Anaemia in Pregnancy Study PDF

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 Societys Institute of Nursing Sciences

Nehru Nagar, Belgaum-590 010. Karnataka, India.
2005
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 Belgaum is 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.
Mrs. Anitha. M.
Post Graduate Student
K.L.E.S. Institute of Nursing
Sciences, Nehru Nagar,
Belgaum-10.
Date :
Place : Belgaum
II
CERTIFICATE BY THE GUIDE
This is to certify that the dissertation entitled A Study To Assess The

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 :
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
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
III
ENDORSEMENT BY THE HOD, PRINCIPAL,

K.L.E SOCIETYS INSTITUTE OF NURSING SCIENCES,
NEHRU NAGAR, BELGAUM 590 010
This is to certify that the dissertation entitled A Study To Assess The

Pregnant Mothers Attending Antenatal Clinics In Selected Hospitals Of Belgaum is 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 :
Seal & Signature
Mrs. Sudha. J. Narvekar. M.Sc (N)

HOD,
Department of Obstetrics &
Gynecological Nursing
K.L.E.S Institute of Nursing Sciences,
Belgaum.
Mr. R. S. Hooli. MSc. (N)

Principal
K.L.E.S Institute of Nursing
Sciences, Belgaum
Date :
Date :
Place : Belgaum
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.
MRS. ANITHA. M.
Post Graduate Student
K.L.E.S. Institute of Nursing
Sciences, Nehru Nagar,
Belgaum-10.
Date
Place : Belgaum
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.SS
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.Ss Belgaum for extending his Cooperation, 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.Ss 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,
Solutions
Mr. Kaleem of Sheegra Designing and Printing
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 dont 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.
Mrs. Anitha. M
XIV
LIST OF FIGURES
Figures
Particulars
Page No.
Conceptual frame work
11
Research process
28
LIST OF GRAPHS
Graphs
1
Particulars
Distribution of mothers according to sociodemographic
Page No.
33
data
2
Distribution of mothers according to base line data
36
Distribution of subjects according to level of knowledge
38
of disease aspects and prevention of anaemia

4
Distribution of mothers according to various aspects of
40
anaemia
5
Distribution of mothers according to knowledge on
42
causes
6
Distribution of mothers according to knowledge on signs
44
and symptoms of anaemia

7
Distribution of mothers according to practices regarding
50
diet
8
Distribution of mothers according to hygienic practices
52
Distribution of mothers according to practices regarding
54
treatment
TABLE OF CONTENTS
Chapter
I
Particulars
INTRODUCTION
Page No.
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
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
21
Chapter
Particulars
Page No.
IV
ANALYSIS AND INTERPRETATION OF DATA
29
MAJOR FINDINS, DISCUSSION, MAJOR
60
FINDINGS, SUMMARY & CONCLUSION

VI
BIBLIOGRAPHY
78
APPENDICES
84
ABSTRACT
129
ABBREVIATIONS
132
VII
LIST OF TABLES
Table No
Particulars
Page No
Distribution of mothers according to sociodemographic
31
data
1b
34
Mean, median and standard deviation of knowledge
37
scores of the registered pregnant mothers regarding

prevention of the anaemia
3
Distribution of subjects according to level of knowledge
37
of disease aspects and prevention of anaemia

4a
39
various aspects of anaemia

4b
41
causes
4c
43
signs and symptoms of anaemia

5a
45
sources of iron rich foods

5b
46
personal hygiene
5c
47
treatment
6a
Distribution of mothers according to practices
48
regarding diet
6b
VIII
51
Table No
6c
Particulars
Distribution of mothers according to practices
Page No
53
regarding treatment
7
Mean and standard deviation of practices scores
53
regarding prevention of anaemia among registered

pregnant mothers
8a
Association between knowledge and age
55
8b
Association between knowledge and Womens
55
Education
8c
Association between knowledge and Family income
56
8d
Association between knowledge and Gravid status of
56
mothers obstetric score

9a
Association between practices and age
57
9b
Association between practices and womens education
57
9c
Association between practices and family income
58
9d
Association between practices and gravid status of
58
mothers obstetric score

10
Association between knowledge and practices

regarding prevention of anaemia among registered
pregnant mothers
IX
59
LIST OF APPENDICES
Appendix
Particulars
Page No.
Letter requesting opinion and suggestions from

experts
84
Blue print
86
Tool for data collection
87
Content validation proforma
113
Criteria checklist for evaluation of tool

requesting suggestions and opinions from the
experts
116
List of experts
120
Certificate of validation
121
Letter seeking permission to conduct study
126
Master chart
127
XI
Abbreviations
CHAPTER I
INTRODUCTION
Maternal death is an avoidable tragedy : we can prevent it1
- 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 mothers 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
2nd 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 8090%. 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
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 clinics regarding prevention of anaemia at 0.05 level of
significance.
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 perform certain activities regarding

prevention of anaemia.
INCLUSION CRITERIA
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, womens

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 subjects 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.
10
Abbreviations
11
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 TO PREVALENCE OF ANAEMIA IN

PREGNANT MOTHERS :
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.
12
Abbreviations
74%) of these anaemias 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
13
Abbreviations
revealed the distribution of (Hb) measurements obtained by colour counter in the
population of 729 antenatal women examined. Percentage prevalences 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
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 respondents
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
15
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 Effects 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
16
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
women were
not having adequate
knowledge regarding anaemia prevention.21

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
17
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 TREATMENT OF ANAEMIA IN

PREGNANT MOTHERS:
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
18
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
19
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 nonreligious 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
20
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.
21
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.
22
Abbreviations
ii. Exclusive Criteria:
Antenatal mothers :
Admitted in antenatal wards.
Who are not registered.
Associated with the complications such as systemic disease and highrisk 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.
23
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. < X -1 SD poor knowledge
2. X 1 SD to + 1SD average knowledge
3. >X + 1SD Good knowledge
24
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.
25
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 Spearmans 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
26
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
27
Abbreviations
RESEARCH PROCESS
Target
population
Registered pregnant mothers

attending antenatal clinics
Sample size
105 in number
Sampling
Purposive sampling
Instrument
Structured interview
Data Collection
Socio-demographic variable
Knowledge regarding anaemia
Knowledge regarding prevention
of anaemia
Practices regarding prevention of
anaemia
Analysis
Descriptive and
inferential statistics
28
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, womens education,
husbands education, religion, type of family, womens 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
3. Item-wise analysis of subjects regarding practices related to prevention of
anaemia.
29
Abbreviations
4. Distribution of level knowledge according to selected variables, that is age,
womens education, family income and Gravida.
5. Distribution of classification of practices according to selected variables,
that is age, womens education, family income and Gravida.
6. Association between the knowledge and practices regarding prevention of
anaemia among registered pregnant mothers.
30
Abbreviations
SECTION I :
TABLE NO. 1A
Distribution of mothers according to sociodemographic data
N = 105
S.No
1
Variables
Frequency (f)
Percentage (%)
15-19 yrs
20-24 yrs
25-29 yrs
30 yrs and above
Womens education :
No formal education
Primary education
Secondary education
Higher secondary education
Graduate
Husbands education :
No formal education
Primary education
Secondary education
Graduate
Religion :
Hindu
Muslim
Christian
Any other
Type of family :
Nuclear family
Joint family
Womans occupation :
House wife
Labourer
Professional
Familys income :
Below Rs. 2000/ month
Rs. 2001 3000/ month
Rs. 3001 4000/ month
Rs. 4001 5000/ month
Rs. 5001 & above
Diet :
Vegetarian
Mixed
21
56
24
4
20.00
53.33
22.85
3.80
35
16
30
12
12
33.33
15.23
28.57
11.42
11.42
6
22
34
24
19
5.71
20.95
32.38
22.85
18.09
71
27
5
2
67.61
25.71
4.76
1.90
58
47
55.23
44.76
100
3
2
95.23
2.85
1.90
23
41
28
12
1
21.90
39.04
26.66
11.53
0.95
28
77
26.66
73.33
Age :
31
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. Husbands 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 mothers
belonged to nuclear family and only 47 (44.76%) belonged to joint family.
Regarding occupational status of women majority 100 (95.23%) of the
mothers 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.
32
Abbreviations
Graph - 1
33
Abbreviations
TABLE NO. 1 B
N = 105
S.No
9
Variables
Registered during
1st trimester
2nd trimester
3rd trimester
Obstetric score
Primigravida
Multigravida
11.1 Menstrual history
Less than 3 days
Between 3 to 5 days
More than 5 days
10
11
Frequency (f)
Percentage (%)
59
38
10
56.19
36.19
9.52
33
72
31.42
68.57
4
97
4
3.80
92.38
3.80
Heavy & regular
41
39.04
Heavy & irregular
2.85
Scanty & regular
58
55.23
Scanty & irregular
2.85
< 2 years
18
17.14
2 3 years
49
46.66
> 3 years
6.66
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)
2.85
11.2 Amount of blood flow
12
Birth spacing between previous

pregnancies
13
Haemoglobin level (According to

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

registered during 1st trimester, where as 38 (36.19%) of mothers were registered
during 2nd trimester, only 10 (9.52%) of the mothers were registered during 3rd
trimester.
34
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.
35
Abbreviations
Graph - 2
36
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
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).
37
Abbreviations
Graph 3
38
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 (%)
Pregnancy creates large demand of iron
95
90.47
Increase Hb% in the blood is anaemia
31
29.52
Anaemia is a nutritional disorder
55
52.38
Haemoglobin value in pregnancy is iron
31
29.52
46
43.80
8gm%
5
Iron required for Hb formation
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.
39
Abbreviations
Graph - 4
Distribution of mothers according to various aspects of anaemia
40
Abbreviations
TABLE NO. 4 B
Distribution of mothers according to knowledge on causes
N = 105
S.
No
Causes
Frequency (f)
Percentage
(%)
Obesity in pregnancy
18
17.14
Hook worm infestation and malaria
24
22.85
Haemorroids during pregnancy
18
17.14
History of heavy menstrual flow
20
19.04
Bleeding disorders
25
23.80
Repeated pregnancies
41
39.04
Recurrent abortions
64
60.95
Twin pregnancy
17
16.19
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.
41
Abbreviations
Graph - 5
42
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 (%)
Tiredness and weakness
84
80.00
Pallor of the face, eyes, lips, tongue and
57
54.28
11
10.47
nails
3
Palpitation and breathing difficulty
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.
43
Abbreviations
Graph - 6
Distribution of mothers according to knowledge on signs and symptoms of anaemia
44
Abbreviations
TABLE NO. 5A
Distribution of mothers according to knowledge on sources of iron rich foods
N = 105
S. No Diet
Frequency (f)
Percentage (%)
Well balanced diet prevents anaemia
88
83.80
Green leafy vegetables, cabbage and

sprouted grams are rich in iron
76
72.38
Avoidance of Ragi and Jaggery
53
50.47
Meat, fish, liver and eggs contain rich

source of iron
73
69.52
Avoidance of Potato during pregnancy
40
38.09
Dates & dry grapes contains rich source

of iron
78
74.28
Absorption iron and citrus fruits
19
18.09
Interference of Tea and coffee with iron
18
17.14
Avoid iron tablets with milk
46
43.80
10
Consuming meals lastly whatever is left

over
85
80.95
11
Fasting during pregnancy
74
70.47
The above table describes that 88 (83.80%) of mothers responded correctly

that well balanced diet prevents anaemia, whereas 85 (80.95%) of mothers
responded correctly that pregnant mothers should not eat last in the family, and
also 78 (74.28%) of them responded correctly that dates and dry grapes are rich
sources of iron. 76 (72.38%) of mothers responded correctly that green leafy
vegetables, cabbage and sprouted grains are rich in iron, 73 (69.52%) of mothers
responded correctly that meat, fish, liver and eggs are rich in iron, whereas 53
(50.47%) of mothers knew that ragi and jaggery should not to be avoided during
pregnancy. Forty-six (43.80%) of mothers had knowledge that iron tablets are not
to be taken with milk or any hot drinks. Forty (38.09%) of mothers knew that
potato should not be avoided during pregnancy.
Only 18 (17.14%) of the mothers were aware that tea and coffee inhibits
absorption of iron. Nineteen (18.09%) of the mothers were aware that orange and
lemon juice promotes absorption of iron.
45
Abbreviations
TABLE NO. 5B
Distribution of mothers according to knowledge on personal hygiene
N = 105
S. No
PERSONAL HYGIENE
Nails must be kept clean and short
Washing
hands
with
mud
after
Frequency (f)
Percentage (%)
103
98.09
50
47.61
94
89.52
defecation is good
3
Wearing of chappals for open fields
From the above table, the items revealed that majority 103 (98.09%) of
mothers knew that nails must be always kept clean and short. where as 94
(89.52%) of mothers responded that foot wear should be used while walking in
open fields and only 50 (47. 61%) of mothers were aware that using mud for
washing hands after defection is a wrong practice.
46
Abbreviations
TABLE NO. 5C
Distribution of mothers according to knowledge on treatment
N = 105
S. No Treatment
Frequency (f)
Percentage (%)
Regular medical check up is necessary
102
97.14
Daily intake of iron and folic acid tablet is
44
41.90
15
14.28
48
45.71
92
87.61
not necessary
3
Iron and folic acid tablet leads to big

