sar2020 study viewer Rajiv Gandhi University of Health Sciences, Karnataka SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION NAME OF THE CANDIDATE ‘Ms. SRITAKALYANI PARAMKUSAM 1 YEAR M.Sc. NURSING RATHNA COLLEGE OF NURSING, B.M. Road, HASSAN, KARNATAKA 2 | NAME OF THE RATHNA COLLEGE OF NURSING, INSTITUTION B.M Road, HASSAN, KARNATAKA 3. | COURSE OF MASTERS OF SCIENCE IN NURSING STUDY AND CHILD HEALTH NURSING SUBJECT 4 | DATE OF 15/07.2013 ADMISSION TO COURSE 5 | TILE OF THE “EFFECTIVENESS OF STRUCTURED TEACHING TOPIC PROGRAMME ON KNOWLEDGE REGARDING SIX KILLER DISEASES AMONG MOTHERS OF UNDERFIVE CHILDREN IN RAJEEV HOSPITAL AT HASSAN.” 6 |STATEMENT OF|“STUDY TO ASSESS THE EFFECTIVENESS OF THE PROBLEM STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING SIX KILLER DISEASES AMONG MOTHERS OF UNDERFIVE CHILDREN IN RAJEEV HOSPITAL AT HASSAN.” hitpsistudyres.comisoc!10892833)rajv-gancht-university-othealh-sciences-kamataka rt18/2020 study viewer 6, BRIEF RESUME OF THE INTENDED WORK ‘TRODUCTIO! “The Children shows the man as morning shows the day”. - John Milton. Paediatric is the branch of medicine that deals with the medical care of infants children and adolescents. Treating a child is not like treating a miniature adult, A major difference between pediatrics and adult medicine is that children are mina roes and in most jurisdictions, cannot make decisions for themselves.’ Children are an embodiment of our dreams and hopes for the future. Child hood is more precious period in human lifecycle. It requires more care and protection from the diseases. They are the most vulnerable group in the society. The physical health of a child is important because it is associated with mental and social development of children. Mothers are the first care provider of children, is needed to reduce the underfive mortality rates.” Killer diseases around the world are indeed difficulty to halt, Although medical knowledge and advance technologies have made significant improvement and breakthroughs, there are still infectious diseases that continue to ravage and claim millions of lives. No more than six deadly infectious diseases — Tuberculosis, diphtheria, pertrusis, measles, poliomyelitis, tetanus. Account for half of all premature death killing mostly children and young adults. Every three seconds a young child dies in most case from an infectious disease? Infectious diseases are now the world’s biggest killer of children and young adults They account for more than thirteen millions deaths a year one in too deathly developing countries. hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 2118/2020 study viewer Diseases which include in six killers are diphtheria is an acute infectious disease caused by the bacteria corynebacterium diphtheria. It is characterized by local inflammation of the epithelial surface formation of membrane and severe toxemia. This can be transmitted from person to person via respiratory droplets. This particularly afifcts the heart muscle, nervous system and adrenal tissue. About 25,000 diphtheria cases in underfive children are reported in India every year.> pertussins or whooping cough is a highly contagious disease caused Bordetella pertussis, which is transmitted through respiratory exeretions. the Chinese call it a “Hundred Day Cough’. it kills about 30,000 children a year. About 10% of all whooping cough cases and about half of the death occur in children under one year. Tetanus is not a communicable disease but acquired through environmental contaminations. The bacterium clostridium tetani, which can grow in dirty flesh wounds, produces a neurotoxin causing convulsions and eventual death. Tetanus referred to in the old testament as the seventh day death “Report shows that it killed an estimated 2,00,000 newboms and 30,000 mothers in 2001. Tetanus kills approximately 1,80,000 women and children, nearly 60,000 of which are newborns, annually most in developing countries.” Tuberculosis is a bacterial infection caused by mycobacterium Tuberculosis Transmitted through respiratory droplets, Tuberculosis is highly contagious. According to WHO estimates, tuberculosis kills approximately 40,000 children every year and two nillion people globally per annum. Measles is an acute viral infection. It is transmitted by droplet infection. The acute illness will last for about two weeks and is characterized by coryzal symptoms, conjunctivitis, bronchitis rash, fever and general misery. According to WHO report, in 2008, there were 1,64,000 measles death globally nearly 450 deaths every day or 18 death every ‘hour. over 95% of measles of