RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA

BRIEF RESUME OF INTENDED WORK

6.1 INTRODUCTION:

1

1NAME OF THE CANDIDATE

AND ADDRESS

Mrs.SILIYA. K V

1ST YEAR M.Sc NURSING

RAJIV GANDHI COLLEGE OF NURSING

IIT CAMPUS, OPP. MEENAKSHI TEMPLE

BANNERGHATTA ROAD

BANGALORE – 76.

2 NAME OF THE INSTITUTION RAJIV GANDHI COLLEGE OF NURSING

3 COURSE OF STUDY & SUBJECTFIRST YEAR M.Sc NURSING

PAEDIATRIC NURSING

4 DATE OF ADMISSION 01/06/2011

5 TITLE OF THE TOPIC

A STUDY TO ASSESS THE EFFECTIVENESS

OF STRUCTURED TEACHING PROGRAM

AMONG MOTHERS OF UNDER FIVE CHILDREN

ON KNOWLEDGE REGARDING VITAMIN

DEFICIENCY AND ITS PREVENTIVE MEASURES

IN A SELECTED URBAN AREA AT BANGALORE

We are guilty of many errors and many faults, but our worst crime is abandoning the

children, neglecting the foundation of life. Many of the things we need can wait. The child cannot.

Right now is the time his bones are being formed, his blood is being made and his senses are being

developed.

“ T o him we cannot answer Tomorrow, His name is Today”

Gabriela Mistra

"Don't forget to take your vitamin!" "Eat your salad — it's packed with vitamins!"

you've probably heard at least one parent say But what exactly are vitamins? Vitamins and minerals are

substances that are found in foods we eat. Your body needs them to work properly, so you grow and

develop just like you should. When it comes to vitamins, each one has a special role to play. Ingesting

vitamins is extremely important to keep our bodies healthy, they are essential to life (hence the name

that comes from “vital” and “amines”) 1. Kids who eat balanced diets are probably getting all the

vitamins and minerals they need from the foods they eat, so supplementation usually isn't necessary.

Children who are very picky may be missing out on some nutrients, and there is growing research

showing many children may not be meeting their vitamin needs2.

Whenever a man or woman plans to build a house for them and their family the very first

thing they carry out is securing all the best materials which he or she can afford. The same thing or

matter is applicable to the most wonderful of the houses that is the human body. Basically we are the

builders and every day we select materials for building of our body. These materials are required to be

chosen rightly in order to carry out the process of body building very properly. This construction

basically begins from the day we step in this world and it continues for our whole life. And in order to

live in strong house or strong body we need to select the right materials. So one should not allow

anything which is inferior go inside their body. Only the best things should be allowed to go inside the

body.3

Vitamins by definition are the substances which we need in our body for its normal

functioning. Basically the vitamins are required in our body for the healthy growth; healthy vision, to

make connective tissues much stronger and bones too become strong with the good consumption of

vitamins. It also helps us to fight against all the infections cancer and number of other disease. The

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presence of the right amount of vitamin in our body helps us to heal wounds; it also prevents us

from bleeding to death and to keep all the teeth strong and very healthy.3

Vitamins are fetched entirely from the food and number of other plants. In order to get

good quantity of vitamins we must select those foods which are very good in the vitamin and protein

content. Money should not be an issue when it comes over the good diet of your child. This is because

of the fact that no one can live long on the unbalanced diet. So one should eat and enjoy the taste of

food which is full of vitamins and other materials which are required for the body building3

More than 254 million children suffer from vitamin deficiency worldwide in each year,

20-40 million children suffer from mild vitamin-A deficiency and three million children from severe

deficiency. World health organization estimates that 100 to 140 million children under the age of five

may be living with dangerously low vitamin-stores. More than four million children are worldwide

exhibit sign of severe deficiency. In Karnataka 0.3% of children are suffering from vitamin deficiency.4

In India nearly 600 million children die from hunger and malnutrition each year and lack

of essential vitamins and minerals also increased risk of dying from child hood diseases. Millennium

development goals set a target of decreasing rate of death among children under five by two-third

between 1990-2015.between 1960and 1990 number of child death fell at a rate of 2.5 each year. Since