babies
Iron and folic acid tablet leads to

constipation
Adequate treatment is necessary to

eradicate Hookworm
From the above table the items revealed that majority 102 (97.14%) of
mothers had knowledge that regular medical check up during pregnancy is
necessary; 92 (87.61%) mothers knew that to prevent anaemia, adequate treatment
is necessary to eradicate Hookworm infestation and malaria, whereas 44 (41.90%)
of mothers that knew regular intake of iron and folic acid tablet is necessary
during pregnancy, only 15 (14.28%) of mothers were aware that intake of iron and
folic acid tablet does not leads to big babies.
47
Abbreviations
SECTION III
PRACTICES REGARDING PREVENTION OF ANAEMIA
TABLE NO. 6A
Distribution of mothers according to practices regarding diet
N = 105
S.
No
DIET
BENEFICIAL
PRACTICES
F
%
NON- BENEFICIAL
PRACTICES
F
%
Pregnancy imposes extra energy

and nutrients
93
88.57
12
11.42
Change in normal dietary pattern
58
55.23
47
44.76
Following strict meal schedule
76
72.38
29
27.61
Consuming meals lastly whatever

is left over
100
95.23
4.76
Continued fasting during

pregnancy
100
95.23
4.76
Eating special food preparations

during fasting
22
20.95
83
79.04
Avoidance of hot foods
34
32.38
71
67.61
Following pica practices
94
89.52
11
10.47
Including of meat, fish, eggs
44
41.90
61
58.09
10
Intake of green leafy vegetables

and sprouted grams
63
60.00
42
40.00
11
Washing vegetables before cutting
103
98.09
1.90
12
Including seasonal fruits and dry

fruits
98
93.33
6.66
13
Drinking of eight to ten glasses of

water
60
57.14
45
42.85
14
Including fibre rich diet and fruits
57
54.28
48
45.71
15
Eating Ragi and jaggery
64
60.95
41
39.04
From the above table items related to diet revealed that majority 10 0
(95.23%) of mothers were taking food before consumption of family members and
100 (95.23%) mothers were not fasting on any day during pregnancy. Ninety-eight
48
Abbreviations
(93.33%) mothers were taking seasonal fruits and dry fruits during pregnancy.
Ninety four (89.52%) mothers gave no history of pica. Ninety-three (88.57%) of
mothers were aware that pregnancy needs extra energy and nutrients. Seventy-six
(72.38%) of mothers were practicing strict meal schedule. Sixty-four (60.95%) of
mothers were using ragi and jaggery in their diet. Sixty three (60%) of mothers
were using, green leafy vegetables and sprouted grams regularly. 60 (57.14%) of
mothers were drinking 8-10 glasses of water per day, 58 (55.23%) of mothers
changed their normal dietary pattern due to pregnancy and 57 (54.28%) of mothers
were taking fibre rich diet and fruits regularly. Only 22 (20.95%) of mothers were
taking special food preparations during fasting, 34 (32.38%) of mothers did not
consume hot foods during pregnancy and 44 (41.90%) of mothers were eating
meat, fish and eggs during pregnancy.
49
Abbreviations
Graph - 7
50
Abbreviations
TABLE NO. 6B
N = 105
S.
No
HYGIENE
BENEFICIAL
PRACTICES
F
%
NON- BENEFICIAL
PRACTICES
F
%
Practicing open-air defecation
52
49.52
53
50.47
Wearing of chappals
63
60.00
42
40.00
Hand washing after defecation
70
66.66
35
33.33
Nail care once in a week
58
55.23
47
44.76
From the above table, items related to hygiene describes that majority 70
(66.66%) of the mothers were washing the hands with soap after defecation and
majority 63 (60%) of the mothers were using chappals when going for open air
defecation, only 52 (49.52%) of mothers were practicing open air defecation, 58
(55.23%) mothers were cutting their nails once in a week.
51
Abbreviations
Graph - 8
52
Abbreviations
TABLE NO. 6C
Distribution of mothers according to practices regarding treatment
N = 105
Treatment
BENEFICIAL
PRACTICES
F
%
Seeking medical help during

pregnancy
104
99.04
0.95
Periodical deworming
35
33.33
70
66.66
Iron requirement for the

growth of the baby
97
92.38
7.61
Regular in take of iron

supplements
58
55.23
47
44.76
S. No
NON- BENEFICIAL
PRACTICES
F
%
From the above table items related to treatment depicts that maximum 104
(99.04%) of the mothers seek medical help during pregnancy. Ninety-seven
(92.38%) of mothers were taking iron supplements for the growth of the baby and
58 (55.23%) of the mothers were taking regular iron supplements. Only 35
(33.33%) of the mothers took medications for deworming.
Table No. 7 :
Mean and standard deviation of practices scores regarding prevention of anaemia
among registered pregnant mothers
N=105
Mean
Standard deviation (SD)
15.22
4.82
The table No 7 shows the mean and SD of practices scores. Mean 15.22, SD 4.82.
53
Abbreviations
Graph - 9
54
Abbreviations
ASSOCIATION
BETWEEN
KNOWLEDGE
AND
SELECTED
VARIABLES
TABLE NO. 8A
Association between knowledge and age
Age
N = 105
Knowledge
Total
Poor
Average
Good
15-19
10
21
20-24
40
56
25-30
22
24
31 yrs and above
Total
16
76
13
105
P = 0.015
2 = 12.355
df = 4
2 calculated value shows that there is statistically significant association

between age of the mothers and level of knowledge at p<0.005.
TABLE NO. 8B
Association between knowledge and Womens Education :
Womens education
N = 105
Knowledge
Total
Poor
Average
Good
No formal education
13
22
35
Primary education
14
16
Secondary education
25
30
12
Graduate
12
Total
16
76
13
105
P = 0.000
2 = 20.586
df = 2

between mothers educational status and level of knowledge at p<0.005.
55
Abbreviations
TABLE NO. 8C
Association between knowledge and Family income
N = 105
Knowledge
Family income
Total
Poor
Average
Good
Below 2000/month
21
23
Rs. 2001-3000/month
11
28
41
Rs. 3001-4000/month
21
28
Rs. 4001-5000/month
12
Rs. 5001 and above
Total
16
76
13
105
P = 0.000
2 = 19.047
df = 4

between mothers family income and level of knowledge at p<0.005.
TABLE NO. 8D
Association between knowledge and Gravid status of mothers obstetric score
N = 105
Gravida
Knowledge
Total
Poor
Average
Good
Primigravida
27
33
Multigravida
14
49
72
16
76
13
105
Total
P = 0.196
2 = 3.254
df = 2
2 calculated value shows that there is no statistically significant

association between mothers gravid status and level of knowledge at p<0.005.
56
Abbreviations
ASSOCIATION BETWEEN PRACTICES AND SELECTED VARIABLES
TABLE NO. 9A
Association between practices and age
Age
N = 105
Practices
Total
Beneficial
Non-beneficial
15-19
16
21
20-24
15
41
56
25-30
16
24
31 yrs and above
04
Total
28
77
105
P = 0.932
2 = 0.140
df = 2

association between age in years of the mothers and practices at p<0.005.
TABLE NO. 9B
Association between practices and womens education
N = 105
Practices
Womens education
Total
Beneficial
Non-beneficial
No formal education
33
35
Primary education
15
16
Secondary education
15
15
30
04
12
Graduate
10
12
28
77
df = 3
105
Total
P = 0.000
= 22.381
2

between mothers educational status and practices at p<0.005.
57
Abbreviations
TABLE NO. 9C
Association between practices and family income
N = 105
Practices
Family income
Total
Beneficial
Non-beneficial
Below 2000/month
21
23
Rs. 2001-3000/month
36
41
Rs. 3001-4000/month
14
14
28
Rs. 4001-5000/month
05
12
Rs. 5001 and above
01
01
28
77
105
Total
P = 0.000
2 = 20.828
df = 2

between mothers family income and practices at p<0.005.
TABLE NO. 9D
Association between practices and gravid status of mothers obstetric score :
N = 105
Gravid status
Practices
Total
Beneficial
Non-beneficial
Primigravida
12
21
33
Multigravida
16
56
72
Total
28
77
105
P = 0.120
2 = 2.314
df = 1

association between mothers gravid status and practices at p<0.005.
58
Abbreviations
ASSOCIATION BETWEEN KNOWLEDGE AND PRACTICES
TABLE NO. 10
Association between knowledge and practices regarding prevention of anaemia
among registered pregnant mothers
N=105
Practices
S.
No
Knowledge
Total
Beneficial
Non-beneficial
Poor
16
16
Average
16
60
76
Good
12
01
13
Total
28
77
105
P = 0.000
2 = 28.972
df = 1

between level of knowledge and practices at p < 0.005 level of significance. This
clearly shows that women having good knowledge tend to show inclination
towards beneficial practices than women with poor and average knowledge.
59
Abbreviations
CHAPTER V
Major Findings, Discussion, Summary, Conclusion,

Implications, Limitations & Recommendations
Major Findings
Findings are as follows :
Majority of mothers (53.33%) were between the age group of 20-24 years.
Most of the mothers (33.33%) had no formal education.
Majority of the mothers (61.61%) belonged to Hindu religion.
Majority of the mothers (55.23%) were from nuclear family.
Maximum of the mothers (95.23%) were housewives.
Data regarding income status showed that majority of the families income
(39.04%) ranged between Rs. 200/- 3000 per month.
Data regarding diet showed that most of the mothers (73.33%) were taking
mixed diet.
Most of the mothers (56.19%) were registered during 1st trimester.
Regarding gravid status, majority of the mothers (68.57%) were
multigravida.
Data regarding birth spacing between previous pregnancies shows that
majority of the mothers (46.66%) had the range between 2-3 years.
According to WHO classification the haemoglobin of the mothers shows
that majority (50.47%) of them had mild anaemia.
60
Abbreviations
To summarize the study, following are major findings :
1. 49.14% of the mothers had knowledge regarding disease aspects of
anaemia, 33.64% had knowledge regarding cause whereas 48.19% had
knowledge about signs and symptoms.
2. Knowledge regarding prevention anaemia showed that 56.27% of the
mothers had knowledge regarding diet, 78.04% had knowledge regarding
personal hygiene, whereas 57.33% had knowledge about treatment.
3. Practices regarding prevention of anaemia showed that 67.67% of the
mothers were taking care of diet, 57.85%, of the mothers maintained
adequate personal hygiene, 70.00% of mothers seeked medical help.
4. There is statistically significant association between age in years of the
mothers and level of knowledge at P<0.005 level of significance.
5. There is statistically significant association between mothers educational
status and level of knowledge at P<0.005 level of significance.
6. There is statistically significant association between mothers family
income and level of knowledge at P<0.005 level of significance.
7. There is statistically significant association between womens education
and practices at P<0.005 level of significance.
8. There is statistically significant association between family income of the
mothers and practices at p < 0.005 level of significance.
Looking into above facts (Ho) hypothesis is accepted since value of
calculated 2 (28-972) shows that there is significant association between
knowledge and practices at the level of p < 0.005. This clearly shows that women
having good knowledge tend to show inclination towards beneficial practices than
women with poor and average knowledge.
61
Abbreviations
Discussion
This chapter deals with the discussion and summary of the study and the
conclusions drawn. Nursing implications of the study are also given for the
different aspects like nursing education, nursing practice. It classifies the
limitations of the study and suggests recommendation for the future research.
The study was undertaken with the main purpose of assessing the level of
knowledge and identify the practices regarding prevention of anaemia among
registered pregnant mothers attending antenatal clinics. To achieve the set
objectives of the study, a total of 105 mothers were studied. In order to get the
projected results, the study focused its attention on registered pregnant mothers
attending antenatal clinics in K.L.E.S Hospital and MRC Belgaum. Samples were
selected as per planned sampling criteria and structured interview schedule with
the following headings used to elicit the responses
1.
Knowledge regarding anaemia and knowledge regarding prevention of

