International Journal of Trend in Scientific Research and Development (IJTSRD)

Volume 5 Issue 4, May-June 2021 Available Online: www.ijtsrd.com e-ISSN: 2456 – 6470

A Study to Assess the Effectiveness of Structured Teaching

Programme on Knowledge Regarding Management of Low
Birth Weight (LBW) Babies among Postnatal Mothers in
Selected Community at Gwalior
Ms. Divya Singh1, Ms. Sunita Singh2
1Nursing
Tutor, Department of Community Health Nursing,
2Nursing
Tutor, Department of Obstetrics and Gynecological Nursing,
1,2Baba Educational Society Institute of Paramedical College of Nursing, Lucknow, Uttar Pradesh, India

ABSTRACT How to cite this paper: Ms. Divya Singh |

Background: Low birth weight is one of the important causes for the high Ms. Sunita Singh "A Study to Assess the
infant mortality rate in developing countries. In India during the year 1991, Effectiveness of Structured Teaching
the IMR was 80 per 1000 live births & neonatal mortality rate (NMR) was 51 Programme on Knowledge Regarding
per 1000 live births.LBW babies have been reported to lag behind their Management of Low Birth Weight (LBW)
heavier counterpart in development for the rest of their lives. Objective: The Babies among Postnatal Mothers in
present study attempted to assess the effectiveness of structured teaching Selected Community at Gwalior"
programme on knowledge regarding management of low birth weight (LBW) Published in
babies among postnatal mothers. Methods: In the present study, evaluative International Journal
research approach was selected; one group pre-test and post-test design was of Trend in Scientific
adopted. The structured interview schedule on management of low birth Research and
weight (LBW) babies among postnatal Mothers was used to collect the data. Development (ijtsrd),
The main study was conducted at Kedarpur and Barai rural community ISSN: 2456-6470,
Gwalior, Madhya Pradesh, with the sample size of 40 postnatal mothers Volume-5 | Issue-4,
IJTSRD42452
selected by using convenient sampling technique and the collected data were June 2021, pp.982-
analyzed and interpreted based on descriptive and inferential statistics. 988, URL:
Results: The overall mean score of the subjects in pre-test was 56.25% with www.ijtsrd.com/papers/ijtsrd42452.pdf
standard deviation 2.80. In post-test, the mean percentage of the Overall
means score of the subjects in post-test was 76.25% with standard deviation Copyright © 2021 by author (s) and
2.28. The obtained ‘t’ value was greater than the table value and found to be International Journal of Trend in Scientific
highly significant at the level of p<0.005. The findings evidenced structured Research and Development Journal. This
teaching programme was effective in increasing the knowledge of the is an Open Access article distributed
postnatal mothers regarding management of low birth weight (LBW) babies. under the terms of
Conclusion: The study concluded that there was a significant improvement in the Creative
the knowledge after structured teaching programme. Thus structured teaching Commons Attribution
programme is effective in improving the knowledge of the mothers. License (CC BY 4.0)
(http://creativecommons.org/licenses/by/4.0)
KEYWORDS: Structure teaching programme, Effectiveness, Knowledge, Postnatal
mothers, Low birth weight

INTRODUCTION:
Motherhood is a beautiful and joyous experience to a full-term babies who are small for date due to intrauterine
woman. The health of the mother during pregnancy is growth retardation.3
important to give birth to a healthy baby. The best and most
Survival of LBW new born during first month of life is
precious gift a mother can give her baby is the gift of health.1
determined by stressors of intrauterine life, problems faced
The healthy new born is born at term, cries immediately
during delivery as well as by adjustment to new
after delivery and establishes satisfactory rhythmic
environment. Birth weight is the single most important
pulmonary respiration. In India reports of various studies
marker of adverse perinatal, neonatal and infantile outcome.
shows birth weights of mature new born varying between
Over 80 percent of all neonatal deaths occur among the LBW
2.5 to 3.9 kgs with a mean of 2.7 kgs.2
babies. LBW infants have 2-3 times increased risk of
WHO has defined the term “low birth weight” as birth weight mortality due to infection compared to normal birth weight
less than 2500 grams. As per the definition babies with birth babies. The common problems associated with premature
weight of less than 2500 grams are classified as low birth babies are hypothermia respiratory distress syndrome,
weight irrespective of the duration of the gestational period. difficulty in feeding because of weakness, more susceptible
New-borns with birth weight (for gestational age) of less to infection, greater likelihood of contracting jaundice.4
than 10th percentile are categorized as “small for date”
NEED FOR STUDY:
(SFD). Thus the term low birth weight includes preterm
Low birth weight new-borns forms a paediatric priority
babies (those born before 37 weeks of gestation) as well as
because they have less chance of survival than babies

