INTRODUCTION:

Water is the essence of life and basic human right, essential to all and for sustainable development.¹ It is known that drinking water is our most precious resource for our economy, our daily lives and to the health of our environment.

Drinking water and sanitation is a fundamental health service without which there cannot be any improvement.²Drinking water and sanitation inadequacies hinder economic and social development, constitute a major hurdle to poverty alleviation and inevitably lead to environmental degradation. Water must be safe and wholesome. It should be easily accessible, adequate in quantity, free from contamination, safe and readily available throughout the year.³

OBJECTIVES OF THE STUDY:

1. To assess the Knowledge regarding prevention of water-borne diseases among mothers of underfive children

2. To assess the attitude regarding prevention of water-borne diseases among mothers of underfive children

3. To assess the practice regarding prevention of water-borne diseases among mothers of underfive children

4. To associate the knowledge, attitude and practice regarding prevention of water-borne diseases with selected demographic variables.

5. To develop an information booklets on prevention of water-borne diseases.

RESEARCH METHODOLOGY:

This chapter presents the methodology of the study to assess the knowledge attitude and practice regarding prevention of water-borne diseases among mothers of underfive children residing at selected rural areas in Bangalore with a view to develop an information booklet.

Research methodology is a way to systemically solve the research problem. It is a science of studying how research is done scientifically. Methodology deals with a brief description of the different steps which were undertaken by the investigator for the study. It includes the description of research approach, research design, setting of the study, population, sampling technique, criteria for selection of sample and its size, selection of tools, scoring, pilot study, data collection procedure and the plan for data analysis.

RESEARCH APPROACH:

The approach to research is the umbrella that covers the basic procedure for conducting research.

A descriptive approach was adopted for the study as it aims to assess the knowledge, attitude and practice regarding prevention of water-borne diseases among mothers of underfive children residing at selected rural areas.

The traditional strategy for conducting evaluative research consists of the following steps:

· Determining the objectives of the programme.

· Developing a means of measuring the attainment of those objectives.

· Collecting the data.

· Interpreting the data in terms of the objectives.

RESEARCH DESIGN

The research design is the plan, structure, and strategy of investigations of answering the research question is the overall plan or blue print the researchers select to carry out their study.

Quantitative research method is a formal, objective, systematic process in which numerical data are used to obtain information. Descriptive research design was used on to assess the knowledge attitude and practice on prevention of water-borne diseases among mothers of underfive children with pre test with the structured knowledge questionnaire, attitude scale and practice check list.

This can be represented as,

Group

Assess the Knowledge, attitude and practice

Intervention

Mothers of under five children

Information booklets

O1 = Assess the knowledge, attitude and practice on prevention of water-borne diseases among mothers of underfive children

X = Given by Information booklets

VARIABLES UNDER THE STUDY:

Variables are the concepts at various levels of abstraction that are measured, manipulated and controlled in the study. In this study, three types of variables are considered. They are dependent, independent and demographical variables.

Independent variable: These are the variables, which can be purposely manipulated or changed by the researcher. In this study information booklets on prevention of water born disease among the mothers of under five children are the independent variables.

Dependent variable: Dependent variables are the change occurring as a result of manipulation of independent variable this study, knowledge, attitude and practice on prevention of water born disease among the mothers of under five children is the dependent variables.

Baseline Variable: Age, Religion, Types of family, income of the family, Education of mother, Sources of drinking water, have you exposure any education programme on prevention of water borne diseases and Source of information.

SETTING OF THE STUDY

Setting is the physical location and condition in which data collection takes place. The study was conducted in Machohalli rural area Bangalore, where mothers of under five children are available. The area selected was under the jurisdiction Shantidhama College of nursing, Bangalore.

The setting for the study was selected on the basis of:

· Geographic proximity

· Feasibility of conducting the study

· Availability of the sample

Population:

Population means all possible elements that could be included in research. It represents the entire group under study. Target population is the total group of subjects about whom the investigator is interested and the result would be reasonably generalized. The accessible population of subjects available for particular study.