anaemia.
2.
Practices regarding prevention of anaemia.
SECTION I
Ia. Findings related to sociodemographic data :
Table : 1A represents the distribution of mothers according to socio
demographic and baseline data. Majority of the mothers (53.33%) were in the age
group of 20-24 years and only (3.80%) were in the age group of 30 years and
above. Similar findings were found in a study done by Eddama Mahmoud R.
62
Abbreviations
(1995) which showed that associated risk factors with anaemia in pregnancy were
increasing with age. The range of anaemia in the following age groups was for 20
years 27.6%; 20-24 years 55.4%; 25-29 years 51%; and 30 years and above
47.2%.49 Regarding their educational status, (33.33%) of the mothers had no
formal education while (11.42%) were graduates. This indicates that literacy level
of women in India has not improved (32.38%) of husbands had secondary
education and only (5.71%) did not have any education. This shows that husbands
are always more educated than wives
It was observed that majority of mothers (67.61%) were Hindus and
(1.90%) belonged to other religion. It was also seen from the above table that
(55.23%) of the mothers belonged to Nuclear Family; only (44.76%) belonged to
Joint Family. One of the reason for disintegration of the family from joint to
nuclear may be due to unemployment. Most of the rural families are shifting to the
urban areas for the sake of jobs. It was also seen that majority of the mothers
(95.23%) were housewives and (1.90%) were professionals. Further from the
economic point of view, the family income indicated that majority of the families
(39.04%) income ranges were between Rs. 2001-3000 per month and (0.95%)
ranges were between Rs. 5001 and above per month. Hence to balance income, the
mothers were not able to lead a healthy life style.
It was also observed that majority of the mothers (73.33%) were taking
mixed diet, only (26.66%) of the mothers were taking vegetarian diet. Similar
findings supports the study done by Griffiths and Bentely 2001. They founded
that Disparities in womens nutrition status were primarily related to womens
access to resources and income.13
63
Abbreviations
Ib. Findings related to base line data :
Regarding registration majority of the mothers (56.19%) were registered
during 1st trimester, only (9.52%) were registered during 3rd trimester. It was
observed that majority (68.57%) of the mothers were multigravidas where as
(only 31.42%) were primigravidas. This indicates that multigravida mothers had
awareness regarding registration. Regarding birth spacing between previous
pregnancies, majority (46.66%) of the mothers ranges were between 2-3 years,
only (6.66%) had <3 years of gap between 2 pregnancies. According to WHO
classification, the haemoglobin level of the mothers shows that majority (50.47%)
of them had mild anaemia, only (2.85%) had severe anaemia. Similar findings
were found in a study done by Gies.S Barbin B.J Yassin M.A and Cuevas, L.E
(2003), where 10.4% of mothers had mild anaemia 4.2% had moderate anaemia
(0.3%) had severe anaemic.36
SECTION II
Findings related to knowledge regarding anaemia and its prevention of
anaemia :
Table No. 4a depicts that 95 (90.47%) of mothers knew that pregnancy
creates large demand of iron. Only 31 (29.52%) of mothers were aware of what is
anaemia and 31 (29.52%) of mothers knew the normal value of haemoglobin. This
clearly shows that majority of mothers had poor knowledge regarding disease
aspects of anaemia.
Table No 4b reveals that 91 (86.66%) of mothers knew that faulty dietary
habits causes anaemia. Only 18 (17.14%) were aware that obesity in pregnancy
and also haemorroids causes anaemia. The findings of the study supports the study
64
Abbreviations
supports the study done by Kilemann (2000), Amin (2000) hypothesized that
findings in women with low BMI (<18.5 kg M2) would have a higher risk of
anaemia compared to women of normal or overweight.48
This clearly shows that majority of mothers had poor knowledge regarding
causes of anaemia..
Table No. 4c shows that majority 84 (80%) of the mothers had good
knowledge that tiredness and weakness were the symptoms of anaemia. Only 11
(10.47%) of mothers were aware that palpitation and breathing difficulty are the
signs of anaemia.
The findings of the study supports the study done by Gies. S. Brabin B.J.
Yassin M.A and Cuevas L.E. (2003). The reported complaints and their
frequencies shows that breathlessness was reported more frequently by pregnant
anaemic women, while dizziness was reported by 117 women. Anaemic pregnant
women stopped walking more frequently than that of non-anaemic women (76.5%
vs 56% P=0.19). As Swollen face (16.7% vs 3.1% P=0.02) and perceived paleness
or change of skin colour (22.2% vs 9.9% P=0.11) were more frequently reported
by women with Hb level <10g/dl. The over all mean knowledge for signs and
symptoms were 50.6 (48.19%). This depicts that majority of mothers had poor
knowledge regarding signs and symptoms of anaemia.36
Table 5a describes that 88 (83.80%) of mothers responded correctly that
well balanced diet prevents anaemia. Only 18 (17.14%) of the mothers were aware
that tea and coffee habits absorption of Iron. Nineteen (18.09%) of the mothers
were aware that orange and lemon juice promotes absorption of Iron. The findings
of the study supports the study done by New Castle Tyne (2001) explained that
awareness of the link between anaemia and diet may be low. In a national lifestyle
surveys, less than 1% of respondents mentioned anaemia as a problem related to
65
Abbreviations
diet. They also found that anaemia tended to be more common in those who rarely
or never ate meat.47 This clearly shows that majority of mothers had average
knowledge regarding diet.
In Table 5b it was found that majority of the mothers had good knowledge
regarding personal hygiene.
Table 5c describes with knowledge regarding treatment. whereas 44
(41.90%) of mothers knew that regular. Intake of iron folic acid tablet is necessary
during pregnancy. The findings of the study supports the study done by Verma,
M. Chhatwal, J. and Varughese, P. V. (1995) shows that there was a significant
rise in knowledge for the need for Hematinics tablets during pregnancy in both
control and intervention groups but only the intervention group showed a
significant rise in the knowledge of the purpose of taking tablets.38 It is evident
that majority of the mothers had average knowledge regarding treatment.
SECTION III
Findings related to practices regarding prevention of anaemia :
Table 6a depicts items related to practices of diet revealed that majority
100 (95.23%) of mothers were taking food before consumption of family members
and Ninety-four (89.52%) mothers gave no history of pica. The findings of the
study supports the study done by Manocha S, Aneeta A.M Puram R.K. (1992).
It explained that women in all the three villages of Haryana developed craving for
citrus foods, raw mango, guava, tomato red chillies and pickles of all kinds. A few
craved for sweets, aversion towards certain foods like pulses, chapattis, fried foods
during pregnancy is noticeable drawing inedible substances like chullah ash,
chullah mud and clay is found to be common in 26%, 46% and 16% of the
66
Abbreviations
respondents respectively. Women were found to be very causal about their foods
intakes.35
Table 6b describes that majority 63 (60%) of the mothers were using
chappals while going for open air defecation. The findings of the study contradicts
the study done by Tanjua D Karmarkar V, Sampathkumar S Jayalakshmi and
Abel R (1998). In this study data collected as to the practice of wearing slippers
while going out, founded that, only 4.0% tribal women were wearing slippers
regularly while 64.0% were wearing occasionally and 32.0% were not wearing at
all. This may increase the chances of getting hookworm infestation there by
causing anaemia.37
Table 6c items related to practices regarding treatment depicts that ninetyseven (92.38%) of mothers were taking iron supplements for the growth of the
baby and 58 (55.23%) of the mothers were taking regular iron supplements. Only
35 (33.33%) of the mothers took medications for deworming. Similar findings
supported the study done by Dr. Chandra C. P (2004) found that, 74 (59.68%)
pregnant women took IFA tablets and 50 (40.32%) did not take. Among 74 who
received IFA tablets, only 52 (70.27%) pregnant women took the tablets regularly
and remaining 22 (29.73%) took the tablets irregularly. The various causes for not
taking of IFA tablets by the pregnant women in our study were : no antenatal care
in to (20.00%) diarrhoea among 10 (20.00%) vomiting in 9 (18.00%) gastritis
among 5 (10.00%) cause body heat in 4 (8.00%) and in 3 (6.00%) each due to
head ache, constipation, fetus will grow big leading to difficult labour and bitter
taste. The over all mean practices was 73.50 (70.00%).34
67
Abbreviations
Findings related to knowledge and selected variables :
There is statistically significant association between age in years of the
mothers and level of knowledge at P<0.005 level of significance. Hence the
research hypothesis is accepted.
There is statistically significant association between mothers educational
status and level of knowledge at P<0.005 level of significance. Hence the research
hypothesis is accepted.
There is statistically significant association between mothers family income
and level of knowledge at P<0.005 level of significance. Hence the research
There is no statistically significant association between gravid status of
mothers obstetric score and level of knowledge at P<0.005 level of significance.
Hence the research hypothesis is rejected.
Findings related to practices and selected variables :
There is no statistically significant association between age in years of
mothers and practices at P<0.005 level of significance. Hence the research
hypothesis is rejected.
There is statistically significant association between womens education
and practices at P<0.005 level of significance. Hence the research hypothesis is
accepted.
There is statistically significant association between family income of the
mothers and practices at p < 0.005 level of significance. Hence the research
68
Abbreviations
There is no statistically significant association between gravid status of the
mothers obstetric score and practices at p < 0.005 level of significance. Hence the
research hypothesis is rejected.
Findings related to association between knowledge and practices :

There is statistically significant association between level of knowledge
and practices at p < 0.005 level of significance. This clearly shows that women
69
Abbreviations
SUMMARY
Despite dramatic advances in human health that have occurred during the
20th century; the beginning of 21st century still has many places in the world with
high maternal mortality rates due to anaemia complications during pregnancy and
puerperium.
A WHO study shows that anaemia prevalence is disportionately high in the
developing countries due to poverty, inadequate diet, certain diseases, lactation
and poor access to health services and lack of awareness regarding anemia and its
prevention.
Pregnant mothers needs to improve their practices on preventive,
promotive and curative aspects to prevent the consequences of anaemia. It is of a
concern that pregnant mothers should equip themselves with adequate knowledge
about the disease aspects and prevention of untoward complications through
beneficial practices.
The present study was conducted with a view to find out levels of
knowledge and practices regarding prevention of anaemia among registered
pregnant mothers.
The conceptual framework for the study was derived from the health
promotion model proposed by Nola J. Pender in the year 1996. The main
component of this framework are individual characteristics and experiences,
activity related affect, commitment of a plan of action.
The tool for the data collection included background proforma knowledge
and practices questionnaire regarding prevention of anaemia.
70
Abbreviations
The data collection was carried out between 01/09/2005 to
30/09/2005
which included collection of information on socio-demographic and baseline data

structured interview schedule. In this verbal responses were recorded with use of
structured interview schedule at K.L.E.S obstetrics and gynaecological antenatal
OPD.
The subjects studied were 105 registered pregnant mothers.
Findings are as follows :
Majority of mothers (53.33%) were between the age group of 20-24 years.
Most of the mothers (33.33%) had no formal education.
Majority of the mothers (61.61%) belonged to Hindu religion.
Majority of the mothers (55.23%) were from nuclear family.
Maximum of the mothers (95.23%) were housewives.
Data regarding income status showed that majority of the families income
(39.04%) ranged between Rs. 200/- 3000 per month.
Data regarding diet showed that most of the mothers (73.33%) were taking
mixed diet.
Most of the mothers (56.19%) were registered during 1st trimester.
Regarding gravid status, majority of the mothers (68.57%) were
multigravida.
Data regarding birth spacing between previous pregnancies shows that
majority of the mothers (46.66%) had the range between 2-3 years.
According to WHO classification the haemoglobin of the mothers shows
that majority (50.47%) of them had mild anaemia.
71
Abbreviations
To summarize the study, following are major findings :
anaemia, 33.64% had knowledge regarding cause whereas 48.19%
had knowledge about signs and symptoms.
2. Knowledge regarding prevention anaemia showed that 56.27% of
the mothers had knowledge regarding diet, 78.04% had knowledge
regarding personal hygiene, whereas 57.33% had knowledge about
treatment.
3. Practices regarding prevention of anaemia showed that 67.67% of
the mothers were taking care of diet, 57.85%, of the mothers
maintained adequate personal hygiene, 70.00% of mothers seeked
medical help.
4. There is statistically significant association between age in years of
the mothers and level of knowledge at P<0.005 level of
significance.
5. There is statistically significant association between mothers
educational status and level of knowledge at P<0.005 level of
significance.
6. There is statistically significant association between mothers family
income and level of knowledge at P<0.005 level of significance.
7. There is statistically significant association between womens
education and practices at P<0.005 level of significance.
8. There is statistically significant association between family income
of the mothers and practices at p < 0.005 level of significance.
72
Abbreviations
Looking into above facts (Ho) hypothesis is accepted since value of
knowledge and practices at the level of p < 0.005. This clearly shows that women
73
Abbreviations
CONCLUSION
Based on the findings of the study, the following conclusions were drawn
1.
Knowledge regarding disease aspects, causes and signs and symptoms

was poor.
2.
Knowledge regarding prevention of anaemia shows that, knowledge on

dietary aspect was average, personal hygiene was good and treatment
was average.
3.
Practices regarding prevention of anaemia shows that dietary practices

were good, Hygiene practices were average and practices regarding
treatment were good.
4.
There was a significant relationship between the age in year of the

mothers and level of knowledge.
5.
There was a significant relationship between the educational status of the

