A STUDY TO ASSESS THE KNOWLEDGE REGRADING

PREVENTION OF ANEMIA AMONG ADOLESCENT GIRLS

IN SCHOOL IN SERILINGAMPALLY
HYDERABAD.
BY
Miss .B. AKHILA
Miss. K.AMULYA
Miss. K.MADHURI
Miss .CH. RAMYA
Miss. B.SAI KUMARI
Miss .G.STELLA
Miss .TANAZ FATIMA

MAHALI DAKSHATA SAMITHI AND BANSILA MALANI

COLLEGE OF NURSING, GANGARAM,HYDERABAD,
TELANGANA AFFILIATED TO K.N.R UNIVERSITY OF HEALTH
SCIENCES, WARANGAL ,TELANGANA
MARCH -2022
 ‘’ A STUDY TO ASSESS THE KNOWLEDGE REGARDING
PREVENTION OF ANEMIA AMONG ADOLESCENT GIRLS IN
SCHOOL IN SERILINGAMPALLY
HYDERABAD .
BY
Miss .B. AKHILA
Miss. K.AMULYA
Miss. K.MADHURI
Miss . CH. RAMYA
Miss. B. SAI KUMARI
Miss .G. STELLA
Miss .TANAZ FATIMA

In partial fulfilment of the requirement for the Degree of

Bachelor of Science in Nursing

Under the guidance of

Mrs. K. UMA MAHESWARI MADAM ,
M.sc .(N) PROFESSOR

MAHALI DAKSHATA SAMITHI AND BANSILA MALANI

COLLEGE OF NURSING, GANGARAM,HYDERABAD,
TELANGANA AFFILIATED TO K.N.R UNIVERSITY OF HEALTH
SCIENCES, WARANGAL ,TELANGANA
MARCH -2022

‘’A STUDY TO ASSESS THE KNOWLEDGE REGARDING PREVENTION OF

 ANEMIA AMONG ADOLESCENT GIRLS IN SCHOOL
SERLINGAMPALLY
HYDERABAD

BY

Miss .B .AKHILA
Miss. K.AMULYA
Miss. K MADHURI
Miss .CH.RAMYA
Miss. B.SAI KUMARI
Miss . G.STELLA
Miss .TANAZ FATIMA

Thesis submitted to the KNR University of health science, Warangal,Telangana

in partial fulfilment of the Degree of B.Sc Nursing at Mahila Dakshata Samithi
And Bansilal Malani College Of Nursing , Hyderabad

Advisor
Mrs.K.UMA MAHESWARI
PROFESSOR
Mahila Dakshata Samithi And Bansilal
Malani College Of Nursing,
Hyderabad

CERTIFICATE

Certified that this is the bonafide work

 of

Miss .B .AKHILA
Miss. K.AMULYA
Miss. K.MADHURI
Miss .CH.RAMYA
Miss. B.SAI KUMARI
Miss .G.STELLA
Miss .TANAZ FATIMA

at
Mahila Dakshata Samithi & Bansilal Malani College of Nursing,
Hyderabad submitted to the Kaloji narayanarao University of Health
Sciences, Warangal .

In Partial fulfillment of the requirement for the Degree of B.Sc., Nursing.

Mrs. K.UMA MAHESWARI

M.Sc.(nursing)

Professor
Mahila Dakshata Samithi &
Bansilal Manali College Of Nursing

March - 2022

ENDORSEMENT BY THE GUDIE , PRINCIPAL/

HEAD OF THE INSTITUTION
 This is to certify that the project entitled ‘’A study to assess the
knowledge regarding prevention of anemia among adolescent girls in
school in serilingampally Hyderabad, is a bonfide research work done
by Miss.B.Akhila, Miss.K. Amulya, Miss.K.Madhuri ,
Miss.CH.Ramya,Miss.B.Sai kumari, Miss.G.Stella .Miss.Tanaz Fatima
under the guidance of Mrs .uma madam M.sc(N) Professor, Mahila
Dakshatha Samithi & Bansilal Malani College Of Nursing, Hyderabad.

Signature of the Guide Signature of the Principal

DATE: DATE:
PLACE: PLACE:

DECLARATION OF THE CANDIDATES

We, hereby declare that project entitled ‘’A STUDY TO ASSESS THE
KNOWLEDGE REGARDING PREVENTION OF ANEMIA AMONG ADOLESCENT
GIRLS IN SCHOOL IN SELI LINGAMPALLY’’ Hyderabad ,Telangana, is a bonafide
and genius work carried out by us under the guidance of Mrs. K. Uma
Maheshwari M.sc [N] Professor Mahila Dakshata samithi & Bansilal Malani
College Of Nursing ,Chandanagar, Hyderabad.

Signature of the candidates

1. Miss .B.Akhila
2. Miss.K . Amulya
3. Mrs. K.Madhuri
4. Miss . B.Sai kumari
5. Miss . CH. Ramya
6. Miss. G. stella
7. Miss . Tanaz Fatima
DATE;

PLACE;

ABSTRACT
 Anaemia is a blood disorder /disease. The situation has become more complex and severe
every year making this disease to seek more public attention. As it is more complex and
there are various studies which shows the need to control and prevent it. A descriptive study
to assess the knowledge of people regarding prevention and control of anemia in, Govt
high school sherilingampally ,Hyderabad.

The objectives of the study were to assess the knowledge of students [adolescent
girls]
Regarding prevention and control of anaemia and find association between the knowledge
of adolescent girls.On concept of anaemia prevention and control of anaemia with selected
variables like education.
Purposive sampling technique was used to select sample for study data was
collected by interview and structured questionnaire method. The tool consists of section of
questionnaire regarding prevention and control of anaemia.
The data was analyzed by using descriptive and inferential statistics like mean,
median, standard deviation and chi-square.
10% of girls having of excellent knowledge

70% of girls having of good knowledge

20% of girls having of poor knowledge

Recommendation of study

 To assess the knowledge of girls regarding prevention of anemia

 identify the relationship between the knowledge of the girls with selected variables
[age,religion,education,type of family]
 To The approach used for collection of data was descriptive survey method the sample
consisted of 30 adolescent girls at Govt.high school at Sherilingampally,Hyderabad.
 Tools was found to be feasible and reliable in pilot study and hence the same tool was used
for the major study also.
 To create the knowledge and awareness in adolescent girls regarding prevention and
management of anemia .The investigative recommends teaching classes by health
professionals,teaching of iron rich diet .