deaths occuring in low income counties, the majority of which occur in children under the age of five. In 2010, about 85% of the world’s children received one dose of measles vaccine by their first birthday through routine health services ~ up from hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 32118/2020 study viewer 72 in 2009, The fatality rate of diseases in India is between 1-3% and complication of measles kill almost two lakhs children in India every year? Poliomyelitis is an acute viral infection caused by an RNA virus mainly transmitted through fecal oral route and via droplet infection. It is an acute illness with an infection ranging from subclinical illness through a non paralytic fever to a septic meningitis or paralysis. In south East Asia region India is the only country reporting polio cases, 874 cases were reported in the year 2007 and the majority of the cases were reported from UP and Bihar. About 559 cases of wild poliovirus were detected in the country in the year 2008, out of which 2 causes were from Punjab state, Report shows about 1349 reported cases in 2010 and in 2011, only parts of your countries in the world remain endemic for the disease." Thousands of children’s still die from vaccine preventable diseases each year. So there is a need for early detection and proper administration of immunization in appropriate dose at accurate time and improvement of knowledge of underfive mothers regarding six killer diseases is needed for reducing the child hood mortality and morbidity rates, ‘A child mother is not the only key player, each mother should be aware about safeguard the health of their children as wealth of their family, society and the community physical health of a child is important because it is associated with mental and social development of children. Mothers must be a good knowledgeable person regarding stages of growth and development, child care and about immunization schedules ete for saving the life of their children.* “Short may hurt a little but the disease but they prevent can hurt a little more” 6.2 NEED FOR THE STUDY. “Health should mean a Jot more than escape from the death or for that matter, escape from diseases” Six killer diseases causes a major threat to children and this decreases the health status and making them more vulnerable to infection disease. This causes threat to their life hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 42118/2020 study viewer The mortality rate of underfive children is still 49/1000 live births. The major causes of death is vaccine preventable diseases such as neonatal tetamis, measles, tuberculosis, diphtheria, pertusis and polio. Infectious diseases are now he world’s biggest killer of children and young adults. They account for more than 13 million deaths a year — one in two deaths in developing countries over the next hour above, 1500 people will die from an infectious disease — over half of them children underfive."? In developing countries including India each year 30 lakh infants and children are dying and another 30 lakh are become crippled deaf or mental retarded because of six vaccine preventable diseases namely diphtheria, partusis, neonatal tetanus, polio, measles and tuberculosis. Today’s children’s are tomorrow's future citizens, especially the warriors of our country. The standard economical status of nation can be improved by promoting the health status and reducing the mortality rate of the children. In india due to various belief, lack of information and low literacy rate the children are not fully protected against vaccine preventable disease. So there is a need to assess the knowledge regarding six killer diseases among mothers of underfive children about vaccination and vaccine preventable diseases will helps to promote the health of the children. A study was conducted regarding knowledge attitude and practice of mothers regarding killer diseases and immunization in wardha district. Sample size was 130 months in the age group of 15-44 years and 142 children aged 12-59 months were selected by cluster sampling method. Out of this 100 mothers and 122 children could be contracted for education of immunization coverage and assessing matemal knowledge and practice regarding immunization. 52.5% children were fully immunized and 45.1% were partially immunized. Vaccine coverage for BCG and primary doses of DPT/OPV was 95.9% and % respectively. It was 57.4% for measly and 63.14% for booster dose of DPT/OPV. above 85 ‘Study shows that mothers had a fair knowledge regarding need for immunization but a poor knowledge regarding the six killer diseases prevention and doses of the vaccines."* hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 52118/2020 study viewer Tetanus incidence rate is one of the leading causes of infant mortality 5 to 10% of neonatal deaths in Calcutta were due to tetanus. Geographical vaccination in incidence have been related to climate, organic content of soil; the disease in Calcutta during 1971 was 24/1,00,000 population this incidence is highest among agriculture workers. Some 1,10,000 cases of neonatal tetanus are estimated to occur annually in India about 1,00,000 of the (90%) are die. Tuberculosis incidence include — not a single country succeeded in reaching a point of controlee less than 1 percent tuberculin positive among children of age group 0 to 14. In the world there are about 15 million cases of infectious Tuberculosis at present; 2 — 3 million people added every year and 1-2 million people die every year prevalence of active cases 1-8 percent population out 4 percent prevalence rate in towns , cities and villages are same and it showed increase with age." Measles (Rubeola) — mortality varies greatly in different parts of the world. It is 100 to 400 times more likely to causes death in preschool children of a developing country than in the US and Europe. In developing countries, case fatality rates range from 2 to 15 percent as compared to 2 perl,00,000 notified cases in developed countries recent estimates by UNICEF suggest that measures is responsible for more than 2.5 million childhood deaths annually. In India, measles is a major cause of morbidity and a significant contributor to childhood mortality. In 1986, there were 140,827 notified cases and deaths. from, measles. Poliomyelitis incidence are in 1980 nearly 42,000 cases were notified to WHO, the data from 136 countries representing 82 percent of the total population, Now immunization has brought marked reduction. India plays an impotent role in the global eradication of poliomyelitis. Lameness surveys in several northern India states revealed annul incidence rates of 2 to 5 per 1000 rural pre-school children and 1 to 3 per 1000 urban pre-school children, Surveys in south India suggest that the prevalence of poliomyelitis lameness among school children is about 3 to 5 per 1000 implying an annual incidence in the whole population of about 15 per 1,00,000. At least 70,000 children develop polio each year in hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 22118/2020 study viewer India. It is a worldwide disease affecting people particularly in Africa and Asia. In India the first reported epidemic of poliomyelitis occurred in 1949 in and around Bombay city. Since then more epidemics have occurred at various times in Andrapradesh, UP, Gujarat, ‘Maharashtra, Rajasthan, Tamilnadu, Delhi ad recently (1981) in Kerala."* More than 30 million children are un immunized either because of unavailability of health services, vaccines and lack of knowledge of families, un informed or misinformed about when and why to bring their children for immunization. So this stimulates the investigator to spread accurate information regarding six killer diseases to the mothers, who are the first teachers will help to save many young lives. Hence the researcher left, there is a need to conduct a study among rural mothers where accessibility to health education is less and educate them about vaccine preventable diseases and promote the health of their children. “Man can learn nothing except by going from the known to unknown”? + Claude Bernard a review of literature is defined as a broad, comprehensive in depth, systematic and critical review of scholarly publications print materials audiovisual materially and personal communications””"6 - Polit and Hungier The review is based on the following headings General information about six killer diseases 2. Knowledge of mothers related to six killer diseases among underfive children 3. Effect of teaching programme on six killer diseases. hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 72118/2020 study viewer 631 GEN EAL INFORMATION ABOU SIX KILLER DISEASES: The main six vaccines preventable diseases are polio, diphtheria, measles, tetanus, tuberculosis and pertusis. All these diseases are vaccine preventable. Diphtheria is an acute infectious disease caused by chorine bacterinm diphtheria Diphtheria (is an acute infections disease caused by) causes a grayish membrane in the respiratory tract which can cause respiratory obstruction. It is spread by droplet infection and through contact with articles contaminated by infected persons. The most reliable preventive