduate

6

10

7

5

2

20.00%

30.00%

23.33%

16.66%

   6.66%

TOTAL

30

100%

4

Occupation

House wife

Farmer

Laborer

Other

13

6

7

4

43.33%

20.00%

23.33%

13.33%

TOTAL

30

100%

7

Source Of Information

 

Peer group

Mass media

Newspaper/ magazine

24

5

1

80.00%

16.66%

3.33%

TOTAL

30

100%

 

·        The present study reveals that out of 30 under five children’s mothers, 21 (70.00%) of them are in the age group of 26-30 years, 6 (20.00%) belonged to 26-30 years, 3 (10.00%) are in the age group of 31-35 years.

·        It is observed from the present study that majority 2uslims and 1 (3.33%) were Christians.

·        The present study reveals that majority 10 (30.00%) were complete primary education, 6 (20.00%) were illiterate 7 (23.33%) had got secondary education, 5(16.66%) had high school education and remaining 2(6.66%) had graduation.

·        The present study depicts that 13 (43.33. %) were house wives, 7 (23.33%) were laborer 6 (20.00%) were farmer and 10 (10.00) were skilled workers.

·        It is found in the present study that 24 (80.00%) got information from peer group, 5 (16.66%) got information from Radio/TV 1 (3.33%) got information aboutweaning practices from news paper /magazine.

 

Pre-Test Knowledge Score Regarding Weaning.

Percentage and Mean of the Pre-test

 

N

Minimum

Maximum

Mean

Mean%

S.D

S.D%

Total

30

 

3

 

 

12

 

5.9

 

29.5%

 

2.57

 

s12.85%

Valid N (list wise)

30

 

The data from the above table shows that, in pre-test under-five children’s mothers were having on average 29.5%3% knowledge regarding weaning and mean score was 5.9±2.57.

 

Mean, Standard Deviation and mean percentage of knowledge of under-five children’s mothers.

Knowledge

Max Score

Mean

SD

Mean%

Introduction of weaning.

3

1.06

0.98

5.30%

Define weaning.

1

0.26

0.44

1.30%

Qualities of weaning.

5

1.76

1.13

8.80%

Principles of weaning.

6

1.76

1.19

8.80%

weaning at different age

5

1.06

1.14

5.30%

It is observed from the present study that the Mean, Standard deviation and Mean difference of aspects of knowledge of under-five children’s mothers. It reveals that the subjects had a maximum mean of 1.76 with a standard deviation of 1.19 and mean percentage of 8.80% for qualities and principles of weaning. The mean score of 1.06 with standard deviation of 1.14 and mean percentage of 5.30% for introduction and weaning at different age. The mean score of 0.26 with a standard deviation 0.44 and mean percentage of 1.30% for Definition of weaning.

 

Association of demographic variable with the level of pre-test knowledge score of under-five children’s mothers.

Demographic Variable

Avg.

Poor

c2

D.F

Level of Significance at 0.5 level

 

1.        Age in year

20-25 years

1

5

5.43

4

3.357

calc2>tabc2

NS

26-30 years

 

21

31-35 years

 

3

2.       Religion

Hindu

2

22

0.522

2

5.991

calc2<tabc2

S

Muslim

 

5

Christian

 

1

3.       Educational Status

Illiterate

 

6

16.11

4

9.488

calc2>tabc2

NS

Primary

 

10

Secondary

 

7

High school

 

5

Graduate

1

1

4.       Occupation

House wife

 

13

0.00

3

7.815

calc2<tabc2

S

Farmer

 

6

Laborer

 

7

Other

 

4

5. Source Of Information

 

Peer group

2

22

3.75

2

5.991

calc2<tabc2

S

Mass media

2

3

Newspaper/ magazine

 

1

 

Variables of age (χ2=5.43), Religion (χ2= 0.522), Educational Status (χ2=16.11), Occupation (χ2=0.00), source of Information (χ2=3.75),)was found significant at 0.05 level of significance , Thus it can be interpreted that there is a significant association between knowledge of under-five children’s mothers with their Religion, Occupation and source of information, and there is no significant association between knowledge of Under-five children’s mothers with selected sociodemographic variables such as age,and educational status.