ACKNOWLEGEMENT
Any person who is engaged in research needs help guidance and encouragement from
others. As we come to the end of four years of Bsc Nursing dregee mahila daskshata
samithi& bansila malani college of nursing ,we would like to place on record our in debtness
to all those who contributed to not just the comletetness of this paper, but also have been
accompanying us during these past four years.

First of all the investigators extend their heartyful thanks to lord almighty. The omnipotent
and omnipresent power behind who help as to turn whole work into a successful mission.

We are obliged to the principal and all the facilities of mahila dakshata samithi and bansilal
malani college of nursing for there strong support and encouragement all through the study.

The investigators have great pleasure of acknowledge with thanks to Mrs.Sushila

Patil ,m.sc.[n],principal Mahila Dakshatha samithi and bansilal malani college of nursing.
Our guide for her valuable suggestion , patience , encouragement, motivation, support,
innovative ideas and timely help for the successful completion of the study.

We also t ake this opportunity to express our sincere thanks to Mrs. K. Uma Maheshwari ,
senior tutor for their meticulous and guidance through our study , Our heartly thganks to
our beloved tutors Mrs. Veronica mam, Mrs. Vindhya mam ,Mrs. Deepika mam ,Mrs.
Deepa mam .Mrs. Anusha mam . for their support and help through our the study .

We, express our thanks to Mrs. Srinivas , clerk Mahila Dakshata Samithi &Bansilal Malani
College Of Nursing ,for timely help in the clerical works .

Our hearty thanks to the

We also thank the librarians of Mahila Dakshata Samithi &Bansilal Malani College Of Nursing
.for their timely help by providing necessary books journals .
We investigators are thankfull to Y S Net Services , chandanagar,Hyderabad. For their
skillfull computerization and graphic presentation of manuscript.
We are highly indebted to our Parents ,Family members and well wishers for their
perpetual love, prayers and financial support through out the study.
We are greatly thankful to our beloved friends who have constructed a lot for the
completion of this study .your friendship and encouragement shall be cherished forever.

Signature of candidates
1. MISS.B.Akhila
2. MISS. K .Amulya
3. MISS.K.Madhuri
4. MISS.B.Sai kumari
5. MISS .CH. Ramya
6. MISS.G.Stella
7. MISS.Tanaz fatima

Place;
Date;
S.NO CONTENT Page no
INTRODUCTION
I
❖ Need for the study

❖ Statement of the problem

❖ Objective of the study

❖ Conceptual framework

❖ Operational definition

❖ Research hypothesis

❖ Assumptions

❖ Delimitations of the study

❖ summary

REVIEW OF THE LITERATURE

II

o Review of literature related to

knowledge on Prevention of Anemia
among Adolescent
o Review of Literature related to diseases
condition
o Literature related to Types
o Literature to related to risk factors
o Literature related to prevention of Anemia
o Literature related to complications
o Literature related management
o Literature related to treatment
METHOOOGY
III
▪ Research Approach
 ▪ Research design

▪ Setting of the study

▪ Variables

▪ Sample

▪ Sample technique

▪ Criteria for sample collection

▪ Method of data collection

▪ Reliability of the tool

▪ Data collection procedure

▪ Plan of data analysis

▪ Summary

IV
ANALYSIS ,INTERPRETATION &DISCUSSION
 ❖ Objective of study

❖ Organization of data

PART –I Formulating frequency &percentage

distribution bar &pie diagrams for the demographic
characteristics of anemia among adolescent girls

PART:-2 Formulating frequency &percentage

distribution of knowledge regarding prevention of
anemia.

PART:- 3 Computation of range mean ,range,median ,

and standard deviation

PART:- 4 Association of knowledge level and

demographic variables

SUMMARY,CONCLUSION ,IMPLICATIONS AND

V RECOMMENDATIONS.

BIBLIOGRAPHY.
VI

APPENDICES
VII
LIST OF TABLES.
Title Page .no
Fig.No.

I Frequency and percentage distribution of

Anemia under the age
II Frequency and percentage distribution of family
income
III Frequency and percentage distribution of type
of family
IV Frequency and percentage distribution from
where u get information about anemia
V Frequency and percentage distribution of
menstrual cycle status
LIST OF APPENDIX

Pg
FIG .NO TITLE No
Appendix Letter to the school principal
A serilingampally, hyderabad

Appendix A study assess the knowledge regarding

B prevention of anemia among adolescent
girls (questionnaire )

Appendix List of experts guidance

C
CHAPTER:-1
INTRODUCTION
Chapter 1
Introduction

pregnant women <1g/dl for pregnant women and children from 6 months to 6years and <12
Anemia is a major health problem throughout the world. The prevalence of anemia is higher
in developing countries like India . Especially affecting toddler , preschooler, school age ,
adolescent and women of child bearing age WHO defines anemia as a condition in which the
Hemoglobin content of the blood is lower than normal as a result of a deficiency of one or
more essential nutrients .The cut off paint of HB levels recommended by WHO to diagnosis
anemia are <13g/dl for adult men <12g/dL for adult for children from 6 years to 14 years.

WHO Data Hose [1995-2005]

Micronutrient deficiency information system estimated the prevalence of anemia among
the industrialized and Non- industrialized countries the other factors such malaria and
parasitic infections.
Anemia is a serious public health problem which affects the mental and physical
Development as well as health maintenance and work performance.
This is may be due to inadequate iron intake poor iron absorption increased iron need or
chronic blood loss.
National family health survey [2005-2006] reported that more than 5 % of the women in
India were Anemic, WHO estimated that the prevalence of anemia among the reproductive
age group of women was 14% in developed countries and 51% in developing countries while
it was 65-75% in India.
Anemia is the most common

WHO Data Hose [1995-2005]

