Children are the first call on the agenda of Human Resource Development-not only because young children are the most vulnerable, but because the foundation for lifelong learning and human development is laid in these crucial, early years [1].

A mother-child bond is key to emotional development. When a child is born, his first interaction is with his mother. His mother is his teacher, he learns from her. A mother must create a proper environment for the child to play, learn and grow. There is strong relationship between maternal education and child health outcomes [2]. Educated mothers were more autonomous with respect to decisions about their children’s health [3]. 

The future of a nation is shaped by the investment it makes in its children. India is a country suffering from Malnourishment, high Mortality rate and poverty. Pediatric Malnutrition has always been a matter of national concern especially in the rural parts of the country [4]. 

In order to counter the health and mortality issues of the nation, a need of medical and health care experts was felt by the government of India. In 1974, India adopted a well-defined National Policy for Children [6]. In accomplishment of this policy it was decided to start a holistic multi-centric programme with an intensive package of services. The decision led to the formulation of Integrated Child Development Services (ICDS) scheme-one of the most prestigious programmes of the Government of India (GOI) [7].

Objectives

• To assess the knowledge regarding Integrated Child Development Scheme among mothers of under five year children in selected urban area Boileauganj, District Shimla (H.P.)

• To develop and administer a Structured Teaching Programme on Integrated Child Development Scheme among mothers of under five year children in selected urban area Boileauganj, District Shimla (H.P.)

• To evaluate the effectiveness of Structured Teaching Programme on Integrated Child Development Scheme among mothers of under five year children in selected urban area Boileauganj, District Shimla (H.P.)

To determine association of post-test knowledge of mothers of under five year children with selected demographic variables.

• Research Approach: Quantitative

• Research Design: Pre Experimental one group pre-test post-test design

• Setting of the Study: Selected urban area Boileauganj, District Shimla (H.P.)

• Study Population: Mothers of under five year children at stlected area

• Sample Size: Mothers of under five year children at selected area and sample size is 60

• Sampling Technique: Non-Probability -convenience sampling technique

Inclusion Criteria

The mothers of under five year children who are:

• Residing in selected urban community area Boileauganj, district Shimla (H.P.)

• Willing to participate

• Understand Hindi/English

• Available at the time of data collection

Exclusion Criteria

The mothers of under five year children who are:

• Mothers who will not be present at the time of data collection

• Not willing to participate

Development of Tool

The present study aim to assess the pre-test knowledge of mothers of under five year children regarding Integrated Child Development Scheme. The student researcher developed a structure knowledge questionnaire to collect the demographic data and to assess the knowledge regarding Integrated Child Development Scheme.

Description of Tool

Section I: It consists of 7 items related to demographic characteristics including base line information such as: age, education qualification, religion, marital status, occupation, number of under five year children in the family, source of information about Integrated Child Development Scheme.

Section II

Structured knowledge questionnaire consists of 30 items related to Integrated Child Development Scheme. Each item was multiple choice in nature with options.

Validity of Tool

By the experts in this field.

Permission

A written permission was taken from Concerned Authorities of area i.e. Medical officer, CDPO, Councilor of the area for pilot as well as final study.

Mothers’s of under five year children were explained about the study and its objectives and written consent was taken from them.

Informed Consent

Informed written consent was taken from the participants and confidentiality was also maintained.

Data Collection

A knowledge questionnaires related to Integrated Child Development Scheme was used to assess the knowledge of mothers. Pre-test was conducted and thereafter Structured Teaching Programme was administered regarding Integrated Child Development Scheme. After a week post test was conducted using same questionnaire. The data was presented in the master data sheet. 

Data Analysis

Analysis and interpretation of data was done by using descriptive and inferential statistics, mean, frequency, standard deviation, t-test, chi-square test and Karl Pearson’s test.

The data was organized and represented under following sections:

• Section I: Findings related to distribution of socio-demographic variables in terms of frequency and percentage

• Section II: Findings related to pre-test knowledge score of mothers of under five year children regarding Integrated Child Development Scheme

• Section III: Findings related to post-test knowledge score of mothers of under five year children regarding Integrated Child Development Scheme

• Section IV: Findings related to effectiveness of Structured Teaching Program regarding Integrated Child Development Scheme among mothers of under five year children

• Section V: Findings related to association of post-test knowledge regarding Integrated Child Development Scheme among mothers of under five year children with selected demographic variables

Section I

Table 1 it was seen majority of samples 40% (24) were in age group of >27-31 years, 25% (15) were in >23-27 and above 31 year of age group and only 10% (6) in 19-23 years of age group. Majority of mothers completed their high schooling and senior secondary schooling i.e. 25% (15), followed by Graduate 18.3% (11), 15% (9 were post graduate, 13.3% (8) were completed their primary schooling. Largely sample belongs to Hindu religion 91.7% (55), followed by 6.7% (4) were Sikh and 1.7% (1) belongs to Muslim religion. As per marital status, 98.3% (59) mothers were married and 1.7% (1) was widow. 

Largely sample were home maker i.e. 73.3% (44), Government employees were 25% (15), private employee were 16.7% (10), 3.3% (2) sample on other job. Majority of sample 70% (42) having one under five year children, 25% (15) having two, 5% (3) having three and no one having more than three under five year children. Out of 60 samples, 75% (45) were previous knowledge about ICDS, 25% (15) sample were having knowledge up to some extent. More of sample 63.3%(38) having knowledge from anganwadi workers, 15% (9) from mass media , 11.7% (7) from friends/relatives, 6.7% (4) from health professionals, 3.3% (2) from printed media.