1990 phase load to just 1.5 percentage. WHO, UNICEF and IMCI emphasis importance of improved

diet and feeding practices.5

India is home to 40 percent of the world’s malnourished children and 35 percent of the

developing world’s, low-birth-weight infants; every year 2.5 million children die in India, accounting

for one in five deaths in the world. More than half of these deaths could be prevented if children were

well nourished. India’s progress in reducing child malnutrition has been slow. The prevalence of child

malnutrition in India deviates further from the expected level at the country’s per capita income than in

any other large developing country.6

Karnataka has a population of 45 million; The state has a literacy rate of 56%. The food

consumption patterns reveal that cereals and millets are the main food items. However, protective foods

(i.e. foods that are rich in proteins, vitamins and minerals) are consumed in lesser amounts. When

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compared with the average Indian recommended dietary intake (RDI), the intake of energy in adults was

found to be higher, as was protein. The average intake of vitamins, however, was 50% less than the

recommended dietary intake. An improvement in the nutritional status of rural adults has been observed

in recent years. Protein energy malnutrition, vitamin deficiency disorders are the major nutritional

deficiencies among preschool children, in Karnataka.7

Malawi, The World Bank estimates that India is ranked 2nd in the world of the number of

Children suffering from malnutrition, after Bangladesh (in 1998), where 47% of the children exhibit a degree of

malnutrition. The prevalence of underweight children in India is among the highest in the world, and is nearly

double that of Sub-Saharan Africa with dire consequences for mobility, mortality, productivity and economic

growth.27The UN estimates that 2.1 million Indian children die before reaching the age of 5 every year – four

every minute – mostly from preventable illnesses such as diarrhoea, typhoid, malaria, measles and pneumonia.

Every day, 1,000 Indian children die because of diarrhoea alone. According to the 1991 census of India, it has

around 150 million children, constituting 17.5% of India's population, who are below the age of 6 years.8

The 2011 Global Hunger Index (GHI) Report ranked India 15th, amongst leading

countries with hunger situation. It also places India amongst the three countries where the GHI between

1996 and 2011 went up from 22.9 to 23.7, while 78 out of the 81 developing countries studied,

including Pakistan, Nepal, Bangladesh, Vietnam, Kenya, Nigeria, Myanmar, Uganda, Zimbabwe and

succeeded in.9

In society children need extra care because they are our supreme assets. As the children

of today form human resources of tomorrow this is all the more because the role of human element is

becoming more and more crucial in.10

6.2 NEED OF THE STUDY

In his Independence Day speech on 2011 August 15 th to the nation, Prime Minister

Manmohan Singh stated, “The problem of malnutrition is a matter of national shame.... I appeal to

the nation to resolve and work hard to eradicate malnutrition in five years”.

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Malnutrition in India, as in other developing countries, results from a series of

interrelated factors rooted in poverty, including a lack of access to food, health care, safe water,

sanitation services, and appropriate child feeding and caring practices. These interrelated factors are in

turn exacerbated by poor households’ and communities’ lack of access to human, financial, social,

natural, and physical capital, combined with social discrimination, lack of education.11

“Every one who cares about the future of children and the development of nations should

read this report” said UNICEF executive director Carol Bellamy. “The overwhelming scope of the

problem makes it clear that we must reach out to whole population and protect from the devastating

consequences of vitamin and mineral deficiency”.12

Unless action against vitamin and mineral deficiencies move onto new level the

developing world’s children will remain at risk of never reaching their full potential, the report

concludes. And the UN will not achieve its goals eradicating extreme poverty improving maternal

health and reducing child mortality by two-thirds by 2015.12

While the number of children and woman who die because of vitamin and mineral

deficiencies is great, greater still is the number of people who live with these deficiencies and their

consequences. The negative impact on their health is significant. More often than not they suffer

multiple deficiencies and, therefore, multiple impairments.13

The global community should be outraged by the millions of children that either die or

are disabled each year because of malnutrition. We know how to prevent and treat it. The missing link is

the political will to place nutrition squarely on the development agenda and to commit the necessary

resources to implement programs, particularly food fortification, that we know can deliver sustainable

improvements not only to the current generation of people at risk .14

At least two children die every minute of every day because they have not received the

protection vitamin A supplementation can provide. In the span of two decades, micronutrient

supplementation programs have become a mainstream national health goal to reduce childhood

mortality and morbidity in 70 countries. The goal now must be to ensure that every vulnerable child

