DECLARATION BY THE CANDIDATE

I hereby declare that I will strictly follow COVID protocol during research study entitled
“Nutritional education programme on knowledge and practice regarding prevention of vitamin
A deficiency disorders among mothers of under five children” carried out by me under the
guidance of Mrs. Indu P C, Assistant professor, Department of Child Health Nursing,
Government College of Nursing, Thrissur.

Thrissur Aswathy R C

1
Title

Effect of nutritional education programme on knowledge and practice regarding prevention of

vitamin A deficiency disorders among mothers of under five children

Background of the problem

Nutritional deficiencies can be very significant to the overall health of infants and children
because growth and development can be seriously hindered by shortage in essential vitamins
and nutrients. Vitamins are also responsible for the breakdown of food molecules during
digestion, formation of bones, blood cells, hormones, muscles, nerves and genetic materials of
our living cells. Deficiency of these vitamins results in certain diseases and disorders.(1)

Human body needs macronutrients such as carbohydrates, proteins and fats and micro nutrients
such as vitamins and minerals. Although the body needs only a small amount of vitamins and
minerals (for this reason, they are generally referred to as micronutrients), a lack of sufficient
micronutrients in the diet affects the health and development of both children and adults and
results in potentially life-threatening deficiency diseases.

Vitamin A deficiency is a major controllable nutritional problem in developing countries. It is

estimated that 30,000-40,000 children in India may lose their eye-sight because of vitamin A
deficiency. The drying of conjunctiva and cornea may lead to ulceration which causes
permanent scarring or irreversible damage and blindness. Xerophthalmia occurs when the body
stores of vitamin A are exhausted owing to low dietary intake of vitamin A rich foods or
interference in absorption of retinol in the body.(2)

The World Health Organization has classified vitamin A deficiency as a public health problem
affecting about one third of children aged 6 to 59 months in 2013 with the highest rates in sub-
Saharan Africa (48 per cent) and South Asia (44 per cent).(3)

Vitamin A deficiency (VAD) is one of the most serious childhood nutritional diseases and is
often associated with protein energy malnutrition. Vitamin A deficiency causes night blindness
and in more serious cases, may damage the eyes, cause total blindness and increase the risk of
infection and death. Each year, an estimated 3,00,000 children in developing countries lose
their eyesight because of vitamin A deficiency and two thirds of these children are at risk of
dying. Vitamin A deficiency affects adults, pregnant and lactating women.

2
Vitamin A deficiency occurs when a child or adult does not consume enough vitamin A rich
foods or enough fat. Fats and oils help in the absorption of vitamin A. So, when a diet is low
in fat, only small amounts of vitamin A are absorbed. Vitamin A deficiency is often worsened
by health problems such as measles and diarrhoea which also increase vitamin A needs.
Vitamin A deficiency is particularly common in areas of low rainfall with distinct wet and dry
seasons and where the availability and regular consumption of green leafy vegetables and
yellow- and orange-coloured fruits are seasonal.

The best way to prevent Vitamin A deficiency is to encourage families to grow and eat foods
that are rich in vitamin A. These include plant foods such as dark green leafy vegetables and
yellow- or orange-coloured fruits as well as the wide range of indigenous leafy vegetables.
Among animal foods, liver is particularly rich in vitamin A. Before the introduction of weaning
foods, breastmilk is the only source of vitamin A for the infant. Lactating mothers should
therefore eat plenty of foods rich in vitamin A to meet their own needs as well as those of their
breastfeeding child. Adequate fat or oil must also be consumed in order to improve the vitamin
A level(4).

Malnutrition among the children is still a challenge for India and hindrance in achieving the
sustainable development goals for health in India. India is leading among its neighbouring
countries in terms of magnitude of clinical and subclinical Vitamin A deficiency among young
children. According to National Nutrition Monitoring Bureau (NNMB) Survey, around 62%
of the preschool children in India are found to suffer from Vitamin A deficiency and 21.5%
have a low serum retinol level <0.35 μmol/l. According to UNICEF, only 56% of the children
6–59 months received two-dose vitamin A supplementation coverage in India. National Family
Health Survey 2015 revealed that around 60% of the children age 6–59 months received
Vitamin A supplementation and 44% children aged 6–23 months have taken Vitamin A
enriched food. This coverage varied according to various socio economic and demographic
characteristics. There is a scarcity of studies specially focusing on micronutrient deficiency
among Indian children, hence there is need for studies exploring the specific micronutrient
deficiencies among children.(5)

3
Need and significance

First and foremost, health, safety and nutrition for the young child is written on behalf of young
children everywhere. Ultimately, it is the children who benefit from having parents who
understand and know how to protect and promote their safety and well-being by knowing
regarding nutrition. Nutrition is the provision to cells and organisms of the materials necessary
(in the form of food) to support life. Many common health problems can be prevented or
alleviated with a healthy diet. Nutrients are organic and inorganic complexes contained in food.
There are six major classes of nutrients those are mainly carbohydrates, fats, minerals, protein,
vitamins and water. These nutrient classes can be categorized as either macronutrients or
micronutrients. The macronutrients include carbohydrates, fats, protein and water. The
micronutrients are minerals and vitamins. The macronutrients provide structural material
(amino acids from which proteins are built and lipids from which cell membranes and some
signalling molecules are built) and energy. Vitamins, minerals, fibre and water do not provide
energy but are required for other reasons. A third class of dietary material, fibre is also required
for both mechanical and biochemical reasons although the exact reasons remain unclear.
Mother is the one who take care of the child, it is very important that she should need to have
knowledge regarding care of under-five and nutrition which they need. Healthy eating and
physical activity are essential for growth and development in childhood. To help children
develop healthy eating patterns from an early age, it is important that the food and eating
patterns to which they are exposed-both at home and outside the home-are those which promote
positive attitudes to good nutrition.(6)

A study was conducted to assess burden of sub-clinical VAD among under-five children and
to study the determinants of sub-clinical VAD among those children. They conducted a
systematic search by a manual search of pre-identified journals, a general electronic search,
electronic search of dedicated websites/databases and personal communication with experts.
Sub-clinical VAD is a huge public health problem globally, most widespread among pre-school
children of low-income countries. Nearly 33.3% of under-five children suffer from sub-clinical
VAD globally. The major determinants of this condition include diets containing insufficient
vitamin A rich foods, diarrhoea, measles, respiratory infections, poor breast feeding practises,
lack of supplementary vitamin A intake and malnutrition. The study concluded to have
immediate needs of action to be taken urgently to meet the rising burden of sub-clinical VAD.
This problem can be dealt with the help of initiatives ranging from promotion of breastfeeding,

4
encouraging intake of vitamin A rich foods, vitamin A supplementation and food
fortification.(7)

A Case-control study was conducted in Bihta Primary Health Centre area, Bihar to determine
the correlates of vitamin A deficiency among 4,205 preschool-age children. Main outcome
measures were dietary habits, maternal literacy and birth order. Vitamin A deficiency was
found to be significantly higher (p<0.01) in children on a vegetarian diet (7.14%) (OR 5.32).
Children born to a literate mother had a prevalence of only 1.35% in relation to a corresponding
value of 4.11% in children born to illiterate mothers (p<0.01) (OR 3.15). Birth order of
preschool-age children was significantly related to vitamin A deficiency. In birth order less
than or equal to three, the prevalence was 2.81%, in comparison to those with birth order four
or more in whom the magnitude was significantly higher (p<0.01) at 5.61% (OR 2.08).(8)

