International Journal of Health Sciences and Research

www.ijhsr.org ISSN: 2249-9571

Original Research Article

Effectiveness of Health Education Package on Knowledge and Practice

Regarding Care of Low Birth Weight Babies (LBW) Among Post Natal
Mothers
Mrs. Kavita Bhoknal

Clinical Instructor, Pravara Institute of Medical Sciences (DU) College of Nursing, Loni (Bk), Tal. Rahata, Dist.
Ahmednagar, Maharashtra

ABSTRACT

Background: It was estimated that around 25 millions of low weight babies are born annually and
they are exposed to number of problems like hypoglycemia, infection, hypothermia and respiratory
problems etc. It is essential that the babies are taken care specially with utmost precaution. They need
special nursing care. The present study was undertaken with an aim to determine the effectiveness of
health education package on care of LBW baby among post natal mothers.
Material and methods: A quasi experimental study, pre and post test design without control group
approach was undertaken among post natal mothers of Pravara Rural Hospital, Loni (Bk). A total of
50 post natal mothers were selected by simple random sampling technique, and self prepared and
content validated structured questionnaire (for knowledge) and checklist (for practice) was used for
data collection. The descriptive statistics (mean, SD and inferential statistics (chi square test) were
applied wherever required.
Results: In pre test, the overall knowledge score was (21.2±4.52) which is 66% (average) whereas
after implementation of health education package (post test) the score has improved i.e. (29.4±1.51)
which is 91.81% (good) and found statistically significant (t =6.28) at p<0.05 level. Similarly the post
test practice score had improved from ‘partially adaptive’ practice (15.78±3.34) to ‘completely
adaptive’ practice (23.32±1.93) and found significant (t=6.28) at p<0.05 level. It was noted that
practice on care of LBW babies had significant association with demographic variables like
educational qualification (x2=5.99), type of family (x2=4.56) and parity of mother (x2=8.06) at p<0.05
level.
Conclusion: The study outcome revealed that the health education package was found effective in
improving the knowledge and practice on care of low birth weight baby of post natal mothers. It
should be emphasized to have a health education packages on care of LBW babies in daily practice to
enhance awareness and increase the competency of postnatal mothers.

Keywords: Effectiveness, Health education package, Knowledge, Practice, Low birth weight babies

INTRODUCTION few hours of life, before significant

The birth weight of an infant is the postnatal weight loss has occurred. [1]
single most important determinant of its The new born health challenge faced
chances of survival, growth and by India is bigger than that experienced by
development. The ideal birth weight for a any other country. Each year 20% of the
newborn baby is 2500 kilograms and above. world’s infants (26 million) are born in our
As per World Health Organization low birth country. Currently for every minute three
weight baby (LBW) is one with a birth neonates are dying in India and every fourth
weight of less than 2500 grams the baby born is low birth weight. The current
measurement being taken within the first neonatal mortality rate (NMR) is 43 per

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Kavita Bhoknal. Effectiveness of Health Education Package on Knowledge and Practice Regarding Care of Low
Birth Weight Babies (LBW) Among Post Natal Mothers