Micronutrient deficiency information system estimated the prevalence of anemia among
the industrialized and Non- industrialized countries the other factors such malaria and
parasitic infections.
Anemia is a serious public health problem which affects the mental and physical
Development as well as health maintenance and work performance.
This is may be due to inadequate iron intake poor iron absorption increased iron need or
chronic blood loss.
National family health survey [2005-2006] reported that more than 5 % of the women in
India were Anemic, WHO estimated that the prevalence of anemia among the reproductive
age group of women was 14% in developed countries and 51% in developing countries while
it was 65-75% in India.
Anemia is the most common
more essential nutrients .
Most of the anemia are due to inadequate supply of nutrients like iron folic acid and
vitamins B12 proteins, amino acids , vitamin A,C and other vitamin B Complex group niacin
and pantothenic acid are also involved in the level maintence of hemoglobin. pregnant
women <1g/dl for pregnant women and children from 6 months to 6years and <12 Anemia
is a major health problem throughout the world. The prevalence of anemia is higher in
developing countries like India . Especially affecting toddler , preschooler, school age ,
adolescent and women of child bearing age throughout the world. The prevalence of
anemia is higher in developing countries like India . Especially affecting toddler , pregnant
women and children from 6 months to 6years and <12 Anemia is a major health problem
throughout the world. The prevalence of anemia is higher in developing countries like India .
Especially affecting toddler , preschooler, school age , adolescent and women of child
bearing age throughout the world.
WHO defines anemia as a condition in which the Hemoglobin content of the blood is lower
than normal as a result of a deficiency of one or more essential nutrients .The cut off paint
of HB levels recommended by WHO to diagnosis anemia are <13g/dl for adult men <12g/di
for adult for children from 6 years to 14 years.

WHO Data Hose [1995-2005]

Micronutrient deficiency information system estimated the prevalence of anemia among
the industrialized and Non- industrialized countries the other factors such malaria and
parasitic infections.
Anemia is a serious public health problem which affects the mental and physical
Development as well as health maintenance and work performance.
This is may be due to inadequate iron intake poor iron absorption increased iron need or
chronic blood loss.
National family health survey [2005-2006] reported that more than 5 % of the women in
India were Anemic, WHO estimated that the prevalence of anemia among the reproductive
age group of women was 14% in developed countries and 51% in developing countries while
it was 65-75% in India.
Anemia is the most common

Incidences of anemia among adolescent girls

Prevalence of anemia among adolescent girls who had attained menarche was observed to
be 71.7 % (95% (1.66—3-77.1) AS PER THE WHO classification .among the 195 anemic
adolescent girls, severe, moderate and mild anemia was observed in 4.8% .41.2% and 25.7%
respectively

WHO (2001)-2003)
Overall prevalence of anemia was found to be 48.63% the majority of the anemia girls
(55.64%).
Among 225 girls 188(73.73%) were from the early adolescent age group (10-14years).

2006-2010
The prevalence of anemia was 22% (95%) CI (17.6-26.1) late adolescent were 2 times more
likely to have anemia as compared to early adolescents (AOR; 1.95-95] CI 1.09,3.47) .

(2011-2015) D.kamble saudan singh .

The prevalence of anemia was found to be 59 % with mean (+/-SN ) HB of 11.3 GM/dl(+/-
1.55} among participants.
Among 203 girls 65% participants were of age 14-15 years with mean (+/-1.55) among 203
participants.

2020
Using CNNS date we found that 28.5% of adolescents ( Girls;39.6% Boys ;17.6%) were
anemic with variation by region or state .
Among adults 57% of women and 25% of men (in the (15-49groups) have anemia.

2021-2022

The prevalence of anemia among the girls was 21.1% and 9.4% among women with an
average hemoglobin level in adolescents of 10.75g/dl (+/0.79) and in adults 11.20gldl (+/-
0.61).whereas HIV was 76.49+/- 8.22FL in adolescents and 7.61+/-8.62FL in adults.

India

Using CNNS data, we found that 28.5% of adolescents (Girls 39.6% boys 17.6% ) were
anemic with variation by region or state.

Worldwide incidence of anemia among adolescent girls (2000)-(2005)

Globally in 2019, 40% (95% uncertainty interval( 6) (36-44) to 48%(45-51) in 2000.

Survey data covered 48-8% of the global population 76-1% of preschool aged children,69.0%
of pregnant women and 73.5% of non-pregnant women.
The estimated global anemia prevalence is 24-8% (95% c1 22.9,26.7% affecting 1.62 bilion
people [95%cI 1-50 1.74 billion].

2019-2022
In 2019, approximately 1.8 billion individuals lived with anemia.
WHO estimates that 42% of children less than 5yrs of age and 40% of pregnant women
worldwide.
 NEED FOR THE STUDY
‘I wish you could realize that
The destiny of our beloved land lies
Not in us the parents but in our children’.
Anemia is the most common form of malnutrition in the world being most prevalent and
severe in young children (6-24 Months) and women of young children (6-24months) and
women of reproductive age. Evidences suggest high prevalence of iron deficiency anemia is
associated with developmental delays, behavioral disorders and poor baby development. In
animal modal intrauterine and early life latent iron deficiency induced irreversible
neurotransmitter alteration for the pregnant women, anemia can be particularly devastating
, if she is Severely anemic (<7g/dl), it can mean still birth or low birth weight for the baby
and death for the women if she suffers another maternal complication. It usually from a
nutritional deficiency of iron folic and vit-b12
Now a Days anemia is one of the world most prevalent nutritional problems. Several studies
concerning anemia prevalence were carried out for children under 5 years and for mothers.
30% infants and children between age of 6 months to 5 years of age were found to be
anemia with highest prevalence rate of 57% being among the youngest children aged 6-11
months attributer to the poor maternal nutrition status.

MEGHENDRA BANERJEE AND GOP N GOSH(2005);

Reported an examples of studies seeking to understand the high incidence of anemia among
the fisher community although coastal communities are mainly non-vegetarian and receive
a good amount them, could be to low consumption of green and leafy vegetables, poor
sanitary conditions, which leads to warm (largely hook warm) infestation, ignorance about
anemia .its consequences and prevention strategies and misconceptions regarding the iron
and folic acid supplements, resulting in a high incidence of anemia.

D’SOUZA AND RANGARA JAN (2007);

Reported that the occurrence of restless leg syndrome was significantly higher among those
who had anemia the initial symptoms of anemia are Unnoticeable
In severe cases there will be inadequate oxygen supply to major organs supply to major
organs in the body.
This will cause various health problems such as kidney failure, lung diseases and
cardiovascular diseases and ultimately it leads to death.

DEVI (2014);
Did a study on prevalence of anemia among children age 10 to15 years in urban at
chidambaram’ Atotal of 500 children were included in the study to obtain an almost equal
sample of pre and post menarched girls. The total students in the government girls higer
secondary school were 3078. Out of total 500 student surveyed 292 students (58.4%) werw
found to be anemiac.
Majority were in the age group of 11 years (39.6%) and 14 years (33.6%)and 74.2% were
from joint family
Most of them belong to upper lower class (66.6%) none of the girls had loss of appetite.
26.8% was found with pale conjunctiva.
There was no statistically significant association between anemia and variables such as
birth order, socio economic status of the famiy ,family type ans age at onset of menarch
and usage of sanitary latrine.
There was a stastistically significant association between anemia and variables such as
age, personal hygiene,body mass index and menarche status.

