INTRODUCTION:

Family is a basic unit of society. It is Unit of Service. The independency of family members is an important concept is defining family. Every family is a social system, it has its own cultures, values and rules has structured and basic functions and moves through stages (Amarnath, 2014).¹ The population in the world is currently growing at a rate of over 1% per year.

India houses almost 17.3% of the world’s protected couples and 20% of the world’s eligible couples with unmet needs. The large population size of India not only impacts its own health outcomes but also the global health indicators. Contraceptive use is one of the major factor to stabilize the population growth and couple protection rate (CPR) is the proxy measure used to ascertain the contraceptive use by eligible couples.² In normal sexual life, a woman can conceive within 24 hours of release of mature ovum if it enters the fallopian tube and meets with sperm but the conception can be prevented by using any of the contraceptive method. Contraception is an effective method to reduce maternal mortality by preventing unwanted pregnancy and unsafe abortion by and by promoting healthy pregnancies. The knowledge of contraception is very effective because couples can make decision about the timing and number of child they want actual. For many years, family planning experts have generally agreed that a 24 months or 2-year birth interval is important for infant, child and maternal health. Studies have shown that birth intervals less than 2 year are associated with adverse prenatal and maternal outcomes. The knowledge of the contraception is one of the most basic and essential health care services and smaller families are better able to meet their house hold and economic needs.³ The primary goal of health services among eligible couples encompasses family planning as well identifies and tries to spread knowledge about women’s health, foetal health and infant and child health as well. Ideally this knowledge should attain certain objectives like avoiding unwanted births, pregnancies, to regulate interval between births and to determine number of children in a family and its effect on population density. Despite the scope of health services in the aforementioned areas limited evidence exists to demonstrate effectiveness at improving maternal and child health.⁴

STATEMENT OF THE PROBLEM:

A study to assess the effectiveness of structured teaching program on the knowledge regarding health services among eligible couples in selected community area in Bengaluru.

OBJECTIVES OF THE STUDY:

1. To assess the level of knowledge regarding the health services among eligible couples.

2. To evaluate the effectiveness of structured teaching program in terms of knowledge gain in for eligible couples regarding health care services.

3. To find out an association between knowledge scores with selected socio-demographic variable.

RESEARCH HYPOTHESES:

H_1:There will be a statistically significant difference between pretest and posttest knowledge scores.

H_2:There will be statistically significant association between knowledge scores with selected demographic variables.

ASSUMPTIONS:

Eligible couples in selected community area in Bangalore may have inadequate knowledge regarding health services especially catered to them.

RESEARCH APPROACH:

For the present study quasi experimental design with one group pre-test – post-test group was used. The researcher selected area, Thagachaguppe, Bengaluru as the setting for the present study. The researcher had selected this area to conduct research study because of feasibility. In this study, non-probability convenient sampling technique was used for selecting the subjects from the sample frame. 60 Eligible couples. Non probability convenient sampling method was used. A structured questionnaire was used to assess the knowledge of eligible couples.

RESULT:

Table 1: Demographic profile of the eligible couples. N=60

Sl. No	Demographic variables	Frequency	Percentage (%)
I.	Age (in years)
a)	15-22	06	10%
b)	23-30	30	50%
c)	31-37	14	23.33%
d)	38-45	10	16.667%
II.	Gender
a)	Male	00	0%
b)	Female	60	100%
III.	Educational Qualification
a)	Illiterate	18	30%
b)	Primary	28	46.667%
c)	Secondary	12	20%
d)	Degree/Diploma	02	3.33%
IV.	Duration of marriage (in years)
a)	0-5	40	66.667%
b)	5-10	10	16.667%
c)	10-15	06	10%
d)	15-20	04	6.667%
e)	20-25	00	0%
V.	Desire to have children
a)	Yes	22	36.667%
b)	No	38	63.33%
VI.	Use of contraception
a)	Yes	28	46.667%
b)	No	32	53.33%
VII.	Languages Known
a)	Hindi	14	23.33%
b)	Kannada	34	56.667%
c)	English	6	10%
d)	Others	6	10%

The maximum number of participants,30 (50%) belonged to the age group 23-30, 14 were in the age group 31-37 (23.33%) and 10 were in the group of 38yrs to 45yrs (16.667%) and rest were in 15-22 years group (10%).

All were female participants.

There were samples who were Illiterate, 18(30%), of Primary education, 28(46.667%), Secondary, 12(20%) and some having Degree/Diploma,02(3.33%).

Duration of marriage (in years) was found to be, 0-5 in 40(66.667%), 5-10 in 10 (16.667%), 10-15 in 06(10%), 15-20 in 04(6.667%) and 20-25 in00(0%).

Desire to have children was found to be affirmative in, 22(36.667%) and negative in, 38(63.33%).

Use of contraception was prevalent among 28(46.667%) and not among 32(53.33%)

Languages Known by the samples like, Hindi,14(23.33%), Kannada, 34(56.667%), English, 6(10%) and Others, 6(10%).

Table 2: Overall level of knowledge in pre-test and post-test knowledge of participants on services available to the eligible couples.

Categories	Pre-Test			Post-test
Categories	Scores	No.	%	Scores	No.	%
Inadequate	0-15	49	81.67%	0-15	3	5%
Moderately Adequate	15-23	11	18.33%	15-23	10	16.67%
Adequate	23-30	-	-	23-30	47	78.33%

Above table 2 shows that during pretest out of 60 participants, 49 (81.67%) had inadequate knowledge and 11(18.33%) had moderately adequate knowledge. Whereas in post-test only 3 (5%) had inadequate knowledge scores, 10 (16.67%) had moderately adequate knowledge scores and rest 47 (78.33%) participants had adequate knowledge score.

