RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
SYNOPSIS PERFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION
Name of the candidate andAddress (in block letters) / MR. PRAVEEN .B. KADUR
1ST YEAR M.SC NURSING BAPUJI COLLEGE OF NURSING, DAVANGERE-04.
2. / Name of the institution / BAPUJI COLLEGE OF NURSING DAVANGERE-04, KARNATAKA.
3. / Course of Study and subject / M.SC NURSING 1ST YEAR COMMUNITY HEALTH NURSING.
4. / Date of Admission To Course / 1ST JUNE 2007
5. / Title of the Topic / “EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING IMMUNIZATION AMONG MOTHERS OF UNDERFIVE CHILDREN” IN HADADI VILLAGE. DAVANGERE.
6.0 Introduction
Immunization is a proven tool for controlling and even eradicating disease.1
The child needs to be protected from six infectious and vaccine preventable diseases. These diseases include tuberculosis, tetanus, diphtheria, whooping cough and poliomyelitis.2
The underfive childrens can be saved from deaths by immunizing them at the right age and right time and by completing the full course of immunization.2
According to UNICEF immunization is currently preventing an estimated two million deaths among children under five every year.3
India has one of the highest under five mortality rates in the world with an estimate of 85/1000 live births in 2006, the underfive mortality rate in the Karnataka state was 88/1000 live births in 2006. one of the factors contributing to underfive mortality is the ignorance of child care.4
Global immunization coverage has greatly increased since WHO’s expanded programme on immunization began in 1974. In 2003, global DPT3 (three doses of the diphtheria, pertussis, teanus combination vaccine) coverage was 78% up from 20% in 1980. However, 27 million children world wide were not reached by DPT3 in 2003, including 9.9million on south Asia and 9.6 million in sub-Saharan Africa.1
An estimated 2.1 million people around the world died on 2002 of diseases preventable by used vaccines. This toll included 1.4 million children under the age of five.1
Immunization is one of the most effective public health interventions to reduce childhood mortality due to vaccine preventable diseases.5
6.1 Need for the study:-
The physical health of a child is important because it is associated with the mental and social development of a children. Mothers are the first care providers of their children, is needed to reduce the underfive mortality rate. One of the ways to achieve reduction of underfive mortality is to educate the mothers on matters pertaining to child care.6
Singh and Yadav (1998) conducted a study to determine the relationship between the literacy status and immunization coverage on Bihar. The analysis revealed a fairly low immunization coverage (<33%) for all vaccines and it was found that literacy status of mothers had a significant influence on the immunization level. Lack of awareness and motivation was cited as the main reason for non-immunization. Education of mothers improves their knowledge which in turn changes their attitude.
Each year since 1990, immunization with routine vaccines has reached more than 70 percent of children world wide. At the UN General Assembly special session in 2002 the international community adopted the specific target of immunizing by 2010 atleast 90 percent of childrens in each country.3
This area of study has been selected because even today the mortality of under five children is high and it is mainly due to diseases that can be prevented. Hence, the need was felt to identify the learning needs of mothers and educate them regarding immunization by introducing structured teaching programme and promoting health of underfive children which inturn reduces mortality among under five children.
6.2 Review of Literature
The purpose for review of literature is to obtain comprehensive knowledge base and in depth of information from previous studies.