1000 live birth accounts for nearly two – LBW is a multifaceted problem with
thirds of all infant mortality and half of some known and few unknown reasons. The
under five child mortality. Over one third of etiology of LBW is also complex with
all neonatal deaths occur on the first day of demographic, nutritional, reproductive, and
life, almost half within three days, and socioeconomic factors each potentially
nearly three four of them in the first week. playing a role. These causes can be enlisted
[2]
as maternal Hemoglobin (Hb) level, hard
The reduction of low birth weight manual work during antenatal period,
forms an important contribution to the maternal nutrition, economic condition,
Millennium Development Goal (MDG) for antenatal care, parent’s education, tobacco
reducing child mortality. Activities towards use, maternal age, and parity. [8]
the achievement of the MDGs will need to It is important to recognize that
ensure a healthy start in life for children by nursery personnel need to be trained to
making certain that women commence accept what a mother feels, and praise what
pregnancy healthy and well nourished, and a mother is doing right. Give practical help,
go through pregnancy and child birth safely. relevant information and suggestions
Low birth weight is therefore an important regarding lactation supporting lactation in
indicator for monitoring progress towards mothers of Very Low- Birth weight
these internationally agreed-upon goals. [3] (VLBW) infant are achievable with
Maternal malnutrition and anemia appropriate knowledge, attitude and skill. [9]
are the most important causes responsible Along with the training of health
for reduced birth weight in developing care professionals including nurses, TBA’s
nations. Other maternal factors playing a and anganwadi workers, it has also been
part include young age at conception, universally accepted that improved survival
multiple pregnancies; pregnancy induced rate of low birth weight babies can be
hypertension, infections, substance abuse successfully achieved by training and
etc. Genetic factors also play a role. [4] educating the mother’s and family members
The pre-maturely born baby did not on home based care. The programs of
have enough time to fully develop all his Government of India (GOI) namely Child
body organs like brain, Lungs, Heart, Survival and Safe Motherhood (CSSM) and
Kidneys and Liver etc. He is prone to Reproductive Child Health program (RCH)
several health problems due to lack of emphasizes the need of involving mother
maturity of vital organs. [5] and family members in essential new born
WHO (2009) focused on the care which focus on feeding, maintaining of
importance of caring for LBW infants, proper warmth, recognizing danger signs in
including feeding, kangaroo mother care, the new born, immunization, spacing,
hygiene, cord & skin care, early detection follow up and screening. [10]
and treatment of infections and A number of scientific studies and
complications which can remarkably reduce systematic reviews showed a significant
mortality of LBW infants. [6] improvement in awareness and skill in care
In India over 30% of the infants are of LBW babies. Alongside it was
born as low birth weight. Nearly 75% of the recommended that the education and
neonatal deaths and 50% of infant death training must be integral part of nursing
occur among low birth-weight neonates. In care, thereby reduces the occurrence of
Davangere in the year 2009 there are 995 associated illness and mortality of LBW
cases of low birth babies are admitted in babies. Thus the present study was
NICU of Bapuji Child Health Institution undertaken with an aim to assess the
among there are nearly 350 deaths are awareness, and determine the effectiveness
reported. [7] of health education package on care of
LBW baby among post natal mothers.

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Kavita Bhoknal. Effectiveness of Health Education Package on Knowledge and Practice Regarding Care of Low
Birth Weight Babies (LBW) Among Post Natal Mothers

MATERIALS AND METHODS educative materials such as leaflet,

A quasi experimental study, pre and pamphlets in local language. Post test was
post test design without control group carried out (on the day of discharge) with
approach was undertaken among the post help of same structured questionnaire. The
natal mothers admitted at Pravara Rural collected data were complied, tabulated and
Hospital, Loni (Bk), Dist. Ahmednagar, analyzed based on objectives/hypotheses
Maharashtra. A total 50 post natal mothers with help of descriptive (mean, SD and
were selected by simple random sampling mean %) and inferential (chi square test)
technique who met the inclusion criteria’s. statistical methods.
The post natal mothers had pregnancy
associated diseases such as DM, eclampsia RESULTS
and PIH; and had LSCS delivery was Socio demographic profile of post natal
excluded from the study. The self prepared mothers: Higher percentage (46%) were in
and content validated structured the age group of 19 – 22 years, and similar
questionnaire (for knowledge) and checklist percent (36%) and (34%) had secondary
(for practice) was used to gather data related school education as well as primary
to the study variables. It includes three education respectively. More than half
sections such as 1. Section A – socio (52%) of them were home makers and
demographic data of the post natal mothers significant percent (18%) were farmers,
(6 items) and clinical characteristics (5 majority (74%) were belongs to joint family
items); 2. Section B – dichotomous wherein (26%) were nuclear family. Half
questionnaire for knowledge assessment (32 (50%) of them were Hindus, and (38%) had
items – including the sub sections like a) monthly income of Rs. 3001 – 6000
introduction on LBW baby (3 items) b) followed by (28%) had income of Rs. 6001
management of LBW baby (9 items) c) – 9000. A significant percent (36%) of them
thermoregulation (4 items) d) feeding (5 had information on care of LBW babies
items) e) skin care (4 items) f) eye care through health care professionals whereas
(3items) g) infection control (5 items) and (30%) got information via mass medias like
h) complication (2 items). The correct television and radio etc.
response carries the score of one and wrong Clinical characteristics of post natal
response carries zero score; and 3. Section C mothers: More than half (54%) of post
– checklist for practice assessment (26 natal mothers were primi gravid and the
items). The each correct step caries a score remaining (46%) were multi para mothers.
of one and the incorrect/wrong step caries a Majority (74%) of them had gestational age
score of zero. Based on scores knowledge between 37 – 40 weeks, while significant
was categorized as poor, average and good; percent (26%) had less than 37 weeks.
similarly the practice was categorized in to Majority (60%) of them had height of 141 –
not adaptive, partially adoptive and 145 cm, wherein (22%) had height <140
completely adoptive practice. cm. Half (52%) of mothers had weight less
The reliability testing echoed that than 50 kg and remaining (42%) had weight
the tool was found reliable (questionnaire between 51 – 60 kg while a significant
r=0.72 and checklist r=0.96). The pre testing proportion (52%) of mothers had anemia.
was conducted before implementation of Socio demographic profile of low birth
Health Education Package on care of LBW weight baby: Majority (62%) of LBW
baby by using the structured questionnaire babies was ‘baby girl’ and remaining (38%)
followed by investigator implemented the were ‘baby boy’. Two third (66%) of babies
health education package regarding care of had birth weight between 2001 – 2500 gm
LBW baby. It was carried out with help of whereas a significant percent (34%) had
lecture cum discussion (45 – 60 minutes for weight less than 2000 gm. Half (52%) of the
two days) along with supplementation of baby’s had asphyxia, and (32%) had co