A community based cross-sectional study was carried out in rural areas of West Bengal with
the aim to assess the prevalence of vitamin A deficiency (VAD) among rural preschool
children. Clinical examination was carried out on 9,228 children for the signs and symptoms
of VAD and a sub-sample of 590 children were covered for the estimation of blood vitamin A
levels using dried blood spot (DBS) method. The prevalence of Bitot's spots was 0.6% (95%
CI=0.44, 0.76) which is more than the public health significance and it increased with increase
in age. The prevalence was significantly higher (p<0.001) among boys (0.8%) as compared to
girls (0.4%). The proportion of children with subclinical vitamin A deficiency (blood vitamin
A < 20 ug/dL) was 61% (95% CI: 52.3-65.1), and it was significantly (p<0.01) higher among
the children of lower socioeconomic communities.(9)

Review of literature

Literature on vitamin A deficiency in children

A study was conducted to assess the effectiveness of planned teaching programme on

knowledge regarding prevention of Vitamin A deficiency among the mothers of under five
children in selected rural areas of Vidharbha region. The method used for this study was quasi
experimental one group pretest post-test research design. The population and samples were
mothers of under five children of selected rural area who were fulfilling the inclusion and
exclusion criteria and the sample consisted of sixty mothers. The sampling technique used in
this study was non-probability convenient sampling. Based on the objectives and the hypothesis

5
the data were analysed by using various statistical tests. Analysis of data showed that there is
significant difference between pre-test and post-test knowledge. The p value is less than the
level of significance that is 0.05. This indicates that the gain in post-test knowledge is
significant. It proves the significance of planned teaching programme in the improvement of
the knowledge statistically. The calculated ‘t’ values are much higher than the tabulated values.
In this study marked improvement of scores in the post test as 61.67% of samples had good
score and 38.33% of samples had excellent and average scores. Hence it is statistically
interpreted that the planned teaching programme on prevention of vitamin A deficiency among
the mothers of under five children was effective(10).

A study was conducted to assess the effectiveness of structured teaching programme on

prevention and management of vitamin-A prophylaxis among mothers of under five children
in selected urban primary health centre, Koyambedu. A quantitative experimental research was
conducted among 60 antenatal mothers. A purposive sampling technique was used to select the
sample. Self-administered structured questionnaires were used to collect the demographic data.
The pre-test mean score of knowledge was 4.95 with standard deviation 1.43 and the post-test
mean score of knowledge was 13.05 with standard deviation 2.17. The calculated paired ‘t’ test
value (t = 23.043) was found to be statistically highly significant at p< 0.001 level. This clearly
infers that there was significant improvement was observed in the post test level of knowledge
on prevention and management of Vitamin A prophylaxis among mothers of under-five
children.(11)

A study was conducted among mothers of under five children to assess knowledge and practice
regarding vitamin A & its deficiency by using quantitative research approach with descriptive
research design. To assess the knowledge regarding Vitamin A and its deficiency structured
knowledge questionnaire was used. Through checklist practice regarding Vitamin A and its
deficiency was identified. The collected data was tabulated and analysed by using descriptive
and inferential statistics. The results shows that among majority of the samples (90%) were
having poor, (8.71%) were having average and (1.28 %) were having good knowledge score.
Majority of the samples (83%) have demonstrated poor practice and 17% have demonstrated
good practice regarding Vitamin A and its deficiency. Knowledge of food based vitamin A can
make sustained improvements in knowledge and dietary practices. Hence, health care providers
should be trained and encouraged to provide a more personalized health education to the
mothers of under five children to bring awareness regarding vitamin A and its deficiency.(12)

6
Problem statement

A study to assess the effect of nutritional education programme on knowledge and practice
regarding prevention of vitamin A deficiency disorders among mothers of under five children
admitted in Pediatric wards, Government Medical College Hospital, Thrissur.

Research question

What are the effects of nutritional education programme on the knowledge and practice
regarding prevention of vitamin A deficiency disorders among mothers of under five children?

Purpose of the study

The purpose of the study is to assess the effect of nutritional education programme on
knowledge and practice regarding prevention of vitamin A deficiency disorders among mothers
of under five children admitted in Pediatric wards, Government Medical College Hospital,
Thrissur.

Objectives

Primary objectives

 Find the effect of nutritional education programme on knowledge regarding prevention

of vitamin A deficiency disorders among mothers of under five children.
 Find the effect of nutritional education programme on practice regarding prevention of
vitamin A deficiency disorders among mothers of under five children.
 Find the relation between knowledge and practice regarding prevention of vitamin A
deficiency disorders among mothers of under five children.
Secondary objectives
 Find the association between knowledge regarding prevention of vitamin A deficiency
disorders among mothers of under five children with selected variables.
 Find the association between practice regarding prevention of vitamin A deficiency
disorders among mothers of under five children with selected variables.

7
Operational definition

Effect: Refers to the change in the mean knowledge and practice score of mothers regarding
prevention of vitamin A deficiency disorders among under five children after administration of
nutritional education programme.

Nutritional education programme: Refers to a planned teaching session regarding prevention

of vitamin A deficiency disorders of a duration of 30 minutes given by the researcher to the
mothers of under five children admitted in pediatric wards of Government Medical College
Hospital, Thrissur. It include teaching cum discussion on the functions of Vitamin A, causes,
symptoms and the prevention of vitamin A deficiency disorder among under five children using
powerpoint, charts and leaflets.

Knowledge: refers to the awareness of mothers of under five children regarding basic
information of vitamin A, symptoms associated with vitamin A deficiency disorders and
measures to prevent vitamin A deficiency disorders among under five children measured using
structured questionnaire.

Practice: refers to the reported routine activities carried out by the mothers of under five
children regarding the prevention of vitamin A deficiency disorders measured using structured
questionnaire and a food frequency table.

Vitamin A deficiency disorders: refers to decreased intake of vitamin A rich food, poor
absorption or high excretion of vitamin A associated with some common illnesses.

Mothers of under five children: refers to the female parent of admitted children in the age
group of 1- 5 years who are admitted in Pediatric wards, Govt Medical College Hospital,
Thrissur.

Selected variables: refers to mother’s age, religion, education, type of family, number of
under five children, employment status, area of living, monthly income, diet, previous
information regarding vitamin A deficiency disorders.

8
Assumptions

 Children are at higher risk of developing vitamin A deficiency disorders.

 The knowledge level of mothers regarding the prevention of vitamin A deficiency
disorders in children vary.
 The practice of mothers regarding the prevention of vitamin A deficiency disorders
depends upon the cultural beliefs and traditional practices.

Hypotheses

H1: There is a significant difference in the mean score of knowledge regarding prevention of
vitamin A deficiency disorders among mothers of under five children between control group
and experimental group.