1) Singh MC, Badole CM, Sigh MP (1994):- Conducted study on one hundred and thirty mothers in the age group (15-44) years and 142 children aged (12-59) months were selected in Wardha district, out of this 100 mothers and 122 children could be contacted for evaluation of immunization coverage and assessing maternal knowledge and practice regarding immunization 52.5% children were fully immunized and 45.1% were partially immunized. Vaccine coverage for B.C.G. and primary doses of DPT/OPV was 95.9% and above 85% respectively. It was 57.4% for measles and 63.04% for booster dose was 36.96%. mothers had a knowledge regarding need for immunization but a poor knowledge regarding the diseases prevented and doses of the vaccines.7
2) Zell E.R, Battaglia MP, Wright RA (2000):- Conducted study on National Immunization survey (NIS) was designed to measure vaccination coverage estimates for the US, the 50 states. The NIS includes a random-digit-dialed telephone survey and a provider record check study. Data are weighted to account for the sample design and to reduce non response and non coverage biases in order to improve vaccination coverage estimates. NIS estimates are highly comparable to vaccination estimates derived from the national Health Interview survey. The NIS allows comparisons between states and urban areas over time and if used to evaluate current and new vaccination strategies.8
3) Stokley S, Smith PJ, Klevens RM (2001):- Study was conducted to estimate the vaccination coverage level of childrens living in rural and urban areas to identify statistically significant differences. Childrens aged 19-35 months participating on the 1999 National Immunization Survey were included in the study. Statistically significant differences in vaccination coverage levels between the rural population and their urban counterparts were determined for individual vaccines and vaccine series. Results; overall 18% of the children included on the 1999 NIS lived in a rural area, 46% lived in a sub urban area and 36% lived an urban area.9
4) Mathew JL, Babbar H, Yadav S (2002):- Conducted study on 500 children under the age of 5 years belonging to a low income group. All were attending the paediatrics out patient department of a large teaching hospital in New Delhi, India. Only 25% were found to have received complete primary immunization as per the National Immunization schedule (bacilli calmette – Guerin at birth, 3 doses of diphtheria, pertussis and tetanus and oral poliovirus vaccine at 6,10 and 14 weeks and measles at 9 months). The major reasons for non-immunization of the children were migration to a native village (26.4%), domestic problems (9.6%). The immunization centre was located too far from their home (9.6%) and for child was unwell when the vaccination was due (9%). The lack of awareness and fear of side effects constituted a small minority of reasons for non-immunization.10
5) Smith P.J, Hoaglin D.C (2005):- Conducted study to obtain vaccination since 1994 the NIS has monitored progress toward the Healthy people 2000 and 2010 vaccination goals. A mail survey to vaccination providers to obtain vaccination histories used to estimate vaccination coverage rates. Results in 2001 among infants with completed RDD interviews, 0.3 percent were entirely unvaccinated. Together, the new non telephone adjustment and the refinement for unvaccinated infants yielded revised estimates that were within 1.5 percentage points of the original estimate obtained using the 1998-2001 methodology.11
6) Topuzoglu A, Ozaydin GA, Cali S, Cebeci D (2005):- Conducted study was conducted to determine the coverage of the expanded programme of Immunization (EPI) of the ministry of Health and the coverage of private vaccines in the umraniye Health District in order to establish approaches for improving vaccination services. Thirty streets were selected at random from each health care region, utilization of vaccination services and vaccination status of children under the age of 5 years were determined by face to face interviews Results, vaccination coverage was as follows. Hepatitis B third dose, 84.6%; BCG, 94.8%; DPT third dose, 90.1%; Oral polio virus (OPV) third dose, 90.0%; Measles, mumps, rubella (MMR), 13.3%;, The full vaccination rates for children under 5 years were 68.3%.12
7) Linkins RW, Salmon DA, Pan WK (2006):- Conducted study to assess the attitudes of parents of vaccinated and unvaccinated children regarding; support for immunization registries; laws authorizing registries and mandating provider reporting and financial worth and responsibility of registry development and implementation methods; A case control study of parents of 815 children exempt from school vaccination requirements and 1630 fully vaccinated children was conducted. Surveys administered to the parents, asked about views on registries and perceived utility and safety of vaccines. Results; Surveys were completed by 56.1% of respondents, fewer than 10% of parents were aware of immunization registries on their communities.13
6.3 Statement of Problem:-
A Study to assess the effectiveness of structured teaching programme on knowledge regarding immunization among mothers of underfive children in Hadadi village. Davangere.
6.4 Objectives of the study:-
1. To assess the knowledge of immunization among mothers of under five children .
2. To prepare and introduce structured teaching programme on immunization among mothers of under five children.
3. To assess the effectiveness of structured teaching programme on immunization through knowledge score .
4.To find the difference between pre-test and post-test knowledge score.
5.To determine the association between pre-test knowledge score and selected demographic variables.
6.5 Operational definition:-
1. Assess:- In the present study it is the organized systematic and continuous process of collecting data from mothers of under five children.
2. Effectiveness:- In this study effectiveness means “Improving the knowledge regarding immunization for mothers of under five by structured teaching programme which may result differences between pre and post test score”.
3. Structured teaching programme:- In the present study it refers to systematically planned teaching programme designed to provide information regarding immunization among mothers of under five children.
4. Knowledge:- It refers to correct response of the mothers of under five to knowledge items on immunization as achieved by knowledge score.
5. Immunization:- It refers to the process of protecting under five children against disease like diphtheria, polio, tetanus, whooping cough, tuberculosis and measles by following the schedule prescribed by national immunization schedule.
6. Under five children:- In the present study under five is defined as one whose age is below 5 years.
6.6 Hypothesis:
H1: There will be a significant difference between knowledge of under five mothers regarding immunization in before and after administration of structured teaching programme.
