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A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED

TEACHING PROGRAMME ON KNOWLEDGE AND
PRACTICE OF POSTNATAL MOTHERS WITH
REGARD TO ESSENTIAL NEWBORN
CARE AT KOVILPALAYAM,
COIMBATORE

By
Reg. No: 301316101

A DISSERTATION SUBMITTED TO THE TAMIL NADU

Dr. M. G. R. MEDICAL UNIVERSITY, CHENNAI IN
PARTIAL FULFILLMENT OF REQUIREMENT
FOR THE DEGREE OF MASTER OF
SCIENCE IN NURSING

OCTOBER 2015
 A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED
TEACHING PROGRAMME ON KNOWLEDGE AND
PRACTICE OF POSTNATAL MOTHERS WITH
REGARD TO ESSENTIAL NEWBORN
CARE AT KOVILPALAYAM,
COIMBATORE

By
Reg. No: 301316101

Approved by

_______________ _______________
EXTERNAL INTERNAL

A DISSERTATION SUBMITTED TO THE TAMIL NADU

Dr. M. G. R. MEDICAL UNIVERSITY, CHENNAI IN
PARTIAL FULFILLMENT OF REQUIREMENT
FOR THE DEGREE OF MASTER OF
SCIENCE IN NURSING

OCTOBER 2015
 A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED
TEACHING PROGRAMME ON KNOWLEDGE AND
PRACTICE OF POSTNATAL MOTHERS WITH
REGARD TO ESSENTIAL NEWBORN
CARE AT KOVILPALAYAM,
COIMBATORE

CERTIFIED THAT THIS IS THE BONAFIDE WORK OF

Reg. No: 301316101

PPG College of Nursing
Coimbatore

SIGNATURE : ________________________ COLLEGE SEAL

Dr. P. MUTHULAKSHMI, M.Sc(N)., M.Phil., Ph.D.,

Principal,
PPG College of Nursing,
Coimbatore - 35.

A DISSERTATION SUBMITTED TO THE TAMIL NADU

Dr. M. G. R. MEDICAL UNIVERSITY, CHENNAI IN
PARTIAL FULFILLMENT OF REQUIREMENT
FOR THE DEGREE OF MASTER OF
SCIENCE IN NURSING

OCTOBER 2015
 A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED
TEACHING PROGRAMME ON KNOWLEDGE AND
PRACTICE OF POSTNATAL MOTHERS WITH
REGARD TO ESSENTIAL NEWBORN
CARE AT KOVILPALAYAM,
COIMBATORE
APPROVED BY THE DISSERTATION COMMITTEE ON MARCH 2014

RESEARCH GUIDE :
Dr. P. MUTHULAKSHMI, M.Sc(N)., M.Phil, Ph.D.,
Principal,
PPG College of Nursing,
Coimbatore.

SUBJECT GUIDE :
Dr. K. JEYABARATHI, M.Sc (N)., Ph.D.,
HOD, Department of Child Health Nursing,
PPG College of Nursing,
Coimbatore-35.

MEDICAL GUIDE :
Dr. RAJENDRAN, MD., D.Ch.,
Consultant Pediatrician,
Ashwin Hospital,
Coimbatore - 12.

A DISSERTATION SUBMITTED TO THE TAMIL NADU

Dr. M. G. R. MEDICAL UNIVERSITY, CHENNAI IN
PARTIAL FULFILLMENT OF REQUIREMENT
FOR THE DEGREE OF MASTER OF
SCIENCE IN NURSING

OCTOBER 2015
 Dedicated to
Almighty God,
Husband,
Lovable Parents,
Brother, Sister
& Friends
 ACKNOWLEDGEMENT

Glory to Almighty God for giving me special graces, love compassion and

immense showers of blessing bestowed on me, which gave me the strength and

courage to overcome all difficulties and enables me to achieve this target peacefully.

I am greatly indebted to my husband Mr. Hari Babu, family and friends for

their love, support, prayer, encouragement and help throughout my study.

I am grateful to Dr. L.P. Thangavalu, M.S., F.R.C.S, Chairman and

Mrs. Shanthi Thangavelu, M.A., Correspondent of P.P.G Memorial charitable

Trust, Coimbatore for their encouragement and providing the source of success for the

study.

It is my long felt desire to express my profound gratitude and exclusive thanks

to Dr. P. Muthulakshmi, M.Sc (N)., M.Phil., Ph.D., Principal, P.P.G college of

nursing. It is a matter of fact that without her esteemed suggestions, highly scholarly

touch and piercing insight from the inception till the completion of the study, this

work could not have been presented in the manner it has been made. Her timely

encouragement support me a lot throughout my study, which is truly immeasurable

and also express my gratitude for her valuable guidance and help in the statistical

analysis of the data which is the core of the study

It is a great privilege to express my sincere thanks and deep sense of

indebtedness to my esteemed subject guide Dr. K. Jeyabarathi, M.Sc (N)., Ph.D.,

HOD, Department of Child Health nursing department for her ken support,

encouragement, guidance, valuable suggestions and constructive evaluations which

have enabled me to shape this research as a worthy contribution.

I extent my sincere thanks Mrs. Manibarathi, M.Sc(N)., (Ph.D),

Mrs. Blessly Pramila, M.Sc (N)., Department of child health Nursing for their

esteemed suggestions, constant support, timely help and guidance till the completion

of my study.

I expressed my respect and tribute to Prof. L. Kalaivani, M.Sc (N)., (Ph.D)

(Obstetrics and Gynecological Nursing), Dr. B. Rajalakshmi M.sc (N) Ph.D.,

(Medical Surgical Nursing) and all other Faculty Members of P.P.G College of

Nursing for their valuable suggestions, co-operation and timely support throughout

the endeavour.

I express my sincere my gratitude to Prof. Venugopal, Statistician for the

expert guidance and suggestions in the statistical analysis of the data.

I take this opportunity to thank the Experts who have done the content

validity and valuable suggestions in the modifications of the tool.

I extend my thanks to the Dissertation Committee Members for their healthy

criticism, supportive suggestions which moulded the research.

I thank the Librarian and Assistant Librarian for their kind cooperation in

providing the necessary materials.

 I would also express my sincere thanks to Mr. N. Siva Kumar of Nawal

Comtech Solutions, Saravanampatti for his patience, dedication and timely

cooperation in typing this manuscript.

I duly acknowledge all the Participants in the study for their esteemed

presence and co-operation without which I could not have completed the work

successfully.

I thank all my well wishers who helped me directly and indirectly throughout

the study.
 LIST OF CONTENTS

CHAPTER CONTENTS PAGE No.

I INTRODUCTION 1

Need for the Study 6

Statement of the Problem 8

Objectives 8

Hypothesis 8

Operational Definitions 9

Assumptions 10

II REVIEW OF LITERATURE 11

Conceptual Framework 19

III METHODOLOGY 23

Research Approach 23

Research Design 23

Setting of the Study 24

Variables 24

Population 24

Sample Size 24

Sampling Technique 25

Criteria for Selection of Samples 25

Description of the Tool 25

Testing of the Tool 26

Pilot Study 26

Data Collection Procedure 27

Plan for Data Analysis 27

CHAPTER CONTENTS PAGE No.

IV DATA ANALYSIS AND INTERPRETATION 29

V RESULTS AND DISCUSSION 51

VI SUMMARY, CONCLUSION, 54

NURSING IMPLICATIONS, LIMITATIONS AND

RECOMMENDATIONS

REFERENCES

ABSTRACT

APPENDICES
 LIST OF TABLES

S.No. CONTENT PAGE No.

1. Distribution of Demographic Variables of Postnatal Mothers 30

2. Distribution of Statistical Value of Pretest and Post Test 42

Knowledge Scores of Postnatal Mothers with Regard to

Essential New Born Care

3. Distribution of Statistical Value of Pretest and Post Test 44

Practice Scores of Postnatal Mothers with Regard to Essential

New Born Care

4. Correlation Between Pretest Knowledge and Practice Scores 46

of Postnatal Mothers with Regard to Essential New Born

Care

5. Correlation Between Post Test Knowledge and Practice 46

Scores of Postnatal Mothers with Regard to Essential New

Born Care

6. Association of Selected Demographic Variables with Level of 47

Knowledge with Regard to Essential New Born Care of

Postnatal Mothers in Post Test Score

7. Association of Selected Demographic Variables with Level of 49

Practice with Regard to Essential New Born Care of Postnatal

Mothers in Post Test Score

 LIST OF FIGURES

S.No. CONTENTS PAGE No.

1. Modified Conceptual Framework Based on Modified Rosen 22

2. The Schematic Representation of the Research Design 23

3. The Schematic Representation of the Variables 24

4. The Overall View of Research Methodology 28
5. Distributions of Demographic Variables According to the 33
Age
6. Distribution of Demographic Variables According to the 34
Education
7. Distribution of Demographic Variables According to the 35
Religion
8. Distribution of Demographic Variables According to the 36
Parity
9. Distribution of Demographic Variables According to the 37
Type of Delivery
10. Distribution of Demographic Variables According to the 38
Family Income
11. Distribution of Demographic Variables According to the 39
Age of the Child
12. Distribution of Demographic Variables According to the Sex 40
of the Child
13. Distribution of Demographic Variables According to the 41
Weight of the Baby
14. Comparison of Mean Score of Pretest and Post Test 43
Knowledge Score Regarding Essential New Born Care
Among Postnatal Mothers
15. Comparison of Mean Score of Pretest and Post Test Practice 45
Score Regarding Essential New Born Care Among
Postnatal Mothers
 LIST OF APPENDICES

APPENDIX TITLE

1. Letter seeking permission for conducting the study

2. Letter seeking permission from Experts for content validity of the

tool

3. Format for the content validity

4. List of experts for content validity

5. Questionnaire

English

Tamil

6. Teaching Module

English

Tamil
 1

CHAPTER - I

Introduction

, means the bestowing of some form of life by the nature, to this world.

Being born is the purest virtues that can be held by a living being as after that one is

exposed to life, where one can breathe, feel, have emotions,

these one is exposed to all such virtues. This is a state in which we consider the

achievement of a new form of life (Karlson, 2007).

, babies have

amazing abilities. Yet they are completely depended on others for feeding, warmth

and comfort. Newborn is a continuum of the fetal life and very important transient

time to adopt extra uterine life. The physical and mental wellbeing of every individual

depends on the correct management of events in perinatal period (Stephon. W

Elizabeth, 2004).

All the neonates have certain needs that must be met for them to thrive and

take their place in society. There are nine universal needs of the newborn infant that is

a clear airway, established respiration, warmth, protection from hemorrhage,

protection from infection, identification and observation, nourishment and fluids,

love-parent attachment and res (Al. Sabir, 2003).

Newborn care often receives less than optimum attention. Although over the

past 25 years. Child survival programs have helped to reduce the death rate among

children under age 5, the biggest impact has been on reducing mortality from diseases
 2

that affect infants and children more than 1 month old. As a result, the vast majority

of infant deaths occur during the first month of life,

nearly 15 times greater than at any other time before his or her first birth (Castello. A

and Manandhard, 2000).

The principles of essential newborn care is simple, requiring no expensive

high technology equipment resuscitation, warmth to avoid hypothermia, early breast

feeding, hygiene, support for the mother infant relationship and early treatment for

low birth weight or sick infants (Hocken Berry and Willson, 2005).

Environmental temperature should be maintained according to baby weight

and age to avoid hypothermia. It is necessary to dry up the baby and wrap the baby

with clothes make sure the baby head is covered (Dutta. P, 2008).

Nutrition is essential for optimal growth and development especially in the

first few months of life, because brain growth is proceeding at such a rapid rate.

Breast feeding is the preferred form of nutrition for all infants it should be initiated

within first half an hour of birth or as soon as possible. Early sucking provides

warmth colostrum is most suitable and contains a high concentration of protein and

other nutrients. It is rich in anti-infective factors and protects the baby from

respiratory infections and gastro intestinal infections caused by enterococci, otitis

media, numerous allergies and atopy (Hocken Berry and Wilson, 2005).

The first week of life is the most crucial period in the life of an infant. This is

because the newborn has to adapt itself rapidly and successfully to an alien external
 3

environment. The risk of death is greatest during the first 24-48 hours after birth.

