A Comparative Study to Assess the Knowledge and Health Seeking behavior regarding Danger Signs in Newborns among Primi mothers in a selected Urban and Rural Area of Bhilai, (C.G)

Julie Anand

M.Sc. Nursing (Child Health Nursing),

Associate Professor Child Health Nursing, Shri Shankaracharya College of Nursing, Hudco,

Bhilai, Chhattisgarh India.

*Corresponding Author E-mail: juliemanand@gmail.com

ABSTRACT:

This study was conducted with the objectives to assess the knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers in urban and rural areas and to compare the knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers in urban and rural areas And also to correlate knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers in urban and rural areas and to prepare a booklet regarding danger sign in identification and management of newborn danger signs for mothers. Keeping in view the objective of the study the research design selected for the present study is comparative research design to assess the knowledge and health seeking behaviors regarding danger signs in newborns. The sample size is, 100 primi mothers, 50 each from urban and rural areas. A purposive sampling technique was used to assess the knowledge of primi mothers regarding newborn danger signs. Overall analysis shows that in urban area majority 90% had good knowledge, 10% had average knowledge and none of them had poor knowledge. In rural area majority of mothers i.e., 96% had poor knowledge, 4% had average knowledge and none of them had good knowledge. and also there is significant difference between health seeking behaviours of mothers in urban and rural areas regarding danger signs in newborn. In urban area mean, mean score %, SD, CV of knowledge is 170.56, 87.02, 7.6, and 4.4 respectively. Whereas mean, mean score %, SD, CV of health seeking behavior is 55.96, 93.2, 4.9 and 8.7 respectively. In rural area mean, mean score%, SD, CV of knowledge is 107.96, 62.6, 6.3 and 5.8 respectively. Whereas mean, mean score %, SD, CV of health seeking behavior is 15.34, 55.5, 3.05 and 19.8 respectively. Findings shows that there is significant difference between the level of knowledge as well as health seeking behaviour in urban and rural area regarding danger signs in newborn among primi mothers.

KEYWORDS: Knowledge, Health Seeking Behaviors, Danger Signs, Newborns, Primi Mothers.

INTRODUCTION:

An estimated 130 million babies are born each year and about 4 million of them die in the neonatal period. Nearly 99% of all neonatal deaths occur in low- and Middle-income countries.

A quarter of the global neonatal deaths occur in India and little progress has been made in reducing it in the last decade. Current new born mortality rate is 34 per 1000 live births and current world wide new born mortality rate is 16.19 per live births. A combination of universal outreach and family community care intervention at 90% coverage has been estimated to avoid 18 to 37% of neonatal deaths. These interventions include family care of the new born, essential new born care, resuscitation of the new born, care for low-birth-weight babies, emergency new born care and early detection of danger signs.

The primary causes of neonatal mortality are believed to be complications of prematurity (21%), birth asphyxia and injury (23%), neonatal tetanus (7%), congenital anomalies (7%) and diarrhoea (3%) with low birth weight contributing to a large proportion of deaths (1).

Most of these newborns die at home while being cared by mothers, relatives and traditional birth attendants. Despite proven cost-effective solutions such as promoting antenatal tetanus toxoid immunization, skilled attendance during delivery, immediate and exclusive breastfeeding, and clean cord care, there has been relatively little change in neonatal mortality rate (NMR), especially in developing countries. To achieve Millennium Development Goals, it is expected to reduce the Neonatal mortality by two third of the present rate, which is not an easy task by any standard of neonatal care.

NEED FOR THE STUDY:

Many communities keep mothers and babies indoor for the first month after Birth. If the mother or baby become ill during the period of seclusion, seeking health care is often delayed, yet sick babies often die within a few hours or delays can be Fatal. Poor knowledge on part of mothers can lead to disastrous results in the field of Care giving. Mother has to regulate the child ‘s behavior, attitudes, outlook and home environment in family, since these are the basic factors that influence the growth of Newborn.