It is evident that the table 3 above shows that in pretest out of 60 participants in aspects of knowledge of reproductive system and its mechanism 33(55%) had inadequate knowledge, 23 (38.33%) had moderately adequate knowledge. On contraception 37 (61.67%) had inadequate knowledge, 23 (38.33%) had moderately adequate knowledge. 53 (88.33%) participants had inadequate knowledge on parenthood, 7(11.67%) had moderately adequate knowledge. 55 (91.67%) had inadequate knowledge on genetic counselling, 5(8.33%) had moderately adequate knowledge. 54 (90%) had inadequate knowledge on marriage counselling and 6 (10%) had moderately adequate knowledge. 9 (15%) had inadequate knowledge in where and how to avail the health services and 51 (85%) had moderately adequate knowledge.

It is evident that the table 4 above shows that in pretest out of 60 participants in aspects of knowledge of reproductive system and its mechanism, 35(58.33%) had moderately adequate knowledge, 25 (41.67%) had adequate knowledge. On contraception 42 (70%) had moderately adequate knowledge,18 (30%) had adequate knowledge.¹ (1.67%) participant had inadequate knowledge on parenthood,31(48.33%) had moderately adequate knowledge, 28(46.67%) had adequate knowledge.³

(5%) had inadequate knowledge on genetic counselling, 29 (83.33%) had moderately adequate knowledge and 54 (90%) had adequate knowledge.² (3.33%) had inadequate knowledge on marriage counselling, 34 (56.67%) had moderately adequate knowledge and 26 (43.44%) had adequate knowledge. 22 (36.67%) had moderately adequate knowledge in where and how to avail the health services and 38(63.33%) had adequate knowledge.

Table 3: Aspect wise pre-test knowledge of participants on services available for eligible couples.

Pre-test	Inadequate		Moderate		Adequate		Total
Pre-test	No.	Percentage	No.	Percentage	No.	Percentage	Total
Knowledge on Reproductive system	33	55	27	45	-	-	60	100%
Knowledge on Contraception	37	61.67	23	38.33	-	-	60	100%
Knowledge on Parenthood	53	88.33	7	11.67	-	-	60	100%
Knowledge on Genetic counseling	55	91.67	5	8.33	-	-	60	100%
Knowledge on Marriage counselling	54	90	6	10	-	-	60	100%
Knowledge on Availability of services	9	15	51	85	-	-	60	100%

Table 4: Aspect wise post-test knowledge of services available to the eligible couples.

Post-test	Inadequate		Moderate		Adequate		Total
Post-test	No.	Percentage	No.	Percentage	No.	Percentage	Total
Knowledge on Reproductive system	-	-	35	58.33	25	41.67	60	100%
Knowledge on Contraception	-	-	42	70	18	30	60	100%
Knowledge on Parenthood	1	1.67	31	48.33	28	46.67	60	100%
Knowledge on Genetic counselling	3	5	29	83.33	54	90	60	100%
Knowledge on Marriage counselling	2	3.33	34	56.67	26	43.33	60	100%
Knowledge on Availability of services	-	-	22	36.67	38	63.33	60	100%

Table 6: Association between post-test knowledge and selected demographical variables.

Descriptive Statistics
	N	Minimum	Maximum	Mean	Std. Deviation
Age	60	1.00	4.00	2.4833	.85354
Gender	60	2.00	2.00	2.0000	.00000
Education	60	1.00	4.00	1.9667	.80183
Duration of Marriage	60	1.00	4.00	1.5833	.94406
Desire to have child	60	1.00	2.00	1.3667	.48596
Use of contraception	60	1.00	2.00	1.5333	.50310
Language	60	1.00	4.00	1.6833	.92958
Knowledge pretest	60	1.00	2.00	1.0283	.24395
Knowledge posttest	60	1.00	2.00	1.7833	.41545

Table 7: Association of socio-demographic variables with post-test levels of knowledge.

Sl no.	Demographic variables	Inadequate/ moderate knowledge (0-22.5)		Adequate knowledge		Chi-squared χ²value	Ρ>0.05
Sl no.	Demographic variables	No.	%	No.	%	Chi-squared χ²value	p=7.82
Age in years	15-22	5	17.241	8	25.80	χ²⁼25.434 df=3
	23-30	11	37.93	16	51.61
	31-37	6	20.689	5	16.12
	38-45	7	24.13	2	6.45
Educational qualification	Illiterate	11	37.93	2	6.45	χ2=38.723 df=3
	Primary	7	24.13	5	16.12
	Secondary	6	20.689	7	22.58
	Degree/Diploma	5	17.24	17	54.83
Duration Marriage	0-5	3	10.34	8	25.80	χ2=8.298 df=3
	5-10	9	31.03	17	54.83
	10-15	8	27.58	3	9.67
	15-20	9	31.03	3	9.67
Desire to have children	Yes	16	55.17	15	48.38	χ2 =9.608 df=3
Desire to have children	No	13	44.82	16	51.61	χ2 =9.608 df=3
Use of Contraception	Yes	2	6.89	28	90.32	χ2=18.967 df=3
Use of Contraception	No	27	93.10	3	9.67	χ2=18.967 df=3
Languages known	Hindi	13	44.82	9	29.03	χ2=12.691 df=3
	Kannada	10	34.48	11	37.93
	English	-	-	8	25.80
	Others	6	20.68	2	6.45

Knowledge Variable	Improvement Mean	Standard Deviation	Paired ‘t’ test value
Overall	43.53%	0.50329	3.892