The population selected for the study comprised of all the mothers of underfive children residing at Machohalli rural area at Bangalore and accessible population consists of mothers of underfive children residing at Machohalli rural area, who met the inclusion criteria.

SAMPLING PROCEDURE:

Sample and Sample Size: A finite subset of the population selected from it with the objective of investigating its properties is called a sample. The sample of the study would compromise of 60 mothers of underfive children residing at Machohalli rural area, who fulfilling inclusion criteria.

Sampling Technique: Sampling is a process of selecting a group of people, events or portion of the population to represent the entire population. In non probability purposive sampling technique, not every element of the population has an opportunity for being included in the sample.

Non probability purposive sampling technique is used for the study to select 60 mothers of underfive children residing at Machohalli rural area at Bangalore.

SAMPLING CRITERIA:

Inclusion criteria:

· Only mothers of under five children

· Who are willing to participate in the study

· Mothers who can read or write English or Kannada.

· Mothers who are available at time of data collection

Exclusion criteria

· Under five Mothers who are not available at the time of study

· Under five Mothers who are sick

· Those who are not willing to participate in the study

· Mothers who have above five year children

Development of the Tool for Data Collection:

Treece and Treece, (2000) stated that the instrument selected in research should as far as possible be the vehicle that would best obtain data for drawing conclusions pertinent to the study and add to the body of knowledge in the discipline.

Description of the Tool:

Part I: Baseline variables

Part II: Structured knowledge questionnaire.

Part III: Likert scale.

Part IV: Practice check list.

Part I: Baseline variables: This is designed to elicit the baseline information from respondents consisting of 8 items consists of Age, Religion, Types of family, income of the family, Education of mother, Sources of drinking water, have you exposure any education programme on prevention of water borne diseases

RESULT:

Part I: Description of Baseline Characteristics by Using Frequency and Percentage Distribution. N0=60

Table 1: Distribution of frequency and percentage according to demographical variables

Sl. no	Variables	Frequency	Percentage
1.	Age in year
	a) 21 to 25	9	15
	b) 26 to 30	16	26.66
	c) 31 to 35	28	46.66
	d) 36 years and above	7	11.66
2	Religion
	a) Hindu	29	48.33
	b) Muslim	5	8.33
	c) Christian	26	43.33
3	Type of family
	a) Nuclear	32	53.33
	b) Joint	28	46.66
4	Monthly income
	a) Rs 5000 to 10000	7	11.67
	b) Rs 10001 to 15000	22	36.67
	c) Rs 15001 to 20000	25	41.67
	d) Rs 25000 and above	6	10.00
5	Education status of mother
	a) Illiterate	11	18.33
	b) Higher secondary	12	20
	c) PUC	18	30
	d) Degree	14	23.33
	e) Master degree	5	8.33
6	Source of drinking water
	a) Well water	16	26.66
	b) Tap water	29	48.33
	c) Hand pump	15	25
7	Have you exposure any education programme on prevention of water born disease
	a) Yes	11	18.33
	b) No	49	81.66
8	Source of information
	a) Health personals	29	48.33
	b) Friends and relatives	12	20
	c) Mass media	16	26.66
	d) News papers	3	5

The result indicates that out of 60 samples, majority of mothers of under five children 28(46.66%) were belongs to 31 to 35 years, 16(26.66%) were belongs to 26 to 30 years, 9(15%) were belongs to 21 to 25 years and 7(11.66%) were belongs to 36 years and above, based on the religion 29(48.33%) were belongs to Hindu, 18( 30%) were Christian and 13(21.66%) were Muslim, based on the type of family 32( 53.33%) were belongs to nuclear family and 28(46.66%) were belongs to joint family, based on the monthly income 25(41.66%) were belongs to 15000 to 20000, 22(36.67%) were belongs to 10001 to 15000, 7(11.66%) were belongs to 5000 to 10000 and 6 (10%) 25000 and above ,based on the education of the mothers 18(30%) were studied PUC, 14(23.33%) were studied degree, 12(20%) were studied higher secondary, 11(18.33%) were illiterate and 5(8.33%) were master degree, based on the source of drinking water 29(48.33%) were using tap water, 16(26.66%) were using well water and 15(25%) were using hand pump, based on the have you exposure any education programme on prevention of water born disease 49(81.66%) were not exposure any education programme on prevention of water born disease and 11( 18.33%) were exposure any education programme on prevention of water born disease and source of information 29(48.33%) were get information from health personals, 16(26.66%) were from mass media, 12(20%) were from friends and relatives and 3(5%) were from news papers.

