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Indian Journal of Community Medicine

KAP of Urban, Rural and Tribal AWWs and Beneficiary Mother Nutrition in Lactation

Author(s): A. Joshi, M. M Husain, M. Inamdar

Vol. 29, No. 4 (2004-10 - 2004-12)

Introduction

A large proportion of malnutrition could be avoided if mothers knew how to make better use of foods available to them. In poor Indian communities the nursing mothers only take rice supplemented with little pulses and vegetables. Milk is used in tea or coffee. In India it is custom to breast feed infants for prolonged periods ranging from six months up to even three years. It is fortunate that despite a faulty and insufficient maternal diet the quality of breast milk does not suffer. On the other hand, it compares well with that of nursing mothers consuming excellent diets in other parts of the world. Perhaps the Indian nursing mother keeps up the quality by withdrawing nutrients from her bone, blood and muscle for the formation of milk, since her inadequate diet is incapable of producing the nutrition required for satisfactory milk production. Continuous withdrawal of nutrition from the maternal body may lead to osteomalacia. In order that she may breast-feed her infant without any undue strain on her own body, she must continue to eat an adequate and balanced diet to meet the requirements of lactation. Diet of lactating mother and her nutritional status during pregnancy affects a certain extents quality and quantity of breast milk.

Research Question

What are the comparative KAP of Anganwadi Workers (AWWs) and Beneficiary Mothers (MBs) of urban, rural and tribal areas regarding nutrition in lactation?

Materials and method

In present study 60 AWWs and 480 BMs formed the sample. The sampling was done in two stages; firstly, three ICDS blocks were selected purposefully from Urban (Indore), Rural (Sanwer) and Tribal (Dhar) areas to cover all types of population. Secondly, samples of AWWs and BMs were selected randomly from above selected ICDS blocks. Those AWWs who have had at least two years of working stay at that place and those BMs who have had a young baby up to three years of age were selected for the study. In this way 20-20 AWWs and 160 BMs (8-8 BMs per each AWW) have been studied from each Urban, Rural and Tribal ICDS blocks.

The information regarding their practices in lactation has been collected through interview method with the help of a pre-tested questionnaire solely designed for this purpose. The data was gathered through door-to-door survey by face-to-face interview.

Results

The significance of difference among mean scores of the groups so obtained has been tested statistically by ANOVA; The obtained `F' value is 94.66 which is significant so the mean scores of knowledge obtained by AWWs and BMs of urban, rural and tribal area regarding nutrition in lactation is significantly different.

As the mean scores obtained for knowledge of nutrition in lactation by the comparative groups are significantly different, so the group-to-group variance in mean value is find out by multiple range `t' tests. The results are presented in Table No. I, which shows that urban AWWs obtained maximum mean scores 0.95 (0.21) in comparison to all other groups, while tribal AWWs secured minimum mean marks 0.70 (0.46). On the other hand BMs of rural area are found the least achiever as this group obtained only 0.13 (0.33) mean marks. The table further explains that the mean scores of rural and tribal AWWs and rural BMs are not significantly different.

Table I: Mean (SD) and Group-to-Group Analysis of Variance Regarding Knowledge of Nutrition in Lactation of AWWs and BMs

Groups Mean SD  Groups
  Urban
AWW's
Rural
AWW's
Tribal
AWW's
Urban
BM's
Rural
BM's
Tribal
BM's
Urban AWW's 0.95 0.21 - * * * * *
Rural AWW's 0.75 0.43 * - - - * *
Tribal AWW's 0.70 0.46 * - - - * *
Urban BM's 0.64 0.47 * * - - * *
Rural BM's 0.13 0.33 * * * * - *
Tribal BM's 0.44 0.49 * * * * * -
* Significantly Different

Table II : Mean (SD) and Group-to-Group Analysis of Variance Regarding Attitude of Nutrition in Lactation of AWWs and BMs

  Groups
Groups Mean SD Urban
AWW's
Rural
AWW's
Tribal
AWW's
Urban
BM's
Rural
BM's
Tribal
BM's
Urban AWW's 0.98 0.12 - - - * * *
Rural AWW's 0.93 0.25 - - - * - -
Tribal AWW's 0.98 0.12 - - - * - *
Urban BM's 0.77 0.41 * * * - * *
Rural BM's 0.92 0.27 - - - * - -
Tribal BM's 0.98 0.32 * - * * - -
* Significantly Different

Table III : Mean (SD) and Group-to-Group Analysis of Variance Regarding Practice of Nutrition in Lactation of AWWs and BMs

  Groups
Groups Mean SD Urban
AWW's
Rural
AWW's
Tribal
AWW's
Urban
BM's
Rural
BM's
Tribal
BM's
Urban AWW's 0.78 0.34 - - - * - *
Rural AWW's 0.80 0.35 - - - * - -
Tribal AWW's 0.86 0.29 - - - * - *
Urban BM's 0.68 0.41 * * * - * *
Rural BM's 0.79 0.36 - - - * - -
Tribal BM's 0.85 0.31 - - - * - -
* Significantly Different

`F' value for the significant difference in mean scores of attitude obtained by AWWs and BMs of urban, rural and tribal area regarding nutrition in lactation is also found significantly different. The group-to-group variance in mean value is found out by multiple range `t' tests and results are presented in Table No. II. The table indicates that the urban and tribal AWWs are the highest scoring groups with mean 0.98 (0.12). Rural AWWs and rural mothers are found a little lower scorer with mean 0.93 (0.25) and 0.92 (0.27) respectively. Urban group of mothers are least achiever among all groups of mothers and workers with mean 0.77 (0.41). The scores of urban and tribal mothers are significantly lower than their respective AWWs.

The `F' value of mean scores of practice obtained by AWWs and BMs of urban, rural and tribal area regarding nutrition in lactation was significantly different. The group-to-group variance in mean value is found out by multiple range `t' tests. The results are presented in Table No. III, which indicate that the tribal groups of both categories are having highest scores with 0.86 (0.29) and 0.85 (0.31) mean marks respectively of AWWs and BMs. The mean scores of urban and rural groups of both AWWs and mothers were not very much different with each other but are having quite low mean scores not more than 80% in comparison to both their tribal counterparts. Urban mothers also shown significant difference with all remaining groups in this regards.

Discussion

Knowledge of urban AWWs was significantly higher than their mothers and also than their other groups of AWWs. In attitude again the scores of urban and tribal AWWs were found significantly more than their respective BMs, but the scores of anganwadi workers were not significantly different with each other. The scores of urban AWWs were significantly higher in practices of nutrition in lactation, but AWWs were not significantly different among the groups in scoring in this regard. Mean scores so obtained by the groups were in knowledge 0.13 to 0.95, in attitude 0.77-0.98 and in practice 0.68 to 0.86, so we can say that the practices and attitude of nutrition in lactation is quite good and not broadly different among the groups, category wise as well as area wise. Conversely knowledge is found from very low to very highest level. Many studies regarding knowledge of nutrition in ICDS functionaries and beneficiaries frequently revealed the lack of knowledge among them. Yegammai, C. and Nivarai, Rita, (1993) report that in Hyderabad, a majority of women beneficiaries did not go in person to receive the food which naturally affected their knowledge ragarding the programme.

References

1. Yegammai, C. and Nivarai, Rita, Knowledge, attitude and practices (KAP) of and nutritional and health status of beneficiaries of ICDS programme in Coimbator and Hyderabad. Ind. J. Nutr. Dietet., 1993 30(3), 61-65

Department of Health Education,
All India Institute of Hygiene & Public Health,
110, Chittaranjan Avenue, Kolkata-700 073.

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