method for diphtheria is active immunization by DPT and DT to all children by universal coverage. Pertusis is highly infectious and causes by the bacteria Bordetella pertussis. It is spread by droplet infection. Treatment is only effective when antibodies are given in very early stage. Early stage of whooping cough presents like a typical upper respiratory tract catarrhal illness. Active immunization is the best measure for Prevention of partusis. DPT should be administered with 3 doses from weeks of age at one month interval. A booster dose is given after one year of 3 dose or at 16-24 months of age. Polio is an acute illness with an infection ranging from subclinical illness through a non paralysis acute fever to a septic meningitis or paralytic fever to a septic meningitis or paralysis. The virus has a high affinity for nervous tissue and replicate in motor neurons. The only effective therapy is prevention by oral polio vaccination. ‘Measles is an acute viral infection. It is transmitted by droplet injection it is the acute illness will last for about 2 weeks and it is characterized by coryzal symptoms conjunetives, bronchitis, rash fever and general misery. The disease can be preventing by the administrative of measles vaccination at the age of 9 months. Tuberculosis is caused by mycobacterium Tuberculosis. It is highly infectious disease spreading by droplet infection. The major cause of death in Aids BCG vaccination, hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 82118/2020 study viewer Tetanus is caused by the bacteria clostridium tetani, The symptoms include muscle rigidity and spasm, dysphasia and ocular paralysis, cardiovascular collapse, hyperpyrexia, brains team intoxication once the disease is established the benefit of antitoxin and antibiotic are questionable. The patient is likely to need sedation, paralysis and ventilation. Active immunization of pregnant women with tetanus toxid and infants and children with DPT, DT and TT are the best definite method of prevention. 63.2 KNOWLEDEGE OF MOTHERS RELATED TO SIX KILLER DISEASES ERFIVE CHILDREN AMONG U A cross sectional study was conducted in Ahmadabad to assess the awareness and knowledge of mothers of underfive children regarding immunization. The sample size was mothers. The respondents were tested by interviews and questionnaire, Result of the study reveals that mother having inadequate knowledge regarding importance of immunization and its timings. The researcher concluded that Anganwadi workers and television were the two most important sources for spreading health education messages.!” A study was conducted to determine the knowledge, attitude and practices of mothers regarding acute respiratory infections in Trichy, Tamilnadu, Sample size was 200 mothers. A semi structured questionnaire consisting of 20 questions were used to assess the knowledge regarding the meaning caused, predisposing factors, symptoms, prevention and treatment result of the study evaluated by structured questionnaire and three point likerts scale were used to assess the mothers attitude. Result of the study showed significant improvement and the researcher conducted that health education programmes make an effective improvement in mother knowledge attitude and practices regarding acute respiratory infections.” A cross sectional study was conducted in east Delhi to assess the knowledge regarding six killer diseases and about routine immunization among mothers by children. The sample size was 680 mothers, Data collected by semi opened questionnaire method and statistical analysis was done by chi-square test. The result shows that the educational hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 9118/2020 study viewer level of respondent was strongly associated with their knowledge about routine immunization. The study conducted that there is a need to start more educational and awareness programs for mother o achieve the goal." A cross sectional study was conducted among mother to assess the maternal knowledge and perceptions about six killer diseases and need of routine immunization programme in a semi urban area in Rajasthan, Sample size was 166 mothers and data collected through pretest on interview schedule and questionnaire method. The results showed that among the 12-34 month of old children 50% fully 31.3% partially and 18.7% not at all immunized result shows majority of the mother. Expressed favorable attitude and satisfaction regarding the programme. The study conduct that many of them were aware about importance of vaccination in general, specific information about importance of