Part II: Assess the Level of Knowledge on Prevention of Water Born Disease among Mothers of Under Five Children

Table 2: Frequency percentage distribution of level of knowledge on prevention of water born disease among mothers of under five children

Sl No	Level of knowledge	Frequency	Percentage
1	Inadequate knowledge	31	51.66
2	Moderately adequate knowledge	20	33.33
3	Adequate knowledge	9	15
	Total	60	100

Data presented in table 3 shows distribution of level of knowledge mothers of under five children on prevention of water born disease 31 (51.66%) mothers of under five children had inadequate knowledge, 20(33.33%) had moderately adequate knowledge and 9(15%) had adequate knowledge on prevention of water born disease.

Part III: To Assess the Attitude Regarding Prevention of Water-Borne Diseases Among Mothers of Underfive Children

The above table represents that prevention of water born disease among mothers of under five children 30 (50%) were had unfavorable attitudes, 18(30%) had most favorable and 12 (20%) had most favorable attitude toward prevention of water born disease.

Table 3: Frequency percentage distribution of level of attitude on prevention of water born disease among mothers of under five children.

Level of attitude	Score	No of Respondents
Level of attitude	Score	No	%
Most favorable	<50%	18	30
Favorable	50--75%	12	20
Unfavorable	> 75%	30	50
Total		60	100%

Part IV: Assess the Level of Practice on Prevention of Water Born Disease among Mothers of Under Five Children

Table 4: Frequency percentage distribution of level of practice on prevention of water born disease among mothers of under five children

Level of Practice	Score	No of Respondents
Level of Practice	Score	No	%
Inadequate practice	76-100%	26	43.33
Moderately adequate practice	51-75%	19	26.66
Adequate practice	≤50%	15	25
Total		60	100%

The above table represents that level of practice on prevention of water born disease among mothers of under five children 26 (43.33%) had inadequate practice, 19(26.66%) Moderately adequate practice and 15 (25%) had Adequate practice on prevention of water born disease.

Distribution of Range, Mean, Median, Standard Deviation and Mean Percentage of Knowledge, Attitude and Practice Score. No.=60

Table 5: Distribution of range, mean, median, standard deviation and mean percentage of knowledge, attitude and practice score

Sl no	Overall score	Max score	Range	Med-ian	Mean	SD	Mean %
1	Overall knowledge score	23	12- 21	12.5	20.56	2.29	64.25
2	Overall attitude score	10	10-17	6.50	11.4	1.54	62.65
3	Overall practice	10	10-17	8.12	12.2	1.20	69.16

The above table represents the overall distribution of knowledge, attitude and scores. The knowledge is distributed with a range of 12-21, mean of 20.56, median 12.5. SD 2.29 and mean percentage 64.25 %. Attitude with arrange of 10-17, 11.4 mean scores, 11.4 median scores, 1.54 as SD score and mean percentage 62.65 and practice range 10 -17, mean 12.2, median 8.12, SD 1.20 and mean percentage is 69.16 respectively.

Correlation between Overall Knowledge, Attitude and Practice Scores

Table 6: Correlation between overall knowledge and attitude scores

Domain- Pre test	Mean	SD	Mean%	Correlation 'r' value
Knowledge	20.56	2.29	64.25	0.44*
Attitude	11.4	1.54	62.65	0.44*
Practice	12.2	1.20	69.16

The above table represents that correlation of knowledge, attitude and practice on prevention of water born disease were analyzes through Spearman’s rank correlation method, it shows that there is a positive correlation between knowledge, attitude and practice score r =0.43 and p=< 0.001. Hence it was found statistically significant; there is correlation between knowledge attitude and practice score (i.e.) when the knowledge increases, there is a favorable attitude and good practice towards the prevention of water born disease among the mothers of under five children.