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 International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
weighing 2500 gm. Half of the prenatal and one third of method between the investigator and study subject that
infant mortality are due to the low birth weight. Low birth helps for knowing about factors affecting and management
weight may lead to serious physical and mental handicap in of LBW new-borns
those who survive. Incidence of LBW new-borns in India is
Low birth weight: Any new born or neonate weighing less
estimated to be 5-7 percent in some of the industrially
than 2500gm at birth irrespective of gestational age. In this
advanced countries.5
study it refers to those new born whose weight at birth was
In India about 25-35 percent of babies are born with low less than 2500gms irrespective of gestational age.
birth weight. Over 80 percent of neonatal deaths and 50
MATERIAL AND METHOD:
percent of infant deaths occur among low birth weight
Research approach:
neonates. A LBW new born may face problems like
An evaluative research approach was adopted.
hypothermia, increased chance to acquire infection due to
lack of immunity and LBW new-borns are at high risk of Research design:
having problem with feeding which later can lead to Quasi-Experimental with one group pre-test post- test
malnutrition10. Hence it is important to educate the mother design.
about the problem and how to manage the new born with
Variables:
such problems.6
 Dependent variable-knowledge of postnatal mothers
More than 95% of low birth weight babies are born in regarding management of low birth weight (LBW)
developing countries. However, data collection for low birth babies.
weight is difficult because babies are not weighed at birth in  Independent variable-Structured teaching programme
many countries. Nearly 4 million babies die in the first on management of low birth weight (LBW) babies.
month of life and premature birth are major causes. Half of  Extraneous variables-Age, education, occupation,
all low birth weight babies are in south-central Asia, where religion, Family income, gravida, type of diet, type of diet
27% of infant are born below 5.5 pounds low birth weight Type of Present Delivery, previous history of Low Birth
levels in sub-subsaharan.7 Weight Baby, Source of information regarding Low Birth
Weight Baby.
The researcher felt the need to identify the needs of mothers
and educate them on care of LBW new-borns, so as to Setting:
improve the care of LBW new-borns and to promote normal The study was conducted in Kedarpur and Barai rural
and healthy growth and development and thereby reduce community Gwalior.
LBW new-borns mortality and morbidity.
Population:
PROBLEM STATEMENT:  Target population-Postnatal mothers with low birth
“A study to assess the effectiveness of structured teaching weight babies in selected community at Gwalior.
programme on knowledge regarding management of low
Sample:
birth weight (LBW) babies among postnatal mothers in
Postnatal mothers residing in selected community at
selected community at Gwalior.”
Gwalior.
OBJECTIVES:
Sample size: 40
1. 1.To determine the level of knowledge of postnatal
mothers regarding management of low birth weight Sample techniques:
babies by pre-test score Convenient sampling technique was adopted to select the
2. To evaluate the effectiveness of structured teaching samples.
programme on management of lowbirth weight babies.
Criteria for sample selection:
3. To find the association between pre-test & post-test
Inclusion criteria of the present study were-
knowledge scores with selected demographic variables
 Postnatal mothers who are willing to participate in the
HYPOTHESIS: study.
H1: There will be a significant difference between pre and  Postnatal mothers those who are available during data
post-test knowledge scores of mothers. collection.
H2: There will be significant association between pre-test
Exclusion criteria of the present study were-
and post-test knowledge scores with selected demographic
 Mothers who are previously not sensitized with similar
variable.
studies.
OPERATIONAL DEFINITIONS
Tool and method of data collection:
Assess: It refers to knowledge level of mothers regarding the
Part I: Comprised demographic data
factors affecting & management of low birth weight babies.
Part II: Comprised Structured interview schedule for
Knowledge:
postnatal mothers, which had very relevant, relevant, need
In this study it refers to the correct response of mothers of
modification, not relevant and remarks of experts.
LBW new-borns to the knowledge item in a structured
teaching programme on the care ofLBW new-borns& Selection and development of tool: In present study data
expressed in term of knowledge scores. collection technique was structured interview schedule. It is
considered to be the appropriate instrument to elicit the
Mothers: It refers to individuals who are having new born
response both from literates and illiterates. Keeping this in
babies whose birth weight is less than 2500gms.
mind structured interview schedule was selected and
Structured teaching Programme: Refers to systematically developed on management of low birth weight (LBW)
developed instructional babies. The tool was developed by internet search, an

