Sindhu Final Thesis
Sindhu Final Thesis
Sindhu Final Thesis
By
Dissertation submitted to
In partial fulfillment
IN
2013
i
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
The dissertation has not formed the basis for the award of any degree to me
previously by any other University.
Place: Bangalore
(MS.SINDHU PAUL)
ii
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
Place: Bangalore
Bangalore.
iii
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
Seal and Signature of the H.O. D. Seal and Signature of the Principal
Date: Date:
Place: Bangalore Place: Bangalore
iv
RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,
BANGALORE, KARNATAKA.
COPY RIGHT
v
ACKNOWLEDGEMENT
Gratitude can never be expressed in words but this is only the deep
appreciation which makes the words to flow from one’s inner heart.
Firstly, I praise and thank Lord almighty for his abundant grace and blessing
showered on me by keeping me in good health and helping me to complete this study
successfully.
vi
has also given inspiration, encouragement to complete this dissertation in a
successful way.
I express my thanks to the experts who have validated the research tool
and guided me with valuable suggestions.
I convey my special thanks to all my friends for their constant help and
encouragement.
Last but not least, I would like to express my sincere gratitude to all the
persons and colleagues who had directly and indirectly maintained my optimal
inspiration through out this research study.
vii
ABSTRACT
"If you can imagine it, you can achieve it. If you can dream it, you can become it."
- William Arthur Ward
RESEARCH HYPOTHESIS
viii
CONCEPTUAL FRAMEWORK
The framework of the study was adopted from the General Systems Theory
with input, throughput, output and feedback, first introduced by Ludwig Von
Bertalanffy (1968) as explained by Newby (1996)
METHODOLOGY
An evaluative research approach was utilized in the study, as the study aimed
at evaluating the effectiveness of structured teaching programme regarding
immunization among mothers of under fives. Thirty mothers were selected by using
purposive sampling technique. The study was conducted in Yelahanka government
hospital.
RESULTS
ix
Data analysis on knowledge of mothers of under fives regarding
immunization
During the pre test most of the sample having not adequate level of knowledge scores
regarding immunization. After administration of structured teaching programme,
there was marked improvement in the knowledge of the sample with majority
27(90%) gained adequate knowledge score and 3(10%) of the sample had moderate
knowledge regarding immunization.
The overall mean and standard deviation of post-test knowledge score regarding
immunization in mothers of under five’s were34 with a standard deviation 2.94.In the
present study, the mean post-test knowledge score was 34 which are apparently higher
the mean pre-test knowledge scores17.70 and the mean difference was 16.30.The
calculated paired test value(t cal =13.67,p=0.00) is greater than the table value (t
tab=1.7) which represents significant gain knowledge through the structured teaching
programme.
The result shows that, there is no significant association between pre-test and
demographic variables.
Recommendations
x
LIST OF ABBREVIATIONS
Sl.no Abbreviations Expansions
xi
LIST OF THE CONTENT
I INTRODUCTION 1-6
II OBJECTIVES 7-11
IV METHODOLOGY 20-27
V RESULTS 28-44
VI DISCUSSION 45-47
IX BIBLIOGRAPHY 53-55
X ANNEXURES 56-104
xii
LIST OF TABLES
xiii
LIST OF FIGURES
FIGURE PAGE
NO. FIGURES NO.
Conceptual Frame Work Based On Modified General System Theory
1. 11
Proposed By Ludwig von Bertalanffy(1968)
xiv
TABLE OF ANNEXURES
xv
CHAPTER 1
INTRODUCTION
“what a child doesn‟t receive he can seldom later”
Immunization helps protect you and your children from disease. They
also help reduce the spread of disease to others and prevent epidemics. Most
immunization given by shots, they are called vaccines. Immunization describes
the whole process of delivery of vaccine and the immunity it generates in an
individual and population. A vaccine is a special form of disease Causing agent
(e.g.: virus or bacteria) that has been developed to protect against that disease.1
1
The goal of immunizing children against chief diseases responsible for
child mortality and morbidity is indeed a noble one. However, it is not an easy
task to achieve. In a developing country like India, the sheer logistics of the
numbers of the target population that stretches across geographically diverse
regions make universal immunization of children a Herculean task. However,
the health sector of this country is making admirable achievements in that
several millions of potential life years have been saved from getting lost to
vaccine preventable diseases through the universal immunization program .4
`There are several reasons to aim for universal coverage. The factors that
should be helpful are many. The Indian culture promotes safe nurturing of
children. Hardly do we find parents who risk their children to life-threatening
diseases, unless they being unaware or misinformed. All vaccines under the
routine immunization programme are provided free-of-charge. However, the
figures for the coverage of routine immunization (RI) are lagging. The current
level of coverage of „fully-immunized‟ children under the national
immunization programme is quite low, as pointed out by several studies.5
The child needs to be protected from 11 infectious and vaccine
preventable diseases. These diseases include tuberculosis, tetanus, diphtheria,
whooping cough and poliomyelitis. The under five children can be saved from
deaths by immunizing them at the right age and right time and by completing
the full course of immunization.5
According to UNICEF immunization is currently preventing an estimated
two million deaths among children under five every year.
India has one of the highest under five mortality rates in the world with an
estimate of 64/1000 live births in 2010, the under five mortality rate in the
Karnataka state was 56/1000 live births in 2010. One of the factors contributing
to under five mortality is the ignorance of child care.6
Global immunization coverage has greatly increased since WHO‟s
expanded programme on immunization began in 1974. In India expanded
programme on immunization was launched in January 1978. UNICEF renamed
the expanded programme on immunization as Universal Immunization
Programme (UIP) and it was launched in India in November, 1985.7
2
In 2010, global DPT3 (three doses of the diphtheria, pertussis, tetanus
combination vaccine) coverage was 68% up from 50% in 2005. However, 27
million children world wide were not reached by DPT3 in 2010, including
9.9million on south Asia and 9.6 million in sub-Saharan Africa.8
In 1978, Expanded programme on Immunization was started by the
Government of India to reduce mortality and morbidity and also to achieve self-
sufficiency in the production of vaccines. Communicable diseases are still
number one killer ailments of mankind with 16.5 million deaths every year.
