Knowledge and Attitude of Mothers towards

MCH Services provided by the Primary Health Centers

Mrs. M. Chandrakala,

Associate Professor, Kamineni College of Nursing, L. B. Nagar, Hyderabad, Andhra Pradesh – 500068.

*Corresponding Author Email: chandrakala.maddirala@gmail.com

ABSTRACT

Two thirds of India's population is comprised of mothers and children. Mothers and children constitute a priority group as they are the major consumers of health services. Maternal and child health (MCH) services form one of the important components of Public health services provided through primary health centers. They play an important role in the prevention of maternal and infant mortality rates. However, MCH services are underutilized due to ignorance and unawareness among the primary group.

Objectives

· To assess the knowledge and attitude of mothers regarding MCH services provided at PHCs.

· To associate the knowledge and attitude of mothers on MCH services with that of their demographic variables.

Methods

Descriptive research design was used for the study. 30 mothers between 18-45 years were selected conveniently from urban slums of Hyderabad. Data was analyzed using descriptive and inferential statistics.

Major findings of the study

· Results revealed that 57% of the mothers had average knowledge and only 20% had adequate Knowledge on MCH services.

· Only 3% of the mothers had positive attitude on MCH services, 13% had negative attitude and 53% had neutral attitude on MCH services.

· It was found that there was a significant association between level of knowledge and education of mothers. The study also revealed that age, education and economic status of the mother influenced their attitude on MCH services.

Conclusion

Mothers are not having adequate knowledge and positive attitude towards MCH services. It is very important to educate the public about MCH services in order to promote the utilization these of services.

KEY WORDS: MCH services, Primary Health Center, Knowledge, Attitude, Mothers.

In any community mothers and children constitute a priority group and they comprise approximately 71.14 percent of the population in developing countries. In India women of the child bearing age (15-45 years) constitute 22.2 percent, and children under 15 years of age about 35.3 percentage of the total population.

As they constitute large number (57.5), mother and children are the major consumers of health services.

Mothers and children not only constitute a large group but they are also vulnerable group. Health problems affecting this group are multifactorial and constitute one of the most serious health problems affecting the community particularly in developing countries. To alleviate this problem maternal and child health (MCH) services are provided as an integrated package of essential health care known as primary health care. The term maternal and child health refers to the preventive, promotive, curative and rehabilitative health care for mothers and children.¹

India has an excellent infrastructural layout for the delivery of MCH services in the community through a network of sub centers, primary health centers, community health centers, district hospitals, state medical college hospitals, and other hospitals in the public and private sectors. However, the health pyramid does not function effectively because of limited resources, communication delays, a lack of commitment on the part of health professionals and above all, a lack of managerial skills, supervision, and political will. The allocation of financial resources for the delivery of health care continues to be meager.²

Maternal mortality and morbidity continue to be high despite the existence of national programs for improving maternal and child health in India. This could be related to several factors, an important one being non-utilization or under-utilization of maternal health-care services, especially amongst the rural poor and urban slum population due to either lack of awareness or access to health-care services and this is evidenced by the following studies.²

A study by Agrawal Tandan and Srivastav “to assess the delivery pattern of MCH services in urban Varanasi” revealed that only 26.2 per cent of the beneficiaries had knowledge of MCH centers and around 25 per cent of the beneficiaries had utilized them.³

Bajaj assessed Knowledge and utilization of MCH services in Delhi slums among 500 married women aged 15-49 years. Findings indicated low utilization of the MCH services provided by the public health care system. One of the primary reasons for the non-utilization of MCH services may be the lack of knowledge on these services offered by the government. It was also found that half of the respondents were dissatisfied with PHC services which shows their negative attitude towards these services.⁴

Kumar and Singh in their study on “Assessment of community attitude regarding the services of PHC: A medical geographic study” conclude that more than half the respondents were dissatisfied with the PHC services but would not complain for fear of penalization. The authors then list some of the common expectations of the community viz. free and better medicines, proper treatment, attention from PHC staff and an ambulance service for an emergency.⁵

Understanding of the knowledge and attitude of the community regarding maternity care during pregnancy, delivery and postnatal period is required for better implementation of education programmes for better utilization of MCH services by the community. The present study, therefore, was carried out to evaluate knowledge and attitude of mothers regarding MCH services among mothers living in a slum in Hyderabad.