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 International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
extensive review of literature, and the various experts in the subject was selected by convenient sampling technique. The
field of nursing and based on the investigator’s personal investigator given self-introduction explained the purpose of
experience the Structured Interview schedule on the study, subject’s willingness to participate in the study
management of low birth weight (LBW) babies. was ascertained. The subjects are assured anonymity and
confidentiality of the information provided by them and
Description of the tool: Structured Interview schedule
written informed consent was obtained. The pre-test was
consist of 2 parts i.e. Part I and part II
conducted by administering the Structured Interview
Part I: Consists of items on demographic variables like, age, schedule followed by STP on management of low birth
education, occupation, religion, Family income, gravida, type weight baby. On the 7th day post test was conducted by
of diet, type of diet Type of Present Delivery, previous using the same tool, each subject took 30 minutes to answer
history of Low Birth Weight Baby, Source of information the Interview schedule.
regarding Low Birth Weight Baby.
Ethical consideration:
Part II: Consists of 40 knowledge items related to Ethical Clearance will be obtained from the in University or
management of low birth weight baby which include General College ethical committee. Informed written consent will be
concept, Physiological alteration in a low birth weight, taken from the study subjects after giving proper
Breast feeding, Kangaroo mother care, Physical care, explanation of the purpose of the study. Informed consent
Temperature, Prevention of infection. will be developed in English as well as in Hindi language.
Confidentiality and anonymity of the subjects will be
SCORING KEY
maintained throughout the study.
Scoring key is prepared for Part-I by coding the demographic
variables. For Part-II score ‘1’ and ‘0’ are awarded to correct Plan for data analysis:
and wrong response. Thus the maximum score is 40.  Demographic variables would be analyzed using
descriptive statistics i.e. frequency and percentage.
To interpret the level of knowledge the scores subjected as
follows:  Pre and post-test knowledge scores of the participants
Inadequate <50, Moderate 50- 75, Adequate > 75 were planned to be summarized in mean, standard
deviation and mean percentage.
Reliability of tool:Split Half method was used and reliability
co-efficient was calculated by using raw score formula. The  The paired ‘t’ value was planned to test hypothesis for
calculated ‘r’ value is 0.81 and the developed tool was found the purpose of the effectiveness of teaching programme.
to be highly reliable.
 The chi square value were planned to be computed in
Data collection procedure- After obtaining the formal order to test hypothesis to find out the relationship
permission from the district health officer Chickaballapur between pre- test knowledge level and demographic
[dist].The main study was conducted among 40 subjects; the variables.
RESULTS:
Table-1Distribution of subjects according to their demographic variables
S.NO Demographic variables Frequency Percentage
1. Age of mothers in Years
18-27years 16 40
28-37years 20 50
38-47 years 04 10
2. Educational Level
Primary education 12 30
Secondary education 14 35
Intermediate 01 2.5
Graduate 09 22.5
Post-graduation and above 4 10
3. Occupation
House wife 15 37.5
Agriculture 05 12.5
Government employee 19 47.5
Self employed 01 2.5
4. Religion
Hindu 14 35
Muslim 18 45
Christian 08 20
5. Family income
Below Rs. 5000 5 12.5
Rs. 5001-10000 18 45
Rs. 10001-15000 01 2.5
Rs. 15001-20000 04 10
Rs. 20001 and above 12 30
6. Gravida status
Prime 29 72.5
Second 11 27.5