Measles killed 2 per 100 cases in the developing world and this can be high as
10 per 100 or even more in the areas inhabited by the poorest of the poor having
combined misfortune virtually all the children would catch measles. In world
every year 5 million children‟s are die because of Tuberculosis, Diphtheria,
Tetanus, Pertussis and Poliomyelitis.9
Initially, the programme was focused on children under 5 years but later
children under 2 years were targeted. Eventually in 1985 with a view to energize
and universalize the immunization coverage, EPI programme was redesignated
as “Universal Immunization Programme” (UIP) in India and the target age for
children was further reduced to infancy. In due course, as the UIP activity
expanded and covered the entire country, the immunization coverage in respect
of oral polio vaccine increased to more than 90%.10
According to WHO report (1997) there has been 19 percent of under five
mortality in the developing world due to diarrheal diseases and about 18 percent
due to vaccine preventable diseases. The recent study (2006) conducted in India
revealed that 71.7% of children were fully immunized, 9.8% were partially
immunized and 8.5% had not been immunized. Coverage of each individual
3
vaccine shows that BCG (85.6%), DPT-1(90.3%), DPT-2(88.7%), DPT-
3(80.2%), OPV-1(92.0%), OPV-2(90.3%), OPV-3(82.2%) and measles 73.6%
and also they have found that not being aware of the immunization schedule
was cited as the main reason (41.2%) and non availability of the immunization
service was another reason (45.5%).12
Each child has basic human needs like adults to fulfill the essentials of life
and to promote growth and development. Immunization is one of the needs of
the children. The responsibilities of the nursing personnel is to help the parents
to emphasize on promotion of health, prevention of illness, maintenance of
health and restoration of health.14
4
NEED FOR THE STUDY
-Thomas fuller
Each year since 1990, immunization with routine vaccines has reached
more than 70 %of children world wide. At the UN General Assembly special
session in 2007 the international community adopted the specific target of
immunizing by 2010 at least 90 percent of children‟s in each country.17
World wide approximately 130 million children are born every year in
which 91 million are from developing countries. America and Europe maintains
over 90% of immunization and western pacific maintains 92% of immunization
while eastern Mediterranean maintains 86% of immunization.114 countries has
reached 90% of immunization where 150 countries has reached 80% of
immunization.18
The child mortality rate or under-5 mortality rate is the number of
children who die by the age of five, per thousand live births. In 2007, the world
5
average was 68 (6.8%) In 2006, the average in developing countries was 79
(down from 103 in 1990), whereas the average in industrialized countries was 6
(down from 10 in 1990). The world's child mortality rate has dropped by over
60% since 1960.19
Around 10 million children die under the age of five every year and over 27
million infants in the world do not get full routine immunization. The predicted world‟s
infant mortality rate during the year 2005 to 2010 is 47 per 1000 birth where the actual
infant mortality rate is 57 per 1000 births.20
In India over all statistics says that 80% immunization has been covered.
In 1985, the Universal Immunization Programme was started in India with the
aim of achieving at least 85% coverage of primary immunization of infants. 93
percent of all under-5 deaths occur in Africa and Asia. Half of these deaths
occur in five countries: India, Nigeria, Democratic Republic of Congo, Pakistan,
and China.21
According to NFHS-3(National family heath survey.) report, the
percentage of children who received all basic vaccinations in Karnataka was
only 55% and 6.9% receives no vaccinations. These indicates that India still
lags far behind the goal of universal immunization coverage of children. All
these reveals that targeted education and vaccination campaigns are essential to
achieve the elimination of childhood infections.22
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 under five children which in turn reduces mortality
among under five children.
6
CHAPTER-II
OBJECTIVES
OBJECTIVES
HYPOTHESIS
OPERATIONAL DEFINITION
1.Assess:-In the present study assess refers to the organized systematic and
continuous process gathering information on knowledge of immunization from
mother of under five children.
7
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.
Assumption
8
CONCEPTUAL FRAME WORK
The conceptual frame work selected for this study is based upon the
general system theory developed by Ludwig von Bertalanffy, According to
general system theory, a system consist of a set of interacting components, all
contributing to the over all goal of the system. Any system consists of input,
through process and out put. This study aims at developing and evaluating
structured teaching programme on knowledge of mothers regarding
immunization.
9
immunization including knowledge on general information, purpose,
importance, immunization schedule, and purpose of giving each vaccine.
Feed back: The feed back is the environment responses to the system. Feed
back may be positive, negative, or neutral. In this study input was assessing the
knowledge of mothers regarding immunization. Through process was the
activity phase where structured teaching programme was regarding
immunization. output refers to change in level of knowledge regarding
immunization after the structured which was measured by using post-test. Feed
back strengthen the input and through process .
10
INPUT THROUGH PUT OUTPUT
POST TEST
Assessment of demographic data
of mothers
1.Age of the mother
Define immunity define vaccine
2. Religion INCREASED IN
KNOWLEDGE
3. Educational status
Purpose of
4. Occupation Structured each
11
CHAPTER-III
REVIEW OF LITERATURE
12
An exploratory study was conducted to assess immunization coverage
among 500 mothers of 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 calamite – 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.25
A comparative study was conducted to estimate the vaccination coverage
level of children‟s living in rural and urban areas to identify statistically
significant differences. Children‟s aged between 19-35 months residing in Kolar
District of Bangalore participating on the 2008 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 as evidenced by 28% of
the children were covered by immunization residing in rural areas whereas 46%
were covered in Urban area. The study recommended that health care personnel
need to execute the awareness among the needy population of the Kolar
District.26
A cross-sectional 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 Yelanhanka 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. The findings of the study 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%.27
13
A comparative study was conducted between two slums in Tamil Nadu to
evaluate the reason being not immunized in the two slums. The study revealed
that group A was 69.7% immunized and group B was 79.8% immunized. The
conclusion of the study was that there is no adequate information to the crowd
about immunization.28
A cross- sectional study was conducted t o assess the knowledge
about immunization among six hundred and eighty-two caretakers
accompanying children under 5 years in Pulse polio immunization centres in
East Delhi. The data was collected by using Pre-tested semi-open-ended
questionnaire. The collected data was analyzed by using Proportions, Chi-
square test. The study results shows that the proportions of respondents who had
awareness about different aspects of immunization, such as weekday of
immunization (37.0%), age group for immunization (49.1%), number of visits
required in the first year of life (27.0%), were all low. When asked to name the
four diseases covered under the immunization programme in Delhi, only 268
(39.3%) could name at least three. The study concluded that the need of the hour
is to make Immunization a „felt need‟ of the community. Making caretakers
more aware about immunization is a vital step in achieving the health goal of
the country.29
14
Literature related to knowledge regarding immunization among
mothers of under five children.
A logistic study was conducted to find out: (a) the immunization status of
children admitted to a paediatric ward of tertiary-care hospital in
Delhi, India and (b) reasons for partial immunization and non-immunization.
Parents of 325 consecutively-admitted children aged 12-60 months were
interviewed using a semi-structured questionnaire. A child who had missed any
of the vaccines given under the national immunization programme till one year
of age was classified as partially-immunized while those who had not received
any vaccine up to 12 months of age or received only pulse polio vaccine were
classified as non-immunized. Reasons for partial/non-immunization were
recorded using open-ended questions. Of the 325 children (148 males, 177
females), 58 (17.84%) were completely immunized, 156 (48%) were partially
immunized, and 111 (34.15%) were non-immunized. Mothers were the primary
respondents in 84% of the cases The most common reasons for partial or non-
immunization were inadequate knowledge about immunization or belief that
vaccine has side-effects, lack of faith in immunization. The immunization status
needs to be improved by educating mothers and caregivers regarding
immunizations.31
A health survey regarding immunization status among one hundred and
thirty mothers in the age group (15-44) years and 142 children aged (12-59)
months were selected in Warta 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. The
study recommended that mothers need to improve their knowledge regarding
immunization thereby preventing disease which can be prevented by vaccine.32
15
A case control study was conducted to assess the level of knowledge
among 800 parents in Tumkur, regarding support for immunization registries
laws, authorizing registries and mandating provider reporting and financial
worth and responsibility of registry development and implementation methods.
