A
Descriptive Study to Assess the Knowledge on, Inhibition of Promotion of,
Substitution feeding as per IMS Act 2003, among staff nurses in selected in
LT.B.R.K. Memorial Hospital at Jagdalpur, Bastar, Chhattisgarh 2015
Mrs.
Smita Jha1, Mrs. Vidhya Ansh2, Ms. Renuka3,
Ms. Reena Roy3, Ms. Shalu C.3,
Ms.
Vijaya Laxmi3
1Associate Professor, H.O.D. Obstetrical and Gynaecological Nursing, Govt. College of Nursing, Jagdalpur (C.G.)
2Demonstrator, Govt.
College of Nursing, Jagdalpur (C.G.)
3B.Sc. Nursing
Forth Year, Govt. College of Nursing, Jagdalpur (C.G.)
*Corresponding Author Email: smita.chaure@gmail.com
ABSTRACT:
Introduction: Substitution
feeding is artificial feeding no one should have rights of it. Before 1992 year
substitution feeding was abundantly used without any crime. TNAI circulated
notice regarding inhibition of promotion of substitution feeding by
professional nurse in year 2015. Practice against the IMS act 2003 by nurses
will affect the professional substandard. Breast feeding is best
feeding for infant. Each year breast feeding saved 2, 50,000 no. of lives.
Contraindication of breast feeding is breast abscess mother is undertaking
psychiatric drugs. The stand for IMS act is infant milk substitutes, feeding
bottles and infant foods regulation of production supply and distribution act.
According to act any person who is advertising promotion the substitution
feeding will be punishable. Objectives: 1. To assess the knowledge on promotion of
inhibition of substitution feeding as per IMS act 2003 among staff nurse.2.
To find out the relationship between knowledge of staff nurses on promotion
of Inhibition substitution feeding as per IMS act 2003 with selected variables
as
age, sex, Education level, year of work experience, exposure, source of
information.3. To develop pamphlet on promotion of
inhibition of substitution feeding as per IMS act 2003 based on the outcome of
the study. Design: Non
experimental Descriptive design. Setting: the study was conducted in
Shri L. B. R. K. Memorial Hospital, Jagdalpur, C.G. Participants: 60
staff nurses. Measurement and tool: The knowledge on, inhibition of
promotion of, substitution feeding as per IMS act 2003, assessed by structured
multiple choice questionnaire and checklist. Descriptive and inferential
statistics were used to analyze the data. Findings: The data revealed
that 50% patients had below average knowledge score regarding, inhibition of
promotion of, substitution feeding as per IMS Act 2003, followed by 45% good
score and 5% obtained poor score. Further major findings also showed that
according to variables the knowledge on, inhibition of promotion of,
substitution feeding as per IMS act 2003, were all non significant at p<0.05
level except the variable of years of work experience in hospital .
Conclusion: The
study reveals that there is significant increase in the knowledge on inhibition
of promotion of substitution feeding as per IMS act 2003 by years of work
experience in the hospital among all staff nurses.
KEYWORDS: Inhibition
of promotion of substitution feeding as per IMS act 2003; pamphlet; all staff
nurses
INTRODUCTION:
The purpose of the infant milk
substitute’s feeding bottles and foods act 1992 and its 2003 amended is to
promote breast feeding of New born children and infants. It also looks to
ensure that approximately. TNAI circulated notice regarding
inhibition of promotion of substitution feeding by professional nurse in year
2015. Practice against the IMS act 2003 by nurses will affect the professional
substandard. According to the United
Nations Children's Fund (UNICEF), more than 10 million children die yearly,
mainly from preventable diseases such as diarrhea, pneumonia, measles and
malaria. It is estimated that if every baby is exclusively breast-fed from
birth to six months, an estimated 3,500 children’s lives can be saved each day.
India has the highest number of under-5 child deaths in the world, and
exclusive breast-feeding is considered the best intervention possible to reduce
mortality rates. Malnutrition is responsible for 55% of the
infant mortality seen in India. Breast feeding exclusively for the first six
months of an infant’s life and complementary feeding up to two year age is
essential to bottle malnutrition. The artificial feeding is a
hazardous procedure in poor homes because of the dangers of contraindication
and having dilution of the feed. It is an expensive affair and having hazards
as underfeeding, multiple nutritional deficiencies, gastroenteritis and other
superadded infection. Include lactose intolerance, obesity, atherosclerosis,
relatively poor learning abilities, poor parent- child relationship, frequent
pregnancy, family disruption and population explosion. The statement
of objectives presented in Parliament during the enactment of the IMS Act
clearly stated More than 2.4 million child deaths occur in India
each year and two-thirds of these deaths are related to inappropriate infant
feeding practices. To protect infant health , India became one of the few
countries in Asia to fully implement the International Code of Marketing of
Breast milk Substitutes with the enactment of the Infant Milk Substitutes,
Feeding Bottles and Infant Foods (Regulation of Production, Supply and Distribution)
Act, 1992 (41 of 1992) (hereinafter referred to as "the IMS Act").