H2: There is a significant difference in the mean score of practice regarding prevention of
vitamin A deficiency disorders among mothers of under five children between control group
and experimental group.

H3: There is a significant relation between knowledge and practice regarding prevention of
vitamin A deficiency disorders among mothers of under five children

H4: There is a significant association between knowledge regarding prevention of vitamin A

deficiency disorders among mothers of under five children and selected variables

H5: There is a significant association between practice regarding prevention of vitamin A

deficiency disorders among mothers of under five children and selected variables.

Conceptual framework

The study is based on the health promotion model, propounded by Nola J. Pender.

According to this theory, it identifies cognitive – perceptual factors in the individual that are
modified by situational, personal and interpersonal characteristics to result in the participation
in health promoting behaviors in the presence of cue action.

The following are cognitive-perceptual factors defined as primary motivational mechanism for
the activities related to health promotion. These are importance of health, perceived control of
health, perceived self-efficiency, definition of health, perceived health status, perceived
benefits of behaviors and perceived barriers to health promoting behavior habits.

9
Perceived control of health: The individual's perception of his own ability to change his health
can motivate his desire for health.

Perceived self-efficiency: The individual's strong belief that a behavior is possible can
influence the occurrence of that behavior.

Perceived health status: The current state of feeling well as well as feeling ill can determine the
likelihood of initiating health promoting behavior.

Perceived benefits of behavior: The individuals may be more inclined to begin or continue
health promoting behaviors if the benefits to such behavior are considered high.

Perceived barrier to health promoting behavior. The individual's belief that an activity or
behavior is difficult or unavailable may influence his attention to engage in it.

Modifying factors: Modifying factors are those factors which is having indirect influence on
behaviors such as age, gender, education, income, family patterns of health care behavior,
expectation of significant others etc. which plays roles in the determination of health care
behaviors.

In this study the cognitive perceptual factors refer to the knowledge of mothers of under five
children regarding the prevention of vitamin A deficiency disorders.

Perceived control of health is their perception regarding importance of nutrition, attitude

towards adopting necessary changes to prevent the vitamin A deficiency disorders.

Perceived health status: Perception regarding the current nutritional status of their children
determines the likelihood of initiating health promoting behaviour in-order to prevent vitamin
A deficiency disorder.

Perceived benefits of behavior: mothers may be more interested to adopt the new dietary
pattern of children if the benefits to such behaviors are considered high.

Perceived barriers of health promoting behaviour: Inadequate knowledge, low educational

status, low socio-economic status and lack of motivation of mothers to adopt the new dietary
pattern for their children and health problem of the child.

Modifying factors in this study includes age, sex, no: of siblings, education of parents and
family income and the situational factors are availability of nutritional resources, vitamin rich
food, Vitamin A supplementation status and dietary pattern of children.

10
Behavioral factors are feeding practice and dietary pattern of children. In this study the
cognitive perceptual factors in the mothers are modified by behavioral factors such as dietary
pattern result in the likelihood of improvement of nutritional status and prevent vitamin A
deficiency disorders after educating with information guide.

Cognitive and perceptual factors Modifying factors Participating in

health promoting behaviour

Figure 1: Conceptual framework on the effect of nutritional education programme on

knowledge and practice of mothers of under five children regarding vitamin A deficiency
disorders based on Pender’s Health Promotion Model

11
Research methodology

Research approach

Quantitative research approach.

Research design

Quasi experimental pre-test post-test control group design

Variables

Independent variable: Nutritional education programme.

Dependent variables: Knowledge and reported practice of mothers regarding prevention of

vitamin A deficiency disorders

Setting of the study

The setting of the study is Pediatric wards of Government Medical college Hospital, Thrissur.

Study population

Mothers of admitted under five children in Pediatric wards of Government Medical College
Hospital, Thrissur.

Sample size

Sample size of the present study is derived from a study conducted by Sathiyabama G, Kiruba
J and Shiny HS to assess the effectiveness of structured teaching programme on prevention and
management of vitamin-A prophylaxis among mothers of under five children in selected urban
primary health centre, Koyambedu using the following formula

2SD2(Zα/2 +Zβ)

d2

2 x (3.6)2(1.96 + 0.84)2 = 23
8.1
As per calculation, sample size of each group is 23. Considering the attrition rate, the sample
size will be fixed as 30 in each group (30 in experimental group and 30 in control group).

Sampling Technique

Convenient sampling technique

12
Inclusion criteria for sampling

Mothers:

 who are willing to participate in the study.

 who are the primary caregivers of their children.
 who prepare food regularly for their children in the home settings.

Exclusion criteria

Mothers:

 who do not understand malayalam

 whose child has any kind of critical illness.
 whose child has any malabsorption syndrome.
 whose children has liver or kidney disfunction.

Tools and techniques for the study

Data will be collected using following tools.

Tool 1: Interview schedule to assess the socio personal data

Structured questionnaire to assess the socio personal data is designed to collect baseline
information regarding mothers and their under five children. It consists of two sections.

Section A: Socio personal data sheet

Socio personal variables of mother includes 10 items which include age of mother, age of
child, reason for present hospitalization, religion, education, type of family, number of under
five children, employment status, area of living, monthly family income, type of family diet
and previous information regarding prevention of vitamin A deficiency disorders among under
five children.

Section B: Immunization schedule of under five children.

Immunization schedule is used to assess the immunization status of the child up to the age.

Technique: Semi structured interview

13
Tool 2:

This tool includes interview schedule to assess knowledge of mothers of under five children
regarding vitamin A deficiency disorders . It consists of

Section A- Structured questionnaire to assess knowledge of mothers of under five children

regarding prevention of vitamin A deficiency disorders. It consists of 15 questions. Each
question carries one mark with a total score of 15.

The knowledge score is divided into three categories.

Good knowledge:11-15
Average knowledge: 6-10
Poor knowledge: 1-5
Technique: Semi structured interview
Tool 3:

This tool includes interview schedule to assess the reported practice of mothers of under five
children. This tool is categorized into two sections.

Section A: Structured questionnaire to assess the practice of mothers of under five children
regarding prevention of vitamin A deficiency disorders. It consists of 5 questions. Each
questions carries one mark.

Technique: Semi structured interview

Section B: This consists of food frequency table to assess the feeding practice of the
mothers of under five children. It includes assessment of feeding practice of 8 food items in
the last week. Maximum score is 24 and minimum score is 0.

The total practice score is 29 and minimum score is 0.

Good practice: 20-29

Average practice: 10-19

Poor practice: 0-9

Technique: Self report

14
Pilot Study

After getting approval from the scientific review committee and Institutional Ethics
Committee, pilot study will be conducted in 10 samples (5 experimental group and 5 control
group) admitted in Pediatric wards of Government Medical College Hospital, Thrissur. A
briefing of the study will be given to the mothers and researcher will establish a good rapport
with them. After obtaining their informed consent, socio personal data of mother and clinical
data of child will be collected. Pretest will be conducted using structured knowledge
questionnaire, structured practice questionnaire and food frequency table that is specially
designed for this study. After that, nutritional educational programme regarding prevention of
vitamin A deficiency disorders will be administered to the experimental group on the same
day. The post test will be conducted after 2 weeks using telephonic interview. The data obtained
will be statistically analyzed using descriptive and inferential statistics. A nutritional education
programme will also be given to the control group at the end of their post-test.