If the mothers are not acquainted with a recognition and referral of newborn Danger signs, it might affect the rearing of their children. Providing timely education in the form of intervention to mothers could fill these gaps in knowledge. Mortality among sick neonates is very high and facilities for appropriate care for every sick neonate are less. It may take a long time for a sick neonate to reach a hospital. It is therefore important that they are identified earlier and referred for appropriate treatment.

During the community posting in B.sc nursing training period as well as in formal and informal discussions with the mothers of the children, the investigator had got the idea. So based on the above findings and the investigators experience in neonatal, pediatric and obstetric wards the investigator has decided to conduct research on knowledge of primi mothers regarding danger signs in newborn in urban and rural areas of Bhilai.

OBJECTIVES:

1. To assess the knowledge regarding danger signs in newborns among primi mothers in urban and rural areas.

2. To assess the health seeking behaviors regarding danger signs in newborns among primi mothers in urban and rural areas.

3. To compare the knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers in urban and rural areas.

4. To correlate knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers in urban and rural areas.

5. To prepare a booklet regarding danger sign in identification and management of newborn danger signs for mothers.

HYPOTHESIS:

H1: There will be significant difference between knowledge and health seeking behavior of primi mothers regarding danger signs in new born among primi mothers of urban and rural areas.

H2: There will be significant correlation between knowledge and health seeking behavior of primi mothers regarding danger signs in new born among primi mothers of urban and rural areas.

CONCEPTUAL FRAMEWORK:

The conceptual framework model selected for this study is Becker MH’S health belief model, which addresses the relationship between the persons belief and behaviour. It provides a way of understanding and predicting how client will behave in relation to their health how they will comply with health care therapies.

In the present study individual perception refers to perceived susceptibility is danger signs in newborns and perceived seriousness is poor health seeking behaviours.

METHODOLOGY:

Research approach: Descriptive research approach

Research design: Comparative research

VARIABLE:

Variables are defined as the characteristics, property, trait or attribute of the person or thing observed in a study. Polit Hungler describes variable as an attribute of person or objects that varies. In the present study the variables are-

Dependent variable:

Dependent variables are knowledge and health seeking behavior of primi mothers regarding newborn danger signs

Functional variable:

Socio demographic variables like age, education, religion, occupation, type of family and exposure to information.

Setting of the study:

This study was conducted on primi mothers of urban and rural areas bhilai C.G.

Population:

The target population of the study is all the primi mothers at urban and rural areas bhilai C.G.

Sampling techniques:

Purposive sampling

Sample size:

For present study, 100 primi mothers were selected, 50 each from urban and rural areas

SAMPLING CRITERIA:

Inclusion criteria:

Mothers

· Who are Primi?

· Who are willing to participate?

· Those who present at the time of study.

Exclusion criteria:

Mothers

· Mothers who are not willing to participate.

· Mothers with more than one child

· Mothers who are not present at the time of study.

Description of Tool:

· Self structured questions for mother’s recognition of newborn danger signs.

· Rating scale for assessing health seeking behaviors in mother.

· Checklist for assessing common home care seeking practices in certain danger signs.

Data Collection Method:

A formal written permission was obtained from the hospital authority of sector hospital for urban and uttai CHC for rural area. The data collection period for the main study was from 4^th May to June 3^rd. The purpose of the study was explained to the mothers.

Data Analysis and Interpretation:

Descriptive statistics such as frequency, percentage, mean and standard deviation is used to assess the knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers

Table 1.1 Overall analysis to assess the knowledge of mothers regarding newborn danger signs

Level of Knowledge	URBAN(n1=50)		RURAL(n2=50)
Level of Knowledge	Frequ- Ency (f)	Percentage (%)	Frequency(f)	Percentage (%)
>160 Good	45	90	0	0
130-160 Average	5	10	2	4
<130 Poor	0	0	48	96
TOTAL	50	100	50	100

Figure: 1.1 Cone diagram representing the distribution of knowledge of mothers according to overall analysis of knowledge score

Shows that in urban area majority 90% had good knowledge, 10% had average knowledge and none of them had poor knowledge. In rural area majority of mothers i.e. 96% is had poor knowledge only 4% is had an average knowledge and none of them had good knowledge.