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receives the vitamin A they require.15

Good nutrition, especially in the first years of a child's life, provides lifelong benefits in

health, education and productivity. However, one in four children under-five in the developing world

approximately 148 million children – suffer from under nutrition. Affordable and proven micronutrient

interventions to address under nutrition exist. We must work collectively to scale up access to these

micronutrients, so children everywhere have the chance to reach their full potential and contribute to the

development of their communities.16

Every day, national economies suffer significant yet unnecessary losses in productivity

due to vitamin and mineral deficiencies. In countries with the highest numbers of people living with

physical and intellectual impairments, the lost potential for economic growth is staggering.Mothers

tending to sick or disabled children lose days of work. Adults living with reduced energy and

intelligence are unable to fully contribute to society.17

Nutrients help in physical and mental growth of children and also help in preventing

nutritional deficiency diseases.Education helps to increase knowledge of mothers this helps to give the

children required balanced diet and to plan a well balanced diet for family. Researcher need to assess

the knowledge of mothers and then educating the mothers about vitamins and its deficiency diseases and

its importance in promoting physical and mental health of children.

Researcher during his experience has also found that mothers had lack of knowledge

regarding the prevention of vitamin deficiency disorders. So investigator felt the need to assess the

mother’s knowledge regarding prevention of vitamin deficiency disorders in under- five children and to

impart structured teaching programme to improve the mother’s knowledge Thus increasing health of

children.

6.3. REVIEW OF LITRATURE

Polit and Hungler(1999) review of literature can be described as “a critical summery of

research on topic interest, generally prepared to put a research problem in context or to identify gapes

and weakness in prior studies so as to justify a new investigation”.18

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For better understanding of the topic review is categorised into :

1. General information about vitamin deficiency diseases of under-five children.

2. Study related to knowledge of mothers regarding vitamin deficiency diseases of under-

five children.

3. Study related to prevention of vitamin deficiency diseases of under- five children.

4. Study related to effectiveness of structured teaching program to mothers.

1. General information about vitamin deficiency diseases of under-five children.

There are two types of vitamins: fat soluble and water soluble. When you eat foods that contain

fat-soluble vitamins, the vitamins are stored in the fat tissues in your body and in your liver. They wait around in

your body fat until your body needs them. Fat-soluble vitamins are happy to stay stored in your body for awhile

— some stay for a few days, some for up to 6 months! Then, when it's time for them to be used, special carriers in

your body take them to where they're needed. Vitamins A, D, E, and K are all fat-soluble vitamins. Water-soluble

vitamins are different. When you eat foods that have water-soluble vitamins, the vitamins don't get stored as

much in your body. Instead, they travel through your bloodstream. Whatever your body doesn't use comes out

when you urinate (pee).So these kinds of vitamins need to be replaced often because they don't stick around! This

crowd of vitamins includes vitamin C and the big group of B vitamins — B1 (thiamine), B2 (riboflavin), niacin,

B6 (pyridoxine), folic acid, B12 (cobalamine), biotin, and pantothenic acid.19

Diseases due to vitamin deficiency are Keratinizing metaplasia - Due to vitamin A

deficiency the epithelial lining of respiratory passage becomes rough dry and keratinized. Xerosis -

Dryness of skin and conjunctiva due to a vit A deficiency.Xerophthalmia - Dry and lustreless cornea

and conjunctiva due to a vit A deficiency.Bitots's spot - White or greasy triangular deposits on the

bulbar conjunctiva adjacent to the lateral margin of the cornea due to vitamin A deficiency.

Keratomalacia - Xerosis and ulceration of the cornea resulting from severe vit A deficiency.Nyctalopia

or Night blindness - Poor vision at night due to decreased synthesis of Rhodopsine in absence of vit A.