Newborn morality is one of the most neglected health problems in the developing

world, there are estimated 4 million neonatal deaths worldwide each year. Moreover,

it is estimated to account for 40% of under five deaths and two-third of infant deaths.

The proportion is generally higher in rural areas. According to World Health Report

2005, global neonatal mortalities rate is 36/1000, while in developing counties, the

rate is 39/10006 (Belsey. M, 2000).

Nearly 26 million babies are born in India each year, this accounts for 20% of

global birth, of these, 1.2 million die before completing the first four weeks of life.

This accounts for nearly 30 percent of the total 3.9 million neonatal death world wide.

The current neonatal mortality rate in India is 44/1000 live births, it accounts

for nearly two-third of infant mortality and half of under five mortality; Over one-

third of all neonatal deaths occur on the first day of life. Almost half within three days

and nearly three fourth in the first week. The rate of neonatal mortality varies widely

among the different states ranging from 10 per 1000 live births in Kerala to around 60

in Orissa and Madhya Pradesh. The states of Uttar Pradesh, Madhya Pradesh and

Bihar together contributed to over half of all newborn tests in India in 2000 (Park. K,

2007).

The principal causes of infant mortality in India are low birth weight (57%),

respiratory infections (17%), Diarrhoeal diseases (4%), Congenital malformation

(5%), and Cord infection(2%). Birth injury (3%) and unclassified are about 8%.
 4

The neonatal mortality rate in India is 43 per 1000 live births, in Bangladesh

36 per 1000 lives, in Srilanka 11 per 1000 live births, in Pakistan 57 per live births, in

Nepal 40 per 1000 live births, and in China 21 per 1000 live births. In U.S.A 5 per

1000 live births and U.K 4 per 1000 live births. The main causes of neonatal mortality

are intrinsically linked to the health of the mother at the care she receives before,

during and immediately after giving birth. Asphyxia and birth injuries usually result

from poorly managed labour and delivery and lack of access to obstetric services.

Many neonatal infections, such as Tetanus and Congenital Syphilis, can be prevented

by caring during pregnancy and child birth. Inadequate calorie or micronutrient intake

also results in poorer pregnancy outcomes. It has been argued that nearly three

quarters of all neonatal deaths would be prevented if women were adequately

nourished and received appropriate care during pregnancy, child birth and in the

postnatal period (Singhal. K, 1998).

Mcclure Carlo, Wright et.al., (2007) conducted a study to evaluate the

effectiveness of the World Health Organization's (WHO) essential newborn care

(ENC) course in improving knowledge and skills of nurse midwives in low risk

delivery clinics in a developing country. The study concluded that there are

significant improvements in trainees' knowledge and skills in essential newborn care

following WHO ENC course (Anne Tinker, 2002).

The survival of newborn babies depends on the care provided. International

, and

recent global assessments have confirmed that doing so makes good social and

economics contributions .
 5

The risk of neonatal mortality is more acute in rural areas where expert

obstetric care is scarce, and the home environmental conditions in which the baby is

born, are usually unsatisfactory. Roughly 60% of birth in less developed counties

occurred at home, so parents need to be educated about what they can do to save their

newborn lives. Families need to adapt better nutritional practices, including

breastfeeding ; learn how to dry and warm their newborns; and better understand the

danger signs of maternal and neonatal complication saving newborn lives depends on

a broad based condition that include donors and international organizations that can

provide policy focus and finding, governments that are willing to expand their

commitment to national and local health care services, and NGOs and gross roots

organizations that can work with communities to pass on information on saving

newborns (Park. K, 2007).

The challenges of reducing neonatal mortality require solutions through

research to inform programme innovation and action-oriented policies designed to

improve newborn health. In all these above programmes, the mother plays a vital role.

The community health nurse can educate the mothers regarding essential new born

care and regarding antenatal care and postnatal care and regarding importance of

institutional deliveries and through proper guidance and education regarding essential

newborn care (Benny. W. Elizabeth, 2004).

Since mothers are the primary care takers of the newborns round the clock, it

is the most important priority to improve their knowledge and competency. If a

mother is educated, she can educate the entire family and the community as well.
 6

Need for the Study

Newborn or neonatal period include the time from birth to 28 days of life. This

is the crucial period in laying the foundation of good health. At this time specific

biological and psychological needs must be met to ensure the survival and health

development of the child into a future adult (Hocken Berry and Wilson, 2005).

The major causes of neonatal deaths globally were estimated to be due to

complications of pre-maturity, (28%) sepsis, pneumonia (26%), birth asphyxia,

injuries (23%), tetanus (7%), congenital anomalies (7%) and diarrhoea (3%). A study

done by Baqui, et.al., (2006) in rural Uttar Pradesh showed that out of 618 neonatal

deaths, 32% deaths were on the day of birth, 50% occurred during the first 3 days of

life and 71% were during the first week of life. (Indian Institute of population 2010)

Care practices immediately after delivery play a major role in causing neonatal

morbidities and mortalities. Essential newborn care practices were outlined to

decrease the neonatal morbidity and mortalities. These practices include clean cord

care, thermal care, and initiating breast feeding immediately after birth. The

traditional practices like applying cow dung on the umbilical stump, oil instillation

into nose, eyes also contribute to newborns risk of morbidity and mortality (Kesterten,

A. J, 2010).

WHO reported that each year about 4 million newborns die before they are

four weeks of life. Ninety eight percent of these deaths occurring in developing

countries. Mortality rates are high in Sub-Saharan Africa and Asia. Two thirds of

newborn deaths occur in the WHO regions of Africa (28%) and East Asia (36%).
 7

Neonatal mortality rate is now 6.5 times lower in the high income countries than other

countries. The lifetime risk for a newborn baby is 1 in 5 in Africa compared with 1 in

125 in more developed countries.

than in urban area at 27/1000 live births. Orissa have the highest neonatal mortality

rate of 61/1000 live births. Karnataka, Uttar Pradesh, Madhya Pradesh, West Bengal,

Punjab have the neonatal mortality rate of 54/1000, 53/1000, 51/1000, 31/1000,

29/1000 live births respectively. Kerala have the lowest neonatal mortality of 10/1000

live births respectively. It is necessary together to meet both national and the

millennium development goal to reduce Neonatal Mortality rate by two thirds

between 1990 and 2015. In India, Andhra Pradesh stands 6 place in neonatal mortality

rate of 30/1000 live births (WHO, 2011).

Still traditional practices of newborn care are seen among the mothers which

are harmful to the newborn. Such as practice of pre-lacteal feeds like feeding sugar

water or honey, castor oil, application of oil and powder to the umbilical cord,

application of Kajal, instillation of oil in babies eye, ear and nose, baby being exposed

and not covered well, lack of hygienic practices these are all contributes to the

increased rate of neonatal morbidity and mortality.

Best practices of newborn care that includes maintenance of temperature,

exclusive breastfeeding, skin care, eye care, cord care, prevention of infection,

immunization (Mathur, N. B, 2010).

 8

Hence as a first step, the researcher felt the need for assessing the knowledge

and practices of postnatal mothers with regard to essential newborn care at

Kovilpalayam, Coimbatore.

Statement of the Problem

A Study to Assess the effectiveness of planned teaching programme on

Knowledge and Practice of Postnatal mothers with regard to essential newborn care at

Kovilpalayam, Coimbatore.

Objectives

To assess the knowledge and practice of postnatal mothers with regard to

essential newborn care.

To deliver planned teaching programme with regard to essential newborn care.

To evaluate the effectiveness of planned teaching programme with regard to

essential newborn care..

To determine the co-relation between the knowledge and practice of postnatal

mothers with regard to essential newborn care

To find out the association between knowledge and practice with selected

demographic variables

Hypothesis

H1 There is a significant difference between knowledge and practice with regard

to essential newborn care in pre & post test scores.

 9

Operational Definitions

Assess

It refers to examine the knowledge and practices of postnatal mothers

regarding essential newborn care.

Effectiveness

It refers to gained level of knowledge and practice by significant

difference between pre and post test scores.

Planned Teaching Programme

It refers to the written and verbal instructions systematically developed

and designed for a selected group of post natal mothers in Kovilpalayam to

provide information on essential newborn care.

Knowledge

Refers to the level of understanding of postnatal mothers with regard to

essential new born care as measured by their correct responses to knowledge items

of questionnaire.

Practice

It refers to the care given by the postnatal mothers to newborn after birth

as indicated by observation checklist.

Postnatal Mothers

Refers to mothers who have undergone instrumental operative or normal

vaginal delivery.
 10

Essential Newborn Care

Refers to the basic care to the new born which includes maintenance of

temperature, exclusive breastfeeding, skin care, eye care, cord care, prevention of

infection, immunization and early recognition of danger signs.

Assumptions

Postnatal mothers may not have adequate knowledge on essential newborn

care.

Teaching programme will enhance the knowledge of postnatal mothers with

regard to essential newborn care.

 11

CHAPTER - II

Review of Literature

One of the major functions of literature review is to ascertain what is already

known in relation to a problem of interest. Review of literature is a written summary

of the state of existing knowledge on a research problem. It involves systematic

identification, location, scrutinization and summary of written material that contain

information once research problem (Richard, 2009).

The Reviews of Literature for the Present Study is Organized in 3 Sections

Literature related to knowledge of postnatal mothers on essential newborn

care.

Literature related to practices of postnatal mothers on essential newborn care

Literature related to effectiveness of teaching programme on essential

newborn care.

Literature Related to Knowledge of Postnatal Mothers on Essential Newborn

Care

Dulitha N. Fernado (2007) conducted a cross sectional study was conducted to

assess mothers knowledge on newborn care as well as factors associated with poor

knowledge among hospital delivered mothers in Puttalem district of Srilanka. They

had selected 446 mother-newborn pairs from five hospitals. Data were collected

by using a questionnaire. Results showed that primipara (95%), unemployed women

(95%) and those with delayed antenatal booking visits (95%), were more likely to

have poor knowledge. Mothers had a satisfactory level of knowledge about breast
 12

feeding and recognition of danger signs, but knowledge about care of the umbilical

cord was poor. Maternal education programmes should place more emphasis on primi

mothers, unemployed women and those with delayed booking Visits.

Mohamed Asif Padiyath, Bhagat (2010) conducted a descriptive study to

assess the knowledge and attitude on neonatal care practices among postnatal mothers

in a Tertiary Care Hospital of South India. They had selected 100 post natal mothers.

Data were collected by using a structured questionnaire Results of the study showed

that knowledge of mothers were inadequate in areas of umbilical cord care (35%),

thermal care (76%) and vaccine preventable diseases (19%), of them still practice oil

instillation into nostrils, 61% of them administer gripe water to their babies. The study

indicated that awareness and attitude of postnatal mothers towards neonatal care has

lots of lacunae among low socio economic status.

Vidhya. K (2011) conducted a pre-experimental study to assess the

effectiveness of innovative teaching programme on newborn care among antenatal

mothers in Raja Muthaiah Hospital in North India. They had selected 30 antenatal

mothers by convenient sampling technique. Data were collected by using a structured

questionnaire. The pre-test results showed that 97% of the antenatal mothers had

inadequate knowledge on newborn care and post test results showed that 70% of the

antenatal mothers gained adequate knowledge on newborn care and 30% of antenatal

mothers gained moderately adequate knowledge on newborn care. This study

demonstrated that video teaching programme was effective in imparting knowledge to

the antenatal mothers.

 13

Romano. N, Byurohanya, et.al., (2009) conducted a qualitative study to

explore the perceptions among postnatal mothers of skin to skin contact and newborn

baby care at St. Francis Hospital, Nsawhya, Uganda. They had selected 30 mothers.

Data were collected by using interview method. The study showed that mother

expressed varying opinions about the usefulness of skin to skin contact, some knew

about its use to reduce the risk of hypothermia, whereas some believed skin to skin

contact was an intervention used to distract them from the pain in the post delivery

period. The study concluded the health care providers need to be encourage to

continuing educate and implements skin to skin contact.

Usha. M. Bhandari, Khorde, et.al., (2010) Conducted a study to evaluate the

effectiveness of planned teaching progress on knowledge of mothers on prevention of

hypothermic among newborns in selected hospitals of Belgum, Karnataka. They had

selected 30 postnatal mothers by non-probability sampling technique. Data were

collected by using a structured interview schedule. The study results showed that

there was statistically significant association between knowledge of mothers and age

and religion and there was no statistical association between knowledge of mothers.