MATERIALS AND METHODS:

Research design and setting: A descriptive research design was selected for the study. The study was conducted in urban slums of Hyderabad.

Sample and sampling technique: Samples for the study included 30 mothers who were between 18 to 45 years of age, with at least one child. A non probability convenient sampling technique was used to select the sample.

Instrument and data collection procedure: A structured interview schedule was prepared to collect data related to knowledge and attitude of mothers on MCH services. It consists of demographic data; knowledge related questionnaire and a rating scale to assess the attitude of the mothers. Data was collected by interview technique after obtaining consent from the mothers.

Plan for data analysis

Descriptive statistics: Frequency and percentage distribution were used to study the demographic variables of the mothers. Frequency and percentage distribution were used to assess the level of Knowledge and attitude of mothers on MCH services.

Inferential statistics: Chi-square test was used to find out the association between demographic variables and level of knowledge and attitude of mothers on MCH services. Level of significance was fixed at 5% level.

RESULTS:

Demographic findings revealed that Most(76%) of the participants were between the age group of 24-30 years, 50% of them were Hindus, 47% were illiterates, 76% were housewives and 63% of their family income was found to be Rs.2000-4000. Majority of the mothers had two children at the time of data collection and 73% of them belonged to nuclear family.

Based on knowledge levels, only 23% of the mothers had adequate knowledge, 57% had average knowledge, and about 20% had inadequate knowledge about MCH services provided by PHCs.

Attitude scores showed that, only 3% of the mothers had positive attitude, 54% had neutral attitude and 43% had negative attitude towards MCH services provided by PHCs.

The study revealed that there was a significant association between education and knowledge levels of mothers and also there was a significant association between attitude levels and age, education and family income of mothers at P< 0.05 level.

DISCUSSION:

The research findings showed that most of the mothers are not having adequate knowledge about MCH services. It might be due to their low educational status as evidenced by the results. Negative attitude of the mothers is related to ignorance, perceived poor quality of care, poor communication skills of health personnel, lack of adequate facilities at Primary Health Center, inadequate qualified staff and unavailability of round the clock services. These study findings were supported by the study conducted by Goyal on Awareness and utilization of MCH and FP services by a rural community in Maharashtra revealed that the knowledge of MCH services was significantly different between educated and uneducated respondents.⁶

Hence improving knowledge of mothers by giving health education and developing positive attitude towards MCH services will improve the utilization of these services at Primary Health Center. Not only consumer's perspective, even administrators need to take interventions in order to provide better quality of health services by improving manpower, and by providing minimum physical facilities at Primary Health Centers which would bring change in the attitude of the people on MCH services which in turn improves utilization of these services.

REFERENCES:

1. Park K. Text book of preventive and social medicine. Banarsidas Bhanot, Jabalpur 2010.

2. Agarwal Paras, Singh MM, Garg Suneela. Maternal health-care utilization among women in an urban slum in Delhi. Journal of Family Welfare. 2007; 32(3):203-205.

3. Agrawal K., Tandan J, Srivastava P, et al. An assessment of delivery pattern of MCH services in urban Varanasi. Indian Journal of Preventive and Social Medicine, 1994

4. Bajaj J. Knowledge and utilization of maternal and child health services in Delhi slums. Journal of Family Welfare. 1999 April; 45(1):44-52.

5. Kumar VK and Sing J. Assessment of community attitude regarding the service of PHC: a medical geographic study. Indian Journal of Preventive and Social Medicine. 1994; 62(5):82-86.

6. Goyal RC. Awareness and utilization of MCH and FP services by a rural community in Maharashtra. Indian Journal of Maternal and Child Health.1990, Oct-Dec;1(4):149.

Received on 11.09.2011 Modified on 28.02.2012

Asian J. Nur. Edu. & Research 2(1): Jan.-March 2012; Page 15-17