H1: Under five mothers may have some knowledge, attitude and practice about water born disease.

Hence it was found statistically significant; there is correlation between knowledge attitude and practice score (i.e.) when the knowledge increases, there is a favorable attitude and good practice towards the prevention of water born disease among the mothers of under five children null hypothesis (H₀) rejected and research hypothesis is (H₁₎accepted.

Table 7: Association between the knowledge and selected demographic variables

Sl No	Variables	Frequency	Levels of Knowledge				Chi square
Sl No	Variables	Frequency	≤ Median		> Median		Chi square
1.	Age in year		F	%	F	%
	a) 21 to 25	9	6	70.0	3	30.0	χ2 = 8.53 df=1, p ≥0.05 S*
	b) 26 to 30	16	4	39.33	11	41.00
	c) 31 to 35	28	18	32.66	10	68.2
	d) 36 years and above	7	2	20.0	7	80.0
2	Religion
	a) Hindu	29	30	90.91	3	9.09	χ2 = 0.04 df=3, p ≥0.05 NS.
	b) Muslim	5	18	81.82	4	18.18
	c) Christian	26	5	100.00	0	0.00
3	Type of family
	a) Nuclear	32	35	92.11	3	7.89	χ2 = 1.96 df=3, p ≥0.05 NS.
	b) Joint	28	18	81.82	4	18.18	χ2 = 1.96 df=3, p ≥0.05 NS.
4	Monthly income
	a) Rs 5000 to 10000	7	21	87.50	3	12.50	χ2 = 9.7 df=1, p ≥0.05 S*
	b) Rs 10001 to 15000	22	15	88.24	2	11.76
	c) Rs 15001 to 20000	25	8	80.00	2	20.00
	d) Rs 25000 and above	6	9	100.00	0	0.00
5	Education status of mother
	a) Illiterate	11	8	80.00	2	20.00	χ2 = 7.7 df=3, p ≥0.05 S*
	b) Higher secondary	12	15	88.24	2	11.76
	c) PUC	18	6	75.00	2	25.00
	d) Degree	14	12	92.31	1	7.69
	e) Master degree	5	12	100.00	0	0.00
6	Source of drinking water
	a) Well water	16	17	89.47	2	10.53	χ2 = 2.25 df=3, p ≥0.05 NS.
	b) Tap water	29	27	87.10	4	12.90
	c) Hand pump	15	9	90.00	1	10.00
7	Have you exposure any education programme on prevention of water born disease
	a) Yes	11	25	92.59	2	7.41	χ2 = 2.22 df=3, p ≥0.05 NS.
	b) No	49	28	84.85	5	15.15	χ2 = 2.22 df=3, p ≥0.05 NS.
8	Source of information
	a) Health personals	29	16	80.00	4	20.00	χ2 = 3.38 df=3, p ≥0.05 NS.
	b) Friends and relatives	12	20	95.24	1	4.76
	c) Mass media	16	9	100.00	0	0.00
	d) News papers	3	8	80.00	2	20.00