Phrynoderma or Toad skin - Thick and scaly skin due to vit A deficiency. Xerostomia - Non-secretion

of salvia due to destruction of saliva secreting cells in absence of vit A20

Gena valgum or Knock knee - Due to vit D deficiency in children legs are deformed and

curved inward so that the knees are close together, knocking as the person walks, with the ankles widely

separated. Bowleg - A deformity of children due to vit D deficiency in which one or both legs are bent

outward at the knee.Rickety rosary - The cartilaginous portion of the ribs swell in children due to vit D

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deficiency. Scoliosis - Sideways deviation of the backbone in children due to vit D deficiency. Pigeons

breast – Due to vit D deficiency the lower part of the sternum, xyphoid process project outward

conically by lengthening of the costal cartilage. Harrison’s sulcus - A depression develops on both sides

of the chest wall of a child between the pectoral muscles and lower margin of the rib cage due to vit

D deficiency in children. Craniotabs - Due to vitamin D deficiency in children ossification of the

bones of skull does not take place properly as a result of the presence of soft bone at  various points on

the skull. Pot belly - Due to vitamin D deficiency in children muscle of belly do not developed properly,

as a result the belly muscles become nonelastic, therefore belly protrudes outward.Ricket - Due to

vitamin D deficiency among children the bones do not harden 

and are malformed. Osteomalacia - Softening of bones in adults due to vitamin D deficiency.

Osteoporosis - Loss of bony tissue in adults due to vitamin D deficiency as a 

result bones become brittle.21

Muscular dystrophy - Muscle fails of contract due to vit E deficit Exudative diathesis -

Due to vit E deficiency exudation of fluid takes place from cells and tissues of various parts of the body.

Ceroid pigmentation - In children vit E deficiency leads to deposition of excessive 

pigment at various places on the body. Blood vomiting in new-born - Due to vit K deficiency bleeding

the mouth of newborn baby. Beriberi - A disease of the peripheral nervous system due to deficiency of

vit B1. Wet beriberi - In this type there is an accumulation of tissue fluid within body. Dry beriberi - In

this type paralysis of the limbs take place.Wernick's encephalopathy - In adult vit B1 deficiency leads to

mental confusion or delirium in combination with paralysis of the eye muscles and an uneasy

gait.Nystagmus - Due to vit B1 deficiency in adults disorders of the brain occurs and thereby rapid

involuntary movement of the eye takes place.. Cheilosis - Due to vit B1 deficiency lips become swollen,

cracked with bright red colour.Stomatitis - Inflammation of the mucus lining of the mouth with the

painful white ulcers on cheeks, tongue and gum occur due to vit B1 deficiency.Glossitis - Inflammation

of the tongue takes place and sticky exudation from scalp.. Erythroid hyperplasia - Anaemia caused by

destruction of haemopoietic cells of red bone marrow due to vit B2 deficiency. Chromitrichia - Hair

becomes greyish due to vit B3 deficiency.Pellegra - Scaly dermatitis of exposed surfaces due to vit B5

deficiency. Pernicious anaemia - Anaemia due to absence of vit B12 in diet. Scurvy - Swollen bleeding

gums due to vit C deficiency.21

ANI Jul 16, 2011, 02.51pm IST A new study has found that vitamin c is required for

the proper functioning of the eyes and the brain. The findings could have implications for diseases, like

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scurvy, glaucoma, and epilepsy.We found that cells in the retina need to be bathed' in relatively high

doses of vitamin C, inside Oregon Health and Science University's Vollum InstituteBecause the retina is

part of the central nervous system, this suggests there's likely an important role for vitamin C

throughout our brains, to a degree we had not realized before, he said. The brain has special receptors,

called GABA-type receptors that help modulate the rapid communication between cells in the

brain.GABA receptors in the brain act as an inhibitory brake on excitatory neurons in the brain. The

OHSU researchers found that these GABA-type receptors in the retinal cells stopped functioning

properly when vitamin C was removed. Because retinal cells are a kind of very accessible brain cell, it's

likely that GABA receptors elsewhere in the brain also require vitamin C to function properly, stated

von Goff. And because vitamin C is a major natural antioxidant, it may be that it essentially preserves

the receptors and cells from premature breakdown, he added.The study was recently published in the

Journal of Neurosciience22

Kheth Cheng M O (2011, Natural News) A new study shows that children with psychosis

and other severe mental health disorders also have twice as much vitamins children who are mentally

healthy. The study, presented to the American by researchers from the Oregon Health and Science

University in Portland showed that 21 percent of children with symptoms of severe psychiatric

problems had vitamin D levels below what the American Academy of Pediatrics recommends. That

level compared with 14 percent of children who participated in the National Health and Nutrition

Examination Survey III, a population-based study that assessed the nutrition and health status of both

children and adults in the U.S."That is 50 percent more than children in a normal population, so based

on our findings this means that 1 out of 5 kids with severe mental illness has low vitamin D levels”.23