Surveys administered to the parents, asked about views on registries and
perceived utility and safety of vaccines. The findings shows that surveys were
completed by 56.1% of respondents, fewer than 10% of parents were aware of
immunization registries on their communities. The study recommended that
health care personnel need to create awareness regarding importance of
immunization registries laws to improve the heath indices of the state thereby
can take the intervention to improve child mortality and morbidity rate.33
A study was conducted in 2009 in northern California with the objective
of mother‟s poor knowledge about immunization. 50 women were taken as
samples. Teaching and counselling were taken up as a part of evaluation of their
knowledge. The study revealed many barriers which inhibits the knowledge of
the mother so to improve it the mothers were given the checklist of
immunization for children.34
A community based study was conducted to evaluate the factors affecting
the immunization coverage of children in Assam, India, in the first year of life
of the children. About 62.2% of the children were fully immunized. Lack of
information among the parents was one of the major causes of drop out of
vaccinations. The children from urban areas and mother's education level
showed significant role in immunization coverage. Improvement in female
literacy coupled with the reduction in the drop out rate would add to achieve a
higher target of immunization among children in the study area.35
A cross sectional study on immunization in the town of Pilani was
conducted and a total of 166 mothers were interviewed using a pre-tested
interview schedule/questionnaire on Knowledge. The results showed that among
the 12-24 month old children 50% fully, 31.3% partially and 18.7% not at all
immunized. Many mothers (87%) were aware of the importance
of vaccination in general, specific information about importance of completing
the schedule and knowledge about vaccine preventable diseases other than
poliomyelitis was very limited. Obstacles, misconceptions/beliefs among
16
the mothers of partially immunized children and lack of information among not
at all immunized group were the main reasons of non-immunization. The
implications of the study are to enhance the maternal knowledge about the
vaccine preventable diseases and importance of completing
the immunization schedule through interpersonal mode and to overcome
obstacles to immunization such as accessibility and lack of family support.36
A case control study was conducted to assess Immunization coverage and
the knowledge and practice among one hundred and thirty mothers in the age
group (15-44) years and 142 children aged (12-59) months which were selected
by cluster sampling method from nine villages 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 of DPT/OPV. Drop-out rate from second to third
dose of DPT/OPV was 5.3% and from third to booster dose was
36.96%. Mothers had a fair knowledge regarding need for immunization but a
poor knowledge regarding the diseases prevented and doses of the vaccines.
Commonest side reactions reported were fever (36%) and pain at injection site
(33%). Contraindications listed by mothers were mild cold (41%), mild fever
(24%) or loose stools (14%). Health workers were the major source of
information and 76% knew the use and maintenance of immunization cards.37
17
conducted as part of routine programme of research. These surveys show that
public wants clarity, consistency factual information and openers from those
delivering immunization services.38
18
group pre-test and post-test design was used. The findings revealed that the
post-test knowledge score (26.53%) was higher than the pre-test knowledge
score (13.5%). Therefore, planned teaching programme was found to be an
effective media for educating mothers regarding importance of immunization.41
An evaluative study was conducted among 50 mothers of under five
children in selected paediatric hospital, Pondicherry. The aim of the study was
to evaluate the effectiveness of structured teaching programme(STP) regarding
immunization. A closed ended questionnaire with 30 items related to
immunization was used to collect the data followed by intervention of STP. The
study finding shows that the post-test knowledge score (22.73) was higher than
the pre-test knowledge score (12.78). The study claimed that STP is effective to
enhance mothers mother knowledge regarding the importance of immunization.
The study recommended that nursing personnel should continue in health
teaching approach especially to the health problems which can be prevented.42
19
CHAPTER IV
METHODOLOGY
Research approach
Research design
20
Pre- Treatment Post
test test
Key:
Setting
Variables
The concepts that can take on different quantitative values are called
variables. Variables are the measurable characteristics of a concept of logical of
attributes.
Independent variable
21
In this present study the independent variable was structured teaching
programme on immunization.
Dependent variable
population
The target population of the present study was mothers of under five
children.
Sample
Sample size
Sampling technique
The sampling technique used for the study was purposive sampling
technique, which is a type of non-probability sampling.
Inclusion criteria:
22
Mothers who are available at the time of data collection.
Mothers who can read and understand kannada or English.
Exclusion criteria;
On modifying the tool as per the experts suggestion the final tool consist
of two sections.
Section II :
Section III
23
The tool was translated into regional language. Medical terminologies
were translated into kannada according to the level of under standing of the
samples.
Pilot study
A pilot study is a small scale version or trail run for the major study
conducted to refine the methodology. After obtaining a formal permission from
medical officer, Yelahanka government hospital at Bangalore. The pilot study
was conducted from 15.9.2012 to 28.9.2012 among 10 antenatal mothers were
selected by purposive sampling and those who met sampling criteria.
Reliability
The reliability of the tool was established by using split-half method. The
reliability (r =0.92) was found to be significant.
24
The steps used for data collection were a follows:-
1. The investigator introduce self and explained the purpose of the study.
2. The investigator introduces fixed days for conducting study.
3. Written consent of all mothers of under fives was taken to confirm willingness
to participate in the study.
4. Pre test was administered.
5. Structured teaching programme was administered on the day of pre-test.
6. Post-test was conducted by using the same tool on the 3rd day from the day of
pre test.
7. Data collected was tabulated and analyzed.
Moderate -51-75%
Adequate -76-100%
A score of “1” was awarded to a correct response while a score of “0” was
awarded to incorrect response of structured knowledge questionnaire.
25
2. Frequency, percentage, mean, and standard deviation for the analysis of
knowledge.
3. Paired„t‟ test for testing the effectiveness of structured teaching from pre test
and pot test knowledge.
26
Target Sample Sampling Variables Instrument Method Analysis
Setting
population
Target technique of data
population collectio
n
27
CHAPTER V
RESULTS
Analysis is the process of organizing and synthesizing data in such a way that
research questions can be answered and hypothesis tested.
This chapter deals with the analysis and interpretation of the data collected to
assess the structured teaching programme on knowledge regarding immunization among
mothers of under fives in selected hospital at Bangalore.
3. To determine the association between pre-test knowledge score and selected demographic
variables.