6.7 Assumption:
1. Mothers of under five may deficit of knowledge regarding immunization.
2. Structured teaching programme can significantly increases their knowledge level.
6.8 Delimitation:
1. The study is limited to only mothers of under five children of Hadadi village.
2. Mothers who were able to read and write kannada.
7. / Material and Methods:-
7.1 Source of data collection:-
The data will be collected from the mothers of under five childrens.
Research design:
One group pre-test and post-test experimental design
Setting:
The study will be conducted in Hadadi village.
Population:
In this study population consist of mothers of under five children, who fulfilled the required criteria and those mothers present at the time of study in Hadadi village.
Sample Size: The total study sample consists of 40 mothers of under five children.
Inclusion criteria:
1. Mothers of under five children.
2. Mothers of under five who are willing to participate in the study.
Exclusion criteria:
1. Mothers of under five those who are not willing to participate in the study.
2. Mothers those who are not available at the time of data collection.
7.2 METHODS OF COLLECTION OF DATA:
Sample Technique: Purposive sampling technique.
Instrument:
Step 1:- Socio demographic data.
Step 2:- A structured questionnaire will be prepared to assess the knowledge of mothers of under five children regarding immunization.
Variables:-
Independent Variable: Structured Teaching Programme.
Dependent Variable: Knowledge of mothers regarding immunization.
Data collection method:
Step1 – Researcher introduces himself.
Step2 – Administration of pretest on knowledge regarding immunization.
Step3 – Introduces structured teaching programme.
Step4 – Administration post test on knowledge regarding immunization.
Data analysis Plan: The data will be analyzed by using appropriate statistical method and the finding will be presented in the form of figures and tables.
7.3 Does your study require any investigation or interventions to conduct on patients or other humans or animals? If so, please describe briefly.
Yes, structured teaching programme will be administered to mothers of under five children regarding immunization.
7.4 Has ethical clearance been obtained from your institution in case of 7.3?
Yes, written permission will be obtained from District Health Officer.
8. / List of References:
1) W.H.O. Global Forum for Health Research 2007. www.pubmed.com
2) K.K. Gulani, Text book of community Health Nursing, Principles and practice, Kumar publishing house, Page No. 387.
3) Laura Contreras, U.S. Fund for UNICEF media 212.880.9166, www.pubmed.com
4) K.K. Gulani Text book of community Health Nursing, Principles and practice, Kumar publishing house, Page No. 376-377.
5) G.M. Prabhakara, text book of community health for nurses, PEEPEE publishers, Page No. 305.
6) K. Park, Text book of preventive and social medicine. M/s Banarsidas Bhanot publishers. 16th edition, Page No. 389-390.
7) Singh MC, Badole CM, Singh MP, Immunization coverage and the knowledge and practice of mothers regarding immunization on rural area; Indian J public Health. 1994 Jul – Sep; 32(3); 103-7.
8) Zell ER, Ezzati, Rice TM, Battaglia MP, Wright RA, The NIS was designed to measure vaccination coverage estimates; public Health Rep 2000 Jan. Feb; 115(1); 65-77.
9) Stokley S, Smith PJ, Klevens RM, Battaglia MP; To estimate vaccination coverage levels of children living in rural area; AmJ prev. Med 2001 May; 20(4 suppl); 55-60.
10) Mathew JL, Babbar H, Yadav S; A study was undertaken on 500 children under the age of 5 years belonging to a low in come group. Trop Doct. 2002 Jul; 32(3): 135-8.
11) Smith PJ, Hoaglin DC, Battaglia MP, Khare M, Barker LE; Since 1994 the NIS has monitored progress toward the Healthy people 2000 and 2010 vaccination goals; vital Health stat 2.2005 Mar I (138); 1-55.
12) Topuzoglu A, Ozaydin GA, Calis, Cebeci D, Kalaca S,et al; To determine the coverage of the expanded programme of immunization (EPI) of the ministries of Health; public Health. 2005 Oct; 119 (10): 862-9.
13) Linkins RW, Salmon DA, Omer SB, Pan WK, Stoklev S, et al: To assess the attitudes of parents of vaccinated and un vaccinated scholl-aged children. BMC public Health. 2006 sep 22;6;236.
9. / Signature of the Candidate
10. / Remarks of the Guide
11. / Name and Designation
Of
(In block letters)
11.1 Guide.
11.2 Signature
11.3 Co. Guide
(If any)
11.4 Signature
11.5 Head of Department
11.6 Signature
12. / Remarks of the Principal
12.2 Signature
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