Plan for data collection

The investigator will explain the purpose of the study. Informed consent and their telephone
number will be taken prior to study. A total of 60 sample (30 in control group and 30 in
experimental group) will be selected based on selection criteria from mothers of under five
children admitted in Pediatric wards in Government Medical College, Thrissur. After obtaining
their informed consent, socio personal data and clinical data will be collected. Pretest will be
conducted using structured knowledge questionnaire, structured practice questionnaire and
food frequency table that is specially designed for this study. On the same day nutritional
educational programme will be given for the experimental group. The post test will be
conducted after two weeks using telephonic interview. A nutritional education programme will
also be given to the control group at the end of their post-test. The duration of data collection
period will be 6 weeks.

15
Plan for data analysis

The researcher plan to analyze the data using inferential and descriptive statistics.

 Socio-personal data sheet of mothers will be analyzed in terms of frequency distribution

and percentage distribution.
 Homogeneity of the group will be analyzed using chi square test.
 Correlation between knowledge and practice of mothers of under five children
regarding prevention of vitamin A deficiency disorders will be assessed using Karl
Pearson’s correlation coefficient.
 Association of the knowledge regarding prevention of vitamin A deficiency disorders
among mothers of under five children with selected variables will be assessed using chi
square test.
 Association of the practice regarding prevention of vitamin A deficiency disorders
among mothers of under five children with selected variables will be assessed using chi
square test.
 Unpaired t test will be used for analyzing the significant difference in the mean pretest
and post test score of knowledge and practice of mothers of under five children
regarding prevention of vitamin A deficiency disorders.

BUDGET

Self

Ethical considerations

This study is supposed to conduct after submitting the proposal to institutional ethics review
board and start the study only after getting the permission from institutional ethics review
board. The information acquired from the participants will be utilized only for the purpose of
knowledge and analysis that could further be operated as data, directly or indirectly for research
purpose only. Prior to data collection, consent of respondent will be taken. The participants
will be informed about their rights to terminate the participation at any point of time during the
study and that will not affect the services rendered to them.

16
WORK PLAN

Activities May June July Aug Sept Oct Nov Dec Jan Feb Mar April May June July
Identification
of research
area
Formulation
of research
statement
Review the
related
literature
Formulate
the research
methodology
Write the
research
proposal
Tool
construction
and ethical
clearance
Registration
of research
proposal
Sending tool
for validity
Pilot study
and analysis
Modification
of tool if any
Data
collection

Coding
Data
Analysis

Interpretation

Report
Preparation
of
dissertation
Submission
of
dissertation

17
Reference

1. Nutritional Deficiencies | Learn Pediatrics [Internet]. [cited 2021 Sep 4]. Available from:
http://learn.pediatrics.ubc.ca/body-systems/gastrointestinal/nutritional-deficiencies/

2. Vitamin A deficiency in India - PubMed [Internet]. [cited 2021 Aug 31]. Available from:
https://pubmed.ncbi.nlm.nih.gov/12286294/

3. Vitamin A Deficiency in Children - UNICEF DATA [Internet]. [cited 2021 Aug 31].
Available from: https://data.unicef.org/topic/nutrition/vitamin-a-deficiency/

4. x3996e14 [Internet]. [cited 2021 Jun 8]. Available from:

http://www.fao.org/3/X3996E/x3996e14.htm

5. Kundu S, Rai B, Shukla A. Prevalence and determinants of Vitamin A deficiency among

children in India: Findings from a national cross-sectional survey. Clin Epidemiol Glob
Health. 2021 Jul 1;11:100768.

6. Patali - 2018 - A Descriptive Study to Assess the Knowledge of Mot.pdf.

7. Suri S, Acharya AS. Sub-clinical vitamin A deficiency among under-five children:

Current scenario and future perspectives. Indian J Med Spec. 2016 Apr 1;7(2):83–7.

8. Pal R, Sagar V. Correlates of Vitamin a Deficiency among Indian Rural Preschool-Age

Children. Eur J Ophthalmol. 2007 Nov 1;17(6):1007–9.

9. Arlappa N, Balakrishna N, Laxmaiah A, Nair KM, Brahmam GN. Prevalence of clinical

and sub-clinical vitamin A deficiency among rural preschool children of West Bengal,
India. Indian Pediatr. 2011 Jan;48(1):47–9.

10. Effectiveness of Planned Teaching Programme on Knowledge Regarding Prevention of

Vitamin A Deficiency among the Mothers of Under Five Children in Selected Rural
Areas of Vidharbha Region. Int J Sci Res IJSR. 2016 Apr 5;5(4):1660–2.

11. A study to assess the effectiveness of structured teaching programme on prevention and
management of vitamin-a prophylaxis among mothers of under five children in selected
urban primary health centre, Koyambedu. :3.

12. Knowledge and Practice Regarding Vitamin-A and its Deficiency among Mothers of
under Five Children – International Journal of Psychosocial Rehabilitation [Internet].
[cited 2021 Aug 29]. Available from:
https://www.psychosocial.com/article/PR2020687/28149/

18
 APPENDIX

Informed Consent

In signing this document, I am giving my consent to be subject of the research study titled
“Effect of nutritional education programme on knowledge and practice regarding prevention
of vitamin A deficiency disorders among mothers of under five children” conducted by Ms.
Aswathy R C, MSc Nursing student, Govt. College of Nursing, Thrissur.

I have been informed about the above study in detail and that the data will be collected using
3 different questionnaires and post-test will be conducted after two weeks through telephonic
interview. For the purpose of research study I give my consent to the researcher to access my
telephone number for collecting post-test data in the duration of the study. My willingness to
participate in the study is purely voluntary and I am well aware that I can withdraw myself
even during the course of research study without affecting the services rendered to me. I have
been told that the information’s will be used only for study purpose and also informed about
the confidentiality of the personal data and no name or identification data will be published in
the study report and collected data will be destroyed after the research study. I understand that
Ms. Aswathy R C can be contacted for my doubts, questions or clarifications about the study.
I understand that no financial burden will be incurred on me.

Place: Name of the participant:

Date: Signature :

Witness 1:

Witness 2:

Name of investigator: Ms.Aswathy R C

MSc Nursing
Govt. College of Nursing
Thrissur

Phone No: 0487-2208205

19
 Tool-1

Semi structured questionnaire to assess the socio personal data

Instructions

✓ Attempt all the questions listed

✓ The answers will be kept confidential and will be used only for research purpose

✓ Put a tick (✓) mark in the appropriate answer/fill in the blanks wherever applicable

Section A

Socio personal data sheet

Code No.:

Phone No.:

1. Age of mother in years...

2.Age of child in years…..