6.
There was a significant relationship between the family income of the

7.
There was a significant relationship between the educational status of the

mothers and practices.
8.
There was a significant association between family income of the

mothers and practices.
9.
There was a significant association between level of knowledge and

practices.
With the help of available knowledge and practices, further intensive health
education can be planned and implemented to motivate the mothers to practices

beneficial practices to prevent anaemia among pregnant mothers.
74
Abbreviations
IMPLICATIONS OF THE STUDY

The findings of the study has implications on nursing practice, nursing
education and nursing research.
Implication for Nursing practice :
Since the present study revealed that most of the mothers had average
knowledge and few had poor knowledge than who had good, concerted efforts
must be made by nurse to increase more knowledge and created awareness
regarding prevention of anaemia.
The nurses are the link between the consumers and the health care system.
Being in this pivotal role they could plan and design considering the culture,
custom, tradition, present attitudes and practices.
The nurses may disseminate certain ill practices and false beliefs. They can
also demonstrate and re-demonstrate on identification of signs and symptoms,
practices on diet, hygiene, prevention and control of the disease.
Implications for nursing education :
The educational background of a nurse should equip her with the
knowledge that is necessary to function as a health educator. Since health
education is the way to improve knowledge and modify practices, therefore
nursing education should emphasize on :
Adequate knowledge about anaemia in pregnancy.
The skills to develop and prepare educational materials fitting to the needs.
Competency in guidance and counseling of the mothers and their family
members.
75
Abbreviations
The decision making must be taught to family members. Health personnel
requires knowledge in depth. The education should not provide only knowledge
but it should be practically practiced by the pregnant mothers.
Students and teacher may work together in clinical area to disseminate
knowledge on cause, spread, signs and symptoms and prevention regarding
anaemia and practices.
c. Nursing research :
Based on the findings, the professional and student nurses can conduct
further studies on knowledge and practices regarding prevention of anaemia
among pregnant mothers for the implementation in more broader and easy way to
make the programme people friendly and popular. Further the study will also
motivate the beginning researchers to conduct similar study in large scale.
LIMITATIONS
1. The present study was limited to only 105 pregnant mothers.
2. The study was limited to the samples from out patient departments.
3. The study was limited to registered pregnant mothers attending antenatal
clinics.
4. No broad generalization could be made due to limited area of setting and
limited sample size.
76
Abbreviations
RECOMMENDATIONS
1. A similar study can be conducted in a broader area in order to draw

generalization.
2. A similar study can be conducted in different settings and in different
social economic strata.
3. A study can be conducted on attitude of registered pregnant mothers
regarding prevention of anaemia attending antenatal clinics.
4. A study can be conducted on a large sample of the same problem and a
control group can be kept for comparison of the result.
77
Abbreviations
CHAPTER VI
BIBLIOGRAPHY
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The White Ribbon Alliance for safe motherhood / India. An overview

National RCH policy, Government of India;1997:1-13.
2.
Agarwal. N and Kriplani A. Anaemia in pregnancy. A review : Asian Journal

of OBS. and Gynec Practical, 3 (2) ; 1999March May:8-17.
3.
Basic guide to reproductive and child health programmes Department of

Family Welfare of ministry of health and family welfare of India; 2000
March:23-27.
4.
Nugraheni S.A, Diaswadi. D., Ismail D. Knowledge, attitude and practice of

pregnant women in correlation with anaemia. Community health and
Nutrition Research laboratory, 2003 :18
5.
Atik Triratnawati Socio-Cultural Dimensions of anaemia among pregnant

women in rural areas of Java Indonesia. Indian Journal of Community
Medicine. XXV (5) Sep-Oct : 2003:48-49.
6.
Brabin L, Nicholas S, Gogate A, Gogate S and Karande A. prevalence of

anaemia among women in Mumbai, India. Indian Journal of community
medicine ; Aug 1998:190-98.
7.
Meda N., Mandelbert L., Cartoure M., Dao B., Ovangre A. and Dabis F.
Anaemia during pregnancy in Burkinafaso, West Africa prevalence and
associated factors.
78
Abbreviations
8.
Verhoeff F.H. An analysis of the determinants of anaemia in pregnant

women in rural Malawi and a basis for action. Annuals of Tropical medicine
and Parasitology. March 1999;93(2):119-133.
9.
Saxena V., Srivastava V.K., Idris N.Z., Mohan U., Bushan V., Nutritional
status of rural pregnant women. Indian Journal of community medicine. 2003
Jul-Sept; XXV (3):104-107.
10. Kapil U. Anaemia in urban scum communities of Delhi.

11. Vanden Brock N.R.; Conya C.N., Mhango E. and white S.A. Diagnosing
anaemia in pregnancy in rural clinics assessing the potential of the
haemoglobin colour scale in Malawi.
12. Aswathi A., Thakur R., Dave A., Goyal V.1 Maternal and perintal outcome
in cases of moderate and severe anaemia. Journal of Obst. And Gyn. Of
India. 2001 November / December;51(6):62-65.
13. Bentley ME., Griffiths PL., prevalence and determinants of anaemia among
women in Andhrapradesh. Eur. J Clin Nutr. 2003 Jan ; 57(1):52-60.
14. Massawe S., Urassa E, Lindmark G., Nystram L., Anaemia in pregnancy
perceptional of patients in Dar-es-salum. East AFR Med J. 1995
Aug;72(8):498-503.
15. Ziauddin Hyder S.M; prevalence of anaemia and the associated factors
among pregnant women in two rural areas of Bangladesh. Indian Journal of
Community Medicine;1997 Jan;XXV (7):34-38.
16. Saibaba A., Sarma D.S; Balakrishna N, Raghuram. Utilization of IEC by
Middle level health personnel in the implementation of national nutrition
79
Abbreviations
programmes. Indian journal of community medicine 1997 June;XXIV
(2):75-82.
17. Horner RD., Lackey CJ., Kolasak., Warren K., Pica practices of pregnant
women. IAM Diet Assoc. 1991 Jan;91(1):34-8.
18. Lindsay H.A. Anaemia and iron deficiency : Effects on pregnancy outcome.
American Journal of clinical Nutrition. 2000 May;71(5):1280-1284.
19. Kaur M and Singh K., Effect of Health education on knowledge, attitude and
practices about anaemia among rural women in Chandigarh. Indian Journal
of community medicine 2001 July-Sep; XXVI (3):25-28.
20. Ejidokun. Community attitudes to pregnancy, anaemia, iron and folate
supplementation in urban and rural Lagos, South Western Nigeria.
Midwifery. 2000 Jun;16(2):89-95.
21. Galloway R., et al. Womens perceptions of iron deficiency and anaemia
prevention and control in eight developing countries. Social Science
Medicine 2002 Aug;55(4):529-44.
22. Ursell, Bernie- Management of iron deficiency in pregnancy by using ironrich spa water as a prophylaxis against iron deficiency in pregnancy. Clinical
and
laboratory
Haematology.
ROM
midwives
Journal.
February
2005;8(2):78-79.
23. Mah-E-Munir A., Mohammad AA., Misbahul I.K., Anaemia in pregnant
women of railway colony, Multan. Pakistan J. Med. Res. 2004;43(1):105120.
80
Abbreviations
24. Miaffoc, Some F, Kouyate B, Jahn A, Muller O. Malaria and anaemia
prevention in pregnant women of rural Burkina Faso. BMC pregnancy
childbirth. 2004 Aug;4(1):18.
25. Ekstrom EL., Hyder Z., Chaudhary AM. R, Lonnerdal. B., person L.A; In a
trial comparing weekly and daily supplementation of iron. Turkish Journal of
Haemotology. 1998 April;48(4):107-108.
26. Grover V., Aggarwal OP., Gupta A., Praveen Kumar; Tiwari RS., Effect of
daily and alternate day iron and folic acid supplementation to pregnant
female on the weight of the New born. Indian Journal of community
medicine 1998 Oct-Dec; XXIII(4):165-75.
27. Sharma JB; Arora BS, Kumar. S, Goel S, Hamija A., Helminth and
protozoan intestinal infections; an important cause for anaemia in pregnant
women. Journal of Obst. and Gyn of India 2001 November/December ;
51(6):58-61.
28. Alamgirmurshid., Assessment of iron supplementation activities among
pregnant women in an Upazila of Bangladesh. National Nutrition project
2002 March-June : 58-64.
29. Ringels et al. Awareness of folic acid for neural tube defect prevention
among Israel women. Pediatrics. 2003 June; 5(3)58.
30. Moulesehoul S., Demanouche A, Chafi Y. Benali M., effect of iron
supplementation among pregnant women. Sante 2004 Jan-March; 14(1):219.
81
Abbreviations
31. Ma AG, Chase XC, Wang Y, Xurx, Zheng MC, Lijsi; The multiple vitamin
status of Chinese pregnant women with anaemia and non-anaemia in the last
trimester. J Nutr Sci Vitaminol (Tokyo). 2004 Apr; 50(2): 87-92.
32. Dr. Kiran Bala Iron deficiency anaemia. Womans Era 2005; (1)149-150.
33. A survey by students of D.C.H. Nursing Beliefs and practices of antenatal
mothers in a rural setting. The nursing journal of India 1995 Jan(1):4-8.
34. Dr. Chandra. CP. Knowledge and attitude of the community towards rich
sources of vitamin A and iron in relation to malnutrition, North Gondar,
Ethiopia. The Ethiopian Journal of Health Development 2004;14(1):23-29.
35. Manocha. S, Aneeta A; Dharam vir: cultural Beliefs and practices affecting
the utilisation of health services during pregnancy. Journal of the Indian
Anthropological society. July 1992-27(2);181-185.
36. Gies. S, Brabin B.J. Yassin M.A and Cuevas L.E. comparison of screening
methods for anaemia in pregnant women in Awassa, Ethiopia. Tropical
medicine and international health 8(4) April 2003; 301.
37. Tanuja D; Sampathkumar, V, Jeyalakshmi and Abel R. Nutritional status of
tribal women in Bihar. Indian Journal of community Medicine XXVII (2)
April-June;2002 ; 59-60.
38. Verma-M, Chhatwal J. P Varughese. P.V. Antenatal period an educationa
opportunity. Indian pediatrics. 32, 1995 : 171-177.
39. De Silva, W.I.: Towards Safe Motherhood in Sri Lanka: Knowledge,
Attitudes and Practices During the Period of Maternity. The Journal of
family Welfare. Sept 1996. 41(32) : 18-26.
82
Abbreviations
40. Park. K. Preventive and social medicine 17th edition 2002. Jabalpur
Publications.
41. George Julia B. Nursing theories the base for professional nursing practices.
Appleton and large Narwalk.
42. Polit D and Hungler B. Nursing Research Principles and Method 6th edition,
1991 New York.
43. B. K. Mahajan methods in Biostatistics. 6th edition 1997 Jaypee Brothers
Publication New Delhi.
44. Dr. D. R. Krishnaswami. Methodology of research in Social Sciences.
Himalaya Publication House. Bombay.
45. Dutta DC. Textbook of Obstetrics 6th ed. Calcutta : New Central book
Publishers 2006 ; P. No.: 393-400.
46. Dawn CS. Text book of Obstetrics. Dawn Publications. Bombay.
47. New castle type. British Medical Journal. April 2001; 13(2);44.
48. Kilemann. Amin. Asian Pacific Journal. Sep 2000; 44(1);58.
49. Eddama Mahmoud R. The Nursing Journal of India. Nov 1995; XXI(5);8.
83
Abbreviations
LETTER REQUESTING OPINION AND SUGGESTIONS FROM
EXPERTS
From,
Anitha. M
II nd year M.Sc. Nursing Student
K.L.E.S Institute of Nursing Sciences
Belgaum-590 010
To,
_______________________________
_______________________________
_______________________________
Sub : Letter requesting opinion and suggestions of experts for
establishing content validity of the tool.
Respected Madam,
I am IInd year M.Sc Nursing student of K.L.E.S Institute of Nursing
Sciences, Belgaum, in the speciality of Obstetrics and Gynaecological Nursing. As
per the partial fulfillment of the M.Sc Nursing Degree under Rajiv Gandhi University
of Health Sciences, Bangalore, I have selected the following topic for my dissertation
titled.
A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICES

