Impact of Instructional Programme on Knowledge Regarding Protein Energy Malnutrition among the Mothers of Preschool Children from Selected Rural Areas of Karnataka: A Pilot Study

Abstract

Background of the study: According to World Health organization (WHO), protein energy malnutrition refers to “an imbalance between the supply of protein and energy and the body’s demand for them to ensure optimal growth and function”. It is a major public health problem in India. It affects particularly the preschool children (<6 years) with its direct consequences ranging from physical to cognitive growth and susceptibility to infection. This affects the child at the most crucial period of time of development which can lead to permanent impairment in later life. According to WHO, globally 162 million under-fives were stunted among them 56% lived in Asia and 36% in Africa, 99 million under-fives were underweight among them 67% lived in Asia and 29% in Africa. 50 million under five children were wasted and 17 million were severely wasted. Approximately 71% of them lived in Asia and 28% in Africa, with similar figures for wasted children 69% and 28% respectively. Children who suffer from wasting face a markedly increased chance of death. According to United Nations International children’s Emergency Funds (UNICEF), 13% of children under five years old in the developing world were wasted and 5% were extremely wasted. UNICEF estimates that in developing world 129 million under five children were underweight, nearly one in four and ten percent of them being severely underweight. The prevalence of underweight is higher in Asia than in Africa, with rates of 27 and 21 % respectively. Methods: The quantitative research approach was used for the study. The present study adopted mixed research design in two stages, first stage uses Cross Sectional Descriptive Survey for the identification of preschool children suffering with protein energy malnutrition and second stage Randomized Pretest Posttest Control Group Design for evaluating the Impact of instructional program on knowledge regarding protein energy malnutrition among the mothers of preschool children from selected rural areas of Karnataka was adopted. Nola Penders Model was used as a conceptual framework for the study. Cross sectional survey was conducted in the selected rural areas of Dharwad to screen the preschool children to find the prevalence of protein energy malnutrition in them. A total of 50 (10% of total population of main study) mothers of preschool children were selected as per sampling criteria. 25 each mothers were distributed in experimental and control groups. Structured knowledge questionnaires were used to collect the data from study participants. The results were described by using descriptive and inferential statistics. Results: In the experimental group, Pretest knowledge score mean was 14.16, median was 15, mode was 15, standard deviation 3.27 and score ranged between 8-19. Where as in Posttest, mean was 26.20, median was 27, mode was 15, standard deviation was 2.70 and score ranged between 17-29. Among the participants of control group, Pretest knowledge score mean was 13.84, median was 14, mode was 14, standard deviation 3.03 and score ranged between 7-18. Where as in Posttest, mean was 14.44, median was 15, mode was 15, standard deviation was 2.48 and score ranged between 10-18. In the experimental group, during Pretest, International Journal of Recent Innovations in Medicine and Clinical Research 76 3(12%) respondents had poor Knowledge and 22 (88%) of respondents exhibited an average understanding regarding protein energy malnutrition. In Posttest 1(4%) of respondents expressed an average understanding and 24 (96%) of respondents showed good understanding regarding protein energy malnutrition. Whereas in the control group, during Pretest, 2(8%) of respondents has insufficient comprehension and 23(92%) of respondents had an average knowledge regarding protein energy malnutrition. In the Posttest 5 (20%) of respondents had poor understanding and 20 (80%) of respondents showed an average understanding regarding protein energy malnutrition. In the respondents of experimental group, the findings reveal that the post-test mean knowledge scores was found higher [mean=26.20, SD of 2.70] when compared with mean pretest knowledge score value which was 14.16 with SD of 3.27. Among the respondents of control group, the findings reveal that the post-test mean knowledge scores was found higher [mean=14.44, SD of 2.48] when compared with pre-test mean knowledge score value which was 13.84 with SD of 3.03. Statistical contrast in level of knowledge among research and non-research batches participants during Posttest the ‘t’(48) values was 15.18.and is reported noteworthy at extent of 0.05, further the respondents of experimental group had higher mean of 26.20 during Posttest when compared to controlled group participant’s mean knowledge score of 14.44. This implies the instructional module was efficient in enhancing the level of understanding of participants regarding protein calorie malnutrition. Computed values of Chi square test for association between level of knowledge of respondents regarding protein energy malnutrition and their selected demographic variables is enumerated to be noteworthy at the extent of 0.05, for age group, religion and occupational status of respondents and not found statistically significant for other selected socio demographic variables. Interpretation and Conclusion: The overall findings of the pilot study revealed that the Majority of preschool children mothers’ knowledge regarding protein energy malnutrition was poor.