A PROSPECTIVE STUDY TO ASSESS THE KNOWLEDGE REGARDING MATERNAL AND CHILD HEALTH SERVICES AVAILABLE AMONG ANTENATAL WOMEN

1. Tutor, College of Nursing, Government Medical College and Hospital, Chandigarh. 2. Government Medical College and Hospital, Panjab university, Chandigarh. ...................................................................................................................... Manuscript Info Abstract ......................... ........................................................................ Manuscript History Received: 15 December 2019 Final Accepted: 18 January 2020 Published: February 2020 A prospective study to assess the knowledge regarding maternal and child health services available among antenatal women visiting antenatal OPD, Government Medical College and Hospital, Sector-32, Chandigarh. The objective of the study is to assess the knowledge regarding maternal and child health services available among antenatal mothers and to find out association between knowledge score with selected socio demographic variables.A prospective, observational research design was used.Convenient sampling technique was used to select 120 subjects visiting antenatal OPD, Government Medical College and Hospital, Sector-32, Chandigarh.Data obtained from study subjects by proformas developed by the researchers consisting of Part A to collect socio-demographic data and Part Bto assess knowledge regarding maternal and child health services available.Approval was taken from research and ethical committee of the institution.Written permission was obtained from incharge of academics GMCH, sector32, Chandigarh. Data analysis was done by calculating mean, standard deviation, percentage and correlation coefficient by using descriptive and inferential statistics at p<0.05 was considered statistically significance. Majority of the antenatal women had average knowledge regarading maternal and child helath services available. There were no association between knowledge score and demographic variables. The present study was conducted on 120 antenatal women visiting antenatal OPD at GMCH sector-32, Chandigrh, to assess knowledge regarding maternal and child health services available among antenatal women.

A prospective study to assess the knowledge regarding maternal and child health services available among antenatal women visiting antenatal OPD, Government Medical College and Hospital, Sector-32, Chandigarh. The objective of the study is to assess the knowledge regarding maternal and child health services available among antenatal mothers and to find out association between knowledge score with selected socio demographic variables.A prospective, observational research design was used.Convenient sampling technique was used to select 120 subjects visiting antenatal OPD, Government Medical College and Hospital, Sector-32, Chandigarh.Data obtained from study subjects by proformas developed by the researchers consisting of Part A -to collect socio-demographic data and Part B-to assess knowledge regarding maternal and child health services available.Approval was taken from research and ethical committee of the institution.Written permission was obtained from incharge of academics GMCH, sector-32, Chandigarh. Data analysis was done by calculating mean, standard deviation, percentage and correlation coefficient by using descriptive and inferential statistics at p<0.05 was considered statistically significance. Majority of the antenatal women had average knowledge regarading maternal and child helath services available. There were no association between knowledge score and demographic variables. The present study was conducted on 120 antenatal women visiting antenatal OPD at GMCH sector-32, Chandigrh, to assess knowledge regarding maternal and child health services available among antenatal women.

…………………………………………………………………………………………………….... Introduction:-
Maternal and child Health services (MCH) are the promotive, preventive, curative, rehabilitative health care directed to mother and children in the form of service programmes.In India women in reproductive age (18-45 years) and children below 5 years of age comprise 60% of the total population. Women and children constitute a vulnerable section of the population. As, pregnancy is the vital event for the women so it needs special attention from the time of the conception to the post-natal stage. Mother's health status during pregnancy and after delivery determines the health status of the child. 2 Maternal and Child Health service was first initiated in 1900's in India. Maternal and child health service was the voluntary work co-ordinate maternal and child welfare bureau under Indian red cross society. WHO and UNICEF support contributed to the expansion of maternal and child healthservices. In 1974 the fifth ISSN: 2320-5407 Int. J. Adv. Res. 8(02), 798-802 799 five-year plan first integrated family planning with maternal and child health services. Community volunteers will need to spread awareness and knowledge of family planning and maternal and child health services. 3 The fact that more than 1lakh women in India are estimated to die every year from pregnancy and child birth related causes due to inadequate knowledge of maternal and child health services& illiteracy, poverty, population density etc. The overall efforts of maternal & child health professionals involves practicingmaternal and child health services to provide health care service based on most recent scientific research to assess & identify maternal and child health services problems & plan interventions. 4 Considering the high maternal deaths in developing countries, WHO in 1987 initiated of "safe Motherhood Initiative" at conference in Nairobi, Kenya. Safe Motherhood initiative aim is to reduce maternal mortality & morbidity. Maternal & child health promotion is one of the key commitments in the WHO. 5 With its disparate origin, maternal and child health services has become a family centred, life cycle and developmental approach to meet the health need of the women and children. Health of the mother and children is very important for acceptance and practices of small family norms to establish population. Hence in public health greater emphasis is given to maternal and child health services. Maternal and child health care services are essential and specialized services. More ever children are asset for the family, community and nation, whereas mothers have an important role in their growth and development. 6 Need For The Study: Women, the word sounds so powerful. Since eternity women have played a role more important than men and that is no exaggeration the world would not have been the same lovely, adorable and liveable place without wonderful contribution so selflessly made by women. Women have always carried the burden of being a wife, mother, sister etc. 7 Antenatal care (ANC) is the care given to the pregnant women so that they have safe pregnancy and healthy babies. ANC is pivotal factor for safe motherhood. 8 Most pregnant women in the developing countries, receive insufficient or no prenatal care. More than seven million new born deaths are believed to result from maternal health problem. These estimations do not only show importance of MCH care rather they affect the role and necessity of MCH services in welfare of family, community and country. 9 Problem statement: A prospective study to assess the knowledge regarding maternal and child health services available among antenatal women visiting antenatal OPD, Government Medical College and Hospital, Sector-32, Chandigarh.
Objectives:-1. To assess the knowledge regarding maternal and child health services available among antenatal mothers. 2. To find out association between knowledge score with selected socio demographic variables.