HYPOTHESIS
The data collected are entered in master data sheet, for tabulation and statistical processing in
order to find the relationship. The data collected were edited, tabulated, analyzed, interpreted
28
and findings obtained were in the form of tables and diagrams represent under the following
sections:-
Section II: To assess the level of knowledge on immunization among mothers of under five
by conducting pre- test and post-test.
Section III: To assess the effectiveness of the structured teaching programme on knowledge
regarding immunization among mothers of under five by comparing mean pre-test and post-
test knowledge score and by using paired „t‟ test.
Section IV: To find out the association between pre-test knowledge scores with their
selected demographic variable.
29
SECTION- I
N=30
3 Educational status
a) Primary 14 48
b) Middle school 11 37
c) Secondary 4 13
d) Degree 1 3
Total 30 100
30
4 Occupation
a) House wife 11 37
b) Private 10 33
c) Business 6 20
d) Government 3 10
Total 30 100
5 Type of family
a) Nuclear 12 40
b) Joint 10 33
c) Extended 8 27
Total 30 100
6 Family income
a) Below 5000 5 17
b) 5001-10,000
11 37
c) 10,001-20,000
11 37
d) 20,001-above
3 10
Total 30 100
7 Exposure to source of health
a) Self learning 6 20
b) Mass media 8 27
c) Friends
9 30
d) Health personnel
7 23
Total 30 100
8 Health services availed from
a) P.H.C 11 37
b) Sub centre 7 23
c) Nursing home
8 27
d) Hospital
4 13
Total 30 100
31
9 No of under five child
a) 1 13 43
b) 2 10 33
c) 3
7 23
d) 4 and above
total
10 Age of children
a) 0-1 11 37
b) 1-2 5 17
c) 3-4 9 30
d) 4-5 5 17
Total 30 100
The above table no 2 shows that the frequency and percentage of mothers of under fives
according to their demographic variables
32
Age of the mother in that majority13(43%) of mother were below 25 years, 10(33%) of
mothers belongs to age group between 26-30 years,7(23%)of mothers were belongs to 31-35
years(fig-3)
Religion of mothers shows majority 15(50%) of Hindu and 10(33%) belongs to Muslim and
5(17%)belongs to Christian.(fig-4)
Educational qualification of mothers of under fives shows that majority 14(47%) belonged
to primary followed by 11(37%) belonged to middle school and 4(13%) were belonged to
secondary and 1(3%) were belonged to degree.(fig-5)
In regard to type of family the majority of them are nuclear family14(40%) followed by joint
family10(33%) and in extended family 8(27%)
In regard to family income the majority of them were11(37%) earning between 5001-10,000
followed by 11(37%)in below 5000 and in above 20,001 were belonging to 3(10%).
Exposure to source of health, shows the majority 9(30%) from friends followed by
8(27%)from mass media, and 7(23%) from health personnel and 6(20%) self learning.
Health services availed from11(37%) from PHC and 8(27%) from nursing home and
7(23%) from sub centre and 4(13%) from hospital.
No. of under five children 13(43%) are 1 year of age followed by 10(33.3%) were years
and 7(23%) are 3 years of age.
33
23%
44%
a=below 25 years
b= 26-30 years
33% c = 31-35
17%
50%
a=hindu
b=muslim
33%
c=christian
34
16
a=primary, 14
14
P
12 b=middle, 11
E
R 10
C
E 8
N
6
T c=secondary, 4
A 4
G
2 d=degree, 1
E
0
a=primary b=middle c=secondary d=degree
10%
37%
20%
a= house wife
b=private job
c=business
33% d=government
35
a=nuclear, 12
P 12
E b=joint, 10
R 10
C 8
E c=extended, 8
N 6
T 4
A
2
G
E 0
a=nuclear
b=joint
c=extended
10% 17%
a=below 5000
37% b=5001-10000
36% c=10001-20000
d=20001- above
Fig 8: Pie diagram represents percentage distribution of family income per month.
36
9
P b=mass media, 8c=friends, 9
a=self learning,
8
E 6
7 d=health
R
6 prsonnel, 7
C
E 5
N 4
T 3
A 2
G 1
E 0
a=self
learning b=mass
media c=friends
d=health
prsonnel
a=PHC, 11
12
P
10
E
c=nursing home,
R 8 8
b=sub center, 7
C
E 6
N
4
T
A d=hospital, 4
2
G
E 0
a=PHC
b=sub center
c=nursing
home d=hospital
37
23%
44%
a=1
b=2
c=3
33%
Fig 11: Pie diagram represents percentage distribution of no of under five children
12
a= 0-1, 11
10
P c=3-4, 9
E
R
8
C
E
N
6
T b=1-2, 5 d=4-5, 5
A
G
4
E
0
a= 0-1 b=1-2 c=3-4 d=4-5
38
SECTION II
N=30
Moderate 7 23 3 10
Adequate 2 7 27 90
It is observed in table No.3 that pre test knowledge score of children regarding
immunization among mothers of under fives was inadequate 21(70%), moderate 7(23%),and
adequate2(7%).whereas post-test knowledge score was adequate in 27(90%) mothers,
moderate in 3(10%) mothers and none of them had inadequate knowledge after the structured
teaching programme.
39
Fig 12: Bar diagram represents percentage distribution of pre-test and post test level of
knowledge regarding immunization among mothers of under five
40
SECTION III
Table 4
Over all mean, standard deviation, paired „t‟ value of pre test and post test
N=30
df=29
Post test 34.00 2.948
„t‟ tab=1.7
P=0.00 HS
HS* highly significant, df –degree of freedom
Above data table no.4 depicted that the mean and of post-test knowledge scores among
mothers of under fives was 34, which is significantly higher than mean of pre-test knowledge
scores of 17.70.standard deviation of post-test score and pre-test score is2.948 and 6.09
respectively. The computed paired „t‟ value(13.67,df=29, at the level of p 0.00) is greater
than table value(1.7) which represents significant gain knowledge through structured teaching
program me. Hence the hypothesis is accepted.
41
SECTION IV
To find out the association between post test knowledge scores with their selected
demographic variables.
Table-5
42
5 Type of Nuclear 1 3.3 1 3.3 10 33.3 12 39.9 X2=.362
family Joint 0 - 3 10 7 23.3 10 33.3 df=1
NS
Extended 1 3.3 3 10 4 13.3 8 26.6
TOTAL 2 7 21 30 100
TOTAL 2 7 21 30 100
NS=not significant
43
X2=chi-square
The above table(table no-5) shows the association of pre-test knowledge score with their
selected demographic variables by using chi-square(x2) ,it was evident that ,there was no
significant association between pre-test knowledge score with their demographic variable.
44
CHAPTER VI
DISCUSSION
3. to find association between pre test knowledge scores with selected demographic
variables.
HYPOTHESIS
H: the mean pot-test knowledge score of subject exposed to structured teaching programme
will be significantly greater than the mean pre-test knowledge scores.