3.Reason of hospitalization……

4. Religion

a. Hindu [ ]

b. Christian [ ]

c. Muslim [ ]

d. Any other, specify [ ]

5. Education

a. School education [ ]

b. College education [ ]

c. Professional education [ ]

20
6. Type of family

a. Nuclear family [ ]

b. Joint family [ ]

c. Extended family [ ]

7. Total number of under five children in the house...

8.Employment status

a. Employed [ ]

b. Unemployed [ ]

9. Area of living

a. Panchayath [ ]

b. Municipality [ ]

c. Corporation [ ]

10. Monthly family income...

11. Type of family diet

a. Vegetarian [ ]

b. Mixed [ ]

12. Do you have any previous information regarding prevention of

vitamin A deficiency among under five children

a. No [ ]

b. Yes(specify the source……) [ ]

21
 Section C
Immunization schedule of the under five child

VACCINATION AGE TAKEN NOT REASON FOR NOT

TAKEN TAKING

BCG At birth

Birth dose At birth

OPV At birth

OPV 1,2 & 3 At 6,10,14

weeks
IPV (inactivated 14 weeks
Polio Vaccine)
Pentavalent 1,2 & At 6, 10, 14
3 weeks
Rota Virus At 6, 10, 14
Vaccine weeks
Measles 1st Dose 9 months

Vitamin A 9 months
prophylaxis,
1st Dose

DPT 1st booster 16-24 months

OPV Booster 16-24 months

Measles 2nd dose 16-24 months

Vitamin 1 year
A prophylaxis 1 ½ years
2 years
2 ½ years
3years
3 ½ years
4 years
4 ½ years
5 years

22
 Tool 2

Structured questionnaire to assess knowledge regarding prevention of vitamin A

deficiency disorders among under five children

Section A

Vitamin A

1.What is the most important function of vitamin A?

a. Digestion [ ]

b. Hearing improvement [ ]

c. Eye health [ ]

d. Bone health [ ]

2. Which is the most common vitamin A deficiency disorder?

a. Night blindness [ ]

b. Scurvy [ ]

c. Rickets [ ]

d. Anaemia [ ]

3. What is the common cause of vitamin A deficiency?

a) Low dietary intake of vitamin A [ ]

b) Poor exposure to sunlight [ ]
c) Poor intake of grains [ ]
d) Poor consumption of red meat [ ]

4. Which is the symptoms of vitamin A deficiency among the following?

a. Mood changes [ ]

b. Night blindness [ ]

c. Numbness [ ]

d. Gum bleeding [ ]

23
5. Which among the following is the leading reason for blindness in children?

a. Glaucoma [ ]

b. Vitamin A deficiency [ ]

c. Colour blindness [ ]

d. Cataract [ ]

6. What is the best source of Vitamin A?

a. Poultry [ ]

b. Sweet potato [ ]

c. Legumes [ ]

d. Dairy products [ ]

7.Which among the following Orange coloured vegetable is rich in

vitamin A?

a. Capsicum [ ]

b. Carrot [ ]

d. Tomato [ ]

8.Which among the following Green Vegetable rich in vitamin A?

a. Cucumber [ ]

b. Spinach [ ]

c. Cabbage [ ]

9.Among the following which fruit doesn’t contain vitamin A?

a. Ripe mango [ ]

b. Ripe papaya [ ]

c. Orange [ ]

d. Banana [ ]

24
10. Among the following which animal-source foods are rich in

vitamin A?

a. Liver [ ]

b. Oyster [ ]

c. Red meat [ ]

d. None of the above [ ]

11. Which among the following are rich in vitamin A?

a. Milk [ ]

b. Chocolate [ ]

c. Ice cream [ ]

d. coffee [ ]

12.What are other sources of vitamin A?

a. Breast milk [ ]

b. Powdered milk [ ]

c. Formula milk [ ]

13. How is vitamin A deficiency prevented?

a) Eat/feed vitamin-A-rich foods [ ]

b) Exposure to sunlight [ ]
c) Feed with citrus fruits [ ]
d) Feed with red meat [ ]

25
14.What must be included in the diet to prevent vitamin deficiency?

a. Green leafy vegetables [ ]

b. Cereals [ ]

c. Pulses [ ]

d. Tubers [ ]

15.Vitamin A prophylaxis covers up to which age group?

a. 3 years [ ]

b. 5 years [ ]

c.7 years [ ]

d. 9 years [ ]

26
 Tool 3

Section A

Questionnaire to assess practice regarding prevention of vitamin A deficiency disorders

among mothers of under five children

1. How do you provide green leafy vegetables to your child?

a. Half cooked [ ]

b. Boiled [ ]
c. Steamed [ ]
2.How do you feed your child with other vegetables?
a. Half cooked [ ]
b. Boiled [ ]
c. Steamed [ ]
3.How do you provide selected fruits like apple and guava to your child?
a. With peel [ ]
b. Without peel [ ]
4. Which food do you include more in your child’s diet?
a. Fruits and vegetables [ ]
b. Fast foods [ ]
c. Packed food items [ ]
5.Which oil do you use most to cook food for your child?
a. Coconut oil [ ]
b. Olive oil [ ]
c. Vegetable oil [ ]
d. Sunflower oil [ ]

27
 Section B
Food frequency table to to assess feeding practice among the mothers of under five
children

I would like to ask you about particular foods you may have fed your child during last week.

Put a tick (✓) mark in the appropriate answer and mention the frequency also.

Food frequency table

1.How often did you feed your child with these items?

Sl. No Food items Daily Twice in a Once in a Not given

week week
Vegetables (Carrot,
1 pumpkin etc.)

Green leafy vegetables

2 (Spinach, drumstick
leaves etc.)
Orange coloured fruits
3 (Papaya, Mango etc.)
Fish and fish products
4 (sardine, Tuna,
Mackerel, Cod liver oil
etc)

5 Nuts and seeds

(Peanut, Almond etc.)
Milk and milk
6 products (Milk, curd,
ghee, butter etc.)

7 Egg

Tubers
8 (Potatoes, Sweet
potatoes, Yam, Taro
root etc.)

28
 APPENDIX
സമ്മതപത്തം

ഈ രേഖ ഒപ്പിടുന്നതിലൂടട " അഞ്ച് വയസ്സിന് താടെയുള്ള കുട്ടികളുടട അമ്മമാേിൽ വിറ്റാമിൻ