Hypothesis:
1. H 0 (Null Hypothesis) -There is statistically no association between knowledge score with selected socio demographic variables at p<0.05. 2. H 1 (Research Hypothesis) -There is statistically association between knowledge score with selected socio demographic variables at p<0.05.

Delimitations:
1. The study was delimited to reproductive women. 2. The study included 120 samples only. 3. Women who can read and write was taken for the study.

Material and Methods:-
Quantitative research approach was selected as the study was to assess the knowledge regarding maternal and child health services available among antenatal women.A prospective observational study design was used to utilize the objectives. The study was conducted in antenatal OPD, Government Medical College and Hospital, sector 32, Chandigarh. Target population were all the antenatal women visiting the antenatal OPD at GMCH, Chandigarh.
Convenient sampling technique was used to select the available samples from the target population. Sample size was calculated and 120 mothers were taken. Mothers who were above 18 years of age and who can understand Hindi/English/Punjabi were included in the study.Permission of conducting research study was taken from ethical and research committee of Government Medical College and Hospital, sector 32, Chandigarh. Permission was taken 800 from head of the department of the department of obstetrics and gynecology. Written informed consent from the mothers was taken. Confidentiality and anonymity of samples was maintained.
Tool was constructed and verified to collect data from the samples. It had 2 parts namely 1. Part A-Questionnaire related to socio-demographic profile 2. Part B-Questionnaire related to assess the knowledge regarding maternal and child health services available among antenatal women.
Consent was taken from each mother for collection of data.
Data analysis was done in an agreement with the objectives of the study. Data analysis was done by using the descriptive and inferential statistics. The level of significance was selected at p<0.05. Data analysis was done by calculating mean, mode, median, standard deviation, percentage and ANOVA.

Findings related to Percentage distribution of knowledge regarding maternal and child health services among antenatal women:
It was found that 64.2% and 33.3% gave correct answer regarding MCH services and JSSK respectively. 95.8% gave the correct answer that registration of pregnancy isfree.87.5% of the subjects gave the appropriate response regarding free drugs during pregnancy & post-natal period. 94.2% gave the correct answer that TT (tetanus toxoid) vaccination during pregnancy is free. 76.6% knew regarding free diagnostic tests. 63.3% of subjects gave the appropriate response regarding free diet during antenatal period at anganwadi. 60% subjects knew that transport from home to health institution at the time of deliveryis free. 61.7% of subjects gave the correct answer that diet during hospital stayis free. 65.8% of subjects knew regarding free hospitalization for women for 48 hours after NVD (normal vaginal delivery) and 7 days after caesarean section. 58.3% gave the correct answer that drop back from institution to home after 48 hours stayis free. 41.7% of the subjects gave the appropriate response that Rupees 700 is given to SC/ST mothers after each delivery in rural area under JSY scheme. 65.0% gave the negative response that Rupees 600 is given to SC/ST/BPL mothers after each delivery in urban area under JSY scheme. 60.0% of subjects gave the negative response that there is no provision of incentive for girl child. 75.0% gave the negative response regarding provision of special incentive in case of Intra uterine death. 39.2% of subjects gave the correct answer that MTP servicesare free. 70% gave the appropriate response regarding facilities for family planning (pills, condoms etc.). 24.2% of the subjects knew regarding rupees 1100 is given to men undergoing vasectomy. 25% gave the correct answer that rupees 250 is given to women undergoing tubectomy. 82.5% of the subjects knew regarding free drugs and consumables for infants. 81.7% gave the correct response that tests for infants are free. 82.5% gave the appropriate answer that vaccination for children under National Immunization Schedule is free of cost. 73.3% knew that diet for children in anganwadi is free.

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Percentage distribution of knowledge score regarding maternal and child health services. Figure depicts that 24.2% of total subjects had good knowledge, 62.5% had average knowledge and 13.3% had poor knowledge regarding maternal and child health services. Hence it was concluded that antenatal women had average knowledge regarding maternal and child health services available among them.

Findings related to association between selected socio demographic variables and knowledge score
It was found that knowledge score was significantly associated with father's education (0.008 & df=5) at p<0.05 level and per capita income (0.003 & df=04) at p<0.05 level. No association was found between knowledge score and other demographic variables like age, educational status(self), religion, residential area, occupation(self), occupation(father), monthly family income, no. of family members, socio economic status, obstetric history and place of previous delivery.

Discussion:-
Findings of the study show that antenatal women had average knowledge regarding maternal and child health services available among them. Overall mean knowledge score of antenatal women was (1.716+0.55) that is Out of total subjects 24.2% of total subjects had good knowledge, 62.5% had average knowledge and 13.3% had poor knowledge regarding maternal and child health services.One descriptive study revealed that knowledge regarding antenatal care to the pregnant mothers is less in primigravida, low socioeconomic status and low educational level.

Conclusion:-
The present study was conducted on 120 antenatal women visiting antenatal OPD at GMCH Sector-32, Chandigarh, to assess knowledge regarding maternal and child health services available among antenatal women. The findings of the study reveal that out of total subjects 24.2% had good knowledge, 62.5% had average knowledge and 13.3% had poor knowledge regarding maternal and child health services.