Literature Related to Practices of Postnatal Mothers on Essential Newborn Care

Sabiter Tukedhar (2010) Conducted a study to assess the factors that have an

impact on newborn care practices in Sindhuri district of Nepal. They had selected 815

postnatal mothers. Data were conducted by using a Interview technique. Results of the

study 70% were uneducated and the majority were poor. Safe cord cutting, early

breastfeeding and delayed bathing practices were studied for 803, 810 and 812

women respectively and 70.7%, 46.7% and 16.6% of the eligible sample
 14

demonstrated practices respectively. Social gradient was found to be associated with

all three practices. Rich women were more likely to demonstrate good practices and

bearing a child at the prime age (20-34 years) was likely to result in safe curd cuffing

Disadvantage indigenous. Women demonstrated unsafe cord cutting practices and

Dalit caste/ethinicity women demonstrated poor bathing practices. Maternal

knowledge also emerged as a strong predictor of early breastfeeding and delayed

bathing practices.

Fikree. F. F, Durecher. J. M (2005) conducted an exploratory study to explore

traditional beliefs and care practices and to assess the predictors for giving prelacteal

feeds in low socio-economic status of Karachi, Pakistan. They had selected 525

recently delivered women. Data were collected by using structured questionnaire.

Study results showed that 41% were given pre lacteals as first feed, 82% newborns

were bathed immediately after delivery as the vernix was considered dirty. However,

honey (28.7%) and water (11.8%) were also given in-order to reduce colic and act as

a laxative which were perceived as health benefits by mother.

Allison. C. Moren, et.al., (2008) a study to explore the new born care practices

among slum dwellers in Dhaka, Bangladesh. They had selected 1, 256 postnatal

mothers. Data were collected by using semi structured interviews. Results showed

that 84% of women gave birth at home. 64% of mothers had knowledge about drying

the baby, 59% of the mothers had knowledge on wrapping the baby after birth and

46% of the mothers had knowledge on cord care. Almost all women reported using

sterilized instruments to cut the cord. Exclusive breastfeeding was rare. Most women

reported first giving their babies sweet water, honey and other foods. The study
 15

concluded that educational programmes are needed to provide new born care

immediately after birth delaying bathing and ensuring dry cord care and exclusive

breastfeeding.

Ahmed. F. U, Rahuken, Aleem (2010) conducted a study to find out the

factors influencing the pre-lacteal feeding and its relation to establishment of lactation

in rural Bangaladesh. They had selected 420 post-natal mothers in early post partum

period. Data were collected by using Interview technique. Results showed that pre-

lacteal feeding was given to 77% of the babies, and honey was given to 72% as them.

The common methods of prelactated feeding were by finger (41%) and spoon (40%).

These observation emphasized the need for coordinated efforts for promotion of

proper infant feeding practices in rural community. Reasons of giving pre-lacteal

feeding and the time of first breast feeding influenced the practice significantly

(p<0.05). Type and duration of pre-lacteal feeding had significant negative influence

on Lactation (p<0.05).

Darm Stadd. G. L, et.al., (2007) conducted a survey to assess the newborn

home care practices during the first week of life in Rural Egypt. They had selected

217 Mothers. Data were collected by using questionnaire. The study revealed that

(44%) were given pre-lacteals as first feed (4.3%) of Mothers reported that they did

not wash their hands before giving care to baby, 7% washed hands after diaper

changes. Thermal control was not practiced although Mothers perceived 22% of

newborn to be hypothermic. The study included that mothers need education on new

born practices to improve neonatal health.

 16

Amy. J. Kesterton (2010) conducted a study to assess the healthy and harmful

practices in the Newborns in Karnataka. They had selected postnatal mothers. Data

were collected by using interview survey. The study results showed that many

potentially harmful newborn care practices were unhygienic cord cutting, delayed

breastfeeding and early bathing. Study concluded that the national rural health

mission and integrated management of Neonatal and childhood illness (IMNCI)

programs being implemented in Karnataka.

Literature Related to Effectiveness of Teaching Programme on Essential

Newborn Care

Thomas, Saloni (2005) conducted a comparative study to assess the

knowledge and practices of postnatal mothers regarding neonatal care from selected

urban and rural settings of Bangalore. They had selected 60 postnatal mothers by

purposive sampling technique. Data were collected by using interview schedule. The

study results showed that the knowledge score of postnatal mothers from rural settings

was 38.43% and mothers from urban setting were 49.77%. There was positive

correlation between knowledge and practice except knowledge and practice of

umbilical cord care. Significant Association was found between mothers knowledge

and their age, occupation and parity status. This study concluded that postnatal

mothers from urban setting had more knowledge and good practice then postnatal

mothers from rural setting.

Bhatt Shwetal, Parikh Pooja, et.al., (2011) conducted a study to assess the

knowledge, attitude and practice of postnatal mothers for early imitation of

Breastfeeding in the obstetric wards of a tertiary care hospital of Vadodara city. They
 17

had selected 175 postnatal mothers. Data were collected by using a structured

Questionnaire with open and close ended question results showed that 32.6% mothers

initiated breastfeeding within one hour of delivery. Incidence of early initiation of

breastfeeding in Mothers less than 21 years of age was 29.4%, 24.6% in illiterate

mothers and 25% in those delivering by caesarian section. Early initiation of breast

feeding was maximum (46.7%) in the first and minimum (24.31%) in the third shift of

work of health care workers. Most common causes of delay in initiating breastfeeding

were caesarian section and fatigue (29.7% and 21.2%) respectively. Lack of adequate

information, maternal education level, socio economic factors influences the early

breast feeding practices which can be overcome by proper support, care is

counselling.

M. Sai Sunil Kishore (2010) conducted a study to assess the breastfeeding

knowledge and practices among mothers in a rural population of north India. They

had selected 77 mothers. Data were collected by using interview schedule results

showed that 30% exclusive breastfeeding, their infants till 4th month and 10%

exclusive breastfeeding their infant still 6months of age. There was good attachment

in 42% mothers. Infant pairs and infants were held in correct position by 60%

mothers. Thirty-nine percent of the mothers had satisfactory breastfeeding knowledge.

Study concluded that exclusive breastfeeding practices and breastfeeding knowledge

were suboptimal among the rural North Indian mothers.

Obimbo (2010) conducted a study to assess the knowledge, attitude and

practices of mothers and the knowledge of health workers regarding care of umbilical

cord at Nairobi, Kenya. They had selected 307 mothers. Data were collected by using
 18

interview method. The results showed that 91% of mothers knew of the need for

hygiene during cord cutting and tying the cord. Regarding postnatal cord care 40%

had good knowledge and 66% had good practice, 54% practice postnatal cord care

and 74% mothers were afraid of handling and unhealed cord. 50% of health worker

had correct knowledge on type of postnatal cord care. This study recommended that

health education on cord care be given at all levels of contact with mothers.

Bhavana Singh (2010) conducted a case study to assess the knowledge,

attitude and practices of breastfeeding among postnatal mothers in University

Hospital, Kumasi, Ghana. They had selected 200 mothers. Data were collected by

interview method. Study results showed that the prevalence of breast feeding was

100% and an average duration of breast feeding was about 18 months. Thirty eight

percent of mothers give water to their babies soon after birth. Most of the mothers

were found to know the importance of breast milk as being nutritious (80%),

promoting bonding between mother and child (99%) and being cheaper than buying

supplements (81%). However, (38%) of mothers disagreed to the contraceptive

benefits of breast feeding.

Helmy. F. E (2009) conducted a comparative study to assess the mothers

knowledge and practices of basic newborn care given at home in Tanta City. They

had selected 55 primipara and multipara mothers with newborn babies. Data were

collected by interview, questionnaire and observation checklist. The study revealed

that mother knowledge and practices were good and satisfactory related to newborn

care except breastfeeding. Significant differences were found between primipara and

multipara mothers related to basic newborn care.

 19

Conceptual Framework

Conceptual frame work deals with the interrelated concepts that assembled

together in some rational scheme by virtue of their relevance to a common theme.

The conceptual frame work of the present study is based on Rosenstocks and

Beckers health belief model (1974) The model provides a way of understanding and

predicting how people or an individual behave in relation to their health and they

modify the risk factors and what preventive actions they take to maintain health.

Rosen stocks and Beckers Health Belief Model described the following

components

1. Individual perceptions

2. Modifying factors

3. Likelihood of action

Individual Perceptions

Perceived susceptibility which means that the feelings of an individual

about disease.

Perceived seriousness which is concerned about the consequences of

disease.

Perceived threat, which determines the threat of illness.

Modifying Factors

Factors that modify a person perception which include the following.

Demographic variables, comprises of age, education, occupation, income,

religion, Type of delivery by using these variable knows the postnatal

mothers knowledge and practices regarding newborn care.

 20

Socio psychological variables, which are concerned about social pressure,

influence from peers or from other reference group then they will provide

good health and well being.

Perceived barriers to action.

Individuals take action measures to reduce barriers

Cues to Action

It includes internal cues and external cues. The cues to action makes the

individual become conscious of feelings and begin thinking about how to deal

with the newborn.

Internal Cues

Previous experiences

Knowledge about newborn care

Strong attachment to the baby

Traditional practices

External Cues

Mass media campaign

Information from friends and relatives and health care providers

News papers

Health related magazine articles

Likelihood of Action

The third component likelihood of action depends on the perceived

benefits of action minus the perceived barriers to the action.

 21

Perceived Benefits of the Action : Individual take specific preventive

measures to prevent illness. Postnatal mothers provides adequate newborn

care in promoting health of newborn, bonding relationship, providing

warmth, breast feeding, immunization, prevention of infection. Mothers

with adequate knowledge and practices follows newborn care effectively

and promotes overall development of newborn.

Perceived Barriers to Action : Individual take action measures are

reduced the barriers in action. Barriers which has impact on providing care

to the newborn. Those are parental illiteracy, lack of information regarding

newborn care, cultural practices, low social economic status, lack of

resources. Mothers moderate adequate and inadequate knowledge and

practices lead to lack of skills in providing newborn care. Many barriers

restrict the mother not to practice newborn care.

Likelihood of Taking Recommended Action : Preventive health action

like health education will be required to improve the knowledge and

practices to provide newborn care.

Conceptual framework of the present study assumes that the postnatal mothers

will have some knowledge regarding essential newborn care which is influenced by

age, education, occupation, income, religion, type of delivery and parity and also by

different sources of information like advises from friends and relatives, mass media,

previous experience, news papers which is affected with demographic variables.

The investigator will assess and analyze the knowledge and practices of

postnatal mothers with regard to essential newborn care based on the knowledge

deficit area, health education module will be required to improve the knowledge.
 22

Individual Perception Modifying Factors Likelihood of Action

Demographic Variables Adequate knowledge Perceived Benefits by

and practices Providing adequate new born
Age, Education, Occupation, Income, care with bonding relationship
Religion. Warmth
Moderately adequate Breast feeding
Socio-psychological Variables Immunization
Perceived knowledge and practices
Susceptibility Family income
Perceived Barriers of
Structural Variables Preventive Action
Perceived Inadequate knowledge and Barriers which impact on poor
susceptibility of new Knowledge and practices of postnatal mothers practices newborn care due to parental
born to hypothermia, with regard to essential new born care. illiteracy
neonatal infection,
Lack of information
hypoglycemia.
Cultural practices
Perceived Threat to seriousness and susceptibility leads to Low socio economical status
inadequate newborn care leads to hypothermia, inpaired Lack of resources
growth and development, neonatal death.

Perceived
Seriousness Cues to Action Likelihood of Taking Action
Knowledge about newborn care receives information from friends, Recommended Preventive Health Action
Poor new born care relatives and health care providers, previous experience, strong
leads to cold stress, Preventive health action like health education
attachment to the newborn care, traditional practices, mass media will be required to improve the knowledge
hypoxia, poor growth. campaign, news papers, health related magazine articles. and practice essential new born care

Figure. 1
 23

CHAPTER- III

Methodology

Methodology is the way to solve the problem systematically, that includes

steps of procedure and strategies of the data. In this section the researcher discusses

the research approach, research design, setting of the study, population, sample size,

sampling technique, criteria for the selection of sample. Description of tool, content

validity, reliability, data collection procedure and plan for data analysis.