Table 1.2 represents that there is significant difference between the level of knowledge in urban and rural area regarding danger signs in newborn .The ‘t’ value 44.7 which is more than the critical value (1.98) at 0.05 level of significance.

Table 1.2Analysis to compare the knowledge regarding danger signs in newborns among primi mothers of urban and rural areas

S.NO	Area	Mean Score	SD	SE	‘t’ value at df 99	Critical value at	Inference at 0.05 level of significance
1	URBAN	170.56	7.6	1.4	44.7	1.98	Significant
2	RURAL	107.96	6.3	1.4	44.7	1.98	Significant

Table 1.3Analysis to compare the health seeking behaviour regarding danger signs in newborns among primi mothers of urban and rural area.

S. NO

Area

Mean Score

‘t’ value at df 99

Critical value at

Infer-ence at 0.05 level of significance

Urban area

55.96

4.9

0.81

50.1

1.98

Signifi-cant

Rural area

15.34

3.05

Table 1.4 To correlate the knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers in selected urban area

Study variable

Mean

Mean score (%)

Inference

knowledge

170.56

87.02

7.6

4.4

0.15

Moderately positive correlation

Health seeking behavior

55.96

93.2

4.9

8.7

Table 1.3 represents there is significant difference between health seeking behaviours of mothers in urban and rural areas regarding danger signs in newborn. .The ‘t’ value 50.1 which is more than the critical value (1.98) at 0.05 level of significance

This shows that there is a moderately positive correlation as calculated correlation (0.15) is less than the critical value (0.195) at degree of freedom 98 respectively in urban area

Study variable

Mean

Mean score (%)

Inference

Knowle-

dge

107.96

62.6

6.3

5.8

0.005

Moderately positive correlation

Health seeking behaviour

15.34

55.5

3.05

19.8

This shows that a moderately positive correlation as calculated correlation (0.005) is less than the critical value (0.195) at degree of freedom 98 respectively in rural area.

MAJOR FINDINGS OF STUDY:

The data was collected analysed and interpreted in terms of objectives .Descriptive and inferential statistics were utilized for the data analysis

Distribution of subjects according to socio-demographic variables using frequency and percentage:

1. Majority of mothers in urban area i.e., 27(54%) belong to the age group of 18-25years and In rural area maximum number 25(50%) of mothers were in age group of 26-30years.

2. Regarding the education of mothers, in urban maximum 28(56%) of mothers were having graduation and above and in rural area, majority of mothers i.e., 15(30%) had primary education.

3. With respect to religion of mothers, in urban area majority of mothers i.e., 35(70%) were Hindus. In rural area majority of mothers i.e., 43(86%) were Hindus.

4. Related to occupation of mothers, suggests that in urban area maximum mothers i.e., 19 (38%) were working in private and In rural area majority of mothers i.e. 36 (72%) were housewives.

5. In relation to type of family in urban area 28 (56%) belong to nuclear family In rural area majority i.e. 44 (88%) belong to joint family

6. With regard to source of knowledge, depicts that the exposure of knowledge in urban area is about 23(46%) from friends, 13 (26%) from relatives, 8 (16%) through media and 6(12%) from health care personnel. In rural area majority i.e., 38(76%) knowledge from relatives.

Area wise analysis of knowledge score of primi mothers regarding danger signs in newborn:

In urban area Maximum mean score percentage of mothers regarding the knowledge of newborn danger signs was in bleeding i.e., 99% and minimum score 77% in cyanosis. In rural area maximum mean score percentage of mothers regarding the knowledge of newborn danger signs was in bleeding 68.5% and minimum in 58%in cyanosis.