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7. Family type
Nuclear 31 77.5
Joint 09 22.5
8. Type of diet
Vegetarian 14 35
Non vegetarian 26 65
9. Place of residence
Urban 35 87.5
Rural 05 12.5
10. Type of present delivery
Normal Vaginal 13 32.5
Forceps delivery 04 10
Cesarean Section 23 57.5
11. Previous history of low birth weight baby
Yes 00 00
No 40 100
12. Source of information
Radio/Television 17 42.5
News paper/Books 09 22.5
Family members/Relatives/ Friends 07 17.5
Health Personnel/Health magazines 07 17.5
Table1. described about the frequency, percentage distribution of demographic variable. Distribution of the subject, Majority
of subjects 50 % belong to the age group of 28-37 years, In relation to education 35% completed secondary education, 30% of
subjects were completed primary education, In this study 47.5% of mothers were employed in government set up, 237.5%
were house wife, Majority 45% of mothers belong to Muslim and only 20% belong to Christian religion. In this study 45 %
mother had family income between Rs. 5001-10000, 30% of mother had Rs. 20001 and above, Majority 72. 5% of mothers were
prime gravida and only 27.5% were second gravida. Majority 77.5% of mothers belongs to nuclear family and only 22.5%
belongs to joint family, majority 65% of mothers is to have non vegetarian and only 35% is to have vegetarian, Majority 87.5 %
of mothers were residing in urban area and only 12.5% were residing in rural area, Majority 57.5 % of mothers have under
gone cesarean section, and only 10% of mother underwent forceps delivery, majority 55% of mothers had two children and
only 45% of mothers had one child, Majority 100% of mothers had no history of low birth weight baby and majority 42.5% of
mothers had information from Radio/Television.
Table-2 Pre-test and post-test knowledge level of postnatal mothers
Knowledge level Pre test Pre test Post test Post test
Frequency Percent Frequency Percent
a. Inadequate knowledge 10 25.0 0 0.0
b. Moderate knowledge 30 75.0 20 50.0
c. Adequate knowledge 0 0.0 20 50.0
Total 40 100 40 100

Table 2shows that 75% of participants had moderate knowledge and only 25% had inadequate knowledge in pre-test and in
post-test 50% had adequate knowledge and moderate knowledge respectively.
Table 3: mean, mean percentage and standard deviation for the pre-test knowledge of postnatal mothers
N=40
No. of Max
Sl. N. Knowledge aspects Mean Mean % SD
Items Score
1 General concept 6 6 4.12 68.66 0.853
2 Physiological alteration in a low birth weight new-born 9 9 5.12 56.88 0.822
3 Breast feeding 10 10 5.52 55.2 0.905
4 Kangaroo mother care 3 3 1.72 57.33 0.64
5 Prevention of infection 6 6 2.88 48 1.09
6 Temperature 3 3 1.15 38.33 1.189
7 Physical care 3 3 1.98 66 0.48
Overall 40 40 22.5 56.25 2.801
The above table shows that the maximum mean percentage obtained by the subjects is found in the aspect of general concept
(68.665%) followed by Physical care (66%)kangaroo mother care (57.33%) Physiological alteration (56.88%), Breast
feeding(55.2%), prevention of infection (48%) and least mean score (38.33%) found in the aspect of Temperature. The overall
knowledge scores of respondents were found to be56.25% with standard deviation 2.80 in pre-test.