Research Approach

Experimental approach, a subtype of quantitative approach was used for the

present study. Quasi experimental involves the manipulation of an independent

variable that is implementing of an intervention.

Research Design

The research design provides an overall plan for conducting the study. One

group pre-test post test experimental design. Q1 is pre-test assessment, Q2 is post test

assessment and X is intervention.

Q1 X Q2

Assessing the pretest Assessing the post

knowledge and Planned test knowledge and
practices of teaching practices of
postnatal mothers programme postnatal mothers
regarding essential regarding essential
newborn care newborn care

Figure.2 The Schematic Representation of the Research Design

 24

Setting of the study

The study was conducted at Kovilpalayam village, Coimbatore, which is

situated 5kms away from the college.

Variables

Independent variable was planned teaching programme on essential newborn

care among postnatal mothers. The dependent variable was knowledge and practices

of postnatal mothers regarding essential newborn care. Influencing variables were

demographic variables.

Influencing Variables Dependent Independent

Variable Variable

Demographic variables Knowledge and Planned teaching

such as age, practices among programme on
education, income, postnatal mothers essential new born
occupation, religion, regarding essential care
parity, type of new born care
delivery

Figure. 3 The Schematic Representation of the variables

Population

The population of the study includes postnatal mothers at Kovilpalayam,

Coimbatore.

Sample Size

The sample size included for the study consists of 50 post natal mothers in

Kovilpalayam.
 25

Sampling Technique

Non probability convenient-sampling technique was used for selecting the

samples.

Criteria for Selection of Samples

Inclusive Criteria

Postnatal mothers at Kovilpalayam, Coimbatore.

Mothers who are able to communicate freely in Tamil/English

Mothers who are at the age group 18-40 years

Mothers of any level of education

Exclusive Criteria

Mothers who have babies more than one month of age

Mothers who are not willing or unable to participate in this study

Mothers who are medical/nursing profession

Description of the Tool

The researcher has developed a structured questionnaire after reviewing the

literature and considering the opinion of pediatric nursing experts, to assess the

knowledge and practice regarding selected aspects on essential newborn care.

Selection - 1 Description of Demographic Variables

It includes age of the mother, educational status, occupation, income,

religion, type of delivery, parity.

 26

Section - 2 Knowledge Questionnaire

It consists of 25 multiple choice questions to assess the knowledge

regarding essential new born care. Each question has 4 options in which one

option correct and other 3 options are wrong. Each correct answer carries one

mark, wrong answer carries zero mark.

Section - 3 Practice Questionnaire

It consists of 15 statements to assess the practice of essential newborn care

among postnatal mothers. Both positive and negative questions are formed based

on observational check list.

Testing of the Tool

Content Validity

The tool was given to five experts in the field of pediatric nursing and

medicine for content validity. All comments and suggestions given by the experts

were duly considered and corrections were made after discussion with the

research guide.

Reliability

The reliability of the tool was found by spearman brown split half

technique showing for knowledge of r=+0.79 for practice +0.83 the reliability of

the tool was satisfactory.

Pilot Study

In order to test the relevance and practicability of the study, the pilot study

was conducted among 5 postnatal mothers at Kovilpalayam. The knowledge and

 27

practices regarding essential newborn care were assessed with the prepared

questionnaire. The planned teaching programme was given with the help of power

point presentation. The result of the pilot study showed that inadequate knowledge

and practices regarding essential newborn care in pre test and gain knowledge and

good practice in post test.

Data Collection Procedure

After getting permission from the medical officer of Kovilpalayam PHC, the

researcher met the mothers. The purpose and duration of the study was explained to

the mothers in rural areas and their informed oral consent were obtained. The study

was carried out for a period of 4 weeks from 02.01.2015 to 31.01.2015 . The sample

was collected by non probability convenient sampling with reference to the selected

criteria. The questionnaire was distributed to assess the knowledge and practices on

essential newborn care. After pre-test planned teaching programme was given through

power point presentation . The teaching took about 40-45 minutes for group teaching.

The mothers were encouraged to clarify their doubts, post test was conducted on the

14th day to assess the effectiveness of teaching in improving the knowledge and

practices regarding essential newborn care by using the same questionnaire. Data

collected from 3-4 mothers per day, It took 15-20 minutes to gain information for

each sample.

Plan for Data Analysis

The investigator adopted descriptive and inferential statistics to analyze the

data. The demographic variables were analyzed by using frequency and percentage.

The effectiveness of planned teaching programme and association between variables

2 test respectively.
 28

Research Approach
Quantitative Approach

Research Design
One group pre test post test pre-experimental research design

Population
Postnatal mothers residing at Kovilpalayam

Sampling Technique
Non Probability convenient sampling technique

Sample Size
N = 50

Pretest
Assessment of knowledge and practice regarding
Essential newborn care

Delivery of planned teaching programme regarding

Essential newborn care

Post Test
Reassessment of knowledge and practice regarding
Essential newborn care

Data Analysis
Descriptive and inferential statistics

Summary and Conclusion

Figure. 4 The Overall View of Research Methodology

 29

CHAPTER - IV

Data Analysis and Interpretation

This chapter deals with the analysis and interpretation of data, collected from

50 postnatal mothers, through structured questionnaire. The data collected are

tabulated, analysed and interpreted by using descriptive and inferential statistics.

The analysis and interpretation of data are presented under 4 sections.

Section - I Distribution of demographic variables.

Section - II Description about the knowledge and practice of postnatal mothers

with regard to essential new born care.

Section - III Distribution of correlation between knowledge and practice of

postnatal Mothers with regard to essential new born care.

Section - IV Association of selected demographic variables with level of

knowledge and practice of postnatal mothers with regard to essential

new born care.

 30

SECTION - I

Table. 1 Distribution of Demographic Variables of Postnatal Mothers

(N = 50)

Frequency Percentage
S.No. Demographic Variables
(f) (%)

1. Age of the Mother

a) 18-25 years 11 22%
b) 26-30 years 17 34%
c) 31-36years 22 44%
d) 36 and above 0 0

2. Education
a) Illiterate 14 28%
b) 1st -10th standard 22 44%
c) Higher secondary 9 18%
d) Graduation and above 5 10%

3. Religion
a) Hindu 33 66%
b) Christian 9 18%
c) Muslim 8 16%

4. Parity
a) First delivery 18 36%
b) Second delivery 29 58%
c) Third delivery 3 6%
d) Fourth delivery and above 0 0

(Table 1 continues)
 31

(Table 1 continued)

Frequency Percentage
S.No. Demographic Variables
(f) (%)

5. Type of delivery
a) Vaginal delivery 24 48%
b) Instrumental delivery 4 8%
c) Lower segment cesarean section 22 44%

6. Family Income
a) Less than `. 5, 000/- per month 14 28%

b) `. 5001/- to 10, 000/- per month 22 44%

c) `. 10, 001/- to 15, 000/- per month 9 18%

d) More than `. 15, 001/- per month 5 10%

7. Age of the child

a) 1st day 6th day 22 44%
b) 7th day - 14th day 14 28%
c) 15th day - 21st day 9 18%
d) 22nd day - 28th day 5 10%

8. Sex of child
a) Male 30 60%
b) Female 20 40%

9. Weight of the baby

a) 2 - 2.5 kgs 10 20%
b) 2.5 - 3.0 kgs 16 32%
c) 3.0 - 3.5 kgs 19 38%
d) Above 3.5 kgs 5 10%
 32

Table 1 reveals distribution of demographic variables of post natal mothers.

Regarding age of the mother 11(22%) are the age group of 18-25 years, followed

by in the age group of 26-30 years17( 34%) and most of them were in the age

group of 31-36 years 22( 44%), no mother belongs to the age group of 36 and

above .

With regards to education of the mother 14 (28%) are illiterate, 22 (44%) of

mothers were having education upto 10th standard, followed by higher secondary

education 9 (18%), graduation and above are 5 (10%).

Regarding religion that most of the post natal mothers are belongs to Hindu 33

(66%), followed by Muslim 9(18%), Christians are 8(16%).

With regard to parity is concerned, 1st delivery mothers are18 (36%), almost 29

(58%) are 2nd delivery, followed by 3rd delivery are 3(6%), fourth delivery and

above are not present.

Regarding the type of delivery is taken into consideration, most the postnatal

mothers got normal delivery 24 (48%), lower segment cesarian section 22(44%),

instrumental delivery 4 (8%).

Regarding family income 14 (28%) was less than `. 5000, 22 (44%) were

`. 5001-10000, 9 (185) were `. 10001 -15000, 5 (10%) were 15001 and above.

Regarding the age of the child 22 (44%) are in the first 6 days, 14(28%)

are 7th 14th day, 9(18%) are 15th 21st day baby, 5(10%) are belongs to 22nd

28th day.

With to sex of the baby 30(60%) are male, 20 (40%) are female child.

With regard to weight of the baby 10(20%) babies are 2-2.5kg, 16(32%) are 2.5-3

kg, 19 (38%) are 3-3.5 kg, 5 (10%) weigh above 3.5 kg.
 33

50
18-25 years
45 44%
26-30 years
31-36years
40
36 and above
35 34%

30

25 22%
20

Percentage (%)
15

10

5
0%
0
18-25 years 26-30 years 31-36years 36 and above

Age of the Mother

Figure. 5 Distributions of Demographic Variables According to the Age

 34

50
Illiterate
45 44%
1st -10th standard
40 Higher secondary
Graduation and above
35

30 28%

25

20 18%

Percentage (%)
15
10%
10

0
Illiterate 1st -10th standard Higher secondary Graduation and above

Education

Figure. 6 Distribution of Demographic Variables According to the Education

 35

80
Hindu
70 66% Christian
Muslim
60

50

40

Percentage (%)
30

20 18%
16%

10

0
Hindu Christian Muslim

Religion

Figure. 7 Distribution of Demographic Variables According to the Religion

 36

70
First delivery
Second delivery
60 58%
Third delivery
Fourth delivery and above
50

40 36%

30

Percentage (%)
20

10 6%

0%
0
First delivery Second delivery Third delivery Fourth delivery and
above
Parity

Figure. 8 Distribution of Demographic Variables According to the Parity

 37

60
Vaginal delivery
Instrumental delivery
50 48% Lower segment cesarean section
44%

40

30

Percentage (%)
20

10 8%

0
Vaginal delivery Instrumental delivery Lower segment cesarean section

Type of delivery

Figure. 9 Distribution of Demographic Variables According to the Type of Delivery

 38

50
Less than `.
`. 5, 000/- per month
44%
`.
`. 5001/- to 10, 000/- per month
40 `.`. 10, 001/- to 15, 000/- per month
More than `.
`. 15, 001/- per month

30 28%

20 18%

Percentage (%)
10%
10

0
Less than `.
`. 5, 000/- per `.
`. 5001/- to 10, 000/- per `.
`. 10, 001/- to 15, 000/- More than `.
`. 15, 001/-
month month per month per month

Family Income

Figure. 10 Distribution of Demographic Variables According to the Family Income

 39

50
44%
7th day - 14th day

40 15th day - 21st day

22nd day - 28th day

30 28%

20 18%

Percentage (%)
10%
10

0
7th day - 14th day 15th day - 21st day 22nd day - 28th day

Age of the child

Figure. 11 Distribution of Demographic Variables According to the Age of the Child

 40

Male
Female

40%

60%

Figure. 12 Distribution of Demographic Variables According to the Sex of the Child

 41

45
2 - 2.5 kgs
40 38 2.5 - 3.0 kgs
3.0 - 3.5 kgs
35 Above 3.5 kgs
32

30

25
20
20

Percentage (%)
15
10
10

0
2 - 2.5 kgs 2.5 - 3.0 kgs 3.0 - 3.5 kgs Above 3.5 kgs

Weight of the baby

Figure. 13 Distribution of Demographic Variables According to the Weight of the Baby

 42

SECTION II

Table. 2 Distribution of Statistical Value of Pretest and Post Test Knowledge Scores

of Postnatal Mothers with Regard to Essential New Born Care

(N = 50)

S.No. Knowledge Mean S.D 't' value

1. Pretest 14.5 3.76

15.5*

2. Post test 20 1.4

*significant at 0.05 level

Table 2 shows that the pre test mean score was 14.5 and post test mean score

was 20. The calculated t value 15.5 at (49 df ) is significant at 0.05 level. The findings

implies that the planned teaching programme has significant effect in the

improvement of knowledge regarding essential newborn care.