PROBLEM STATEMENT
A study to assess the knowledge regarding prevention of anemia among
adolescent girls in school at serilingampally , Hyderabad.
OBJECTIVES
1. To assess the knowledge regarding prevention of anemia among adolescent girls.
2. To associate the finding with demographic variables.

PURPOSE
The purpose of the study is to known the knwolege regaring prevention of anemia.

ASSUMPTION
1. Adolescent girls will have some knowledge regading prevention of anemia.
2. Selected sample per the study will be cooperative and respond honestly.
3. The tool prepared for the study will gather reliable and valid data for the study

HYPOTHESIS
Adolescent girls have adequate knowledge regarding prevention of anemia.
1. The study was approved by the ethical committee and a formal permission was
obtained the by the government high school.
2. Informed return consent has taken from the participant.
3. No ethical issues confronted while conducting study
CONCETUFUL FRAMEWORK
The conceptual framework prepared for the study based on health promotion model
proposed by nolajpender[1982]
A conceptual framework are model is made up of concept which are mental images of the
phenomenon. A model is used to denote the symbolic presentation of the concept.
For the present study rosenstock beckers health model 1978 adopted. Rosenstock assumed
that objective of the people will not attempt to adopt the preventive practices unless the
complications are threatening to some aspect of their lives.
The health development model describe the multidimensional nature of person has they
interrelated within there atmosphere to follow the health
The model focused on three araes ;
1. Individual characteristic and experience.
2. Behaviour –specific cognitions and affect
3. Behavioural outcome.

The health promotion model notes that each person has unique personal
characteristic and experiences that effect the subsequent action.
The set of variables for social exact knowledge and touch have significant
motivational meaning [51-53]. These variables can be modified through nursing
actions.
These model is a heuristic device that encourages scholars to look integrative at
variables that have been shown to impact health behaviour. The various promotion
strategies and looks doctor pender have establish and offer in the three publications
of health promotion in nursing practices has well has the under guiding HPM model
can be used foundation for has a nursing protocols and interventions.

SUMMARY
This article dealt with the introduction, background of study, need for the study,
problem statement, objectives ,hypothesis, assumption, operational definition and
conceptual frame work.
CHAPTER:-2
REVIEW OF
LITERATURE
CHAPTER - II
REVIEW OF LITERATURE

Review of literature is one of the most important steps in the research process a review of literature enables
one to get an insight into the various aspects of the problem under study.

It covers promising methodological tools,throws light on ways to improve the efficiency of the data
collection and suggests how to increase effectiveness of data analysis and interpretation.

Review of literature is therefore an essential step in the development of the research project.

THE RELATED LITERATURES ARE PRESENTED IN THE FOLLOWING SUB HEADINGS

1.Studies related to incidence of anemia among adolescent girls

2. Studies related to anemia witn among adolescent girls.

STUDIES RELATED TO ANEMIA AMONG ADOLESCENT GIRLS;

Teye gari et.al [2017] Repeated cross- sectional surveys among 2984 children in 2014 and 3128 children in
2015;and a cohort study [malaria as exposure and anaemia as outcome variable ]were conducted.The study
area faced severe drought and food shortages in 2015.Anaemia was diagnosed using Hemocue HB 301,and
children with hemoglobin <11g/dl werw classified as anaemic. Prevention effort,which could be related to the
drought of food shortage.

There was no significant difference in risk of anaemia among the trial arms. Young age,stunting,malaria and
poverty were the main predictors of anaemia. An increase in the prevalence of anemia was observed over a
year.

KEDIR ABDELA GONETE e.al.2017; A school based cross sectional study was conducted in dembia district
from march 1 to april 30/2017. Out of the randomly selected three high schools ,462 adolescents were
included using the simple random sampling technique. A Standardized structured questionnaire was used to
collect data .Capillary blood samples were drawn from adolescents using a portable Hb201+instrument to
measure haemoglobin. The government should focus on preventing food insecurity with increasing
productivity to improve dietary diversification of the adolescent girls. Anemia is a moderate public health
problem in dembia district.

Binaya chalise et.al. 2018; The cross sectional study was conducted in 2018 at the time of the survey,
Nepal was administratively divided in to five development regions ,14Zones and 75 districts. A nationally
representative cross sectional survey was conducted in 2014 among male and female [Non-pregnant]
adolescents aged 10-19 years old. They used a stratified cluster sampling method to select 3780 adolescents
from 13 districts of Nepal.

The initial sample size was 365,considering a design effect of 1.5 and multiplying the size by 6[total number of
strata]the sample size was 3290. Trained enumerators conducted one-on-one interviews with adolescents
using a pretested structured questionnaire, which covered information on socio –demographic characteristics
sanitation and nutritional participant height and weight was measured using stadiometer and digital weighing
scale ,respectively blood hemoglobin concentraction was measured using the hemocue method. Laboratory
professionals referred hemocue operation manuals for storage of microcuvette and analysis of blood samples.

SEIFU HAGOS GETREYESUS et.al. 2019;The study employed a community based cross sectional
design. The study was conducted on weekends to capture both in school and out of school adolescent girls.
 We performed anemia test using hemocue B-Hemoglobin analyser. We applied a complex survey data
analysis method to estimate the level of anemia .

Data was collected from a total 1323 adolescent girls from each district we randomly selected villages of
ensured that the sampled households had arrange geographical spread within the larger category of rural and
urban

However ,knowing the term ‘anemia ‘was found to be protective against the risk of anemia.

JNUTR METAB et.al.2019 ; A cross –sectional study was conducted among 424randamly sampled
adolescent girls tamale metropolis and Ghana from april to july 2019 using and inter viewer administered
structured questionnaire.

Twenty school health coordinators were purposively selected to answer question on the challenges they face
in implementing the IFAS Program at the school level .

The majority [60%] of the adolescent girls have ever missed taking the iron and folic acid [IFA]
tablet .Adolescent girls perceiving the tablet as family planning medicine [88.8%].

Adolescent girls who were aware of had good knowledge of anemia and had good knowledge of the IFAS
program.