The objective of the IMS Act is to protect breastfeeding from commercial
promotion, and thereby prevent malnutrition and deaths in infants and young
children. The IMS Act controls marketing practices of baby food manufacturers.
Recent research on accelerating child survival clearly establishes that
the universal practice of exclusive breastfeeding for the first six months is
the single most effective child survival intervention, which reduces the under
five child deaths about 16%in India. In India, for about 27million children
born each year, about 1.9 million die before they see their first birthday and
around 2.5 million die by the time they are five years. India has the highest
number of under-five child deaths in the world (Lancet, V 361, and 28 June,
2003). According to the new estimates and modeling exercises, interventions
that is exclusive breastfeeding during first six months and continued
breastfeeding during next 6 months, contribute to highest percentage reduction
of under five child deaths than any other intervention can offer. Every
fourth baby born in India is low birth weight baby, risk of death increases
further in such babies if they are not exclusively breastfed. Two-thirds of
infant deaths i.e. about 1.20 million infants die during first two months. It
is now known that many of these deaths are attributed to inappropriate feeding
practices. WHO and UNICEF estimate that 1.5 million infant lives could be saved
in each year through increased breastfeeding. According to WHO
(SEARO) Regional Advisor of Nutrition Dr Kunal Bagchi “Introducing cereal foods
to a child before 6 months of age displaces mother’s milk and can lead to
serious health risks including diarrhea. Babies should be exclusively breastfed
for the first six months. “A probiotic formula when given to
infants who developed intolerance to cow's milk has reversed the food allergy
by increasing gut bacteria associated with good health, new research shows.” According to Dr. J. P. Dadhich, Pediatrician,
National Coordinator, BPNI “Misleading mothers should be considered a ‘zero
tolerance’ in the interest of children’s health and survival and Government of
India should ensure that such violations end sooner.”
OBJECTIVES:
1 To
assess the knowledge on promotion of inhibition of substitution feeding as per
IMS act 2003 amended among staff nurse.
2 To
find out the relationship between knowledge of staff nurses on promotion
of Inhibition substitution feeding as per IMS act 2003 amended with selected
variables as
age, sex, Education level, year of work experience, exposure, source of
information
3 To
develop pamphlet on promotion of inhibition of substitution feeding as per IMS
act 2003amended based on the outcome of the study.
ASSUMPTION:
The staff nurses do vary in their
knowledge on on
promotion of inhibition of substitution feeding as per IMS act 2003 amended.
MATERIAL AND METHODS:
The research design used in the study
non experimental descriptive design. The population of the present study
comprises of staff nurses from shri L.B.R. K. memorial hospital Jagdalpur. In this study used sampling technique non probability convenient
sampling was used for data collection. After getting the ethical committee
clearance from Shri L. B. R.K. Memorial Hospital,
Jagdalpur and personal consent from staff nurse. The data was collected by
structured multiple choice questionnaires .the sample of the study comprises
all staff nurses and who fulfil the inclusive criteria that has been include in
the study. Both descriptive and inferential statistics were used for data
analysis.
FINDINGS:
SECTION: - I
Socio – Demographic variables of
the staff nurses:
Data revealed that maximum number of
staff nurses (70%) were in the age group of 20-30, followed by (26.60%) belongs
to age group of 31-40, and (3.33%) staff nurses were in age group 41-50. As
regards to gender (100%) were female staff nurses. in relation to educational
highest staff nurses those who were b.sc nursing (70%) followed by G.N.M.
Nursing (15%) and m.sc. nursing ( 5%). regarding years of work experience in
hospital maximum number ( 76.66%) of staff nurses were less than 10 years,
followed by (21.66% ) were having 11-20 years of experience and (1.66%) of
staff nurses were having 21-30 years of work experience. regarding area of
present exposure in hospital maximum number (31.66%) belongs to surgical ward,
followed by (30%)others ward, (20%) were medical ward and (18.33%) were
maternity ward. About source of previous information (81.66%) of staff nurses
were having information from mass media, (11.66%) were having information from
family members and friends, (5%) were having information from others and
(1.66%) were from society.
SECTION–II:
Find out the
relationship between knowledge of promotion of inhibition substitution feeding
as per IMS Act 2003 with selected variables as age, sex,
education level, and year of work experience Exposure, source of information.
Table-1
Association between pre-test knowledge and selected demographic variables N=60
|
S.
no.
|
Variables
|
Good
|
Average
|
Poor
|
|
df
|
Value
|
Inference
|
|
(f)
|
(f)
|
(f)
|
|
1
|
Age
in year
Below
20-30
31-40
41-50
51-60
|
16
9
2
0
|
26
4
0
0
|
2
1
0
0
|
7.0
8
|
6
|
12.59
|
Non
significance
|
|
2
|
Sex
Male
Female
|
0
27
|
0
30
|
0
3
|
0
|
2
|
5.99
|
Non
significance
|
|
3
|
Educational
level
M.Sc.