Overall analysis to assess the knowledge of mothers regarding newborn danger signs:

Reveals that in urban area majority 90% had good knowledge, 10% had average knowledge and none of them had poor knowledge whereas in rural area majority of mothers i.e., 96% had poor knowledge, 4% had average knowledge and none of them had good knowledge

Item wise analysis to assess the health seeking behaviors of primi mothers regarding danger signs in newborn done using frequency and percentage:

Depicts the health seeking behaviors in urban area which shows 15(30%) treated diarrhoea at home ,4(8%) treated hyperthermia at home and 48(96%) treated convulsion at hospital and in rural area 22(44%) treated diarrhoea at home, whereas vomiting and poor feeding left untreated by, 20(40%) and 15(30%) respectively, 16(32%) convulsion and bleeding treated by quack.

‘T’ test to compare the knowledge and health seeking behaviours of primi mothers regarding danger signs in newborn:

Reveals that there is significant difference between the level of knowledge in urban and rural area regarding danger signs in newborn as the ‘t’ value 44.7 which is more than the critical value (1.98) at 0.05 level of significance. It also represents there is significant difference between health seeking behaviours of mothers in urban and rural areas regarding danger signs in newborn as the ‘t’ value 50.1 which is more than the critical value (1.98) at 0.05 level of significance .

Hence first hypothesis H1is accepted:

Analysis done using Karl Pearson’s correlation coefficient to find out the correlation between knowledge and health seeking behaviours of primi mothers regarding danger signs in newborns:

Reveals that mean, mean score %, SD, CV of knowledge is 170.56, 87.02, 7.6, and 4.4 respectively. Whereas mean, mean score %, SD, CV of health seeking behaviour is 55.96, 93.2, 4.9 and 8.7 respectively. This shows that there is a moderately positive correlation as calculated correlation (0.15) is less than the critical value (0.195) at degree of freedom 98 respectively and in rural area mean, mean score %, SD, CV of knowledge is 107.96,62.6,6.3and 5.8 respectively. Whereas mean, mean score %, SD, CV of health seeking behaviour is 15.34, 55.5, 3.05 and 19.8 respectively. This shows that there is a moderately positive correlation as calculated correlation (0.005) is less than the critical value (0.195) at degree of freedom 98 respectively.

Hence second hypothesis H2 is accepted:

Analysis related to common home care seeking practices in certain danger signs in newborn among primi mothers in urban and rural areas by using frequency and percentage:

Depicts that in urban area 40(80%) wrap the baby in hyperthermia,10(20%) give ghutti to the baby during diarrhoea, 6(12%) stops breast feeding during jaundice, 10(20%) give ginger and honey during respiratory problem,16(32%) wrap the baby in hypothermia, 31(62%) starts complimentary feeding during poor feeding whereas in rural area 30(60%) place baby in sunlight in jaundice, 40(80%) give rice water in diarhhea, 42(84%) stops breast feeding in vomiting, 45(90%) bath baby with cold water in hyperthermia, 32(64%) smells things in convulsion.

CONCLUSION:

At the end of the study on knowledge and health seeking behaviors regarding danger signs in newborns among primi mothers found that in urban area majority of mothers have good knowledge whereas in rural area majority of mothers have poor knowledge. However, a significant proportion in rural area did not seek medical attention because they were unaware of the seriousness of the signs presented by their baby. Thus, increase in education of mothers in rural area about neonatal danger signs would contribute greatly to the reduction of neonatal morbidity and mortality. There is a need for developing interventions to increase a mother’s knowledge regarding newborns danger signs.

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Received on 15.02.2024 Modified on 25.03.2024

A and V Pub Int. J. of Nursing and Medical Res. 2024; 3(2):79-83.

DOI: 10.52711/ijnmr.2024.16