The findings of the study are discussed under the following headings:
Age of the mother in that majority13(43%) of mother were below 25 years, 10(33%)
of mothers belongs to age group between 26-30 years,7(23%)of mothers were belongs to 31-
35 years
45
Educational qualification of mothers of under fives shows that majority 14(47%)
belonged to primary followed by 11(37%) belonged to middle school and 4(13%) were
belonged to secondary and 1(3%) were belonged to degree.
In regard to type of family the majority of them are nuclear family14(40%) followed
by joint family10(33%) and in extended family 8(27%)
In regard to family income the majority of them were11(37%) earning between 5001-
10,000 followed by 11(37%)in below 5000 and in above 20,001 were belonging to 3(10%).
Exposure to source of health, shows that majority 9(30%) from friends followed by
8(27%)from mass media, and 7(23%) from health personnel and 6(20%) self learning.
Health services availed majority 11(37%) from PHC and 8(27%) from nursing
home and 7(23%) from sub centre and 4(13%) from hospital.
No. of under five children, 13(43%) are 1 year of age followed by 10(33.3%) were
years and 7(23%) are 3 years of age.
In last age of children majority shows 11(37%) were in 0-1 years of age. 9(17%)
were belonged to 1-2 years of age. 5(17%) were in between3-4 years of age, and in last
5(17%) were in between 4-5.
Finding shows that during pre-test, most of the sample were having in adequate level
of knowledge regarding immunization. After administration of structured teaching program
me, there was marked improvement in the knowledge of the sample with majority 27(90%)
gained adequate knowledge score and3 (10%) of the sample had moderate knowledge score
regarding immunization.
46
Findings related to effectiveness of structured teaching program me on
knowledge of mothers by comparing pre-test and post-test knowledge
score.
Findings shows that the overall mean and standard deviation of post-test knowledge
scores among mothers of under fives regarding immunization was 34 with a standard
deviation of 2.94 which is significantly higher than mean and standard deviation of pre test
knowledge scores of 18.04 with a standard deviation of 4.20. The computed „t‟ value (13.67,
df= 29,at level of p=0.00)is greater than table value (1.7) which represents significant gain in
knowledge through structured teaching program me.
Therefore, the post-test knowledge score was apparently higher than that of the pre-
test knowledge score, the research hypothesis was accepted.
The result shows that, there was no significant association between the mean pre-test
knowledge and selected demographic variables.
47
CHAPTER-VII
CONCLUSION
The present study assessed the knowledge among mothers of under fives regarding
immunization and found that the mothers had inadequate knowledge related to immunization.
After the structured teaching program me on immunization there was significant
improvement on knowledge of mothers of under five regarding immunization. The study
concluded that the structured teaching programme was effective in improving knowledge of
mothers of under fives regarding immunization.
The nursing personnel are challenged to provide standard and quality nursing care.
Hence there is a need for the nurse to take active part to restore the life of patients to
maximize functional capacity. Despite all efforts at preventing unexpected situations, these
situations can do occur. More and more nurses are taking up pediatric specialty, gradually the
role of the pediatric nurses is expanding into liaison nursing.
The findings of this study has implication in various areas of nursing namely nursing
practice, nursing education, nursing administration and nursing research.
Nursing practice
1) The field of pediatric nursing has great responsibility to protect the health of
children‟s.
2) Nurses should be equipped with update knowledge on immunization to impart
appropriate knowledge to the community.
3) Pediatric nurses need to take up the responsibility to create awareness among mothers
of under fives regarding immunization to prevent communicable diseases.
4) Nurse working in various health care setting are key persons who play a major role in
health promotion, health maintenance, and prevention of disease.
5) Nurses and health care providers play a vital role in motivating the mothers to provide
immunization to their children at correct time according to the schedule.
6) Nurse should organize health education campaign to all health care setting about
immunization to prevent immunization.
48
Nursing education
1) The study emphasizes the need for developing good teaching skills among
student nurses on immunization.
2) The nurse educator should emphasize health education on immunization and
to prevent diseases as a part of learning experience for the students.
3) The nurse educator should arrange for the in-service education
programme(seminars, workshops) for student nurse regarding immunization and
to prevent disease.
4)The nurse educator can provide an opportunity for students to actively
participate in immunization programme.
Nursing administration
1) Nurse administrator should guide and monitor the nurse regarding immunization
and has to plan for in services education periodically.
2) Nurse as an administrator plays an important role in educating the professional
and in policy making such as mass health education measures in the hospitals.
3) Nurse administrators should plan regarding the training programme well in
advance.
Nursing research
1) The essence of research is to build a body of knowledge in nursing.
2) Nursing research is the main source by which the nursing profession is growing.
3) The generalization of the study results can be made by replication of the study the
nurse researcher can inculcate practice by strong base research.
4) This study will serve as a valuable reference material for future investigators.
Recommendations
1) A similar study can be done on a large sample to validate and generalize the
findings.
2) This study will be reference for research scholars.
3) Evidence based nursing practice must take higher profile in order to increase
awareness among mothers of under fives.
4) A comparative study between urban and rural knowledge and attitude on
immunization can be conducted.
49
CHAPTER VIII
SUMMARY
The primary aim of the study was to evaluate the effectiveness of structured teaching
programme on knowledge regarding immunization among mothers of under fives in
selected hospitals at Bangalore.
Objectives
3. To find association between pre test knowledge scores with selected demographic
variables.
HYPOTHESIS
H: The mean post test knowledge score of subject exposed to structure teaching
programme will be significantly greater than the mean pre- test knowledge scores.
The conceptual frame work for this study was developed by applying Ludwig Von
Bertalanffy‟s general system theory.
Pre experimental, pre-test and post-test, with an evaluate approach was used to test
the proposed hypothesis. The study sample(n=30) selected for study was mothers of
under fives admitted in pediatric ward at Yelahanka government hospital, Bangalore.
Purposive sampling technique was utilized for the selection of the study samples. In
order to collect data ,a structured knowledge questionnaire was used.
An extensive review of related literature for this present study was done by the
investigator herself which helped investigator to develop the criteria for development of
structured teaching programme and construction of tool. The literature review also
helped in determining the effectiveness of structured teaching programme and plan for
determining and analysis.
50
Findings of the study were presented under the following headings
51
Section IV: association between the pre-test knowledge score and selected
demographic variables
The result shows that, there is no significant association between pre-test and
selected demographic variables.
52
CHAPTER-IX
BIBLIOGRAPHY
1. Dorothy .R. marlow,”Text book of Paediatric Nursing” (2005),6th edition, esevier
publishers, noida,pno593-597
2. M.S Jessie M.chellappa, paediatric nursing ,1st edition, gajanana book publisher,
2000,page no: 42
3. Introduction: immunization: The merck manual medical library: the merck manual of
medical information. Home edition July 2008: available from
URL:http://www.merck.com.