എ യുടട കുറവുമൂലം ഉണ്ടാവുന്ന് അസുഘങ്ങരള തടയുന്നതിനുള്ള അറിവും പേിശീലനവും
സംബന്ധിച്ച രപാഷക വിദ്യാഭ്യാസ പേിപാടിയുടട ത്പഭ്ാവം" എന്ന വിഷയത്തിൽ തൃശൂർ. ഗവ.
നഴ്ിംഗ് രകാരളജിടല ബിേുദ്ാനന്തേ ബിേുദ് വിദ്യാർത്ഥിനി മിസ് അശവതി ആർ സി നടത്തുന്ന
ഗരവഷണ പഠനത്തിന് ഞാൻ സമ്മതം നൽകുന്നു. ഈ പഠനടത്ത കുറിച്ച് എനിക്ക് വിശദ്മായ
വിവേം നൽകിയിട്ടുണ്ട് കൂടാടത ഈ പഠനത്തിനായി ത്പരതയകം േൂപകൽപ്പന ടെയ്ത 3 വയതയസ്ത
രൊദ്യാവലികൾ ഉപരയാഗിച്ച് ഡാറ്റ രശഖേിക്കുകയും ടടലിര ാണിക് അഭ്ിമുഖത്തിലൂടട
േണ്ടാഴചയ്ക്ക് രശഷം രപാസ്റ്റ്-ടടസ്റ്റ് നടത്തുടമന്ന് അറിയിക്കുകയും ടെയ്ത ു. ഗരവഷണ
പഠനത്തിനായി, പഠന കാലയളവിരലക്കുള്ള ഡാറ്റ രശഖേിക്കുന്നതിന് എന്ടറ ടടലിര ാൺ
നമ്പർ രശഖേിക്കാൻ ഞാൻ ഗരവഷകരനാട് എന്ടറ സമ്മതം നൽകുന്നു. പഠനത്തിൽ
പടെടുക്കാനുള്ള എന്ടറ സന്നദ്ധത തികച്ചും സവരമധയാ ഉള്ളതാണ്, എനിക്ക് നൽകിയ
രസവനങ്ങടള ബാധിക്കാടത ഗരവഷണ പഠനത്തിന്ടറ ഏതു ഘട്ടത്തിലും എനിക്ക് ഇതിൽ
നിന്നും പിന്മാറാടമന്നും ഇത് എനിക്ക് ലഭ്ിക്കുന്ന രസവനങ്ങടള ബാധിക്കില്ല എന്ന് ഞാൻ
മനസിലാക്കുന്നു. വിവേങ്ങൾ പഠന ആവശയങ്ങൾക്ക് മാത്തമായി ഉപരയാഗിക്കുടമന്നും
വയക്തിഗത വിവേങ്ങളുടട േഹസയാത്മകതടയക്കുറിച്ചും അറിയിക്കുന്നുടവന്നും പഠന
റിരപ്പാർട്ടിൽ രപരോ തിേിച്ചറിയൽ വിവേങ്ങരളാ ത്പസിദ്ധീകേിക്കിടല്ലന്നും എരന്നാട്
പറഞ്ഞിട്ടുണ്ട്. പഠനടത്തക്കുറിച്ചുള്ള എന്ടറ സംശയങ്ങൾരക്കാ രൊദ്യങ്ങൾരക്കാ
വിശദ്ീകേണങ്ങൾരക്കാ ത്ശീമതി അശവതി ആർ സി ടയ ബന്ധടപ്പടാടമന്ന് ഞാൻ
മനസ്സിലാക്കുന്നു. ഒേു സാമ്പത്തിക ബാധയതയും എന്ടറ രമൽ ഉണ്ടാകിടല്ലന്ന് ഞാൻ
മനസ്സിലാക്കുന്നു.

പടെടുക്കുന്ന വയക്തിയുടട രപേ്:

ഒപ്പ്:

സാക്ഷി 1:

സാക്ഷി 2:

ഗരവഷകന്ടറ രപേ് : അശവതി ആർ സി

എം എസ് .സി രനഴ്ിംഗ് വിദ്യാർത്ഥിനി

ഗവ: രനഴ്ിംഗ് രകാരളജ്

ര ാൺ : 0487-2208205

29
 ഉപകരണം -1

വിഭാഗം- എ

സാമൂഹിക വയക്തിഗത നില വിലയിരുത്തുന്നതിനുള്ള ച ാദ്യാവലി നിർചേശങ്ങൾ

സാമൂഹിക വയക്തിഗത വിവേങ്ങടളപ്പറ്റിയുള്ള െില രൊദ്യങ്ങളാണു ഗരവഷക

രൊദ്ിക്കുന്നത്. ഓരോ രൊദ്യത്തിനനുസേിച്ച് അമ്മമാർ അനുരയാജയമായ ഉത്തേങ്ങൾ
നൽരകണ്ടതാണ്.

ഈ സമയത്ത് ഗരവഷക ഉത്തേങ്ങൾ രേഖടപ്പടുത്തുകയും രൊദ്യങ്ങൾക്ക് രനടേയുള്ള

കളങ്ങളിൽ

[ √ ] ശേി അടയാളടപ്പടുത്തുകയും ടെയ്യുന്നതായിേിക്കും.

അമ്മമാരുടെ ഒരു സാമൂഹിക- വയക്തിഗത ച ാദ്യാവലി

ചകാഡ്:

ച ാൺ നമ്പർ:

1. അമ്മയുടട ത്പായം ...

2.കുട്ടിയുടട ത്പായം (വയസ്സ്) ..

3.ഇരപ്പാെടത്ത ആശുപത്തി ത്പരവശനത്തിനുള്ള കാേണം.

4. മതം

a. ഹിന്ദു [ ]

b. ത്കിസ്തയൻ [ ]

c. മുസ്ിം [ ]

d. മടറ്റടന്തെിലും വയക്തമാക്കുക [ ]

5. വിദ്യാഭ്യാസം

a. സ്കൂൾ വിദ്യാഭ്യാസം [ ]

b. രകാരളജ് വിദ്യാഭ്യാസം [ ]

c. ടത്പാ ഷണൽ വിദ്യാഭ്യാസം [ ]

6. കുടുംബത്തിന്ടറ്റ തേം

a. അണുകുടുംബം [ ]

b. സംയുക്ത കുടുംബം [ ]

c. വിസ്തൃതമായ കുടുംബം [ ]

7. വീട്ടിടല അഞ്ച് വയസ്സിന് താടെയുള്ള കുട്ടികളുടട ആടക എണ്ണം ...

30
8. ടതാെിൽ നില

a. ടതാെിലുള്ളവർ [ ]

b. ടതാെിലില്ലാത്തവർ [ ]

9. താമസിക്കുന്ന ത്പരദ്ശം

a. പഞ്ചായത്ത് [ ]

b. മുനിസിപ്പാലിറ്റി [ ]

c. രകാർപ്പരറഷൻ [ ]

10. ത്പതിമാസ കുടുംബ വേുമാനം ...

11. കുടുംബ ഭ്ക്ഷണ േീതി

a. സസയാഹാേം [ ]

b. മിക്്ഡ് [ ]

12. അഞ്ച് വയസ്സിന് താടെയുള്ള കുട്ടികളിൽ വിറ്റാമിൻ

കുറവുകൾ തടയുന്നതിടനക്കുറിച്ച് നിങ്ങൾക്ക് മുമ്പടത്ത
എടന്തെിലും വിവേങ്ങൾ ഉരണ്ടാ?

a. ഇല്ല [ ]

b. ഉണ്ട് [ ]

31
 വിഭാഗം- ബി

കുട്ടികളുടെ സാമൂഹിക ഡാറ്റ ഷീറ്റ്

1.കുട്ടിയുടട ത്പായം (വയസ്സ്) ..

2. ലിംഗരഭ്ദ്ം

a. ആൺ [ ]

b. ടപണ്ണ് [ ]

3. കുട്ടിയുടട ജനന ത്കമം

4. സരഹാദ്േങ്ങളുടട എണ്ണം.