REGARDING
PREGNANT
PREVENTION
MOTHERS
OF
ANAEMIA
ATTENDING
AMONG
ANTENATAL
REGISTERED
CLINICS
IN
SELECTED HOSPITALS OF BELGAUM

I request you to kindly go through the instrument and state your expert
opinion and suggestions on the appropriateness of the items prepared and the items
84
Abbreviations
which need to be modified or deleted, by using the evaluative criteria checklist
enclosed.
Kindly sign the certificate stating you have validated the tool.
I will be very grateful to you, if you could kindly send the same by 30th
June 2005.
Thanking you, with anticipation.
Yours faithfully,
Date :
Place :
(Anitha. M.)
Enclosures :
1. Blue Print
2. Tool
3. Scoring key
4. Content validation proforma
5. Certificate of validation
6. Stamped self addressed envelope
85
Abbreviations
B.
BLUE PRINT FOR STRUCTURED KNOWLEDGE AND

PRACTICE QUESTIONNAIRE
86
Abbreviations
TOOL FOR DATA COLLECTION

STRUCTURED INTERVIEW SCHEDULE
SECTION I
SOCIO DEMOGRAPHIC AND BASELINE DATA
Code No :
1. Age :
1.1 15-19 yrs
1.2 20-24 yrs
1.3 25-30 yrs
1.4 31 yrs and above
2. Womens education :
2.1 No formal education
2.2 Primary education
2.3 Secondary education
2.4 Higher secondary education
2.5 Graduate
3. Husbands education :
3.1 No formal education
3.2 Primary education
3.3 Secondary education
3.4 Higher secondary education
3.5 Graduate
87
Abbreviations
4. Religion
4.1 Hindu
4.2 Muslim
4.3 Christian
5. Type of family
Nuclear family
Joint family
Extended family
6. Womans occupation
6.1 House wife
6.2 Labourer
6.3 Professional
7. Familys income
7.1 Below Rs. 2000/- month
7.2 Rs. 2001 3000/ month
7.3 Rs. 3001 4000/ month
7.4 Rs. 4001 5000/ month
7.5 Rs. 5001 & above
8. Diet
8.1 Vegetarian
8.2 Non-vegetarian
9. Registered during
9.1 1st trimester
9.2 2nd trimester
9.3 3rd trimester
10. Obstetric score
88
Abbreviations
11. Menstrual history
11.1 a. Less than 3 days
b. Between 3-5 days
c. More than 5 days
11.2 Amount of blood flow

a.
Heavy & regular
b.
Heavy & irregular
c.
Scanty & regular
d.
Scanty & irregular
12. Birth spacing between previous pregnancies
13. Haemoglobin level during 1st visit _____ gm%.
89
Abbreviations
SECTION II
A. KNOWLEDGE REGARDING ANAEMIA

INSTRUCTIONS TO THE RESPONDANTS :
1. Antenatal mothers require correct knowledge and practice regarding
prevention of anemia to avoid complications and maintenance of better living.
2. I will read out the statements. Please say tick (3) yes, no or dont know
as per your knowledge.
3. Your answers will remain strictly confidential.
DISEASE ASPECTS OF ANAEMIA
Yes
Pregnancy creates large demand of iron which is
No
Dont know
needed to develop the fetus and placenta

2
Increase haemoglobin % in the blood is known as

anaemia
Anaemia in pregnancy is a nutritional disorder
The normal value of haemoglobin needed during

pregnancy is 8gm%
Iron
is
important
element
required
for
haemoglobin (Hb) formation during pregnancy

6
Obesity in the pregnancy leads to anaemia
90
Abbreviations
Yes
7
No
Dont know
A major cause of anaemia is hook worm infestation

and malaria
Haemorroids during pregnancy may not cause

anaemia
History of heavy menstrual flow does not cause

anaemia
10
Bleeding disorders in previous pregnancy labour and

puerperium leads to anaemia
11
Repeated pregnancies at short intervals i.e. less than

2 years also cause anaemia
12
Recurrent abortions leads to anaemia
13
Twin pregnancy does not cause anaemia in mother
14
Faulty dietary habits causes anaemia
15
Tiredness and weakness are the symptoms of

anaemia in pregnancy
16
Pallor of the face, eyes, lips, tongue and nails are the
important signs of anaemia
17
Palpitation and breathing difficulty are the signs of

anaemia
91
Abbreviations
B. KNOWLEDGE REGARDING PREVENTION OF ANAEMIA
Yes
I
No
Dont know
DIET
18 A well balanced diet during pregnancy prevents

anaemia
19 Green leafy vegetables, cabbage and sprouted grains
are rich in iron
20 Ragi and Jaggery should be avoided during
pregnancy
21 Meat, fish, liver and eggs are rich sources of iron
22 Eating potato should be avoided during pregnancy
23 Dates & dry grapes contains rich source of iron
24 Orange and lemon juice promotes absorption of iron
25 Tea and coffee inhibits absorption of iron
26 Iron tablet should not be taken with milk or any hot
drinks
27 Pregnant women should eat last after consumption of
all family members whatever is left over
28 Fasting or missing the meals must be avoided during
pregnancy
II
PERSONAL HYGIENE
29 Nails must be always kept clean and short

30 The practice of using mud to wash the hands after
defecation is good
31 Foot wear should be used while walking in open
fields where open air defecation takes place
92
Abbreviations
III Treatment
Yes
No
Dont know
32 Regular medical check up is necessary during

pregnancy
33 Daily intake of iron and folic acid tablet is not
necessary
34 Regular intake of iron and folic acid tablet leads to
big babies
35 Regular intake of iron and folic acid tablet must be
avoided during pregnancy because it leads to
constipation
36 Adequate treatment is necessary to eradicate hook
worm infestation and malaria to prevent anaemia
93
Abbreviations
SECTION III
STRUCTURED INTERVIEW SCHEDULE ON PRACTICES REGARDING
PREVENTION OF ANAEMIA (CHECK LIST)
Instructions to the respondents :
1. I will read out the statements. Please say yes, or no as per your practices.
2. Place tick mark (3) against the columns as per responses of the mothers
DIET
Do you agree that pregnancy imposes the need for extra energy and
Yes
No
nutrients?
2
Have you changed your normal dietary pattern due to pregnancy?
Do you practice strict meal schedule during pregnancy?
Do you have the habit of taking food, which is leftover after

consumption of all family members?
Do you fast during pregnancy?
If yes do you take any special food preparations during fasting?
Do you avoid certain food items which are considered hot foods like
papaya, mangoes, egg and jaggery during pregnancy
Do you have the habit of eating specific items like ash, mud and
charcoal?
If you are a non-vegetarian, do you include meat, fish, eggs in your

diet regularly?
94
Abbreviations
10 Do you include green leafy vegetables and sprouted grams in your
diet regularly?
11 Do you wash the vegetables before cutting ?
12 Do you include seasonal fruits and dry fruits during pregnancy?
13 Do you drink atleast six to eight glasses of water per day?
14 Do you include fibre rich diet and fruits regularly in your diet?
15 Do you use ragi and jaggery in your diet?
II
HYGIENE
16 Do you practice open-air defecation?

17 If yes, do you wear chappals?
18 Do you wash your hands with soap after defecation?
19 Do you cut your nails once in a week?
III TREATMENT
20 Do you seek medical help during pregnancy?
21 Have you taken any medications prescribed by the Doctor for
deworming?
22 Do you take iron supplements for the growth of your baby?
23 If yes, are you taking the iron supplements regularly?
95
Abbreviations
SCORING KEY FACTOR SCORE

Scoring key for knowledge questionnaire
S.No
Answers
Score
Yes
Yes
No
No
Yes
No
Yes
No
No
10
Yes
11
Yes
12
Yes
13
No
14
Yes
15
Yes
16
Yes
17
Yes
18
Yes
19
No
20
Yes
21
No
96
Abbreviations
22
No
23
Yes
24
Yes
25
No
26
Yes
27
Yes
28
No
29
Yes
30
Yes
31
No
32
No
33
No
34
Yes
35
Yes
36
Yes
97
Abbreviations
SCORING KEY FOR PRACTICES

S.No
Answers
Score
Yes
Yes
Yes
No
Yes
Yes
No
No
Yes
10
Yes
11
Yes
12
Yes
13
Yes
14
Yes
15
No
16
Yes
17
Yes
18
Yes
19
Yes
20
Yes
21
Yes
22
Yes
23
Yes
98
Abbreviations
uwu yi
S I
1)
2)
3)
4)
5)
6)
7)
N P
(S)
A) 15-19
) 20-24
N) 25-30
l) 30 Oq h
ou h
A) AwyXN
) ysN
N) uN
l) yu y
C)
yuu
yr ou h
A) AwyXN
) ysN
N) uN
l) yu y
C)
yuu
u
A) u
)
N) Ow
l) Cq
Nhu u
A) AN Nh
) N Nh
N) Nh
EuS
A) Sp
) N N
N) EuS
99
Abbreviations
8)
Nhu Bu (yr rSS)