A study shows lack of vitamin B12 (cobalamin) during the formative first six years of

life could result in long-term reduced cognitive function. Researchers from the Nutrition and Food

Research Institute in Zeist, Netherlands, studied children who had been raised on a strictly vegan

macrobiotic diet until age six. The children ate a lacto vegetarian or omnivorous diet after that

age. Between ages 10 and 16, the 48 adolescents underwent a series of tests designed to determine

cognitive function. They were compared with 24 adolescents fed omnivorous diets from birth. The

psychological tests were designed to measure fluid intelligence, spatial ability, concentration, short-term

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memory, psychomotor development and information-processing speed. Although all of the early

macrobiotic children had been consuming vitamin B12 for several years before the test, almost two-

thirds were found to be B12 deficient as determined by either low serum cobalamin or an elevated

concentration of methylmalonic acid, a marker for B12 deficiency. Almost a third still had B12 intakes

below 50 percent of the Recommended Daily Allowance. The control subjects, all of whom had normal

B12 status, performed better on most psychological tests — including those measuring fluid

intelligence, spatial ability and short-term memory — than those who had been macrobiotic. Those who

were still deficient in B 12 performed worst of all. 24

The prevalence of night blindness, an early in dictator of vitamin A deficiency, was

assessed in children attending a diarrheal disease hospital in Bangladesh. Five per cent of 2971 children

between 1 and 10 years complained of night blindness and 47 per cent of these children as against 6 per

cent of children without night blindness also had ocular signs of vitamin A deficiency (p.<0.01).

Children with night blindness compared to those without were significantly more likely to be

undernourished, and to have a prolonged illness with dysentery and infections

with Shigella and Entamoeba histolytica. Serum levels of vitamin A were below 10 μg/dl in 17 night-

blind patients and were significantly lower in these patients than in 13 age-matched controls without

night blindness (p<0.001). In areas where vitamin A deficiency is common, vitamin A supplements and

locally relevant nutrition education should be offered to children at high risk for vitamin A deficiency,

especially if they have a history of night blindness.25

2 Study related to knowledge of mothers regarding vitamin deficiency diseases of under five

children.

A study was conducted to investigate risk for sub clinical vitamin-A deficiency in under

six years of age in urban slums of Nagpur, India. The study included 308 non-xeropthalmic children

selected randomly from the study population, The current study recognized a significant association

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between female gender, ill-literate mother, lower socio economic status, more than two children of

under five years of age at home, under nutrition, history of Diarrhea, Measles, Acute respiratory tract

infection and sub clinical vitamin-A deficiency on analysis.26

George.E (2000) study conducted in preschool children to estimate food security and to

evaluate socio-economic, demographic, anthropometric measurement associated with food security in a

residential colony. result showed woman with high school education were twice as likely to has well

nourished children compared to illiterate and primary educated.27

Visweswara Rao (2000) conducted a case study in preschool children, Hyderabad in

India.1649 children from rural and 2550 from urban selected. Prevalence of malnutrition by socio-

economic status, income education, computed. result showed better grades of maternal literacy and

occupation reduces malnutrition in preschool children.28

Tsegaye Demissie, Ethiopian Health and Nutrition Research (2009) conduct a study to

determine demographic and health related risk factors of sub clinical vitamin A deficiency. Blood

samples collected from 996 children across nation for analysis of serum retinol. Interview conducted

with mothers. Result showed deficiency associated with those not receiving vitamin A supplement over

the year, belonging to mothers with high parity and low level of knowledge.29

Hunt Joseph (1999) investigated impact of mal nutrition in Asia study covers 2/3rd of

worlds 150 million children under five each country prepared 10 year investment program reviewed

health, community based intervention for children and nutrition analysis. Result showed that educated

and socio economically. empowered Asian woman where the key to improve nutritional status among

child.30

3) Study related to prevention of vitamin deficiency diseases of under five children.

Sachadeva H.P.S (2008) conducted a study to determine role of micro nutrient

supplementation in improving child health, New Delhi.Nurition foundation of India. Result showed

vitamin A supplementation decreases child mortality between 6 months to 6 years.31

Indian Ministry of Human Resources Department of Woman and Child Development.