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Kavita Bhoknal. Effectiveness of Health Education Package on Knowledge and Practice Regarding Care of Low
Birth Weight Babies (LBW) Among Post Natal Mothers

morbid illness like jaundice and nephritic (15.7±3.3) which is 61%, wherein the
syndrome etc. effectiveness was 29% (range 18% to 41%)
Effectiveness of health education package and found statistically significant (t=6.28) at
on knowledge on care of LBW baby: It p<0.05 level. It echoed that the health
was noted from the depicted Table No. I education package was effective in
that the post test mean score was (29.4±1.5) improving the competence on various
which is 92% higher than pre test score aspects of care of LBW among postnatal
(21.2±4.5) which is 66%, wherein the mothers.
effectiveness was 26% (range 02% to 32%) There was a significant association
and found statistically significant (t=6.24) at found between the practice score with socio
p<0.05 level. It highlights that the health demographic variables such as education
education package was effective in (x2=5.99), type of family (x2=4.56) and
enhancing the knowledge on various aspects parity (x2=8.06) at p< 0.05 level. Similarly,
of related to care of LBW among postnatal a coefficient of correlation value depicted a
mothers. positive relationship between knowledge
Effectiveness of health education package and practice scores on care of LBW baby
on practice on care of LBW baby: It was (r=0.8). However there was no statistical
noted from the depicted Table No. II that association found between knowledge score
the post test mean score was (23.3±1.9) and socio demographic variables.
which is 90% higher than pre test score

Table No. I: Effect of health education package on knowledge regarding care of LBW baby N=50
SN Area Max Pre test Post test ‘t’ value
score Mean SD Mean% Mean SD Mean%
1 Introduction to LBW 3 2.8 1.82 93 2.8 0.28 95 5.14*
2 Management of LBW 6 4.2 0.94 71 5.4 0.78 91 5.60*
3 Thermoregulation 4 2.3 1.08 57 3-4 0.69 85 5.80*
4 Feeding 5 3.4 0.98 68 4.8 0.44 96 5.73*
5 Skin Care 4 2.4 0.67 61 3.6 0.54 91 6.01*
6 Eye Care 3 1.9 0.72 64 2.6 0.62 89 4.92*
7 Infection control 5 3.7 1.03 74 4.7 0.51 95 5.14*
8 Complication 2 1.1 0.60 55 1.7 0.41 87 4.94*
Over all 32 21.2 4.52 66 29.4 1.51 92 6.24*
Df – 29 * Significant P<0.05 level