 43

25
Pretest
Post test
20
20

15 14.5

Mean
10

0
Pretest Post test
Knowledge

Figure. 14 Comparison of Mean Score of Pretest and Post Test Knowledge Score Regarding Essential

New Born Care Among Postnatal Mothers

 44

Table. 3 Distribution of Statistical Value of Pretest and Post Test Practice Scores of

Postnatal Mothers with Regard to Essential New Born Care

(N = 50)

S.No. Practice Mean S.D 't' value

1. Pretest 10.7 2.4

16.0*

2. Post test 13 1.5

*significant at 0.05 level

Table 3 shows that the pre test mean score was 10.7 and post test mean score

was13. The calculated t value 16 at (49df ) is significant at 0.05 level. The findings

implies that the planned teaching programme has significant effect in the

improvement of practice regarding essential newborn care.

 45

14
13
Pretest

12 Post test
10.7

10

Mean
6

0
Pretest Post test
Practice

Figure. 15 Comparison of Mean Score of Pretest and Post Test Practice Score Regarding Essential

New Born Care Among Postnatal Mothers

 46

SECTION - III

Table. 4 Correlation Between Pretest Knowledge and Practice Scores of Postnatal

Mothers with Regard to Essential New Born Care

(N = 50)

S.No. Pretest Mean S.D r

1. Knowledge 14.5 3.7

+0.4
2. Practice 10.7 2.4

Table 4 shows that there was a positive correlation between the knowledge

and practice in pre test.

Table. 5 Correlation Between Post Test Knowledge and Practice Scores of Postnatal

Mothers with Regard to Essential New Born Care

(N = 50)

S.No. Post Test Mean S.D r

1. Knowledge 20 1.4
+0.5
2. Practice 13 1.5

Table 5 shows that there was a positive correlation between the knowledge

and practice in post test.

 47

SECTION IV

Table. 6 Association of Selected Demographic Variables with Level of Knowledge

with Regard to Essential New Born Care of Postnatal Mothers in Post Test Score

(N = 50)

Above Below 2
S. No. Variables
Mean Mean

1. Age of the Mother

a) 18 - 25 years 8 3
b) 26 - 30 years 12 5 14.67*
c) 31 - 36 years 13 9
d) 36 and above 0 0

2. Education
a) Illiterate 9 5
st th
b) 1 -10 standard 12 10 12.36*
c) Higher secondary 4 5
d) Graduation and above 4 1

3 Religion
a) Hindu 13 20
b) Christian 5 4 3.98
c) Muslim 4 4

4 Parity
a) First delivery 12 6
b) Second delivery 19 10 11.18*
c) Third delivery 2 1
d) Fourth delivery and above 0 0

5 Type of delivery
a) Vaginal delivery 14 10
b) Instrumental delivery 3 1 3.95
c) Lower segment cesarean section 10 12

(Table 6 continues)
 48

(Table 6 continued)

Above Below 2
S. No. Variables
Mean Mean

6 Family Income
a) Less than `. 5, 000/- per month 9 5
b) `. 5001/- to 10, 000/- per month 9 13 4.7
c) `. 10, 001/- to 15, 000/- per month 5 4
d) More than `. 15, 001/- per month 4 1

7 Age of the child

a) 1st day - 6th day 12 10
b) 7th day - 14th day 8 6 2.74
th st
c) 15 day - 21 day 6 3
nd th
d) 22 day - 28 day 1 4

8 Sex of child
a) Male 22 8 2.93
b) Female 5 15

9 Weight of the baby

a) 2 -2.5 kgs 6 4
b) 2.5-3.0 kgs 8 8 5.3
c) 3.0-3.5 kgs 9 10
d) Above 3.5 kgs 2 3

* Significant

Table 6 shows the associations of demographic variables with post test score
2
of knowledge regarding essential newborn care. The obtained values of age of the

mother is (14.67), education (12.36), parity (11.18) were significant at 0.05 level. It

reveals that there was a significant relationship between post test knowledge score

with age, education, parity. The other demographic variables are not associated with

knowledge.
 49

Table. 7 Association of Selected Demographic Variables with Level of Practice with

Regard to Essential New Born Care of Postnatal Mothers in Post Test Score

(N = 50)

Above Below 2
S. No. Variables
Mean Mean

1. Age of the Mother

a) 18 - 25 years 8 3
b) 26 - 30 years 4 15 4.67
c) 31 - 36 years 10 12
d) 36 and above 0 0

2. Education
a) Illiterate 4 10
b) 1st -10th standard 9 13 5.36
c) Higher secondary 4 5
d) Graduation and above 1 4

3. Religion
a) Hindu 15 18
b) Christian 5 4 3.98
c) Muslim 4 4

4. Parity
a) First delivery 11 7
b) Second delivery 20 9 10.18*
c) Third delivery 2 1
d) Fourth delivery and above 0 0

5. Type of delivery
a) Vaginal delivery 15 9
b) Instrumental delivery 3 1 3.5
c) Lower segment cesarean section 10 12

(Table 7 continues)
 50

(Table 7 continued)

Above Below 2
S. No. Variables
Mean Mean

6. Family Income
a) Less than `. 5, 000/- per month 9 5
b) `. 5001/- to 10, 000/- per month 13 9 3.68
c) `. 10, 001/- to 15, 000/- per month 5 4
d) More than `. 15, 001/- per month 3 2

7. Age of the child

a) 1st day - 6th day 12 10
b) 7th day - 14th day 6 8 2.49
c) 15th day - 21st day 6 3
nd th
d) 22 day - 28 day 1 4

8. Sex of child
a) Male 20 10 2.32
b) Female 7 13

9. Weight of the baby

a) 2 -2.5 kgs 4 6
b) 2.5-3.0 kgs 8 8 5.31
c) 3.0-3.5 kgs 9 10
d) Above 3.5 kgs 2 3

* Significant

Table 7 shows the associations of demographic variables with post test score
2
of practice regarding essential newborn care. The obtained values of parity (10.18)

are significant at 0.05 level. It reveals that there was a significant relationship between

post test practice score with parity. The other demographic variables are not

associated with practice.

 51

CHAPTER - V

Results and Discussion

This is a pre-experimental study intended to assess the effectiveness of

planned teaching programme with regard to essential new born care among post natal

mothers. The result of the study were discussed according to the objective.

The First Objective of the Study was to Assess the Knowledge and Practice of

Postnatal Mothers with Regard to Essential Newborn Care

Structured questionnaire was used to assess the knowledge. The pre test mean

score of knowledge was 14.5and post test mean score was 20.the practice mean score

in pre test was 10.7 and post test was 13. It shows significant difference in pre test and

post test. It implies that there is inadequate knowledge and practice regarding

essential new born care in pre test.

A similar type of study conducted by Carson (2009) to assess the knowledge

on newborn care. The scores of knowledge test were of an acceptable level, pre test

score of knowledge was 18, and the post test mean score was 23.

The Second Objective of the Study was to Deliver Planned Teaching Programme

with Regard to Essential Newborn Care

The planned teaching programme regarding essential new born care among

post natal mothers. The teaching was given by using power pint presentation to small

group of post natal mothers for 40-45 minutes and it was found to be effective as they

were communicating and clarifying their doubts related to essential new born care.
 52

A similar type of study done by Terry (2008) reveals that the teaching

programme was effective and have a positive health benefit to the new born.

The Third Objective of the Study was to Evaluate the Effectiveness of Planned

Teaching Programme with Regard to Essential Newborn Care

The obtained

significant at 0.05 level. It reveals that there was significant improvement in the

knowledge and practice with regard to essential new born care among post natal

mothers.

A similar type of study conducted by Usha (2005) chi-square test was used to

for the comparison of mean

The Fourth Objective of the Study was to Determine the Co-relation Between the

Knowledge and Practice of Postnatal Mothers with Regard to Essential Newborn

Care

The result of the study shows there is a positive correlation between

knowledge and practice with regard to the essential new born care in pre-test and post

test.

The Fifth Objective of the Study was to Find Out the Association Between

Knowledge and Practice with Selected Demographic Variables

The demographic variables like age, education, and the parity are associated

with knowledge score on essential new born care by using chi-square. It reveals that

there was no significant relationship between other demographic variables.

 53

The demographic variables like the parity is associated with practice score on

essential new born care by using chi-square. It reveals that there was no significant

relationship between other demographic variables.

A similar type of study was conducted by Majid (2007) to find out the

association between the demographic variables with post natal mothers knowledge

and practice. There was a strong association between age, parity, sex of the study .
 54

CHAPTER VI

Summary, Conclusion, Nursing Implications,

Limitations and recommendations

Summary

The study was conducted to assess the effectiveness of planned teaching

programme on Knowledge and Practices of Postnatal mothers with regard to essential

newborn care.

The Following Objectives were Set for the Study

To assess the knowledge and practice of postnatal mothers with regard to

essential newborn care.

To deliver planned teaching programme with regard to essential newborn care.

To evaluate the effectiveness of planned teaching programme with regard to

essential newborn care.

To determine the co-relation between the knowledge and practice of postnatal

mothers with regard to essential newborn care.

To find out the association between knowledge and practice with selected

demographic variables.

The Alternative Hypothesis Set for the Study

There is a significant difference between knowledge and practice with regard

to essential newborn care in pre & post test scores.

 55

Major Findings of the Study were as Follows

The pretest mean score of knowledge was 14.5 and post test score of

knowledge was 20 among postnatal mothers.

The pretest for practice was 10.7 and the post test score of practice was 13.

<0.05

level was 15.5.

<0.05 level

was 16.

The correlation between knowledge and practice in pretest regarding essential

new born care among post natal mothers was +0.4.

The correlation between knowledge and practice in post test regarding

essential new born care among post natal mothers was +0.5.

There was association between the post test knowledge score and age,

education, and parity but there was no association between the post test

knowledge scores and other demographic variables.

There was association between the post test practice score and parity but there

was no association between the post test practice scores and other

demographic variables.

Conclusion

The educative measures show that significant improvement in knowledge and

practice regarding essential new born care among post natal mothers. The post test

scores of knowledge and practice were high significant when compared with pretest

scores. Hence the alternative hypothesis accepted.

 56

Nursing Implications

The findings of the study have implications on various areas of nursing

education, nursing practice, nursing administration and nursing research.

Nursing Education

The findings of the study indicate that more emphasis should be placed in

the curriculum on the essential new born care. The nursing curriculum should

consists of knowledge and practices related to teaching strategies and various

modalities. So that nursing students can use different teaching methods to impart

the appropriate knowledge on essential new born care of the focus group. The

students learning experience should provide opportunity to conduct health

education campaign and supervised nursing practices about specific topics

Nursing Practice

Nursing professionals working in the community as well as in the hospital

can understand the importance of health education regarding essential new born

care. So that there is a need for developing structured teaching programme and

health education on different aspects about essential new born care in order to

improve the knowledge and practice regarding essential new born care.

Mass health education campaigns should be organized regularly by health

team to provide education towards essential newborn care and clear the doubts

regarding essential newborn care and motivating them to practice new born care.
 57

Nursing Administration

The nurse administrator should organize the in-service education training

program for nurses and other health care professionals to update their knowledge

and practice about essential newborn care. The nurse administrator should

motivate the health care professionals to organize campaign newborn care.

Nursing Research

The findings of the study serves as basis for the professional and the

student nurses to conduct further studies on essential newborn care. The study will

motivate the beginning researchers to conduct the same study with different

variables and large scale.

Limitations

The study was conducted on a small representative group

The sample size was only 50 hence the findings should be generalized with

caution

The study period was limited to one month

Recommendations

Similar study can be undertaken on a large sample for making a more valid

generalization.

Similar study can be done by including additional demographic variables.

A comprehensive study can be conducted between rural postnatal mothers and

urban postnatal mothers.