4. Hockenberry MJ,Wilson D. Wong‟s nursing care of infants, 8th edition, New Delhi:
Mosby 2009
5. Ball WJ, Binder R C. Paediatric Nursing Caring For Children. 4th ed. New Delhi:
Dorling Kindersley Pvt.Ltd:2009
6. Laura Contreras, U.S. Fund for UNICEF media 212,880,9166.
7. Miles MS,Carlson j, Brunssen S Burchinal p. Journal of paediatric nursing 1999
feb;14(1):44-50
8. UNICEF, “global child mortality continues to drop” on December 8th,2009.
9. GM DHAAR,I ROBBANI, foundations of Elsevier community medicine.1st edition
.India pvt Ltd p.no:969
10. Anita khokhar,immunization status in urban community. Indian journal of preventive
and social medicine.2005 p no:82-86
11. k.k gulani, text book of community health nursing, principles and practice: New
Delhi
12. Basavantappa BT. Text book of child health nursing. New delhi:Tarun ahuja;
13. polkki T, Pietila AM, julkunen K V,laukkala H,Ryhanen p.Dertermine the
relationship between the literacy status and immunization coverage among mothers
of under five children in kolar district in Bangalore. journal of paediatric nursing
2001 aug:17(4):270-2.
14. W.H.O global forum for health research 2010.www.pubmed.com
15. CIA world fact book febryary 19th ,2010
16. World infant mortality rates in 2008,population references bureau.
17. WHO,UNICEF and World Bank, state the world‟s vaccines and immunizations, 3rd
edition, Geneva world health organization 2010.
53
18. UNICEF a look at the urban child: New Delhi, UNICEF 2009.
19. Anjum Q,omair A, Inam S.N, Ahmed y, Usman y,Shaih S,” improving vaccination
status of children under five through health education”journal of paistan medical
association,2004,54(12) 610-613.
20. Singh M, c badole cm singh MP”immunization coverage and the knowledge of
practice of mothers regarding immunization in rural area, Indian jounal of public
health 1994 july 38(3) 103-107.
21. wilson FL ,Brown D L,stephens- ferris M, mothers journa of paediatric nursing2006
feb (1)4-21
22. National Family Heath Survey (NFHS-3) 2006
23. Meheja.N; “The purpose and need of research study and review of literature.”
Nursing times, April 1(12) p no:45-7
24. Bossert E, Hart D.A cross sectional study on national immunization survey (NIS)
united state American Journal Paediatric Nursing.1994::23(1) p.no 33-34
25. Melnyk BM. An exploratory study was conducted to assess immunization coverage
among. Journal of Paediatric Nursing. February 2000; 15(1):4-11.
26. Polkki T, Pietila AM, Julkunen KV, Laukkala H, Ryhanen P. A comparativestudy
to estimate the vaccination coverage level of childrens living in rural and urban
areas . Journal of Paediatric Nursing 2001 Aug;17(4):270-2.
27. Mahat G, Scoloveno MA. A cross-sectional study to determine the coverage of the
expanded programme of Immunization (EPI) of the ministry of Health . Journal of
Paediatric Nursing 2003 Oct;18(5):305-13.
28. Canella B, Mahat G, scoloveno MA Evaluate the reason being not immunized in the
to slums paediatric health care 2004 nov-Dec:18(6):3027
29. Bossert E,Hart D.Ahealth survey regarding immunizationjournal of paediatric
nursing 2009:23(1):33-49.
30. Aggarwa A K,kumar R the immunization status of children and reasons for partial
immunization and non immunization Indian journa of community medicine
200525(3)420-432
31. Vazir S, Naidu AM. To assess the level of knowledge among parents . Indian
Paediatrics 2008 Oct;35:959-65.
32. Sanofer.T.G. The objective of mother‟s poor knowledge about immunization.
American Journal of Public Health. 2009 Jul – Sep; 32(3); 103-7.
54
33. Singh MC, Badole CM, Singh MP. A community based study was conducted to
Evaluate the factors affecting the immunization coverage. Indian Journal of Public
Health. 2008 oct; 22(3); 104-8.
34. Zell ER, Ezzati, Rice TM, Battaglia MP, Wright RA. Immunization in the town of
Pilani Public Health Rep 2000 Jan. Feb; 115(1); 65-77.
35. Topuzoglu A, Ozaydin GA, Calis, Cebeci D, Kalaca S,et al; Immunization coverage
and the knowledge and practice. Journal of publHealth. 2005 Oct; 119 (10): 862-
9.Stokley S, Smith PJ, Klevens RM
36. Stokley S, Smith PJ, Klevens RM, Battaglia MP; The implementation of pertusis
immunization program Journal of Community Medicine 2008 May; 20(4); 55-60.
37. Linkins RW, Salmon DA, Omer SB, Pan WK, Stoklev S, et al: To determine the
knowledge of mothers on immunization of children. BMC public Health. 2006 sep
226;236.
38. Tada Y. Effectiveness of planned teaching programme educational on immunization.
Journal of Paediatric Nursing 2008;22(6):43-48
39. Mayurasakom K. To evaluate the effectiveness of structured teaching programmed.
Indian Journal of Community Medicine 2005;25(3):420-32.
40. BMC public health,2008 nov5:8(1)381,E pub
41. Vaccinations for infants and children Available from URL:
http://www.bolohealth.com/expertspeak/Indukhosla/healthy-skin-and-hair/82-
vaccines-recommended-for-indian-children
42. “Christian Glaud” “Centre for clinical intervention research, H:S Rigshospitalet.
Denmark.
43. Basavanthappa B.T. Nursing research.1st edition, published by jaypee brothers‟, new
Delhi 1998,p.no-93
44. Shaw.implementing conceptual frame work, journal of nursing administration
aug.1973,p no:8-11
45. Polit, F Dennis nursing research principles and methods. 4th edition.philadelpia,JB
Lippincott publications,2000.p no91-92
Net reference
1. www.wikipedia.com
2. www.google.com
3. www.pubmed.com
55
ANNEXURE-I
56
ANNEXURE - II
57
ANNEXURE - III
58
ANNEXURE – IV
This is to certify that content prepared by Ms. Sindhu Paul 2nd year M.Sc. nursing, of Noor
College of Nursing, Bangalore for her study stated A STUDY TO ASSESS THE EFFECTIVENESS
59
ANNEXURE-V
From,
Ms. Sindhu Paul
Bangalore.
To,
……………………..
……………………..
……………………..
Subject: Requisition for expert’s opinion and suggestions for content validity of research tool.
Respected Madam/Sir,
I am 2nd year student of Masters of Nursing at the Noor college of nursing, Bangalore. As a part
of my partial fulfillment of M. Sc (N) programme, I need to construct tool and send it for
valuation and suggestions about my tools which I have enclosed. I humbly request you to certify
regarding your validation in the enclosed format. I will be grateful to your honorable work.