Table 8: Association between the attitude and selected demographic variables

Sl No	Variables	Frequency	Levels of attitude				Chi square
Sl No	Variables	Frequency	≤ Median		> Median		Chi square
1.	Age in year		F	%	F	%
	a) 21 to 25	9	2	44.23	8	56.00	χ2 = 3.56 df=3, p ≥0.05 NS.
	b) 26 to 30	16	10	66.12	4	34.00
	c) 31 to 35	28	8	80.2	2	20.11
	d) 36 years and above	7	12	38.14	14	62.2
2	Religion
	a) Hindu	29	17	53.6	14	47.2	χ2 = 3.41 df=3, p ≥0.05 NS.
	b) Muslim	5	8	26.1	10	74.2
	c) Christian	26	3	40.0	8	60.0
3	Type of family
	a) Nuclear	32	21	65.1	10	35.0	χ2 = 0.21 df=3, p ≥0.05 NS.
	b) Joint	28	18	57.5	11	43.6	χ2 = 0.21 df=3, p ≥0.05 NS.
4	Monthly income
	a) Rs 5000 to 10000	7	6	58.12	4	42.00	χ2 = 3.68 df=3, p ≥0.05 NS.
	b) Rs 10001 to 15000	22	10	41.24	12	59.12
	c) Rs 15001 to 20000	25	8	32.01	14	68,21
	d) Rs 25000 and above	6	3	50.00	3	50.00
5	Education status of mother
	a) Illiterate	11	8	80.00	2	20.00	χ2 = 2.56 df=3, p ≥0.05 NS.
	b) Higher secondary	12	11	88.24	2	11.76
	c) PUC	18	10	75.00	8	25.00
	d) Degree	14	6	92.31	1	7.69
	e) Master degree	5	9	90.0	3	10.00
6	Source of drinking water
	a) Well water	16	14	49.6	12	50.34	χ2 = 2.11 df=3, p ≥0.05 NS.
	b) Tap water	29	12	50.2	12	50.93
	c) Hand pump	15	5	50.2	5	50.2
7	Have you exposure any education programme on prevention of water born disease
	a) Yes	11	14	44.2	15	56.4	χ2 = 9.41 df=3, p ≥0.05 S*
	b) No	49	16	52.1	15	48.4	χ2 = 9.41 df=3, p ≥0.05 S*
8	Source of information
	a) Health personals	29	9	71.0	10	29.4	χ2 = 9.01 df=3, p ≥0.05 S*
	b) Friends and relatives	12	6	50.6	10	50.4
	c) Mass media	16	6	20.2	8	80.11
	d) News papers	3	4	70.0	3	30.12

Table 9: Association between the practice and selected demographic variables

Sl No	Variables	Frequency	Levels of practice				Chi square
Sl No	Variables	Frequency	≤ Median		> Median		Chi square
1.	Age in year		F	%	F	%
	a) 21 to 25	9	10	55.56	8	44.44	χ2 = 0.01 df=3, p ≥0.05 NS
	b) 26 to 30	16	11	56.25	9	43.75
	c) 31 to 35	28	6	60.00	4	40.00
	d) 36 years and above	7	7	60.56	5	39.66
2	Religion
	a) Hindu	29	16	55.17	13	44.83	χ2 = 0.207 df=3, p ≥0.05 NS
	b) Muslim	5	3	60.00	2	40.00
	c) Christian	26	15	57.69	11	42.31
3	Type of family
	a) Nuclear	32	21	55.26	17	44.74	χ2 = 2.34 df=3, p ≥0.05 NS
	b) Joint	28	13	59.09	9	40.91	χ2 = 2.34 df=3, p ≥0.05 NS
4	Monthly income
	a) Rs 5000 to 10000	7	7	4	57.14	3	χ2 = 0.051 df=3, p ≥0.05 NS
	b) Rs 10001 to 15000	22	22	13	59.09	9
	c) Rs 15001 to 20000	25	25	14	56.00	11
	d) Rs 25000 and above	6	6	3	50.00	3
5	Education status of mother
	a) Illiterate	11	2	58.62	11	41.38	χ2 = 22.969 df=3, p ≥0.05 S*
	b) Higher secondary	12	8	53.57	9	46.43
	c) PUC	18	4	66.67	11	33.33
	d) Degree	14	2	55.56	8	44.44
	e) Master degree	5	1	56.25	4	43.75
6	Source of drinking water
	a) Well water	16	10	55.56	8	44.44	χ2 = 6.72 df=1, p ≥0.05 S*
	b) Tap water	29	16	57.14	12	42.86
	c) Hand pump	15	8	57.14	6	42.86
7	Have you exposure any education programme on prevention of water born disease
	a) Yes	11	16	56.25	16	43.75	χ2 = 1.24 df=3, p ≥0.05 NS
	b) No	49	18	57.14	10	42.86	χ2 = 1.24 df=3, p ≥0.05 NS
8	Source of information
	a) Health personals	29	16	55.17	13	44.83	χ2 = 0.32 df=3, p ≥0.05 NS
	b) Friends and relatives	12	1	50.00	01	50.00
	c) Mass media	16	10	62.50	06	37.50
	d) News papers	3	7	53.85	06	46.15