RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BANGALORE, KARNATAKA

SYNOPSIS PERFORMA FOR REGISTRATION OF SUBJECT FOR

DISSERTATION
1. Name of the candidate and MR. PRAVEEN .B. KADUR
Address (in block letters) 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.

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6. Brief Resume of the Intended work:

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

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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

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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

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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

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 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.

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 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:

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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. 16 th
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.

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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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