Similar study can be undertaken by descriptive study .

An experimental study can be undertaken with control group for effective

comparison.
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 ABSTRACT

Statement of the Problem : A Study to Assess the effectiveness of planned teaching

programme on Knowledge and Practice of Postnatal mothers with regard to essential

newborn care at Kovilpalayam, Coimbatore. Study Objectives : (a) To assess the

knowledge and practice of postnatal mothers with regard to essential newborn care.

(b) To deliver planned teaching programme with regard to essential newborn care.

(c) To evaluate the effectiveness of planned teaching programme with regard to

essential newborn care. (d) To determine the co-relation between the knowledge and

practice of postnatal mothers with regard to essential newborn care. (e) To find out

the association between knowledge and practice with selected demographic variables.

Methodology : One group pretest and post test experimental design. The samples for

this present study consisted of 50 postnatal mothers selected by using Non probability

convenient-sampling technique. A questionnaire and check list was used to assess the

knowledge and practice. Result : Inferential and Descriptive statistics were used to

ue in knowledge and practice was higher than

the table value. Conclusion : The study revealed that there is an improvement in

knowledge and practice after delivering the planned teaching programme

To
The Managing Director,

Through
The Principal,
PPG College of Nursing
Coimbatore 35.

Respected Sir,
Sub : Seeking permission for conducting research study

I am a student of M.Sc Nursing in PPG College of Nursing. Our college is affiliated to

the Tamilnadu Dr. M. G. R Medical University, Chennai. I have taken the
specialization in Child Health Nursing.

Topic : A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED

TEACHING PROGRAMME ON KNOWLEDGE AND PRACTICE
OF POSTNATAL MOTHERS WITH REGARD TO ESSENTIAL
NEWBORN CARE AT KOVILPALAYAM, COIMBATORE

I request you to kindly permit me to conduct my study in hospital. Hope you will
consider my requisition and do the needful.

Thanking you,
Yours sincerely,
Date :
Place : Coimbatore
 Requisition Letter for Content Validity

From

M.Sc (N) II Year,

PPG College of Nursing,
Coimbatore 35.

To

Through : Principal, PPG College of Nursing

Respected Sir/Madam,

Sub : Requisition for expert opinion and suggestion for content validity of tool

I am a student of M.Sc (N) II year, PPG College of Nursing affiliated to the

Tamilnadu Dr. M. G. R. Medical University, Chennai. As a partial fulfillment of the
M.Sc (N) programme. I am conducting

A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED

TEACHING PROGRAMME ON KNOWLEDGE AND PRACTICE OF
POSTNATAL MOTHERS WITH REGARD TO ESSENTIAL NEWBORN
CARE AT KOVILPALAYAM, COIMBATORE

Herewith I have enclosed the developed tool for content validity and for the
expert opinion and possible solution. It would be very kind of you to return the same
as early as possible.

Thanking you,
Yours faithfully,
 Format for the Content Validity

Name of the expert :

Address :
Total content for the tool :
Kindly validate each tool and tick wherever applicable

No. of Strongly Not Need

S.No Agree O.K Remarks
Tool/Section Agree Applicable Modification

Remarks Signature of the Expert with Date

 LIST OF EXPERTS

1. Dr. ASHOK KUMAR, M.D,F.P.C.C,

Department of Paediatrics,

Ashwin Hospital,

Coimbatore.

2. Dr. JUNIE MARY MATHEW M.sc (N) ., Ph.D.,

Department of Paediatrics,

SME College of Nursing,

Kottayam.

3. Prof. BABITHA, M.Sc (N).,

Department of Paediatrics,

Nightingale College of Nursing,

Coimbatore.

4. Prof. B . YOGESH KUMAR, M.sc (N).,

Department of Paediatrics,

BRS College of Nursing,

Punjab.

5. Prof. PRIYA, M.Sc (N)., M.Phil.,

Department of paediatrics

C.B.H College of Nursing,

Nagerkovil.
 SECTION - I

Demographic Data

Instructions

Read the following questions carefully and give tick mark ( ) in given boxes

for correct answers

Sample Number _________________

1. Age

a) 18-25 years

b) 26-30 years

c) 31-36years

d) 36 and above

2. Education

a) Illiterate

b) 1st -10th standard

c) Higher secondary

d) Graduation and above

3. Religion

a) Hindu

b) Christian

c) Muslim
4. Parity

a) First delivery

b) Second delivery

c) Third delivery

d) Fourth delivery and above

5. Type of delivery

a) Vaginal delivery

b) Instrumental delivery

c) Lower segment cesarean section

6. Family Income

a) Less than `. 5,000/- per month

b) `. 5001/- to 10,000/- per month

c) `. 10,001/- to 15,000/- per month

d) More than `. 15,001/- per month

7. Age of the child

a) 1st day - 6th day

b) 7th day - 14th day

c) 15th day - 21st day

d) 22nd day - 28th day

8. Sex of the child

a) Male

b) Female
9. Weight of the child

a) 2 - 2.5 kgs

b) 2.5 - 3.0 kgs

c) 3.0 - 3.5 kgs

d) Above 3.5 kgs

 SECTION - II

Questions on Knowledge of Postnatal Mothers with Regard to

Essential Newborn Care

Instructions

Read the following questions carefully and give tick mark ( ) in given boxes

for correct answers

1. How can you maintain body heat of the baby?

a) Dress the baby with napkin and shirt

b) Dress the baby with shirt, napkin and cap

c) Dress the baby with cap, socks, napkin, shirt and wrap the towel

d) Dress the baby with napkin and socks and wrap with towel

2.

heat of the baby?

a) Covering of the hands and arms

b) Covering of the body

c) Covering of the legs and feet

d) Covering of the head

3. What is rooming in?

a) Baby and mother lie down in the same bed

b) Baby and mother sleeps in one room

c) Baby and mother lie down in the seperate bed

d) Baby is kept in a room

4.

a) Hands and legs will be cool

b) Abdomen and legs will be cool

c) Only heads and legs will be cool

d)

5. What do you mean by exclusive breast feeding?

a)

b) Feeding breast milk alone

c)

d) Avoiding breastfeeding to the baby

6. When do you initiate breast feeding to the baby?

a) Within half an hour after the birth of the baby

b) Four hours after the birth of the baby

c) 2days after the birth of the baby

d) 3days after the birth of the baby

7. How often do you breastfeed the baby?

a) Once in 4 hours

b) Whenever the baby demands

c) 3 times in a day

d) Once in a day
8. Which of the following should be done before breast feeding?

a) Clean the breast

b) Take bath

c) Wash hands

d) None of the above

9. How do you hold the baby while breast feeding?

a)

b)

c)

d) be slightly elevated than body

10. How do you know that the baby has taken sufficient feed?

a) Keeps awake for longer times

b) Plays well

c) Sleeps well

d) Cries well

11. How can you keep the baby awake while feeding?

a) By tickling the nose

b) By tickling the hands

c) By rubbing the back

d) By tickling behind ears and on soles

12. How do you expel the swallowed air from the baby?

a)

the abdomen of the baby

b) Making the baby to lie down on the shoulder of the mother

and gently patting on back of the baby

c) Making the baby in side lying position and gently pressing

the abdomen of the baby

d) Making the baby in side lying position and gently pressing the

back of the baby

13. How do you clean the eyes of the new born?

a) From side of the nose to away from the nose(inner

canthus to outer canthus)

b) From side of the eyes towards the nose (outer canthus to

inner canthus)

c) Upper eye lid to lower eye lid

d) Lower eye lid to upper eye lid

14. How do you prevent eye infection?

a) Clean the eyes by using oil

b) Clean the eyes by using breast milk

c) Clean the eyes by using water

d) Clean each eye by using the separate cotton cloth

15. What are the signs of eye infection?

a) Redness

b) Discharge

c) Both (a) & (b)

d) None of the above

16. How do you take care of umbilical cord?

a) Keep the cord covered and dry

b) Keep the cord open and dry

c) Apply coconut oil

d) Apply talcum powder

17. What are the signs of umbilical cord infection?

a) Foul smell

b) Discharge

c) Both (a) & (b)

d) None of the above

18. What type of bath is preferred during winter season?

a) Wipe the baby with wet cloth immersed in warm water

b) Giving bath with very hot water

c) Giving bath with warm water

d) Avoiding bath
19. How do you dry the baby after bath?

a) Wipe the baby from foot end to head end

b) Wipe the baby head end to foot end

c) Wipe the baby from front to back

d) Wipe the baby from back to front

20.

a) Each time after passing motion

b) Each time after passing urine

c) Each time after passing motion and urine

d) While giving bath

21. How do you prevent infection to the baby?

a) Wash hands after handling the baby

b) No need to wash hands

c) Wear gloves before handling the baby

d) Wash hands before handling the baby

22. All of the following measures prevent urinary tract infection

For the baby except

a) Wash hands before bathing

b) Changing wet nappy

c) Cleaning the genitalia after passing urine and motion

d) Adequate intake of breast feed

23. Which of the following are killer diseases for the child?

a) Tuberculosis, Polio, Measles

b) Diphtheria, whooping cough, tetanus

c) Both (a) & (b)

d) None of the above

24. Why immunization is important for the baby?

a) To protect against infectious diseases

b) To protect against allergies

c) To protect against hereditary diseases

d) To protect against vitamin deficiencies

25. Soon after the birth, what are the vaccines should be given to the baby?

a) BCG, Polio drops, DPT

b) BCG, Polio Drops, Measles

c) BCG, Polio drops, Tetanus

d) BCG, Polio drops, Hepatitis-B

26. Why hepatitis B is given for the newborn?

a) To protect against brain fever

b) To protect against jaundice

c) To protect against tetanus

d) To protect against chickenpox

27. Which of the following vaccine protects against tuberculosis?

a) Measles

b) DPT

c) Hepatitis-B

d) BCG

28. How can you manage the baby with fever and pain after vaccination?

a) Avoid giving bath

b) Give warm application at the site of injection

c) Give paracetamol drops as per doctors order

d) No need to do anything

29. Which of the following do not have booster dose?

a) Polio drops

b) BCG

c) Hepatitis B

d) DPT

30. What is pulse polio?

a) Giving polio drops to children as per the schedule

b) Giving polio drops to all children less than five years on the

same day for two times in a year

c) Giving polio drops to children less than 10 years

d) Giving polio drops to children less than 15 years

 SECTION - III

Observation Check List to Assess the Practices of Postnatal Mothers with

Regard to essential new born care

Instructions

Read the following questions carefully and give tick mark ( ) in given boxes

for correct answers

S. No. Items on practices Yes No

1. Mother dresses the baby with shirt, cap, socks, nappy and
wrap with towel.

2. Mother covers the head with cap.

3. Mother and baby lie down together in a bed.

4. Mother checks abdomen and legs for heat loss.

5. Mother cleans the breast before giving the breast feeding.

6. Mother provides only breast feeding for the baby.

7. Mother provides glucose water/honey before feeding the

baby.