New Delhi (1996) adopted multi sartorial approach to eliminate problems of malnutrition. Covered risk

group, mass communication ICDS and CSSM used to educate people about vitamin and other

deficiencies. Supplied Beta Carotene rich food, vitamin A prophylaxis given, intensified immunization

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result showed improvement through survey.32

Hawrah Child in Need Institute,Daulatpur,West Bengal(2005) conducted a study through

distribution of fortified candy with vitamin A 1500 IU,vitamin C 10mg folic acid with 50mcg in

ICDS.After 18 month resurvey conducted, Result showed increase in haemoglobin level, reduction in

prevalence of vitamin A deficiency diseases in children.33

4) Study related to effectiveness of structured teaching program to mothers.

A study was conducted on intake of vitamin-D from food and supplements among

Finnish children age three month to three years. A structured questionnaire method was used to study in

University of temper Finland. Their result revealed that the mean dietary vitamin-D intake exceeded the

recommendation (10 micro g. /day) at the age of three (11-0micro g.) and six months (12.0 micro g.).

Vitamin-D intake from did not differ in children who used and did not use vitamin-D were margarine,

fish, body foods, low-fat milk and eggs. They concluded that vitamin-D supplements are not used

according to the dietary recommendation.34

A study was performed that to assess health visitors knowledge of government guide-

lines for vitamin supplementation for infants and children and advice given to mothers. The study was

conducted in central middle sex, Hospital London UK. The questionnaires method was used. Their

result revealed that a total of 98% (69%) questionnaires were returned from health visitors. They

concluded that rickets has become a national public health issue. The majority of health visitors are

advising vitamin supplements according to government guide lines for breast feeding infants and the

age to which children should continue vitamin supplements. Awareness need to be raised about the

government guideline for vitamin-D supplementation for ethnic minorities to ensure all health visitors

are imparting consistent, correct advise to these families.35

A study carried out on the prevalence of maternal belief about the therapeutic uses of

sunlight in infancy in tropical Australia. Data were collected by interviewing, 114 post-partum patients.

Their result indicated that half of the women had at least one risky belief about the perceived benefit of

the sunning their baby. 36% were in favor of using sunlight to treat neonatal jaundice, 20.2% believed it

was necessary to Sun their baby to prevent vitamin-D deficiency and 10.5% thought sun light was a

good remedy for nappy rash. They found that post-parturient women had a high prevalence of beliefs

that may result in their infant being intentionally exposed to sunlight and which could increase their

Childs future risk of skin Neoplasia. Professional education is needed to change the beliefs of health

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professional who recommended therapies involving sunlight. 36

6.4. STATEMENT OF THE PROBLEM

A study to assess the effectiveness of structured Teaching program among mothers of

under-five children on knowledge regarding vitamin deficiency and its preventive measures in a

selected urban area at Bangalore.

6.5. OBJECTIVES OF THE STUDY

(1) To assess the pre-test knowledge of mothers of under five children regarding vitamin

deficiency and its preventive measures.

(2) To assess post- test knowledge of mothers of under five children regarding vitamin

deficiency and its preventive measures.

(3) To assess the effectiveness of structured Teaching program regarding vitamin

deficiency and its preventive measures among mothers of under five children.

(4) To assess the significant association between pre-test knowledge with selected

demographic variables.

6.6 OPERATIONAL DEFINITION

Assess – To understand the knowledge of mothers regarding Prevention of selected

vitamin deficiency disorders using structured interview schedule.

Effectiveness - It is the difference between pre & post test knowledge score among

mothers of under five children regarding vitamin deficiency disorders and its prevention.

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Structured teaching programme - It refers providing teaching using different audio

visual aids among mothers of under-five children regarding vitamin deficiency disorders

and its prevention.

Prevention-Steps taken by the mother to avoid the vitamin deficiency disorders in under

five children.

Vitamin Deficiency Disorder-In this study, it refers to problems related to the

deficiency of vitamins.

Mothers- Women who are having children age group between 1-5 years.

Under five children- Children in the age group of 1-5 years.

6.7. ASSUMPTIONS

Education helps in gaining more knowledge on vitamin deficiency and its preventive

measures.

Mothers of under five children will be able to understand about vitamin deficiency and

its preventive measures.

Mothers will be able to communicate knowledge gained to other members of society.