 

 

 

Summarization:

The present study depicts that majority 27 (90.00%) of under-five children’s have poorknowledge on weaning, 3 (10.00%) have average knowledge and no have good and excellent knowledge.

 

The data from the above table shows that, in pre-test under-five children’s mothers were having on average 29.5%3% knowledge regarding weaning and mean score was 5.9±2.57.

 

 

 

According to PAHO and WHO, supplementary feeding is the process that begins when human milk is insufficient to meet the nutritional needs of an infant and requires other foods and liquids. The decision to begin complementary feeding depends on socio-economic, physiological, nutritional and psychological factors. The maturation of the neuromuscular, gastrointestinal and renal system influences the chances of success of supplementary feeding. Reflexes and skills in a child with normal development can be expected and the consistency of foods can provide a way to, on one hand allow the ingestion of food and the other to allow the children to exercise their reflexes to enhance neuromuscular maturation. WHO recommends exclusive breastfeeding promotion to six months, as there are several benefits to mother and child; in Mexico, the NOM-043-SSA2-2005 promotes complementary feeding from 6 months. It should be noted that the order of introduction is not definitive and that the literature shows different patterns of input according to the needs of children and their socio-economic and cultural environment. Parents and caregivers select and buy food, model, and establish rules of behavior at home related to food. Evidence suggest that environmental factors acting at an early stage of development of small modeling preferences and eating behaviors(4).

 

An observational study was conducted to investigate the relationship status between iron status of 928 infants and type of weaning foods consumed. According to WHO criteria, 22.7% of the infants were anemic at 8 months and 18.1% at 12 months. More breast-than formula- fed infants wee anemic at 8 and 12 months. Cow’ milk as the main drink was associated with increased anemia at 12 months and low ferritin at 8 and 12 months(5).

 

A cross sectional study was conducted to identify the feeding practice of children aged 6-12 months of age and associated maternal factors in the state of Sao Paulo, Brazil with 24,448 children. It was observed that 63% of the samples were being given porridge, 87% fruit, 78% soups, 64% the family meal, 58% meals including beans, and 36% meat. This study concludes that excessive consumption was observed of liquid and semi-solid foods, suggesting that appropriate guidance on complementary feeding is needed, taking into account age, primi parity, education and employed mother(6).

 

RECOMMENDATIONS:

1.      A similar study can be replicated with a large sample in order to generalize the data.

2.      A similar study can be conducted with different teaching strategies like practice or attitude.

3.      A comparative study can be carried out on knowledge regarding weaning at urban and rural area.

 

REFERENCES:

1.       Park K. “Text Book of Preventive and Social Medicine “, 18th ed.2005,B/S Banarasida Bhanot, Jabalpur, P:409

2.       World health organization, “exclusive breast feeding” 2002-2004. Nutrition: infant and young child, 30 Nov 2006. Online.

3.       Nageshwara Rao C. Feeding the infant .Swasth Hind. 1987; (11) 281-282.

4.       Pérez AB. [Complementary feeding]. Advances in pediatrics. U.S. National Library of Medicine. Available from: https://www.ncbi.nlm.nih.gov/pubmed/22352127.

5.       Hopkins D, Emmett P, Steer C, Rogers I, Noble S, Emond A. Infant feeding in the second 6 months of life related to iron status: an observational study [Internet]. Advances in pediatrics. U.S. National Library of Medicine; 2007. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2083241.

6.       Guest. Feeding habits of children aged 6 to 12 months and. - Scielo.br - PDF Free Download zdoc.site. ZDOC.SITE;. Available from: https://zdoc.site/feeding-habits-of-children-aged-6-to-12-months-and-scielobr.html

 

 

 

 

 

 

 

Received on 02.07.2018       Modified on 05.08.2018

Accepted on 12.10.2018       ©A&V Publications All right reserved

Int.  J. of Advances in Nur. Management. 2018; 6(4): 304-308.

DOI: 10.5958/2454-2652.2018.00069.0