Table 1: Frequency and Percentage Distribution According to their Socio Demographic Variables n = 60

Section II

Table 2 depicts that in pre-test score, 8 (13.3%) had low level knowledge, 51 (85%) had average level of knowledge and only 1 (1.7%) study sample had good level of knowledge.

Table 2: Table showing Frequency and Percentage Distribution of Pre-Test Knowledge Score of Mothers of Under Five Year Children According to their Level of Knowledge Regarding Integrated Child Development Scheme n = 60

Section III

Table 3 show the post-test knowledge scores. None of the sample falls in low level knowledge. Only 12 (20%) falls in average level category and 48 (80%) were having good level knowledge score.

Table 3: Table Showing Frequency and Percentage Distribution of Post-Test Knowledge Score of Mothers of Under Five Year Children According to their Level of Knowledge Regarding Integrated Child Development Scheme

Section IV

Comparison of Pre and Post Test Scores with Paired T-Test: Table 4 data presented in the table shows that by using t-test, it was found that there is significant change in post-test knowledge scores of subjects. The pre-test and post-test mean score for knowledge regarding Integrated Child Development Scheme was 14.40 and 22.12 respectively. Above table shows that mean pre-test score was higher than mean post test score .Standard deviation for pre-test and post-test was ±3.258 and ±2.706. Range for pre-test was 7-21 and for post-test it was 15-27. Mean difference was 7.720. The calculated ‘t’ value 31.226 was greater than the table value (t = 2.00) at 0.05 level of significance.

Table 4: Descriptive Statistical Findings on Effectiveness of Structured Teaching Program (STP) regarding Integrated Child Development Scheme n = 60

*Significance Level 0.05

Section V

Findings related to association of post- test knowledge regarding Integrated Child Development Scheme among mothers of under five year children with selected demographic variables.

Study findings reveals that p value for age, gender, religion, marital status, occupational status, No. of children under five year age, previous knowledge and source of information were more than 0.05 and calculated (χ2) was less than tabulated (χ2) value which indicates that there is no association between age, gender, religion, Marrital status, occupational status, No. of children under five year age, previous knowledge and source of information at 0.05 level of significance and value for educational status of mothers were less than 0.05 and calculated (χ2) was more than tabulated (χ2) value which indicates that there is association with educational status of mothers at 0.05 level of significance.

On the Basis of Findings the Present Study, the Following Result were Drawn: The mean Post-test knowledge (22.12) was higher than the pre-test knowledge score (14.40) after Structured Teaching Programme. There was significant difference (7.72) in pre-test and post–test knowledge of mothers of under five year children regarding Integrated Child Development Scheme after giving Structured Teaching Programme. 

Hence the study findings concluded that, knowledge of mothers was not appropriate before administration of Structured Teaching Programme but after the administration of Structured Teaching Programme had significantly improved the knowledge of mothers of under five year children regarding Integrated Child Development Scheme in selected urban area Boileauganj, District Shimla (H.P.).

Recommendations

On the basis of the findings the study following recommendations has been made:

• Comparative study can be conducted in rural and urban areas regarding the knowledge of mothers on ICDS programme

• Comparative study can be conducted between ICDS programme and other programme related to child health to assess the health status of children

• This similar study can be replicated on large sample there by findings can be generalized for a large population

• A similar study can be conducted by using different research methodology

A study can be carried out to evaluate the efficiency of various teaching strategies like video assisted teaching programme and self-instructional module regarding ICDS programme.

Ethical Approval

Ethical approval was taken from the Ethics Committee of Sister Nivedita Govt. Nursing College, I.G.M.C Shimla.

1. Sachdev, Y. and J. Dasgupta. “Integrated Child Development Services (ICDs) Scheme.” Medical Journal Armed Forces India, vol. 57, no. 2, 2001, pp. 139–143.

2. “Under-Fives.” Lexico, https://www.lexico.com/definition/under-fives. Accessed November 2021.

3. Wikipedia Contributors. “Integrated Child Development Services.” Wikipedia, The Free Encyclopedia, 2021, https://en.wikipedia.org/w/index.php?title=Integrated_Child_Development_Services&oldid=1051597573. Accessed November 2021.

4. Ranjan, A.K. and J. Hamdard. “A Study on the Status of Integrated Child Development Service (ICDS).” Countercurrents.org, http://www.countercurrents.org/ranjan200914.pdf. Accessed November 2021.

5. Subhashini, S. and G. Palaniappan. “Understanding the roles, responsibilities and resultant satisfaction of rural Anganwadi workers in Salem District.” International Research Journal of Engineering and Technology (IRJET), vol. 3, no. 5, 2016, pp. 359–362.

6. Tirath, K. et al. Research on ICDS: An Overview. National institute of public cooperation and child development, 2009, vol. 3, pp. 20–38, https://www.nipccd.nic.in/file/reports/icdsvol3.pdf.

7. ICDS Scheme - WCD Kerala. Government of Kerala, http://wcd.kerala.gov.in/article.php?itid=Mzg3. Accessed November 2021.