5. കുട്ടിയുടട ജനന ഭ്ാേം.

6. പൂർണ്ണമായും മുലയൂട്ടലിന്ടറ്റ കാലാവധി.

7. കുട്ടിയുടട ഇരപ്പാെടത്ത ഭ്ാേം.

8. മുമ്പടത്ത ആശുപത്തിയിൽ ത്പരവശിച്ചതിന്ടറ്റ ഏടതെിലും വിവേം?

a. ഇല്ല [ ]

b. അടത (കാേണം വയക്തമാക്കുക) [ ]

9. ഇരപ്പാെടത്ത ആശുപത്തി ത്പരവശനത്തിനുള്ള കാേണം.

10. നിങ്ങളുടട കുട്ടി ഏടതെിലും മേുന്നുകൾ കെിക്കുന്നുരണ്ടാ?

a. ഇല്ല [ ]

b. അടത [ ]

32
 വിഭാഗം സി

കുട്ടിയുടെ പ്പതിചരാധ നില വിലയിരുത്താൻ വാക്സിചനഷൻ ഷീറ്റ്

വാക്്ിരനഷൻ ത്പായം എടുക്കാ

എടു എടുത്തി
ത്തിട്ടു ത്തതിന
ട്ടില്ല
ണ്ട് ന്ടറ്റ
കാേണം

ബിസിജി ജനിക്കുരമ്പാൾ തടന്ന

ജനിക്കുരമ്പാൾ തടന്ന
ജനന രഡാസ്

ഓറൽ രപാളിരയാ ജനിക്കുരമ്പാൾ തടന്ന

ഓറൽ രപാളിരയാ 1,2 & 3 6,10,14 ആഴചയിൽ

നിർജ്ജീവമാക്കിയ രപാളിരയാ 14 ആഴചയിൽ

വാക്്ിൻ

ടപന്റാവാലന്റ് 1,2 & 3 6, 10, 14 ആഴചയിൽ

രറാട്ട വവറസ് വാക്്ിൻ 6, 10, 14

ആഴചയിൽ

മീസിൽസ് ഒന്നാം രഡാസ് 9 മാസം

9 മാസം
വിറ്റാമിൻ എ, ഒന്നാം രഡാസ്

ഡിപിടി ഒന്നാം ബൂസ്റ്റർ 16-24 മാസം

ഒപിവി ബൂസ്റ്റർ 16-24 മാസം

മീസിൽസ് േണ്ടാം രഡാസ് 16-24 മാസം

വിറ്റാമിൻ എ (2 മുതൽ 9 വടേ 1 വർഷം
രഡാസ്) 1 ½ വർഷം
2 വർഷം
2 ½ വർഷം
3 വർഷം
3 ½ വർഷം
4 വർഷങ്ങൾ
4 ½ വർഷം
5 വർഷം

33
 ഉപകരണം 2

വിഭാഗം- എ

അഞ്ച് വയസ്സിന് താടെയുള്ള കുട്ടികളിൽ വിറ്റാമിൻ എ യുടെ കുറവുമൂലം

ഉണ്ടാവുന്ന് അസുഘങ്ങചള തെയുന്നതിനുള്ള അറിവ് വിലയിരുത്തുന്നതിനുള്ള
ച ാദ്യാവലി

വിറ്റാമിൻ എ

1. വിറ്റാമിൻ എ യുടട ഏറ്റവും ത്പധാനടപ്പട്ട ത്പവർത്തനം എന്താണ്?

a. ദ്ഹനം [ ]

b. ത്ശവണ ടമച്ചടപ്പടുത്തൽ [ ]

c. രനത്ത ആരോഗയം [ ]

d. അസ്ഥി ആരോഗയം [ ]

2. ഏറ്റവും സാധാേണമായ വിറ്റാമിൻ എ യുടട കുറവ് ഏതാണ്?

a. നിശാന്ധത [ ]

b. സ്കർവി [ ]

c. റിക്കറ്റുകൾ [ ]

d. വിളർച്ച [ ]

3. വിറ്റാമിൻ എ യുടട കുറവിന്ടറ സാധാേണ കാേണം എന്താണ്?

a) വിറ്റാമിൻ എ കുറഞ്ഞ അളവിൽ കെിക്കുന്നത് [ ]

b) സൂേയത്പകാശത്തിന്ടറ കുറഞ്ഞ സമ്പർക്കം [ ]

c) ധാനയങ്ങളുടട കുറഞ്ഞ ഉപരഭ്ാഗം [ ]

d) െുവന്ന മാംസത്തിന്ടറ കുറഞ്ഞ ഉപരഭ്ാഗം [ ]

4. ഇനിപ്പറയുന്നവയിൽ വിറ്റാമിൻ എ യുടട അഭ്ാവത്തിന്ടറ

ലക്ഷണങ്ങൾ ഏതാണ്?

a. മാനസികാവസ്ഥ മാറുന്നു [ ]

b. കാഴചക്കുറവ് [ ]

c. മേവിപ്പ് [ ]

d. രമാണയിൽ േക്തത്സാവം [ ]

34
5. കുട്ടികളിൽ അന്ധത ഉണ്ടാകാനുള്ള ത്പധാന കാേണം
ഇനിപ്പറയുന്നവയിൽ ഏതാണ്?

a. കണ്ണിടല അതിമർദ്ദം [ ]

b. വിറ്റാമിൻ എ യുടട കുറവ് [ ]

c. വർണ്ണ അന്ധത [ ]

d. തിമിേം [ ]

6. വിറ്റാമിൻ എ യുടട മികച്ച ഉറവിടം ഏതാണ്?

a. രകാെിയിറച്ചി [ ]

b. മധുേക്കിെങ്ങ് [ ]

c. പയർവർഗ്ഗങ്ങൾ [ ]

d. പാലുൽപ്പന്നങ്ങൾ [ ]

7.ഓറഞ്ച് നിറമുള്ള പച്ചക്കറിയിൽ വിറ്റാമിൻ എ ധാോളം

അടങ്ങിയിേിക്കുന്നത് ഏതിലാണ്?

a. കാപ്്ിക്കം [ ]

b. കാേറ്റ് [ ]

d. തക്കാളി [ ]

8. പച്ചക്കറികളിൽ വിറ്റാമിൻ എ ധാോളം അടങ്ങിയിേിക്കുന്നത്

ഏതിലാണ്?

a. ടവള്ളേിക്ക [ ]

b. െീേ [ ]

c. കാരബജ് [ ]

9. വിറ്റാമിൻ എ അടങ്ങിയിട്ടില്ലാത്ത പെങ്ങളിൽ ഇനിപ്പറയുന്നവയിൽ

ഏതാണ്?

a. പെുത്ത മാങ്ങ [ ]

b. പെുത്ത പപ്പായ [ ]

c. ഓറഞ്ച് [ ]

d. വാെപ്പെം [ ]

10. ഇനിപ്പറയുന്നവയിൽ വിറ്റാമിൻ എ ധാോളം അടങ്ങിയിേിക്കുന്ന

മൃഗ രത്സാതസ്സുകൾ ഏതാണ്?