Date:
Sindhu Paul
60
ANNEXURE-VI
This is to certify that the tool constructed by Mrs.Sindhu Paul 2nd year M.Sc. Nursing, Noor
College of nursing to be used in her study titled, “A study to assess the effectiveness of
structured teaching program me on knowledge regarding immunization among mothers of under
five children in selected pediatric ward in Bangalore”. Has been validated by the undersigned.
The suggestion and modification given by me will be incorporated by the investigator in concern
with their respective guide. Then she can proceed to do the research.
NAME
DESIGNATION:
COLLEGE:
PLACE:
DATE:
61
ANNEXURE – VII
Asso. Professor
Bangalore
2) Mrs. Sujatha
Lectures
Bangalore
HOD
Bangalore
4) Mrs. Indira
HOD
Bangalore
62
5) Mr. Jinslin Oliver
HOD
Bangalore
Bangalore
HOD,
Dept. of Paediatrics
Kohinoor Hospital
Mumbai.
8) Dr. Krishnappa
Dept. of Paediatric
Bangalore.
Depat. Of Paediatrics
ACME, Kannur
Kerala.
63
ANNEXURE-VIII
64
ANNEXURE-9
STRUCTURED QUESTIONNAIRE
INSTRUCTIONS:
This Section Contains Questions Regarding You. Please Mark( )In Appropriate Space
This Information Provides Will Be Exclusively Used For The Purpose Of Research Study And
Will Be Kept Confidential.
65
5. Type of family
a. Nuclear ( )
b. Joint ( )
c. Extended ( )
6. Family income
a. Below 5000 ( )
b. 5001-10,000 ( )
c. 10,001-20,000 ( )
d. 20,001-above ( )
66
c. 3-4 ( )
d. 4-5 ( )
(c) Both ( )
2. What is a Vaccine?
4. What is Immunization?
67
B.KNOWLEDGE QUESTIONNAIRE.
(a) 6 weeks ( )
(b) At Birth ( )
( )
(c) At 10 weeks
(a) 6 weeks ( )
( )
(b) 14 weeks
( )
(c) At Birth
(a) At Birth ( )
( )
(b) 10 weeks
( )
(c) 14 weeks
(a) 6 months ( )
(b) 6 weeks ( )
( )
(c) 14 weeks
(a) At Birth ( )
( )
(b) 14 weeks
( )
(c) 6 weeks
68
10. At what age Hib1 to be given
(a) 6 weeks ( )
( )
(b) 10 weeks
( )
(c) 6 months
(a) 4 weeks ( )
(b) 6 weeks ( )
( )
(c) 10 weeks
12. Which age group children are administered pneumococcal conjugate vaccine (PCV)
(a) At birth
( )
(b) 10 weeks ( )
(c) 6 weeks ( )
(a) 6 weeks ( )
(b) 1 year ( )
( )
(c) 10 weeks
(a) 1 year ( )
( )
(b) 10 weeks
( )
(c) 6 months
(a) 10 weeks ( )
( )
(b) 14 weeks
( )
(c) 6 weeks
69
16. At which age group PCV2 to be given
( )
(a) 14 weeks
( )
(b) 10 weeks
( )
(c) 6 months
(a) 6 months ( )
( )
(b) 14 weeks
( )
(c) 10 weeks
(a) 1 year ( )
( )
(b) 14 weeks
( )
(c) 6 weeks
(a) 6 months ( )
(b) 10 weeks ( )
( )
(c) 14 weeks
70
22. At which age group children is administered hepatitis B3
(a) 2 months ( )
( )
(b) 6 months
( )
(c) 10 months
(a) Typhoid ( )
(b) Cholera ( )
(c) Measles ( )
(a) 2 years ( )
( )
(b) 15-18 months
( )
(c) 6 months
(a) 6 months ( )
( )
(b) 1 year
( )
(c) 15-18 months
(a) 15 months ( )
(b) 18 months ( )
( )
(c) 2 year
71
28. Which vaccine to be given at the age of 18 months
(a) Typhoid ( )
(b) Hepatitis A ( )
( )
(c) Measles
(a) 1 year
( )
(b) 5 year ( )
(c) 2 year ( )
(a) 5 year ( )
(b) 3 year ( )
( )
(c) 2 year
(a) 1 year ( )
(b) 5 year ( )
( )
(c) 2 year
(c) Tuberculosis
(a) OPV
(b) MMR
(c) DPT
72
34. Which vaccine is administered for diphtheria
(a) IPV ( )
(b) DPT ( )
( )
(c) Hib
(a) Pneumonia ( )
( )
(b) Meningitis
( )
(c) Diarrhea
(a) Pneumonia ( )
(b) Typhoid ( )
(c) Meningitis ( )
(a) Hepatitis ( )
(b) Encephalitis ( )
( )
(c) Meningitis
(a) MMR ( )
(b) DTP ( )
(c) PCV ( )
(a) OPV ( )
(b) MMR ( )
(c) Hib ( )
73
40. What is the purpose of giving varicella vaccine?
(a) Measles
( )
(b) Chicken pox ( )
(c) Typhoid ( )
74
ANNEXURE-X
SCORE KEY
ITEM NO SCORE KEY SCORE
1. C 1
2. A 1
3. C 1
4. B 1
5. B 1
6. A 1
7. D 1
8. C 1
9. A 1
10. A 1
11. B 1
12. B 1
13. A 1
14. C 1
15. B 1
16. C 1
17. C 1
18. A 1
19. C 1
20. C 1
21. A 1
22. B 1
23. C 1
24. A 1
25. B 1
26. C 1
27. A 1
28. B 1
29. C 1
30. A 1
31. B 1
32. C 1
33. A 1
34. B 1
35. C 1
36. A 1
37. C 1
38. A 1
39. B 1
40. A 1
75
ANNEXURE-XI
LESSON PLAN
ON
IMMUNIZATION
76
STRUCTURED TEACHING PROGRAMME
Class/Group/Batch : Mothers
Sample strength : 30
Venue : Hospital
77
General objective:
On completion of Structured Teaching Program me on immunization the mother will be able to gain knowledge regarding immunization and will
develop desirable attitude and skill regarding immunization.
Specific objective
At the end of class the mothers will be able to
Define vaccine
Define immunity
Describe the purpose of immunization
Describe about importance of immunization
Enumerate immunization schedule
Enlist about each immunization
78
S.No TIME SPECIFIC CONTENT INSTRUCTER LEARNER’S
OBJECTIVE ACTIVITY ACTIVITY AV AIDS EVALUATION
Introduction:-
1. 1mt. Introduce the Babies are born
topic with some natural immunity Lecture cum Listen
which they get from their discussion attentively to Flash cards
mother and through breast method the lecture.
feeding .having a child
immunized gives extra
protection against illness.
Immunisation prepares our
bodies to fight against
2. 1mt. diseases, in case we come in
Define contact with them in future. Lecture method
vaccines Listen
attentively to Flash cards
Vaccines are substances the lecture
3. 1mt. designed to produce specific
protection against diseases.