APARAJITA CHATTOPADHYAY et.al. 2019; As a part of intervention programme ,study is based on baseline
cross –sectional data. It was conducted in three Indian states [Bihar, 0disha ,and chattisgarh],

Concerted convergent actions focusing on the provision of clean water within the household
premise ,measures took stop open defection ,promotion of hand washing ,accessibility of sanitary napkins ,
poverty alleviation and behavior are needed.

From a sampling of 6352 adolescent girls , information on WASH practices ,accessibility , to health services and
anthropometric measurements was collected .

Findings showed 82% of the adolescent girls were practicing open defection and 76% were not using sanitart
napkins .

Health ,nutrition and livelihood programmes must be interspersed and adolescent must be encouraged to
take a part in the programmes .

AMAHA KAHSAY ET.AL.2020; Study among purposively selected adolescent girls and school teachers from rural
districts of Tigray region .

Food insecurity ,limited nutrition awareness in the community , limited access to a water source , high
workload ,service providers little attention for adolescent nutrition .

We conducted 11 focused group discussion with adolescent girls , 17 in death interviews [seven with teachers ,
seven with in –school adolescent girls , and three with out – of –school adolescent girls] using a Semi
structured guide .

Bounded by food taboo , high burden of workload among be adolescent girls ,women empowerment and
nutritional limited settings such as the rural areas of Tigray region .

RINA AGUSTINA et.al. 2020; we conducted a cross –sectional survey in 335 school –going adolescent
girls aged 12-19 years from three districts in west java using multi –stage cluster sampling .

The findings therefore indicated the importance of improving dietary quality and diversity in a regular meal
pattern ,especially meal frequency and meal skipping .

The sampling of the girls , 45% were anemic and 17% overweight or obese .

To reduce the risk of anemia and overweight obesity among adolescent girls.
 NAZNEEN HABIB et.al. 2020; A Cross –sectional study was conducted for assessing anemia prevalence and its
societal factors among adolescent school girls . The study and its ethical clearance were approved by the
international Islamic university .

The purpose of the study was orally explained to the respondents and their mothers .Confidentiality of the
information and privacy of the respondents were also maintained.

AJK has three division and 10 districts [19,20] and muzaffarabad division was randomly selected for this study .
poverty and inadequate health facilities at far flung areas ,insufficient diet ,unawareness about anemia , and its
health consequences make the female population vulnerable to iron deficiency anemia [IDA] .

2.STUDIES RELATED TO ANEMIA WITH INTERVENTION AMONG ADOLESCENT GIRLS;

MOHAN JOSHI et.al . 2013 ; Randomized controlled trial was conducted in adolescent girls visiting .

The 120 anemic [hemoglobin ,<12 gm% adolescent girls(10-19 years ) were distributed randomly by block
randomization in two groups; one receiving daily Iron and folic acid supplementation and in other group
receiving weekly Iron and Folic Acid supplementation for 3 months.

All the study subjects were given de worming (Albendazole 400 mg) and required health education
separately .

Both the groups were monitored for Hemoglobin estimation,compliance and adverse drug reactions.

“Daily Iron folic Acid ‘ tablets was 6.1=10.98. in daily iron folic acid supplementation group [p=0.0012] ,
making weekly regimen more promising then daily regimen with better treatment compliance .

APARAJITH CHATTAPADHYAY et.al. 2019; The study is a part of the SWABHIMAN Program which
aimed at improving the nutritional status of adolescent girls , pregnant women ,and mothers of children less
than two years age in three poverty packets of india dominated by tribal population .

Odisha were used to elict information on ; [i]socio demographic profile [ii] wash practices [main source facility
water ,accessibility of water facility , use of sanitation facility used , practice of open defection , use of soap
after defection of use of napkins during mensuration ] , [iii] adolescent access to health services [accessed
health services in last six months , visited anganwadi accessed any health services , counseling by a frontline
health worker , [iv] anthropometric measurements . Were collected using the standard technique.

Adolescent girls was drawn using the simple random sampling. Fourty 6 % sampling population belongs to
scheduled trite. Data were collected by trained teams, field investigators.

REDIET TAKELE REGASA et. al . 2019; A School based cross –sectional study was conducted among
school going adolescent girls of wayu tuqu district, south west Ethiopia and a 3 stage randam sampling
technique was used to select study participants. Data were entered into epidata version 3.1 and analysed using
STATA version 12.

The prevalence of anemia among adolescent girls was a moderate public health problem . To improve the
prevailing nutritional problem, there must be inter- sectorial collaboration among health sectors and
education sectors in providing nutritional educational and counseling based on age and menarche status.

PLOSONE el.at 2020; A cross –section study was conducted in three districts of west java province,
Indonesia, in 2016 as a part of the baseline survey of “Iron folate supplementation program” conducted by the
department of nutrition, faculty of medicine. The subjects were school going adolescent girls aged 12-19 years
.

As the current study was a part of a baseline date of the larger intervention study of iron folic acid
supplementation, this study with a total of 340 adolescent girls. Minimum sample size of 240 and 191 were
required to detect associations between dietary quality and anemia. The use of 340 sample enables better
power for the current study out comes.
SUMMARY Further research is needed to better understand the positive and negative factors that are
associated with anemia among adolescent girls. This study contributes to a better understanding of anemia
among adolescent girls.
CHAPTER:-3
METHODOLOGY
CHAPTER-3
METHODOLOGY
Research methodology is the designed to develop or refine methods of obtaining ,organizing or
analysing data ( polit ,2011)

This chapter deals with research approach design variables under study ,the settings population ,
sample, sampling technique criteria for sample selection, data collection, tool and technique
description of the tool, validity, reliability, scoring interpretation, pilot study, method of data
collection plan for data analysis ethical consideration

RESEARCH APPROACH

Quantitative approach is the powerful for testing. Hypothesis of causal relationship among
variables.

In this quantitative research approach was adopted

RESEARCH DESIGN

Research design is the over all plan for obtaining answer to the questions being. Studied for handling
some of the difficulties encountered during research process. (pilot ,2011)

In this study quasi experimental one group pre test post test design was adopted to determine
structured teaching programme on knowledge regarding presentation of iron deficiency anemia
among the mothers of preschool children in selected hospitals

The diagrammatic representation of the design is as follows

Gruop pretest intervenction Posttest

Experimental 01 x 02

group - - -

01 – represent the pretest scoring on knowledge regarding iron deficiency anemia among the
mothers of preschool children by using structured knowledge questionnaire

X - represent administrating the intervenctions structured teaching programme

02- represent the post test scoring on knowledge regarding iron deficiency. Knowledge questionaries

VARIABLES

Independent variable – structured teaching programme on iron deficiency anemia

Dependent variable – knowledge among mothers of preschool children regarding iron deficiency
anemia.