A) . 2000 Oq Nm
) . 2001-3000
N) . 3001-4000
l) . 4000-5000
. 5001 Oq X
C)
9)
Bu u
A) P
)
N)
10) wup
A) u
) Hlw
N) w
11) S NX
12) Gq XNu
12.1 Av
A) 3 vwSTq Nm
) 5 vwSTq X
12.2 Nu yo
A) X q Nu
) X q Nu
N) Nm q Nu
l) Nm q Nu
13
vw S DTw S wlw Aq
14) A) uw i N
NoNu
h 12.1 S
) D S
S II
100
Abbreviations
B)
I)
I)
1)
2)
Nwq S
rN/bw
uwNxS
XwS
NS xmu S Hu
xm u, qv
EqSSwT (9)
Yu Sr.
Nwq Su S
S zlS S
u pSS
A Nnu Yw
mNw Klqu.
u A Sr
Nu NoNu
XN Nwq
Hwq.
3)
4)
5)
II)
6)
7)
8)
9)
S
Nwq
AyNq S.
uoT, S 8
Sw NoNu
ANq Cqu.
S,
NoNu qNS
A Nn Ku
Qu uq.
NoS
S, c
NwqS
NoSqu.
NN S ,
NwqS Q No.
S Su
Nwq EgSu
Cu.
Yw Qqvu
101
Abbreviations
10)
11)
12)
13)
14)
III)
15
16
17
)
I)
18)
19)
Nwq EgSu
Cu.
vw S S
oqwuu u
quS NwqS
NoSq.
Hl STq Nm
Av u
Suu
NwqgSqu.
u Syq
BSu NwqS
NoSqu.
A N qw,
q
Nwqwh
lv.
qy B yur
Nwqwh
lqu.
YS S oS
S ANq,
S
Nwq oSTu.
Q, NoS,
ESS, qiS S
wS YN Nwq
Qu YTu.
Humq S Ehu
quS Nwq
Qu YST.
Nwq xqo Nq
rN
ys
S qw
B Nwqw
qlqu.
qy yS,
HN q
Nlu NS
102
Abbreviations
20)
21)
22)
23)
24)
25)
26)
27)
28)
II)
29)
30)
31)
Nnu XTqu.
S T S
rwuw qlN.
, w, S
gS Ar X
Nnu .
S BSl
rwuw qlN.
Qc S Kou Nnu
X qw
vq.
Oq S xS
Nnu Nw
Yq.
X S Nz Nnu
Nw qlq.
Nnu qw
, S yx bqS
u.
Nhu H u Fhu
wq, Eu AmSw
S Fh
lN.
S Ey
luw As Fh
qzuw
qlN.
O BS
ESSw S
X S ouTh
NN.
cw wq
pxu N q m
Ku.
cw wlq
u SuS
wlulS yuSw
EyTN.
103
Abbreviations
III)
YOq
32)
S
Nuu BS
qyn AN.
Nnu S yN
Blw qS vwxq
w ASq.
qyu Nnu S
yN Bmw
qSw
uu NS
ulSq.
S qyu
Nnu S yN
Bmw qSw
uw qlN
INu Auu uq
EgSqu.
Nwqw
xr, NN S
u xwST
Yw YOq ASqu.
33)
34)
35)
26)
104
Abbreviations
S III
B)
I)
I)
1)
2)
3)
4)
5)
6)
7)
Nwq xqo
Nqu yurS
Nuu uw
l (yw yi)
uwNxS
XwS.
NS xmu S Hu
xm P u qv
EqSSwT (9)
Yu Sr.
ys
u A
Sr
qw Yw O S
yNq
ASqwlqu
Huw xKyr ?
x cu ysu
Nw S
Nou uv ?
S x Nkou
q Nuu Fhu
yurw Awr
?
Nhu H u Fhu
wq Eu AmSw Fh
l m xTu ?
S x Ey
lr ?
x Eq uu, Eyu
x u
Bwwu r
?
X N
yusSu ySp
yy, wo, g
S uq Nu
B yusS
ww
S x
105
Abbreviations
8)
9)
10)
11)
12)
13)
14)
15)
qlr ?
v, o S
CuSq
yusSw rw
m xTu ?
x STu,
, w, gSw
x Bu qyu
EyTr.
qy yS
S Nlu
NSw qyu x
Bu Nmv?
NySw x
q u
Xr ?
TS qN u
oSw S Sl
Kouq
yusSw
SuS x
r ?
yr vw x Nx 6 u 8
SS xw
Nmr ?
wq B S
oSw qyu x
ysu ?
x Bu T S
w EyTr ?
II)
BS
16)
x cw Sl
Sl Sr ?
uu, x
yuSw
ur ?
cw wq x
xu Nqr ?
17)
18)
106
Abbreviations
19)
x u Ku
ESSw Nq
Nr ?
III)
YOq
20)
S x
uO w
qSuNr.
cqS xpST x
u xmu
uu
MvSw v ?
Sw pSST x
Nnu yN
yusSw rv
?
uu, x Nnu
yN yusSw
qyu rv ?
21)
22)
23)
107
Abbreviations
dgddddfdy ddI
ddd 1
dzSdedI ddeUdf
1. IdyN da
2. dSd
A.
15-19 dd
d. 20-24 dd
I.
25-30 dd
N. 30 dy dTfd dd
3. dfdy eddPd
A.
edTdT
d. dddedI
I.
ddedI
N. Dd dddedI
B.
dQdfdT
4. deddy eddPd
A.
edTdT
d. dddedI
I.
ddedI
N. Dd ddedI
B.
dQdfdT
5. ddd
A.
eUaQj
d. dgedd
I.
eddd
N. BdT
6.
IgLjad dddf
A.
eddd
108
Abbreviations
d. HId
I.
7.
edddTfd
dddydd SddddSd
A.
dTIdd
d. ddyITQdT
I.
SdddddeSdI
N. BdT
8.
IdzLgaedI Ddd (dddfI)

A.
. 2000 d Idf
d. . 2001-300
I.
. 3001-4000
N. . 4001-5000
B.
9.
. 5000 dydd ddd
AdUdT
A.
ddIUdTf
d. ddaddddTf
I.
QdyUfeU
10. ddddfdf ddyaQPdfdf dyV

A.
deUSdd dfd deUSddd
d. dgOSdd dfd deUSddd

I.
dydLdd dfd deUSddd
11. dddfSdydd AdOddd
12. dddfI ddVfdd dmddad

1
Idddddf
1.1
3 eQddddydd Idf
1.2
5 eQdddadydd ddd
109
Abbreviations
Td dgdSddddd
2.1
djd AdPdf edSdedddPdy
2.2
djd AdPdf Aededd
2.3
Idf AdPdf edSdedddPdy
2.4
Idf AdePd Aededd
13. AddfSdd Qdyd, ddddTPdydfd AadT

14. TIdddfd ddyUddy dddPd
14.1 ddd dyTfd _______ dcd%
d. d eddfd ________dcd%
110
Abbreviations
111
Abbreviations
BLUE PRINT FOR STRUCTURED KNOWLEDGE AND PRACTICE QUESTIONNAIRE
S.No
IA
IB
Content
PART - II
Structure Questionnaire
i. Disease aspects of anameia
ii. Causes
iii. Signs and symptoms
of anaemia
i. Diet
ii. Personal Hygiene
iii. Treatment
PART - III
Check list
anaemia
i. Diet
ii. Personal Hygiene
iii. Treatment
TOTAL
Knowledge
Practices
No. of items
No. of items
Total no. of Percentage

items
(%)
1,2,3,4,5,
6,7,8,9,10,11,12,13,14
15,16, 17
5
9
3
8.47
15.25
5.08
18,19,20,21,22,23,24,25,26,27,28
29,30,31
32,33,34,35,36
11
3
5
18.64
5.08
8.47
36
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15
16,17,18,19
20,21,22,23
23
15
4
4
59
25.42
6.77
6.77
99.97%
Knowledge Questionnaire %=
61.01%
Practice Questionnaire %
38.96%
Total %
99.97%
112
Abbreviations
CONTENT VALIDATION PROFORMA
SECTION II
A. Knowledge of patients regarding disease aspects of anaemia, causes, signs
and symptoms.
B. Knowledge regarding prevention of anaemia consists of diet, personal
hygiene and treatment.
A. Knowledge regarding anaemia.
I. Disease aspects of anaemia
S.No.
Content
Relevant
Accurate
Appropriate
Remarks
Relevant
Accurate
Appropriate
Remarks
II. Causes
S.No.
Content
10
11
12
13
14
113
Abbreviations
III. Signs and symptoms
S.No.
Content
15
16
Appropriate
Remarks
B. Knowledge regarding prevention of anaemia

I. Diet
S.No. Content Relevant
Accurate
Appropriate
Remarks
17
18
19
20
21
22
23
24
25
10
26
Relevant
Accurate
II. Personal hygiene

S.No.
Content
27
28
29
Relevant
Accurate
Appropriate
Remarks
Relevant
Accurate
Appropriate
Remarks
III. Treatment
S.No.
Content
30
31
32
33
34
114
Abbreviations
SECTION III
Practices regarding prevention of anaemia including diet, personal hygiene
and treatment.
I. Diet
S.No.
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Content
1
2
3
4
5
6
7
8
9
10
11
12
13
14
Relevant
Accurate
Appropriate
Remarks
Relevant
Accurate
Appropriate
Remarks
Relevant
Accurate
Appropriate
Remarks
II. Personal Hygiene
S.No.
1
2
3
4
Content
15
16
17
18
III. Treatment
S.No.
1
2
3
4
5
Content
19
20
21
22
23
115
Abbreviations
CRITERIA CHECKLIST FOR EVALUATION OF TOOL

REQUESTING SUGGESTIONS AND OPINIONS FROM THE
EXPERTS
Respected Madam,
Kindly go through the tool and give your response in the columns given in the
criterion table against each questions I request you to kindly give your valuable
suggestions on the content of the tool. Please give your expert comments on the items
you disagreed partially agree to be deleted which will help in modification of the tool.
SECTION I
Content
Demographic Data
S.
No
Relevant
Agree
Disagree
Organized
appropriately
Agree
Disagree
Measurable
Agree
Disagree
Remarks
1
2
3
4
5
6
7
8
9
10
11
12
13
116
Abbreviations
SECTION II : STRUCTURED QUESTIONNAIRE ON
A. Knowledge regarding anaemia
Content
1. Various aspects of
anaemia
S.
No
Relevant
Agree
Disagree
Organized
appropriately
Agree
Disagree
Measurable
Agree
Remarks
Disagree
1
2
3
4
5
2. Causes
6
7
8
9
10
11
12
13
14
3. Signs and
15
symptoms
16
17
B. Knowledge regarding prevention of anaemia
1. Diet
18
19
20
21
22
23
24
25
26
117
Abbreviations
Content
S.
Relevant
appropriately
Measurable
Remarks
No
Agree
2. Personal hygiene
Organized
Disagree
Agree
Disagree
Agree
Disagree
27
28
29
3. Treatment
30
31
32
33
34
SECTION III : STRUCTURED INTERVIEW SCHEDULE
PRACTICES REGARDING PREVENTION OF ANAEMIA INCLUDING DIET, PERSONAL

HYGIENE AND TREATMENT
1. Diet
1
2
3
4
5
6
7
8
9
10
11
12
13
14
118
Abbreviations
Content
S.
appropriately
Measurable
Remarks
No
Agree
2. Personal Hygiene
Organized
Relevant
Disagree
Agree
Disagree
Agree
Disagree
15
16
17
18
3. Treatment
19
20
21
22
General comments :
Signature of the expert
Name :
Designation :
Date :
119
Abbreviations
LIST OF EXPERTS
1. Mrs. Suvarna B. Talawar.
Lecturer HOD (OBG Dept)
Govt. College of Nursing
Fort Road, Bangalore.
2. Mrs. P. Shanthi. Ida.

Prof & HOD (OBG Dept)
M. S. Ramaiyya College of Nursing,
Bangalore 54.
3. Mrs. S. Vijaylakshmi.
Reader,
Omayal Achi College of Nursing,
Avadi, Chennai.
4. Mrs. Nilima. Bhore.

Associate Prof. (OBG Dept)
Bharatiya Vidhya Peet.
College of Nursing, Pune.
5. Mrs. Marie. Pinto.

Assoc. Prof. (OBG Dept)
Fr Mullar College of Nursing,
Mangalore.
120
Abbreviations
121
Abbreviations
122
Abbreviations
123
Abbreviations
124
Abbreviations
125
Abbreviations
Letter Seeking Permission To Conduct Study
126
Abbreviations
Master Chart
KNOWLEDGE
Patient
Percentage
Score
C.No.
(%)
Patient
Percentage
Score
C.No.
(%)
Patient
Percentage
Score
C.No.
(%)
19
52.8
36
17
47.22
71
17
47.22
14
38.88
37
19
52.77
72
18
50
14
38.88
38
23
63.88
73
22
61.11
12
33.33
39
20
55.55
74
19
52.77
10
27.77
40
17
47.22
75
19
52.77
14
38.88
41
18
50
76
28
77.77
17
47.22
42
15
41.66
77
15
41.66
30
83.33
43
14
38.88
78
28
77.77
15
41.66
44
13
36.11
79
25
69.44
10
12
33.33
45
19
52.77
80
21
33.33
11
17
47.22
46
18
50
81
21
33.33
12
21
58.33
47
23
63.88
82
11
30.55
13
17
47.22
48
17
47.22
83
20
55.55
14
20
55.55
49
27
75
84
13
36.11
15
19
52.77
50
22
61.11
85
15
41.66
16
21
58.33
51
30
83.33
86
22
61.11
17
17
47.22
52
18
50
87
17
47.22
18
18
50
53
17
47.22
88
18
50
19
18
50
54
19
52.77
89
16
44.44
20
14
38.88
55
17
47.22
90
21
58.33
21
21
42.2
56
18
50
91
25
69.44
22
17
47.22
57
16
44.44
92
21
58.33
23
13
36.11
58
17
47.22
93
22
61.11
24
21
58.33
59
14
38.88
94
11
30.55
25
10
27.77
60
20
55.55
95
22
61.11
26
22
61.11
61
22
61.11
96
21
33.33
27
14
38.88
62
18
50
97
11
30.55
28
16
44.44
63
17
47.22
98
10
27.77
29
18
50
64
19
52.77
99
17
47.77
30
11
30.55
65
17
47.22
100
30
83.33
31
30
83.33
66
13
36.11
101
12
33.33
32
13
36.11
67
14
38.88
102
17
47.22
33
12
33.33
68
14
38.88
103
18
50
34
29
80.55
69
17
47.22
104
30
83.33
35
20
55.55
70
19
52.77
105
22.22
127
Abbreviations
Master Chart
PRACTICES
Patient
Percentage
Score
C.No.
(%)
Patient
Percentage
Score
C.No.
(%)
Patient
Percentage
Score
C.No.
(%)
18
78.26
36
10
100
71
11
47.82
39.13
37
81
72
19
82.6
12
52.17
38
22
99.65
73
21
91.3
10
43.47
39
21
91.3
74
19
82.6
10
43.47
40
19
82.6
75
19
82.6
13
56.52
41
20
86.95
76
26.08
10
43.47
42
13
56.52
77
19
82.6
10
43.47
43
11
47.82
78
21
91.3
10
43.47
44
23
100
79
19
82.6
10
10
43.47
45
11
47.82
80
18
78.26
11
10
43.47
46
11
47.82
81
16
69.56
12
22
95.65
47
21
91.3
82
20
86.95
13
21
91.3
48
13
56.52
83
23
100
14
21
91.3
49
18
78.26
84
15
65.21
15
20
86.95
50
16
69.56
85
12
52.17
16
22
95.65
51
18
78.26
86
21
91.3
17
39.13
52
17
73.91
87
15
65.21
18
10
43.47
53
19
82.6
88
17
73.91
19
10
43.47
54
17
73.91
89
15
65.21
20
11
47.82
55
18
78.26
90
18
78.26
21
21
91.3
56
10
43.47
91
18
78.26
22
11
47.82
57
11
47.82
92
19
82.6
23
10
43.47
58
10
43.47
93
20
86.95
24
21
91.3
59
10
43.47
94
34.78
25
43.47
60
21
91.3
95
22
95.65
26
16
91.3
61
21
91.3
96
22
95.65
27
10
34.78
62
17
73.91
97
10
43.47
28
10
69.56
63
17
73.91
98
11
47.82
29
20
43.47
64
17
73.91
99
21
91.3
30
11
43.47
65
10
43.47
100
21
91.3
31
13
86.95
66
11
47.82
101
14
60.86
32
21
47.82
67
11
47.82
102
17
73.91
33
11
56.52
68
11
47.82
103
17
73.91
34
10
91.3
69
11
47.82
104
21
91.3
35
47.82
70
11
47.82
105
26.08
128
Abbreviations
ABSTRACT
A study, titled A study to assess the knowledge and practices regarding
prevention of anaemia among registered pregnant mothers attending antenatal
clinics in selected hospitals of Belgaum was undertaken by Mrs. Anitha M. in
partial fulfillment of the requirement to award the Degree of Master of Science in
Nursing. at K.L.E.S Institute of Nursing Sciences, Belgaum, a college affiliated to
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore.
OBJECTIVES OF THE STUDY