Define
immunity
Immunity is the ability of the Lecture cum
4. 2mt body to recognize, destroy, discussion
and eliminate antigenic
Define about material. Method.
immunisation
79
purpose of introduction of a vaccine. questions carefully. and
immunisation. answering the
questions
6. 2mt. Immunisation helps to
provide specific protection
from diseases. It also helps to
List reduce the spread of diseases
importance of to others and prevent
immunisation. epidemics.
At birth -BCG,OPV,
Hep B1
PCV 1, RV
1.
10 Weeks -Hep B 2,
80
IPV 2, Hib 2,
PCV 2, RV 2
PCV 3, RV
3.
6 months -OPV 1
9 Months -OPV 2,
Measles.
-Hib Booster,
PCV Booster
8. 10 mt.
-MMR 1,
Varicella 1,
81
Meningococcal,
Varicella 2,
POLIO VACCINATION
DPT (Diphtheria, pertusis, Lecture method
tetanus):-this vaccine is and asking
administering to prevent questions.
these three diseases. It is
82
administered at the age 6
wks-14 wks.
Diphtheria is
an acute infectious disease
caused by coryne bacterium
diphtheria. It affects children
under 10 years of age.
Pertusis is
otherwise known as
whooping cough. It is an DPT
infectious disease affecting
the respiratory tract.
Tetanus is an
acute disease caused by
clostridium tetani leading to
5 to 10 percent of neonatal
deaths.
PCV (pneumococcal
vaccine):-This is a vaccine
against streptococcus
pneumonia. Minimum age of
this vaccine is 6 wks.
POLIO CHILD
MMR vaccine:-this vaccine
is to prevent mumps,
83
measles, and rubella.
MEASLES:-This vaccine is
used to prevent measles. It
should be administered at the
age of 9 months.
HEPATITIS B
VACCINE:-this vaccine is
used for Hepatitis B virus.
First dose of this vaccine
should be given at birth. MUMBS
VARICELLA VACCINE:-
This vaccine is for varicella
virus. Minimum age is 16-24
months. Rubella
CHOLERA VACCINE:-
This vaccine is to prevent
cholera. This should be
administered at the age of
one year.
84
Lecture method Listening
INFLUENZA:-This vaccine carefully.
should be administered
minimum age of 6 months.
And to be given yearly. It is
used for influenza.
MPSV:-Administered at the
age of 2 years. And this
vaccine for meningococcal
infection
TYPHOID VACCINE:-this
vaccine is given for typhoid
fever, and it is administered
at the age of 2-3 years.
CONCLUSION:-
Immunization is urgent. It is
vital to immunize children
early in life. Immunization
protects against several
dangerous diseases. A child
who is not immunized is
more likely to become under
nourished, to become
disabled and to die.
85
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104
MASTER CODING SHEET
PLANNED KNOWLEDGE QUESTIONAIRE FOR PRE TEST SCORE SCORE INTERPRETATION
Sl.No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 total score Percentage Inadequate <50% moderate 51-75 Adequate 76 -100
1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 0 0 1 1 0 1 0 1 0 1 1 1 1 31 77.50%
2 0 1 1 1 0 1 0 0 1 0 1 1 1 1 1 0 1 1 1 0 0 1 1 0 1 1 1 1 1 1 0 0 1 0 1 1 1 1 1 1 28 70%
3 1 1 1 1 0 1 1 1 1 0 1 1 1 1 0 1 1 1 0 0 1 1 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 32 80%
4 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 1 1 35 87.50%
5 1 1 1 0 1 1 0 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 35 88%
6 1 1 1 1 0 1 1 1 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 0 1 1 0 0 32 80.00%
7 0 1 0 1 0 0 0 1 1 1 1 1 0 1 1 0 1 1 1 1 1 1 0 1 1 1 0 0 1 1 1 1 1 0 0 1 1 1 0 1 27 67.50%
8 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 37 93%
9 1 1 1 1 0 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 36 90%
10 1 1 1 0 1 1 0 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 35 87.50%
11 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1 1 35 87.50%
12 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 0 1 1 1 1 0 1 1 1 1 0 1 33 82.50%
13 1 1 0 1 1 1 0 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 37 92.50%
14 1 1 1 1 0 1 1 1 0 1 1 0 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 0 0 0 1 31 77.50%
15 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 11 1 0 0 1 1 35 87.50%
16 1 1 0 1 1 1 0 1 1 1 1 1 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 35 87.50%
17 1 1 1 1 0 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 0 1 0 1 1 33 82.50%
18 1 1 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 0 1 1 1 1 1 1 0 1 1 1 0 1 1 0 1 31 77.50%
19 1 1 1 1 0 1 1 1 1 0 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 36 90.00%
20 1 1 1 1 0 1 0 1 1 1 1 0 1 1 0 1 1 1 0 0 1 1 0 1 1 1 1 1 1 0 1 1 1 0 1 1 1 1 1 1 31 77.50%
21 1 0 0 1 1 0 1 0 1 0 1 1 0 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 0 1 1 1 0 29 72.50%
22 1 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 37 92.50%
23 1 1 0 0 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 36 90%
24 1 1 1 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 37 92.50%
25 1 1 0 1 1 1 1 0 1 1 1 1 1 1 0 1 1 1 0 1 1 1 0 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 33 82.50%
26 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 38 95%
27 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 37 92.50%
28 1 1 1 1 0 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 0 1 1 1 1 1 1 36 90%
29 1 1 1 1 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 38 95%
30 1 1 1 0 1 1 1 0 1 1 0 1 1 1 1 1 0 1 1 0 1 1 1 0 1 1 1 1 0 1 1 1 1 1 0 1 1 1 1 0 31 77.50%
DEMOGRAPHIC VARIABLES
Sl.no Age Religion Education Status Occupation Type of Family Family Income Exposure of source of health Health services availed No of underfive Age of children Age
1 a a a b a b c d a c
2 b b b a a a d b b d
3 a c a a c b b a a a
4 c a b c a c b c b b
5 b a c b c c c a c c
6 b b d d b d d c a a
7 a c a a b c b a a a
8 c a b b c h a a b b
9 a b b b a c a c c c
10 a a a a b c c b a a
11 b b b b b b c a b a
12 a b b c c a d d b b
13 b a a a a a b c c c
14 c a a b b b b a a a
15 a c c d c c a b a a
16 a a a c c b d c b c
17 b a a a a a a a a c
18 c b b b b b c a b d
19 a a a c a b b b a a
20 b a a a a b c c c c
21 a b b c b c a b a a
22 c c c d a d a a b d
23 a a a a c b c c c b
24 b b b b a c b d a d
25 b a a b a c c a b c
26 a a a a b a d b a a
27 c b b b b c d d c b
28 a a b a b b c a a d
29 b b a a a c b c b c
30 c c c c c b d b c a