8. Mother gives breast feeding whenever the child cries

9. Mother holds the head slightly elevated than body while

feeding the baby

10.
feeding the baby

11. Baby sleeps well before feeding

12. Mother no need to keeps the baby awake while feeding.

13. Mother keeps patts gently on back of the baby before each
feed to break the wind

14. Mother cleans the eyes from outer canthus to inner canthus for
the baby.

15. Mother cleans each eye by using a same cotton cloth

 SECTION - II

Answer Key

S. No. Answers score

1. d 1
2. d 1
3. a 1
4. b 1
5. b 1
6. a 1
7. b 1
8. a 1
9. d 1
10. c 1
11. d 1
12. b 1
13. a 1
14. d 1
15. c 1
16. b 1
17. c 1
18. a 1
19. b 1
20. c 1
21. d 1
22. a 1
23. c 1
24. a 1
25. d 1
26. b 1
27. d 1
28. c 1
29. b 1
30. b 1
 SECTION - III

Answer Key

Q. No. Answers Score

1. YES 1

2. YES 1

3. YES 1

4. YES 1

5. YES 1

6. YES 1

7. YES 1

8. YES 1

9. YES 1

10. YES 1

11. NO 1

12. NO 1

13. NO 1

14. NO 1

15. NO 1
 g F jp - m

Kiwahd Neh;fhzy; gbtk;

khjphp vz; : ___________

1. taJ tUlq;fspy;

m) 18-25

M) 26-30

,) 31-36

<) 36 kw;Wk; mjw;F Nky;

2. fy;tp

m) gbg;gwptpy;iy

M) 1 tJ Kjy; 10 tJ tiu

,) ,ilepiyf;fy;tp

<) gl;lk; kw;Wk; mjw;F Nky;

3. kjk;

m) ,e;J kjk;

M) fphp];j;Jth;

,) K];yPk;
4. kfg;NgW vz;zpf;if

m) Kjy;

M) ,uz;lhtJ

,) %d;whtJ

<) ehd;fhtJ kw;Wk; mjw;F Nky;

5. gpurt Kiw

m) Rfg;gpurtk;

M) MAjKiw gpurtk;

,) mWit rpfpr;ir Kiw gpurtk;

6. FLk;g khj tUkhdk;

m) &. 5000 tpl Fiwthf

M) &. 5001- &. 10>000 tiu

,) &. 10>001- &. 15>000 tiu

<) &. 15> 001 kw;Wk; mjw;F Nky;

7. Foe;ijapd; taJ

m) 1 Kjy; 6 ehl;fs;

M) 7 Kjy; 14 ehl;fs;

,) 15 Kjy; 21 ehl;fs;

<) 22 Kjy; 28 ehl;fs;

8. Foe;ijapd; ghypdk;

m) Mz;

M) ngz;

9. Foe;ijapd; vil

m) 2 - 2.5 fp.fp

M) 2.5 - 3 fp.fp

,) 3.0 - 3.5 fp.fp

<) 3.5 fp.fp f;F Nky;

 g F jp - M

mj;jpathrpa Foe;ij guhkupg;G Fwpj;J gpurtj;jpw;F gpwF

jha;khh;fs; mwpT Nfs;tpfs;

1. vt;thW ePq;fs; Foe;ijapd; cly; ntg;gj;ij jf;fitj;Jf; nfhs;s

KbAk;?

m) Foe;ijf;F fhy; rl;il kw;Wk; rl;il cLj;Jjy;;

M) Foe;ijf;F fhy; rl;il> rl;il kw;Wk; njhg;gp cLj;Jjy;

,) Foe;ijf;F njhg;gp> rhf;]>; rl;il kw;Wk; Jz;L cLj;Jjy;

<) Foe;ijf;F rhf;];> fhy;rl;il kw;Wk; Jz;L cLj;Jjy;

2. Foe;ijapd; cly; ntg;gepiyia jf;fitf;f Foe;ijapd; ve;j

gFjpia %l Ntz;Lk;.

m) cs;sq;if gFjp

M) KOtJk;

,) fhy; kw;Wk; cs;sq;fhy;

<) jiy gFjp

3. &kpq; vd;why; vd;d?

m) Foe;ij kw;Wk; jha; xNu gLf;ifapy; ,Ug;gJ

M) Foe;ij kw;Wk; jha; xNu miwapy; ,Ug;gJ

,) Foe;ij jha; ntt;NtW gLf;ifapy; ,Ug;gJ

<) Foe;ij jdp miwapy; ,Ug;gJ

4. Foe;ij cly; ntg;gk; ,of;Fk; NghJ Foe;ij cly; epiy vt;thW

,Uf;Fk; ?

m) iffs; kw;Wk; fhy;fs; Fsph;e;J ,Uf;Fk;

M) tapW kw;Wk; fhy;fs; Fsph;e;J ,Uf;Fk;

,) jiy kw;Wk; fhy;fs; Fsph;e;J ,Uf;Fk

<) Foe;ijapd; clypy; ve;j khw;wKk; ,y;iy

5. ePq;fs; jha;ghy; kl;Lk; jUtJ vd;gjw;f;fhd mh;j;jk; vd;d?

m) gRtpd; ghy; jUtJ

M) jha;g;ghy; kl;Lk; jUtJ

,) jha; ghy; kw;Wk; gRtpd; ghy; jUtJ

<) Foe;ijf;F jha;g;ghy; NfhLg;gij jtph;j;jy;

6. ePq;fs; Foe;ijf;F vg;NghJ jha;gg

; hy; nfhLf;f njhlq;FtPh;fs;?

m) Foe;ij gpwe;j ½ kzp Neuj;jpw;F gpwF

M) Foe;ij gpwe;j 4 kzp Neuj;jpw;F gpwF

,) Foe;ij gpwe;j 2 ehl;fSf;F gpwF

<) Foe;ij gpwe;j 3 ehl;fSf;F gpwF

7. ePq;fs; Foe;ijf;F vj;jid Kiw jha;g;ghy; nfhLg;gPw;fs;?

m) 4 kzp Neuj;jpw;F xU Kiw

M) Foe;ijapd; Njitf;Nfw;g;g

,) xU ehisf;F 3 jlit

<) xU ehisf;F 1 jlit

8. gpd;tUtdtw;Ws; vij jha;g;ghy; jUtjw;F Kd; nra;a Ntz;Lk;?

m) khh;gf Rj;jk;

M) Fspf;f Ntz;Lk;

,) iffs; fOt Ntz;Lk;

<) vJTk; Njitapy;iy

9. Foe;ijf;F jha;g;ghy; nfhLf;Fk; NghJ vt;thW Foe;ijia gpbf;f

Ntz;Lk;?

m) Foe;ijapd; jiy kw;Wk; Njhs;gl;il Neuhf ,Uf;f Ntz;Lk;

M) Foe;ijapd; jiy kw;Wk; cly; Neh;Nfhl;by; ,Uf;f Ntz;Lk;

,) Foe;ijapd; jiyia jho;j;jp gpbf;f Ntz;Lk;

<) Foe;ijapd; jiyia jho;j;jpgpbf;f Ntz;Lk;

10. Foe;ij NghJkhd ghy; cl;nfhz;lij vt;thW mwptPh;fs;?

m) ePz;l fhyk; tpopj;J ,Ug;gJ

M) ed;whf ,Ug;gJ

,) ed;whf cwq;FtJ

<) ed;whf mOtJ

11. Foe;ijf;F jha;g;ghy; nfhLf;Fk; NghJ vt;thW tpopj;jpUf;f itg;gPh;fs;?

m) %f;F Edpia njhLtjd; %yk;

M) iffis njhLtjd; %yk;

,) KJF gFjpia jlTtjd; %yk;

<) fhJ kly; kw;Wk; cs;sq;fhy;fis njhLtjd; %yk;

12. Foe;ij cl;nfhz;l fhw;iw vt;thW ntspNaw;WtPh;fs;?

m) Foe;ij jhapd; kbapy; mku itj;J tapw;Wg; gFjpia

nkJthf mOj;Jjy;

M) Foe;ijia jhapd; Njhspy; itj;J nkJthf jl;bf;

nfhLg;gJ

,) Foe;ijia gf;f epiyapy; gLf;f itj;J tapw;W gFjpia

mOj;Jjy;

<) Foe;ijia gf;fepiyapy; gLf;f itj;J > KJF gFjpia

jlTjy;

13. ePq;fs; gpwe;j Foe;ijapd; fz;fis vt;thW Rj;jk; nra;tPh;fs;

m) fz;fs; cs;spUe;J ntspg;gf;fk;

M) fz;fs; ntspgf;fk; ,Ue;J cs;gf;fk;

,) Nky; kw;Wk; fPo; ,ik

<) fPo; kw;Wk; Nky; ,ik

14. ePq;fs; fz; njhw;W guthky; ,Uf;f vd;d nra;tPh;fs;?

m) vz;nza; gad;gLj;jp fz;fis gad;gLj;Jjy;

M) khh;gf ghy; gad;gLj;jp fz;fis Rj;jk; nra;jy;

,) ePh; %yk; fz;fs; Rj;jk; nra;jy;

<) jdp gUj;jp Jzp gad;gLj;jp xt;nthU fz;izAk;

Rj;jk; nra;jy;
15. fz; njhw;W Nehapd; milahsq;fs; vd;d?

m) fz; rpte;J ,Uj;jy;

M) ePh; tbjy;

,) Nkw;fz;l ,uz;Lk;

<) vJTk; ,y;iy

16. ePq;fs; njhg;Gs; nfhbia vt;thW ghh;j;Jf; nfhs;tPh;fs;?

m) njhg;Gs; nfhbia %b itj;J cyu itj;jy;

M) njhg;Gs; nfhbia jpwe;j epiyapy; itj;jy;

,) Njq;fha; vz;nza; jltp

<) gTlh; jlTtjd; %yk;

17. njhg;Gs; nfhbapd; njhw;W mwpFwpfs; vd;d?

m) Jh;ehw;wk;

M) ePh; tbjy;

,) Nkw;fz;l ,uz;Lk;

<) ,it vJTk; ,y;iy

18. Fsph; fhyq;fspy; vd;d tif Fspay; rpwe;jJ?

m) #lhd ePh; kw;Wk; Jzpahy; Foe;ijia Jilj;jy;

M) kpfTk; #lhd jz;zPh; Fspay; nfhLj;jy;

,) #lhd jz;zPh; Fspay;

<) Fspay; jtph;j;jy;

19. Foe;ijia Fspghl;bagpd; vt;thW Jilg;gPh;fs;?

m) Foe;ijapd; fhy; Kjy; jiy tiu

M) Foe;ijapd; jiy Kjy; fhy; tiu

,) Kd;gFjp kw;Wk; gpd;gFjp

<) gpd;gFjp kw;Wk; Kd;gFjp

20. Foe;ijapd; gpwg;G cWg;G vj;jid jlit Rj;jk; nra;a Ntz;lk;

m) kyk; fopj;jgpwF xt;nthU KiwAk;

M) rpWePh; fopj;j gpwF

,) rpWePh; fopj;j gpwF

<) Fspaypd; NghJ

21. ePq;fs; Foe;ijf;F njhw;W Vw;glhky; ,Uf;f vd;d nra;tPh;fs;?

m) Foe;ijia ifahz;l gpwF iffis fOTjy;

M) iffis fOt Ntz;ba mtrpak; ,y;iy

,) Foe;ij njhLtjw;F Kd; ifAiwfs; mzptJ

<) Foe;ijia njhLtjw;F Kd;G iffis fOTjy;

22. rpWePh; ghij Neha; njhw;W jLg;gjw;f;fhd fhuzpfs; ,it

midj;Jk;> xd;iw jtpu mJ vJ?

m) Fspf;Fk; Kd; iffis ed;whf fOtJ

M) <ukhd Jzpia khw;Wjy;

,) rpWePh; kw;Wk; kyk; fopj;j gpwF Rj;jk; nra;jy;

<) NghJkhd msT ghy; nfhLj;jy;

23. gpd;tUtdtw;Ws; vit kpff;nfhba Neha;fs;?

m) fhrNeha;> NghypNah> jl;lk;ik

M) njhz;il milg;ghd; Neha;> ff;Fthd;

,Uky;> nll;ld];

,) Nkw;fz;l ,uz;Lk;

<) ,it vJTk; ,y;iy

24. Vd; Foe;ijfSf;F jLg;Grp mtrpakhFk;.

m) njhw;W Neha;fSf;F vjpuhf ghJfhf;f

M) xt;thikf;F vjpuhf ghJfhf;f

,) guk;giu Neha;fSf;F vjpuhf ghJfhf;f

<) rj;Jf;Fiwghl;Lf;F vjpuhf ghJfhf;f

25. Foe;ij gpwe;jTld; nfhLf;fNtz;ba jLg;G+rp vit?

m) gprp[p> NghypNah nrhl;L kUe;J> bgpb

M) gprp[p> NghypNah> kprpy;];

,) gprp[p> NghypNah> nll;lhd];

<) gprp[p> NghypNah> kQ;rs; fhkhiy - gp

26. Vd; n`gilb]; - gp gpwe;j Foe;ijf;F nfhLf;fg;gLfpwJ?

m) %isf; fha;r;rYf;F vjpuhf ghJfhf;f

M) kQ;rs; fhkiyf;F vjpuhf ghJfhf;f

,) Vw;Gtypf;F vjpuhf ghJfhf;f

<) rpd;dk;ikf;F vjpuhf ghJfhf;f

27. gpd;tUtdtw;Ws; ve;j jLg;G+rp fhrNeha;f;F vjpuhf ghJfhf;fpwJ?