completing the schedule and knowledge about vaccine preventable disease The implications of the study are to enhance the maternal knowledge about the vaccine preventable diseases and importance of completing the immunization schedule through interpersonal such as accessibility and lack of family support.!? A community based cross sectional study was conducted in Dhaka, Bangladesh to assess the knowledge and practices of mothers in urban communities regarding six killer diseases in underfive children sample size was 750 rural mothers, taken in simple random basis, Data gathered by open ended interview. Result of study shows that mother having inndequate knowledge regarding concluded that mothers need more education and training for their behavioural change.”° A study was conducted in Assam, India to evaluate the factors the immunization coverage in the first year of life of the children. About 62.2% of the children were fully immunized result the study shows that parents having inadequate knowledge regarding diseases and its preventive method. The researcher conducted that there is a need to improve the mothers educational status will help to achieve higher target of immunization among children?! 10 hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 1072118/2020 study viewer A study was conducted in Karachi to evaluate the knowledge of mothers regarding vaccine preventable diseases and immunization status of underfive children. A total of 100 houses were used to the study intervention was given in the form of health education by the medical students on childhood diseases and immunization status. Result of the study shows a significantly increased the vaccination status of underfive children. The research shows the improvement of mothers knowledge is crucial part for the Prevention of diseases.”” A cross sectional study was conducted to find out the vaccination status of the tribal mothers and their underfive children Durgapur Villages. The sample consist of 92 tribal mothers and 91 underfive children The study was carried out in 4 tribal villages. According to national EPI schedule it was re sealed that 58.2% of the children were fully vaccinated 26.4% incompletely and 15.4% not vaccinated. The study observed that vaccination status in tribal children was satisfactory in relation to national coverage but the vaccination status of the trial mothers was not satisfactoi A study was conducted in Kudat District subah to assess the knowledge and attitude towards tuberculosis. The sample size was 205 mothers from 210 selected houses. Data collected by questionnaire method regarding tuberculosis. Generally the knowledge about the clinical features of tuberculosis was poor among mothers. And the respondents were still perceived negative attitudes towards tuberculosis the study conducted that there is a need of more interventional programs for mothers about tuberculosis.”* A cross sectioned study was conducted regarding six killer diseases among mothers of underfive children in Nigeria. The sample size was 124 mothers and cluster sampling technique were used for the study and data collected through interview and structured questionnaire the result showed that mother having lack of knowledge regarding its causes, symptoms and prevention so the researcher suggested that there is a need of health education regarding six killer diseases among mothers. al hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka war18/2020 study viewer 6.3.3 EFFECT OF TEACHING PROGRAMME ON SIX KILLER DISEASES. A study was conducted evaluate the effectiveness of teaching programme among mother about childhood immunization in United state. Sample size was 40 postructure teachin programmeartum mothers. Pamphlets were should as a method of importing information about child hood immunization post test result shows a significant improvement in mothers knowledge level regarding childhood immunization so the researcher concluded that there is a need to provide information in a concise fiiendly and as per their level of understanding. A. study was conducted in California to evaluate the opportunities for preventing tuberculosis among children below 5 year of age. Data collected from public health records of child and their adult source cases. He result shows 165 children reported with tuberculosis. The result shows there is lacking in knowledge about availability of opportunities for preventing tuberculosis. So the study concludes there is a need to make improvement I case detection, case management and contact investigation are necessary to eliminate tuberculosis in children.?” A survey was done in Sudan to evaluate the immunization coverage among underfive children sample size was 410 males and females. Result reveals of children and education level of mother. Researcher conducted that large difference found in vaccination coverage by residential area and level of mothers education.”