6.8. HYPOTHESIS

H1:There is a significant relationship between pre test and post test knowledge score of mothers

of under five children regarding vitamin deficiency and its preventive measures.

H2:There is a significant assosiation between pretest knowledge between selected demographic

variables such as age, education, occupation, place of residence and religion.

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6.9. DELIMITATION

This study is limited to:-

A period of 4-6 weeks.

Sample size is 50 samples.

The study is limited to only urban area at Bangalore.

7. MATERIALS AND METHODS

7.1. SOURCE OF DATA:

Data will be collected from mothers of under five children in urban area at Bangalore.

7.1.1 RESEARCH DESIGN:

Research design used in this study is one group pre test and post test design.

7.1.2. SETTINGS:

The study setting is a selected urban area at Bangalore

7.1.3. POPULATION:

The target population of the study consists of mothers of under -five children from

selected urban areas at Bangalore.

7.2. METHOD OF DATA COLLECTION

7.2.1. SAMPLING PROCEDURE: Convenient sampling technique.

7.2.2. SAMPLE SIZE: The sample size consists of 50 mothers of under five children from urban

areas at Bangalore.

7.2.3. INCLUSION CRITERIA:

Mothers with children above five years.

Those who are able to read and write Kannada/English.

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Those who are willing to participate.

Those who are residing in urban area.

7.2.4. EXCLUSION CRITERIA:

Those who are not willing to participate.

Those who are illiterate mothers.

Those having serious physical or mental illness.

Mothers with children above five.

7.2.5. INSTRUMENT INTENDED TO BE USED:

The instrument indented to be used has three parts.

Part A –Demographic variables

Part B-Knowledge questionnaire

Part-C-Planned teaching programme

7.2.6. DATA COLLECTION METHOD:

Data will be collected from mothers of under five children in urban area before and after

PTP

7.2.7. PLAN FOR DATA ANALYSIS:

Planned according to the objectiveness of the study using descriptive statistics and

inferential statistics.

Descriptive statistics – mean, median, mode, standard deviation, percentage calculation.

Inferential statistics. – Chi square and T test.

7.3. DOES THE STUDY REQUIRE INVESTIGATION OR INTERVIEW TO BE

CONDUCTED ON PATIENT OR OTHER ANIMAL?

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Yes, the study will be conducted among mothers of under-five children from selected

urban areas at Bangalore.

7.4. HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION?

Yes, prior written permission order will be obtained from the college and from the

primary health centre of urban areas before conduction of the study. The proposed study will be

conducted with the approval of research committee of college. Prior permission also obtained from the

mothers of under five children in urban area before and after planed teaching program. Ensured

participants confidentially and no harm during study.

8. LIST OF REFERENCES

1. George Well, Vitamin-D-Deficiency-Diseases. http://georgewell.hubpages.com/hub

2. Shereen Jegtive, http://nutrition.about.com/od/nutritionforchildren/a/kidssupplemnts.htm .

3. Vitamin for kids available at http/vitamins diary, org/vitamins-for-kids-html.

4. Underwood B.A. Vitamin-A deficiency disorders, international efforts to control a preventable

pox. Journal of nutrition 2004. Jan; 134 (1): 231-6

5. George Daga, Indian Journal of Pediatrics, Research Abstracts on 1998 to

2008.www.pubmed.com

6. M.swaminathan, D.Sc, F.N.”A Hand Book of Food and Nutrition”, Fifth edition, Bangalore

Printing and Publishing. Page No:42 to 47

7. Sheela K. Nutrition scenario in Karnataka, A state in southern India. 2007. Department of rural

home science. Bangalore, India.

8. "World Bank Report". Source: The World Bank (2009). Retrieved 2009-03-13. "World Bank

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19

SIGNATURE OF THE CANDIDATE

REMARKS OF THE GUIDEVitamin deficiency are most commonly seen among under five children hence the study can be proceeded

NAME AND DESIGNATION OF THE GUIDE

Mrs. Susan Shyla Abraham.

Associate Professor

SIGNATURE

HEAD OF THE DEPARTMENT Mrs. Susan Shyla Abraham.

Associate Professor

SIGNATURE

REMARKS OF THE CHAIRMAN AND PRINCIPAL

Vitamin deficiency among under- five is a major problem hence the study is appropriate to conduct.

SIGNATURE OF THE PRINCIPAL