SETTING OF THE STUDY

Setting is the physical location and condition in which the data collection take place in the study.

In this study will be conducted in government school at sangareddy district

POPULATION

population is the entire set of individual or object having some common defining characteristics

In the present study, population comprised of mothers of preschool children in selected area.

TARGET POPULATION

Mother of preschool children who are admitted in selected area.

ACCESSIBLE POPULATION

Mother of preschool children ( 20-40 yrs) who are selected in primary health care center.

SAMPLE IN CRITERIA

Purpose sampling techniques

EXPERIMENTAL GROUP

30 mothers of preschool children

pretest level of knowledge regarding iron deficiency anemia

structured teaching programme

posttest level of pretest level of knowledge regarding iron deficiency anemia

analysis and interpretation results.

SCHEMATIC REPRESNTATIONS OF RESEARCH DESIGN

TARGET POPULATION

A target population is defined as the entire population in which a research is interested and to which
he or she would like to generalized the study result.

In this present study target population comprised of mothers of preschool children in selected areas

ACCESSIBLE POPULATION

An accessible population is defined as the population of people available. For a particular study –
often a non- random subset of the target population.

SAMPLE

Sample refers to a fraction or portion of the element in a universe drawn out deliberately in a
planned representative manners for studying interested characteristics of large group of population

SAMPLE SIZE

In this study the sample comprised of 30 of mothers of preschool children who are between the
age group of 20-40 years and admitted in selected areas .

SAMPLE TECHNIQUE
 It refers to the process of selecting a portion of the population to represent the entire population

CRITERIA FOR SAMPLE SELECTION

Sampling criteria involves selecting areas that meetb some predetermined criteria of importance.
The criteria for sample selection are mainly depicted undr two heading, which includes the inclusive
criteria and exclusive criteria.

Inclusive criteria

The study includes ; mothers of preschool children who are between the age group of 20-40years

Mothers of preschool children who are willing to participant in the study

Mothers of preschool children who can understand telugu or English

Exclusive criteria

Mothers of preschool children who are not willing to participate in the study

Mothers of preschool children those who are not available at the time of data collection

DEVELOPMENT OF THE TOOL

Tool development is a complex and time consuming process, it consists of defing the construct to
be measured, formulating the items ,assessing the items for content validity developing instructions
for respondents ,pretesting, estimating the reliability and conducting pilot study.

DESCRIPTION OF THE TOOLS

The tool used for the study was demographic variables and structured knowledge questionnaire
based on the objectives of the study and with the guidance of experts in the filed of medical expert

SECTION –A ; demographic variables

It consists of demographic variables such as age religion, education, occupation, residence, type of
family, family income, previous knowledge on anemia source of information an anemia.

SECTION –B

It consists of 25 iron deficiency anemia related questions including causes symptoms, diagnosis,
treatment, management of anemia. Each questions as 4 options in which one correct which is scored
1. Maximum score is 20.

Scoring interpretation

● 0-40% inadequate knowledge

● 41-70% moderate knowledge

● 71-100% adequate knowledge

VALIDITY

validity is a degree to which as instrument measures what is intendernal to measure

the validity of the tool was established in consultaion with focus experts in the field of nursing and
one medical expert. Modifications were done as per suggestion of the experts in the tool.

RELIABILITY

Reliability is the degree of consistence of dependability with which an instrument measures the
attribute it is designed to measures

The reliability of the tool was established by using test retest method ( karl pearson formula)

Reliability of the tool was r = 0.86, so the too was focused to be reliable

PILOT STUDY

Pilot study is a small scale version or trial qeen designed to test method to be used in a large more
vigorous study which is sometimes refered to as the patent study.

In order to test the feasibility, relevance and practicability of the study, a pilot study was conducted
among adolescence.

The data collection period was one week before starting the study the researcher obtained oral and
written permission from the hospitals.

METHODS OF DATA COLLECTION / DATA COLLECTION PROCEDURE

After formal written permission obtained from principal of MDS and BM college of nursing

Samples were selected as per inclusion criteria rapport was established with the adolescence and
brief introduction about the study. Knowledge questionnaire Used to assess the pretest knowledge
of adolescence regarding iron deficiency anemia.

Followed by the pretest structured, teaching, programme was given for 45 minutes and 20
minutes was given for clarification of doubts. The content includes introduction, definition,
incidence, causes, signs and symptoms, diagnostic evaluation, treatment management of iron
deficiency anemia.

Plan for data analysis

1) Frequency and percentage distribution will be used to describe demographic variable.

2) Mean and standard deviation will be used to analyse the pretest and posttest level of
knowledge regarding iron deficiency anemia.

Inferential statistics

1) paired t- test will be used to compare the pretest and post test level knowledge regarding iron
deficiency anemia.
2) Chi- square test will be used to associate pretest level of knowledge regarding iron deficiency
anemia. With thus selected demographic variable.

Ethical consideration

The proposed study was conducted after approach of the dissertation committee.
CHAPTER:-4
ANALYSIS
INTERPRETATION
 CHAPTER - IV
ANALYSIS AND INTERPRETATION OF THE DATA
This chapter describes the analysis and interpretation of the data collected to assess the knowledge
of people regarding prevention of Anemia. The aim of the analysis was to reduce ,organize and give
meaning to the data. The data analysis is the systematic organization and synthesis of research data.

Objectives;
1. To assess the knowledge regarding prevention of Anemia, Among the adolescent girls.
2. To associate the findings with selected demographic variables

ORGANIZATION OF THE STUDY FINDIGS

The analysis and interpretation of the observations are given in the following section

1. Section –A : sample characteristic in frequencies and percentages.

2. Section – B : Assess the level of knowledge on anemia among the adolescent girls.
3. Section – C : association of level of knowledge on anemia among adolescent girls with their
selected demographic variables.

SECTION – A
Sample characteristics
In this study a convenient sampling technique was adopted. The participants were above 10
years of age and below 18 years of age serilingampalle ZPHS school {Rural} , R.R. Dist,
Hyderabad. The data is presented in table 1.