* 6.4 STATEMENT OF THE PROBLEM: “A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON KNOWLEDGE REGARDING SIX KILLER DISEASES AMONG MOTHERS OF UNDERFIVE CHILDREN IN RAJEEV HOSPITAL AT HASSAN”. b hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 122118/2020 study viewer 64 OBJECTIVES OF THE STUDY 1. To assess the level of knowledge regarding six killer disease among mothers of underfive children, 2. To evaluate the effectiveness of structured teaching programme by comparing the pretest and post test knowledge scores. 3. To associate between the levels of knowledge regarding six killer disease with selected demographic variables among mothers of underfive children 6.6 HYPOTHESIS ‘© Pos test knowledge will be significantly higher than the pre test knowledge scores of the mothers of underfive children. 6.7 ASSUMPTIONS This study assumes that The mother of underfive children possess inadequate knowledge regarding six killer disease. Appropriate education will helps to increase the knowledge of the mother of under five children regarding six killer disease 6.8 OPERATIONAL DEFINITIONS: % ASSESSMENT: Estimate the value of mothers of under five children’s knowledge regarding six killer disease. hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 1392118/2020 study viewer ‘EFFECTIVENESS: In the study effectiveness refer to the extent to which structured teaching programs will help on six killer diseases has a achieved the desired effect in improving the knowledge of mothers of underfive children as evidenced by post test knowledge scores. * STRUCTURED TEACHING PROGRAMME: It refers to the systematically developed programme designed for mothers of underfive children to provide information regarding six killer diseases. + KNOWLEDGE: In the study knowledge refers to the correct responses obtained from the mother of underfive children regarding six killer diseases as elicited through structured Interview schedule. “SIX KILLER DISEASES: These are communicable and spread worldwide. It includes diphtheria pertussis Tuberculosis tetanus polio and measles. Inclusion Criteria: ‘Mothers of underfive children those who are attending the OPD (outpatient department) in Rajeev hospital at Hassan. # Those who willing to participate in the study. ‘* Those who have selected in the method of data collection © Mothers who can read and/or write Kannada and/or English. Exclusion Criteria # Who are not co-operative © Who are not available during the study ‘© Who are suffering with any others forms of diseases 14 hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka ait18/2020 study viewer 6.10 DELIMITATION OF THE STUDY: ‘* The study is limited only to mothers of underfive children, Mothers available at the period of study only. ‘* Measurements of scores of knowledge once before and after structure teaching programme only. 6.11 SIGNIFICANCE OF STUDY: ‘The significance of the study is to show the effectiveness of STRUCTURE TEACHING PROGRAMME on six killer diseases among mother of underfive children. 6.12 CONCEPTUAL FRAME WORK: This study is based on general system theory. 7. METHODS AND MATERIALS TO STUDY: 7.1 SOURCES OF DATA: The data will be collected from the mothers of underfive children those who are attending the outpatient department in Rajeev Hospital at Hassan. 7.2 RESEARCH DESIGN: A quasi experimental research approach with pre and post test with experimental group and randomization without a control group. Group Pre-test Intervention Post test Mothers of | O1 x 02 underfive children who are attending the OPD in Rajeev ‘Hospital at Hassan. Keys Ol-outcome of pre test knowledge score regarding six killer disease among mothers of underfive children, hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 152118/2020 study viewer X- Systematically educating the mother of underfive children to improve their knowledge regarding six killer diseases. 02- Outcome of post test knowledge score regarding six killer disease among the mothers of underfive children, 7.3 METHODS OF DATA COLLECTION: Data collection is planned through structured interview schedule for demographic variable and structured questionnaire to assess the knowledge 7.4 SAMPLING PROCEDURE: = Population: all mothers of underfive children’s attending OPD in Rajeev Hospital in Hassan, Karnataka - Sample: The mothers of underfive children who had fulfilled the inclusion and exclusion criteria - Sample Size: A total of sixty mothers of underfive children are taken for study. - Sample technique: Simple Randomized technique will be used. - Setting: Study will be conducted at OPD in Rajeev Hospital, at Hassan, t Study: Pilot study is planned with 10% of mothers of underfive children other that sample. 