a. കേൾ [ ]

b. മുത്തുെിപ്പി [ ]

c. െുവന്ന മാംസം [ ]

35
11. ഇനിപ്പറയുന്നവയിൽ വിറ്റാമിൻ എ ധാോളം അടങ്ങിയിട്ടുള്ളത്
ഏതാണ്?

a. പാൽ [ ]

b. രൊരേറ്റ് [ ]

c. ഐസ്ത്കീം [ ]

d. രകാ ി [ ]

12. വിറ്റാമിൻ എ യുടട മറ്റ് ഉറവിടങ്ങൾ ഏതാണ്?

a. മുലപ്പാൽ [ ]

b. ടപാടി പാൽ [ ]

c. ര ാർമുല ീഡ് [ ]

13. വിറ്റാമിൻ എ യുടട കുറവ് എങ്ങടന തടയാം?

a) വിറ്റാമിൻ എ അടങ്ങിയ ഭ്ക്ഷണങ്ങൾ നൽകുക [ ]

b) സൂേയത്പകാശം എല്കുക [ ]

c) സിത്ടസ് പെങ്ങൾ നൽകുക [ ]

d) െുവന്ന മാംസം നൽകുക [ ]

14.വിറ്റാമിൻ എ കുറവ് തടയാൻ ഭ്ക്ഷണത്തിൽ അധികമായി

എന്താണ് ഉൾടപടുരത്തണ്ടത്?

a. പച്ച ഇലക്കറികൾ [ ]

b. ധാനയങ്ങൾ [ ]

c. പയർവർഗ്ഗങ്ങൾ [ ]

d. കിെങ്ങുവർഗ്ഗങ്ങൾ [ ]

15. വിറ്റാമിൻ എ രത്പാ ിലാക്്ിസ് ഏത് ത്പായത്തിലുള്ളവടേ ഉൾടക്കാള്ളുന്നു?

a. 3 വർഷം [ ]

b. 5 വർഷം [ ]

c. 7 വർഷം [ ]

d. 9 വർഷം [ ]

36
 ഉപകരണം 3

വിഭാഗം- എ

വിറ്റാമിൻ എ യുടെ കുറവുമൂലം ഉണ്ടാവുന്ന് അസുഘങ്ങചള തെയുന്നതിനുള്ള

ദദ്നംദ്ിന ശീലങ്ങൾ വിലയിരുത്തുന്നതിനുള്ള ച ാദ്യാവലി

1.നിങ്ങളുടട കുട്ടിയ്ക്ക് നല്കാൻ പച്ചിലക്കറികൾ എങ്ങടന

ആണ് പാകം ടെയുന്നത് ?

a. പകുതി രവവിച്ച [ ]

b. തിളപ്പിച്ച [ ]

c. ആവിയിൽ [ ]

2.നിങ്ങളുടട കുട്ടിയ്ക്ക് നല്കാൻ മറ്റ് പച്ചക്കറികൾ എങ്ങടന

ആണ് പാകം ടെയുന്നത്?

a. പകുതി രവവിച്ച [ ]

b. തിളപ്പിച്ച [ ]

c. ആവിയിൽ [ ]

3.നിങ്ങളുടട കുട്ടിക്ക് ആപ്പിൾ, രപേ എന്നിവ രപാലുള്ള

തിേടഞ്ഞടുത്ത പെങ്ങൾ എങ്ങടന ആണ് നൽകുന്നത് ?

a. ടതാലി കളഞ്ഞ [ ]

b. ടതാലിരയാടുകൂടി [ ]

4. നിങ്ങളുടട കുട്ടിയുടട ഭ്ക്ഷണത്തിൽ ഏത് ഭ്ക്ഷണമാണ്

കൂടുതൽ ഉൾടപ്പടുത്തുന്നത്?

a. പെങ്ങളും പച്ചക്കറികളും [ ]

b. ാസ്റ്റ് ുഡുകൾ [ ]

c. പായ്ക്ക് ടെയ്ത ഭ്ക്ഷയവസ്തുക്കൾ [ ]

37
5.നിങ്ങളുടട കുട്ടിക്ക് ഭ്ക്ഷണം പാകം ടെയ്യാൻ ഏത് എണ്ണയാണ്

നിങ്ങൾ കൂടുതൽ ഉപരയാഗിക്കുന്നത്?

a. ടവളിടച്ചണ്ണ [ ]

b. ഒലിവ് ഓയിൽ [ ]

c. ടവജിറ്റബിൾ ഓയിൽ [ ]

d. സൺഫ്ലവർ ഓയിൽ [ ]

38
 വിഭാഗം-ബി

അഞ്ച് വയസ്സിന് താടെയുള്ള കുട്ടികളുടെ അമ്മമാർക്കിെയിൽ ദദ്നംദ്ിന

ശീലങ്ങൾ വിലയിരുത്തുന്ന ഭക്ഷണ ആവൃത്തി പട്ടിക

കെിഞ്ഞ ഒോഴചയ്ക്കിടട നിങ്ങളുടട കുട്ടിക്ക് നൽകിയ ത്പരതയക ഭ്ക്ഷണങ്ങടളക്കുറിച്ച് ഞാൻ

നിങ്ങരളാട് രൊദ്ിക്കാൻ ആത്ഗഹിക്കുന്നു.

ഉെിതമായ ഉത്തേത്തിൽ ഒേു ശേി (✓) അടയാളം ഇടുക, ആവൃത്തിയും പോമർശിക്കുക.

ഭക്ഷണ ആവൃത്തി പട്ടിക

എത്ത തവണ നിങ്ങൾ ഈ ഇനങ്ങൾ നിങ്ങളുടട കുട്ടിക്കു നൽകുന്നു

Sl. ഭ്ക്ഷണങ്ങൾ ദ്ിവരസന ആഴചയിൽ ആഴചയി ഉപരയാഗി

N0 േണ്ടുതവണ ൽ ക്കില്ല
ഒേിക്ക
ൽ
പച്ചക്കറികൾ
1 (കാേറ്റ്,മത്തങ്ങ
മുതലായവ)

2 പച്ച ഇലക്കറികൾ
(െീേ, , മുേിങ്ങ ഇല
മുതലായവ)
ഓറഞ്ച് നിറമുള്ള
3 പെങ്ങൾ (പപ്പായ,
മാങ്ങ മുതലായവ)

മത്സ്യവും മത്സ്യ
4 ഉൽപ്പന്നങ്ങളും
(മത്തി, െൂേ ,
അയല, മീൻ എണ്ണ
ഗുളിക,മുതലായവ)

5 പയർവർഗ്ഗങ്ങൾ(
അണ്ടിപ്പേിപ്പ്,
നിലക്കടല
മുതലായവ
പാലും
6 പാലുൽപ്പന്നങ്ങളും
(പാൽ, വതേ്, ടനയ്യ്
, ടവണ്ണ,
മുതലായവ)

7 മുട്ട

8 കിെങ്ങുവർഗ്ഗങ്ങൾ
(ഉേുളക്കിെങ്ങ്,
മധുേക്കിെങ്ങ്,
രെന, രെമ്പ്
മുതലായവ)

39