m) jl;lk;ik

M) bgpb

,) n`gilb]; - gp

<) gp.rp.[p

28. Foe;ijf;F jLg;G+rp nfhLj;j gpwF Vw;gLk; fha;r;ry; kw;Wk; typia

vt;thW rhpnra;tPh;fs;?

m) Fspaiy jtph;g;gJ

M) #lhd xj;jlk; nfhLg;gJ

,) fha;r;ry; kUe;J nfhLg;gJ

<) vJTk; Njitapy;iy

29. gpd;tUtdtw;Ws; vjw;F G+];lh; Nlh]; Njitapy;iy?

m) NghypNah nrhl;L kUe;J

M) gp.rp.[p

,) kQ;rs; fhkhiy gp

<) b.gp.b

30. gy;]; NghypNah vd;why; vd;d?

m) ml;ltidg;gb NghypNah nrhl;L kUe;J nfhLg;gJ

M) 5 taJf;F FIwthd midj;J Foe;ijfSf;Fk;

XNu ehspy; tUlj;jpw;F ,UKiw jUtJ

,) 10 tajpw;F Fiwthf Foe;ijfSf;F jUtJ

<) 15 tajpw;F Fiwthf Foe;ijfSf;F jUtJ

 gFjp- ,

vz; eilKiwfs; Mk; ,y;iy

1. Foe;ijia rl;il> rhf];> Foe;ij Milfs;

kw;Wk; Jz;L nfhz;L Nghh;j;jp itf;f

Ntz;Lk;

2. Foe;ij jiyia njhg;gp nfhz;L %lNtz;Lk;

3. jha; kw;Wk; Foe;ij gLf;ifapy; xd;whf

gLj;Jf;nfhs;s Ntz;Lk;

4. Foe;ijapd; tapW kw;Wk; fhy; gFjpia njhl;L

ntg;gj;ij czu Ntz;Lk;

5. jha;g;ghy; nfhLf;Fk; Kd; khh;gf gFjpia

Rj;jk; nra;a Ntz;Lk;

6. jha; Foe;ijf;F jha;g;ghy; kl;Lk; toq;f

Ntz;Lk;

7. Foe;ijf;F FSf;Nfh]; kw;Wk; Njd; ghy;

Gfl;Ltjw;FKd; nfhLf;f Ntz;lk;

8. Foe;ij mOk; Nghnjy;yhk; mk;kh jha;ghy;

nfhLf;f Ntz;Lk;.

9. Foe;ijf;F ghy; Gfl;Lk;NghJ rw;W jiyia

cah;j;jp gpbf;f Ntz;Lk;

10. Foe;ij ghy; Fbf;Fk; NghJ jhapd; khh;gfg;

gFjp KOtJkhf Foe;ijapd; thapy; ,Uf;f

Ntz;Lk;

11. Foe;ij jha;ghy; Fbf;Fk; Kd; ed;whf cwq;f

Ntz;Lk;

12. Foe;ij jha;g;ghy; mUe;Jk; NghJ tpopj;jpUf;f

Ntz;ba mtrpakpy;iy.

13. Foe;ijf;F xt;nthU Kiw ghy;; Gfl;Lk;

NghJk; KJF gFjpia nkJthf jltptpl

Ntzz;Lk;

14. Foe;ijapd; fz;fis ntspg;Gwk; ,Ue;J

cl;Gwkhf Rj;jk; nra;a Ntz;Lk;

15. Foe;ijapd; ,U fz;fisAk; xNu Jzpia

nfhz;L Jilf;f Ntz;Lk;.

 -
gjpy;fs;

Nfs;tp vd; gjpy; kjpg;ngz;

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 -
gjpy;fs;

Nfs;tp vd; gjpy; kjpg;ngz;

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A STUDY TO ASSESS THE EFFECTIVENESS OF PLANNED
TEACHING PROGRAMME ON KNOWLEDGE AND
PRACTICE OF POSTNATAL MOTHERS WITH
REGARD TO ESSENTIAL NEWBORN
CARE AT KOVILPALAYAM,
COIMBATORE
 HEALTH EDUCATION ON ESSENTIAL NEWBORN CARE

Topic : Essential Newborn Care

Group : Postnatal Mothers

Place : Postnatal Ward

Time : 30 minute

Metods of taeching : Lecture cum Discussion

Teaching aid : Power Point Presentation

Centarl Objective

At the end of the class the mothers will acquire in depth knowledge regarding Essential newborn care.

Specific Objective

The mothers will able to

Introduce the topic

List down the principles of newborn care

Enlist the essentials of newborn care

Explain about the Warm chain

Describe the initiating breast feeding

Explain about the prevention of infections

 Teacher
Specific Objective Content
Activity
Introduce the topic Introduction

More than half of the deaths during the infancy occur during the neonatal period (28 days of life). L

asphyxia, hypothermia, and infections. Babies born with a low birth weight (less than 2500 gms) are at a C

higher risk of dying due to these causes. By taking care of the health of the mother during pregnancy and by T

providing essential newborn care in the health facility can be reduced significantly. U

Care of the mother during antenatal period and delivery, and provision of essential care to the I

newborn at birth and during the neonatal period can reduce neonatal and infant mortality rates significantly. N

Under the CSSM programme and now under the RCH programme, the interventions aimed at improving G

survival of infants during the prenatal period are being undertaken.

List down the Principles of Newborn Care

principles of Prevention of hypothermia

newborn care Exclusive breast feeding

Prevention of infection

Enlist the essentials Essentials of Newborn Care L

of newborn care The four basic needs of all babies at the time of birth (and for the first few weeks of life) E

Warmth C

Mothers milk T

Protection from infection U

G
 mother and other

caregivers. Therefore it is important to provide proper care to all the neonates immediately after birth. All

newborns require essential newborn care to minimize the risk of illness and maximize their growth and

development. This care will also prevent many newborn emergencies.

Explain about the Ensuring Warmth : Warm Chain L

Warm chain E

the baby will become ill and may even die. This is a way a baby MUST be dried immediately after birth and C

delivered onto a warm towel or piece of cloth, and loosely wrapped before being placed naked between the T

R
Warm Chain
I
Keep the baby clothed and wrapped with the head covered
N
Minimize bathing especially in cool weather or for small babies
G
Keep the baby close to the mother
 Use kangaroo care for stable LBW babies and for re-warming stable bigger babies

Show the mother hoe to avoid hypothermia, how to recognize it, and hoe to re-warm a cold baby.

Describe the Initiating Breast Feeding L

initiating breast During the initial skin-to-skin contact position after birth, the baby should keep between the mothers E

feeding breast; this would ensure early initiation of breast feeding. C

T
Initially, the baby might want to rest and would be a sleep. This rest period may from a few minutes
U
to 30-40 minutes before the baby shows signs of wanting to breastfeed. After this period ( remember each
R
baby is different and this period might vary), the baby will usually open his/her mouth and start to move the
I
head from side to side; he may also being to dribble. These signs indicate that the baby is ready to
N
breastfeed.
G

The mother should be helped in feeding the baby shows these signs. Both the mother and the baby
 opposite the nipple and areola. The baby should attach to the breast by itself when it is ready. When the

baby is attached, attachment and positioning should be checked. The mother should be helped to correct

anything which is not quite right.

Explain about the Prevention of Infections L

prevention of Clean Chain E

infections C

from the adverse environment of surroundings; cleanliness at delivery reduces the risk of infection for the T

mother and the baby, especially neonatal sepsis and tetanus. Cleanliness requires mothers, families and U

health professional to avoid harmful traditional practices, and prepare necessary materials. Hand washing is R

the single most important step to be emphasized to both family members and health care workers. I

N
Measures to Prevent Infection
G
All care givers should wash hands before handling the baby

Feed only breast milk

Keep the cord clean and dry; do not apply anything

 wash your hands after changing daiper/napkin. Keep the baby

clothed and wrapped with the head covered.

L
Care of the Cord
E

I
Instruction to the Mother on Cord Care
N
No tub bathing until cord falls off. Do not sponge bath to clean the baby. See to it that cord as baby
G
powder or antibiotic, except the prescribed antiseptic solution which is 70% alcohol.

Avoid wetting the cord. Fold diaper below so that it does not cover the cord and does not get wet

when the diaper soaks with urine.

Leave cord exposed to air. Do not apply dressing or abdominal binder over it. The cord dries and

separates more rapidly if it is exposed to air.

 If you notice the cord to be bleeding, apply firm pressure and check cord clamp if loose and fasten.

Report any unusual signs and symptoms which indicate infection.

Foul odour in the cord L

Presence of discharge E

Redness around the cord C

The cord remains wet and does not fall off within 7 to 10 days T

Newborn fever U

R
Eye Care
I

N
diseases are common, eye care is needed soon after delivery because infections such as gonorrhoea can be
G
passed onto the baby during the birthing process which can result in blindness

A baby's eyes should be wiped as soon as possible after birth. Both eyes should be gently wiped

with separate sterile swabs soaked in warm sterile water.

 Eye drops or ointment should be given within one hour of delivery. This can be done after the baby

has been dried or when he is being held by his mother.

L
After instilling the eye drops, care should be taken so that the drug is not washed away
E

Do's: C

Clean eyes immediately after birth with swabs soaked in sterile water using separate swabs for each T

eye. Clean from medial to lateral side U

Give prophylactic eye drops within 1 hour of birth as per hospital policy R

I
Don'ts:
N
Do not apply anything else (e.g.Kajal) in the eye
G

Bathing

Newborn babies are very delicate and therefore bathing a newborn baby can be an intimidating task.

As a result most parents forget that bathing a newborn baby can be converted into one of the enjoyable

routines of the day.

Follow the Below Mentioned Tips for Bathing a New Born Baby Safely

Always prefer sponge bathing for your newborn baby as it allows the scab developed on the

umbilical cord to fall off and allows the navel to heal. L

Assemble all accessories such as a shallow plastic basin filled with several inches of warm water, a E

soft blanket or towel, a wash cloth, change of clothes, clean diaper, cotton balls, extra towels, mild C

baby shampoo and soap(if necessary) for the sponge bathing. T

Place your baby on his back on the towel or blanket on the changing table pad. Keep the bathing U

room warm for the baby. R

Fill the infant tub with bath water up to two inches. The ideal water temperature suitable for your I

newborn baby is 90 degrees Fahrenheit (32 degrees Celsius). Avoid using hot water as it can N

accidentally scald the skin of your baby. G

such as underarms, behind the ears, neck and diaper area need thorough cleaning. Use soap only

when your newborn baby is dirty. Be gentle in washing your newborn baby as they may experience
 pain when there is too much poking and prodding.

Make sure you hold your newborn baby by placing one hand on the baby firmly. Get assistance from

someone to get the needed accessories while bathing your baby. Never leave your baby unattended L

or alone in the tub. E

Use few drops of no- C

hair appears too dirty. T

Gently dry the baby using a towel. If you observe peeling skin, apply a mild baby lotion after bath. U

Dead skin in newborns is common and usually comes off itself. Put on the diaper and clothes and R

place her in a safe place, such as a crib or a baby seat before you remove the bath supplies. I

N
Immunization
G
Most newborns do not need any vaccinations, unless the mother carries the hepatitis B virus.

If parents have hepatitis B, the baby should be vaccinated against it within 12 hours after birth. He or

she also should receive a special gamma globulin shot that helps to protect her against hepatitis B

infection.

If mother were not tested or have risk factors for hepatitis B infection, infant should be vaccinated
 against hepatitis B and, in some cases, also receive the special gamma globulin shot.

Some pediatricians start hepatitis vaccinations in the newborn period. The first dose of hepatitis B

vaccine can be given safely anytime between birth and two months of age in full-term infants.
( 28 ) . ,

( 2500 )

. RCH CSSM

.
( )

.
 .

. ,

; .

, .
.

- ,

, .

30-40

. (

) ,

; .

. ,
 .

. ,

;
 / daiper /

, .

. 70%

, .

soaks .

.
 .

7 10

. ,

birthing

,
 .

swabs

swabs

swabs

(egKajal)
 .

, ,

, , , ,

, ,

( )

90

(32 ) .
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