Table -1 PERCENTAGE DISTRIBUTION OF PEOPLE ACCORDING TO DEMOGRAPHIC

VARIABLES
S.N Demographic variables frequency [f] percentages [%]

1. AGE
a] 10 to 12 1 3.3%
 b] 13 to 18 29 96.6%

2. FAMILY INCOME
a] less than 5000/- month 7 23.3%
b] 5000/- to 7000/-month 6 20%
c] 7000/- to 10000/- per year 11 36.6%
d] more than 10000/- 6 20%
3. TYPE OF FAMILY
a] joint family 8 26.6%
b] nuclear family 22 73.3%
4. FROM WHERE YOU GET
INFORMATION ABOUT ANEMIA
a] teacher 8 26.6%
b] health worker 22 73.3%
c] media - -
5. MENSTRUAL CYCLE SATUS
a] irregular 9 30%
b] regular 21 70%
table -1 : describes the distribution of socio demographic among adolescent girls
: describe the distribution of menstrual history among adolescent girls
: most of the people 12 ( 40%) belongs to 8 th classes ,18 ( 60%) were belongs to
9 th
class.
: most of the people 8 (20%) have income 10000/- Rs. Per month, 11 ( 36.6%)
7000 – 10000/- Rs. Per month, 6 ( 20%) 5000 – 7000/- Rs. Per month,7 (23.3%)
Less than 5000/-
: majority 22 ( 73.3%) belonged to nuclear family and 8 (26.6%) belonged to joint
Family
 family

2nd Qtr
27%

nuclear family
73%

Fig 1. Doughnut diagram showing the percentage distribution of type of family

The data present in fig 1 show that majority are nuclear family 73% and joint family 27% .

80
70 73.3
60
50
40
30
20 26.6
10
0
teacher media
0 health worker all of the
0 above

Assess the level of knowledge on anemia among adolescent girls.

The level of knowledge shows that in the rural area , 21 (70%) had good knowledge ,6(20%)
had average knowledge and 3(10%) had excellent knowledge on anemia among adolescent girls.

Table -2 : frequency and percentage distribution of level of knowledge on anemia among

adolescent girls.

N=30

Level of knowledge No %

Low (0-25%) 0 0

Average ( 26-50%) 6 20.0

Good (51-75%) 21 70.0

 Excellent (76-100%) 3 10.0

70

20

0
10
low
average
good
excellent

F+ig 3 : cylindrical diagram showing percentage distribution of knowledge scores .+85

The data presented in fig 3 show that majority of students i.e, 21 (70% ) had an good knowledge
on anemia.

Computation of Mean , and Standard Deviation of Knowledge Scores

The knowledge of school children was computed by computation of mean, and standard
deviation of knowledge score.

Table 2: mean and standard deviation of knowledge scores on anemia among adolescent girls

Knowledge Score

Minimum score 6.0

Maximum score 16.0

Mean 12.30

Standard deviation 2.29

In the present study, the mean score level of knowledge among adolescent girls was 12.30 with
standard deviation 2.29 with the minimum score 6.0 and maximum score of 16.0. this clearly infers.
There is a significant difference in the level of knowledge an anemia.

CONCLUSION :
The finding revealed that the level of knowledge on anemia among adolescent girls had adequate
knowledge about anemia and there is need to improve the knowledge throught the advertisement
and conduction the health education programme .

ACKNOWLEDGEMENT :
author would like to appreciate pearticipants for there cooperation to complete the study
successfully.

REFFERENCES ;

● D.C Dutta, text of book of obstetrics ,6 th edition,

● Medical surgical nursing , 7 th edition.

 CHAPTER:-5

SUMMARY
CONCLUSION
 IMPLICATIONS
RECOMMENDATIONS
CHAPTER – V
SUMMARY, CONCLUSION, IMPLICATION,
LIMITATIONS AND RECOMMENDATION.
This chapter presents a brief summary of the research, study conclusions and implication for the
field of nursing, recommendation for the future research students and limitation

SUMMARY OF THE STUDY

The articles presences in brief summary of the study and its significant findings. It also includes
the implications for nursing and health services followed by delimitations. This articles also deals
with the recommendations for future research in this field.

To assess the knowledge regarding prevention of anemia among adolescent girls in selected area.

The purpose of the study is to make the people understanding regarding the prevention of
anemia.

The objectives of the study were

1. To asses the knowledge of regarding prevention of anemia among the adolescent girls
2. To associate the knowledge of regarding the prevention of anemia.

The study assumed that the selected sample for the study will be cooperative and respond
honestly, the tool prepared for the study, will gather reliable and valid data for the study, each
person will have some knowledge regarding prevention of anemia

The questionarrie consisted of three parts

Part 1: deals with the identification data

Part 2: deals with the knowledge of adolescent girls regarding anemia .

Part 3: personal information givien on the anemia.

CONCLUSION
After the complete analysis, this study leads to subsequent conclusion.

Overall study shows that 70% of the adolescent girls had good level of knowledge score, 20% had
average, 10% had excellent of the adolescent girls . adolescent girls had good knowledge regarding
prevention of anemia. Hence, it is essential to improve their knowledge on prevention of anemia to
prevent themselves from complications.

LIMITATIONS
The following limitations where identified during the study.

1. The study was limitated to the adolesencent girls

2. The study was related to adolescent girls in govt.high school.

IMPLICATIONS

● The study of the study revealed that there is a vast scope for adolescent school girls to
improve their knowledge regarding anemia.
● The adolescent girls to be trained regaring the prevention of anemia.

RECOMMENDATIONS
Keeping in view the finding of the study, the following recommendation are made :

1. Comparative studies can be done to assess the various parictes in various regions of the
county.
2. Studies can be conducted to assess the prevalence of anemia in adolescent girls.
3. Experimental study can be conducted on similar topic.

SUMMARY

This chapter deals with the summary of the study, major findings, conclusion, limitation and
recommendations.
BILIOGRAPHY
 BIBLOGRAPHY
TEXT BOOK

1) Park.k, Text Book of preventive and social medicine, 20th

edition ,M/S banarsidas banana publishers , Pp559.
2) DC Duttas ‘’ Text book of obstretics ‘’7th edition 2013, new central
book Agency (P)Ltd ,London, page no ‘’260-268.
3) Kothari C R,Research methodology method and
techiniques .second edition ,new age international P Ltd
publishers ,Delhi, Pp200.
4) Suddarth’s & burnner’’ Text book of medical & surgical
nursing ,Twelfths edition ,wolters Publication, page np.910-927.