1. To assess the knowledge regarding prevention of anaemia among registered
pregnant mothers.
2. To identify the practices regarding prevention of anaemia among registered
pregnant mothers.
3. To find out the relationship between knowledge and selected variables
4. To find out the relationship between practices and selected variables
5. To find out the relationship between knowledge and practices regarding
prevention of anaemia among registered pregnant mothers.
The independent variable is knowledge and practices of mothers regarding
prevention of anaemia and dependent variables is pregnant mothers.
The conceptual framework for the study was derived from the health
promotion model proposed by Nola J. Pender in the year 1996. The main
129
Abbreviations
component of this framework are individual characteristics and experiences,
activity related affect, commitment of a plan of action.
The tool for the data collection included background performa knowledge
and practices questionnaire regarding prevention of anaemia.
The data collection was carried out between / /2005 to / /2005 which
included collection of information on sociodemographic and baseline data
structured interview schedule. In this verbal responses were recorded with use of
structured interview schedule at K.L.E.S obstetrics and gynaecological antenatal
OPD.
The subjects studied were 105 in number characteristics of the subjects
were as follows :
MAJOR FINDINGS OF THE STUDY :
anaemia, 33.64% had knowledge regarding cause whereas 48.19% had
knowledge about signs and symptoms.
2. Knowledge regarding prevention anaemia showed that 56.27% of the
mothers had knowledge regarding diet, 78.04% had knowledge regarding
personal hygiene, whereas 57.33% had knowledge about treatment.
3. Practices regarding prevention of anaemia showed that 67.67% of the
mothers were taking care of diet, 57.85%, of the mothers maintained
adequate personal hygiene, 70.00% of mothers seeked medical help.
4. There is statistically significant association between age in years of the
mothers and level of knowledge at P<0.005 level of significance.
5. There is statistically significant association between mothers educational
status and level of knowledge at P<0.005 level of significance.
130
Abbreviations
6. There is statistically significant association between mothers family income
and level of knowledge at P<0.005 level of significance.
7. There is statistically significant association between womens education
and practices at P<0.005 level of significance.
8. There is statistically significant association between family income of the
mothers and practices at p < 0.005 level of significance.
9. Looking into above facts (Ho) hypothesis is accepted since value of
knowledge and practices at the level of p < 0.005. This clearly shows that
women having good knowledge tend to show inclination towards beneficial
practices than women with poor and average knowledge.
The study concluded, with the help of available knowledge and practices,
further intensive health education can be planned and implemented to motivate the
mothers to practices beneficial practice to prevent anaemia among pregnant
mothers.
On the bases of findings following recommendations are made :
1. A similar study can be conducted in a broader area in order to draw
generalization.
2. A similar study can be conducted in different settings and in different
social economic strata.
3. A study can be conducted on attitude of registered pregnant mothers
regarding prevention of anaemia attending antenatal clinics.
4. A study can be conducted on a large sample of the same problem and a
control group can be kept for comparison of the result.
Key words :
Prevention anaemia, Knowledge, Practice, Registered pregnant mothers,
antenatal clinics.
131
Abbreviations
List of Abbreviations
Mean
SD
Standard Deviation
Hb%
Haemoglobin percentage
WHO
World Health Organization
Chi-square
OPD
Out Patient Department
132
CONCEPTUALFRAMEWORK
BASED ON THE HEALTH PROMOTION MODEL PROPOSED BY DR. NOLA J. PENDER (1996)
INDIVIDUAL
ACTIVITY RELATED
CHARACTERISTICS &
BEHAVIOURAL OUTCOME
AFFECT
EXPERIENCES
Adequate knowledge &

Correct practices
Personal factors :
Age
Womens education
Family annual income
Type of diet
Obstetric score
Haemoglobin level
Personal
H ygiene
T reatment
Existing knowledge and

practices of antenatal mothers
regarding prevention of
anaemia in the following areas :
1. Knowledge regarding
anaemia & its
2. Practices regarding
Diet
Inadequate knowledge &

Incorrect practices
FEED BACK
11
Key
Area under study

Area not under study
Health
promotion
(Healthy
mother &
Healthy
baby
Commitment to a plan
of action.
Planned teaching
programme on
preventive measures
of anaemia
Dedicated to
My Beloved Family
Members
& Teachers
Research Setting
Antenatal OPD KLES Hospital & MRC,
Belgaum.
Collecting Data From The Mother
Let every child be born by choice and not by
Save the Mother

Save the Generations
Nutrition received during antenatal

period determines the growth &
development
Appendix C
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99
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100
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101
Appendix C
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102
Appendix C
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103
Appendix C
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104
Appendix C
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105
Appendix C
ASqu.
106
Appendix C
S III
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XwS.
NS xmu S
Hu xm P u
qv
EqSSwT (9)
Yu Sr.
ys
qw Yw O S
yNq
ASqwlqu
Huw xKyr ?
x cu ysu
Nw S
Nou uv ?
S x
Nkou q
Nuu Fhu
yurw
Awr ?
Nhu H u
Fhu wq Eu
AmSw Fh l
m xTu ?
S x Ey
lr ?
x Eq uu,
Eyu x
u Bwwu
r ?
X N
yusSu ySp
yy, wo, g
S uq Nu
A Sr
u
107
Appendix C
8)
9)
10)
11)
12)
13)
14)
15)
II)
16)
17)
B yusS
ww
S x
qlr ?
v, o S
CuSq
yusSw rw
m xTu ?
x STu,
, w, gSw
x Bu qyu
EyTr.
qy yS
S Nlu
NSw qyu x
Bu Nmv?
NySw x
q u
Xr ?
TS qN u
oSw S Sl
Kouq
yusSw
SuS x
r ?
yr vw x Nx 6 u 8
SS xw
Nmr ?
wq B S
oSw qyu x
ysu ?
x Bu T S
w EyTr ?
BS
x cw Sl
Sl Sr?
uu, x
yuSw
ur ?
108
Appendix C
18) cw wq x
xu Nqr ?
19) x u Ku
ESSw Nq
Nr ?
III)
YOq
20) S x
uO w
qSuNr.
21) cqS xpST x
u xmu
uu
MvSw v ?
22) Sw pSST x
Nnu yN
yusSw
rv ?
23) uu, x Nnu
yN yusSw
qyu rv ?
109
Appendix C
dgddddfdy ddI
ddd 1
dzSdedI ddeUdf
1 IdyN da
.
2 dSd
.
A 15-19 dd
.
20-24 dd
d
.
I 25-30 dd
.
N 30 dy dTfd dd
.
3 dfdy eddPd
.
A edTdT
.
dddedI
d
.
I ddedI
.
N Dd dddedI
.
B dQdfdT
.
4 deddy eddPd
.
106
Appendix C
A edTdT
.
dddedI
d
.
I ddedI
.
N Dd ddedI
.
B dQdfdT
.
5 ddd
.
A eUaQj
.
dgedd
d
.
I eddd
.
N BdT
6. IgLjad dddf
A eddd
.
HId
d
.
I
edddTfd
107
Appendix C
.
7. dddydd SddddSd
A dTIdd
.
ddyITQdT
d
.
I SdddddeSdI
.
N BdT
.
8. IdzLgaedI Ddd (dddfI)
A . 2000 d Idf
.
. 2001-300
d
.
I . 3001-4000
.
N . 4001-5000
.
B . 5000 dydd ddd
.
9. AdUdT
A ddIUdTf
.
ddaddddTf
d
.
I
QdyUfeU
108
Appendix C
.
1 ddddfdf ddyaQPdfdf dyV
0.
A deUSdd dfd deUSddd
.
dgOSdd dfd deUSddd
d
.
I dydLdd dfd deUSddd
.
1 dddfSdydd AdOddd
1.
1 dddfI ddVfdd dmddad

2.
1
Idddddf
1.
1
3 eQddddydd Idf
1.
2
5 eQdddadydd ddd
Td dgdSddddd
2.
1
djd AdPdf edSdedddPdy
2.
2
djd AdPdf Aededd
2.
3
Idf AdPdf edSdedddPdy
2.
4
Idf AdePd Aededd
109
Appendix C
1 AddfSdd Qdyd, ddddTPdydfd AadT

3.
1 TIdddfd ddyUddy dddPd
4.
14 ddd dyTfd _______ dcd%
.1
d d eddfd ________dcd%
.
110
Appendix C
QgdTd ddd
djddd : ddd dddf QdeddySdd eTSdd
dddyd ddyI-dddddddyT DdTdQdd (9) Adf
dgPd ITddf.
.da
daNgTdydd eddSdf
ddddyd dgdddf
d ddTydf ddO
UdyPSddddMf
Tddy ddyU
dddPd ddd Udy
2.
Tddddy ddyUddy
dddPd ddOSdddy
daNgTdyd Udyddy
3.
ddddyd
AdUdTddfd
IddTdydgVy
daNgTdyd Udyddy
4.
ddddyd
Tdddfd
ddyUdddPd 8 dbd%
Adddy
5.
dddddyd
TdddLfddeO
dedddddPd ddOPdy
SddySd Adddy ddddy
IdTPdy
6.
dddddyd
djddPdddgVy
daNgTdyd Udyddy
7.
daNgTdyddy
dUdddf IdTPdy
ddyTfSdd AdPdf Ijdf
Udyd
8.
dddddyd
djVSddd Uy
UdySd ddUf ddeUd

ddUf
111
Appendix C
daNgTdydddy IdTPd
ddUf
9.
dddfI ddVfdd Aed

Tdddd Uy
daNgTdydddy IdTPd
UdySd
10.
Td ddddfd AdePd
SdedddPdd AdedSdd
ddddTPdd dImdf d
ddVaddPdddg dgQd
daNgTdyd UdyPdddy
IdTPd Udyd dIdy
11.
dT dddfd Qdyd
ddddTPdydfd AdaT
Uy 2 ddddydd Idf
Adyd dTf dNgTdyd
UdyB dIdy
12.
ddaTddT dddddd
dgVy daNgTdyd
Udyddy
13.
dgVf ddddTPddy
dgVy dddydd
daNgTdyd UdyPSdddf
dSddd dddy
14.
dgIfSdd AdUdTSdd
ddeSda dgVy
daNgTdyd Udyddy.
3
15.
edUy d ddPdya
dIdd d AdIddPdd
Uf dddddydfd
daNgTdyddf ddPdy
AdUyd
.da
daNgTdydd eddSdf
16.
dyUTd, NdyVy, AdyM,

ddy, dfd eRIy UdyPdy
UdySd ddUf ddeUd

ddUf
112
Appendix C
Uz daNgTdydddf
dUdddf ddPdy
Udyd
17.
ddddyJdddddd
ANdVd d UmQSdddf
dNdN Uf
ddddydfd
daNgTdydddf edUy
Udyd
daNgTdyd
LdVPSddITfdd
dyPddSdd IdV
dfeddSdI ddd
AdUdT
18.
Dd d dadgdfd
AdUdTddy
dddddyd dddd
IySddd daNgTdyd
LVj dIddy
19.
eUTSdd dddyddSdd,
Idydf d INddSdy
USddddy ddyUddy
dddPd AedI Addy
20.
dddPdf d djV
dddddyd
LdVddy
21.
ddad, SdIjd, dddy d