Table No. II: Effect of health education package on practice about care of LBW baby N=50
SN Area Max Pre test Post test ‘t’ value
score Mean SD Mean% Mean SD Mean%
1 Care of fever 4 3.0 0.70 77 3.9 0.73 98 5.41*
2 Nutrition care 5 3.5 0.67 71 4.4 0.57 89 4.85*
3 Skin care 4 2.5 0.75 64 3.4 0.64 86 5.77*
4 Cord care 4 2.1 1.03 54 3.8 0.4 95 5.89*
5 Eye care 3 1.2 0.69 41 2.3 0.70 78 1.44
6 Infection control 6 3.1 1.24 53 5.32 0.76 89 6.29*
Over all 26 15.78 3.34 61 23.32 1.93 90 6.28*
Df – 29 * Significant P<0.05 level

DISCUSSION Majority (74%) of post natal

Half (52%) of post natal mothers had mothers had gestational age 37-40Weeks
weight less than 50kg while the remaining, and (26%) had gestational age less than 37
(42%) mothers had weight between 51-60 weeks. These findings were correlated with
kg and only (6% ) had weight above 61- the Meresa Gebremedhin, Fentie Ambaw,
kg.This finding were contradictory with the Eleni Admassu and Haileselassie Berhane
findings of Jaya Suryawanshi and Kaveri were from the babies born at gestational age
were from (69%) ≥45 kg whereas (61%) had of 37 weeks and more (69.43). [12]
<45 kg weight of the post natal mothers. [11] Half (52%) of post natal mothers had
anemia and (42%) had other co morbid

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Kavita Bhoknal. Effectiveness of Health Education Package on Knowledge and Practice Regarding Care of Low
Birth Weight Babies (LBW) Among Post Natal Mothers

illness. These findings were correlated with awareness influences the practice of post
WHO criteria findings that 51.13% of natal mothers on practice on care of LBW
mothers are anemic.5.03% mothers had the baby.
history pregnancy induced hypertension and
24.75% mothers had one of the obstetric CONCLUSION
complications during their pregnancy. [13] Low birth weight is one of the most
More than half (66%) of low birth significant contributing factors for neonatal
weight baby between 2001 – 2500 gm and morbidity and mortality. The reduction of
significant percent 34% of the baby’s had low birth weight and care of LBW babies
birth weight less than 2000 gm, This forms significant contribution in the
findings were contradictory with the millennium development goal. The parental
findings of Pravati Tripathy that higher education and training is paramount
percent 42% were between 1500 – 2000 gm important for mothers to overcome the
and only 26% were 2000 – 2500 gm. [14] health issues related to LBW babies, and it’s
There was a statistically significant a need of the hour. The study result
difference was found after the highlights that health education package
implementation of health education package was effective in improving knowledge as
to post natal mothers. It highlights that the well the practice on care of LBW babies,
nursing intervention was effective in and found statistically significance. It was
enhancing the awareness and practice of evident that there was a significant positive
care of LBW babies. These facts were relationship was existed between knowledge
consistent with study by Sheoran P, Babu and practice regarding care of LBW babies.
M, Mandal K and Rai K that the nurse led Hence, it should be emphasized that
education enables the knowledge and skill having educational sessions along with
on care of LBW babies among the maternal educative material like pamphlet, leaflet,
mothers. [15] poster would thereby improve the
The study findings show that knowledge and develop competencies on
recognition of LBW by mothers is difficult care of low birth weight baby. Thus it
especially when the baby is not weighed. significantly contributes in reducing the
Knowledge regarding causes and care of mortality and morbidity rate, minimize the
LBW babies was high among mothers who impact of complication. It contributes in
delivered in the hospital compared to those achieving the notion on health baby wealthy
who delivered in lower level health facilities nation.
or at home. There are beliefs especially
associated with causes of LBW, keeping the Source of Funding: Self
baby warm and feeding which affect the Conflict of Interest: Nil
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Birth Weight Babies (LBW) Among Post Natal Mothers

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How to cite this article: Bhoknal K. Effectiveness of health education package on knowledge and
practice regarding care of low birth weight babies (LBW) among post natal mothers. Int J Health
Sci Res. 2018; 8(3):167-172.

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