16 hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 1612118/2020 study viewer 8. VARIABLES 8.1 DEPENDENT VARIABLE: Knowledge on six killer disease among the mothers of underfive children. 8.2 INDEPENDENT VARIABLE: Structure Teaching Programme regarding six killer disease. 9. PLAN OF DATA ANALYSIS: 9.1 DESCRIPTIVE STATISTICS: * To describe the demographic variables and knowledge by number percentage Mean, ‘Median and Standard Deviation. 9.2 INFERENTIAL STATISTICS * To compare the knowledge within the experimental group by paired test is planned * Chi-Square will be used to analyze the level of knowledge with dependent variables. 10. ETHICAL CLEARANCE: 1. Does the study require any investigation or investigations to be conducted on patients or humans or animals? If so please describe briefly. No. 2. Has ethical clearance been obtained from your institution? Yes. 1. Permission will be obtained from the research committee of Rathna College of Nursing. 2. Permission will be obtained from the authority of Rajeev Hospital in Hassan. 3. Informed consent will be obtained from the study participants. W hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka a718/2020 study viewer 11. BIBLIOGRAPHY: wpe a 10. rr RD 14. 16. 1. 18, 19. 20. http:// en.wilepedia.org/wiki/pediatries_ Access date: 01.12.2010. Sherene G Edwin, “Effectiveness of PPT on Knowledge attitude and practice of mothers towards ARI among mothers. “ Volume C.No.11. Nov.09. www wekepedia com. www. ited for children.org/know more/knowmore_30104.htm. www, who.int/media centre factsheets/fs286/en/indes.html. K. Park text book of preventive and social medicine; Banarasidas Publications, edition 18 p149,58,64,67. Lawn JE, Cousens S, Zupan J, 4 million neonatal deaths: Lancet 2005, P.891-900, . UNICEF. annual report 2010:2011. www. childingfo.org/low-birth weight.html. \www..who .int/media centre factsheets/fs286/en/index.btml. http://en.wikipedia.org. wikipedia, vaccinations “Access date 01.03.2011 wow. wikipedia.com. . Indian Journal of public health ISSN 0019-557X CODENIPBHAH. . BT. Basavamthappa ~ Community Health Nursing 2 Edition. 15. N.R.Brothers, Jacob and singh, “ Pediatrie Nursing” 3* edition 2007. . Polit Denise F. Nursing Research: Principle and Method 7* ed.philadelphia Lippincot williams and wilkins: 2004, P 28-30. Heath line: ISSN 2229 ~ 337Xvolume L.issue 1, July- December2010, P.12-15. Dalal A, Silveria MP, Immunization status of children in GOA, Indian Pediatrics 2005: 42: P.401. . Department of family welfare, MOHFW. 1999: New Delhi. Khan Az:Study of Knowledge and practice of urban mothers in Dhaka in India Journal of social health 115(5) P.314-317. http:// tropej.oxford journals.org/search. 18 hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 1812118/2020 study viewer 22. Anjuma Asmair A, Inam SN Department of Community health sciences, Zianuddin Medical University, Karachi PMID, 1610447. 23. Rahman M Banerji M Rahaman M Akhter FO. Vaccinations status of tribal mother and their underfive children mymensingh 2006 jan :15(1) P. 55-57. 24, Prathap G and Lim L Epidemiology and control of tuberculosis in Malaysia journal of Malaysia society of health 1984:4: P.1-9 sabah (1995) annual report of tuberculosis control programme. 25.D A Adeyinta, C Aimakhui six killer diseases among mothers of under five children in south west Nigeria, the internet journal of epidemiology. 2009 vol 7:P02. 26. Evers, Deboarh B” American journal of maternal and child health 2001. Lippincott Williams and Wilkins, Ine 27. Labato N Mart, Moble C. Janet, Missed opportunities for prevent TB among children younger than five year of age: journal of Paediatrics, Vol .106, No.06 Dec 2006 P.75, 28. http:// www. ajo/ info/index. php/saiplissue/view/17. 19 hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka 192118/2020 study viewer 12. ignature of candidate: 13. Remarks of the guide: 14, Name and Designation of the guide: 14.1 Signature: 14.2 Head of the Department 143 Signature 15, Remarks of the Principal 15.1 Signature hitpsstudyres.comidoc!10892633\rajv-gancht-university-of-healh-sciences~karnataka ovesar2020 study viewer hitpsistudyres.comisoc!10892833)rajv-gancht-university-othealh-sciences-kamataka 212