JOURNALS
1)Taye gari et.al (2017); Repeated cross sectional surveys among
2984 children in 2014 &3128 children in 2015; and a coherent study
(malaria has exposure and anemia has out come viabirable )were
conducted.
2)Kedir abdela gonete et.al.2017;A School based cross sectional
study was conducted in dembia district from march 1st –April
30/2017. Out of the randomly selected there high schools , 462
adolesecent were including using the simple randam sample
technique.
3) Binaya chalise et,al.2018; A Cross sectional study was conducted
in 2018 at the time of survey ,Nepal was admistratively divided in to
five development regions,14 zones &75 districts.
4)Mohan joshi et,al.2013; Randamized controlled trial was
conducted in adolescent girls visiting ‘urban health and training
centers’ during the study period june, 2011 – oct ,2012.
5)Rediet Takele regasa et,al 2019; A School based cross sectional
was conducted among school going adolescent girls of wayu tuqa
district, south west Ethiopia and a 3-stage random sampling
techinique was used to select study participants.
WEDSITE;
Every day health
www.everydayhealth.com
med line plus[.govt]
https;//medline plus.gov,anemia
Healthline
https;//healthline .com>health
https;/www.take iron seriously.com
APPENDICES
 APPENDIX-A

Letter seeking permission to conduct study in Serilingampally

From To
Mrs H. Sushila Patil The school principal,
Principal , serilingampally,
Mahila Dakshata Samithi & Bansilal Hyderabad.
Malan College Of Nursing.

Respected sir\madam

Sub: Mahila Dakshata Samithi & Bansilal Malani College Of Nursing Hyderabad IV
Year B.Sc.(Nursing) students (list enclosed) Permission for - conduct of Main Study -
Requesting – Regarding.

This is for your kind information that, IV year B.Sc. (Nursing) students of
Mahila Dakshata Samithi & Bansilal Malani College Of Nursing have selected
following problem for their Project Work. This is required KNR University of Health
Sciences Telangana Warangal in partial fulfillment of their B.Sc.(Nursing) IV year
programme.

"A Study to assess the knowledge regarding prevention of anemia among

adolescent girls in serilingampally,Hyderabad

In this connection they would like to come to your community for main
study. Hence, I request you to accord this permission for study and extend your
guidance and co-operation in this matter.

Thanking you,

Yours Sincerely

Principal,
List of 4th Year BS.c (Nursing) Students:
1. MS. B. Akhila
2. MS. K.Amulya
 3. MS. K.Madhuri
4. MS. B.Sai kumari
5. MS. CH.Ramya
6. MS. G.Stella
7. MS. Tanaz Fatima

APPENDIX B

KNOWLEDGE QUESTIONNAIRE ON ANEMIA AMOG ADOLESCENT GIRLS

INTRODUCTION

Please choose the correct answer for each question from the options give below and corresponding
alphabet in the box given.

SECTION –A

DEMOGRAPHIC DATA

1. Age of person [ ]
a. 10 -12 years
b. 13 – 18 years
2. Family income [ ]
a. Less than 5000/- month
b. 5000 -7000/- month
c. 7000 -10000/- per year
d. More than 10000/-
3. Type of family [ ]
a. Joint family
b. Nuclear family
4. From where you get information about anemia [ ]
a. Teacher
b. Health workers
c. Media
d. All of the above
5. Menstrual cycle status [ ]
a. Regular
b. Irregular
 SECTION - B

CONCEPT OF ANEMIA

1. What is anemia [ ]
a. Low level of hemoglobin
b. Low level of oxygen in blood
c. Blockage in the arteries
d. None of the above
2. What is the normal hemoglobin level in the blood of girls [ ]
a. 12 drms/dl
b. 15 grms/dl
c. 10 grms/dl
d. None of the above
3. Why do adolescent girls become anemic [ ]
a. Lack of iron deficient nutrition
b. Lack of iron and folic acid supplementation
c. Lack of awareness about anemia
d. All of the above
4. What does hemoglobin contains [ ]
a. Iron
b. Carbon dioxide
c. Oxygen
d. A and C
5. What are the common causes of anemia [ ]
a. Dietary intake deficiency of vitamins
b. Intestinal worm infection
c. Low intake of iron and folic acid
d. All of the above
6. What are the common symptoms of anemia [ ]
a. Soreness of the mouth
b. Dizziness , shortness of breath
c. Lack of interest
d. All of the above
7. How to identify anemia [ ]
a. Palmer pallor
b. Breathlessness
c. A and B
 d. None of the above

8. What are the type of anemia [ ]

a. hemolytic
b. iron deficiency
c. sickle cell
d. all of the above
9. How can we prevent of anemia [ ]
a. Intake of iron supplements
b. Adequate dietary intake
c. Intake of folic acid and B12
d. All of the above

10. What are the foods that are rich in iron [ ]

a. Carbohydrate
b. Vitamins
c. Minerals
d. All of the above
11. Which fruits are rich in iron [ ]
a. Apple , banana
b. Watermelon
c. A and B
d. None of the above
12. What are iron rich vegetables [ ]
a. Spinach
b. Beat root and potato
c. Cauliflower
d. All of the above
13. How anemia can be treated [ ]
a. Iron supplement
b. Folic acid
c. A and B
d. Don’t know
14. Does vitamin – c enhance iron absorption [ ]
a. Yes
b. No
c. Don’t know
15. Is sever anemia life threatening [ ]
a. Yes
b. No
c. Don’t know
16. Adolescent girls need iron more than other age groups be different [ ]
 a. Yes
b. No
17. Which nutrient is deficit when we have anemia [ ]
a. Iodine
b. Iron
c. Calcium
d. None of the above
18. Does the iron need of a adolescent girls is different from other age groups [ ]
a. Yes
b. No
c. Don’t know
19. Effects of anemia [ ]
a. Impact on growth and development
b. Impaction learning
c. Decreased work capability
20. Is severe anemia life threatening [ ]
a. Yes
b. No
c. Don’t know
 SECTION – C

PERSONAL PRACTISE OF IRON INTAKE

21. Eating salads and vegetables daily is a good habit [ ]
a. Yes
b. No
22. Have you checked hemoglobin level in blood before [ ]
a. Yes
b. No
23. How often you take albandazole tablet [ ]
a. Once in year
b. Twice in a year
c. Will not use
24. Will you take iron reach foods daily [ ]
a. Yes
b. No

25.Do u have any knowledge about anemia prevention programme [ ]

a. yes

b. no