Nursing
B.Sc.
Nursing
G.N.M.
A.N.M.
|
3
16
8
0
|
0
24
6
0
|
0
2
1
0
|
1.
75
|
6
|
12.59
|
significance
|
|
4
|
Years
of work experience in hospital
0-10
11-20
21-30
31-40
41
and above
|
26
6
1
0
0
|
24
6
0
0
0
|
2
1
0
0
0
|
17.
47
|
8
|
15.5
|
Non
significance
|
|
5
|
Area
of present exposure in hospital.
Medical
Surgical
Maternity
Others,
if yes, specify------
|
2
12
6
9
|
8
8
4
8
|
0
0
0
3
|
11.
37
|
6
|
12.59
|
Non
significance
|
|
6
|
Source
of information on inhibition of promotion of the substitution feeding.
Mass
media
Family
member and friends
Society
Others,
if yes specify-
|
24
2
0
1
|
22
5
1
2
|
3
0
0
0
|
3.5
3
|
6
|
12.59
|
|
Chi square test
was computed to find the association between the pre-test knowledge level and
selected demographical variables. The finding showed that according to
variables the knowledge on promotion of substitution feeding as per IMS act
2003 of staff nurses were not significant at p<0.05 level. Further finding
also showed that knowledge of staff nurse and demographical. Variable such as
age, sex, educational level, area of present exposure, Source of
information on inhibition of promotion of the substitution feeding. And
signification association the Years of work experience in hospital by staff
nurses of different wards.
CONCLUSION:
The study reveals
that there is significant increase in the knowledge on inhibition of
promotion of substitution feeding as per IMS act 2003 among all staff nurses.
Thus pamphlet was found to be effective improving the knowledge on inhibition
of promotion of substitution feeding as per IMS act 2003 among all staff
nurses.
RECOMMENDATIONS:
The study can be replicated in various
setting.
ACKNOWLEDGEMENTS:
We would like to acknowledge studying
participants for their support to complete this study.
INTEREST OF CONFLICT:
None
REFERENCES:
1.
Dutta
D. C. Text book of Obstetrics and Gynecology. 7th ed. Jaypee
Brothers; 2003 page no. 113
2.
Wilson
David: Wong’s essentials of Pediatric Nursing; 8th ed. Mosby
Elsevier; 2009; Page no. 1772
3.
Yadav
Manoj: Textbook of Child Health Nursing with procedure; S. Vikas and company,
India, 2013; page no. 157
4.
Basvanthapa
BT. A Textbook of Pediatric Nursing. 2nd ed. Jaypee brothers; New
DelhiPage
no. 167
5.
Basavanthappa
BT. Nursing Research; New Delhi jay pee brother’s medical publisher (p) Ltd
2003.
6.
SS.
Kulbir methodology of Research in education: New Delhi; sterling publisher
private Ltd 1984.
7.
Droske
James Ashwill: Textbook of pediatric nursing; 1st ed. Published by
jaypee brother Ltd page no. 635
8.
Polit
DF, Beck TC. Nursing Research principles and methods; 7th ed.
Philadephia: Lippincott Williams and Wilkins 2004
9.
Neiswadomy
RM, foundation of nursing research; 3rd ed. published by London prentice hall
International Ltd; 1998.
10. Burn N, Grove SK.
Understanding Nursing Research; 2nd ed. New Delhi Harcourt Pvt. Ltd;
2002.
11. Sharma SK,
Textbook of Nursing Research; 2nd ed. jaypee brothers Publisher Ltd;
2007.
12. http://pubmed.com
13. www.thehindu.com/todays-paper/tp.../tp...ims-act../article3084372.ece
14. www.bis.org.in/cert/G-258.pdf
15. https://extranet.who.int/.../IND%202003%20Infant%20Milk%20Substitut.
16. medind.nic.in/ibv/t05/i1/ibvt05i1p88.pdf
17. www.slideshare.net/ArabindaMohanty/ims-act-92-modified-in2003
18. www.childlineindia.org.in
› ... › Child Related Legislations
19. timesofindia.indiatimes.com/
20. ibfan.org/heinz-nestle-abbott-breaking-the-rules-misleading-mothers
21. Website (www.mofpi.nic.in)
22. https://books.google.co.in/books?isbn=9350258412
23. Abudejaja A,
infant feeding practice in north –eastern region of Libyan Arab Jamahiri Gyryounis
Med J. 1982: 29-36.
24. US. Department of
Health and Human Services (2000), Health people 2010, http://www. healthy
people.gov/
DOI: 10.5958/2349-2996.2017.00036.2