AaNf Sddddy
ddyUddy ddddPd
AdfI AdLdy
22.
dTdLy ddPdy
dddddyd
SddSd ITddy
23.
dgIy dyQdPdy, ddgI

AdPdf ddgTddSdy
ddyUdSdy dddPd
AdfI Addy
113
Appendix C
24.
daSdddd d edadjdd
Td dyddy IySdddy
ddyU ddPd SddySd
Udydy
25.
dUd d IdacRf
dyddddy ddyU
dddPdddd ANdVd
Udyddy
26.
ddyUdSdd ddySdd
dgdddTdydT d
dTddQddd dTdydT
dydj dSdyd
27.
ddddfdy dTdd
daNVfadf dydPd
IySdddadT ddSd
dydPSddd ddddy
28.
Ddddd ITpdy d
Ddddf TdUdPdy USdd
ddyf dddeddy
LdVdPSddd
2
.
da
dzSdeII dJdd
daNgTdydd eddSdf
Udy
Sd
ddU
f
ddeU
d
ddUf
29. ddy dyUdf dJ d Idf

Myddedd
30. dzdddadT ddeddy Udd
dgPdy Uf ddSd ddaddf
AdUy
31. dTdddUyT ddddadd
eIadd dyddddy Idd
ITddadd dSdddy
ddQddPdy dddTddfd
3
DdddT
32. ddeTeTI ddddPdf

114
Appendix C
ddddTPdyd
dyVdyadyVfa ITpdy
AdddSdI AdUy
33. QTTdyd ddyUddyVf d
RdcdfI AcdfNdf ddVf
dyPdy deft ddUf
34. QTTdyd ddyU d RdabdfI
ddyVfdy ddyLddfd dgd
ddyyLy Udydy
35. ddyUddVf d RdacdfI
AacdfN ddVf
dddddyd QTTdyd
dydg dSdy IdTPd
SdddgVy dVddTdyd
Udydy.
36. SddySd df IdVdf dyPSdddy
115
Appendix C
daNgTdyd UdyUg dSdy dPdgd

ITddSddSdd Imdfadd AdOddd
.
da
daNgTdydd eddSdf
AdUdT
1.
dgUddd Uy dTdy Id, If

ddddyd ddd AdPdf
ddydI dTd Addy?
2.
dgUf dgddd QTTdyddd

AdUdT dddddydgVy
dQddd Id?
3.
dgUf dddddydgVy
edddd d SddySd AdUdT
dydd Id?
4.
dgUddd dgdSdd
dTSdddf dydPd
dyddddSddTd dydLf
dyddSddf ddSd AdUy Id?
5.
dgUf ddddTPdyddy
dT dgddy dyUdfdy
Dddd ddd-Myddd Id?
6.
dT UdySd, dT Ddddf
Addddd IdUf dydd Id?
7.
dgUf dddddyd ddC,

ANfa, Adady, djV, ddTdy
dQdd SdSd ITdd Id ?
8.
dgUddd dNg, Tdd eIadd

IdyVdd SddddTdy dQdd
dPSdddf ddSd (BJd)
AdUy Id?
9.
dT dgUf ddaddUdTf
AdUdad dT, dgUf Tdyd
ddad, dddy, ANfa Sddadd
dydPddad ddddyd ddd
Udy
Sd
ddU
f
ddeU
d
ddUf
116
Appendix C
ITdd Id?
10. dgdSdd dydPddad dddy
ddSdd d DINdydf
INddSdy Sddadd
ddddyd Adddy Id ?
11. IddPSdddjdf dgUf
eUTSdd dddy ddSdd
dydjd dydd Id?
12. dddddyd ddyddddfd
Dddd RVy, dgId dydd
dydd Id?
117
Appendix B -
BLUE PRINT
FOR STRUCTURED KNOWLEDGE AND PRACTICE QUESTIONNAIRE

S.No
IA
IB
Knowledge
No. of items
Practices
No. of items
Total no.
of items
Percentage
(%)
1,2,3,4,5,
6,7,8,9,10,11,12,13,14
15,16, 17
5
9
3
8.47
15.25
5.08
18,19,20,21,22,23,24,25,26,27,28
29,30,31
32,33,34,35,36
11
3
5
18.64
5.08
8.47
36
1,2,3,4,5,6,7,8,9,10,11,12,13,14,15
16,17,18,19
20,21,22,23
23
15
4
4
59
25.42
6.77
6.77
99.97%
Content
PART - II
Structure Questionnaire
i.
Disease aspects of
anameia
ii.
Causes
iii.
Signs and symptoms
of anaemia
i.
Diet
ii.
Personal Hygiene
iii.
Treatment
PART - III
Check list
anaemia
i.
Diet
ii.
Personal Hygiene
iii.
Treatment
TOTAL
Knowledge Questionnaire %=
61.01%
Practice Questionnaire %
38.96%
Total %
99.97%
86
Age
Womens education
5
Husbands education
Religion
33
Type of
family
2.1
2
Woman's
occupation
Family's income
Mixed
28
Vegetarian
Rs. 5001 & above
12
Rs. 4001 5000/ month
27
Rs. 3001 4000/ month
Rs. 2001 3000/ month
Below Rs. 2000/ month
3
Professional
0
Labourer
House wife
50
Joint family
56
Nuclear family
Any other
24
Christian
30
Muslim
75
Hindu
16
Graduate
22
35
Secondary education
24
Primary education
No formal education
12
Graduate
Secondary education
Primary education
No formal education
30 yrs and above
21
25-29 yrs
25
20-24 yrs
15-19 yrs
GRAPH - 1
100
100
71
77
58
47
34
41
23
28
19
12
1
Diet
Registered during
Obstetric score
Menstrual history
Amount of blood flow
Birth spacing between

previous pregnancies
Severe
degree (<7.0
gm/dl)
33
Moderate
degree (7.1
9.0 gm/dl)
49
Mild degree
(9.1 11
gm/dl)
10
> 3 years
2 3 years
20
< 2 years
Scanty &
irregular
59
Scanty &
regular
Heavy &
irregular
38
Heavy &
regular
More than 5
days
100
Between 3 to
5 days
Less than 3
days
80
Multigravida
Primigravida
40
3rd trimester
60
2nd trimester
1st trimester
GRAPH - 2
Distribution of mothers according to baseline data
120
97
72
58
53
41
29
18
3
36
Haemoglobin level
(According to WHO
classification
GRAPH - 3
76
80
70
60
50
40
16
13
30
20
10
0
38
<X-1SD (<13) Poor
X 1SD to X + SD (13 + 21) average
>X + 1SD (>21)-Good
GRAPH - 4
Distribution of mothers according to knowledge on various aspects of anaemia
95
100
90
80
70
55
60
46
50
40
31
31
30
20
10
0
Anaemia is a
Haemoglobin value Iron required for Hb
Pregnancy creates Increase Hb% in the
formation
blood is anaemia
nutritional disorder in pregnancy is iron
large demand of
8gm%
iron
40
100
20
Faulty dietary
habits
Twin pregnancy
Recurrent
abortions
24
Repeated
pregnancies
18
42
Bleeding disorders
18
History of heavy
menstrual flow
Haemorroids
during pregnancy
40
Hook worm
infestation and
malaria
Obesity in
pregnancy
GRAPH - 5
91
80
64
60
41
25
17
20
GRAPH - 6
Distribution of mothers according to knowledge on signs and

symptoms of anaemia
11
57
44
Tiredness and weakness
84
Pallor of the face, eyes, lips, tongue and nails
Palpitation and breathing difficulty
0
47
44
29
12
50
BENEFICIAL PRACTICES
63
60
42
45
5
11
2
NON- BENEFICIAL PRACTICES
Eating Ragi and jaggery
61
Including fibre rich diet and

fruits
94
Drinking of eight to ten

glasses of water
103
Including seasonal fruits and

dry fruits
100
Washing vegetables before

cutting
58
Intake of green leafy

vegetables and sprouted
grams
76
Including of meat, fish, eggs
93
Following pica practices
40
Avoidance of hot foods
Eating special food

preparations during fasting
100
Continued fasting during

pregnancy
20
Consuming meals lastly

whatever is left over
80
Following strict meal

schedule
60
Change in normal dietary

pattern
100
Pregnancy imposes extra

energy and nutrients
GRAPH - 7
120
98
83
71
57
64
48
34
41
22
7
GRAPH - 8

70
70
63
58
60
52
53
47
50
42
40
35
30
20
10
0
Practicing open-air
defecation
Wearing of chappals
52
Hand washing after

defecation
Nail care once in a week
GRAPH - 9
120
100
104
97
80
70
60
58
47
40
35
20
8
0
1
Seeking medical help during
pregnancy
Periodical deworming
54
Iron requirement for the

growth of the baby
Regular in take of iron

supplements

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A STUDY TO ASSESS THE KNOWLEDGE AND PRACTICES REGARDING

PREVENTION OF ANAEMIA AMONG REGISTERED PREGNANT

Under the guidance of

Department of Obstetrics & Gynaecological Nursing

K.L.E Societys Institute of Nursing Sciences

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

DECLARATION BY THE CANDIDATE

I hereby declare that this dissertation entitled - A Study To Assess The

CERTIFICATE BY THE GUIDE

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

a bonafide research work done by Mrs. Anitha. M. in partial fulfillment of the

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

Mrs. Sangeeta Kharde M.Sc (N)

ENDORSEMENT BY THE HOD, PRINCIPAL,

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

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

Seal & Signature :

Seal & Signature

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

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

Declaration by the candidate

I hereby declare that Rajiv Gandhi University of Health Sciences,

Assistant professor, K.L.E.S Institute of Nursing Sciences,

Belgaum. Her unconditional support, guidance, valuable suggestions, untiring efforts,

Prof. Mrs. S. J. Narvekar Prof. R. S. Hooli, Prof Mrs. Milka

Madhale, Prof. David A. Kola, Prof. Mrs. Sheela Williams, Prof.

Assistant Professors Mrs. Vijayalaxmi, Mrs. Sangeetha Kharde,

Mrs. Sudha. A. Raddi, Ms. Meenakshi M. Devangamath, Mrs. Suchitra Ratod

who helped in Kannada and Marathi translations of the tool.

Mr. Kaleem of Sheegra Designing and Printing

My sincere thanks to our Librarians Mr. Prakash Mr. Mahindra

for permitting and facilitating me to make use of the reservoir of

Conceptual frame work

Distribution of mothers according to base line data

Distribution of subjects according to level of knowledge

of disease aspects and prevention of anaemia

Distribution of mothers according to various aspects of

Distribution of mothers according to knowledge on

Distribution of mothers according to knowledge on signs

and symptoms of anaemia

Distribution of mothers according to practices regarding

Distribution of mothers according to hygienic practices

Distribution of mothers according to practices regarding

Need for the study

Literature related to prevalence of anaemia in

ANALYSIS AND INTERPRETATION OF DATA

MAJOR FINDINS, DISCUSSION, MAJOR

FINDINGS, SUMMARY & CONCLUSION

Distribution of mothers according to sociodemographic

Distribution of mothers according to base line data

Mean, median and standard deviation of knowledge

scores of the registered pregnant mothers regarding

Distribution of subjects according to level of knowledge

of disease aspects and prevention of anaemia

Distribution of mothers according to knowledge on

various aspects of anaemia

Distribution of mothers according to knowledge on

Distribution of mothers according to knowledge on

signs and symptoms of anaemia

Distribution of mothers according to knowledge on

sources of iron rich foods

Distribution of mothers according to knowledge on