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Table – 4: mean, mean percentage and standard deviation for the post-test knowledge of postnatal mothers
N=40
Sl. No. Knowledge aspects No. of Items Max Score Mean Mean % SD
1 General concept 6 6 4.35 72.5 0.533
2 Physiological alteration in a low birth weight newborn 9 9 7.8 86.66 1.203
3 Breast feeding 10 10 7.4 74 0.955
4 Kangaroo mother care 3 3 2.38 79.33 0.49
5 Prevention of infection 6 6 5.08 84.66 0.944
6 Temperature 3 3 1.82 60.66 0.594
7 Physical care 3 3 1.82 60.66 0.549
Overall 40 40 30.65 76.25 2.282

The above table shows that the maximum mean percentage obtained by the subjects is found in the physiological alteration
(86.66%) followed by Prevention of infection(84.66%) kangaroo mother care (79.33%) breast feeding (74%), general
concept(72.5%), and least mean score (60.66%) found in the aspect of Temperature and physical care respectively. The overall
knowledge scores of respondents were found to be 76.25% with standard deviation 2.282 in post-test.
Table5: Comparison of pre-test and post-test Knowledge scores of postnatal mothers regarding Management of
low-birth-weight babies
N=40
Sl. Pre test Post test Mean t
Knowledge aspects Df Inference
No. Mean S D Mean S D difference Value
1 General concept 4.12 0.853 4.35 0.533 0.23 1.548 39 NS
2 Physiological alteration in a low birth weight new born 5.12 0.822 7.8 1.203 2.67 11.213 39 S
3 Breast feeding 5.52 0.905 7.4 0.955 1.87 10.233 39 S
4 Kangaroo mother care 1.72 0.64 2.38 0.49 0.65 4.932 39 S
5 Prevention of infection 2.88 1.09 5.08 0.944 2.20 9.814 39 S
6 Temperature 1.15 1.189 1.82 0.594 0.67 3.420 39 S
7 Physical care 1.98 0.48 1.82 0.549 0.15 1.290 39 NS
Overall 22.5 2.801 30.65 2.282 8.15 13.968 39 S
From the above table it is evident that the obtained "t" value 13.96 is greater than the table value at 0.01 level of significance.
Therefore, "t" value is found to be significant. It means there is gain in knowledge level of mothers. This supports that
structured teaching programme on management of low-birth-weight baby’s is effective in increasing the knowledge level of
mothers.

Fig: Comparison of pre and post-test Knowledge scores of postnatal mothers

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 International Journal of Trend in Scientific Research and Development (IJTSRD) @ www.ijtsrd.com eISSN: 2456-6470
Table – 6: Association of Pre-test knowledge scores of postnatal mothers with selected demographic variables
N= 40
P value
Variables Below Median Median and Above Chi square Df Inference
(0.5)
1. Age in Years
A. 18-27 Years 11 5
B. 28-37 Years 6 14 6.111 2 0.047 NS
C. 37-47 Years 1 3
2. Education
A. Primary Education 9 3
B. Secondary Education 3 11
C. Intermediate 1 0 9.264 4 0.055 NS
D. Graduate 3 6
E. Post Graduation and above 2 2
3. Occupation
A. House wife 5 10
B. Agriculture 3 2
2.545 3 0.467 NS
C. Government employee 10 9
D. Selfe employee 0 1
4. Religion
A. Hindu 3 11
B. Muslim 11 7 5.111 2 0.078 NS
C. Christian 4 4
5. Family income
A. Below Rs. 5000 2 3
B. Rs. 5001-10000 5 13
C. Rs. 100-15000 1 0 8.440 4 0.077 NS
D. Rs. 15001-20000 1 3
E. Rs. 201 and above 9 3
6. Gravida Status
A. Prime 14 15
0.457 1 0.499 NS
B. Second 4 7
7. Family type
A. Nuclear 14 17
0.001 1 0.970 NS
B. Joint 4 5
8. Type of Diet
A. Vegetarian 8 6
1.283 1 0.257 NS
B. Non vegetarian 10 16
9. Place of residence
A. Urban 16 19
0.058 1 0.810 NS
B. Rural 2 3
10. Type of delivery
A. Normal 4 9
B. Forceps delivery 1 3 2.944 2 0.229 NS
C. Cesarean Section 13 10
11. Previous History of Low birth Weight
A. No 18 22 - - - -
12. Source of Information
A. Radio/Television 11 6
B. News paper/Books 4 5
C. Family members/Relatives/ Friends 1 6 6.100 3 0.107 NS

D. Health Personnel/Health magazines 2 5

The finding shows that the obtained χ2 value is less than the table value at0.05 levels of significance.
Therefore, there is no significant association between pre-test and post-test knowledge scores with selected demographic
variables of participants.

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DISCUSSION  A comparative study can be conducted between urban
EFFECTIVENESS OF STRUCTURED and rural settings.
TEACHINGPROGRAMME ON MANAGEMENT OF LOW
 A study can be carried out to evaluate the efficiency of
BIRTH WEIGHT BABIES
various teaching strategies like self-instructional
The present study reveals that overall mean knowledge
module, pamphlets, leaflets and computer-assisted
score obtained by the subjects was 22.5 in the pre-test
instruction on low birth weight babies.
whereas the overall knowledge obtained by the subjects was
30.65 in the post-test. The improvement means score for Conflict of interest: No
overall knowledge was 8.15 with the ‘t’ value of 13.96 was
Financial support: Self
greater than the table value at 0.05. Hence the research
hypothesis which stated there will be significant difference REFERENCE:
in pre and post level knowledge on management of low birth [1] Singh M. Care of newborn. 6th ed. New Delhi: Sagar
weight (LBW) babies among postnatal mothers was Publications; 2004.
accepted. This showed that the structured teaching
[2] Dawn CS. Textbook of obstetrics, neonatology and
programme was effective in increasing the knowledge of the
reproductive and child health education. 16th ed.
postnatal mothers regarding management of low birth
Kolkata: Dawn Books; 2004.
weight (LBW) babies.
[3] Gurav BR, Kartikeyan S, Jape RM. Low birth weight
The following study is similar to investigator study which
babies. [Online]. Available from:
supports the study.
URL:http://www.bhj.org/journal/2003_4503_july/lo
The study conducted by E BinuMargerat et al. who assessed wbirth_413.htm
effectiveness of awareness programme on care of new-born
[4] Premature babies. India Parenting. [Online]. Available
for mothers of neonates in selected hospitals of Udupi
from:
District, Madhya Pradesh.
URL:http://www.indiaparenting.com/articles/data/a
It was found that there was improvement in knowledge. rt06_003.shtml.
CONCLUSION: [5] Trivedi CR, Maralankar DV. Epidemiology of LBW in
Conclusions drawn from present study was as follows- Ahmedabad. Indian Journal of Paediatrics; 53:795-
800.
Structured teaching programme is an effective method. The
pre-test mean is 22.5 and post-test mean score is 30.65 and [6] Das KB, Mishra NR, Mishra PO, Bhargava V, Prakash A.
the ‘t’ value was 13.96. The obtained ‘t’ value 13.96 was Comparative outcome of low birth weight babies.
found to be significant at 0.01 Levels of significance. Indian Pediatrics 1993 Jan; 30(1):15-21.
RECOMMENDATIONS: [7] Ramang Raghu ST, Devagan A, Sood LS, Gupta A,
 An experimental study can be undertaken with a control Ravichander B. Low birth weight babies: incidence
group for effective comparison of the result. and risk factors. Medical Journal of Armed Forces of
India 1998 Jul; 53(3):191-5.
 A study can be conducted by including additional
demographic variables. [8] E BinuMargerat et al. care of newborn by their
mothers. Nightingale Nursing Times. Vol 4 Juiy 08.

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